Federal Issues

ACEP Legislation Gains Additional Co-Sponsors
ACEP - sponsored legislation, the “Access to Emergency Medical Services Act of 2007,” (H.R. 882/S.1003) continues to gain support in Congress.  The following members were recently added as co-sponsors:

Sen. Ken Salazar (D-CO)
Rep. Andre Carson (D-IN)

There are currently 135 co-sponsors in the House and 18 in the Senate.

House Committee Condemns Lack of Emergency Surge Capacity
The House Oversight and Government Reform Committee conducted two hearings criticizing the Administration's efforts to cut Medicaid funding to states because it would further harm emergency department surge capacity.  The hearing featured testimony from Roger Lewis, MD, PhD, FACEP, who is an attending physician and professor in the Harbor-UCLA Medical Center Emergency Department, and the release of the Oversight and Government Reform Committee’s survey that examined capacity at seven major U.S. cities – five that are considered at greatest risk of a terrorist attack (Washington, DC, New York, Los Angeles, Chicago, and Houston), as well as the two cities where the national party nominating conventions will be held this summer (Denver and Minneapolis).

The survey took place on Tuesday, March 25 at 4:30 pm and found the 34 Level I trauma centers in the cities’ surveyed did not have sufficient ED capacity to treat a sudden influx of victims from a terrorist bombing; had virtually no free ICU beds to treat the most seriously injured casualties; and did not have enough regular inpatient beds to handle the less seriously injured victims.

According to the committee's survey, Washington and Los Angeles hospitals were especially strained.  Three of five L.A. hospitals were on diversion and two Washington hospitals reported no available beds.  Washington Hospital Center was operating at 286 percent of capacity, making it the single most overcrowded hospital surveyed.

At the second hearing on Wednesday, the committee heard the Administration's response from HHS Secretary Michael Leavitt and Homeland Security Secretary Michael Chertoff who acknowledged gaps in the capability of hospitals to deal with a mass-casualty terrorist attack or other disasters, but stated congressional efforts to block pending Medicaid regulations will not fix the problem.

To view the surge capacity survey results and read the testimony of the witnesses from either hearing, go to http://oversight.house.gov/.

House Committee Takes Action on Poison Control Centers and Health Centers
In early May, the Energy and Commerce Committee approved by voice vote the "Poison Center Support, Enhancement, and Awareness Act of 2008" (H.R. 5669).  The bill, sponsored by Rep. Ed Towns (D-NY), would reauthorize the nationwide toll-free phone number for poison centers, expand the national media campaign to educate the public and health care providers about poison prevention and poison center resources, and continue HHS grants for the 61 national poison control centers.

The committee also approved by voice vote, the "Health Centers Renewal Act of 2008" (H.R. 1343), which would reauthorize the program through 2012 and grant liability protection for physicians who volunteer at the centers or travel to provide services in emergencies.  The Senate HELP Committee approved a similar bill, S. 901, on November 14.

The full House of Representatives could take action on these two bills as early as mid-May.

Boarding Solutions Report Released
ACEP’s Boarding Solutions Task Force recently completed a new report, “Emergency Department Crowding:  High-Impact Solutions.”  The report recommends little or no-cost solutions that will have a positive impact on EM patients and the amount of time they are boarded in the emergency department.

In late April, ACEP President Linda Lawrence, President-Elect Nick Jouriles, Immediate Past President Brian Keaton, ACEP’s Executive Director Dean Wilkerson and Associate Executive Director Gordon Wheeler met with top leaders from the American Hospital Association, including their CEO, chairman and senior staff members.

The AHA officials agreed to share the report with their member hospitals and continue to work with ACEP on solutions to crowding and boarding.