HF 2129 (LSB 5740HH (7) 83)

HOUSE FILE 2129

BY  T. OLSON

A BILL FOR

An Act relating to measuring and improving the quality of care for stroke patients.
BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:

    Section 1.  NEW SECTION.  147A.30  Definitions.

   As used in this subchapter, unless the context otherwise requires:

   1.  “Categorization” means a determination by the department that a hospital is capable of acting as a level 1, level 2, or level 3 stroke center in accordance with criteria adopted pursuant to chapter 17A for level 1, level 2, or level 3 stroke care capabilities.
   2.  “Department” means the department of public health.
   3.  “Hospital” means a facility licensed under chapter 135B.
   4.  “Stroke center” means a hospital which provides stroke care and has been verified by the department as having level 1, level 2, or level 3 care capabilities and issued a certificate of verification pursuant to this subchapter.
   5.  “Stroke triage system” means an organized approach to providing personnel, facilities, and equipment for effective and coordinated stroke care.
   6.  “Verification” means a formal process by which the department certifies a hospital to provide stroke care in accordance with criteria established for a level 1, level 2, or level 3 stroke center.
    Sec. 2.  NEW SECTION.  147A.31  Stroke triage plan and system development.
   1.  The department is designated as the lead agency in this state responsible for the development of a statewide stroke triage system.
   2.  The department, in consultation with the EMS advisory council, shall develop, coordinate, and monitor a statewide stroke triage plan and system.
   a.  The plan shall provide for a statewide prehospital and interhospital stroke triage strategy to promote rapid access for stroke patients to appropriate organized stroke care through publication and regular updating of information on resources for stroke care, and publication of generally accepted criteria for stroke triage and appropriate transfer.
   b.  The system shall include but is not limited to the following:
   (1)  The categorization of all hospitals as stroke centers by the department in accordance with their capacity to provide stroke care.
   (2)  The issuance of a certificate of verification for each categorized hospital from the department at the level demonstrated by the hospital. The standards and verification process shall be established by rule and may vary as appropriate by level of stroke care capability. To the extent possible, the standards and verification process shall be coordinated with other applicable accreditation and licensing standards.
   (3)  Upon verification and the issuance of a certificate of verification, a hospital shall agree to maintain a level of commitment and resources sufficient to meet responsibilities and standards as required by the stroke care criteria established by rule under this subchapter. Verifications are valid for a period of three years or as determined by the department and are renewable. As part of the verification and renewal process, the department may conduct periodic on-site reviews of the services and facilities of the hospital.
    Sec. 3.  NEW SECTION.  147A.32  Statewide stroke registry.
   1.  The department shall maintain a statewide stroke registry to compile information and statistics on stroke care including prevalence, mortality, and performance metrics for acute stroke patients. The purposes of the statewide stroke registry are to monitor, evaluate, and provide guidance to health care quality improvement efforts for the education, diagnosis, and treatment of acute stroke; to facilitate the implementation of quality of stroke care improvements in Iowa hospitals; and to track the progress of Iowa hospitals in meeting national benchmarks for stroke care.
   2.  The data collected by and furnished to the department pursuant to this section are confidential records of the condition, diagnosis, care, or treatment of patients or former patients, including outpatients, pursuant to section 22.7, subsection 2. Compilations of information prepared for release or dissemination from the data collected are not confidential under section 22.7, subsection 2. However, information which individually identifies patients shall not be disclosed and state and federal law regarding patient confidentiality shall apply.
   3.  To the extent possible, activities under this section shall be coordinated with other health data collection methods.
    Sec. 4.  NEW SECTION.  147A.33  Adoption of rules.

   The department shall adopt rules to implement the stroke triage system and statewide stroke registry under this subchapter. The rules shall include designating stroke as a reportable disease pursuant to chapter 139A.
    Sec. 5.  DIRECTIVE TO CODE EDITOR.  The Code editor shall codify sections 147A.30, 147A.31, 147A.32, and 147A.33, as enacted in this Act, in a new subchapter in chapter 147A entitled the “stroke triage plan and system”.
EXPLANATION
   This bill creates a new subchapter in Code chapter 147A relating to the establishment by the department of public health (DPH) of a stroke triage plan and system. The department is designated as the lead agency responsible for the development of a statewide stroke triage plan and system. The plan is to provide for a statewide prehospital and interhospital stroke triage strategy to promote rapid access for stroke patients to appropriate organized stroke care. The system is to include the categorization of all hospitals as stroke centers by the department in accordance with their capacity to provide stroke care, certification of verification of all categorized hospitals by the department at the level demonstrated by the hospital; and, upon issuance of a certificate of verification, agreement of a hospital to maintain a level of commitment and resources sufficient to meet responsibilities and standards as required by the stroke care criteria.
   The bill also directs DPH to maintain a statewide stroke registry to compile information and statistics on stroke care including prevalence, mortality, and performance metrics for acute stroke patients. The purposes of the statewide stroke registry are to monitor, evaluate, and provide guidance to health care quality improvement efforts for the education, diagnosis, and treatment of acute stroke; to facilitate the implementation of quality of stroke care improvements in Iowa hospitals; and to track the progress of Iowa hospitals in meeting national benchmarks for stroke care.
   The bill directs DPH to adopt rules to implement the stroke triage plan and system and the statewide stroke registry. The rules shall include designating stroke as a reportable disease pursuant to Code chapter 139A.