| 1 | 1 | | FIRSTREGULARSESSION |
|---|
| 2 | 2 | | HOUSEBILLNO.1561 |
|---|
| 3 | 3 | | 103RDGENERALASSEMBLY |
|---|
| 4 | 4 | | INTRODUCEDBYREPRESENTATIVEGALLICK. |
|---|
| 5 | 5 | | 3165H.01I JOSEPHENGLER,ChiefClerk |
|---|
| 6 | 6 | | ANACT |
|---|
| 7 | 7 | | Torepealsection190.241,RSMo,andtoenactinlieuthereofonenewsectionrelatingto |
|---|
| 8 | 8 | | traumacenterdesignations. |
|---|
| 9 | 9 | | BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows: |
|---|
| 10 | 10 | | SectionA.Section190.241,RSMo,isrepealedandonenewsectionenactedinlieu |
|---|
| 11 | 11 | | 2thereof,tobeknownassection190.241,toreadasfollows: |
|---|
| 12 | 12 | | 190.241.1.Exceptasprovidedforinsubsection4ofthissection,thedepartment |
|---|
| 13 | 13 | | 2shalldesignateahospitalasanadult,pediatricoradultandpediatrictraumacenterwhena |
|---|
| 14 | 14 | | 3hospital,uponproperapplicationsubmittedbythehospitalandsitereview,hasbeenfoundby |
|---|
| 15 | 15 | | 4thedepartmenttomeettheapplicableleveloftraumacentercriteriafordesignationin |
|---|
| 16 | 16 | | 5accordancewithrulesadoptedbythedepartmentasprescribedbysection190.185.Site |
|---|
| 17 | 17 | | 6reviewmayoccuron-siteorbyanyreasonablemeansofcommunication,orbyany |
|---|
| 18 | 18 | | 7combinationthereof.Suchrulesshallincludedesignationasatraumacenterwithoutsite |
|---|
| 19 | 19 | | 8reviewifsuchhospitalisverifiedbyanationalverifyingordesignatingbodyatthelevel |
|---|
| 20 | 20 | | 9whichcorrespondstoalevelapprovedinrule.Indevelopingtraumacenterdesignation |
|---|
| 21 | 21 | | 10criteria,thedepartmentshalluse,asitdeemspracticable,peer-reviewedandevidence-based |
|---|
| 22 | 22 | | 11clinicalresearchandguidelinesincluding,butnotlimitedto,themostrecentguidelinesofthe |
|---|
| 23 | 23 | | 12AmericanCollegeofSurgeons.Thedepartmentshallnotdenyaqualifiedhospital |
|---|
| 24 | 24 | | 13designationasalevelI,II,orIIItraumacenterbasedsolelyonthedistanceormileage |
|---|
| 25 | 25 | | 14betweentraumacenters. |
|---|
| 26 | 26 | | 15 2.Exceptasprovidedforinsubsection4ofthissection,thedepartmentshall |
|---|
| 27 | 27 | | 16designateahospitalasaSTEMIorstrokecenterwhensuchhospital,uponproperapplication |
|---|
| 28 | 28 | | 17andsitereview,hasbeenfoundbythedepartmenttomeettheapplicablelevelofSTEMIor |
|---|
| 29 | 29 | | EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis |
|---|
| 30 | 30 | | intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 18strokecentercriteriafordesignationinaccordancewithrulesadoptedbythedepartmentas |
|---|
| 31 | 31 | | 19prescribedbysection190.185.Sitereviewmayoccuron-siteorbyanyreasonablemeansof |
|---|
| 32 | 32 | | 20communication,orbyanycombinationthereof.IndevelopingSTEMIcenterandstroke |
|---|
| 33 | 33 | | 21centerdesignationcriteria,thedepartmentshalluse,asitdeemspracticable,peer-reviewed |
|---|
| 34 | 34 | | 22andevidence-basedclinicalresearchandguidelinesincluding,butnotlimitedto,themost |
|---|
| 35 | 35 | | 23recentguidelinesoftheAmericanCollegeofCardiology,theAmericanHeartAssociation,or |
|---|
| 36 | 36 | | 24theAmericanStrokeAssociation.SuchrulesshallincludedesignationasaSTEMIcenteror |
|---|
| 37 | 37 | | 25strokecenterwithoutsitereviewifsuchhospitaliscertifiedbyanationalbody. |
|---|
| 38 | 38 | | 26 3.Thedepartmentofhealthandseniorservicesshall,notlessthanonceeverythree |
|---|
