Monmouth Ocean Hospital Service Corporation

The Monmouth Ocean Hospital Service Corporation (commonly referred to as MONOC) is a non-profit hospital services company which provides emergency and non-emergency medical transport services in New Jersey. In addition to EMS services, MONOC also operates a state-of-the-art 9-1-1 Communications Center which services numerous jurisdictions within New Jersey. MONOC was formed in 1978 as a cooperative by member hospitals, which today includes hospitals from three of New Jersey's health care networks; Meridian Health System, Robert Wood Johnson Health Network and the Saint Barnabas Health Care System.

List of MONOC Member Hospitals:

• Saint Barnabas Medical Center
• Clara Maass Medical Center
• Newark Beth Israel Medical Center
• Bayshore Community Hospital
• Riverview Medical Center
• University Medical Center at Princeton
• Monmouth Medical Center
• CentraState Medical Center
• Jersey Shore University Medical Center
• Ocean Medical Center
• Kimball Medical Center
• Community Medical Center
• Southern Ocean County Hospital
• Deborah Heart and Lung Center
• Saint Michael's Medical Center

One of MONOC's programs is the operation of paramedic services through a state-granted geographic exclusivity in Monmouth and Ocean counties, as well as portions of several other counties in northern New Jersey, under a Certificate of Need (CN) issued from the New Jersey Department of Health and Senior Services.

Services & Divisions

Mobile Intensive Care Paramedic Service

MONOC’s Advanced Life Support Division (ALS) was started in 1985 to provide a higher level of emergency medical service to the community in conjunction with municipal volunteer first aid squads throughout Monmouth and Northern Ocean Counties. This service grew slowly to a system in which seven Mobile Intensive Care Units (MICU) were strategically stationed throughout the two counties to provide rapid response to all life-threatening emergencies. Early on, these units were dispatched by the dispatch centers in the respective counties served. This was ultimately changed to allow the MONOC Dispatch Center to more efficiently dispatch the units via redundant radio communication with portable and mobile radios, Nextel cellular phones and GPS technology. This allows for the closest appropriate unit to be automatically selected and sent to the emergency.

In 2003, through an agreement with St. Barnabas Health Care System’s (SBHCS), MONOC acquired five additional MICUs, encompassing the remainder of Ocean County. In 2004, through yet another merger with the remaining SBHCS hospitals, MONOC acquired their remaining six MICUs in Northern New Jersey. This increased MONOC’s ALS coverage area to Union, Essex, and Hudson Counties. In 2005, Passaic Beth Israel Medical Center became a member of MONOC, adding two additional MICUs and coverage in Passaic, and Bergen Counties.

All of MONOC’s ALS vehicles are licensed by The New Jersey Department of Health and Senior Services Office of Emergency Medical Services. In addition to what is carried on Basic Life Support units (BLS), the MICUs staffed with either two certified Mobile Intensive Care Paramedics (MICP) or one Mobile Intensive Care Paramedic (MICP) and a Mobile Intensive Care Nurse (MICN). MONOC currently employs approximately 250 Paramedics who report to 17 different locations throughout New Jersey.

Basic Life Support

MONOC’s Basic Life Support Division (BLS) was started in 1995 to provide emergency medical service to the residents of Jackson Township, to support our Advanced Life Support (ALS) operations and to provide non-emergency transportation service to our member hospitals. The division grew over the years to service all of the transportation needs for Southern Ocean County Hospital, Atlantic City Medical Center; City and Mainland Divisions, Bayshore Community Hospital, Centrastate Medical Center, and University Medical Center at Princeton. In 2003, MONOC entered into contracts with St. Barnabas Health Care System’s (SBHCS) southern hospitals; acquiring EMTAC EMS and the responsibility of all transportation for Kimball Medical Center, Community Medical Center and Monmouth Medical Center. In 2004, MONOC assumed responsibility of SBHCS northern facilities and the remainder of EMTAC, servicing St. Barnabas Medical Center, Irvington General Hospital, Union Hospital, and Newark Beth Israel. Ultimately, MONOC began to provide service to both Passaic Beth Israel, and Deborah Heart and Lung Center.

Since the inception of MONOC’s BLS Division, emergency medical service has been provided to Atlantic City, Jackson, Linwood, Fort Monmouth, East Windsor, Hightstown, Pemberton, Freehold, Tinton Falls, Middletown, Long Branch, Irvington, Orange, Springfield, and South Orange. This is in addition to the BLS backup program offered to all municipalities in Atlantic, Monmouth, Middlesex, Ocean, Essex, and Union Counties.

All of MONOC’s over one hundred BLS ambulances are licensed by the New Jersey Department of Health and Senior Services Office of Emergency Medical Services.

Specialty Care Transport Services

MONOC’s Specialty Care Transport Division (SCT) was started in 1995 to provide care to critically ill or injured patients in need of transport from one hospital to another. SCT units are staffed with a minimum of one State Licensed Registered Nurse (RN) who is also certified as an Emergency Medical Technician (EMT), and one State Certified Emergency Medical Technician (EMT) allowing for dispatch to Basic Life Support emergency assignments. Optimally, the SCT Unit is staffed with a Mobile Intensive Care Nurse(MICN) and Mobile Intensive Care Paramedic (MICP) to allow for dispatch to both Advanced Life Support (ALS) and Basic Life Support (BLS) emergency assignments. Currently, MONOC provides primary SCT services to Community Medical Center, Saint Barnabas Medical Center and Burn Unit, Clara Maas Medical Center, Newark Beth Israel Medical Center, Bayshore Community Hospital, University Medical Center at Princeton, Monmouth Medical Center, CentraState Medical Center, Kimball Medical Center, Deborah Heart and Lung Center and Southern Ocean County Hospital. Additionally the units can be requested by non-member hospitals.

