HLS 12RS-2595 ENGROSSED
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Regular Session, 2012
HOUSE CONCURRENT RESOLUTI ON NO. 108
BY REPRESENTATIVE SIMON
HOSPITALS: Establishes a study committee to study inpatient transfers between hospitals,
public or private, and make recommendations on the establishment of transfer
agreements
A CONCURRENT RESOLUTI ON1
To create a study committee to study inpatient transfers between hospitals, public and2
private, and make recommendations on the establishment of hospital to hospital3
transfer agreements.4
WHEREAS, there is a systematic problem with lack of access to life saving health5
care for individuals with speciality problems, especially the uninsured; and6
WHEREAS, the scope of this study is designed to encompass multiple critical issues7
which have all served to impede the transfer of indigent hospital inpatients to other facilities8
with specialized capabilities, including but not limited to: hospital capacity, liability,9
payment issues, clearly defined emergent care circumstances, and transfer protocols; and 10
WHEREAS, there is no federal or state obligation to accept an inpatient transfer from11
an admitting hospital in situations where the patient requires specialized care that is not12
available at the admitting hospital; and13
WHEREAS, the recognition of the existence of a fundamental right to emergent care14
needs to extend beyond the initial access point of care to the specialized care of hospital15
inpatients in situations where the admitting hospital lacks adequate technological resources16
to provide the appropriate level of care; and 17
WHEREAS, the difficulty in accessing specialized care has been exacerbated by the18
lack of access to neurosurgeons in the state; and 19 HLS 12RS-2595 ENGROSSED
HCR NO. 108
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WHEREAS, the severe shortage of neurosurgeons is attributable to many factors,1
including the static number of neurosurgical residency training program graduates,2
medicolegal pressures, and rising professional liability insurance costs; and3
WHEREAS, there is a need for a dedicated trauma system to deal effectively with4
severely injured patients along with the purposeful organization of existing health care5
resources can help to ensure the optimal treatment of all injured patients, regardless of their6
admission status; and 7
WHEREAS, the lack of structured speciality care has created the need for a8
standardized system of care with appropriate criteria and procedures for transferring hospital9
inpatients to facilities with specialized capabilities to adequately and effectively address10
patients' health concerns; and 11
WHEREAS, a deep understanding and commitment to resolve these issues have been12
exhibited by community leaders, EMS systems, hospitals, physicians, medical boards, state13
and local policymakers, and patient families. 14
THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby15
create a study committee, composed of members as hereinafter provided, to study and make16
recommendations with respect to the transfer of hospital inpatients who require specialty17
care needs. 18
BE IT FURTHER RESOLVED that the study committee created herein shall be19
composed of six members as follows: 20
(1) A member of the Louisiana Emergency Response Network (LERN) appointed21
by the executive director of LERN.22
(2) A physician member of the LSU Health Care Services Division appointed by the23
chief executive officer.24
(3) A member of the Louisiana Hospital Association appointed by the president and25
chief executive officer of the association.26
(4) A member of the Louisiana State Medical Society appointed by the president.27
(5) A member of the Louisiana State Board of Medical Examiners appointed by the28
executive director of the board.29 HLS 12RS-2595 ENGROSSED
HCR NO. 108
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(6) A physician member of the Interim LSU Public Hospital (known as the Medical1
Center of Louisiana at New Orleans) appointed by the medical director.2
BE IT FURTHER RESOLVED that the chairman of the study committee shall be the3
member representing LERN and the chairman shall facilitate the organization of the4
committee in the adoption of rules of procedure, adoption of a work schedule, and adoption5
of any additional measures that it deems necessary for the timely performance of its duties.6
BE IT FURTHER RESOLVED that members of the study committee shall serve7
without compensation but may be reimbursed for incurred expenses as provided by their8
respective organizations; that legislative members shall receive such per diem and expenses9
as is provided for legislators during attendance at committee meetings; and that other10
members shall be paid in accordance with state travel regulations by the respective11
departments, agencies, or associations of which they are officers or employees. 12
BE IT FURTHER RESOLVED that the study committee may request and utilize13
such counsel, assistance, personnel, facilities, and advice as may be obtained from any and14
all sources, public and private, including but not limited to state agencies, business, labor,15
private research agencies, individuals, and organizations.16
BE IT FURTHER RESOLVED the study committee, at a minimum, shall review and17
consider the following: (1) physician involvement; (2) utilization review and case18
management; (3) transfer protocols; (4) communication, prioritization, and coordination19
problems; (5) hospitals who refuse patients based on inability to pay in comparison to those20
that lack capacity; (6) hospital versus physician acceptance; (7) liability and legal21
reimbursement; (8) clearly defined emergent circumstances and event triggers; (9) priority22
of types of care; (10) capacity saturation; (11) lack of neurosurgeons; (12) abuse of the23
system; (13) staff education; and (14) information technology.24
BE IT FURTHER RESOLVED that the study committee shall outline and establish25
a practical step-by-step guide for implementing inpatient transfers. 26
BE IT FURTHER RESOLVED that the study committee shall study the development27
of written hospital transfer agreements for the transfer of inpatients in the event of28
emergency situations.29 HLS 12RS-2595 ENGROSSED
HCR NO. 108
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BE IT FURTHER RESOLVED that these contractual commitments shall require the1
transferring hospitals to only transfer those patients who require services that the transferring2
hospital cannot provide.3
BE IT FURTHER RESOLVED that the study committee shall examine Louisiana's4
trauma center system and investigate the impact that additional dedicated trauma centers5
would have on improving access to critical care in the state.6
BE IT FURTHER RESOLVED that the study committee shall also consider the need7
of establishing a regional trauma registry to collect data to assess the appropriateness,8
timeliness, as well as costs and outcome, of transporting hospital inpatients between9
hospitals.10
BE IT FURTHER RESOLVED that the study committee shall establish an effective11
action plan for implementing its findings.12
BE IT FURTHER RESOLVED that the study committee shall have the authority to13
consider, investigate, and evaluate any and all other matters or issues relevant to improving14
the delivery of care to hospital inpatients in need of treatment at facilities with specialized15
capabilities. 16
BE IT FURTHER RESOLVED that the study committee shall meet as necessary and17
shall report its findings to the House Committee on Health and Welfare and the Senate18
Committee on Health and Welfare not later than February 1, 2013.19
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
Simon HCR No. 108
Creates a study committee to study inpatient transfers between hospitals, public and private,
and make recommendations on the establishment of hospital to hospital transfer agreements.
Specifies that the study committee created will be composed of six members as follows:
(1)A member of the La. Emergency Response Network (LERN) appointed by the
executive director of LERN.
(2)A physician member of the LSU Health Care Services Division appointed by the
chief executive officer.
(3)A member of the La. Hospital Association appointed by the president and chief
executive officer of the association. HLS 12RS-2595 ENGROSSED
HCR NO. 108
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(4)A member of the La. State Medical Society appointed by the president.
(5)A member of the La. State Board of Medical Examiners appointed by the executive
director of the board.
(6)A physician member of the Interim LSU Public Hospital (known as the Medical
Center of La. at New Orleans) appointed by the medical director.
Requires the study committee to submit its findings to the House Committee on Health and
Welfare and the Senate Committee on Health and Welfare not later than Feb. 1, 2013.
Summary of Amendments Adopted by House
Committee Amendments Proposed by House Committee on Health and Welfare to the
original bill.
1. Removed a duplicate reference to the shortage of neurosurgeons from the
illustrative list of issues that the study committee on inpatient hospital transfers
must address.