Bill Text: IA SSB1147 | 2017-2018 | 87th General Assembly | Introduced
Bill Title: A bill for an act relating to stroke care quality improvement.
Spectrum: Committee Bill
Status: (N/A - Dead) 2017-02-28 - Subcommittee recommends amendment and passage. [SSB1147 Detail]
Download: Iowa-2017-SSB1147-Introduced.html
Senate
Study
Bill
1147
-
Introduced
SENATE
FILE
_____
BY
(PROPOSED
COMMITTEE
ON
HUMAN
RESOURCES
BILL
BY
CHAIRPERSON
SEGEBART)
A
BILL
FOR
An
Act
relating
to
stroke
care
quality
improvement.
1
BE
IT
ENACTED
BY
THE
GENERAL
ASSEMBLY
OF
THE
STATE
OF
IOWA:
2
TLSB
2504XC
(4)
87
pf/nh
S.F.
_____
Section
1.
NEW
SECTION
.
147A.30
Definitions.
1
As
used
in
this
subchapter,
unless
the
context
otherwise
2
requires:
3
1.
“Department”
means
the
department
of
public
health.
4
2.
“Emergency
medical
services”
or
“EMS”
means
as
defined
5
in
section
147A.1.
6
3.
“Emergency
medical
services
medical
director”
means
as
7
defined
in
section
147A.1.
8
Sec.
2.
NEW
SECTION
.
147A.31
Designations
——
level
of
care
9
relating
to
stroke.
10
1.
The
department
shall
specify
by
rules
adopted
pursuant
11
to
chapter
17A,
the
criteria
for
designation
of
a
hospital
as
12
a
comprehensive
stroke
center,
a
primary
stroke
center,
or
an
13
acute
stroke-ready
hospital.
A
hospital
seeking
a
designation
14
shall
apply
to
the
department
for
such
designation,
and
if
the
15
department
determines
that
the
hospital
meets
the
applicable
16
criteria
for
the
requested
designation,
the
department
shall
17
certify
the
hospital
accordingly.
18
2.
The
department
shall
recognize,
in
lieu
of
the
19
criteria
established
by
the
department,
accreditation
by
20
the
American
heart
association,
the
joint
commission
on
the
21
accreditation
of
health
care
organizations,
or
other
nationally
22
recognized
organization
that
provides
such
accreditation,
for
23
certification
of
a
hospital
as
a
comprehensive
stroke
center,
24
a
primary
stroke
center,
or
an
acute
stroke-ready
hospital,
25
as
applicable,
if
the
hospital
is
in
good
standing
with
and
26
maintains
certification
through
such
national
organization.
27
3.
The
department
may
suspend
or
revoke
a
hospital's
28
certification
as
a
comprehensive
stroke
center,
primary
stroke
29
center,
or
acute
stroke-ready
hospital,
after
notice
and
30
hearing,
if
the
department
determines
that
the
hospital
is
not
31
in
compliance
with
the
requirements
of
this
section
or
the
32
rules
adopted
under
this
section.
33
4.
Comprehensive
stroke
centers
and
primary
stroke
centers
34
are
encouraged
to
coordinate
efforts,
through
coordinated
35
-1-
LSB
2504XC
(4)
87
pf/nh
1/
6
S.F.
_____
stroke
care
agreements
with
acute
stroke-ready
hospitals
1
throughout
the
state,
to
provide
appropriate
access
to
care
for
2
acute
stroke
patients.
The
coordinating
stroke
care
agreement
3
shall
be
in
writing
and
shall
include,
at
a
minimum,
all
of
the
4
following:
5
a.
Transfer
agreements
for
the
transport
of
a
stroke
patient
6
from
an
acute
stroke-ready
hospital
to
a
comprehensive
stroke
7
center
or
primary
stroke
center
for
the
purpose
of
stroke
8
treatment
therapies
which
the
acute
stroke-ready
hospital
is
9
not
capable
of
providing.
10
b.
Communication
criteria
and
protocols
with
the
acute
11
stroke-ready
hospital.
12
Sec.
3.
NEW
SECTION
.
147A.32
Stroke
triage
assessment
13
1.
By
January
15,
annually,
the
department
shall
forward
the
14
current
list
of
the
designated
comprehensive
stroke
centers,
15
primary
stroke
centers,
and
acute
stroke-ready
hospitals,
16
to
the
medical
director
of
each
licensed
emergency
medical
17
services
provider
in
the
state.
The
department
shall
maintain
18
a
copy
of
the
list
in
the
bureau
of
emergency
and
trauma
19
services
within
the
department
and
shall
post
the
list
on
the
20
department’s
internet
site.
21
2.
The
department
shall
specify
by
rules
adopted
pursuant
to
22
chapter
17A
a
nationally
recognized
standardized
sample
stroke
23
triage
assessment
tool.
