Budget Amendment ID: FY2018-S3-562-R1
Redraft EHS 562
Preventing Death and Disability From Stroke
Messrs. Montigny, Rush and Moore, Ms. Gobi, Ms. O'Connor Ives and Mr. O'Connor moved that the proposed new text be amended in section 2, by inserting after item 4513-1111 the following new item:-
“4513-1121 For a statewide STOP stroke program; provided, that funds shall be expended for stroke treatment and ongoing prevention services; provided further, that the department of public health shall 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 funds 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 funds shall be expended to oversee the operation and administration of designated primary stroke service hospital programs, established by 105 CMR 130.1400; provided further, that such 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 staff who may be responsible for ensuring compliance with primary stroke service designation criteria and/or for data analysis……………………………………………………………………………… $630,000.”
and by inserting after section___the following new section:-
“SECTION X. Chapter 111 of the General laws, as appearing in the 2014 Official Edition, is hereby amended by inserting after Section 51J the following 3 sections:-
Section 51K. Designation of acute stroke ready hospitals, primary stroke centers and comprehensive stroke centers.
The department shall designate hospitals that meet the criteria set forth in this Act as an acute stroke ready hospital, primary stroke center or comprehensive stroke center.
A hospital shall apply to the department for designation provided the hospital has been certified by The Joint Commission, American Heart Association or other department-approved, nationally recognized certifying body as an acute stroke ready hospital, primary stroke center or comprehensive stroke center.
Until the adoption of rules and regulations authorized by this subsection, the department shall designate primary stroke service hospitals as acute stroke ready hospitals capable of providing care previously denoted in regulations as primary stroke service care. The department shall promulgate such rules and regulations within 180 days of passage of this Act.
Until the department begins the designation of all three tiers of stroke facilities, hospitals may maintain primary stroke service designation utilizing the existing processes and criteria for a 6-month period. Primary stroke service hospitals at the time that the department begins the designation process shall be recognized as acute stroke-ready hospitals. After that time, all primary stroke service hospitals will be considered acute stroke-ready hospitals, regardless of additional capacity, until they apply for and receive a higher designation of primary stroke center or comprehensive stroke center.
Section 51L. Emergency medical services providers; assessment and transportation of stroke patients to designated stroke center.
All regional EMS councils, as defined in section 1 of chapter 111C, shall establish pre-hospital care protocols related to the assessment, treatment, transport and rerouting of stroke patients by licensed emergency medical services providers in this state to acute stroke ready hospitals, primary stroke centers and comprehensive stroke centers facilities. Such protocols shall include plans for the triage and transport of suspected stroke patients, including, but not limited to, those who may have an emergent large vessel occlusion, to an appropriate facility, within a specified timeframe of onset of symptoms and additional criteria to determine which level of care is the most appropriate destination. EMS authorities will base their protocols on national recognized guidelines for transport of acute stroke patients. Such protocols will also consider the capability of an emergency receiving facility to improve outcomes for those patients suspected, based on clinical severity, of having an emergent large vessel occlusion. The department shall promulgate regulations to address protocols within 180 days of passage of this Act.
The department shall make available the list of designated stroke centers, including the identification of hospitals with continuous neurointerventional coverage, to the medical director of each licensed emergency medical services provider; shall maintain a copy of the list in the office designated within the department to oversee emergency medical services; and shall post a list of all designated stroke centers and the level of care to the department website. The department shall update the list of designated stroke centers at least annually.
Section 51M Continuous improvement of quality of care for stroke patients.
The department shall maintain a data oversight process which shall include:
(a) A Massachusetts stroke registry database that compiles information and statistics on stroke care which align with nationally recognized stroke measures.
(b) Hospitals designated by the department as acute stroke ready hospitals, primary stroke centers or comprehensive stroke centers shall utilize a nationally recognized data platform to collect the stroke data set which is required by the state and by the acute stroke ready hospitals, primary stroke centers or comprehensive stroke centers designating body.
(c) These data elements will be collected via the data registry platform and transmitted to the State for inclusion in the Massachusetts stroke registry.
(d) The department will convene a group of experts with input from key stroke stakeholders and professional societies, including, but not limited to, a representative from the American Stroke Association, the Massachusetts Neurologic Association, Society of Neurointerventional Surgery, Massachusetts Council of Community Hospitals, and Massachusetts College of Emergency Physicians, to form a state stroke advisory taskforce that will assist with data oversight, program management and advice regarding the stroke system of care. This task force will meet at least quarterly to review data and provide advice.”