Chapter 303
2017 -- S 0923
Enacted 09/27/2017

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

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
jJoint cCommission on aAccreditation of hHealthcare oOrganizations 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 jJoint cCommission on
aAccreditation of hHealthcare oOrganizations (the jJoint cCommission) 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 jJoint cCommission (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 jJoint cCommission on Accreditation, 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
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 jJoint cCommission on Accreditation. 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
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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LC002721
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