S.B. 127 Pediatric Care Amendments: transcript

Thank you, Mr. Chair. And I know that there is, uh, a p physician online who couldn't get here in person as well. Uh, Hillary Hughes, who can certainly speak to this bill as well for me. Um, this bill is come together after, don't you love it when you have stakeholder conversations and there's a lot of agreement and a lot of head nodding, and a lot of ways that you work together to support good concepts. And that's really kind of the messaging behind how this bill came together. So, Senate Bill 1 27 Pediatric care Amendments would essentially enact specific provisions to support the provision of pediatric care across the state. So it doesn't matter if you're in Hurricane or if you're in Payson, or if you're in Salt Lake, or if you're in Lehi, that there will be supports, excuse me, to ensure that we have the right supplies, the right masks, the right endotracheal tubes, the right things, so that any care anywhere in the state can be pediatric appropriate. We worked with the hospital associations, we worked with DPS and our emergency folks. We worked with people that work in this space. We worked with the Utah Pediatric Trauma Network. So essentially what we want to do with this bill, and there is no fiscal note on it. It's a lot of it's already happening, but we wanna put it in place, codify it, and make it so that there's a, a, an easier path for people all across the state to participate. Um, and we, our hope with it is that studies have shown with appropriate pediatric readiness, you have 60% lower mortality, mortality risk in injured children, 76% lower risk in ill children. And an estimated 2,143 children's lives saved every year because you had the right equipment at the time when it was critical. And when you have a critically ill or injured kid, you don't have time to say someone run to the or, or someone run to the wherever you need it to be. Right there. Um, another little small piece of this bill is that, um, the Utah Pediatric Trauma Network, which is funded through the legislature, we wanted to put it into its own space. So it is becoming a 5 0 1 C3. So there's no association with any particular health system, which I hope will give all of the participating hospitals and entities the feeling that this is not directed by any one body. It's directed by folks in pediatric care spaces without any particular vested interest that way. Uh, Dr. Hughes, if you're on, perhaps you could, uh, add some additional context for me. Are you, does that conclude your We can go to her in your Yeah. As my, as my co-presenter. She may have more detail. She's online. Okay.

Hi Allall. Can you see me and hear me? You're There. Thank you. Welcome. Okay. Thank you guys so much for giving me a chance just to, um, help Dr. Plum introduce this bill. Senator Plumb, sorry, I know her mostly is Dr. Plum, but, um, as she, as she said, and there's a few others here that'll, that'll help speak to this bill as well. Um, a lot of what I've done over the past decade is work with a, a national initiative called the National Pediatric Readiness Project. And this is federally funded through HRSA and DHHS. And the goal is, as Dr. Plum alluded to, to make sure that we have the right equipment for every kid, the right supplies, the right protocols, the right care for every kid, anywhere they live, regardless of geography. We wanna make sure that every child gets the very best care, um, as possible. And a lot of this stems from the fact that when we look back, historically children have had, um, different outcomes in adults when it comes to emergency care. And a lot of that is because of just numbers. You know, we don't, most emergency departments don't see more than 10 kids a month, um, in their small critical access hospitals. Um, even the bigger hospitals, sometimes they're seeing 10 kids a day. And when you talk about a truly critically ill or injured child, um, it's just a, a matter of volume and being comfortable with those kids and time matters when we're talking about a, a, a real bad injury or a very sick child. The initial hour or two is, um, really crucial to determine outcome. We have good data showing that if you have very robust initial management of that child resuscitation and management of that child, they're gonna have a better outcome and decreased mortality. So for the past couple decades, we've done these national, this national pediatric re readiness project. Part of it has been an assessment of all emergency departments across the country. And we have been able to link this to outcome data. And when you take this assessment, you get a score. This is all free, it's all federally part of this federally funded project. You get a score and, um, the higher the score, the better. The more peds ready you are, the more ready you are to take care of any kid who walks through your door. And that score has been linked to mortality. So if you are in this highest quartile pediatric readiness, your risk of death, um, from injury, illness goes down as much as 76%. Now, we can't put a pediatric ER doctor and we can't put a pediatric surgeon and we can't put a pediatric anesthesiologist in every hospital in America. That's just not practical. And we know here in Utah, we have pretty long, um, delays in getting kids to our pediatric center just because of our rural nature of our state and weather patterns and all kinds of stuff that affects how fast we can transfer a patient. So it is so important that we man our emergency departments with every tool possible so that they can stabilize and they can use the very best evidence and resources to treat those children and give them the best outcome possible. And that's what this project is about. And so this bill that, um, Senator Plumb has introduced, um, takes a lot of these concepts of pediatric readiness and outlines some of the most important ones, like having something called a pediatric emergency care coordinator who's like a pediatric champion in the ed, who helps make sure pediatric voices are heard. And, um, things like making sure we weigh our kids in kilograms instead of pounds, where we can have medication errors, making sure staff have training of if a critical kid comes in, they know where to run to get the pediatric supplies. Oftentimes these supplies are kept in a small bag or cart 'cause they're not often needed. Things like breathing tubes for children and making sure they have training on how to use those supplies. Thank you. So that's kinda what this bill bill's outlining. And it's, um, just showing the importance of, of, um, this work and making sure every Utah Emergency Department is on board. And then sharing that data with our, um, department of, um, DD it's hundred. Um, our, it's DPS now, right? Jen? DTS? Yes. Yeah. Um, so we've moved bureaus where the EM s for Children Program lands now, but, um, making sure that they can also be aware of this data so they can do reach outs to hospitals and, and help improve. And like Dr. Or Justice Senator Plumb said, we have these resources. We're not asking any hospital to have to come up with re resources. The EMS for Children program has binders of protocols and we have trainings that we come out and do, and we have tons of resources online for people. So we're not asking anyone to have to do anything they don't already have.

