Who Answers the Call? Inside New Jersey's Fraying Ambulance System
In March 2012, Bergen County's Regional Emergency Medical Service was slated for elimination in a round of budget cuts. The unit kept two ambulances on the road from 6 a.m. to 6 p.m. every day of the year as a backup for local squads, and it had answered 788 calls the year before. The county executive's office considered it redundant, CBS New York reported. EMT Judy Herman warned that response times would rise without it.
Eleven years later, the county built a new one. Volunteer ambulance corps in Elmwood Park, Rochelle Park, Maywood and Bogota had dissolved for lack of members, and "we had cops waiting for ambulances for 45 minutes sometimes," county emergency management coordinator Capt. Matthew Tiedemann told NorthJersey.com. Bergen County EMS launched on Feb. 9, 2023, with used ambulances bought with federal pandemic relief money. By the end of November it had answered 3,272 calls in 67 of the county's 70 municipalities and grown to eight ambulances, according to a later NorthJersey.com report.
The swing from cutting a county backup to depending on one tracks a statewide shift. New Jersey's ambulance system grew up around volunteers, and the volunteers are thinning out faster than anything has been designed to replace them.
How an Ambulance Gets to You
A medical 911 call in New Jersey usually sets two layers of care in motion. The first is basic life support, the ambulance crew of emergency medical technicians, or EMTs. Basic life support means stabilizing a patient, performing CPR, controlling bleeding, splinting fractures and driving the patient to a hospital. For the most serious calls, a second layer can follow. Paramedics, who can give medications and more advanced treatment, work in units called mobile intensive care units, which in New Jersey are run by hospitals.
The basic life support crew is the piece that varies most from town to town. Depending on where someone lives, the ambulance might belong to a volunteer squad, the fire department, a hospital, a private company or, increasingly, the county. State lawmakers now describe the arrangement as "a patchwork of volunteer and paid squads associated with fire departments, hospitals and private companies," New Jersey Monitor reported.
That patchwork exists partly because no state law requires a municipality to provide ambulance service at all, the way towns must provide police, firefighting and sanitation. A volunteer squad has historically run on donations, fundraisers, municipal contributions and whoever can cover a shift. Paid crews need steady revenue, which usually means billing patients' insurance. Bergen County's service, for example, bills insurance, Medicare and Medicaid and does not bill uninsured patients, County Executive James Tedesco said.
The volunteer side is shrinking. The number of volunteer rescue squads in New Jersey has fallen from about 400 in the early 2000s to less than half that today, according to Chief Kevin Beyrouty of the New Jersey Firefighters Mutual Benevolent Association, a union that backs legislation to make ambulance service mandatory. When a town's squad can't staff a call, the gap gets filled by a paid contractor, a neighboring town's ambulance or, if neither arrives quickly, nobody for a while.
How Long the Wait Has Gotten
New Jersey recommends an average EMS response time of less than 15 minutes. State data from June 2025 through June 2026, compiled by NJ.com and published by EMS1, shows nine of the 21 counties averaging longer than that. Warren County was slowest at 22 minutes, followed by Sussex at 20, Salem at 18.33, Hunterdon at 18.1, Somerset at 18, Monmouth and Passaic at 17, Ocean at 16.1 and Morris at 16. Bergen sat right at the 15-minute line. Atlantic and Camden posted the state's best average, 12 minutes.
For comparison, the National Emergency Medical Services Information System, a federal database of ambulance records, reported a nationwide median response time of 7.1 minutes in 2023, with about 1 in 10 patients waiting longer than 15 minutes.
Response time is a blunt measure, and EMS leaders caution against reading it alone. Leading EMS associations say most 911 medical calls do not require an ambulance in under 10 minutes, and in 2024 the American Ambulance Association, the American Paramedic Association and other groups urged communities to judge their systems on more than speed. For a cardiac arrest, a stroke or severe bleeding, though, minutes decide outcomes, and the county averages show where the system is stretched thinnest.
The Technology That Moves Ambulances
The machinery behind a response starts in the dispatch center. A computer-aided dispatch system, software that logs each call and tracks every unit's status, pairs with GPS receivers in the ambulances so a dispatcher can see which crew is closest and whether it is free. Bergen County's unit is dispatched through a hospital association system that sends the closest ambulance by GPS.
