Healthcare Provider Hotline

Creates a healthcare provider hotline within the department of
health to which healthcare providers may report a patient care
situation that the healthcare provider reasonably believes is
likely to result in harm to a patient. 

THE SENATE                              S.B. NO.           572
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  The legislature finds that the increased
 2 emphasis on managed care within the healthcare industry has
 3 generated a great interest in protecting the rights of healthcare
 4 consumers.  The recent passage of the Hawaii Patient Bill of
 5 Rights and Responsibilities Act allows greater consumer access to
 6 information about healthcare plans, including grievance
 7 procedures for consumers who are concerned about access to
 8 healthcare providers and resources.
 9      However, healthcare providers concerned about consumers
10 receiving appropriate services do not have a mechanism for
11 confidential reporting of patient care situations that they
12 consider may result in harm to the patient.  
13      While some healthcare institutions may provide for
14 confidential reporting by their employees, such is not the case
15 for healthcare providers statewide.  
16      Healthcare providers have identified patient care situations
17 they believe are unsafe.  Unfortunately, some healthcare
18 providers do not report these conditions due to ramifications
19 concerning job security.  In instances when these situations have

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 1 been called to the attention of the institution, little or
 2 nothing has been done to address the concerns of the healthcare
 3 provider.  The inability of knowledgeable healthcare providers to
 4 speak freely and confidentially about unsafe patient care
 5 situations erodes the patients right to accessible, quality
 6 heathcare services.  
 7      The purpose of this Act is to support increased consumer
 8 access to quality healthcare services by providing healthcare
 9 providers with a confidential toll free telephone hotline through
10 which they may report patient care situations they believe are
11 likely to result in harm to a patient.
12      SECTION 2.  Chapter 321, Hawaii Revised Statutes, is amended
13 by adding a new section to part XXIII to be appropriately
14 designated and to read as follows:
15      "321-    Healthcare provider hotline.  (a)  As used in this
16 section:
17      "Department" means the department of health.
18      "Provider hotline" means a toll-free telephone line from
19 which calls will be taken from any healthcare provider desiring
20 to report a patient care situation that the healthcare provider
21 reasonably believes is likely to result in harm to a patient.
22      "Healthcare provider" means an individual who holds a Hawaii
23 license or certification in a healthcare field.

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                                     S.B. NO.           572

 1      "Healthcare entity" means any acute care hospital, long-term
 2 care facility, care home, home care agency, rehabilitation
 3 facility, outpatient or ambulatory clinic, healthcare provider
 4 office, or any entity providing healthcare services.
 5      (b)  The department shall make available a toll-free
 6 healthcare hotline for the purposes of accepting calls from
 7 healthcare providers who desire to report a patient care
 8 situation that the healthcare provider reasonably believes is
 9 likely to result in harm to a patient.
10      The healthcare provider shall be considered to be acting in
11 good faith if the individual has previously notified the
12 healthcare entity of the situation and reasonably believes the
13 following:
14      (1)  The information is true;
15      (2)  The information reported by the healthcare provider
16           evidences a violation of a law, rule, or regulation, or
17           of a generally recognized professional or clinical
18           standard; or related to care services or conditions
19           which potentially endangers one or more patients.
20      (c)  The identity of an individual healthcare provider who
21 makes a report to the department about the quality of care,
22 services, or conditions which potentially endanger one or more
23 patients shall remain confidential and shall not be disclosed by

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                                     S.B. NO.           572

 1 any person except upon the written consent of the individual
 2 healthcare provider.  Information provided about patient care
 3 situations, including the identification of patients, shall be
 4 considered confidential and not a public record.  The healthcare
 5 provider shall not be considered to have violated any patient
 6 confidentiality provisions when making a report through the
 7 healthcare provider hotline.
 8      (d)  No healthcare entity shall by policy, contract,
 9 procedure, or other formal or informal means subject to reprisal
10 directly or indirectly use, or threaten to use, any authority or
11 influence, in any manner whatsoever, which tends to discourage,
12 restrain, suppress, dissuade, deter, prevent, interfere, coerce,
13 or discriminate against any healthcare provider who in good faith
14 reports a situation that the healthcare provider reasonably
15 believes is likely to result in harm to a patient.
16      (e)  The department shall begin the investigation of each
17 report within forty-eight hours of the report being made by a
18 healtcare provider.  A thorough investigation shall be conducted
19 within seven working days from the commencement of the
20 investigation.
21      The findings of the investigation shall be provided to the
22 healthcare provider who reported the situation and to the
23 healthcare entity with recommendations for corrective action, if

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                                     S.B. NO.           572

 1 necessary.
 2      The department may assess any healthcare entity that fails
 3 to cooperate with the investigation in a timely manner or fails
 4 to submit information necessary for the investigation a penalty
 5 of not more than $1,000 for each situation in which the entity is
 6 involved and does not cooperate in a timely manner with the
 7 departments investigation.
 8      (f)  The department shall provide an informational report to
 9 the legislature on an annual basis.  The report on the healthcare
10 provider hotline shall include the:
11      (1)  Date of each reported situation;
12      (2)  Type of provider by category;
13      (3)  Type of healthcare entity by category;
14      (4)  General nature of each reported situation;
15      (5)  Action taken by the department; and
16      (6)  Resolution of each report.
17 The department shall adopt rules in accordance with chapter 91
18 for the purposes of this section."
19      SECTION 3.  There is appropriated out of the general
20 revenues of the State of Hawaii the sum of $60,000, or so much
21 thereof as may be necessary for fiscal year 1999-2000, for the
22 purpose of establishing and implementing a healtcare provider
23 hotline.

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                                     S.B. NO.           572

 1      SECTION 4.  The sum appropriated shall be expended by the
 2 department of health for the purposes of this Act.
 3      SECTION 5.  This Act shall take effect upon its approval.
 5                           INTRODUCED BY:  _______________________