| 1 | The Committee on Health Care recommends the following: |
| 2 |
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| 3 | Committee Substitute |
| 4 | Remove the entire bill and insert: |
| 5 | A bill to be entitled |
| 6 | An act relating to primary and comprehensive stroke |
| 7 | centers; providing legislative findings and intent; |
| 8 | providing definitions; requiring the Agency for Health Care |
| 9 | Administration to create and make available on its Internet |
| 10 | website and to the Department of Health a list of primary |
| 11 | and comprehensive stroke centers; providing criteria for |
| 12 | inclusion on such list; requiring a hospital that no longer |
| 13 | meets such criteria to notify the agency; requiring the |
| 14 | agency to remove such hospital from the list; providing an |
| 15 | exception; requiring the hospital to notify emergency |
| 16 | personnel if services become unavailable or resume; |
| 17 | requiring the agency to remove a hospital from the list |
| 18 | under certain conditions; requiring the agency to notify |
| 19 | all hospitals in the state of the list; requiring the |
| 20 | agency to develop criteria for primary and comprehensive |
| 21 | stroke centers; providing construction; prohibiting a |
| 22 | person from claiming that a facility is a state-listed |
| 23 | stroke center unless the facility has provided notice to |
| 24 | the agency; requiring the department to circulate a list of |
| 25 | stroke centers to certain medical directors; requiring the |
| 26 | department to develop a sample stroke triage or stroke |
| 27 | alert assessment tool; requiring emergency personnel to |
| 28 | utilize a similar tool; requiring the medical director of |
| 29 | each emergency medical services provider to develop and |
| 30 | implement certain protocols; requiring compliance by a |
| 31 | certain date; providing an effective date. |
| 32 |
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| 33 | WHEREAS, stroke is the third leading killer in the United |
| 34 | States and in Florida, and |
| 35 | WHEREAS, stroke is also a leading cause of serious long- |
| 36 | term disability in this state, and |
| 37 | WHEREAS, 165,000 people die from stroke in the United |
| 38 | States every year, including 10,000 people in this state, and |
| 39 | WHEREAS, 60 percent of all deaths from strokes occur in |
| 40 | women, and |
| 41 | WHEREAS, approximately 4.5 million stroke survivors are |
| 42 | alive today, and as many as 25 percent are permanently disabled, |
| 43 | and |
| 44 | WHEREAS, nearly 30 percent of all people who suffer a |
| 45 | stroke are under age 65, and |
| 46 | WHEREAS, it is estimated that strokes cost the United |
| 47 | States nearly $50 billion a year in total costs, with direct |
| 48 | costs estimated at $28 billion, and |
| 49 | WHEREAS, as the population ages, death and disability from |
| 50 | stroke will increase dramatically if this state does not |
| 51 | implement strategies that will improve the survival of victims |
| 52 | of stroke in all communities across this state, and |
| 53 | WHEREAS, emergency medical services may be transporting |
| 54 | stroke victims to hospitals that do not have specialized |
| 55 | programs for providing timely and effective treatment for stroke |
| 56 | victims, NOW, THEREFORE, |
| 57 |
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| 58 | Be It Enacted by the Legislature of the State of Florida: |
| 59 |
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| 60 | Section 1. Legislative findings and intent.-- |
| 61 | (1) The Legislature finds that rapid identification, |
| 62 | diagnosis, and treatment of stroke can save the lives of stroke |
| 63 | victims and in some cases can reverse impairments such as |
| 64 | paralysis, leaving stroke victims with few or no neurological |
| 65 | deficits. |
| 66 | (2) The Legislature further finds that a strong system for |
| 67 | stroke survival is needed in the state's communities in order to |
| 68 | treat stroke victims in a timely manner and to improve the |
| 69 | overall treatment of stroke victims. Therefore, the Legislature |
| 70 | intends to promote the development of an emergency treatment |
| 71 | system in this state that will allow stroke victims to be |
| 72 | quickly identified and transported to and treated in facilities |
| 73 | that have specialized programs for providing timely and |
| 74 | effective treatment for stroke victims. |
| 75 | Section 2. Definitions.--As used in this act, the term: |
| 76 | (1) "Agency" means the Agency for Health Care |
| 77 | Administration. |
| 78 | (2) "Department" means the Department of Health. |
| 79 | Section 3. State-listed primary stroke centers and |
| 80 | comprehensive stroke centers; notification of hospitals.-- |
| 81 | (1) The Agency for Health Care Administration shall make |
| 82 | available on its Internet website and to the Department of |
| 83 | Health a list of the names and locations of hospitals that meet |