| 39 | 39 | | 27years,conductasitereviewofeverytrauma,STEMI,andstrokecenterthroughappropriate |
|---|
| 40 | 40 | | 28departmentpersonneloraqualifiedcontractor,withtheexceptionoftraumacenters,STEMI |
|---|
| 41 | 41 | | 29centers,andstrokecentersdesignatedpursuanttosubsection4ofthissection;however,this |
|---|
| 42 | 42 | | 30provisionisnotintendedtolimitthedepartment'sabilitytoconductacomplaintinvestigation |
|---|
| 43 | 43 | | 31pursuanttosubdivision(3)ofsubsection2ofsection197.080ofanytrauma,STEMI,or |
|---|
| 44 | 44 | | 32strokecenter.Sitereviewsshallbecoordinatedforthedifferenttypesofcenterstotheextent |
|---|
| 45 | 45 | | 33practicablewithhospitallicensureinspectionsconductedunderchapter197.Nopersonshall |
|---|
| 46 | 46 | | 34beaqualifiedcontractorforpurposesofthissubsectionwhohasasubstantialconflictof |
|---|
| 47 | 47 | | 35interestintheoperationofanytrauma,STEMI,orstrokecenterunderreview.The |
|---|
| 48 | 48 | | 36departmentmaydeny,placeonprobation,suspendorrevokesuchdesignationinanycasein |
|---|
| 49 | 49 | | 37whichithasdeterminedtherehasbeenasubstantialfailuretocomplywiththeprovisionsof |
|---|
| 50 | 50 | | 38thischapteroranyrulesorregulationspromulgatedpursuanttothischapter.Centersthatare |
|---|
| 51 | 51 | | 39placedonprobationarystatusshallberequiredtodemonstratecompliancewiththeprovisions |
|---|
| 52 | 52 | | 40ofthischapterandanyrulesorregulationspromulgatedunderthischapterwithintwelve |
|---|
| 53 | 53 | | 41monthsofthedateofthereceiptofthenoticeofprobationarystatus,unlessotherwise |
|---|
| 54 | 54 | | 42providedbyasettlementagreementwithadurationofamaximumofeighteenmonths |
|---|
| 55 | 55 | | 43betweenthedepartmentandthedesignatedcenter.Ifthedepartmentofhealthandsenior |
|---|
| 56 | 56 | | 44serviceshasdeterminedthatahospitalisnotincompliancewithsuchprovisionsor |
|---|
| 57 | 57 | | 45regulations,itmayconductadditionalannouncedorunannouncedsitereviewsofthehospital |
|---|
| 58 | 58 | | 46toverifycompliance.Ifatrauma,STEMI,orstrokecenterfailstwoconsecutivesitereviews |
|---|
| 59 | 59 | | 47becauseofsubstantialnoncompliancewithstandardsprescribedbysections190.001to |
|---|
| 60 | 60 | | 48190.245orrulesadoptedbythedepartmentpursuanttosections190.001to190.245,its |
|---|
| 61 | 61 | | 49centerdesignationshallberevoked. |
|---|
| 62 | 62 | | 50 4.(1)Insteadofapplyingfortrauma,STEMI,orstrokecenterdesignationunder |
|---|
| 63 | 63 | | 51subsection1or2ofthissection,ahospitalmayapplyfortrauma,STEMI,orstrokecenter |
|---|
| 64 | 64 | | 52designationunderthissubsection.Uponreceiptofanapplicationonaformprescribedbythe |
|---|
| 65 | 65 | | 53department,thedepartmentshalldesignatesuchhospitalatastatelevelthatcorrespondstoa |
|---|
| 66 | 66 | | 54similarnationaldesignationassetforthinrulespromulgatedbythedepartment.Therules |
|---|
| 67 | 67 | | HB1561 2 55shallbebasedonstandardsofnationallyrecognizedorganizationsandtherecommendations |
|---|
| 68 | 68 | | 56ofthetime-criticaldiagnosisadvisorycommittee. |
|---|
| 69 | 69 | | 57 (2)Exceptasprovidedbysubsection5ofthissection,thedepartmentshallnot |
|---|
| 70 | 70 | | 58requirecompliancewithanyadditionalstandardsforestablishingorrenewingtrauma, |
|---|
| 71 | 71 | | 59STEMI,orstrokedesignationsunderthissubsection.Thedesignationshallcontinueifsuch |
|---|
| 72 | 72 | | 60hospitalremainscertifiedorverified.Thedepartmentmayremoveahospital'sdesignationas |