Thank you, Mr. Chair. Thank you, uh, co to committee for any questions.

Please introduce yourself. Eric Bour DeMeyer with the Department of Public Safety and Bureau of EMS. And I fully support this, uh, amendment and bill as stated. And I think the good doctors have sold this. So, uh, but we, we prove on our side it's good. This is a good medicine.

Hi, I'm Mike Eley, and I, uh, I am the, I work with Dr. Hughes and, um, the director of the data center that coordinates all the data collection for this National Pediatric Readiness Project assessment. And in short, we support this bill. And in the bottom line is it, does it improved pediatric readiness leads to improved outcomes. Thank you. Okay.

Uh, thank you Mr. Chair. I would love to recommend that, uh, we move Senate Bill 1 27 forward to the full body of the Senate with a favorable recommendation. Wonderful.

Thanks to all the folks and to all of, uh, the people who get it.

Alright, I would love that. SB 1 27. Doing a quick text up now for the couple of folks to join online, uh, about this bill. So, Senate Bill 1 27 is something that is pretty near and dear to my heart, working in a pediatric emergency department and working with folks who truly care about pediatric care across this state. Um, as I've watched the evolution in my career, you know, 2000 early two thousands felt like nearly every sick or or or injured kiddo ended up coming up to Primary Children's, to Salt Lake City. And in time you start to take a look at that and you realize, boy, that's really disruptive. You, you take families away from their jobs outta their communities. We have great local hospitals who perhaps just need some additional resources, training and skills to be able to be exceptional as well. And as that kind of realization has happened, I've watched this unfolding of our hospitals across the state seek out and attain knowledge to be really good at pediatric care. Now that being said, sometimes there is a situation when a child does need to come up here to Salt Lake or to Lehi for that more critical level care. And that's what Primary Children's is, therefore, but the services provided in so many of our statewide hospitals are something that I think are worth continuing to support, to support the education, to support the growth, to support the folks who are sometimes anxious, nervous. I mean, an ill, ill or an injured kid makes people little edgy when you see that. And I get why, because the stakes feel so high. But I'll tell you, in the 25 plus years I have watched these, these spaces really blossom and, and provide excellent care. This bill aims to keep supporting that by essentially continuing to maintain pediatric readiness by keeping the education, by keeping the support in place. And we know that if we do this nationally, we've seen that there's 60% lower mortality risk in injured children when there's good pediatric readiness, 76% lower mortality risk in, in the significantly or seriously ill children. And it's estimated that twenty one hundred and forty three kids' lives are saved every year just by having the right readiness pieces. Well, what does that mean? Well, things like having the right mask sizes, if you're gonna be bag and masking, providing oxygen, having the right endotracheal tubes, having the right IV sizes, having the right pieces in place, even a brass low tape so that you can measure out what the estimated weight of a kiddo is, that you can't either too sick to put on a scale. All of these pieces, if you have 'em in place, are going to lead to better outcomes and better care. And I think ideally, better health for our kids. This bill basically enacts specific envisions to and provisions, excuse me, to support pediatric care across the state by reinforcing core concepts of the National Pediatric Readiness Project. Uh, it requires participation of all Utah hospitals, and I'll tell you, we've got the buy-in, uh, Utah Hospital Association is on board. This will fall in line with what's happened with the Utah Pediatric Trauma Network, which has participation of all 49 hospitals across the state. Um, and, and those recommendations essentially have that there's a, a PA Peck, they call them a p, pediatric Emergency Care Coordinator, who's designated, and they're the go-to. And this kind of readiness project will help them assess where they are, help get them resources if they're not where they want to be. It's not a competition. There's no public shaming of anyone that XY, Z hospital is below or above a BC hospital. It's really about that kind of overall mentality of come together, educate, and provide the best, uh, care for kids. Uh, we do in this state have longstanding support for EMS for children. EMSC, if anyone may remember, Senator Orrin Hatch was the original Senator Vickers who sponsored that EMSC program in 1984. And I think this really falls in line with that continued dedication to excellence in the care that we provide kids. One piece you'll note at the end of it, it does appear that there's some sort of an appropriation bit of language. Well, that actually applies to the Utah Pediatric Trauma Network who has been housed within Primary Children's. And, and I think in fairness, that made some folks a little uncomfortable that there was one, uh, entity that appeared to perhaps have more say than others. And so it's coming out, the Utah Pediatric Trauma Network is coming out into its own 5 0 1 C3, and this is just a piece of language that allows the funding to follow them. But that's not new funding, it's just taking it out to have it be in its own objective space. And with that, I'm, I'm open to any questions.

