Senate File 457 - Introduced
SENATE FILE
BY COMMITTEE ON HUMAN
RESOURCES
(SUCCESSOR TO SSB
1147)
A BILL FOR
1 An Act relating to stroke care quality improvement.
2 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
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PAG LIN
1 1 Section 1. NEW SECTION. 147A.30 Definitions.
1 2 As used in this subchapter, unless the context otherwise
1 3 requires:
1 4 1. "Department" means the department of public health.
1 5 2. "Emergency medical services" or "EMS" means as defined
1 6 in section 147A.1.
1 7 3. "Emergency medical services medical director" means as
1 8 defined in section 147A.1.
1 9 Sec. 2. NEW SECTION. 147A.31 Designations == level of care
1 10 relating to stroke.
1 11 1. The department shall recognize accreditation by the
1 12 American heart association, the joint commission on the
1 13 accreditation of health care organizations, or other nationally
1 14 recognized organization that provides such accreditation, for
1 15 certification of a hospital as a comprehensive stroke center,
1 16 a primary stroke center, or an acute stroke=ready hospital,
1 17 as applicable, if the hospital is in good standing with and
1 18 maintains certification through such national organization.
1 19 2. The department may suspend or revoke a hospital's
1 20 certification as a comprehensive stroke center, primary stroke
1 21 center, or acute stroke=ready hospital, after notice and
1 22 hearing, if the department determines that the hospital is not
1 23 in compliance with the requirements of this section or the
1 24 rules adopted under this section.
1 25 3. Comprehensive stroke centers and primary stroke centers
1 26 are encouraged to coordinate efforts, through coordinated
1 27 stroke care agreements with acute stroke=ready hospitals
1 28 throughout the state, to provide appropriate access to care for
1 29 acute stroke patients. The coordinating stroke care agreement
1 30 shall be in writing and shall include, at a minimum, all of the
1 31 following:
1 32 a. Transfer agreements for the transport of a stroke patient
1 33 from an acute stroke=ready hospital to a comprehensive stroke
1 34 center or primary stroke center for the purpose of stroke
1 35 treatment therapies which the acute stroke=ready hospital is
2 1 not capable of providing.
2 2 b. Communication criteria and protocols with the acute
2 3 stroke=ready hospital.
2 4 Sec. 3. NEW SECTION. 147A.32 Stroke triage assessment.
2 5 1. By January 15, annually, the department shall forward the
2 6 current list of the designated comprehensive stroke centers,
2 7 primary stroke centers, and acute stroke=ready hospitals,
2 8 to the medical director of each licensed emergency medical
2 9 services provider in the state. The department shall maintain
2 10 a copy of the list in the bureau of emergency and trauma
2 11 services within the department and shall post the list on the
2 12 department's internet site.
2 13 2. The department shall specify by rules adopted pursuant to
2 14 chapter 17A a nationally recognized standardized sample stroke
2 15 triage assessment tool. The department shall distribute the
2 16 sample stroke triage assessment tool to each licensed emergency
2 17 medical services provider and shall post the tool on the
2 18 department's internet site. Each licensed emergency medical
2 19 services provider shall use the sample stroke triage assessment
2 20 tool adopted by rules of the department or, alternatively, a
2 21 stroke triage assessment tool that is substantially similar to
2 22 the sample stroke triage assessment tool as part of the state
2 23 stroke triage process.
2 24 3. All licensed emergency medical services providers in the
2 25 state shall establish prehospital care protocols related to
2 26 the assessment, treatment, and transport of stroke patients by
2 27 licensed emergency medical services providers. Such protocols
2 28 shall include the development and implementation of plans
2 29 for the triage and transport of acute stroke patients to the
2 30 closest comprehensive stroke center, primary stroke center, or,
2 31 when appropriate, to an acute stroke=ready hospital, within a
2 32 specified time relative to the onset of a patient's symptoms.
2 33 4. All licensed emergency medical services providers
2 34 in the state shall establish, as part of current training
2 35 requirements, protocols to assure that licensed emergency
3 1 medical services providers and 911 dispatch personnel receive
3 2 regular training on the assessment and treatment of stroke
3 3 patients.
3 4 5. All data reported under this section shall be made
3 5 available to the department and to any other agency that
3 6 has responsibility for the management and administration of
3 7 emergency medical services throughout the state.
3 8 6. This section shall not be construed to require disclosure
3 9 of any confidential information or other data in violation of
3 10 the federal Health Insurance Portability and Accountability Act
3 11 of 1996, Pub. L. No. 104=191.
3 12 Sec. 4. NEW SECTION. 147A.33 Continuous quality improvement
3 13 for persons with stroke.
3 14 1. The department shall establish and implement a plan for
3 15 achieving continuous quality improvement in the care provided
3 16 under a statewide system for stroke response and treatment.