MONOC’s SCT units are strategically deployed from three different parkway rest stops and posted throughout the state in order to provide the fastest response to requesting facilities and municipalities. As with the company's ALS and BLS units, MONOC’s SCT vehicles are linked to MONOC’s dispatch center via GPS technology allowing for the closest unit to be sent to the request.

The approximately 35 nurses who staff MONOC's SCT units must meet extensive standards set forth by The New Jersey Department of Health and Senior Services. Specifically, MONOC nurses must possess training/certification in: CPR for Professional Rescuers, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation, Pre-Hospital Trauma Life Support (or Trauma Nursing Core Course), and Intra-Aortic Balloon Pump Certification. Additionally, they must have several years of experience in Emergency Room and Intensive Care nursing. Theses transport units are capable of providing most high level Intensive Care Unit's services in a mobile platform.

Typical jobs might include trauma transfers, burn transfers, Pediatric/Neonatal ICU transfers (with or without a team), ICU transfers, high risk OB/GYN, Stroke/Neurological transfers, STEMI/NSTEMI (heart attack) transfers, transfers of patients with balloon pumps, impella devices, ventilators, chest tubes, ECMO (with a team), open chest transfers, CVP-Line Monitoring, A-Line Monitoring, etc. Skills include all Advanced Life Support skills and any specialized skills of the Registered Nurse. For example: cardiac monitoring, intubation, sedation, paralysis, pain management, rapid sequence induction, needle chest decompression, chest tubes, needle tracheotomies, intraosseous vascular access, intravenous infusions including blood products and vasopressors, etc. These procedures may be performed under standing orders though an Emergency Medicine physician is available 24/7/365 should additional orders or assistance be needed.

All SCT charts are reviewed by medical command for appropriate care, compliance, and quality assurance and improvement.

Bariatric Transport Services

In an effort to provide the highest level of care, safety and dignity to an ever-increasing population of morbidly obese patients, The Monmouth-Ocean Hospital Services Corporation (MONOC Emergency Medical Services) has developed a “Bariatric Transport Unit” equipped with specially trained personnel and innovative equipment designed to transport patients weighing up to 1,600 pounds.

The MONOC Bariatric Transport Unit is larger than any of the other ambulances in MONOC’s fleet, and features a hydraulic suspension capable of lowering the back of the vehicle to allow a stretcher to be more easily loaded. It has also been equipped with a bariatric stretcher that is larger and able to accommodate patients weighing up to 1,600 pounds, a system of portable ramps, and an electric winch designed to load and unload the patient with safety and a reduced chance of injury to the caregivers. All of the vehicle modifications were performed by MONOC’s Fleet Services Department.

Tactical EMS

This team is specially trained to provide medical support to tactical law enforcement officials for missions that may be of a high-risk nature. “Tactical Medics” are trained and equipped to function in a high-risk environment providing specialized skills and equipment for the safety of all concerned. The Team currently provides support to The NJSP Teams unit, Monmouth County Emergency Response Team (MOCERT) Manchester Police as well as other local Law Enforcement agencies.

Communications

The MONOC Communications Center (commonly referred to as "Control") is a fully integrated dispatch center responsible for answering 9-1-1 calls for contracted municipalities and taking requests for emergency services from six counties. As an EMD agency, MONOC provides the 9-1-1 caller with medical instructions until an emergency unit arrives on scene.

The Control Center is listed as a member of the Association of Public Safety Communications Officials (APCO) and National Emergency Number Association (NENA) and a local member of NJ-NENA, and the National Association of Air Medical Communication Specialists (NAACS). MONOC achieved its 9-1-1 certifications through the National Emergency Communications Institute (NECI) and Office of Emergency Telecommunication Services (OETS) and actively participate in the NJ Emergency Medical Services Communication Group. MONOC was the first agency in New Jersey to have attained accreditation by CAAS (the Commission of Accreditation of Ambulance Services), which reviews and evaluates dispatch operations as part of its comprehensive assessment process.

Flight Program

On April 6, 2006 the Office of Emergency Medical Services (OEMS) of the New Jersey Department of Health and Senior Services issued an Air Medical Unit License to MONOC.

MONOC's MedEVAC (known as MONOC One) is currently based at the Miller Airport in Berkeley Township, New Jersey. Although specifically aimed at the interfacility transport market, MONOC MedEVAC is also the primary "911 Scene" response helicopter for southern Monmouth and the majority of Ocean Counties.

MONOC utilizes a specially configured American Eurocopter EC135, one of the most advanced medical helicopters available, MONOC MedEVAC, aside from normal specialty care transport capabilities, is capable of transporting patients who require intra-aortic balloon pump services; never before available in New Jersey.

MONOC's MedEVAC is staffed at all times by a highly experienced pilot and two highly experienced medical providers: one flight certified Registered Nurse, and one flight certified Mobile Intensive Care Paramedic.

Accreditation

MONOC holds professional accreditation in emergency medical services, communications and medical education through the Commission on Accreditation of Ambulance Services (CAAS), The Commission on Accreditation of Medical Transport Systems (CAMTS,) the Commission on Accreditation of Allied Health Education Programs (CAAHEP), the American Council on Education (ACE), and the Continuing Education Coordinating Board for Emergency Services (CECBEMS).

Controversies

MONOC's billing practices have been controversial and have been investigated by the media and legislators.^[1]

Coverage areas

Monmouth, Ocean, Union, Essex,Passaic, and Hudson Counties^[2]

References