Hospital Corp. of Northwest, Inc. v. Arizona Department of Health Services

988 P.2d 168, 195 Ariz. 383, 295 Ariz. Adv. Rep. 17, 1999 Ariz. App. LEXIS 78
CourtCourt of Appeals of Arizona
DecidedMay 11, 1999
DocketNo. 1 CA-CV 98-0277
StatusPublished
Cited by8 cases

This text of 988 P.2d 168 (Hospital Corp. of Northwest, Inc. v. Arizona Department of Health Services) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Hospital Corp. of Northwest, Inc. v. Arizona Department of Health Services, 988 P.2d 168, 195 Ariz. 383, 295 Ariz. Adv. Rep. 17, 1999 Ariz. App. LEXIS 78 (Ark. Ct. App. 1999).

Opinion

OPINION

WEISBERG, Judge.

¶ 1 Disagreeing with the Arizona Department of Health Services’ (DHS) interpretation of the scope of practice for paramedics, Hospital Corporation of Northwest, Inc. (Northwest) appeals from the trial court’s grant of summary judgment to DHS. We affirm.

FACTUAL AND PROCEDURAL BACKGROUND

¶2 Northwest allowed DHS-certified paramedics, while under the supervision of physicians, to administer some medications to emergency room patients. The medications included aspirin, Tylenol, Mylanta, and ibuprofen, which, Northwest admits, paramedics are not allowed to dispense in the field.

¶ 3 Upon DHS’s request, Northwest ceased the disputed practice. Northwest then filed a declaratory judgment action seeking the interpretation of the authorized scope of practice of DHS-certified paramedics while working in hospital emergency rooms under the supervision of physicians. DHS sought summary judgment, contending that the scope of a paramedic’s practice is prescribed by statute and regulation, neither of which allows paramedics to administer these medications in a hospital. Northwest responded that the relevant statutes and regulations apply only to paramedics in the field but not to those who work inside a hospital under physician supervision. The trial court granted DHS summary judgment, from which Northwest timely appealed. We have jurisdiction pursuant to Arizona Revised Statutes Annotated (A.R.S.) section 12-2101(B).

DISCUSSION

¶ 4 Statutory interpretation involves questions of law, which we review de novo. State Compensation Fund v. Superior Court (EnerGCorp, Inc.), 190 Ariz. 371, 374-75, 948 P.2d 499, 502-03 (App.1997). A statute’s language may be the best indicator of its intent, and if we find no clearly expressed legislative intent to the contrary, the language is conclusive. State ex rel. Corbin v. Pickrell, 136 Ariz. 589, 594, 667 P.2d 1304, 1309 (1983). But if the words fail to reveal the legislature’s intent, and the legislative history is unclear, we will consider the entire statutory scheme, its subject matter, consequences, purpose, and spirit so as to give the statute a fair and sensible meaning. Stuart v. Insurance Co. of N. Am., 152 Ariz. 78, 81, 730 P.2d 255, 258 (App.1986). Here, the legislature has adequately expressed itself.

¶ 5 Northwest argues that the statutory scheme reflected by A.R.S. sections 36-2201 et seq. manifests an intent to regulate paramedics in the field but not in a hospital setting. DHS responds that nothing in the statutes indicates a legislative intent to regulate paramedics in the field only. We agree with DHS.

¶ 6 There are numerous statutory and regulatory references to paramedics working in the field, but these do not demonstrate a legislative intent to exempt paramedics working in a hospital from regulation. See City of Phoenix v. Donofrio, 99 Ariz. 130, 133, 407 [385]*385P.2d 91, 93 (1965) (court will not read into statute something not clearly within the intent as gathered from the statute). Rather, the extensive regulation of pre-hospital activities naturally reflects the reality that most of the work by paramedics is in response to emergencies in the field; thus, most of the statutes and regulations relate to those activities and conditions.

¶ 7 Northwest, however, contends that the administrative regulations, particularly Arizona Administrative Code (A.A.C.) R9-25-608, when read with other provisions governing emergency medical services, manifest the intent to govern paramedics only as they render pre-hospital services in the field. Northwest therefore concludes that paramedics under physician supervision in a hospital should not be limited to providing only those services that are authorized in the field. We disagree.

¶ 8 To begin, A.A.C. R9-25-6081 empowers a paramedic to provide only those types of treatment or medications set forth in the Arizona Advanced Life Support Curricula; and the Curricula does not authorize paramedics to administer the subject drugs either in the field or in the hospital. This rule, therefore, does not advance Northwest’s position.

119 Next, A.A.C. R9-13-402 allows that paramedics may “upon order of the medical control authority, do any of the following: ... [ajdminister medications as determined by the Department.” R9-13-402(B)(4) (September 30, 1994)(emphasis added).2 But no order has been issued by DHS, or even requested by Northwest, that would allow paramedics to administer the subject drugs to patients at any location.

¶ 10 Moreover, the statutory scheme found in Chapter 21.1 is broadly titled, “Emergency Medical Services.” In A.R.S. section 36-2217 (1995), the legislature created exemptions from regulation for certain persons, vehicles, and equipment; but none of these exemptions pertains to paramedics working in hospital emergency rooms. The statutes define “[ejmergency medical services” as “those services required following an accident or an emergency medical situation ... [f]or on-site emergency medical care” and “[i]n the use of emergency receiving facilities.” A.R.S. § 36-2201(ll)(a), (d) (1995). An emergency receiving facility is “a licensed health care institution that offers emergency medical services, is staffed twenty-four hours a day and has a physician on cafi.” A.R.S. §-36-2201(13) (1995). Thus, the legislature evidenced its intent to regulate emergency medical care whether rendered at an accident site or in an emergency receiving facility such as a hospital emergency room.

¶ 11 In other provisions, the legislature has empowered the director of DHS to adopt “standards and criteria for the ... certification ... of emergency medical technicians and ambulance attendants.” A.R.S. § 36-2202(A)(2) (1995). The director must set standards governing “the quality of emergency care,” A.R.S. § 36-2202(A)(3) (1995), and must develop testing procedures and adopt standardized training and medical standards for the certification of all classes of emergency medical technicians. A.R.S. § 36-2204(2), (1), (3) (1995). Also, the director must “establish protocols[3] ... governing the medical treatments, ... medications and techniques which may be administered or performed by each class of emergency medical technician.” A.R.S. § 36-2205 (1995) (emphasis added).

¶ 12 DHS argues that the plain and unambiguous language of these statutes grants it the authority to regulate paramedics’ activities wherever they are performed and that no rules of construction are needed to interpret them. We agree.

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Bluebook (online)
988 P.2d 168, 195 Ariz. 383, 295 Ariz. Adv. Rep. 17, 1999 Ariz. App. LEXIS 78, Counsel Stack Legal Research, https://law.counselstack.com/opinion/hospital-corp-of-northwest-inc-v-arizona-department-of-health-services-arizctapp-1999.