An Act concerning pediatric emergency departments and supplementing Title 26 of the Revised Statutes.

Be It Enacted by the Senate and General Assembly of the State of New Jersey:

1. a. A general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall not advertise or otherwise hold itself out to the public as providing the services of a level-one pediatric emergency department unless the requirements set forth in this subsection are met.

(1) The hospital shall maintain a separate, designated pediatric emergency department exclusively for the care of pediatric patients;

(2) The director of the pediatric emergency department shall be a board certified pediatric emergency medicine physician, and shall not serve in the capacity of director of any other pediatric emergency department.

(3) The nurse with day-to-day managerial responsibility for nursing in the pediatric emergency department shall be a certified pediatric emergency nurse, and shall not serve in a managerial capacity at any other pediatric emergency department.

(4) The pediatric emergency department shall operate and be staffed on a 24-hour basis with one of the following:

(a) a board certified pediatric emergency physician;

(b) a board eligible pediatric emergency physician;

(c) a board certified pediatrician with at least three years of experience working in a pediatric emergency department; or

(d) a board certified general emergency medicine physician with at least three years of experience working in a pediatric emergency department.

(5) The hospital shall maintain staff in the following subspecialties:

(a) pediatric anesthesiology;

(b) pediatric cardiology;

(d) pediatric infectious diseases;

(e) pediatric nephrology;

(f) pediatric neurology;

(g) pediatric orthopedics;

(h) pediatric pulmonology;

(i) pediatric radiology; and

(j) pediatric surgery.

(6) The hospital shall maintain a formal consultative relationship with the following physician subspecialists, who shall be available for consultations within one hour of a request for consultation:

(a) pediatric endocrinologist;

(b) pediatric gastroenterologist;

(d) pediatric otolaryngologist;

(e) pediatric urologist; and

(f) pediatric ophthalmologist.

(7) The hospital shall maintain separate pediatric inpatient and pediatric intensive care units in the hospital.

b. A general hospital licensed pursuant to P.L.1971, c.136 (C.26:2H-1 et seq.) shall not advertise or otherwise hold itself out to the public as providing the services of a level-two pediatric emergency department unless the requirements set forth in this subsection are met.

(1) The hospital shall maintain a designated space for the care of pediatric patients.

(4) The hospital shall have a separate pediatric inpatient unit or pediatric intensive care unit, or shall have a formal transfer agreement in place with a hospital that provides the services of a level-one pediatric emergency pursuant to subsection a. of this section.

(5) The hospital shall maintain a formal consultative relationship with the following physician subspecialists, who shall be available for consultations within one hour of a request for consultation:

(a) pediatric anesthesiologist;

(b) pediatric cardiologist;

(d) pediatric infectious disease specialist;

(e) pediatric nephrologist;

(f) pediatric neurologist;

(g) pediatric orthopedist;

(h) pediatric pulmonologist;

(i) pediatric radiologist;

(j) pediatric surgeon;

(k) pediatric endocrinologist;

(l) pediatric gastroenterologist;

(m) pediatric neurosurgeon;

(n) pediatric otolaryngologist;

(o) pediatric urologist; and

(p) pediatric ophthalmologist.

c. For purposes of this section, "pediatric" means the period of time beginning with the 29th day following birth up to, but not including, a person's 18th birthday.

2. The Department of Health shall compile the data submitted annually by each general hospital from the hospital's pediatric emergency medicine registry, as required pursuant to N.J.A.C.8:43G-12.4, and include in the New Jersey Hospital Performance Report, issued annually by the department, hospital-specific data from the individual hospital registries. The department shall select those data elements from the hospital registries that it deems most relevant for inclusion in the report.

3. The Commissioner of Health, in accordance with the "Administrative Procedure Act," P.L.1968, c.410 (C.52:14B-1 et seq.), shall adopt such rules and regulations as the commissioner deems necessary to carry out the provisions of this act.

4. This act shall take effect on the first day of the sixth month next following the date of enactment, but the Commissioner of Health may take such anticipatory administrative action in advance thereof as shall be necessary for the implementation of this act.

STATEMENT

This bill prohibits hospitals in the State from advertising to the public that they provide the services of level-one or level-two pediatric emergency departments unless certain requirements specified in the bill are met. The bill also requires that the Department of Health (DOH) include in its annual New Jersey Hospital Performance Report hospital-specific data pertaining to pediatric emergency care deemed by the department to be most relevant for inclusion in the report.

Specifically, the bill requires that a level-one or level-two pediatric emergency departments have a board certified pediatric emergency medicine physician as its director and a certified pediatric emergency nurse responsible for day-to-day managerial responsibility. Neither the director nor the nurse manager would be permitted to hold that position in another facility.

A level-one pediatric emergency department would further be required to be staffed on a 24-hour basis by a board certified pediatric emergency physician, a board eligible pediatric emergency physician, a board certified pediatrician with at least three years of experience working in a pediatric emergency department, or a board certified general emergency medicine physician with at least three years of experience working in a pediatric emergency department. The hospital would also be required to maintain a separate pediatric inpatient or pediatric intensive care unit. In addition, the hospital would be required to maintain staff with pediatric subspecialties specified in the bill and to maintain formal consultative relationships with additional specified physician subspecialists, who would be available for consultation within one hour of a request for consultation.

Level-two pediatric emergency departments would be required to be in a space designated exclusively for the care of pediatric patients, and the hospital would be required to have a separate pediatric inpatient unit or pediatric intensive care unit, or a formal transfer agreement in place with a hospital that provides the services of a level-one pediatric emergency department. The hospital would also be required to maintain formal consultative relationships with specified physician pediatric subspecialists, who would be available for consultation within one hour of a request for consultation.

The bill also requires that DOH compile data submitted annually by each general hospital from its pediatric emergency medicine registry pursuant to current department regulations, and to include in the annual New Jersey Hospital Performance Report hospital-specific data deemed by DOH to be most relevant for inclusion in the report.

The bill would take effect on the first day of the sixth month after the date of enactment.