HB 57-EMERGENCY MED. SVCS: REVIEW ORGANIZATIONS  4:02:06 PM CHAIR PRAX announced that the next order of business would be HOUSE BILL NO. 57, "An Act relating to review organizations and permitting an emergency medical services provider to establish a review organization; and relating to patient records." 4:02:31 PM REPRESENTATIVE STANLEY WRIGHT, Alaska State Legislature, as prime sponsor, paraphrased the sponsor statement [hardcover in committee packet], which read as follows [original punctuation provided]: House Bill 57 gives EMS agencies protections for peer review activities. Peer review is an intensive self-evaluation process used within healthcare organizations in order to continuously monitor and improve patient care. Peer review activities are non-discoverable this important protection is provided by states to healthcare organizations to establish an environment conducive to improvement, without fear of discovery and litigation. The current status provides a chilling effect on the openness and educational process that EMS peer review provides. This proposed legislation will promote candor and objectivity in EMS system review and discussion. It is essential that allowing EMS medical practitioners to frankly discuss care and conduct in a confidential setting, without worry about external access to the information, would enhance the quality of pre-hospital medical practice. Past legal decisions have asserted that the existing statutory provisions which provide this protection to medical facilities, institutions, or hospital governing bodies and their committees, provide the same protections to emergency medical services (EMS) and fire-based pre-hospital agencies. This is an untested theory and places pre-hospital medical agencies in an unprotected status which other entities enjoy. HB 57 changes the definition of "review organization" to include EMS groups who perform quality improvement functions. By doing so, they are afforded equitable immunity and confidentiality protection that hospitals and other healthcare workers enjoy. Peer review protection is essential if Alaska's EMS systems are to be used to their maximum potential. Passage of this legislation enhances the safety of the public and the educational process for EMS through the peer review program. 4:04:35 PM PI RIORDAN-RANDALL, Staff, Representative Stanley Wright, Alaska State Legislature, on behalf of Representative Wright, prime sponsor of HB 57, read the sectional analysis [included in the committee packet], which read as follows [original punctuation provided]: Section I: Amends AS 18.23.070(1) to Include EMT's, dispatchers, and paramedics in the definition of "health care provider" for the purpose of peer review protection. Section II: Amends the definition of "healthcare provider" in AS 18.23.070(3) to include EMS agencies and employees who are conducting peer review activities. Section III: AS 18.23.070(5) is amended to include emergency medical services agencies and employees under the definition of a "review organization" 4:07:28 PM BRIAN WEBB, representing self, referred to his written testimony [included in committee packet]. He noted that he had previously spoken to the importance of recruitment and retention of emergency medical services (EMS) medical directors, and he called HB 57 a request to provide protections to EMS services, the fire departments that engage in EMS quality assurance programs, and individual EMS responders, including many volunteers. He said EMS committees not only review patient care activities but also openly challenge medical directors and training officers to defend the care given. He said Alaska EMS is just asking the legislature to provide a level of equity in statute for EMS. 4:12:18 PM DR. JOSEPH LIVENGOOD, representing self, shared that he is an acute care surgeon that works in Fairbanks and Ketchikan, and also serves as EMS director for several agencies. He said it is important to have the information necessary to improve patient care. He said that HB 57 clarifies that EMS agencies are identified as a covered entity under the Health Insurance Portability and Accountability Act (HIPPA) privacy rules, which allow for the sharing of patient information for the purpose of quality management and for discussion to occur without discoverability that may be misconstrued or presented out of context during an outside review. He relayed to members that such protections are in place already for hospitals and clinics, but for EMS they are not. 4:14:39 PM REPRESENTATIVE MINA noted that podiatrists are not included in statute. She asked, with the chilling effect happening with quality assurance for EMS, whether that is happening with podiatry. MR. WEBB answered that, in 2015, podiatrists had the same concern as EMS. He said that there was an amendment to the original bill adding podiatrists, and that, during the drafting of HB 57, it was decided that it would be left in. 4:15:55 PM CHAIR PRAX announced that HB 57 was held over.