RESOLUTION

WHEREAS, a trauma center for treating life-threatening injury is essential to the health and well-being of our community; and

WHEREAS, The Queen's Medical Center operates the only trauma center in the State of Hawaii with a Level II Trauma Center designation from the American College of Surgeons; and

WHEREAS, several hospitals across the State provide emergency medical services at their facilities; and

WHEREAS, the federally-mandated Emergency Medical Treatment and Labor Act requires that hospitals medically screen patients that come to an emergency department to determine if an emergency medical condition exists, and if so, to stabilize the patient; and

WHEREAS, the Emergency Medical Treatment and Labor Act allows the transfer of a patient to another hospital after all possible stabilizing efforts have been made, if the patient's condition requires a "higher level of care" not available at the original hospital; and

WHEREAS, while many hospitals across the State rely on physicians to be on-call to address the emergency medical needs of patients who come into the emergency room, the need for specialists to be on-call at The Queen's Medical Center is particularly acute because of the demands required to maintain the Trauma Center; and

WHEREAS, the specialists that are needed to meet the trauma and emergency medical needs of the State include, among others, neurosurgeons, orthopedic surgeons, hand surgeons, plastic and reconstructive surgeons, and general trauma surgeons; and

WHEREAS, several factors have had a negative impact on the availability of physicians to be on call for emergency services and trauma care, including a negative effect on the physician's private practice and the physician's personal quality of life, uncompensated care, low reimbursement rates, and liability and medical malpractice concerns; and

WHEREAS, the reduction in the number of physician specialists willing and available to be on-call has created a crisis for emergency departments at hospitals across the State of Hawaii and across the nation; and

WHEREAS, the Department of Health has the statutory authority and responsibility to establish, administer, and maintain a State Comprehensive Emergency Medical Services System to serve the emergency health needs of the people of the State under part XVIII, chapter 321, Hawaii Revised Statutes; and

WHEREAS, the Department of Health also has the power and duty to regulate health care facilities, including hospitals and their components and emergency departments and trauma centers, and thus needs to adopt a leadership role in addressing the "on-call" crisis; and

WHEREAS, increasingly, hospitals across the nation are looking to government for assistance in addressing this crisis; and

WHEREAS, in Hawaii, the need exists to review the problem and the State's response thereto, and there is some indication that private entities may be willing to provide some funding towards conducting this review; now, therefore,

BE IT RESOLVED by the House of Representatives of the Twenty-third Legislature of the State of Hawaii, Regular Session of 2005, the Senate concurring, that the Legislative Reference Bureau and the Department of Health are requested to conduct studies in coordination with each other, to evaluate the impact of the physician on-call crisis on the ability of The Queen's Medical Center Trauma Center to provide emergency medical services in the State of Hawaii and to recommend any appropriate government and private sector actions in response; and

BE IT FURTHER RESOLVED that Department of Health, in its part of the study, is requested to include, in particular, an analysis of the pertinent issues including:

BE IT FURTHER RESOLVED that the Legislative Reference Bureau, in its part of the study, is requested to identify and analyze any appropriate government response to the on-call crisis including:

BE IT FURTHER RESOLVED that the Legislative Reference Bureau and the Department of Health are requested to interview and seek the input of as many stakeholders as possible for their respective parts of the study including:

BE IT FURTHER RESOLVED that the Legislative Reference Bureau and the Department of Health may contract with private contractors to facilitate the completion of this study; and

BE IT FURTHER RESOLVED that the Legislative Reference Bureau and the Department of Health are both requested to report their findings and recommendations, including any necessary proposed legislation, to the Legislature no later than twenty days prior to the convening of the Regular Session of 2006; and

BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Director of the Legislative Reference Bureau, the President and Chief Executive Officer of The Queen's Medical Center, and to the Director of Health, who in turn is requested to transmit copies to other interested entities.

Report Title:

Queens Med. Center; Trauma Center; LRB/DOH Study On-Call Crisis