SPONSOR: |
Sen. Hall-Long & Sen. Henry & Sen. Poore
& Sen. Pettyjohn & Rep. Bentz & Rep. Briggs King & Rep.
Longhurst |
|
Rep.
Baumbach |
DELAWARE STATE SENATE 148th GENERAL ASSEMBLY |
SENATE BILL NO. 265 |
AN ACT TO AMEND TITLE 16 OF THE DELAWARE CODE RELATING TO A STATEWIDE STROKE CARE SYSTEM. |
WHEREAS, it is the intent of the Delaware General Assembly to establish a statewide stroke care system in order to ensure the highest caliber of stroke care available.
NOW, THEREFORE:
Section 1. Amend § 1001, Title 16 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:
§ 1001 Definitions.
As used in this chapter:
“Acute
Health Care Facility” means any facility which is established, maintained
and operated for the purpose of providing immediate and emergent care to
individuals suffering from a life-threatening medical condition.
Section 2. Amend § 1019 of Title 16 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:
§ 1019 Designation
of acute health care facilities hospitals as primary
stroke centers.
(a) The Secretary of Health and Social Services
shall designate as a comprehensive stroke center any acute health care facility
within Delaware, or an out-of-state acute health care facility upon request,
which has received Advanced Certification for Comprehensive Stroke Centers
issued by The Joint Commission or an equivalent certification by another
nationally recognized guidelines-based accrediting organization as determined
by the Secretary.
(a
b) The Secretary of Health and Social Services shall designate as
a primary stroke center any hospital acute health care facility
within Delaware, or an out-of-state acute health care facility upon request,
which has received a Certificate of Distinction Advanced
Certification for Primary Stroke Centers issued by The Joint Commission on
Accreditation of Healthcare Organizations) (JCAHO). or an equivalent certification by another
nationally recognized guidelines-based accrediting organization as determined
by the Secretary.
(c) The Secretary of Health and Social Services
shall designate as an acute stroke ready center any acute health care facility
within Delaware, or an out-of-state acute health care facility upon request,
which has received Advanced Certification for Acute Stroke Ready Centers issued
by The Joint Commission on Accreditation of Healthcare Organizations or
an equivalent certification by another nationally recognized guidelines-based
accrediting organization as determined by the Secretary.
(d)
The Secretary of Health and Social
Services may establish other distinct categories of stroke center certification
if additional categories are established by The Joint Commission or by an
equivalent nationally recognized guidelines-based accrediting organization as
determined by the Secretary, and may designate any acute health care facility
as such based on certification by The Joint Commission or other nationally
recognized guidelines-based accrediting organization.
(be) The
Secretary shall suspend or revoke a hospital's distinction facility’s
designation as a comprehensive stroke center, primary stroke center,
acute stroke ready center or other categorization if The JCAHO Joint
Commission on Accreditation of Healthcare Organizations or equivalent
nationally recognized guidelines-based accrediting organization as determined
by the Secretary suspends or revokes a hospital's facility’s Certificate
of Distinction for Primary Stoke Center. certification.
Section 3. Amend § 9702, Title 16 of the Delaware Code by making deletions as shown by strike through and insertions as shown by underline as follows:
§ 9702 Definitions.
As used in this subchapter:
“Acute Health Care Facility” means
any facility which is established, maintained and operated for the purpose
of providing immediate and emergent care to individuals suffering from a
life-threatening medical condition.
“Inclusive
Statewide Stroke Care System” means a Stroke System in which all current and
future providers of hospital and/or prehospital health care services may
participate, at a level commensurate with the scope of their resources, as
required in a Stroke Facility.
"Inclusive
Statewide Trauma Care System" means a Trauma System in which all current
and future providers of hospital and/or pre-hospital health care services may
participate, at a level commensurate with the scope of their resources, as outlined
in paragraph (21) required in a Specialty care unit of this section.
"Specialty
care unit" shall mean sophisticated treatment facilities that provide
advanced specialized definitive care for critically ill patients. The units
shall be available for the diagnosis and care of specific patient problems
including major trauma, burns, spinal cord injury, stroke, poisoning,
acute cardiac, high-risk infant and behavioral emergencies.
“Stroke
Facility” shall. mean an acute care hospital or freestanding
emergency department that has received and maintains current State of Delaware
designation as a Stroke Center, as determined by the Secretary of Health and
Social Services, or an acute care hospital or freestanding emergency department
that has not achieved such a designation but participates in the care of stroke
patients and contributes data to the Delaware Stroke System Registry and
Quality Improvement Program.
“Stroke
Patient” shall mean any person with an episode of neurological dysfunction or
headache caused by focal cerebral, spinal, or retinal infarction or by a focal
collection of blood within the brain parenchyma, ventricular system, or
subarachnoid space that is not caused by trauma.
Section 4. Amend
Chapter 97, Title 16 of the Delaware Code by addition of subsection (20) to
read as follows: making deletions as shown by strike through and insertions
as shown by underline as follows:
§ 9703 Delaware Emergency Medical Services Oversight Council.
(a) There is established the Delaware Emergency Medical Services Oversight Council (“DEMSOC”). The Council shall consist of the following members:
(20) The Chair of the Stroke System Committee.
§ 9704 Office of Emergency Medical Services — Created; purpose.
(h)
Except for those activities and responsibilities for basic life support, which
is under the jurisdiction of the State Fire Prevention Commission, the Office
of Emergency Medical Services shall have jurisdiction over the development,
implementation and maintenance of a statewide stroke system.