|---|
| 73 | 73 | | 61atraumacenter,STEMIcenter,orstrokecenterifthehospitalrequestsremovalofthe |
|---|
| 74 | 74 | | 62designationorthedepartmentdeterminesthatthecertificateorverificationthatqualifiedthe |
|---|
| 75 | 75 | | 63hospitalforthedesignationunderthissubsectionhasbeensuspendedorrevoked.Any |
|---|
| 76 | 76 | | 64decisionmadebythedepartmenttowithdrawitsdesignationofacenterpursuanttothis |
|---|
| 77 | 77 | | 65subsectionthatisbasedontherevocationorsuspensionofacertificationorverificationbya |
|---|
| 78 | 78 | | 66certifyingorverifyingorganizationshallnotbesubjecttojudicialreview.Thedepartment |
|---|
| 79 | 79 | | 67shallreporttothecertifyingorverifyingorganizationanycomplaintitreceivesrelatedtothe |
|---|
| 80 | 80 | | 68centerdesignatedpursuanttothissubsection.Thedepartmentshallalsoadvisethe |
|---|
| 81 | 81 | | 69complainantwhichorganizationcertifiedorverifiedthecenterandprovidethenecessary |
|---|
| 82 | 82 | | 70contactinformationshouldthecomplainantwishtopursueacomplaintwiththecertifyingor |
|---|
| 83 | 83 | | 71verifyingorganization. |
|---|
| 84 | 84 | | 72 5.Anyhospitalreceivingdesignationasatraumacenter,STEMIcenter,orstroke |
|---|
| 85 | 85 | | 73centerpursuanttosubsection4ofthissectionshall: |
|---|
| 86 | 86 | | 74 (1)Withinthirtydaysofanychangesorreceiptofacertificateorverification,submit |
|---|
| 87 | 87 | | 75tothedepartmentproofofcertificationorverificationandthenamesandcontactinformation |
|---|
| 88 | 88 | | 76ofthecenter'smedicaldirectorandtheprogrammanager;and |
|---|
| 89 | 89 | | 77 (2)Participateinlocalandregionalemergencymedicalservicessystemsforpurposes |
|---|
| 90 | 90 | | 78ofprovidingtraining,sharingclinicaleducationalresources,andcollaboratingonimproving |
|---|
| 91 | 91 | | 79patientoutcomes. |
|---|
| 92 | 92 | | 80 |
|---|
| 93 | 93 | | 81AnyhospitalreceivingdesignationasalevelIIIstrokecenterpursuanttosubsection4ofthis |
|---|
| 94 | 94 | | 82sectionshallhaveaformalagreementwithalevelIorlevelIIstrokecenterforphysician |
|---|
| 95 | 95 | | 83consultativeservicesforevaluationofstrokepatientsforthrombolytictherapyandthecareof |
|---|
| 96 | 96 | | 84thepatientpost-thrombolytictherapy. |
|---|
| 97 | 97 | | 85 6.Hospitalsdesignatedasatraumacenter,STEMIcenter,orstrokecenterbythe |
|---|
| 98 | 98 | | 86departmentshallsubmitdatabyoneofthefollowingmethods: |
|---|
| 99 | 99 | | 87 (1)Enteringhospitaldataintoastateregistry;or |
|---|
| 100 | 100 | | 88 (2)Enteringhospitaldataintoanationalregistryordatabank.Ahospitalsubmitting |
|---|
| 101 | 101 | | 89datapursuanttothissubdivisionshallnotberequiredtocollectandsubmitanyadditional |
|---|
| 102 | 102 | | 90trauma,STEMI,orstrokecenterdataelements.Nohospitalsubmittingdatatoanationaldata |
|---|
| 103 | 103 | | 91registryordatabankunderthissubdivisionshallwithholdauthorizationforthedepartmentto |
|---|
| 104 | 104 | | HB1561 3 92accesssuchdatathroughsuchnationaldataregistryordatabank.Nothinginthissubdivision |
|---|
| 105 | 105 | | 93shallbeconstruedasrequiringduplicativedataentrybyahospitalthatisotherwise |
|---|
| 106 | 106 | | 94complyingwiththeprovisionsofthissubsection.Failureofthedepartmenttoobtainaccess |
|---|
| 107 | 107 | | 95todatasubmittedtoanationaldataregistryordatabankshallnotbeconstruedashospital |
|---|
| 108 | 108 | | 96noncomplianceunderthissubsection. |
|---|