Yeah. I have a few questions for you. What, um, what are you hearing from like the rural remote communities on, on something like this? On, on maybe what the impacts might be? Yeah.

Do you know what I'm realizing? I should have my phone a friend who I think is online who can help because they're actually doing the day-to-day as my kind of a co-presenter, if that might be. Okay. Do, do we see a Dr. Hillary Hughes online to be able to promote because they're actually the ones having the conversation. Okay. So that, that'd be much better.

Hey everyone, can you hear me?

Thanks so much for allowing me to speak and thanks Senator Plumb for, um, bringing this bill up.

So, um, people do always have concern about our rural hospitals. Hillary, Would you mind to just introduce yourself and where you live and who you represent? Thank you.

I'm Hillary Hughes. I'm a pediatric emergency medicine physician that works with Dr. Plummet, um, primary Children's Hospital. I also am the principal investigator for the EMS for Children Data Center, which is the National Data Center that happens to live here in Utah within the University of Utah. I am speaking on this also as a, a private citizen, sharing my opinions, however, but I would say that I've been in this position for more than a decade working on pediatric readiness, um, across Utah and across the Intermountain West. And we have a lot of support from our rural communities, these pediatric patients who come in critically ill or injured. Cause a lot of anxiety, a lot of worry. Everyone wants to do the very best for children within Utah and across the United States. And we have already been working with our rural hospitals, especially our rural nine, that are not affiliated with other big, um, medical systems. We go out and we do training with them. We already go over this assessment with them. We provide resource binders with protocols that are evidence-based. We, um, work with them to solve issues of systems in their emergency department to facilitate care. And we've had nothing but support from our rural hospitals. Um, we do not make them reinvent the wheel. We do not make them come up with any of this themselves. We have all of the resources they need to achieve this level of readiness.

And then a couple, maybe a couple more questions, if that's okay?

Yes, go ahead. Um, does, does this align currently with accreditation standards or does this go above what accreditation standards would be? Do you want me to take that Dr. Or Senator? Yeah.

Oh, yes, please. Okay. So this aligns, um, with accreditation standards in that we have an expectation of an emergency department having basic resuscitative equipment, however it goes above, and that we're making sure that there are specific pediatric components to protocols, guidelines, um, equipment lists that aren't always completely outlined within, um, standards. However, those standards are also changing. The American College of Emergency Physicians is also starting to incorporate pediatric readiness into their standards and are starting to verify emergency departments as being pediatric ready as well. And we're also working with Joint Commission to put in, um, accreditation standards. In addition, every trauma center that is verified by the American College of Surgeons has to incorporate these pediatric readiness standards into their system to be trauma verified.

