SB3146 HD1

Report Title:

Emergency Medical Services

Description:

Appropriates funds for various emergency medical services. (SB3146 HD1)

THE SENATE	S.B. NO.	3146
TWENTY-THIRD LEGISLATURE, 2006		S.D. 2
STATE OF HAWAII		H.D. 1

A BILL FOR AN ACT

MAKING AN APPROPRIATION FOR EMERGENCY MEDICAL SERVICES.

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

PART I

SECTION 1. The legislature finds that the United States Army's 68th Medical Company's Medical Assistance to Safety and Traffic helicopters have served Hawaii for the past thirty-one years. These military aeromedical helicopters have transported over seven thousand patients and saved countless lives by transporting patients from rural areas, particularly in West Oahu and the North Shore of Oahu, to tertiary hospitals. Located at Wheeler Army Air Field, the aeromedical helicopters provide a vital service at no cost to rural Oahu.

However, the legislature also finds that due to the increased military activity in Afghanistan, Somalia, and Iraq, the aeromedical helicopters may soon be deployed to those areas, leaving rural Oahu residents without aeromedical services. The legislature believes that providing intra-island aeromedical services to rural Oahu is necessary for the health and safety of residents and therefore is a matter of statewide concern.

It is not the intent of this part to supplant existing ground or fixed-wing transport, especially for routine or non-emergency inter-facility transportation. The aeromedical helicopter unit would use triage protocols to ensure the medically appropriate dispatch of the unit. Helicopter use would be based on national aeromedical triage and transport guidelines as established by the Association of Air Medical Services, the American College of Surgeons, and the National Association of Emergency Medical Services Physicians.

The purpose of this part is to appropriate funds to provide intra-island emergency aeromedical services to rural Oahu only.

SECTION 2. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2006-2007 for a grant-in-aid to the director of health to contract with an existing government agency or United States military unit to provide intra-island roto-wing emergency aeromedical services for rural Oahu only:

(1) Provided that the emergency aeromedical helicopter services:

(A) Shall not supplant existing ground or fixed-wing transport, especially for routine or non-emergency inter-facility transportation; and

(B) Shall use triage protocols that are based on national aeromedical triage and transport guidelines established by the Association of Air Medical Services, the American College of Surgeons, and the National Association of Emergency Medical Services Physicians;

and

(2) Provided further that:

(A) One additional ground emergency medical services ambulance shall be provided until the specified intra-island roto-wing aeromedical services are secured to ensure maximum emergency transport coverage; and

(B) The city and county of Honolulu shall share in the cost to contract with an existing government agency or United States military unit to provide intra-island roto-wing aeromedical services for rural Oahu only.

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

PART II

SECTION 3. The legislature finds that the current practice of staffing the aeromedical helicopter unit on the island of Hawaii by using ground ambulance personnel reduces operational effectiveness and safety by:

(1) Reducing the number of available ground ambulance units assessed and deemed necessary to effectively serve a given community or geographic area. The current practice of using the South Kohala ambulance unit as the primary coverage unit and Waikoloa as the secondary coverage unit has a direct effect on the delivery of ambulance services to residents and visitors of those respective communities. Although this same effect may be experienced with daily emergency medical services operations, it would be minimized through the use of a dedicated aeromedical crew;

(2) Extending the out-of-service time for the respective ground ambulance units involved in the mission through the staffing of the helicopter;

(3) Reducing the quality and effectiveness of patient care by using personnel who are unfamiliar or less familiar with the operation of the helicopter unit. This includes but is not limited to:

(A) Flight physiology;

(B) Patient loading and extrication;

(D) Space and altitude limitations; and

(E) Aircraft performance limitations;

(4) Using personnel who are unfamiliar or less familiar with the equipment of the helicopter unit. This includes but is not limited to:

(A) Radio and communications equipment;

(B) Aircraft lighting;

(D) Emergency evacuation and shut-down procedures;

(E) Flight following; and

(F) Scene operations and safety;

(5) Using personnel who are uncomfortable with or psychologically and physiologically affected by helicopter flight and operations;

(6) Using personnel who may have physical characteristics, such as height and weight, that limit performance or operations; and

(7) Operating with limited availability of personal protective equipment, such as flight suits and helmets.

