STAND. COM. REP. NO. 1787

Honolulu, Hawaii

, 2005

RE: H.C.R. No. 229

H.D. 1

S.D. 1

 

 

Honorable Robert Bunda

President of the Senate

Twenty-Third State Legislature

Regular Session of 2005

State of Hawaii

Sir:

Your Committee on Health, to which was referred H.C.R. No. 229, H.D. 1, entitled:

"HOUSE CONCURRENT RESOLUTION REQUESTING THE DEPARTMENT OF HEALTH TO EVALUATE THE IMPACT OF THE PHYSICIAN "ON-CALL" CRISIS ON THE QUEEN'S MEDICAL CENTER TRAUMA CENTER'S ABILITY TO PROVIDE EMERGENCY MEDICAL SERVICES IN THE STATE OF HAWAII AND TO RECOMMEND APPROPRIATE PRIVATE SECTOR AND GOVERNMENT RESPONSES TO THE "ON-CALL" CRISIS TO ENSURE CONTINUED ACCESS TO TRAUMA LEVEL CARE,"

begs leave to report as follows:

The purpose of this measure is to request the Department of Health to study 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 Hawaii and to recommend appropriate public and private responses to the crisis.

The Healthcare Association of Hawaii, the President and Chief Executive Officer of Hawaii Health Systems Corporation, Kaiser Permanente, the Program Director of the University of Hawaii Surgical Residency Program, and the Vice-President of Surgical Services at The Queen's Medical Center submitted testimony in support of this measure. The Department of Health and the Vice President of Medical Affairs at The Queen's Medical Center submitted testimony in support with amendments. The Hawaii Independent Physicians Association submitted testimony in support of the intent with recommendations and offered its assistance to the Legislative Reference Bureau with information to complete the study of the requirements for mandating physicians on-call.

Your Committee finds that it is more appropriate for the Department of Health to report on the factual issues surrounding the on-call problem and its impact on health care facilities in the State, and for the Legislative Reference Bureau to focus on policy-oriented issues.

Your Committee has amended this measure by conforming all of its provisions to the language in S.C.R. No. 199, S.D. 2. The Department of Health is requested to conduct an analysis of the on-call crisis including:

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

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

(3) The response of The Queen's Medical Center to address this crisis and keep the Trauma Center operational;

(4) The role of the Trauma Center in the state comprehensive emergency medical services system;

(5) A description of the impact, if any, of the on-call crisis on the delivery of non-trauma emergency medical services at select hospitals across the State including neighbor island hospitals; and

(6) An analysis of how the decision to transfer patients is made, including a description of the transfer process, and recommendations to improve this process, if any, to enhance patient outcomes.

The Legislative Reference Bureau is requested to identify and analyze any appropriate government response to the on-call crisis including:

(1) The experience and response of other states and cities facing a similar on-call crisis;

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

(3) Options to address liability concerns faced by on-call physicians; and

(4) An analysis that looks at the pros and cons of mandating that physicians "take call" in order to:

(A) Obtain or maintain a license to practice medicine in the State of Hawaii; or

(B) Receive privileges to admit patients to a hospital located in the State of Hawaii.

As affirmed by the record of votes of the members of your Committee on Health that is attached to this report, your Committee concurs with the intent and purpose of H.C.R. No. 229, H.D. 1, as amended herein, and recommends its adoption in the form attached hereto as H.C.R. No. 229, H.D. 1, S.D. 1.

Respectfully submitted on behalf of the members of the Committee on Health,

____________________________

ROSALYN H. BAKER, Chair