Senate Bill 2597

AN ACT RELATING TO THE MISSISSIPPI STROKE SYSTEM OF CARE AND STEMI SYSTEM OF CARE; DEFINING AND REQUIRING EMERGENCY MEDICAL SERVICES TRAINING AND TRANSPORT PROTOCOL PLANS FOR STEMI PATIENTS AND ACUTE STROKE PATIENTS IN ACCORDANCE WITH AMERICAN HEART ASSOCIATION CRITERIA; TO AUTHORIZE AND DIRECT THE STATE DEPARTMENT OF HEALTH TO IDENTIFY AND RECOGNIZE STEMI AND MULTILEVEL STROKE CENTERS; AND FOR RELATED PURPOSES.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MISSISSIPPI:

SECTION 1. Definitions. As used in the act:

(a) "STEMI" means a ST-elevated Myocardial Infraction; a very serious type of heart attack during which one (1) of the heart's major arteries (one (1) of the arteries that supplies oxygen and nutrient-rich blood to the heart muscle) is blocked. ST-segment elevation is an abnormality detected on the 12-lead ECG;

(b) "STEMI-receiving centers" means a Mission: Lifeline Heart Attack Receiving Center STEMI Accreditation indentified hospitals that meet treatment criteria. Accreditation denotes the highest level of care and established proven guidelines and best practice for systems of care through the approved Mission: Lifeline National Registry Program, ACTION Registry®-GWTG™.

(c) "STEMI-Referring Centers" means a Mission: Lifeline STEMI-Referring Center Accreditation identified hospitals that meet high standards of performance in prompt diagnosis and transfer of patients. Accreditation denotes the highest level of care.

(d) "Mission: Lifeline" means the American Heart Association Program designed to transform heart attack patient outcomes by connecting health care providers, prehospital providers and community stakeholders in a proactive system of care that saves and improves lives from symptom onset through cardiac rehabilitation.

(e) "Comprehensive stroke center" (CSC) means hospitals that have met certain criteria determined by a nationally recognized certifying body that have reached measures developed for the management of both ischemic and hemorrhagic stroke patients in hospitals equipped with the clinical expertise, infrastructure, and specialized neurointerventional and imaging services needed to provide the next level of stroke care. This is the highest level of stroke certification possible.

(f) "Primary stroke center" (PSC) means a hospital-based center with the resources and processes to care for acute stroke patients. A primary stroke center is certified as such by the Joint Commission or a nationally recognized certifying body.

(g) "Acute stroke-ready hospital" (ASRH) means hospitals that meet standards to support better outcomes for stroke care as part of a stroke system of care developed in collaboration with the Joint Commission or nationally recognized certifying body.

(h) "The department" means the State Department of Health.

(i) "The board" means State Board of Health.

(j) "EMS" means Emergency Medical Services.

(k) "Emergency Medical Services provider" means a person who uses a limited amount of equipment to perform the initial assessment of and intervention with sick, wounded or otherwise incapacitated persons who (i) is trained to assist other EMS personnel by successfully completing, and remaining current in refresher training in accordance with, an approved "First Responder: National Standard Curriculum" training program, as developed and promulgated by the United States Department of Transportation; (ii) is nationally registered as a first responder by the National Registry of Emergency Medical Technicians; and (iii) is certified as a medical first responder by the State Department of Health, Division of Emergency Medical Services.

SECTION 2. Recognition of STEMI-Receiving Centers and STEMI-Referring Centers. (1) The department shall identify hospitals that meet the criteria set forth in this act as STEMI-Receiving Centers or STEMI-Referring Centers.

(2) The board shall adopt rules for recognition of any hospital as a STEMI-Receiving Center if that hospital has been accredited as a Mission: Lifeline STEMI-Receiving Center by the American Heart Association (AHA) accreditation process or another department-approved nationally recognized organization that provides STEMI-Receiving Center accreditation.

(3) The board shall adopt rules for recognition of any hospital as a STEMI-Referring Center if that hospital has been accredited as a Mission: Lifeline STEMI-Referring Center by the American Heart Association accreditation process or another department-approved nationally recognized organization that provides STEMI-Referring Center accreditation.

(4) The department may suspend or revoke a hospital's designation as a STEMI-Receiving Center or a STEMI-Referring Center, after notice and hearing, if the department determines that the hospital is not in compliance with the requirements of this act.

(5) STEMI-Receiving Centers are encouraged to coordinate, through agreement, with STEMI-Referring Centers throughout the state to provide appropriate access to care for acute heart attack patients.

SECTION 3. Recognition of comprehensive stroke centers, primary stroke centers and acute stroke-ready hospitals. (1) The department shall recognize as many accredited acute care hospitals as comprehensive stroke centers as apply and are certified as a Comprehensive Stroke Center by the American Heart Association, the Joint Commission or a department-approved nationally recognized guidelines-based organization that provides comprehensive stroke center hospital certification for stroke care, provided that each applicant continues to maintain its certification.

(2) The department shall recognize as many accredited acute care hospitals as primary stroke centers as apply and are certified as a primary stroke center by the American Heart Association, the Joint Commission or a department-approved nationally recognized guidelines based organization that provides primary stroke center hospital certification for stroke care, provided that each applicant continues to maintain its certification.

(3) The department shall recognize as many accredited acute care hospitals as acute stroke-ready hospitals as apply and are certified as an acute stroke-ready hospital by the American Heart Association, the Joint Commission or a department-approved nationally recognized guidelines based organization that provides acute stroke-ready hospital certification for stroke care, provided that each applicant continues to maintain its certification.

SECTION 4. Emergency medical services providers; assessment and transportation of STEMI patients to STEMI-Receiving Centers and STEMI-Referring Centers; assessment and transportation of stroke patients to a comprehensive stroke center, primary stroke center or acute stroke-ready hospital. (1) All EMS authorities across the state shall develop and implement prehospital care protocol plans related to the assessment, treatment, and transport of STEMI heart attack patients by an emergency medical service provider in this state. Such protocols shall include plans for the triage and transport of STEMI heart attack patients to the closest STEMI-Receiving Center or when appropriate to a STEMI-Referring Center, within a specified timeframe of onset of symptoms.

(2) The Mississippi Department of Health through the Division of Emergency Medical Services shall adopt and distribute a nationally recognized standardized stroke-triage assessment tool. The Mississippi Department of Health through the Division of Emergency Medical Services shall post this stroke assessment tool on their respective websites and provide a copy of the assessment tool to each licensed emergency medical services provider no later than July 1, 2018. Each licensed emergency medical services provider must use a stroke-triage assessment tool that is substantially similar to the sample stroke-triage assessment tool provided by The Mississippi Department of Health through the Division of Emergency Medical Services.

(3) All EMS authorities across the state shall establish prehospital care protocols related to the assessment, treatment, and transport of stroke patients by licensed emergency medical services providers in this state. Such protocols shall include the development and implementation of plans for the triage and transport of acute stroke patients.

(4) All EMS authorities across the state shall establish, as part of current training requirements, protocols to assure that licensed emergency medical services providers and 911 dispatch personnel receive regular training on the assessment and treatment of stroke patients.

SECTION 5. This act shall take effect and be in force from and after July 1, 2018.