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Regular Session, 2012
HOUSE CONCURRENT RESOLUTI ON NO. 108
BY REPRESENTATIVE SIMON
A CONCURRENT RESOLUTI ON
To create a study committee to study inpatient transfers between hospitals, public and
private, and make recommendations on the establishment of hospital to hospital
transfer agreements.
WHEREAS, there is a systematic problem with lack of access to life saving health
care for individuals with speciality problems, especially the uninsured; and
WHEREAS, the scope of this study is designed to encompass multiple critical issues
which have all served to impede the transfer of indigent hospital inpatients to other facilities
with specialized capabilities, including but not limited to: hospital capacity, liability,
payment issues, clearly defined emergent care circumstances, and transfer protocols; and
WHEREAS, there is no federal or state obligation to accept an inpatient transfer from
an admitting hospital in situations where the patient requires specialized care that is not
available at the admitting hospital; and
WHEREAS, the recognition of the existence of a fundamental right to emergent care
needs to extend beyond the initial access point of care to the specialized care of hospital
inpatients in situations where the admitting hospital lacks adequate technological resources
to provide the appropriate level of care; and
WHEREAS, the difficulty in accessing specialized care has been exacerbated by the
lack of access to neurosurgeons in the state; and
WHEREAS, the severe shortage of neurosurgeons is attributable to many factors,
including the static number of neurosurgical residency training program graduates,
medicolegal pressures, and rising professional liability insurance costs; and
WHEREAS, there is a need for a dedicated trauma system to deal effectively with
severely injured patients along with the purposeful organization of existing health care ENROLLEDHCR NO. 108
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resources can help to ensure the optimal treatment of all injured patients, regardless of their
admission status; and
WHEREAS, the lack of structured speciality care has created the need for a
standardized system of care with appropriate criteria and procedures for transferring hospital
inpatients to facilities with specialized capabilities to adequately and effectively address
patients' health concerns; and
WHEREAS, a deep understanding and commitment to resolve these issues have been
exhibited by community leaders, EMS systems, hospitals, physicians, medical boards, state
and local policymakers, and patient families.
THEREFORE, BE IT RESOLVED that the Legislature of Louisiana does hereby
create a study committee, composed of members as hereinafter provided, to study and make
recommendations with respect to the transfer of hospital inpatients who require specialty
care needs.
BE IT FURTHER RESOLVED that the study committee created herein shall be
composed of six members as follows:
(1) A member of the Louisiana 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 Louisiana Hospital Association appointed by the president and
chief executive officer of the association.
(4) A member of the Louisiana State Medical Society appointed by the president.
(5) A member of the Louisiana 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 Louisiana at New Orleans) appointed by the medical director.
(7) A member of Our Lady of the Lake Regional Medical Center appointed by the
president and chief executive officer.
BE IT FURTHER RESOLVED that the chairman of the study committee shall be the
member representing LERN and the chairman shall facilitate the organization of the ENROLLEDHCR NO. 108
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committee in the adoption of rules of procedure, adoption of a work schedule, and adoption
of any additional measures that it deems necessary for the timely performance of its duties.
BE IT FURTHER RESOLVED that members of the study committee shall serve
without compensation but may be reimbursed for incurred expenses as provided by their
respective organizations; that legislative members shall receive such per diem and expenses
as is provided for legislators during attendance at committee meetings; and that other
members shall be paid in accordance with state travel regulations by the respective
departments, agencies, or associations of which they are officers or employees.
BE IT FURTHER RESOLVED that the study committee may request and utilize
such counsel, assistance, personnel, facilities, and advice as may be obtained from any and
all sources, public and private, including but not limited to state agencies, business, labor,
private research agencies, individuals, and organizations.
BE IT FURTHER RESOLVED the study committee, at a minimum, shall review and
consider the following: (1) physician involvement; (2) utilization review and case
management; (3) transfer protocols; (4) communication, prioritization, and coordination
problems; (5) hospitals who refuse patients based on inability to pay in comparison to those
that lack capacity; (6) hospital versus physician acceptance; (7) liability and legal
reimbursement; (8) clearly defined emergent circumstances and event triggers; (9) priority
of types of care; (10) capacity saturation; (11) lack of neurosurgeons; (12) abuse of the
system; (13) staff education; and (14) information technology.
BE IT FURTHER RESOLVED that the study committee shall outline and establish
a practical step-by-step guide for implementing inpatient transfers.
BE IT FURTHER RESOLVED that the study committee shall study the development
of written hospital transfer agreements for the transfer of inpatients in the event of
emergency situations.
BE IT FURTHER RESOLVED that these contractual commitments shall require the
transferring hospitals to only transfer those patients who require services that the transferring
hospital cannot provide.
BE IT FURTHER RESOLVED that the study committee shall examine Louisiana's
trauma center system and investigate the impact that additional dedicated trauma centers
would have on improving access to critical care in the state. ENROLLEDHCR NO. 108
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BE IT FURTHER RESOLVED that the study committee shall also consider the need
of establishing a regional trauma registry to collect data to assess the appropriateness,
timeliness, as well as costs and outcome, of transporting hospital inpatients between
hospitals.
BE IT FURTHER RESOLVED that the study committee shall establish an effective
action plan for implementing its findings.
BE IT FURTHER RESOLVED that the study committee shall have the authority to
consider, investigate, and evaluate any and all other matters or issues relevant to improving
the delivery of care to hospital inpatients in need of treatment at facilities with specialized
capabilities.
BE IT FURTHER RESOLVED that the study committee shall meet as necessary and
shall report its findings to the House Committee on Health and Welfare and the Senate
Committee on Health and Welfare not later than February 1, 2013.
SPEAKER OF THE HOUSE OF REPRESENTATI VES
PRESIDENT OF THE SENATE