Bill Text: NJ S2973 | 2010-2011 | Regular Session | Introduced
Bill Title: Establishes "Emergency Department Triage Referral Pilot Program" in DHSS.
Spectrum: Bipartisan Bill
Status: (Introduced - Dead) 2011-06-27 - Introduced in the Senate, Referred to Senate Health, Human Services and Senior Citizens Committee [S2973 Detail]
Download: New_Jersey-2010-S2973-Introduced.html
Sponsored by:
Senator ROBERT W. SINGER
District 30 (Burlington, Mercer, Monmouth and Ocean)
Senator JOSEPH F. VITALE
District 19 (Middlesex)
SYNOPSIS
Establishes "Emergency Department Triage Referral Pilot Program" in DHSS.
CURRENT VERSION OF TEXT
As introduced.
An Act concerning hospital emergency department use and supplementing Title 26 of the Revised Statues.
Be It Enacted by the Senate and General Assembly of the State of New Jersey:
1. There is established a two-year "Emergency Department Triage Referral Pilot Program" in the Department of Health and Senior Services. The purpose of the program shall be to assess the feasibility of curbing inappropriate use of hospital emergency departments by mandating the referral of patients who seek non-emergency or non-urgent care at emergency departments to federally qualified health centers and other primary care providers. Such referrals shall be intended to ensure that these patients receive treatment and follow-up care that is more appropriate to their needs and that is provided in a more cost effective manner.
2. The pilot program shall be established in six general hospitals in the State, two each in the northern, central, and southern areas of the State.
a. A general hospital in the State interested in participating in the pilot program shall apply to the Department of Health and Senior Services on a form and manner prescribed by the Commissioner of Health and Senior Services.
b. The commissioner shall select those hospitals that best meet the purposes of this act.
3. The pilot program shall provide as follows:
a. When a patient presents at a participating hospital's emergency department and, after performing triage on the patient, the triage health care professional determines that the patient is not in need of emergency or urgent health care services, the hospital, notwithstanding the provisions of section 14 of P.L.1992, c.160 (C.26:2H-18.64) to the contrary, shall not provide care and treatment to the patient and shall, instead, refer the patient to the nearest federally qualified health center or other ambulatory primary care clinic or to the patient's primary care provider, if any, for care and treatment; and
b. A participating hospital shall establish a formal referral relationship with the federally qualified health center located nearest to the hospital, and with such other ambulatory primary care clinics located in the service area of the hospital, as the hospital determines appropriate. The referral relationship shall include procedures for directing and referring non-emergency and non-urgent care hospital emergency department patients for prompt, appropriate care and treatment at the center or clinic and, to the extent possible, for making an appointment to be seen by a health care provider at the center or clinic.
4. a. The participating hospitals shall report to the Department of Health and Senior Services 24 months after the pilot program becomes operational. The report shall include, but not be limited to, the number of persons referred to federally qualified health centers, other primary care clinics and primary care providers; the primary health care reason the patient presented at the emergency department; the source of payment of the patient; and the impact of the pilot program in reducing non-emergency or non-urgent emergency department visits by patients.
b. The Commissioner of Health and Senior Services shall report to the Governor, and to the Legislature pursuant to section 2 of P.L.1991, c.164 (C.52:14-19.1), prior to the expiration of this act on the results of the pilot program and whether the program should be continued or expanded to other hospitals. The commissioner shall also recommend such legislation as the commissioner deems necessary.
5. The Commissioner of Health and Senior Services shall, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), adopt such rules and regulations as the commissioner deems necessary to carry out the provisions of this act.
6. This act shall take effect on the 120th day following enactment and shall expire 30 months after the effective date, but the Commissioner of Health and Senior Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.
STATEMENT
This bill establishes a two-year "Emergency Department Triage Referral Pilot Program" in the Department of Health and Senior Services (DHSS).
The purpose of the program is to assess the feasibility of curbing inappropriate use of hospital emergency departments by mandating the referral of patients who seek non-emergency or non-urgent care at emergency departments to federally qualified health centers (FQHCs) and other primary care providers. Such referrals are intended to ensure that these patients receive treatment and follow-up care that is more appropriate to their needs and that is provided in a more cost effective manner.
The pilot program shall be established in six general hospitals in the State, two each in the northern, central and southern areas of the State. A general hospital in the State interested in participating in the pilot program shall apply to DHSS in a manner and form prescribed by the Commissioner of Health and Senior Services, and the commissioner will select those hospitals that best meet the purposes of the pilot program.
The pilot program shall provide as follows:
· When a patient presents at a participating hospital's emergency department and, after performing triage on the patient, the triage health care professional determines that the patient is not in need of emergency or urgent health care services, the hospital, notwithstanding the provisions of section 14 of P.L.1992, c.160 (C.26:2H-18.64) to the contrary, shall not provide care and treatment to the patient and shall, instead, refer the patient to the nearest FQHC or other ambulatory primary care clinic or to the patient's primary care provider, if any, for care and treatment.
· A participating hospital shall establish a formal referral relationship with the FQHC located nearest to the hospital, and with such other ambulatory primary care clinics located in the service area of the hospital, as the hospital determines appropriate. The referral relationship shall include procedures for directing and referring non-emergency and non-urgent care hospital emergency department patients for prompt, appropriate care and treatment at the FQHC or clinic and, to the extent possible, for making an appointment to be seen by a health care provider at the FQHC or clinic.
· The participating hospitals shall report to DHSS 24 months after the pilot program becomes operational. The report shall include, but not be limited to, the number of persons referred to FQHCs, other primary care clinics and primary care providers; the primary health care reason the patient presented at the emergency department; the source of payment of the patient; and the impact of the pilot program in reducing non-emergency or non-urgent emergency department visits by patients.
· The Commissioner of Health and Senior Services shall report to the Governor and the Legislature prior to the expiration of this bill on the results of the pilot program and whether the program should be continued or expanded to other hospitals. The commissioner shall also recommend such legislation as the commissioner deems necessary.
The bill takes effect on the 120th day following enactment and expires 30 months after the effective date, but the Commissioner of Health and Senior Services may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of the pilot program.
