Chapter 088
2009 -- S 0752 SUBSTITUTE A
Enacted 07/09/09
A N A C T
RELATING TO HEALTH AND SAFETY -- STROKE PREVENTION ACT OF 2009
Introduced By: Senators Doyle, Maselli, Tassoni, McBurney, and Connors
Date Introduced: February 26, 2009
It is enacted by the
General Assembly as follows:
SECTION
1. Title 23 of the General Laws entitled "HEALTH AND SAFETY" is
hereby
amended by adding thereto
the following chapter:
CHAPTER
78.1
STROKE
PREVENTION AND TREATMENT ACT OF 2009
23-78.1-1. Short
title. – This chapter shall be known and may be cited as the “Stroke
Prevention and Treatment Act of 2009.”
23-78.1-2.
Legislative findings. – It is hereby found and declared as follows:
(1) The rapid
identification, diagnosis, and treatment of stroke can save the lives of stroke
victims and in some cases can reverse neurological
damage such as paralysis and speech and
language impairments, leaving stroke victims with few
or no neurological deficits;
(2) Despite significant
advances in diagnosis, treatment and prevention, stroke is the third
(3rd) leading cause of death and a leading cause of
disability; an estimated seven hundred eighty
thousand (780,000) new and recurrent strokes occur
each year in this country; and with the aging
of the population, the number of persons who have
strokes is projected to increase;
(3) This year in
a potentially treatable stroke and more than six hundred
(600) Rhode Islanders will die from
stroke-related complications. This tragic loss of life
and viability creates an annual financial
burden for the state of over three hundred twelve
million dollars ($312,000,000) in medical costs,
supportive care, and lost productivity;
(4) Although new
treatments are available to improve the clinical outcomes of stroke,
some acute care hospitals may lack the necessary staff
and equipment to optimally triage and treat
stroke patients, including the provision of optimal,
safe and effective emergency care for these
patients;
(5) An effective
system to support stroke survival is needed in our communities in order
to treat stroke patients in a timely manner and to
improve the overall treatment of stroke patients
in order to increase survival and decrease the
disabilities associated with stroke. There is a public
health need for acute care hospitals in this state to
establish primary stoke centers to ensure the
rapid triage, diagnostic evaluation and treatment of
patients suffering an acute stroke;
(6) Primary stroke
centers should be established for the treatment of acute stroke. Primary
stroke centers should be established in as many acute
care hospitals as possible. These centers
would evaluate, stabilize and provide emergency and in
patient care to patients with acute stroke;
and
(7) That it is in the
best interest of the residents of this state to establish a program to
facilitate development of stroke treatment
capabilities throughout the state. This program will
provide specific patient care and support services
criteria that stroke centers must meet in order to
ensure that stroke patients receive safe and effective
care. It is also in the best interest of the
people of this state to modify the state’s emergency
medical response system to assure that acute
stroke victims may be quickly identified and
transported to and treated in facilities that have
appropriate programs for providing timely and
effective treatment for stroke victims.
(8) For the purposes
of pre-hospital transfer and triage clarification, an “acute stroke” is
defined as any new-persistent focal neurological
deficit determined to be less than six (6) hours
since last seen normal.
23-78.1-3. Designation
of
the department of health shall establish a process to
recognize primary stroke centers in Rhode
Island. A hospital shall be designated as a “
a certificate of distinction for primary stroke
centers issued by the joint commission on
accreditation of healthcare organizations (joint
commission);
(b) The department of
health shall recognize as many hospitals as
stroke centers 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
health determines that the hospital is not in
compliance with the requirements of this chapter.
23-78.1-4. Acute
care hospitals. – (a) All acute care hospitals shall maintain
readiness to
treat stroke patients. This shall include:
(1) Adherence with
American Heart Association/American Stroke Association
guidelines;
(2) Establishment of
written care protocols for the treatment of ischemic
and hemorrhagic
stroke patients, including transfer of acute stroke
patients to a primary stroke center as
appropriate and medically indicated;
(3) Participation in
Get With The Guidelines/Stroke to collect nationally recognized
stroke measures and ensure continuous quality
improvement;
(4) Participation in
the
Network to provide oversight for the stroke system of
care and to share best practices.
23-78.1-5.
Emergency medical services providers; triage and transportation of
stroke patients. – (a) The department of health, division of
advisory board shall adopt and distribute a nationally
recognized standardized assessment took
for stroke. The division of
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
(b) The department of
health, division of
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 primary stroke
center as appropriate and within a specified timeframe
of onset of symptoms;
(c) By June 1 of
each year, the department of health, division of emergency medical
services (
services agency in this state and shall post a list of
primary stroke centers on the division of
website. For the purposes of this chapter, the
division of
in
designated by that state’s department of public health
as meeting the criteria for primary stroke
centers as established by the brain attack coalition;
(d) Each emergency
medical services provider must comply with all sections of this
chapter by June 1, 2010.
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 primary
stroke center 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.
(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
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
on statewide progress toward improving quality of care
and patient outcomes under the statewide
system for stroke response and treatment.
23-78.1-7. Patient
treatment. – This chapter is not a medical practice guideline and
may
not be used to restrict the authority of a hospital to
provide services for which it has received a
license under state law. The general assembly intends
that all patients be treated individually
based on each patient’s needs and circumstances.
23-78.1-8.
Regulatory authority. – The department of health shall have the
authority to
adopt rules to carry out the purposes of this chapter.
SECTION
2. This act shall take effect upon passage.
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LC01809/SUB A
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