HB4699 95TH GENERAL ASSEMBLY

LRB095 18756 KBJ 44875 b

95TH GENERAL ASSEMBLY
State of Illinois
2007 and 2008
HB4699

Introduced 1/30/2008, by Rep. Bob Biggins

SYNOPSIS AS INTRODUCED:

New Act

Creates the Primary Stroke Center Designation Act. Sets forth the findings of the General Assembly. Provides that the Director of Public Health shall designate as many hospitals as Primary Stroke Centers as apply for the designation, provided that the hospital meets the criteria set forth in the Act. Provides the criteria necessary for designation as a Primary Stroke Center. Provides that the Director of Public Health may suspend or revoke a hospital's designation as a Primary Stroke Center after notice and hearing if the Director determines that the hospital does not comply with the requirements of the Act. Provides that the Director of Public Health may award matching grants to hospitals that seek designation as Primary Stroke Centers and demonstrate a need for financial assistance to develop the necessary infrastructure. Provides that the Director of Public Health must, not later than July 1, 2010, prepare and submit to the Governor, the President of the Senate, and the Speaker of the General Assembly a report indicating the total number of hospitals that have applied for grants under the Act before July 1, 2010 and the number of those applicants that have been found eligible for the grants, the total number of grants awarded, the name and address of each grantee and hospital and the amount of the award to each, and the amount of each award that has been awarded to the grantee. Effective immediately.

FISCAL NOTE ACT MAY APPLY

A BILL FOR

AN ACT concerning public health.

Be it enacted by the People of the State of Illinois, represented in the General Assembly:

Section 1. Short title. This Act may be cited as the Primary Stroke Center Designation Act.

Section 5. Findings.

(a) The General Assembly finds and declares that:

(1) Despite significant advances in diagnosis, treatment, and prevention, stroke remains the third highest killer in the United States. An estimated 700,000 to 750,000 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. Stroke is the number 3 killer of Illinois residents. Stroke leads to the death of more than 7,500 citizens of Illinois each year and disables thousands more. Illinois, Indiana, and Ohio have higher stroke mortality rates than neighboring states Michigan, Minnesota, and Wisconsin. Furthermore, a pattern of higher mortality exists in rural Illinois where there are few Primary Stroke Centers and limited access to hospitals.

(2) Although new treatments are available to improve the clinical outcomes of stroke, many acute care hospitals 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.

(3) A level of stroke center 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 care to patients with acute stroke and then, depending on the patient's needs and the center's capabilities, either admit the patient and provide inpatient care or transfer the patient to the closest, most appropriate facility.

(4) There is a public health need for acute care hospitals in this State to establish stroke centers to ensure rapid triage, diagnostic evaluation, and treatment of patients suffering a stroke. This should result in increased survival and a decrease in the disabilities associated with stroke.

(5) It is in the best interest of the residents of this State to establish a program to designate stroke centers throughout the State, to 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, and to provide financial support to acute care hospitals to encourage them to develop stroke centers in all areas of the State.

Section 10. Designation of Primary Stroke Centers.

(a) The Director of Public Health shall designate as many hospitals as Primary Stroke Centers as apply for the designation, provided that the hospital meets the criteria set forth in this Act. In addition to the criteria set forth in this Act, the Director is encouraged to take into consideration whether the hospital contracts with carriers that provide coverage through the State Medicaid program.

(b) A hospital shall be designated as a Primary Stroke Center if it has received a Certificate of Distinction for Primary Stroke Centers issued by the Joint Commission on Accreditation of Healthcare Organizations or another nationally recognized accrediting body as determined by the Department, or the Illinois Department of Public Health using its own criteria, as long as it is consistent with the criteria established by the Brain Attack Coalition. If the hospital has not received the Certificate of Distinction for Primary Stroke Centers, the hospital shall be designated as a Primary Stroke Center at the discretion of the Director of Public Health if the following criteria, as established by the Brain Attack Coalition, has been met.

(c) With respect to patient care, the hospital must:

(1) maintain acute stroke team availability to see an emergency department patient within 15 minutes of arrival at the emergency department, 24 hours a day, 7 days a week;

(2) maintain written care protocols and standing orders for emergency care of stroke patients;

(3) maintain neurology and emergency department personnel trained in the diagnosis and treatment of acute stroke;

(4) maintain telemetry or critical care beds staffed by physicians and nurses who are trained and experienced in caring for acute stroke patients;

(5) provide for neurosurgical services, including operating room availability either at the hospital or under agreement with a comprehensive stroke center within a 2 hour distance, 24 hours a day, 7 days a week; and

(6) provide acute care rehabilitation services.

(d) With respect to support services, the hospital must:

(1) demonstrate an institutional commitment and support of a stroke center, including having a designated physician serving as Stroke Center Director with special training and experience in caring for stroke patients;

(2) maintain neuro-imaging services capability, which shall include computerized tomography scanning or magnetic resonance imaging and interpretation of the image that is available 24 hours a day, 7 days a week, within 25 minutes of order entry;

(3) maintain laboratory services capability, which shall include blood testing, electrocardiography, and X-ray services that are available 24 hours a day, 7 days a week, within 45 minutes of order entry;

(4) develop and maintain outcomes and quality activities, which shall include a database or registry to track patient outcomes. This data shall include, at a minimum: the number of patients evaluated; the number of patients receiving acute interventional therapy; the amount of time from patient presentation to delivery of acute interventional therapy; patient length of stay; patient functional outcome; and patient morbidity;

(5) provide annual continuing education on stroke to support emergency services personnel regarding stroke diagnosis and treatment, which will be the responsibility of the Stroke Center Director;

(6) require the Stroke Center Director to obtain a minimum of 8 hours of continuing education on stroke each year; and

(7) demonstrate a continuing commitment to ongoing education to the general public about stroke, which includes conducting at least two programs annually for the general public on the prevention, recognition, diagnosis, and treatment of stroke.

(e) The Director of Public Health may suspend or revoke a hospital's designation as a Primary Stroke Center after notice and hearing if the Director determines that the hospital is not in compliance with the requirements of this Act.

Section 15. Grants.

(a) In order to encourage and ensure the establishment of Primary Stroke Centers throughout the State, the Director of Public Health may award matching grants to hospitals that seek designation as Primary Stroke Centers and demonstrate a need for financial assistance to develop the necessary infrastructure, including personnel and equipment, or to meet the fee requirements for accreditation surveys in order to satisfy the criteria for designation provided pursuant to this Act. The matching grants shall not exceed $250,000 or 50% of the hospitals's cost for developing the necessary infrastructure, whichever is less.

(b) A hospital seeking designation as a Primary Stroke Center may apply to the Director of Public Health for a matching grant in a manner and form designated by the Director and provide such information as the Director deems necessary to determine if the hospital is eligible for the grant.

(c) Matching grant awards shall be made to at least 2 applicant hospitals in the northern region of this State, at least 2 applicant hospitals in the central region of this State, and at least 2 applicant hospitals in the southern region of this State, provided in the case of each region that the applicant hospital receiving the grants must be eligible under the provisions of this Act.

Section 20. Report. The Director of Public Health must, not later than July 1, 2010, prepare and submit to the Governor, the President of the Senate, and the Speaker of the House of Representatives a report indicating the total number of hospitals that have applied for grants under Section 15 of this Act before July 1, 2010 and the number of those applicants that have been found eligible for the grants, the total number of grants awarded, the name and address of each grantee, and the amount of the award issued to each grantee.

Section 25. Rules. The Director of Public Health shall adopt rules to carry out the purposes of this Act.

Section 99. Effective date. This Act takes effect upon becoming law.