And then last question, um, does this open the door for, for more administration as far as like creating a position? And sometimes I see in rural hospitals that, um, and this is just my observation, I am by no means speaking for anyone, but, um, sometimes administrative positions overtake the positions of hands-on care. So we take someone that's really good at hands-on care, we put 'em in administration. Now we have that person that's not really hands-on anymore. And, and there's a more of a cost to these hospitals because they create a position. I don't know many people that will add responsibilities without the idea of, you need to pay me more now. So so does this create some of that burden?

So we do not, there's no provision in here that says this has to be a paid position. Um, ideally we would love for hospitals to give a little FTE mostly to be, um, able to do what's called quality improvement, which is case review. That's a big component in making sure we're doing the very best for children. However, we don't specify that it has to be a paid position, just that there has to be that point of contact recognized so that we know who to go to, to reach out when we wanna share resources.

I completely agree with you, and I think that is a, um, an issue. But this, in, in most places when we've studied this position across the country, it's maybe like a 0.1 or 0.2 ft e. So that person is still majority working clinically rather than an administrative position. That's all. Thank you, Representative Monson.

That actually sparked a question for me actually. Do you feel like this is something that could then actually be absorbed by, say your education coordinator in your hospital or, or whatever, something where they just Yeah. They're just kind of absorbing that and adding in a little bit of the pediatric, um, specifications?

Absolutely. So a lot of, especially in some of our smaller hospitals, we know that people wear several hats. Oftentimes this role is shared by the trauma manager, or this is very similar to those of you who are, um, familiar with things like our STEMI or our stroke programs. Uh, the STEMI or stroke coordinator, um, can share this role. And, um, I agree. I I think when you're doing education, when you're teaching people about airway, you also make sure you teach about pediatric airway. And when you're looking at supplies, you make sure this is the person who makes sure that you have all those supplies. So it's feeding into the routine ER care. Just making sure we have a pediatric lens.

Thank you for that. It was, I, I agree. And I, and I share those same concerns as Representative Monson. We're not wanting to, to increase the administrative state anymore than we already have it.

Thank you. Uh, my name is Eric Meyer. I'm the director of the, uh, bureau of EMS for the State of Utah. And I just wanted to say, uh, thanks to all those who, uh, um, championed this bill. Um, for us, we oversee the EMSC program, um, and the, the Utah Pediatric Pediatric Trauma Network, uh, efforts. So, um, we are very grateful for this. And what this does for us is this allows us to complete work already in progress. Um, I like the word lens that was just used. And so this allows us to see those things that are happening so we can provide the, the right resources, we can adjust, uh, in motion, so to say, uh, as we get this. And so this is very valuable. So this is an effort already underway. Um, this allows us to capture the information and, uh, be better, uh, at medicine. So. Great. Thank you. Appreciate your comments.

Oh, thank you, Mrs. Chairman. Uh, I applaud, uh, Senator Plumb for bringing this forward is Nodal Laryngologist. Uh, this is really down our alley. And, uh, you know, you want the equipment to be available when you have the emergency, and it sounds like an easy thing to do. But there's, uh, multiple manufacturers, uh, there's changes that are constantly taking place. So there's turnover of these, uh, important elements of, uh, equipment that are required. And, uh, it takes a lot of coordination to, uh, have sets ready and sizes that are ready. Um, inner hospital relationship. 'cause some of these things are so expensive, sometimes you have to borrow equipment, uh, and to do that in an emergency, uh, situation, uh, everybody's really kind of hands on and willing to work, uh, with it. But it takes this coordination, but could go.