| 109 | 109 | | 97 7.Whencollectingandanalyzingdatapursuanttotheprovisionsofthissection,the |
|---|
| 110 | 110 | | 98departmentshallcomplywiththefollowingrequirements: |
|---|
| 111 | 111 | | 99 (1)Namesofanyhealthcareprofessionals,asdefinedinsection376.1350,shallnot |
|---|
| 112 | 112 | | 100besubjecttodisclosure; |
|---|
| 113 | 113 | | 101 (2)Thedatashallnotbedisclosedinamannerthatpermitstheidentificationofan |
|---|
| 114 | 114 | | 102individualpatientorencounter; |
|---|
| 115 | 115 | | 103 (3)Thedatashallbeusedfortheevaluationandimprovementofhospitaland |
|---|
| 116 | 116 | | 104emergencymedicalservices'trauma,stroke,andSTEMIcare;and |
|---|
| 117 | 117 | | 105 (4)Trauma,STEMI,andstrokecenterdataelementsshallconformtonational |
|---|
| 118 | 118 | | 106registryordatabankdataelements,andincludepublisheddetailedmeasurespecifications, |
|---|
| 119 | 119 | | 107datacodinginstructions,andpatientpopulationinclusionandexclusioncriteriatoensuredata |
|---|
| 120 | 120 | | 108reliabilityandvalidity. |
|---|
| 121 | 121 | | 109 8.Thedepartmentshallnothaveauthoritytoestablishadditionaleducation |
|---|
| 122 | 122 | | 110requirementsforphysicianswhoareemergencymedicineboard-certifiedorboard-eligible |
|---|
| 123 | 123 | | 111throughtheAmericanBoardofEmergencyMedicine(ABEM)ortheAmericanOsteopathic |
|---|
| 124 | 124 | | 112BoardofEmergencyMedicine(AOBEM)andwhoarepracticingintheemergency |
|---|
| 125 | 125 | | 113departmentofafacilitydesignatedasatraumacenter,STEMIcenter,orstrokecenterbythe |
|---|
| 126 | 126 | | 114departmentunderthissection.Thedepartmentshalldeemtheeducationrequirements |
|---|
| 127 | 127 | | 115promulgatedbyABEMorAOBEMtomeetthestandardsfordesignationsunderthissection. |
|---|
| 128 | 128 | | 116Educationrequirementsfornon-ABEMornon-AOBEMcertifiedphysicians,nurses,and |
|---|
| 129 | 129 | | 117otherproviderswhoprovidecareatafacilitydesignatedasatraumacenter,STEMIcenter,or |
|---|
| 130 | 130 | | 118strokecenterbythedepartmentunderthissectionshallmirrorbutnotexceedthose |
|---|
| 131 | 131 | | 119establishedbynationaldesignatingorverifyingbodiesoftraumacenters,STEMIcenters,or |
|---|
| 132 | 132 | | 120strokecenters. |
|---|
| 133 | 133 | | 121 9.Thedepartmentofhealthandseniorservicesmayestablishappropriatefeesto |
|---|
| 134 | 134 | | 122offsetonlythecostsoftrauma,STEMI,andstrokecentersurveys. |
|---|
| 135 | 135 | | 123 10.NohospitalshallholditselfouttothepublicasaSTEMIcenter,strokecenter, |
|---|
| 136 | 136 | | 124adulttraumacenter,pediatrictraumacenter,oranadultandpediatrictraumacenterunlessit |
|---|
| 137 | 137 | | 125isdesignatedassuchbythedepartmentofhealthandseniorservices. |
|---|
| 138 | 138 | | 126 11.Anypersonaggrievedbyanactionofthedepartmentofhealthandseniorservices |
|---|
| 139 | 139 | | 127affectingthetrauma,STEMI,orstrokecenterdesignationpursuanttothischapter,including |
|---|
| 140 | 140 | | 128therevocation,thesuspension,orthegrantingof,refusaltogrant,orfailuretorenewa |
|---|
| 141 | 141 | | HB1561 4 129designation,mayseekadeterminationthereonbytheadministrativehearingcommission |
|---|
| 142 | 142 | | 130underchapter621.Itshallnotbeaconditiontosuchdeterminationthatthepersonaggrieved |
|---|
| 143 | 143 | | 131seekareconsideration,arehearing,orexhaustanyotherprocedurewithinthedepartment. |
|---|
| 144 | 144 | | âś” |
|---|
| 145 | 145 | | HB1561 5 |
|---|