It is scary to know that an ambulance which does not bill for insurance is not required to be licensed by the state. Instead, these ambulances are "monitored" and "certified" by the New Jersey First Aid Council. The council issues "guidelines," which they cannot legally enforce, and instead they mandate that each squad regulate itself. In other words, unlicensed first aid squads truly have no minimum standards. Therefore, it is not uncommon to find ambulances in the state operating with unqualified, unlicensed personnel. Scary how the state allows this to happen.