The purpose of this part is to appropriate funds to reestablish the practice of employing emergency medical service personnel who are dedicated to staff the aeromedical helicopter unit on the island of Hawaii, and thereby maximize operational effectiveness and operational safety.

SECTION 4. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2006-2007 as a grant-in-aid to the county of Hawaii for dedicated emergency medical service personnel to staff the aeromedical helicopter unit on the island of Hawaii.

The sum appropriated shall be expended by the county of Hawaii for the purposes of this part.

PART III

SECTION 5. The legislature finds that there is a lack of hospitals and health centers in the southern portion of the island of Hawaii, and residents of the area are particularly vulnerable in the event of a serious medical emergency. The most efficient solution is to provide two emergency mobile urgent care units to be stationed at the fire departments in the communities of Ocean View and Volcano.

The purpose of this part is to appropriate funds to provide the people of the southern portion of the island of Hawaii with access to appropriate emergency and urgent medical care.

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 2006-2007 to be used for two emergency mobile urgent care units to be stationed at the fire departments of the Ocean View and Volcano communities on the island of Hawaii.

The sum appropriated shall be expended by the county of Hawaii for the purposes of this part.

PART IV

SECTION 7. The purpose of this part is to appropriate funds for a fully-capable, advanced life support emergency medical services ambulance unit that would provide sixteen-hours-a-day, seven-days-a-week emergency response service to the areas of Lower Mililani, Waipio Gentry, Waikele, Crestview, East Waipahu, Waiawa, and the Pearl City industrial area on Oahu.

SECTION 8. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2006-2007 to be deposited into the emergency medical services special fund.

SECTION 9. There is appropriated out of the emergency medical services special fund the sum of $1 or so much thereof as may be necessary for fiscal year 2006-2007 to establish a fully-capable, advanced life support emergency medical services ambulance unit that would provide sixteen-hours-a-day, seven-days-a-week emergency response service to the areas of Lower Mililani, Waipio Gentry, Waikele, Crestview, East Waipahu, Waiawa, and the Pearl City industrial area on Oahu.

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

PART V

SECTION 10. The legislature finds that the protection and preservation of the health of Hawaii's people is a matter of compelling state interest. Emergency ambulance services, available twenty-four-hours-a-day, seven-days-a-week, can help reduce medical emergency deaths, injuries, and permanent long-term disability and are a key component of the state comprehensive emergency medical services system. The Haiku region of Maui is located at the northern tip of the island and lacks twenty-four-hour, locally-based, advanced life support ambulance service. The nearest ambulance service is located in Makawao, which is forty-five minutes away and the next closest is in Hana, a full ninety minutes away. Both wait times are unacceptably long and endanger the health of residents of the Haiku region.

The purpose of this part is to ensure parity in emergency health care for residents and visitors of the Haiku region of Maui by providing twenty-four-hour, advanced life support ambulance service.

SECTION 11. There is appropriated out of the general revenues of the State of Hawaii the sum of $1 or so much thereof as may be necessary for fiscal year 2006-2007 for twenty-four-hour, advanced life support ambulance service for the Haiku district on the island of Maui.

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

PART VI

SECTION 12. The legislature finds that the Waianae Coast Comprehensive Health Center (WCCHC) serves a population of forty thousand people in Leeward Oahu. It has a twenty-four hour emergency room and only one ambulance. The nearest back-up emergency services are twenty miles away at Saint Francis Medical Center-West.

Emergency services at WCCHC have received legislative appropriations since 1976. Without this legislative support, the WCCHC emergency room would have to close its doors.

The purpose of this part is to appropriate funds for emergency services at the WCCHC.

SECTION 13. 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 2006-2007 for emergency services at the Waianae Coast Comprehensive Health Center.

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

PART VII

SECTION 14. This Act shall take effect on July 1, 2020.