Hi, my name's Jennifer Stout again. Um, I'm with Voices for Utah Children, but I'm actually gonna be representing myself right now. Um, I just wanted to give kind of a real life scenario scenario so you can kind of get an idea, um, of how helpful this would be. Um, when I had my son four years ago, he, I had him at a hospital, um, and like Senator Plumb said, um, this isn't to shame hospitals, this is just to provide education. Um, but I had my son at a certain hospital in Salt, uh, in the Salt Lake Valley. And, um, when he was born, I kept noticing he was squeaking a lot, and it started to concern me. And I told the nurses and they kind of just laughed it off and said it was cute. Um, but my intuition told me something was wrong. Um, so he was with me for two days, and then I was right. I was about to get discharged, and the pediatric nurse came in and I said, Hey, listen, there is something wrong with my son. He keeps squeaking and nobody's listening to me. Um, can you please just figure out if something's wrong before we get discharged? And he listened to him and he decided to, um, check his oxygen while I fed him. And his oxygen was dropping really low every time I fed him. And, um, we almost got discharged. We almost went home. I almost went home with a baby that wasn't ready to go home. Um, he ended up staying at the NICU in this hospital for two weeks. During this two weeks, my son's condition worsened. Um, usually it's supposed to get better, and it was getting worse. And the hospital really just didn't know what was going on. Um, I had to beg for them to transfer me to Primary Children's, which they eventually did. Um, but like this bill says, if they would've had, um, the education, the resources, I wouldn't have had to watch my son suffer for two weeks. And, um, I'm grateful for Primary Children's, but I agree we should be keeping our standard up with other hospitals as well. Um, so thank you for letting me speak on that.

Thanks so much. I just wanted to add, you know, um, I thank you so much for everyone who just spoke up for how important this is. And truly, when we deal with a critically ill or injured child, you know, 90% of kids can be managed spectacularly anywhere. When you're dealing with a critically ill or injured child, that first hour to three hours is what's gonna determine life or death. And we know that if you don't have the right equipment, you don't have the protocol that manages seizures, the best way or traumatic brain injury, um, that's gonna, is gonna lead to outcome differences. We live in a very large rural state. We cannot have a pediatric surgeon in every hospital. We cannot have a pediatric anesthesiologist or ed doctor in every hospital. And so the ability of that hospital to stabilize and resuscitate that child is gonna make a difference on whether they live or die, no matter where they go. And so this is so important to give the hospitals the infrastructure in place to be able to stabilize, manage that child until we can get them to where they need to go on those critical cases. So thank you for considering this bill.

Thank you. And there is a substitute, right?

Thank you. Okay. Um, I would like to make a motion that we favorably recommend SB 1 27 Pediatric Care Amendments. All

Um, it just sounds like an excellent idea, and I think, um, I was already very persuaded, but then hearing from that mother who called in and I just, um, it sounds like it is needed and it would be. Um, and she, anyway, it sounds like a very good bill.

Well, um, I, I, I will waive most of it, but again, with gratitude for Eric showing up in a poo bear tie and, and the folks speaking, uh, as well to the support the bill, uh, I think I know in fact that every hospital in the state wants to do Best Buy Kids. And anything we can do to help them do that just feels that much better.

Uh, I'll waive. Thanks. All right.

There we go. Um, this is a bill that came together working with DPS, our EMS and EMSC, uh, folks from around the state in combination with the Utah Pediatric Trauma Network and ER readiness folks as well. And the goal with this bill is to codify what's essentially already happening across our state. And that is, is the attempt to provide the best care possible for our kids so that someone who happens to be injured or ill here in Salt Lake City, has the same level of pediatric readiness there for them when they get there, as they would in, uh, Vernal or they would in Cedar, or they would in any other sort of space where they're needed. This kind of all started as an effort by the people who care most about kids. So pediatricians, EMT, medics, those type of folks. In realizing when we look at the data that there's a 60% lower mortality risk to injured children if they're pediatric ready and there's a 76% lower mortality risk to ill children if the facility is ill or ready. It's been estimated that about 2,143 children's lives are saved every year just by having the right readiness. What does readiness mean? Well, it means you have the right mask to put oxygen through. It means you have the right endotracheal tubes in. If you have to in a, in a worst case scenario, intubate and breathe for someone, it means you have the right size IV catheters. It means that you're just ready for those truly terrifying scenarios. And I'll tell you, as someone for 20 plus years now who's taken calls from carrying docs around the state, there's almost nothing more horrifying to an emergency department team than when a really sick or injured child comes in. The stakes feel as high as they ever possibly could. So what's happening now is we have this pediatric trauma network that has helped set up education for our different ERs. Used to be back in the beginning of my pediatric ER career, nearly everything that was considered a trauma got shipped up to Salt Lake head injuries, belly injuries, orthopedics injuries, traumatic injuries of all sorts ended up in Salt Lake. And in time we realized that's probably not the smartest thing. When people are removed from their homes, that means missed days of work. That means lost money. That means the fears that go with having your child separated from you, that means ambulance transfer, life flight transfer costs. It would sure make a lot more sense to take all of these hospitals and all these clinicians around the state and make them as ready to care for those kids as anyone. So the pediatric trauma network came into being and they have worked now for years with all 49 of 49 hospitals around the state to help them feel ready to go to care for those kiddos and certainly to help them direct them where else they could be if it turns out to be above where their comfort zone is. Well, what this pediatric readiness bill is doing is now kind of expanding on that. So each of these hospitals, 49 hospitals has what we call apec. It's a pediatric emergency care coordinator. And they track, you know, what do you have, what needs do you have, what sort of supports do you have, where are things going well, where do you need more education? And now just add to that, looking at the readiness piece. So it, does it require anyone to have a, B, C-D-E-F-G pieces? No, it doesn't. It requires that there's someone there to help gather the data and identify if your facility needs more education and if it does, to dispatch that education to you. Uh, Senator Sandall have some questions for me and actually ask some great things that help me understand to think about it a little better. What if you have a free standing er? So one that's not associated with a big hospital? Well, we're not gonna expect, or the system that's set up by this, uh, UPTN and the PECC boy, we can get a lot of those in there, can't we? We're not gonna expect that they put someone everywhere. The main hospital or the main campus that has the satellite 24 hours, they could be put into that mix too, under the same umbrella. So my hope is with this bill, which has a $0 fiscal note because all of this education activity that's going on has been funded. It's going on through our EMS and EMSC program. Uh, I loved hearing the new director of EMS say this is good medicine. And that's really what this is. It's good medicine. With that, I'm open to any questions.

