2017 -- S 0923

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LC002721

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2017

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A N   A C T

RELATING TO HEALTH AND SAFETY -- STROKE PREVENTION AND TREATMENT

ACT OF 2009

     Introduced By: Senator Dennis L. Algiere

     Date Introduced: May 30, 2017

     Referred To: Senate Health & Human Services

     It is enacted by the General Assembly as follows:

     SECTION 1. Sections 23-78.1-3, 23-78.1-5 and 23-78.1-6 of the General Laws in

Chapter 23-78.1 entitled "Stroke Prevention and Treatment Act of 2009" are hereby amended to

read as follows:

     23-78.1-3. Designation of Rhode Island comprehensive and primary stroke centers.

Designation of Rhode Island comprehensive and primary stroke centers and acute stroke

ready hospitals.

     (a) The director of the department of health shall establish a process to recognize

comprehensive and primary stroke centers and acute stroke ready hospitals in Rhode Island. The

joint commission on accreditation of health care organizations and the American Heart

Association/American Stroke Association have collaborated on the development of certification

programs for comprehensive and primary stroke centers and acute stroke ready hospitals that

follow the best practices for stroke care. A hospital shall be designated as a "Rhode Island

comprehensive stroke center," or a "Rhode Island primary stroke center," or a "Rhode Island

acute stroke ready hospital" if it has received a certificate of distinction for comprehensive or

primary stroke centers or "acute stroke ready hospitals" issued by the joint commission on

accreditation of healthcare organizations (the joint commission) or other nationally recognized

certification body, if a formal process is developed in the future;

     (b) The department of health shall recognize as many hospitals as Rhode Island

comprehensive or primary stroke centers or as acute stroke ready hospitals as apply and are

awarded certification by the joint commission (or other nationally recognized certification body,

if a formal process is developed in the future);

     (c) The director of the department of health may suspend or revoke a hospital's state

designation as a Rhode Island comprehensive or primary stroke center, or acute stroke ready

hospital, after notice and hearing, if the department of health determines that the hospital is not in

compliance with the requirements of this chapter.

     23-78.1-5. Emergency medical services providers; triage and transportation of

stroke patients.

     (a) The department of health, division of emergency medical services and the ambulance

service advisory board shall adopt and distribute a nationally recognized standardized assessment

tool for stroke. The division of emergency medical services shall post this stroke assessment tool

on its website and provide a copy of the assessment tool to each licensed emergency medical

services provider no later than January 1, 2010. Each licensed emergency medical services

provider must use the stroke-triage assessment tool provided by the department of health, division

of emergency medical services;

     (b) The department of health, division of emergency medical services and the ambulance

service advisory board shall establish pre-hospital care protocols related to the assessment,

treatment, and transport of stroke patients by licensed, emergency medical services providers in

this state. Such protocols may include plans for the triage and transport of acute stroke patients to

the closest comprehensive or primary stroke center or acute stroke ready hospital as appropriate

and within a specified timeframe of onset of symptoms. The stroke pre-hospital care protocols

shall be reviewed on an annual basis;

     (c) By June 1 of each year, the department of health, division of emergency medical

services (emergency medical services), shall send the list of comprehensive and primary stroke

centers and acute stroke ready hospitals to each licensed emergency medical services agency in

this state and shall post a list of comprehensive and primary stroke centers and acute stroke ready

hospitals on the division of emergency medical services website. For the purposes of this chapter,

the division of emergency medical services may include comprehensive and primary stroke

centers and acute stroke ready hospitals in Massachusetts and Connecticut that are certified by the

joint commission, or are otherwise designated by that state's department of public health as

meeting the criteria for comprehensive or primary stroke centers and acute stroke ready hospitals

as established by the brain attack coalition;

     (d) Each emergency medical services provider must comply with all sections of this

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chapter by June 1, 2010 2018.

     23-78.1-6. Continuous improvement of quality of care for individuals with stroke.

     (a) The department of health shall establish and implement a plan for achieving

continuous quality improvement in the quality of care provided under the statewide system for

stroke response and treatment. In implementing this plan, the department of health shall

undertake the following activities:

     (1) Develop incentives and provide assistance for sharing information and data among

health care providers on ways to improve the quality of care;

     (2) Facilitate the communication and analysis of health information and data among the

health care professionals providing care for individuals with stroke;

     (3) Require the application of evidence-based treatment guidelines regarding the

transitioning of patients to community-based follow-up care in hospital outpatient, physician

office and ambulatory clinic settings for ongoing care after hospital discharge following acute

treatment for a stroke;

     (4) Require comprehensive and primary stroke center hospitals and acute stroke ready

hospitals and emergency medical services agencies to report data consistent with nationally

recognized guidelines on the treatment of individuals with confirmed stroke within the statewide

system for stroke response and treatment;

     (5) Analyze data generated by the statewide system on stroke response and treatment; and

     (6) The department of health shall maintain a statewide stroke database that compiles

information and statistics on stroke care that align with the stroke consensus metrics developed

and approved by the American Heart Association/American Stroke Association, Centers for

Disease Control and Prevention, and the joint commission. The department of health shall utilize

Get With The Guidelines Stroke as the stroke registry data platform or another nationally

recognized data set platform with confidentiality standards no less secure. To every extent

possible, the department of health shall coordinate with national voluntary health organizations

involved in stroke quality improvement to avoid duplication and redundancy. The department of

health shall establish reporting requirements and specifications to ensure the uniformity and

integrity of data submitted to the statewide database/registry.

     (b) Except to the extent necessary to address continuity of care issues, health care

information shall not be provided in a format that contains individually identifiable information

about a patient. The sharing of health care information containing individually identifiable

information about patients shall be limited to that information necessary to address continuity of

care issues, and shall otherwise be released in accordance with chapter 37.3 of title 5 and subject

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to the confidentiality provisions required by that chapter and by other relevant state and federal

law.

     (c) Annual reports. On June 1 after enactment of this chapter and annually thereafter, the

department of health and the Rhode Island stroke task force shall report to the general assembly

on statewide progress toward improving quality of care and patient outcomes under the statewide

system for stroke response and treatment.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO HEALTH AND SAFETY -- STROKE PREVENTION AND TREATMENT

ACT OF 2009

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     This act would permit the department of health to designate hospitals as "acute stroke

ready hospitals."

     This act would take effect upon passage.

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