SB 1020 - Under this act, the state EMS medical director shall serve as an ex officio member of the State Advisory Council on Emergency Medical Services. The Council shall consult with the Time-Critical Diagnosis Advisory Committee established under this act regarding time-critical diagnosis, defined as trauma care, stroke care, and STEMI care occurring either outside of a hospital or in a designated center.

The State EMS Medical Director's Advisory Committee shall review and make recommendations regarding all proposed community and regional time-critical diagnosis plans.

This act repeals the requirement under current law that hospitals disclose data elements under the Missouri Brain and Spinal Cord Injury Registry to the Department of Health and Senior Services' uniform data collection system on all ambulance runs and injured patients.

The Department shall cooperate with hospitals to provide public and professional information related to emergency medical services systems. The Department may provide public information of hospital designations as trauma, stroke, or STEMI centers. The Department shall make publicly available research and guidelines recommended by the Time-Critical Diagnosis Advisory Committee for recommended treatment standards. Currently, the Department makes recommendations for treatment standards, establishes protocols for transport of patients, and approves the development of regional or community-based plans for transporting STEMI or stroke patients. This act includes trauma patients.

Currently, the Department shall conduct a site review of a hospital to determine the applicable level of trauma center, STEMI, or stroke center criteria. Under this act, the site review may occur onsite or by any reasonable means of communication or combination thereof. In developing trauma, STEMI, or stroke center designation criteria, the Department shall use, as practicable, peer-reviewed and evidence-based clinical research and guidelines.

Currently, the Department shall conduct an onsite review of every trauma, STEMI, or stroke center every 5 years. Under this act, a site review shall be conducted every 3 years. The Department may deny, place on probation, suspend, or revoke a center's designation if it has determined there has been a substantial failure to comply with certain regulations. Centers that are placed on probationary status shall show compliance with these regulations within 12 months, unless otherwise provided by a settlement agreement with a maximum duration of 18 months.

This act modifies provisions governing alternative trauma, stroke, and STEMI center designations by repealing current law establishing various designation levels and requiring the Department to designate hospitals seeking alternative designation in manner that corresponds to a similar national designation. A hospital receiving a center designation under this provision may have such designation removed upon the request of the hospital or upon a determination by the Department that the organization certifying or verifying the alternative designation has suspended or revoked its designation. This act requires centers receiving alternative designations under this provision to submit to the Department proof of certification or verification and to participate in local and regional emergency services systems for training, sharing educational resources, and collaboration on improving patient outcomes.

This act modifies data submission requirements for designated centers to require submission to either a state or national registry. Additionally, this act repeals requirements that the data collections system meet certain standards.

This act repeals provisions of current law granting the Board of Registration for the Healing Arts the sole authority to establish education requirements for physicians practicing in an emergency department in a trauma, STEMI, or stroke center. Instead, the Department shall not have authority to establish additional education requirements for emergency medicine board-certified or board-eligible physicians, either through the American Board of Emergency Medicine or American Osteopathic Board of Emergency Medicine, who are practicing in the emergency department of a designated center. The Department shall deem the education requirements of such entities to meet the standards for designation. Education requirements for other physicians, nurses, and other providers who provide care at the designated center shall equal, but not exceed, those established by national designating or verifying bodies of trauma, stroke, or STEMI centers.

Under this act, the Department may only establish appropriate fees to offset the costs of center surveys.

This act adds physician assistants to the list of providers who shall instruct ambulance personnel to transport a severely ill patient to a trauma, STEMI, or stroke center.

Failure of a hospital to provide all medical records and quality improvement documentation necessary for the Department to implement the provisions of this act shall result in the revocation of the hospital's designation as a trauma, STEMI, or stroke center.

This act repeals a provision of law relating to peer review systems for trauma, STEMI, and stroke cases.

Finally, this act establishes the "Time-Critical Diagnosis Advisory Committee" within the Department for the purpose of advising and making recommendations to the Department on improving public and professional education related to time-critical diagnosis; cooperative research endeavors; developing standards and policies relating to time-critical diagnosis; and reviewing and recommending community and regional time-critical diagnosis plans. The Director of the Department shall appoint 14 members to the committee, as specified in the act.

This act is substantially similar to provisions in the truly agreed to and finally passed SS/SCS/HB 2331 (2022), CCS/HCS/SS/SB 690 (2022), and HB 2355 (2022) and similar to SB 541 (2021).

SARAH HASKINS