Emergency Medical Services

Permits DOH to integrate emergency aeromedical services into
statewide emergency medical services.  Establishes an emergency
aeromedical information system and quality improvement advisory
committee. (HB895 HD2)

HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 2
TWENTIETH LEGISLATURE, 1999                                
STATE OF HAWAII                                            

                   A  BILL  FOR  AN  ACT



 1      SECTION 1.  Section 321-222, Hawaii Revised Statutes, is
 2 amended by adding a new definition to be appropriately inserted
 3 and to read as follows:  
 4      ""Emergency aeromedical services" means a secondary response
 5 system that provides immediate critical care and transport by
 6 fixed-wing or rotary-wing aircraft of a patient to a facility
 7 that provides specialized medical care."
 8      SECTION 2.  Section 321-224, Hawaii Revised Statutes, is
 9 amended to read as follows:
10      "321-224  Department of health, functions, duties.  In
11 addition to other functions and duties assigned under this part,
12 the department shall:
13      (1)  Regulate ambulances and ambulance services;
14      (2)  Establish emergency medical services throughout the
15           State, that may include emergency aeromedical services
16           and [which] that shall meet the requirements of this
17           part, subject to section 321-228;
18      (3)  Consult and coordinate with the University of Hawaii,
19           or any other accredited community college, college, or

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                                     H.B. NO.           H.D. 2

 1           university, or any professional organization that
 2           provides emergency medical services training, regarding
 3           the training for basic life support personnel and
 4           advanced life support personnel, as provided in section
 5           321-229;
 6      (4)  Collect and evaluate data for the continued evaluation
 7           of the state system subject to section 321-230;
 8      (5)  Coordinate emergency medical resources and the
 9           allocation of the state system's services and
10           facilities in the event of mass casualties, natural
11           disasters, national emergencies, and other emergencies,
12           ensuring linkage to local, state, and national disaster
13           plans, and participation in exercises to test these
14           plans;
15      (6)  Establish, administer, and maintain a communication
16           system for the state system;
17      (7)  Assist each county in the development of a "911"
18           emergency telephone system;
19      (8)  Secure technical assistance and other assistance and
20           consultation necessary for the implementation of this
21           part, subject to section 321-230;
22      (9)  Implement public information and education programs to
23           inform the public of the state system and its use, and

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                                     H.B. NO.           H.D. 2

 1           disseminate other emergency medical information,
 2           including appropriate methods of medical self-help and
 3           first-aid, and the availability of first-aid training
 4           programs in the State;
 5     (10)  Establish standards and provide training for ground
 6           ambulance dispatchers in the state system, and maintain
 7           a program of quality assurance for dispatch equipment
 8           and operations;
 9     (11)  Support the interagency dispatch policy and procedures
10           for aeromedical transports;
11    [(11)] (12)  Establish a program that will enable emergency
12           service personnel to provide early defibrillation;
13    [(12)] (13)  Establish within the department the emergency
14           medical service system for children;
15    [(13)] (14)  Consult with the advisory committee on matters
16           relating to the implementation of this part; and
17    [(14)] (15)  Establish and maintain standards for emergency
18           medical services course instructor qualifications and
19           requirements for emergency medical services training
20           facilities."
21      SECTION 3.  Section 321-230, Hawaii Revised Statutes, is
22 amended to read as follows:

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                                     H.B. NO.           H.D. 2

 1      "321-230  Technical assistance, data collection,
 2 evaluation.  (a)  The department [of health] may contract for
 3 technical assistance and consultation, including but not limited
 4 to categorization, data collection, and evaluation appropriate to
 5 the needs of the state system.  The collection and analysis of
 6 statewide emergency medical services data, including pediatrics,
 7 trauma, cardiac, medical, and behavioral medical emergencies is
 8 for the purpose of improving the quality of services provided.
 9      For the purposes of this [section,] subsection,
10 "categorization" means systematic identification of the readiness
11 and capabilities of hospitals and their staffs to adequately,
12 expeditiously, and efficiently receive and treat emergency
13 patients.
14      (b)  The department shall establish and maintain an
15 emergency aeromedical medical services information system
16 designed to collect and analyze data to measure the efficiency
17 and effectiveness of each phase of an aeromedical quality
18 improvement program.  
19      The emergency aeromedical medical services information
20 system shall serve the emergency health needs of the people of
21 the State by identifying system strengths and weaknesses and the
22 allocation of resources.  The department, in the implementation
23 of this subsection, shall plan, coordinate, and provide

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                                     H.B. NO.           H.D. 2

 1 assistance to all entities and agencies, public and private,
 2 involved in the system.
 3      The emergency aeromedical medical services information
 4 system shall include the following factual data:
 5      (1)  Communication and dispatch, including:
 6           (A)  Time at initial medical facility for
 7                stabilization;
 8           (B)  Availability and flight time of fixed-wing
 9                emergency aeromedical services to the nearest
10                airport;
11           (C)  Notification to aeromedical dispatch;
12           (D)  Availability and transport time by ground
13                ambulance from hospital to airport;
14           (E)  Flight time of fixed-wing aircraft to Honolulu
15                airport; and
16           (F)  Availability and transportation by ground
17                ambulance to the designated medical center; and
18      (2)  License of emergency aeromedical services based on
19           national standards.
20      (c)  The department shall establish an emergency aeromedical
21 services quality improvement advisory committee to analyze
22 information collected from the aeromedical quality improvement
23 performance measures.  The director of health shall appoint nine

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                                     H.B. NO.           H.D. 2

 1 members to the advisory committee, to include one member:
 2      (1)  From each county representing hospital physicians;
 3      (2)  Representing a major trauma center;
 4      (3)  Specializing in tertiary pediatrics;
 5      (4)  Representing burn center physicians;
 6      (5)  Representing fixed-wing aeromedical services; and
 7      (6)  Representing ground ambulance services."
 8      SECTION 4.  Statutory material to be repealed is bracketed.
 9 New statutory material is underscored.
10      SECTION 5.  This Act shall take effect upon its approval.