Report Title:

Appropriation; On-Call Emergency Care Services at The Queen's Medical Center; on-call crisis study task force.

Description:

Appropriates funds for on-call emergency care services at The Queen's Medical Center in support of its emergency department and trauma center. Establishes a task force to conduct a study on the impact of the on-call crisis center on the State's Level II Trauma Center. Requires a task force report. (HB1478 HD1)

HOUSE OF REPRESENTATIVES

H.B. NO.

1478

TWENTY-THIRD LEGISLATURE, 2005

H.D. 1

STATE OF HAWAII

 


 

A BILL FOR AN ACT

 

making an appropriation for on-call emergency care services at The Queen's Medical Center.

 

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that a trauma center for treating life-threatening injury or sickness in an emergency is essential to our community. The Queen’s Medical Center is the primary trauma center for Hawaii and the only hospital in this state with a Level II Trauma Center designation from the American College of Surgeons.

The legislature further finds that the emergency department at The Queen's Medical Center provides the state with needed emergency care services. This requires physicians to be on-call to address the medical needs of patients who come into the emergency room from across the state. Many specialists, including neurosurgeons, orthopedic surgeons, hand surgeons, plastic and reconstructive surgeons, and trauma general surgeons, among others, need to be on-call to meet the trauma and emergency medical needs of the state.

The legislature further finds that several factors have had a negative impact on the availability of physicians to be on-call. These factors include issues such as professional medical liability, uncompensated care, and insufficient support from hospital-employed physicians with follow-up patient care. As a result, fewer physicians are available to be on-call, thereby creating a crisis situation for many of the hospitals. Although this on-call crisis is not about compensation alone, hospitals have recently begun compensating physicians to be on-call. In recent years, these costs have escalated rapidly and have placed an increasing financial burden on The Queen's Medical Center in its effort to provide trauma and emergency medical services to the people of Hawaii. For fiscal year 2005-2006 these costs are estimated to be $6,900,000.

The purpose of this Act is to make a one-time appropriation to The Queen's Medical Center to pay for the costs it incurs to compensate physicians to be on-call to provide trauma and emergency medical services for the people of Hawaii, including neighbor island patients. This Act also requires that a task force be formed to complete a study of the on-call crisis and its impact on the Level II Trauma Center’s ability to continue delivering emergency medical services to our community.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $6,900,000 or so much thereof as may be necessary for fiscal year 2005-2006 and the same sum or so much thereof as may be necessary for fiscal year 2006-2007 for The Queen's Medical Center to pay for the costs it incurs to compensate physicians to be on-call to provide trauma and emergency medical services.

SECTION 3. The appropriation under section 2 shall be contingent upon the immediate and continuing acceptance by The Queen's Medical Center of patients from the other islands needing emergency medical services or acute care, whether or not those patients are transferred from another medical facility on another island and whether or not they are insured.

The department of health shall obtain assurances from The Queen's Medical Center for purposes of this section prior to and during the release of any funds. The department of health shall monitor The Queen's Medical Center for compliance with this section. If The Queen's Medical Center breaches its assurance, then the department of health shall cease to release the appropriation.

The sums appropriated shall be expended by the department of health for the purposes of this section.

SECTION 4. There is established a task force to consist of three members. One member shall be a representative of the department of health, one member shall be a representative of the John A. Burns School of Medicine, and one member shall be a representative of the Queen's Medical Center. The task force shall conduct a study of the on-call crisis and its impact on the Level II Trauma Center’s ability to continue delivering emergency medical services to all state residents. In particular, the study shall address any appropriate government response to the on-call crisis that is impacting emergency department services at hospitals across the state. The study shall include an analysis of pertinent issues, including:

(1) Description of the on-call issue and the impact on the Level II Trauma Center;

(2) Identification of the factors that have contributed to the issue becoming a crisis;

(3) The response of hospitals in the state to the crisis;

(4) The experience of other states and cities facing a similar crisis;

(5) Identification of any other pertinent issues regarding this crisis and the effects it has on the Level II Trauma Center; and

(6) Identification of appropriate government responses to the crisis, including an analysis of each response, including:

(A) Options to address trauma/emergency department medical services that go uncompensated;

(B) Options to address liability concerns faced by physicians taking call; and

(C) Analysis of the pros and cons of mandating physicians to "take call" in order to receive or maintain a license to practice medicine in the state, or to receive privileges to admit patients to a hospital located in the state.

In completing this study, the task force shall seek input from as many stakeholders as possible, including hospital administrators, physicians, malpractice insurance carriers, and government officials.

SECTION 5. The task force shall submit a report of its findings, recommendations, and any proposed legislation to the legislature at least twenty days prior to the convening of the regular session of 2006.

SECTION 6. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2005-2006 for the task force to conduct the study.

The sum appropriated shall be expended by the department of health for purposes of this section.

SECTION 7. This Act shall take effect on July 1, 2005.