The Police Chief - December 2011 - (Page 28)

• • • • How Police Can Use Hospital Laws to Speed Processing in Hospital Emergency Departments By Dean J. Collins, Assistant Chief, Brookfield, Wisconsin, Police Department, and IACP Life Member; and Stephen A. Frew, JD, Vice President and Risk Consultant, Johnson Insurance Services, Madison, Wisconsin transfer unless the hospital is unable to meet the patient’s needs; provide a list of on-call specialists to back up the emergency department within the capacity of the hospital staff, and require that they respond in a timely manner to the call. follow detailed standards and requirements for transfers of patients, including the use of medical vehicles staffed with medical personnel and equipped with proper life-support capabilities (discharges fall within the definition of transfers, if the patient’s emergency medical condition has not been completely screened and resolved); document all elements of compliance carefully; and report suspected possible violations of the EMTALA by other institutions that result in a patient presenting at the reporting facility. What Patients and Conditions Are Covered? P olice chiefs throughout the United States are frequently confronted with situations where department overtime budgets are strained; physical effort levels are drained; and officers are frustrated by long, drawn-out attempts to access necessary medical care for victims, prisoners, suspects, and psychiatric patients in their local emergency departments. Many of these issues can be resolved proactively if the police administration makes effective use of federal hospital regulations to obtain cooperation from local hospital emergency departments. While police chiefs are responsible for enforcing the criminal laws and complying with myriad regulations affecting departmental procedures, they are likely unaware of the equally large volume of regulations pertaining to hospitals and the enforcement process that can fine, or even close, hospitals in literally days. Among the most feared of these laws is the Emergency Medical Treatment and Active Labor Act (EMTALA). This law was passed in 1986 to restrict hospital “dumping,” or refusal of care because of financial issues. In the following years, the law and its regulations have developed into a complex set of rules that essentially guar28 THE POLICE CHIEF/DECEMBER 2011 antee timely access to emergency health care at hospitals to any and all patients. Properly applied, these rules can help generate hospital cooperation with police to expedite the process to care for patients and prisoners, return officers to the street sooner, cut resulting police expense, and promote effectiveness. Approached incorrectly, however, it can aggravate existing issues and result in a poor community image and potential liability concerns for both the police department and the hospitals involved. Basics of the EMTALA In the broadest of terms, the EMTALA requires hospitals—but not private doctor’s offices, clinics, or laboratories—to • triage and medically screen, including appropriate testing and on-call specialist care, to rule out the presence of an emergency medical condition as defined by the law; • render medical screening and stabilizing medical care without regard to means or ability to pay, and restrict registration processing to prevent financial discrimination; • provide evaluation and stabilizing care within the hospital’s capabilities and not Although EMTALA law and regulations fall under Medicare, the provisions apply to any patient who “presents” (arrives) on an unscheduled basis requesting care. Family members, police, or any other person may make the request on behalf of the person and trigger the law. Federal EMTALA regulations have expanded the definition of “presents” to include any person on hospital property or within 250 yards of the main hospital building and patients in an ambulance crossing onto the property of the hospital. Any person who is on hospital property, who is not already an admitted patient, may trigger EMTALA if they demonstrate symptoms or appearance that would cause a prudent non–medical professional, including a police officer, to believe they need assessment and care. Hospitals are required to have policies and procedures to respond to presenting patients who are known to be in need of assistance in the 250-yard zone (excluding nonhospital private property, businesses, and offices)—or in nonemergency portions of the hospital—and ultimately move the patient to an area where the medical screening exam and care may be provided. To be entitled to a medical screening examination, the patient need only present under circumstances that the hospital, by its employees, becomes aware. Every person, no matter how minor their complaint seems, must receive a medical screening examination (MSE). Triage, however, is not the medical screening examination. Triage only determines the priority for patients to access the medical screening examination, which is generally performed by a physician. Triage may also determine whether the patient will be seen for medical screening in the main emergency department or in the fast-track

Table of Contents for the Digital Edition of The Police Chief - December 2011

President’s Message: The Time for a National Commission Has Come
Legislative Alert: National Criminal Justice Commission Legislation Falls Short of Passage
IACP Foundation: Fueled Up to Fund the Foundation: Harley-Davidson Raffle Kicked Off at Conference
Chief’s Counsel: Postincident Video Review
From the Assistant Director: The U.S. Secret Service Partners with State, Local, and International Law Enforcement to Pursue the World’s Most Wanted Cybercriminals
Advances & Applications
Taking the Straw Man to the Ground: Arguments in Support of the Linear Use-of-Force Continuum
How Police Can Use Hospital Laws to Speed Processing in Hospital Emergency Departments
On Choosing the Right Operational Police Physician
Report of the 118th Annual IACP Conference: Chicago
Board of Officers
General Assemblies
IACP Business
Exhibit Hall
Special Events
Thank You, Chicago
Life Members
New Members
Exhibitor Update
Intelligence-Led Policing: The Future Is Now
“Just a Volunteer”: Supporting An Agency’s Volunteer Program through Difficult Times
Providing Effective Policing for Aboriginal Communities
The IACP and Alcatel-Lucent Present International and Domestic Police Officer of the Year Awards
2011 Author Index
2011 Subject Index
Technology Talk
Index to Advertisers
Highway Safety Initiatives

The Police Chief - December 2011