SENATE AMENDED

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

INTRODUCED BY REICHLEY, CALTAGIRONE, CLYMER, D. COSTA, CUTLER, GILLESPIE, GRELL, HARKINS, JOSEPHS, MILNE, M. O'BRIEN, THOMAS, WATSON, BOBACK, KILLION, SWANGER, DONATUCCI, DAY, TOOHIL, GEIST, SONNEY, MURT, KAUFFMAN, HENNESSEY, DENLINGER, RAPP, FARRY AND PASHINSKI, MAY 24, 2011

AS AMENDED ON THIRD CONSIDERATION, IN SENATE, MAY 7, 2012   

AN ACT

Establishing a Statewide stroke system of care by recognizing 

primary stroke centers and directing the creation of

emergency medical services training and transport protocols;

and providing for the powers and duties of the Department of

Health.

The General Assembly finds and declares as follows:

(1)  The rapid identification, diagnosis and treatment of

stroke can save the lives of stroke patients and in some

cases can minimize neurological damage such as paralysis and

speech and language impairments, leaving stroke patients with

few or minimal neurological deficits.

(2)  Despite significant advances in the diagnosis,

treatment and prevention, stroke is the third leading cause

of death and the leading cause of disability with an

estimated 795,000 new and recurrent strokes occurring each

year in this country, and, with the aging of the population,

the number of persons who have strokes is projected to

increase.

(3)  Although 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 those patients.

(4)  An effective system to support stroke survival is

needed in our communities in order to treat stroke patients

in a timely manner and to improve the overall treatment of

stroke patients in order to increase survival and decrease

the disabilities associated with stroke. There is a public

health need for acute care hospitals in this Commonwealth to

establish primary stroke centers to ensure the rapid triage,

diagnostic evaluation and treatment of patients suffering a

stroke.

(5)  Primary stroke centers should be established for the

treatment of acute strokes. Primary stroke centers should be

established in as many hospitals as possible. These centers

would evaluate, stabilize and provide emergency and inpatient

care to patients with acute stroke.

(6)  Therefore, it is in the best interest of the

residents of this Commonwealth to establish a program to

recognize accredited primary stroke centers whose criteria

provide specific patient care and support services that

hospitals must meet in order to ensure that stroke patients

receive sage and effective care. Further, it is in the best

interest of the people of this Commonwealth to modify the

State's emergency medical response system to assure that

stroke patients may be quickly identified and transported to

and treated in facilities that have stroke protocols for

providing timely and effective treatment for stroke patients.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  Short title.

This act shall be known and may be cited as the Primary

Stroke Center Recognition Act.

Section 2.  Definitions.

The following words and phrases when used in this act shall

have the meanings given to them in this section unless the

context clearly indicates otherwise:

"Department."  The Department of Health of the Commonwealth.

"Emergency medical services agency medical director."  As

defined in 35 PA.C.S. § 8103 (relating to definitions).

"Joint commission."  An independent national not-for-profit

organization that develops and updates organizational standards

and performance measures, conducts on-site evaluations and

awards accreditation decisions to health care facilities,

including hospitals, nursing homes, home care agencies and

ambulatory providers, that are accepted by the Federal

Government for the compliance of Conditions of Participation for

Medicare.

"Licensed acute care hospital."  Any hospital licensed by the

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department which is equipped and staffed for the treatment of

medical or surgical conditions, or both, in the acute or chronic

stages, on an inpatient basis of 24 or more hours.

Section 3.  Recognition of centers.

(a)  General rule.--Upon application by a licensed acute care

hospital, the department shall recognize the hospital as a

primary stroke center if the hospital is certified as a primary

stroke center by the joint commission or another nationally

recognized accrediting organization that provides certification

for stroke care. The designation shall last as long as the

hospital remains certified as a primary stroke center.

(b)  Suspension or revocation of recognition.--The department

may suspend or revoke primary stroke center recognition if the

department determines that the hospital is not in compliance

with provisions of this act requiring accreditation as a primary

stroke center.

Section 4.  Emergency medical services.

(a)  List of primary stroke centers.--The department shall:

(1)  Make available a list of accredited primary stroke

centers to each emergency medical services agency medical

director in this Commonwealth.

(2)  Maintain a copy of the list of primary stroke

centers in the office designated with the department to

oversee emergency medical services.

(3)  Post a list of primary stroke centers on the

department's Internet website.

(b)  Assessment.--The department shall make available and

distribute a nationally recognized standardized stroke triage

assessment tool within 60 days of the effective date of this

act. The department shall:

(1)  Make available a copy to each emergency medical

services agency medical director in this Commonwealth so that

the directors can use the tool or a substantially similar one

to evaluate patients.

(2)  Post the assessment tool on its Internet website.

(c)  Protocols.--The department shall establish protocols

that are related to prehospital assessment, treatment and

transport of stroke patients by licensed emergency medical

services providers. The protocols shall include plans for triage

and transport of acute stroke patients to the closest primary

stroke center or a facility that can provide appropriate

treatment if the primary stroke center is not within a specified

time frame from onset of symptoms.

(d)  Training.--The department shall establish protocols to

ensure that certified emergency medical services providers,

within their scope of practice, receive regular training on the

assessment and treatment of stroke patients.

(e)  Compliance.--Within 60 days of the effective date of

this act, each emergency medical services provider must comply

with all protocols and regulations promulgated by the department

under this act.

Section 5.  Biennial report.

(a)  Duty to prepare and file.--The department shall prepare

a biennial report by July 1 in odd-numbered years in conjunction

with its review of emergency medical services protocols. The

report shall be filed with the Chairman and Minority Chairman of

the Public Health and Welfare Committee of the Senate and the

Chairman and Minority Chairman of the Health Committee of the

House of Representatives.

(b)  Contents.--The report shall include:

(1)  The number, location and county of accredited

primary stroke centers in this Commonwealth.

(2)  Changes in the number and/or locations of primary

stroke centers since the last report.

(3)  A summary of the training protocols to ensure that

certified emergency medical services providers within their

scope of practice receive regular training and assessment and

treatment of stroke patients.

(4)  Any other information the department may deem

necessary.

Section 6.  Effective date.

This act shall take effect in 60 days.