S T A T E   O F   N E W   Y O R K
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                                  7410

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                               May 8, 2015
                               ___________

Introduced  by  M.  of  A.  SIMANOWITZ  -- read once and referred to the
  Committee on Housing

AN ACT to amend the public health law, in relation to stroke centers

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1.  The  public health law is amended by adding a new article
28-F to read as follows:
                              ARTICLE 28-F
                             STROKE CENTERS
SECTION 2899-D. DESIGNATION OF  COMPREHENSIVE  STROKE  CENTERS,  PRIMARY
                  STROKE CENTERS AND ACUTE STROKE READY HOSPITALS.
        2899-E. COMMUNICATION BETWEEN CENTERS.
        2899-F. EMERGENCY SERVICES PROVIDERS; ASSESSMENT AND TRANSPORTA-
                  TION  OF  STROKE  PATIENTS  TO  A COMPREHENSIVE STROKE
                  CENTER, PRIMARY STROKE CENTER OR  ACUTE  STROKE  READY
                  HOSPITAL.
        2899-G. CONTINUOUS  IMPROVEMENT OF THE QUALITY OF CARE FOR INDI-
                  VIDUALS WITH STROKES.
        2899-H. COVERAGE FOR TELEMEDICINE SERVICES.
        2899-I. USE OF DESIGNATION IN ADVERTISING.
        2899-J. DISCLAIMER.
  S 2899-D. DESIGNATION OF COMPREHENSIVE STROKE CENTERS, PRIMARY  STROKE
CENTERS  AND ACUTE STROKE READY HOSPITALS. 1. HOSPITALS MAY APPLY TO THE
DEPARTMENT FOR A DESIGNATION AS A COMPREHENSIVE STROKE  CENTER,  PRIMARY
STROKE CENTER OR ACUTE STROKE READY HOSPITAL.
  2. THE DEPARTMENT SHALL APPROVE ALL APPLICATIONS FOR DESIGNATION WHERE
THE  APPLICANT  HOSPITAL  HAS  BEEN  CERTIFIED AS A COMPREHENSIVE STROKE
CENTER, PRIMARY STROKE CENTER OR ACUTE  STROKE  READY  HOSPITAL  BY  THE
AMERICAN  HEART  ASSOCIATION OR ANY OTHER DEPARTMENT APPROVED NATIONALLY
RECOGNIZED GUIDELINES BASED ORGANIZATION THAT  PROVIDES  THE  RESPECTIVE

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD10750-02-5

              

