Budget Amendment ID: FY2021-S4-297

EHS 297

Preventing Death and Disability from Stroke

Messrs. Montigny, Feeney, Timilty, O'Connor, Eldridge and Moore moved that the proposed new text be amended by inserting after section XX the following section:-

“SECTION XX. Said chapter 111 is hereby further amended by inserting after section 51K the following section:-

Section 51L. (a) The department and regional emergency medical services councils shall annually review and update, if appropriate, their pre-hospital care protocols and point-of-entry plans to ensure stroke patients are transported to the most appropriate facility in accordance with this section.

(b) The department shall make available the list of designated stroke facilities on its website and to the medical director of each licensed emergency medical services provider. The department shall maintain the list in the office designated within the department to oversee emergency medical services and update the list not less than annually.

(c) The department shall convene a group of experts including, but not limited to, a representative from the American Stroke Association, a representative from The Massachusetts Neurologic Association, Inc., a representative from the Society of Neurointerventional Surgery, a representative from Massachusetts College of Emergency Physicians, Inc. and a representative of a regional EMS council, as defined in section 1 of chapter 111C, with input from key stroke stakeholders and professional societies, to form a stroke advisory taskforce that shall assist with data oversight, program management and advice regarding the stroke system of care. The task force shall meet not less than biannually to review data and provide advice.”; and

by inserting after section XX the following section:-

“SECTION XX. Notwithstanding any general or special law to the contrary and not later than 180 days after the effective date of this act, the department of public health shall promulgate regulations that create: (i) a statewide standard pre-hospital care protocol related to the assessment, treatment and transport of stroke patients by emergency medical services providers to a hospital designated by the department to care for stroke patients; provided, however, that the protocol shall be based on national evidence-based guidelines for transport of stroke patients, consider crossing state lines and 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 following the onset of symptoms and additional criteria to determine which level of care is the most appropriate destination; (ii) statewide criteria for designating hospitals in a tiered system, featuring advanced designations in addition to primary stroke services, to treat stroke patients based on patient acuity; provided, however, that the tiers shall be based on criteria from at least 1 nationally-recognized program and shall not permit self-designation; provided further, that in developing such criteria, the department shall consider: (a) designation models and criteria developed by the Joint Commission, DNV GL Healthcare or another national certifying body recognized by the federal Centers for Medicare and Medicaid Services; (b) designation models and criteria adopted by other states and the differences in geography and health care resources of such other states; (c) the clinical and operational capability of a facility to provide stroke services, including emergency and ancillary stroke services; (d) limiting the routing of stroke patients to thrombectomy-capable facilities whenever a comprehensive stroke center is within a recommended timeframe to maximize technical competency and patient outcomes; and (e) procedures to suspend or revoke a facility’s designation if the department determines the facility is not in compliance with designation requirements and procedures to notify emergency medical services providers of any such suspension or revocation; and (iii) recommended national evidence-based quality and utilization metrics for stroke care for use by the center for health information and analysis pursuant to section 14 of chapter 12C of the General Laws; provided, however, that the department shall consider measures in current use in national quality improvement programs including, but not limited to, the federal Centers for Medicare and Medicaid Services, the National Quality Forum, the Paul Coverdell National Acute Stroke Program or other nationally-recognized data platforms.”.