HOUSE OF REPRESENTATIVES

H.B. NO.

1000

THIRTY-FIRST LEGISLATURE, 2021

 

STATE OF HAWAII

 

 

 

 

 

 

A BILL FOR AN ACT

 

 

RELATING TO THE STATE COMPREHENSIVE EMERGENCY MEDICAL SERVICES SYSTEM.

 

 

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

 


SECTION 1. Emergency medical services are available in each of the State's four counties, wherein a resident or visitor can call 911 from anywhere in Hawaii and receive an advanced life support response. Persons in urban areas as well as those in rural or more remote areas have relative parity of access to emergency medical services because the State has emergency medical services provider contracts in each of the four counties. This is the benefit of a comprehensive statewide emergency medical services program.

The term "comprehensive" not only applies to coverage but also to infrastructure. The department of health administers the statewide system, pursuant to part XVIII of chapter 321, Hawaii Revised Statutes, including emergency care and transport, all equipment, medications, medication orders, communications, dispatch, and billing. The department of health is further authorized to establish and charge fees for all air and ground ambulance services, from which all receipts are deposited into the general fund.

Furthermore, the annual cost for a comprehensive statewide emergency medical services system is approaching $100,000,000 annually. Costs continue to increase each biennium primarily due to collective bargaining and service expansion by way of additional ambulances, ambulance stations, or emergency response vehicles. For the current fiscal year 2020-2021, the emergency medical services system has a budget shortfall of approximately $6,400,000, which will likely result in cuts to services.

Therefore, the purpose of this Act is to equitably distribute the cost of operating a state comprehensive emergency medical services system without compromising access, coverage, and quality in counties with a population of more than 500,000, and limit state contributions to $100,000,000. This is accomplished by returning a percentage of billing revenue proportionate to an eligible county's receipts back to the eligible county. This will incentivize greater efficiency within an eligible county including maximizing revenue through improved front-end coding, refining treatment and transport protocols in partnership with local health facilities, and promoting greater evidence-based expansion plans. The department of health would maintain roles and responsibilities that assure overall access, quality, and certain benefits of economies of scale.

SECTION 2. Section 321-323, Hawaii Revised Statutes, is amended to read as follows:

"[[]321-223[]] State comprehensive emergency medical services system, establishment. (a) The department of health shall establish, administer, and maintain, and may share with the counties in the cost of, the state comprehensive emergency medical services system to serve the emergency health needs of the people of the State. The department of health in the implementation of this part shall plan, coordinate, and provide assistance to all entities and agencies, public and private, involved in the state system. All emergency medical services or ambulance services conducted by or under the authority of the department of health or any county shall be consistent with this part.

(b) Counties with a population of more than five hundred thousand shall share in the cost of the state comprehensive emergency medical services system in amounts established by rules adopted pursuant to subsection (d).

(c) The total state share of costs for the state comprehensive emergency medical services system shall not exceed $100,000,000 per year.

(d) No later than July 1, 2022, the department of health shall adopt interim rules, which shall be exempt from chapter 91 and chapter 201M, to effectuate the purposes of this section; provided that the interim rules shall remain in effect until July 1, 2023, or until rules are adopted pursuant to chapter 91, whichever occurs sooner."

SECTION 3. Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 4. This Act shall take effect upon its approval.

 

INTRODUCED BY:

_____________________________

 

 

BY REQUEST


 


 

Report Title:

Emergency Medical System; Cost Sharing

 

Description:

Requires counties with more than 500,000 residents to share in the costs of the emergency medical services system; sets annual limit on state contributions.

 

 

 

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.