Publishers note: Paramedic and Advanced Life Support Mobile Services will continue through patron-hospitals

WALL, NJ - The house that Vince Robbins built is closing - MONOC will be no more. Robbins, who retired recently, set a platinum standard for MICU (Medical Intensive Care Unit) services. Hearing the news is a shock to the MICU community.

After decades of leading the way for Advanced Life Support services, the Board of Directors of Monmouth Ocean Hospital Services Corporation (MONOC) voted to dissolve the corporation. This, according to a letter (excerpted below) to employees from current President Jeff Behm, speaks to the challenging environment that came with maintaining a 'First in Class' MICU operation. 

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"After 40 years of service to our member hospitals and their surrounding communities, we will prepare to say goodbye to our incredible employees who have worked so hard and dedicated themselves to the mission of MONOC for so long. To our friends in the EMS community and to the new MICU programs that will launch throughout our catchment area, we turn the torch over to you and expect you to carry it forward with reverence for the high quality of service we provided. It is certainly a sad time for those of us who collectively form the MONOC Family, but we know new opportunities await us, and we are comforted by the knowledge that we set the tone and led the way in EMS in New Jersey for decades." 

MONOC has been trying to manage a complicated legislative and economic environment for a number of years. Current President and CEO Jeff Behm and former President and CEO Vince Robbins were one of the most formidable teams in the sector. Poor legislative environments, reduced reimbursements and other factors became too difficult to overcome.

Wrote Behm, "Over the last several months, our Board of Directors have been reviewing their individual corporate strategic plans and the diminishing synergies represented by their membership in MONOC. They have also been analyzing the company’s financial outlook and sustainability, while considering recommendations provided by MONOC’s senior management team. As you know, MONOC has experienced a challenging financial environment caused by declining reimbursements and increasing payor restrictions, while the costs of running a high quality, high performance EMS and medical transport program, continued to rise over the last few years. In 2018, our member hospitals for the first time in over 25 years, began paying a subsidy to MONOC to assist with our financial short fall. We have seen a decline in service participation from our members. As these healthcare systems grew and acquired their own EMS programs, the need for MONOC to service them diminished. While we have focused on our core business of the MICU program, a hospital cooperative model, such as MONOC, cannot survive with reduced participation."

The letter continued with the news that is a shock to so many inside and outside the health care space, "With that said, the MONOC Board of Directors have voted unanimously to dissolve MONOC and transfer the MICU program to the patron-hospitals. This will ensure continued viability of MICU services in all of Monmouth and Ocean counties, as well as the designated municipalities within Bergen, Essex, Hudson, Passaic, and Union counties, currently provided by MONOC." 

MONOC is considered to maintain the gold standard in their space. It's training protocols were utilized throughout the state and it's members maintain top certifications. HIstorically, MONOC is a non-profit hospital cooperative designed to improve healthcare and reduce members' costs, comprised of thirteen acute care hospitals throughout New Jersey. This shared services consortium acts as a healthcare co-operative for these acute care hospitals and the over 2.8 million residents that they serve living in more than 1,800 square miles along New Jersey's northern, central and southern shore. It includes hospitals networks such as CentraState Healthcare System, Hackensack Meridian Health and RWJBarnabas Health. MONOC's Board of Directors is comprised of the Presidents/Executive Directors of each member hospital. MONOC was formed in 1978 as "a cooperative venture to improve health care and reduce costs." Among its numerous service lines, MONOC operates Mobile Intensive Care (MICU) Paramedic Services, and Mobile Critical Care Services. Coordinating all of MONOC's communications is a 24/7 state of the art 9-1-1 dispatch center.

Behm's letter outlined the strategic and measured steps that involve winding down the operation.

"On April 1, 2020, the MONOC MICU program will close and Hackensack Meridian Health, and RWJBarnabas Health will assume full operational and administrative responsibility of the program. The CentraState Health System MICU region will be covered by RWJBarnabas Health. The northern region will become the responsibility of RWJBarnabas Health with the exception of Clifton and Passaic, which will become a Hackensack Meridian Health operation.

There will be no disruption of MICU services and every current MONOC paramedic will have the opportunity to seek employment at either or both of the health system’s MICU programs.

From a patient care perspective, services, when called upon, will be similar.The model will simply be different as illustrated in Behm's letter. Clinical operations will close on April 1, 2020 for MONOC and administrative functions are expected to complete service and close by the end of the year.

MONOC stood tall for over 40 years.That is quite an accomplishment in such a dynamic healthcare delivery marketplace. In many respects, MONOC completed its mission.

MICU Paramedics are highly trained medical professionals. In addition to being Emergency Medical Technicians for a minimum of two years, they undergo 1200 hours of training. They are certified by the Department of Health and are required to complete annual competency evaluations and continuing education. Their advanced skills and equipment make the difference between life and death. They bring the emergency room to the patient. They can administer life-saving drugs, insert breathing tubes and start IV lines. Volunteer or commercial or municipal ambulance services cannot legally render this type of care.