Budget Amendment ID: FY2017-S4-631-R1
Redraft EHS 631
Stroke Awareness and Treatment
Messrs. Montigny, Moore, Ross, Lewis and O'Connor and Ms. Lovely moved that the proposed new text be amended in section 2, in item 4513-1121, <w:p><w:r><w:t xml:space="preserve">by striking out the figure “$400,000” and inserting in place thereof the following figure:- “$630,000”; and
by inserting after section 35 the following section:-
“SECTION 35A. Chapter 111 of the General Laws is hereby amended by inserting after section 51J the following 3 sections:-
Section 51K. The department shall identify the hospitals that meet the criteria established in this section to be designated as a comprehensive stroke center, a primary stroke center or an acute stroke capable center. A hospital shall apply to the department for a designation and shall demonstrate to the satisfaction of the department that the hospital meets the applicable criteria for that designation.
The department may recognize as a primary stroke center an accredited acute care hospital that applies for the designation and is certified as a primary stroke center by the American Heart Association, Inc., the Joint Commission on Accreditation of Hospitals or another nationally recognized organization that provides primary stroke center certification for stroke care; provided, however, that the applicant shall maintain its certification.
The department may recognize as a comprehensive stroke center an accredited comprehensive stroke center that applies for the designation and is certified by the American Heart Association, Inc., the Joint Commission on Accreditation of Hospitals or another nationally recognized organization that provides comprehensive stroke center certification for stroke care; provided, however, that the applicant shall continue to maintain its certification.
The department may recognize as an acute stroke capable center an accredited acute stroke capable center that applies for the designation and is certified by the American Heart Association, Inc., the Joint Commission on Accreditation of Hospitals or another nationally recognized organization that provides comprehensive stroke center certification for stroke care; provided, however, that the applicant shall continue to maintain its certification.
Comprehensive stroke centers and primary stroke centers are encouraged to coordinate through agreement with acute stroke capable centers in the commonwealth in order to provide appropriate access to care for acute stroke patients. The coordinating stroke care agreements shall be in writing and include, but not be limited to:
(i) transfer agreements for the transport and acceptance of stroke patients seen by the acute stroke capable center for stroke treatment therapies that the remote treatment stroke center is not capable of providing; and
(ii) communication criteria and protocols with the acute stroke capable centers.
The department may suspend or revoke a hospital's designation as a comprehensive stroke center, primary stroke center or acute stroke capable center after notice and a hearing if the department determines that the hospital is not in compliance with the requirements of this section.
Section 51L. Emergency medical service authorities 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 plans for the triage and transport of acute stroke patients to the closest comprehensive stroke center, primary stroke center or, when appropriate, to an acute stroke capable center, within a specified timeframe of the onset of symptoms.
The department shall: (A) send the list of comprehensive stroke centers, primary stroke centers and acute stroke capable centers to the medical director of each licensed emergency medical services provider in the commonwealth; (B) maintain a copy of the list in the office designated with the department to oversee emergency medical services; and (C) post a list of stroke centers to the department’s website not later than June 1 of each year.
The department shall adopt and distribute a nationally recognized standardized stroke triage assessment tool. The department shall post this stroke assessment tool on its website and provide a copy of the assessment tool to each licensed emergency medical services provider not later than July 1, 2017. A licensed emergency medical services provider shall use a stroke-triage assessment tool that is substantially similar to the sample stroke-triage assessment tool provided by the department.
The department 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 plans for the triage and transport of an acute stroke patient to the closest comprehensive stroke center, primary stroke center or, when appropriate, to an acute stroke capable center, within a specified timeframe of the onset of symptoms.
The department shall establish, as part of current training requirements, protocols to assure that licensed emergency medical services providers and 911 dispatch personnel receive regular training on the assessment and treatment of a stroke patient.
Section 51M. The department shall establish and implement a plan for achieving continuous quality improvement in the quality of care provided under the statewide system for stroke response and treatment. In implementing this plan, the department shall:
(i) maintain a centralized, statewide stroke database that collects, at a minimum, the 10 stroke consensus metrics developed and approved by the American Heart Association, Inc. and American Stroke Association, the Centers for Disease Control and Prevention and the Joint Commission on Accreditation of Hospitals. The department shall utilize “Get with the Guidelines – Stroke” or another nationally recognized data set platform with confidentiality standards that are as secure as the stroke registry data platform. The department shall coordinate, to the extent possible, with national voluntary health organizations that are involved in stroke quality improvement in order to avoid duplication and redundancy;
(ii) require comprehensive stroke centers, primary stroke centers, acute stroke capable centers and emergency medical services agencies to report data consistent with nationally recognized guidelines on the treatment of individuals with confirmed stroke ;
(iii) encourage the sharing of information and data on the ways to improve the quality of care for stroke patients among health care providers;
(iv) facilitate the communication and analysis of health information and data among health care professionals that are providing care for individuals with stroke;
(v) require the application of evidenced-based treatment guidelines regarding the transitioning of patients to community-based follow-up care in hospital outpatient, physician office and ambulatory clinic settings for ongoing care after hospital discharge following acute treatment for stroke; and
(vi) (A) establish a data oversight process and implement a plan for achieving continuous quality improvement in the quality of care provided under the statewide system for stroke response and treatment that shall:
(1) analyze data generated by the registry on stroke response and treatment;
(2) identify potential interventions to improve stroke care in geographic areas or regions of the commonwealth; and
(3) provide recommendations to the department and the general court for the improvement of stroke care and delivery; and
(B) the data reported under clause (A) shall be made available to the department and to any other government agency or a contractor of a government agency that has responsibility for the management and administration of emergency medical services.”; and
by inserting after section 77 the following section:-
“SECTION 77A. An emergency medical services provider shall comply with section 51L of chapter 111 of the General Laws by not later than July 1, 2018.”.