How New Jersey’s EMS Certification Barriers Compromise Veteran Expertise

Ari Meisel
3 min readJul 19, 2024

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Photo by Mpho Mojapelo on Unsplash

Sometimes we can learn as much about how to be productive from a stark example of in efficiency as we can from a well oiled machine. Emergency Medical Services (EMS) practices can vary significantly from one municipality to another. For instance, throughout my career as an Emergency Medical Technician (EMT), I have been certified and practiced in several states, such as New York, where I was authorized to perform tasks like administering albuterol and checking blood sugar levels — crucial capabilities for providing effective emergency care. However, upon moving to New Jersey, I encountered a starkly different set of regulations. Historically, New Jersey did not permit EMTs to administer albuterol or conduct blood sugar tests, which are standard practices in many other states.

Recent Changes Prompting Certification Transfer

Recent legislative changes in New Jersey intended to expand the EMT-B scope of practice to include these critical skills, which I have been trained and certified to perform in my previous states of practice. This expansion prompted me to seek reciprocity for my existing certifications in New Jersey, expecting this process to integrate my extensive background and qualifications seamlessly into the state’s EMS framework.

Initial Steps in the Certification Process

I began the reciprocity process by gathering the necessary verification letters from each state where I had been previously certified, as required by New Jersey. This task involved navigating through various state bureaucracies, many of which had not yet adopted streamlined or digital verification processes, relying instead on outdated methods that required physical, sealed documents.

Unforeseen Challenges with John Jay College Certification

One of the most formidable challenges arose with the requirement to verify my initial EMT training at John Jay College in Manhattan. This program, crucial for my certification, no longer existed — having been discontinued several years after my graduation. New Jersey officials, however, insisted on receiving a formal letter from the college affirming the program’s discontinuation. Despite multiple communications with John Jay College, it was confirmed that no such records or department existed anymore, making it impossible to fulfill New Jersey’s request.

Efforts to Communicate and Resolve Issues

I made extensive efforts to explain the situation to the New Jersey EMS certification authorities, detailing the non-existence of the program and the college’s inability to provide documentation for a defunct department. However, the response was inflexible, maintaining the requirement for documentation that was simply unobtainable.

Impact of Restrictive Practices

During this period, I also grappled with New Jersey’s initially restrictive scope of practice. The limitations on not being able to perform procedures that I had routinely conducted in other states underscored significant inconsistencies in EMS regulatory practices across the U.S., impacting the quality of care I could provide as an EMT.

A Broader Impact

Moreover, I am not alone in this predicament. Another experienced EMT, certified in New York since the early ‘80s, finds himself in a similar bureaucratic bind. Despite our combined experience of over 40 years, current New Jersey regulations effectively prevent us from partnering on a crew without a New Jersey-certified EMT. This regulatory stance suggests a preference for pairing us with less experienced, albeit locally certified, EMTs — a decision that could potentially compromise the quality of patient care.

Conclusion of the Certification Attempt

Ultimately, the bureaucratic impasse left me with the only option New Jersey seemed to offer — redoing the entire 180-hour EMT certification course, an impractical and unnecessary step given my qualifications and experience. This resolution was not only frustrating but also indicative of the broader systemic inefficiencies that need addressing within state EMS certification processes.

Call to Action

This experience underscores an urgent need for legislative and regulatory reform to harmonize EMS certification processes across states. Such reforms should prioritize the recognition of proven competency and extensive field experience over rigid procedural adherence. We urge legislators and government leaders to enact changes that facilitate the integration of skilled professionals into new jurisdictions, thereby ensuring that communities receive the highest standard of emergency medical services. Our goal should be to support EMTs in their life-saving roles, not hinder them with outdated bureaucratic barriers.

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Ari Meisel
Ari Meisel

Written by Ari Meisel

Founder — Less Doing /The Replaceable Founder/ Overwhelmologist/Serial Entrepreneur / Ironman / Author / Inventor