Report Title:

Emergency Medical Services



Requires DOH to integrate emergency aeromedical services into statewide emergency medical services. Establishes emergency aeromedical information system and quality improvement committee.



S.B. NO.









relating to emergency medical services.



SECTION 1. Section 321-222, Hawaii Revised Statutes, is amended by adding a new definition to be appropriately inserted and to read as follows:

""Emergency aeromedical services" means a secondary response system which provides immediate critical care and transport by fixed wing or roto wing aircraft of a patient to a facility that provides specialized medical care."

SECTION 2. Section 321-224, Hawaii Revised Statutes, is amended to read as follows:

"321-224 Department of health, functions, duties. In addition to other functions and duties assigned under this part, the department shall:

(1) Regulate ambulances and ambulance services;

(2) Establish emergency medical services throughout the State, [which] shall include emergency aeromedical services and shall meet the requirements of this part, subject to section 321-228;

(3) Review and approve the curricula and syllabi of training courses offered to emergency medical services personnel who provide basic, intermediate, and advanced life support, consult and coordinate with the University of Hawaii, or any other accredited community college, college, or university, or any professional organization that provides emergency medical services training, regarding the training for basic, intermediate, and advanced life support personnel, as provided in section 321-229;

(4) Collect and evaluate data for the continued evaluation of the state system, subject to section 321-230;

(5) Coordinate emergency medical resources and the allocation of the state system's services and facilities in the event of mass casualties, natural disasters, national emergencies, and other emergencies, ensuring linkage to local, state, and national disaster plans, and participation in exercises to test these plans;

(6) Establish, administer, and maintain a communication system for the state system;

(7) Assist each county in the development of a "911" emergency telephone system;

(8) Secure technical assistance and other assistance and consultation necessary for the implementation of this part, subject to section 321-230;

(9) Implement public information and education programs to inform the public of the state system and its use, and disseminate other emergency medical information, including appropriate methods of medical self-help and first-aid, and the availability of first-aid training programs in the State;

(10) Establish standards and provide training for dispatchers in the state system, and maintain a program of quality assurance for dispatch equipment and operations;

(11) Establish a program that will enable emergency service personnel to provide early defibrillation;

(12) Establish within the department the emergency medical service system for children;

(13) Consult with the advisory committee on matters relating to the implementation of this part; and

(14) Establish and maintain standards for emergency medical services course instructor qualifications and requirements for emergency medical services training facilities."

SECTION 3. Section 321-228, Hawaii Revised Statutes, is amended to read as follows:

"321-228 Emergency medical services; counties. The department of health shall determine, in consultation with the advisory committee under section 321-225, the levels of emergency medical services which shall be implemented in each county. The department of health may contract to provide emergency medical services including emergency aeromedical services or any necessary component of a county emergency services system in conformance with the state system. In the event any county shall apply to the department to operate emergency medical ambulance services within the respective county, the department of health may contract with the county for the provision of such services. The department shall operate emergency medical ambulance services or contract with a private agency in those counties which do not apply to it under this section. Any county or private agency contracting to provide emergency medical ambulance services under this section shall be required by the department to implement such services in a manner and at a level consistent with the levels determined under this section."

SECTION 4. Section 321-230, Hawaii Revised Statutes, is amended to read as follows:

"321-230 Technical assistance, data collection, evaluation. (a) The department of health may contract for technical assistance and consultation, including but not limited to categorization, data collection, and evaluation appropriate to the needs of the state system. The collection and analysis of statewide emergency medical services data, including pediatrics, trauma, cardiac, medical, and behavioral medical emergencies is for the purpose of improving the quality of services provided.

For the purposes of this [section,] subsection, "categorization" means systematic identification of the readiness and capabilities of hospitals and their staffs to adequately, expeditiously, and efficiently receive and treat emergency patients.

(b) The department of health shall establish, administer, and maintain an aeromedical emergency medical services information system designed to collect and analyze data to measure the efficiency and effectiveness of each phase of an aeromedical quality improvement program.

The aeromedical emergency medical services information system shall serve the emergency health needs of the people of the State by identifying system strengths and weaknesses, the allocation of resources, and the development of aeromedical service standards. The department of health in the implementation of this subsection shall plan, coordinate, and provide assistance to all entities and agencies, public and private, involved in the system.

The aeromedical emergency medical services information system shall measure, but is not limited to, the following factors:

(1) Communication and dispatch, including:

(A) Time at initial medical facility for stabilization;

(B) Availability and flight time of fixed-wing emergency aeromedical services to the nearest airport;

(C) Availability and transport time by ground ambulance from hospital to airport;

(D) Flight time of fixed-wing aircraft to Honolulu airport; and

(E) Availability and transportation by ground ambulance to the designated medical center;

(2) Medical oversight by physicians; and

(3) License and standards of emergency aeromedical services.

(c) The department of health shall establish an emergency aeromedical services quality improvement committee to analyze information collected from the aeromedical quality improvement performance measures as established by the American College of Surgeons, and to recommend system standards and resources to improve the Hawaii emergency aeromedical services system. The director of health shall appoint members to the committee, as follows:

(1) One member from each county representing hospital physicians;

(2) One member representing a major trauma center;

(3) One member specializing in tertiary pediatrics;

(4) One member representing burn center physicians;

(5) One member representing aeromedical services; and

(6) One member representing ground ambulance services."

SECTION 5. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 6. This Act shall take effect upon its approval.