So I see the fiscal note is zero, but then it says that it appropriates 278,000 ongoing from the general fund within DPS. Um, can you help me understand Yes. How it re reallocates 278,000 with a $0 fiscal note? Yes.

Thank you Mr. President and I'm glad you brought that up. 'cause I had meant to clarify that the UPTN, Utah Pediatric Trauma Network has an ongoing appropriation and it's had an existence within Primary Children's, uh, the Utah Pediatric Trauma Network. And that made some other facilities, um, a little bit less than comfortable feeling like perhaps there was an association with one healthcare provider setting. And so what's happening, UPTN is coming out into its own not-for-profit space, not affiliated with any one hospital system or organization. And that money is just transferring over into that new not-for-profit, same people, but now truly separated.

Okay, so, uh, I wanna make sure I understand it. So this is money that's already going towards this or is it money that's going outta the general fund to a not-for-profit? So it's money that's going in Senator Palm. Sorry.

Uh, so it's money that's going to the Utah Pediatric Trauma Network. And since this bill was so adjacent to that and there had been requests from within the PRI rider networks around the state that it had a true independent identity, we put this piece in as well. So it's not that this funding is going to fund the pediatric readiness, it's that they work right there together and they were adjacent and germane enough that we put it in here.

Okay. Uh, so, and I I apologize for just making sure I have clarity. So this is not money that's already going to this. It is new money out of the general fund to a nonprofit that exists already using other funds. And this would be additional funds going to that nonprofit

Fund? No, these funds are, sorry, I keep jumping the gun on you, Mr. President. Sorry about that. These funds are already allocated to the UPTN through an appropriation process here, and the UPTN is just changing its identity to become a not-for-profit. So this was the clarity that those funds are going with them. They're not new funds, it's just a bit of a new identity for that UPTN.

Thank you Mr. President. Uh, sponsors yielded. So my question is, um, in one, if this is already an existing practice, uh, we're looking to codify it, uh, I'm very concerned that there are other thing, other entities out there that may be open 24 7, uh, that might be rolled into now an area that they did not have to provide, uh, a pediatric care, uh, coordinator in their system, and then that's gonna cause more to them. So I want to, I wanna first of all understand if, if there's security that we're not, that we don't have any other entities out there that would fall under this, uh, this bill file.

Senator Plumb? No, and I, I think that's an interesting question. When, when this, because Senator asked me about it, my mind started doing the gymnastics about who I may have heard from over the last 20 years that would be of open 24 7. And to my knowledge as well as to the folks I very quickly curbside consulted, which includes our EMS and EMSC directors, uh, for the statewide efforts. It is only in emergency department settings that are 24 hour facilities. Obviously hospitals are, but that provide emergency or urgent care. 24 hour facilities are only those labeled as emergency departments. Um, I'm also certainly willing to, uh, explore further if we are to get this past second reading and, and provide further granularity on that.

