ARIZONA STATE SENATE
Phoenix, Arizona
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 patients 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 patients by the most appropriate
means to the most appropriate medical services provider based on the patients
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 patients 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.
Senate Action
HEA 3/6/01 DPA/SE 7-0-1-0
3rd Read 3/15/01 29-0-1-0
Prepared by Senate Staff
March 19, 2001