| 84 | the criteria for a primary stroke center and the names and |
| 85 | locations of hospitals that meet the criteria for a |
| 86 | comprehensive stroke center. The list of primary and |
| 87 | comprehensive stroke centers shall include only those hospitals |
| 88 | that attest by affidavit submitted to the agency that they meet |
| 89 | the named criteria or those hospitals that attest that they are |
| 90 | certified as primary or comprehensive stroke centers by the |
| 91 | Joint Commission on Accreditation of Healthcare Organizations. |
| 92 | (2) If a hospital no longer plans to meet the criteria for |
| 93 | a primary or comprehensive stroke center, the hospital shall |
| 94 | notify the agency and the agency shall immediately remove the |
| 95 | hospital from the list. This subsection shall not apply to a |
| 96 | hospital that experiences a short-term unavailability of stroke |
| 97 | treatment services. The hospital shall immediately notify all |
| 98 | local emergency medical services providers of the temporary |
| 99 | unavailability of stroke treatment services. The hospital shall |
| 100 | notify all local emergency medical services providers when |
| 101 | services resume. If stroke treatment services are unavailable |
| 102 | for more than 2 months, the agency shall remove the hospital |
| 103 | from the list of primary or comprehensive stroke centers until |
| 104 | the hospital notifies the agency that stroke treatment services |
| 105 | have been restored. |
| 106 | (3) By February 15, 2005, the agency shall notify all |
| 107 | hospitals in the state that the agency is compiling a list of |
| 108 | primary stroke centers and comprehensive stroke centers in the |
| 109 | state. Included in the notification shall be an explanation of |
| 110 | the criteria for a primary stroke center and a comprehensive |
| 111 | stroke center as well as an explanation of the process for being |
| 112 | added to the list of primary and comprehensive stroke centers. |
| 113 | (4) The agency shall develop criteria for a primary stroke |
| 114 | center that are substantially similar to the primary stroke |
| 115 | center certification standards of the Joint Commission on |
| 116 | Accreditation of Healthcare Organizations. |
| 117 | (5) The agency shall develop criteria for a comprehensive |
| 118 | stroke center. In addition, if the Joint Commission on |
| 119 | Accreditation of Healthcare Organizations establishes criteria |
| 120 | for comprehensive stroke centers, the agency shall establish |
| 121 | criteria for comprehensive stroke centers that are substantially |
| 122 | similar to those criteria established by the Joint Commission on |
| 123 | Accreditation of Healthcare Organizations. |
| 124 | (6) Nothing in this section shall be construed as a |
| 125 | medical practice guideline or to restrict the authority of a |
| 126 | hospital to provide service for which it has received a license |
| 127 | pursuant to chapter 395, Florida Statutes. The Legislature |
| 128 | recognizes that all patients need to be treated individually |
| 129 | based on each patient's needs and circumstances. |
| 130 | Section 4. Advertising restrictions.--A person may not |
| 131 | advertise to the public, by way of any medium whatsoever, that a |
| 132 | hospital is a state-listed stroke center unless the hospital has |
| 133 | provided notice to the agency as required by this act. |
| 134 | Section 5. Emergency medical service providers; triage and |
| 135 | transportation of stroke victims to stroke centers.-- |
| 136 | (1) By June 1 of every year, the Department of Health |
| 137 | shall send the list of primary stroke centers and comprehensive |
| 138 | stroke centers to the medical director of all licensed emergency |
| 139 | medical services providers in the state. |
| 140 | (2) The Department of Health must develop a sample stroke |
| 141 | triage or stroke alert assessment tool. The department must post |
| 142 | this sample assessment tool on its Internet website and provide |
| 143 | a copy to all licensed emergency medical services providers no |
| 144 | later than June 1, 2005. All licensed emergency medical services |
| 145 | providers must utilize a stroke triage or stroke alert |
| 146 | assessment tool that is similar to the sample stroke triage or |
| 147 | stroke alert assessment tool provided by the department. |
| 148 | (3) The medical director of each licensed emergency |
| 149 | medical services provider shall develop and implement |
| 150 | assessment, treatment, and transport destination protocols for |
| 151 | stroke patients with the intent to assess, treat, and transport |
| 152 | stroke patients to the most appropriate hospitals. |
| 153 | (4) All emergency medical services providers licensed |
| 154 | under chapter 401, Florida Statutes, must comply with all parts |
| 155 | of this section by July 1, 2005. |
| 156 | Section 6. This act shall take effect July 1, 2004. |