A. 7410                             2

CERTIFICATION,  PROVIDED  THAT  EACH APPLICANT CONTINUES TO MAINTAIN ITS
CERTIFICATION.
  3.  THE DEPARTMENT MAY SUSPEND OR REVOKE A HOSPITAL'S DESIGNATION AS A
COMPREHENSIVE STROKE CENTER, PRIMARY STROKE CENTER OR ACUTE STROKE READY
HOSPITAL AFTER NOTICE AND A HEARING IF THE  DEPARTMENT  DETERMINES  THAT
THE HOSPITAL NO LONGER MEETS THE CRITERIA FOR DESIGNATION.
  S  2899-E.  COMMUNICATION  BETWEEN  CENTERS.  1.  COMPREHENSIVE STROKE
CENTERS AND PRIMARY STROKE CENTERS ARE ENCOURAGED TO COORDINATE, THROUGH
AGREEMENT, WITH ACUTE STROKE READY HOSPITALS  THROUGHOUT  THE  STATE  TO
PROVIDE APPROPRIATE ACCESS TO CARE FOR ACUTE STROKE PATIENTS.
  2.  THE  COORDINATING  STROKE  CARE  AGREEMENT SHALL BE IN WRITING AND
INCLUDE:
  (A)  PROVISIONS  FOR  THE  TRANSPORTATION  AND  ACCEPTANCE  OF  STROKE
PATIENTS  SEEN  BY THE ACUTE STROKE READY HOSPITALS FOR STROKE TREATMENT
THERAPIES WHICH THE REMOTE TREATMENT STROKE CENTER  IS  NOT  CAPABLE  OF
PROVIDING; AND
  (B)  CRITERIA  AND  PROTOCOLS FOR COMMUNICATIONS WITH THE ACUTE STROKE
READY HOSPITALS.
  S 2899-F. EMERGENCY SERVICES PROVIDERS; ASSESSMENT AND  TRANSPORTATION
OF  STROKE  PATIENTS  TO  A  COMPREHENSIVE STROKE CENTER, PRIMARY STROKE
CENTER OR ACUTE STROKE READY HOSPITAL. 1. BY JUNE FIRST OF EACH YEAR THE
DEPARTMENT SHALL SEND A LIST OF COMPREHENSIVE  STROKE  CENTERS,  PRIMARY
STROKE  CENTERS AND ACUTE STROKE READY HOSPITALS TO THE MEDICAL DIRECTOR
OF EACH LICENSED EMERGENCY MEDICAL SERVICES PROVIDER IN THIS STATE.  THE
DEPARTMENT  SHALL MAINTAIN A COPY OF THE LIST AND SHALL POST THE LIST TO
THE DEPARTMENT'S WEBSITE.
  2. THE DEPARTMENT SHALL CREATE A  NATIONALLY  RECOGNIZED  STANDARDIZED
STROKE ASSESSMENT TOOL. THE DEPARTMENT SHALL POST THE ASSESSMENT TOOL ON
THEIR WEBSITE AND PROVIDE A COPY OF THE ASSESSMENT TOOL TO EACH LICENSED
EMERGENCY  MEDICAL  SERVICES  PROVIDER.  EACH LICENSED EMERGENCY MEDICAL
SERVICES PROVIDER SHALL USE A STROKE ASSESSMENT TOOL  THAT  IS  SUBSTAN-
TIALLY SIMILAR TO THE STROKE ASSESSMENT TOOL PROVIDED BY THE DEPARTMENT.
  3.  ALL  EMERGENCY  SERVICES  AUTHORITIES IN THE STATE SHALL ESTABLISH
PRE-HOSPITAL CARE PROTOCOLS RELATED TO  THE  ASSESSMENT,  TREATMENT  AND
TRANSPORT  OF  STROKE  PATIENTS  BY  LICENSED EMERGENCY MEDICAL SERVICES
PROVIDERS IN THE STATE. SUCH PROTOCOLS SHALL INCLUDE THE DEVELOPMENT AND
IMPLEMENTATION OF PLANS FOR THE TRIAGE AND  TRANSPORT  OF  ACUTE  STROKE
PATIENTS  TO  THE  CLOSEST  COMPREHENSIVE  STROKE CENTER, PRIMARY STROKE
CENTER OR ACUTE STROKE READY HOSPITAL, WITHIN A SPECIFIED  TIMEFRAME  OF
THE ONSET OF SYMPTOMS.
  4.  ALL EMERGENCY SERVICES AUTHORITIES IN THE STATE SHALL ESTABLISH AS
PART OF CURRENT TRAINING REQUIREMENTS, PROTOCOLS TO ENSURE THAT LICENSED
EMERGENCY MEDICAL SERVICES PROVIDERS AND  EMERGENCY  DISPATCH  PERSONNEL
RECEIVE  REGULAR  TRAINING  ON  THE  ASSESSMENT  AND TREATMENT OF STROKE
PATIENTS.
  5. ALL EMERGENCY MEDICAL  SERVICES  PROVIDERS  MUST  COMPLY  WITH  THE
PROVISIONS OF THIS SECTION WITHIN ONE YEAR OF THE EFFECTIVE DATE OF THIS
ARTICLE.
  6.  ALL  DATA  REPORTED  UNDER THIS SECTION, WHICH IS NOT PROTECTED BY
CONFIDENTIALITY, SHALL BE MADE AVAILABLE TO THE DEPARTMENT  AND  TO  ANY
AND  ALL OTHER GOVERNMENT AGENCIES OR CONTRACTORS OF GOVERNMENT AGENCIES
THAT HAVE RESPONSIBILITY FOR THE MANAGEMENT AND ADMINISTRATION OF  EMER-
GENCY MEDICAL SERVICES WITHIN THE STATE.
  S  2899-G.  CONTINUOUS IMPROVEMENT OF THE QUALITY OF CARE FOR INDIVID-
UALS WITH STROKES. 1. THE DEPARTMENT SHALL  ESTABLISH  AND  IMPLEMENT  A
PLAN FOR ACHIEVING CONTINUOUS QUALITY IMPROVEMENT OF THE QUALITY OF CARE

