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 SD2)

HOUSE OF REPRESENTATIVES                H.B. NO.           H.D. 2
TWENTIETH LEGISLATURE, 1999                                S.D. 2
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, [which] that may include emergency aeromedical
16           services and that shall meet the requirements of this
17           part, subject to section 321-228;
18      (3)  Consult and coordinate with the University of Hawaii,

Page 2                                                     895
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                                                        S.D. 2

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

Page 3                                                     895
                                     H.B. NO.           H.D. 2
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 1      (9)  Implement public information and education programs to
 2           inform the public of the state system and its use, and
 3           disseminate other emergency medical information,
 4           including appropriate methods of medical self-help and
 5           first-aid, and the availability of first-aid training
 6           programs in the State;
 7     (10)  Establish standards and provide training for ground
 8           ambulance dispatchers in the state system, and maintain
 9           a program of quality assurance for dispatch equipment
10           and operations;
11     (11)  Support the interagency dispatch policy and procedures
12           for aeromedical transports;
13    [(11)] (12)  Establish a program that will enable emergency
14           service personnel to provide early defibrillation;
15    [(12)] (13)  Establish within the department the emergency
16           medical service system for children;
17    [(13)] (14)  Consult with the advisory committee on matters
18           relating to the implementation of this part; and
19    [(14)] (15)  Establish and maintain standards for emergency
20           medical services course instructor qualifications and
21           requirements for emergency medical services training
22           facilities."

Page 4                                                     895
                                     H.B. NO.           H.D. 2
                                                        S.D. 2

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

Page 5                                                     895
                                     H.B. NO.           H.D. 2
                                                        S.D. 2

 1 system shall serve the emergency health needs of the people of
 2 the State by identifying system strengths and weaknesses and the
 3 allocation of resources.  The department, in the implementation
 4 of this subsection, shall plan, coordinate, and provide
 5 assistance to all entities and agencies, public and private,
 6 involved in the system.
 7      The emergency aeromedical medical services information
 8 system shall include the following:
 9      (1)  Communication and dispatch data, including:
10           (A)  Time at initial medical facility for
11                stabilization;
12           (B)  Availability and flight time of emergency
13                aeromedical services to the nearest airport;
14           (C)  Notification time to aeromedical dispatch;
15           (D)  Availability and transport time by ground
16                ambulance from hospital to airport;
17           (E)  Flight time of aircraft to Honolulu airport; and
18           (F)  Availability and transportation by ground
19                ambulance to the designated medical center;
20      (2)  Medical oversight by physicians; and 
21      (3)  License information of emergency aeromedical services
22           based on national standards.

Page 6                                                     895
                                     H.B. NO.           H.D. 2
                                                        S.D. 2

 1      (c)  The department shall establish an emergency aeromedical
 2 services quality improvement advisory committee to analyze
 3 information collected from the aeromedical quality improvement
 4 performance measures under subsection (b).  The director of
 5 health shall appoint nine members to the advisory committee, to
 6 include one member:
 7      (1)  From each county representing hospital physicians;
 8      (2)  Representing a major trauma center;
 9      (3)  Specializing in tertiary pediatrics;
10      (4)  Representing burn center physicians;
11      (5)  Representing aeromedical services; and
12      (6)  Representing ground ambulance services."
13      SECTION 4.  Statutory material to be repealed is bracketed.
14 New statutory material is underscored.
15      SECTION 5.  This Act shall take effect upon its approval.