Budget Amendment ID: FY2016-S3-924-R1

Redraft EHS 924

Stroke Prevention and Awareness

Mr. Montigny and Ms. Gobi moved that the proposed new text be amended in section 2, in item 4513-1121, by adding the following words:- "; provided further, that the department of public health shall expend not less than $200,000 to provide educational programming as part of the F.A.S.T campaign on the signs and symptoms of stroke and stroke warning signs with a focus on communities that have the highest incidence of stroke, which shall not be used for personnel costs; provided further, that the department of public health shall provide quality improvement measures, that align with the stroke consensus metrics by utilizing a nationally recognized data set platform, and expand the statewide registry that compiles information and statistics on stroke care using confidentiality standards not less secure than a nationally recognized data set platform, known as the stroke registry data platform; provided further, that the department shall expend not less than $200,000 to require all primary stroke service hospitals and emergency medical services agencies to report data consistent with nationally recognized guidelines on the treatment of individuals with confirmed stroke in the commonwealth; provided further, that not less than $100,000 shall be expended to oversee the operation and administration of designated primary stroke service hospital programs, established by 105 CMR 130.1400; and provided further, that said funds shall be used to collect and analyze data from designated primary stroke service hospitals in the commonwealth and for the salary of a full-time surveyor who shall be primarily responsible for ensuring compliance with primary stroke service designation criteria”; and

by inserting after section 104 the following section:-

"SECTION 104A. (a) Notwithstanding any general or special law to the contrary, the department of public health shall establish guidelines for establishing a statewide stroke system of care and shall develop a program of accreditation that shall designate  tiered stroke centers of care that include acute ready, primary stroke centers and comprehensive stroke center .The department shall incorporate any existing hospital stroke designations that are nationally recognized including but not limited to the Joint Commission, American Heart Association and department of public health to reduce duplicative accreditation requirements. The department may suspend or revoke a hospital’s designation, after notice and a hearing, if the department of public health determines that the hospital is not in compliance with the requirements of this section. The department shall promulgate regulations to implement the program by June 30, 2016.

(b) The office of emergency medical services shall establish pre-hospital care protocols related to the assessment, treatment and transport of stroke patients by licensed emergency medical services providers. The protocols shall include, but not be limited to, plans based on a specified time frame upon the onset of symptoms for the triage and transport of stroke patients to the closest and most appropriate stroke center of care. The office shall also provide training and outreach to emergency medical service providers on these pre-hospital care protocols and also provide technical assistance on the implementation of these protocols.

(c) The department shall convene an advisory board to provide recommendations to the department when developing regulations under subsection (a) and pre-hospital care protocols under subsection (b). In making its recommendations the board shall consider: (i) current stroke data; (ii) stroke systems of care; (iii) medical best practices; (iv) point of entry protocols; (v) current stroke guidelines; (vi) existing stroke system accreditation programs that may be accepted by the department to meet the department’s established tier designations or criteria; and (vii) any relevant information needed by the board to make its recommendations.

The board shall consist of 11 members appointed by the commissioner of public health: 2 directors of regional emergency medical services councils or their designees; a representative from the American Heart Association, Inc.; the president of the Massachusetts Hospital Association, Inc. or a designee; the president of the Massachusetts Council of Community Hospitals, Inc. or a designee; a representative of the Massachusetts Ambulance Association, Incorporated; the president of the Professional Fire Fighters of Massachusetts or a designee; the president of the Massachusetts College of Emergency Physicians, Inc. or a designee; a representative of the Massachusetts Neurological Association.; the president of the Massachusetts Medical Society or a designee; and a patient advocate. Appointees shall serve without compensation. The board shall make preliminary recommendations to the commissioner of public health not later than December 14, 2015. The board shall provide ongoing advisory support as determined necessary by the commissioner."