The
department
shall
distribute
the
24
sample
stroke
triage
assessment
tool
to
each
licensed
emergency
25
medical
services
provider
and
shall
post
the
tool
on
the
26
department’s
internet
site.
Each
licensed
emergency
medical
27
services
provider
shall
use
the
sample
stroke
triage
assessment
28
tool
adopted
by
rules
of
the
department
or,
alternatively,
a
29
stroke
triage
assessment
tool
that
is
substantially
similar
to
30
the
sample
stroke
triage
assessment
tool
as
part
of
the
state
31
stroke
triage
process.
32
3.
All
licensed
emergency
medical
services
providers
in
the
33
state
shall
establish
prehospital
care
protocols
related
to
34
the
assessment,
treatment,
and
transport
of
stroke
patients
by
35
-2-
LSB
2504XC
(4)
87
pf/nh
2/
6
S.F.
_____
licensed
emergency
medical
services
providers.
Such
protocols
1
shall
include
the
development
and
implementation
of
plans
2
for
the
triage
and
transport
of
acute
stroke
patients
to
the
3
closest
comprehensive
stroke
center,
primary
stroke
center,
or,
4
when
appropriate,
to
an
acute
stroke-ready
hospital,
within
a
5
specified
time
relative
to
the
onset
of
a
patient’s
symptoms.
6
4.
All
licensed
emergency
medical
services
providers
7
in
the
state
shall
establish,
as
part
of
current
training
8
requirements,
protocols
to
assure
that
licensed
emergency
9
medical
services
providers
and
911
dispatch
personnel
receive
10
regular
training
on
the
assessment
and
treatment
of
stroke
11
patients.
12
5.
All
data
reported
under
this
section
shall
be
made
13
available
to
the
department
and
to
any
other
agency
that
14
has
responsibility
for
the
management
and
administration
of
15
emergency
medical
services
throughout
the
state.
16
6.
This
section
shall
not
be
construed
to
require
disclosure
17
of
any
confidential
information
or
other
data
in
violation
of
18
the
federal
Health
Insurance
Portability
and
Accountability
Act
19
of
1996,
Pub.
L.
No.
104-191.
20
Sec.
4.
NEW
SECTION
.
147A.33
Continuous
quality
improvement
21
for
persons
with
stroke.
22
1.
The
department
shall
establish
and
implement
a
plan
for
23
achieving
continuous
quality
improvement
in
the
care
provided
24
under
a
statewide
system
for
stroke
response
and
treatment.
25
In
implementing
the
plan,
the
department
shall
do
all
of
the
26
following:
27
a.
Maintain
a
statewide
stroke
database
that
compiles
28
information
and
statistics
on
stroke
care
that
align
with
29
the
stroke
consensus
metrics
developed
and
approved
by
the
30
American
heart
association
and
the
American
stroke
association.
31
The
department
shall
utilize
the
“get
with
the
guidelines
–
32
stroke”
or
another
nationally
recognized
data
set
platform
with
33
confidentiality
standards
no
less
secure
than
those
utilized
34
by
the
department
for
the
statewide
stroke
database.
To
the
35
-3-
LSB
2504XC
(4)
87
pf/nh
3/
6
S.F.
_____
extent
possible,
the
department
shall
coordinate
with
national
1
voluntary
health
organizations
involved
in
stroke
quality
2
improvement
to
avoid
duplication
and
redundancy.
3
b.
Require
comprehensive
stroke
centers
and
primary
4
stroke
centers
and
encourage
acute
stroke-ready
hospitals
and
5
emergency
medical
services
providers
to
report
data
consistent
6
with
nationally
recognized
guidelines
on
the
treatment
of
7
individuals
with
confirmed
stroke
within
the
state.
8
2.
All
data
reported
under
this
section
shall
be
made
9
available
to
the
department
and
to
any
other
agencies
that
10
have
responsibility
for
the
management
and
administration
of
11
emergency
medical
services
throughout
the
state.
12
3.
Beginning
September
1,
2017,
and
by
each
September
1,
13
thereafter,
the
department
shall
provide
a
summary
report
of
14
the
data
collected
under
this
section
to
the
governor
and
the
15
general
assembly
summarizing
the
progress
made
in
improving
16
quality
of
care
and
patient
outcomes
for
individuals
with
17
stroke.
All
data
shall
be
reported
in
the
aggregate
form
and
18
shall
be
posted
on
the
department’s
internet
site.
19
EXPLANATION
20
The
inclusion
of
this
explanation
does
not
constitute
agreement
with
21
the
explanation’s
substance
by
the
members
of
the
general
assembly.
22
This
bill
relates
to
stroke
care
quality
improvement.
23
The
bill
provides
for
designation
of
hospitals
in
the
state
24
as
comprehensive
stroke
centers,
primary
stroke
centers,
or
25
acute
stroke-ready
hospitals.