Thank you. Just, uh, no additional question Mr. President, but, uh, in following up with my line of thinking, I am concerned about whether we are, uh, somehow wrapping into, uh, existing practice now by codifying it and what benefit we get from that. If there will be somebody on the edge that somehow gets caught up into this net and, uh, and I'm just not sure that we need to codify this exact, this Existing Practice. Thank

As, as always, I do appreciate the additional levels of thinking that comes out when we talk about things on the floor. I, I really do feel like if there's anything I know about our healthcare providers and facilities around the state is that they want to do everything they can when it comes to caring for kids. And they're always so grateful for any of the options that are made available to them. And I really do, knowing, having watched this over the last decade or so, I know the commitment of the people who are educating as well. So if by chance we did uncover something, I would always be willing to come back and undo things that were unintentional. Appreciate the dialogue.

Uh, with that I would call the question please. Mr. Thank

Thank You. Um, I'd like

Thank you Mr. President. Uh, we discussed this bill yesterday and there had been some good questions about how we would be certain we weren't putting too much increased workload on our, uh, emergency departments and facilities. I was able to check in with the program folks as well as the EMS folks and they did not feel there would be an increased load, especially on our freestanding ERs that they could rely on what was already happening in their main programs. Uh, it is a, a very already funded program. It's supported by the Hospitals Association as well as by our EMS and DPS folks. And I feel really, really good about the fact that it will help us statewide take better care of kids. And with that, I'm open to any questions or would call the question. Thank you for the presentation again today.

Uh, thank you Mr. President. I'd call the question please.

Senator Vickers Baldy Aye. Lewin Aye. Brammer Bus Comore Aye. As Camilla Aye. Fillmore Aye. Grover Aye. Harper Aye. Hankins Aye. Ipson Aye. Johnson Aye. Quan McKay? Aye. Mikel Milner Musselman Owens pitcher Plum Aye. Rebi Aye. Sandal Stevenson Stratton Vickers Aye. Weiler Aye. Wilson Winterton Aye. Aye. President Adams Aye. Senate

Representative Hall. Thank you Mr. Speaker. So this bill would enact specific provisions to support pediatric care and readiness standards throughout the state by reinforcing core concepts of the National Pediatric Readiness Project. Um, this bill, um, would, sorry. Um, this bill is supported by the UHSA, the UHA and the DPS and EMS, and they will align with this process in place. The chil children are, are having unique health, sorry, I gotta read, I need my glasses. Children, children have unique health needs in emergencies and require specialized care. And we know that 80% of children who are ill or injured go to general hospitals, often the closest in their communities. And so we wanna make sure that those centers are, are adequately prepared for pediatric, um, injuries and pediatric evaluations. So in Utah, we are a rural state and it can sometimes take hours for children to get to a higher level of care. And so this will help make sure that those intermediate care places are equipped and ready for children's emergencies. National guidelines outline recommendations for being prepared for high quality care for children, also known as pediatric resi readiness. This bill will get us closer to that. Um, there is no fiscal cost to this as a fi, the fiscal transfer will be, is already allowed from appropriated funds to the UPTN, the newly transformed, the newly formed not-for-profit, not-for-profit version that is associated with no individual healthcare system. Um, this, this bill will help with getting our, our hospital systems and emergency rooms ready for pediatric, any pediatric emergencies that they may come in contact with. And, um, it will be a good, uh, a good thing for them. And I'd appreciate your vote. Thank you.

Oh, thank you, Mr. Speaker. Uh, as a ear, nose and throat surgeon, uh, we deal with these, uh, problems all the time. And often the, the issue is, uh, equipment changes the sizes, uh, mean everything. And, and sometimes you just don't have the right equipment available. This gets magnified when you're in an emergency and you have to adapt. What this bill will do is provide a system of coordination among the various, uh, hospitals and departments of a hospital to, uh, respond to these emergencies with the best equipment available. This is, uh, something that we, uh, direly need in our system, and it's really no fault of any particular hospital system. It's just, uh, the means of, um, having the right material available at the time of the emergency. But, uh, I'm planning on supporting this bill. Thank you, Mr. Speaker.

Thank you, Mr. Speaker. This, this does address the unique needs of children in, in trauma, and I'd appreciate your vote. Thank you.