3 17 In implementing the plan, the department shall do all of the
3 18 following:
3 19 a. Maintain a statewide stroke database that compiles
3 20 information and statistics on stroke care that align with
3 21 the stroke consensus metrics developed and approved by the
3 22 American heart association and the American stroke association.
3 23 The department shall utilize the "get with the guidelines =
3 24 stroke" or another nationally recognized data set platform with
3 25 confidentiality standards no less secure than those utilized
3 26 by the department for the statewide stroke database. To the
3 27 extent possible, the department shall coordinate with national
3 28 voluntary health organizations involved in stroke quality
3 29 improvement to avoid duplication and redundancy.
3 30 b. Require comprehensive stroke centers and primary
3 31 stroke centers and encourage acute stroke=ready hospitals and
3 32 emergency medical services providers to report data consistent
3 33 with nationally recognized guidelines on the treatment of
3 34 individuals with confirmed stroke within the state.
3 35 2. All data reported under this section shall be made
4 1 available to the department and to any other agencies that
4 2 have responsibility for the management and administration of
4 3 emergency medical services throughout the state.
4 4 3. Beginning September 1, 2017, and by each September 1,
4 5 thereafter, the department shall provide a summary report of
4 6 the data collected under this section to the governor and the
4 7 general assembly summarizing the progress made in improving
4 8 quality of care and patient outcomes for individuals with
4 9 stroke. All data shall be reported in the aggregate form and
4 10 shall be posted on the department's internet site.
4 11 EXPLANATION
4 12 The inclusion of this explanation does not constitute agreement with
4 13 the explanation's substance by the members of the general assembly.
4 14 This bill relates to stroke care quality improvement.
4 15 The bill provides for recognition by the department of
4 16 public health of accreditation by nationally recognized
4 17 organizations that provide accreditation, for certification of
4 18 a hospital as a comprehensive stroke center, a primary stroke
4 19 center, or an acute stroke=ready hospital, as applicable,
4 20 if the hospital is in good standing with and maintains
4 21 certification through such national organization.
4 22 The bill provides for suspension or revocation of a
4 23 hospital's certification as a comprehensive stroke center,
4 24 primary stroke center, or acute stroke=ready hospital, after
4 25 notice and hearing, if the department determines that the
4 26 hospital is not in compliance with the requirements of the bill
4 27 or the rules adopted under the bill.
4 28 The bill encourages comprehensive stroke centers and primary
4 29 stroke centers to coordinate efforts, through coordinated
4 30 stroke care agreements, with acute stroke=ready hospitals
4 31 throughout the state, to provide appropriate access to care
4 32 for acute stroke patients. The coordinating stroke care
4 33 agreement shall be in writing and shall include, at a minimum,
4 34 transfer agreements between acute stroke=ready hospitals
4 35 and comprehensive stroke centers or primary stroke centers
5 1 and communication criteria and protocols with the acute
5 2 stroke=ready hospital.
5 3 The bill requires that by January 15, annually, DPH shall
5 4 forward the current list of the designated comprehensive
5 5 stroke centers, primary stroke centers, and acute stroke=ready
5 6 hospitals, to the medical director of each licensed emergency
5 7 medical services provider in the state, maintain a copy of the
5 8 list, and post the list on the department's internet site.
5 9 The department shall specify by rule a nationally recognized
5 10 standardized sample stroke triage assessment tool, distribute
5 11 the tool to each licensed emergency medical services provider
5 12 and post the tool on the department's internet site. Each
5 13 licensed emergency medical services provider shall use the
5 14 sample tool or, alternatively, a stroke triage assessment tool
5 15 that is substantially similar to the sample tool as part of the
5 16 state stroke triage process.
5 17 The bill requires all licensed emergency medical services
5 18 providers in the state to establish prehospital care protocols
5 19 related to the assessment, treatment, and transport of stroke
5 20 patients.
5 21 All licensed emergency medical services providers are
5 22 also required to establish, as part of current training
5 23 requirements, protocols to assure that licensed emergency
5 24 medical services providers and 911 dispatch personnel receive
5 25 regular training on the assessment and treatment of stroke
5 26 patients.
5 27 The bill requires DPH to establish and implement a plan
5 28 for achieving continuous quality improvement in the care
5 29 provided under a statewide system for stroke response and
5 30 treatment. In implementing the plan, the department shall:
5 31 maintain a statewide stroke database that compiles information
5 32 and statistics on stroke care; and require comprehensive
5 33 stroke centers and primary stroke centers and encourage acute
5 34 stroke=ready hospitals and emergency medical services providers
5 35 to report data consistent with nationally recognized guidelines
6 1 on the treatment of individuals with confirmed stroke within
6 2 the state.
6 3 The bill requires that beginning September 1, 2017, and
6 4 by each September 1, thereafter, DPH shall provide a summary
6 5 report of the data collected to the governor and the general
6 6 assembly summarizing the progress made in improving quality of
6 7 care and patient outcomes for individuals with stroke. All
6 8 data shall be reported in the aggregate form and shall be
6 9 posted on the department's internet site.
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