Finding a Way through the Hospital Door: The Role of EMTALA in Public Health Emergencies

Abstract

This article examines the Emergency Medical Treatment and Labor Act (EMTALA) in a public health emergency context. Congress enacted EMTALA in 1986 to prohibit the practice of “patient clumping,” which involved hospitals’ refusal to undertake emergency screening and stabilization services for individual patients who sought emergency room care, typically because of insurance status, inability to pay, or other grounds unrelated to the patient’s need for the services or the hospital’s ability to provide them. But in fact EMTALA, whose conceptual roots can be found in the Hospital Survey and Construction Act of 1946 (Hill Burton) as well as an evolution in both the common law and state statutes related to hospital licensure, can be viewed as having a far broader purpose than protection of individuals, and indeed, one that is related to the protection of communities and the public health.

How Low-Income Residents Decide Between Emergency and Primary Health Care for Non-Urgent Treatment

“…Federal law prohibits EDs from denying medical treatment to anyone with an emergency medical condition or requiring payment before someone is treated for a medical emergency. Hence, for residents without transportation or money, EDs will remain the most viable option for medical care regardless of how much they understand about emergencies and=or what negative attitudes they harbor about using EDs (Rosenbaum & Kamoie, 2003). This reality highlights a limitation in the KAP diagnostic approach.…”

Developing emergency care systems: a human rights-based approach

“…All governments should therefore create legislation that guarantees access to emergency care services for all people regardless of race, ethnicity, religion, citizenship status or ability to pay. For example, the constitutions of South Africa (Article 27) 31 and Kenya (Article 43) 32 guarantee that no one may be refused emergency medical treatment, while legislation in the United States of America (Emergency Medical Treatment and Active Labour Act) 33 mandates that anybody who presents to an emergency department for care must be screened and stabilized before requesting payment.…”

Shaping Built Environment of Mental Health Hospitals

“…Bardzo istotne jest tym samym wprowadzenie do procesu projektowego zasad, których bazę stanowi Way Finding [37]. Niewielki stopień skomplikowania przestrzeni oddziału znacząco ułatwia zarówno odnalezienie się pacjentów w nowym otoczeniu, jak i zapamiętywanie lokalizacji pomieszczeń.…”

“…What is important is to introduce the Way Finding [37] rules to the design process. Lack of complexity of the ward space significantly facilitates patients' orientation in new space, as well as their memory of the location of particular rooms.…”