Some systems go further with a practice called system status management. Instead of parking every ambulance at a fixed station, planners use historical call data to move units around through the day, closer to highways at rush hour or near senior housing at midday, so the next call is more likely to be nearby.
Mutual aid is the other safety net. Under standing agreements, neighboring towns send their own ambulances across municipal lines when a town's crew is busy or unavailable. The arrangement works only as well as the neighbor's staffing, however. When several adjacent towns are short at the same moment, a mutual aid request can sit unanswered or get filled by a unit from much farther away.
Software can route an ambulance faster and position it smarter. It cannot staff an ambulance that has no crew.
The Statewide Backstop
Above the local layer sits the New Jersey EMS Task Force, a nonprofit formed after the Sept. 11 attacks to coordinate large-scale medical responses and back up local EMS when an emergency overwhelms it. In 2025, it deployed at least 225 times, mostly to evacuate nursing homes and hospitals and to assist with major emergencies, and logged 1,500 hours of preparedness training, New Jersey Monitor reported in July.
The task force's money is tight. It received $1.1 million from the state Department of Health last year, which carried it through World Cup preparations. The $60.7 billion state budget Gov. Mikie Sherrill signed in late June did not include the $500,000 the group had requested. Task force president Michael Bascom said the group has "zero funds to sustain, repair, or replace any of our equipment," which is valued at $70 million and needs an estimated $30 million in repairs. The group asked the state for at least $8 million in one-time capital funding. Sen. Declan O'Scanlon (R-Monmouth) sponsors a bill to write the task force into state law.
Since then, the Department of Health has posted a new support grant of about $825,000 for October 2026 through June 2027. The grant funds an organization that provides planners and equipment support for the task force, with applications due Oct. 9. TownSquare could not find a public announcement of the award, and even the full grant would cover only a fraction of the repair backlog.
What's Still Unresolved
The biggest open question sits in Trenton. Assemblywoman Carol Murphy (D-Burlington) sponsors A1008, which would make basic life support an essential service that every municipality must provide. Towns could meet the requirement by contracting with a licensed company or nonprofit, partnering with a hospital or fire department, or joining a mutual aid agreement. The Assembly Public Safety and Preparedness Committee advanced the bill 3-0 in May. Republican Assembly members Antwan McClellan and Paul Kanitra abstained, citing volunteer squads' worries that the bill as drafted would make it harder for them to keep serving. The bill next goes to the Assembly Oversight, Reform and Federal Relations Committee. Murphy said she is working on amendments to keep volunteers in the system.
The Senate version, S1421, sponsored by Sens. Joseph Lagana (D-Bergen) and Anthony Bucco (R-Morris), cleared its first committee in March and was referred to the Senate Budget and Appropriations Committee on May 18. Neither version sends towns new state money. A companion measure directing the Department of Health to write a statewide EMS plan, with goals and performance metrics for each community, moved to the Assembly Appropriations Committee.
A mandate without money leaves towns with the same options they have now, at a higher stake. They can hire a private provider, sign on with a hospital, or lean on a neighbor facing the same shortage. Bergen County's answer was to become a provider itself, and Tedesco has said he expects the county to become the primary EMS provider in the long run, alongside hospitals and some towns.
Residents can find out who would answer their own 911 call. Every town knows who its basic life support provider is, and agreements with hospitals, private companies or neighboring towns are approved at public council meetings. Residents can ask how often their squad misses calls and how long mutual aid takes to arrive. Volunteer squads are still recruiting. And A1008 and S1421 are still moving, which makes this a good moment to tell legislators whether a mandate should
come with money.
Sources
NorthJersey.com via Yahoo News, Bergen steps in with countywide EMS services amid shortages of volunteers (Feb. 2023)
NorthJersey.com via Yahoo News, Here's how Bergen County helps towns during shortage of EMS crews (Dec. 8, 2023)
EMS1 (NJ.com), 9 N.J. counties exceed state's recommended EMS response times (Aug. 1, 2026)
New Jersey Monitor, Statewide EMS task force faces shutdown amid funding crisis (July 24, 2026)
NJ Department of Health, EMS Task Force Support Group 2026 grant notice
NJ Department of Health EMS Task Force Support Group 2027 grant listing (via Atom Grants)
New Jersey Legislature, S1421 (2026-2027 session), via LegiScan
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