(i)
A Memorandum of Agreement shall be established between the Office of Emergency
Medical Services of the Division of Public Health and the State Fire Prevention
Commission to foster inclusion and coordination of Basic Life Support Services
within the Statewide Stroke System.
(j)
The Director of Public Health shall establish and appoint a standing Stroke
System Committee and ad hoc committees as deemed appropriate to assist in
oversight of the Inclusive Statewide Stroke Care System. The standing Stroke
System Committee shall convene at least quarterly. Membership on the standing
Stroke System Committee will include, but not be limited to, a representative
of each of the following constituencies to be selected from the three counties
within the State and with best efforts to achieve a balance in membership from
each county:
1) Stroke rehabilitation professionals,
including but not limited to, physical therapists, occupational therapists, and
speech language pathologists;
(2) Practicing
stroke neurologists;
(3) Practicing
Emergency Department physicians;
(4) The Delaware
Healthcare Association;
(5) Advanced Life
Support prehospital providers;
(6) Basic Life
Support prehospital providers;
(7) The State Fire
School;
(8) Practicing
neurosurgeons;
(9) Practicing neurointerventional
radiologists;
(10) Practicing
Registered Nurses involved in Stroke Patient Care;
(11) Emergency
Medical dispatchers;
(12) Hospital administration from each Acute
Health Care Facility which holds or intends to seek stroke center designation
under this title;
(13) The Delaware
State Police Aviation Section; and
(14) A
representative from the State Fire Prevention Commission.
(k)
The Stroke System Committee shall be an advisory group to the Director of
Public Health on the following issues:
(1) Rules governing
the operation of Delaware's Inclusive Statewide Stroke Care System, which will
be based upon national references and data based guidelines, as determined by
the Director of Public Health with the advice of the Stroke System Committee.
(2) Recommendations for corrective action based on the
reviews of the following:
a. statewide
stroke care system operations, including the monitoring for adherence to
adopted policies, procedures, protocols and standards, the availability of
appropriate resources and the periodic review of stroke hospital and
freestanding emergency department participation (designation) criteria.
b. the delivery of emergency medical and
hospital services by stroke care service providers to stroke patients.
(3) Recommendation for modifications of the policies,
procedures and protocols of stroke care as a result of system-wide review.
§ 9706 Office of Emergency Medical Services — Additional functions
(i) The Director of Public Health shall,
except for those activities and responsibilities for basic life support, which
is under the jurisdiction of the State Fire Prevention Commission:
(1) Use the Stroke System Committee recommendations as the
basis for establishing a plan for the implementation and maintenance of
Delaware's Inclusive Statewide Stroke Care System.
(2) The State Stroke System Plan shall address each
component of stroke care as outlined in national references such
as Interactions Within Stroke Systems of Care: A Policy Statement from the
American Heart Association/American Stroke Association: 2013 and subsequent
revisions. These include, but are not limited to
a. Prehospital care - standardized and statewide policies,
procedure and protocols to be used by all emergency medical service providers
and licensed personnel for the identification, treatment and transport of
stroke patients.
b. Prevention - efforts to decrease the numbers and
severity of strokes resulting in decreased demand for care.
c. Hospital care - standards and criteria for hospital
personnel, equipment and designation that identify the necessary resources that
hospitals must have in order to be recognized within Delaware's Inclusive
Statewide Stroke Care System as a specified category stroke facility. These
standards and criteria shall be consistent with those identified in national
stroke system references produced by national accreditation and certification organizations. All expenses associated with utilizing a
nationally recognized accreditation team to verify a hospital's compliance with
hospital designation criteria will be the responsibility of the hospital being
surveyed.
d. Rehabilitative care - standards for the follow-up care
for persons with disabilities resulting from injuries.
e. Stroke continuing education - The ongoing
stroke-related education for stroke care system personnel/providers to maintain
knowledge and skills.
f. Stroke care system evaluation - monitor policies and
procedures regarding the effectiveness/impact of stroke care systems.
(3) Have the authority to promulgate rules for the
management of all components of Delaware's Inclusive Statewide Stroke Care
System, and shall seek input and review from the Stroke System Committee.
(4) Maintain a program of stroke care system evaluation,
including a stroke data collection and registry system and a mechanism for
evaluating and monitoring system performance throughout the continuum of stroke
care.
§ 9707 Confidentiality of quality review program and participants
(d) Confidentiality of Stroke Quality Review
Program and Participants
As used in this
section 'records' means the recordings of interviews and all oral or written
reports, statements, minutes, memoranda, charts, statistics, data and other
documentation generated by the Stroke System Committee or its subcommittees for
the stated purposes of stroke system medical review or quality care review and
audit. All quality management
proceedings shall be confidential.
Records of the Stroke System Committee, its quality care review
committee and members, attendees and visitors at meetings held for stated
purposes of stroke system medical review or quality care review and audit shall
be confidential and privileged and shall be protected from direct or indirect
means of discovery, subpoena, or admission into evidence in any judicial or
administrative proceeding. Raw data shall not be available for public
inspection nor is it a public record within the meaning of the Delaware Freedom
of Information Act.
SYNOPSIS
This bill establishes an Inclusive Statewide Stroke Care System to improve stroke care and survival in the State of Delaware. This bill requires the Secretary of Health and Social Services to designate acute health care facilities that meet certain accreditation requirements as comprehensive stroke centers, primary stroke centers, acute stroke ready centers, and other distinct categories of stroke center certification. The bill also establishes a standing Stroke System Committee to assist in the oversight of the Inclusive Statewide Stroke Care System and provide recommendations for its implementation and maintenance. |
Author: Senator Hall-Long