A
hospital
seeking
a
designation
26
shall
apply
to
the
department
of
public
health
(DPH)
for
27
designation,
and
if
the
department
determines
the
hospital
28
meets
the
applicable
criteria
for
the
requested
designation,
29
the
department
shall
certify
the
hospital
accordingly.
The
30
bill
directs
DPH
to
recognize,
in
lieu
of
the
criteria
31
established
by
the
department,
accreditation
by
nationally
32
recognized
organizations
that
provide
accreditation,
for
33
certification
of
a
hospital
as
a
comprehensive
stroke
center,
34
a
primary
stroke
center,
or
an
acute
stroke-ready
hospital,
35
-4-
LSB
2504XC
(4)
87
pf/nh
4/
6
S.F.
_____
as
applicable,
if
the
hospital
is
in
good
standing
with
and
1
maintains
certification
through
such
national
organization.
2
The
bill
provides
for
suspension
or
revocation
of
a
3
hospital’s
certification
as
a
comprehensive
stroke
center,
4
primary
stroke
center,
or
acute
stroke-ready
hospital,
after
5
notice
and
hearing,
if
the
department
determines
that
the
6
hospital
is
not
in
compliance
with
the
requirements
of
the
bill
7
or
the
rules
adopted
under
the
bill.
8
The
bill
encourages
comprehensive
stroke
centers
and
primary
9
stroke
centers
to
coordinate
efforts,
through
coordinated
10
stroke
care
agreements,
with
acute
stroke-ready
hospitals
11
throughout
the
state,
to
provide
appropriate
access
to
care
12
for
acute
stroke
patients.
The
coordinating
stroke
care
13
agreement
shall
be
in
writing
and
shall
include,
at
a
minimum,
14
transfer
agreements
between
acute
stroke-ready
hospitals
15
and
comprehensive
stroke
centers
or
primary
stroke
centers
16
and
communication
criteria
and
protocols
with
the
acute
17
stroke-ready
hospital.
18
The
bill
requires
that
by
January
15,
annually,
DPH
shall
19
forward
the
current
list
of
the
designated
comprehensive
20
stroke
centers,
primary
stroke
centers,
and
acute
stroke-ready
21
hospitals,
to
the
medical
director
of
each
licensed
emergency
22
medical
services
provider
in
the
state,
maintain
a
copy
of
the
23
list,
and
post
the
list
on
the
department’s
internet
site.
24
The
department
shall
specify
by
rule
a
nationally
recognized
25
standardized
sample
stroke
triage
assessment
tool,
distribute
26
the
tool
to
each
licensed
emergency
medical
services
provider
27
and
post
the
tool
on
the
department’s
internet
site.
Each
28
licensed
emergency
medical
services
provider
shall
use
the
29
sample
tool
or,
alternatively,
a
stroke
triage
assessment
tool
30
that
is
substantially
similar
to
the
sample
tool
as
part
of
the
31
state
stroke
triage
process.
32
The
bill
requires
all
licensed
emergency
medical
services
33
providers
in
the
state
to
establish
prehospital
care
protocols
34
related
to
the
assessment,
treatment,
and
transport
of
stroke
35
-5-
LSB
2504XC
(4)
87
pf/nh
5/
6
S.F.
_____
patients.
1
All
licensed
emergency
medical
services
providers
are
2
also
required
to
establish,
as
part
of
current
training
3
requirements,
protocols
to
assure
that
licensed
emergency
4
medical
services
providers
and
911
dispatch
personnel
receive
5
regular
training
on
the
assessment
and
treatment
of
stroke
6
patients.
7
The
bill
requires
DPH
to
establish
and
implement
a
plan
8
for
achieving
continuous
quality
improvement
in
the
care
9
provided
under
a
statewide
system
for
stroke
response
and
10
treatment.
In
implementing
the
plan,
the
department
shall:
11
maintain
a
statewide
stroke
database
that
compiles
information
12
and
statistics
on
stroke
care;
and
require
comprehensive
13
stroke
centers
and
primary
stroke
centers
and
encourage
acute
14
stroke-ready
hospitals
and
emergency
medical
services
providers
15
to
report
data
consistent
with
nationally
recognized
guidelines
16
on
the
treatment
of
individuals
with
confirmed
stroke
within
17
the
state.
18
The
bill
requires
that
beginning
September
1,
2017,
and
19
by
each
September
1,
thereafter,
DPH
shall
provide
a
summary
20
report
of
the
data
collected
to
the
governor
and
the
general
21
assembly
summarizing
the
progress
made
in
improving
quality
of
22
care
and
patient
outcomes
for
individuals
with
stroke.
All
23
data
shall
be
reported
in
the
aggregate
form
and
shall
be
24
posted
on
the
department’s
internet
site.
25
-6-
LSB
2504XC
(4)
87
pf/nh
6/
6
