Only a handful of emergency medical technicians serve the more than 10,000 residents of Millstone Township through the community’s volunteer first aid squad. Fruitless recruitment efforts and a rising demand for the squad’s services have further hindered the group.
“As our members grow older and move on with their lives, the number of responding members decreases,” said Petronio Zalamea, squad captain. “We have no new volunteers in sight.” Millstone’s conundrum is far from unique. Several factors sparked a decline in New Jersey’s base of volunteer EMTs in recent years. Cooperation among several branches of the emergency medical services (EMS) field has largely kept the sick and injured from going untreated for prolonged periods of time.
“You have to find a way to have volunteer squads and paid services work together to make sure there’s an ambulance that gets out when somebody needs one,” said Howard Meyer, president of the New Jersey State First Aid Council, which represents the interests of more than 80 percent of the state’s unpaid squads. “If you push one out, you’re not going to be able to fill in the spaces like you currently do now.”
For years, most municipalities counted on private, nonprofit first aid squads to provide basic life-support services to residents. Private entities typically jumped in when patients’ conditions required advanced care, Meyer said.
Now, more demanding training requirements, fewer seats available in EMT classes, and a drop in state funding have reduced the supply of new recruits, he said.
The hectic agendas that accompany fulltime jobs cut the amount of time that existing EMTs can offer to a squad, Meyer said. That has left many municipalities with a volunteer first aid presence on nights and weekends, but next to nothing on weekday mornings and afternoons, he said.
“And that’s where a very good working relationship between the volunteers and the paid services can get your people ambulances, particularly during weekdays, when volunteers have the toughest times,” Meyer added.
Groups like MONOC, a nonprofit hospital cooperative originally known as the Monmouth Ocean Hospital Service Corporation, once focused its basic care efforts on the inter-facility transportation of patients, said Scott Matin, vice president of MONOC. As time went on, the thinning of the volunteer pool pushed the nonprofit to answer 911 calls in some areas, he said.
While MONOC has a contract with Red Bank to keep an ambulance in the borough during the day, most of its arrangements are informal, Matin said.
“We have different agreements with towns,” Matin said. “Some are verbal and some are handshakes, where they’ll call us on a particular day and say, ‘Listen, we don’t have a volunteer crew today between these hours. Can you cover us?’ And we will do that.”
MONOC bills patients’ health insurance companies for the rides, and does not charge the municipalities, he said.
The spirit of collaboration helps private EMS units as well. When volunteer squads are well stocked, paid paramedics can more easily reach people who need advanced support, said Mike Semple, director of EMS and emergency preparedness at the Middlesex County-based Raritan Bay Medical Center. That decision is sometimes made on the scene, when ambulances from both a first aid squad and a paid unit arrive.
“It’s actually a very robust system where we have the ability to have the paramedics and the EMTs go out,” Semple said. “If the patient needs the paramedic care, we’re able to provide that. If not, the patient just goes with the ambulance crew and we go to somebody else. So, it gives us a lot of flexibility in taking care of people.”
Some volunteer squads have opted to hire full-time, paid EMTs to offset grim recruitment figures.
Judy Olbrys, the EMS director in Monroe Township, said the municipality switched to the hybrid model in the early 1990s after experiencing a volunteer drought. Now, the squad boasts more than 100 members, 21 of whom are paid, she said.
“It’s been a total win-win situation for the volunteers, the staff and for the residents, with the quality of the care,” Olbrys said. “I wish more communities would consider this structure.”
Howell Township’s first aid team has enjoyed the benefits of a similar situation. There, the Police Department employs a paid first aid unit to serve the municipality during the day, said John Zicha, president of Howell’s all-volunteer squad. He said the squad covers the township at night.
First aid squads from neighboring communities often form mutual-aid pacts. That means a squad performs emergency services in a nearby community when necessary.
Millstone currently uses that model, which is supplemented by assistance from the township’s fire department, Zalamea said.
Although innovative solutions abound, state regulations and a wickedly volatile economy continue to strike fear in EMS officials, especially considering the dense population of Central Jersey.
“We’re always looking for new volunteers, but unfortunately, it’s something that’s harder and harder to do,” Zicha said. “I’ve been on the squad for 15 years, and I’ve seen a huge increase in call volume and fewer volunteers.”
And then there are the outliers. The sleepy Monmouth County suburb of Colts Neck has somehow managed to maintain a steady number of 30-40 volunteers on its first aid squad for years, said Jim Leber, squad president.
He said the unit regularly works from 10 p.m. to 6 a.m., with eight crews of three to four individuals per team. Retirees and stayat home parents man the post during the day, Leber said.
But Leber identifies with the struggles that many of his peers face, and his squad constantly fights to preserve its health.
“We’re quite lucky, but we always could use more,” he said. “That’s for sure.”