ARIZONA STATE SENATE
Phoenix, Arizona
FINAL
REVISED
emergency wards; hospital
diversion
(NOW: patient transport protocols; EMT)
Requires the Director of the
Department of Health Services (DHS) to establish protocols for emergency
medical technicians (EMTs) and ambulance service providers to refer, advise or
transport a patient from an emergency response to the most appropriate health
care institution.
Currently, hospital emergency
departments around the country are experiencing overcrowding and internal
resource limitations. Staff shortages,
facility closures, inappropriate emergency department use and increased use of
emergency department facilities all place a strain on hospital emergency
departments. At times, overcrowding and
resource limitations have resulted in hospital emergency departments refusing
to take patients until a bed is available.
When a hospital emergency department is under diversion, ambulances must
take patients to another facility or wait until a bed becomes available,
depending upon the seriousness of the illness or injury.
According to the Arizona
College of Emergency Physicians, two Maricopa County hospitals were on
diversion 25 percent of the time last winter and one Tucson hospital is now on
diversion 50 percent of the time.
Arizona Administrative Code allows a medical staff committee at a
hospital to exceed the hospital’s licensed capacity in emergency situations
(A.A.C. R9-10-213). Hospitals, which
exceed licensed capacity in emergency situations, are required to suspend
elective admissions until the hospital is below the licensed capacity.
Current statute allows the
Director of DHS to establish protocols allowing an emergency medical service (EMS)
provider to refer, advise or transport a patient by the most appropriate means
to the most appropriate medical services provider based on the patient's
condition. However, rules have not yet
been formally adopted. S.B. 1319
requires the DHS Director to develop protocols for EMTs and ambulance service
providers to refer, advise or transport a patient to the most appropriate
health care institution based upon the patient’s condition, unless the
condition poses an immediate threat to life or limb. Additionally, S.B. 1319 requires the protocols to consider
patient choice, a patient’s health care provider, specialized health care
facilities and local protocols.
There is no cost to the
state general fund associated with the provisions of this measure.
1. Requires the DHS Director to establish triage and treatment protocols for EMTs and ambulance service providers who respond to emergency calls that do not pose a threat to life or limb, within 90 days of the general effective date of this act.
2. Stipulates the protocols are for referring, advising or transporting patients to the most appropriate health care institution based on the patient’s condition and providing a list of alternative sites available to deliver care.
3. Exempts DHS from the rule making process for rules established or revised pursuant to this act.
4. Provides for a general effective date.
Amendments
Adopted by Health Committee
Adopted the strike everything amendment.
Amendments Adopted by Committee of the Whole
1. Removes the authority of the medical director of an EMS provider or ambulance services to establish triage and treatment protocols for EMTs who respond to emergency calls that do not pose a threat to life or limb.
2. Requires the DHS Director to establish protocols for EMTs to refer, advise or transport patients from an emergency response to the most appropriate health care institution, within 90 days of the general effective date of this act.
3. Makes technical changes.
Amendments
Adopted by the House of Representatives
Makes conforming and technical changes.
Senate Action House Action
HEA 3/6/01 DPA/SE 7-0-1-0 HEA 3/26/01 DPA 8-0-0-2-0
3rd Read 3/15/01 29-0-1-0 3rd Read 4/9/01 58-0-2-0
Final Read 4/16/01 28-0-2-0
Signed by the Governor 4/19/01
Chapter Number 157
Prepared by Senate Staff
May 15, 2001