A. 7410                             3

PROVIDED  UNDER  THE STATEWIDE SYSTEM FOR STROKE RESPONSE AND TREATMENT.
IN IMPLEMENTING THIS PLAN THE DEPARTMENT SHALL:
  (A) MAINTAIN A STATEWIDE STROKE DATABASE THAT COMPILES INFORMATION AND
STATISTICS  ON  STROKE CARE THAT ALIGN WITH THE STROKE CONSENSUS METRICS
DEVELOPED AND APPROVED BY THE AMERICAN HEART ASSOCIATION/AMERICAN STROKE
ASSOCIATION. THE DEPARTMENT SHALL UTILIZE "GET  WITH  THE  GUIDELINES  -
STROKE"  OR  ANOTHER NATIONALLY RECOGNIZED DATA SET PLATFORM WITH CONFI-
DENTIALITY STANDARDS NO LESS SECURE, AS THE STROKE REGISTRY  DATA  PLAT-
FORM.  TO  THE  EXTENT  POSSIBLE,  THE  DEPARTMENT SHALL COORDINATE WITH
NATIONAL VOLUNTARY  HEALTH  ORGANIZATIONS  INVOLVED  IN  STROKE  QUALITY
IMPROVEMENT TO AVOID DUPLICATION AND REDUNDANCY.
  (B)  REQUIRE  COMPREHENSIVE  STROKE CENTERS AND PRIMARY STROKE CENTERS
AND  ENCOURAGE  ACUTE  STROKE  READY  HOSPITALS  AND  EMERGENCY  MEDICAL
SERVICES  AGENCIES  TO REPORT DATA CONSISTENT WITH NATIONALLY RECOGNIZED
GUIDELINES ON THE TREATMENT OF INDIVIDUALS WITH CONFIRMED STROKE  WITHIN
THE STATE.
  (C)  ENCOURAGE  SHARING  OF  INFORMATION  AND  DATA  AMONG HEALTH CARE
PROVIDERS ON WAYS TO IMPROVE THE QUALITY OF CARE OF STROKE  PATIENTS  IN
THIS STATE.
  (D)  FACILITATE  THE  COMMUNICATION AND ANALYSIS OF HEALTH INFORMATION
AND DATA AMONG THE HEALTH CARE PROFESSIONALS PROVIDING CARE FOR INDIVID-
UALS WITH STROKE.
  (E) REQUIRE THE APPLICATION OF  EVIDENCED-BASED  TREATMENT  GUIDELINES
REGARDING  THE  TRANSITIONING  OF  PATIENTS TO COMMUNITY-BASED FOLLOW-UP
CARE IN HOSPITAL OUTPATIENT,  PHYSICIAN  OFFICE  AND  AMBULATORY  CLINIC
SETTINGS  FOR  ONGOING  CARE  AFTER  HOSPITAL  DISCHARGE FOLLOWING ACUTE
TREATMENT FOR STROKE.
  (F) ESTABLISH A DATA  OVERSIGHT  PROCESS  AND  IMPLEMENT  A  PLAN  FOR
ACHIEVING CONTINUOUS QUALITY IMPROVEMENT IN THE QUALITY OF CARE PROVIDED
UNDER THE STATEWIDE SYSTEM FOR STROKE RESPONSE AND TREATMENT WHICH SHALL
DO ALL OF THE FOLLOWING:
  (I)  ANALYZE  DATA  GENERATED  BY  THE REGISTRY ON STROKE RESPONSE AND
TREATMENT;
  (II) IDENTIFY  POTENTIAL  INTERVENTIONS  TO  IMPROVE  STROKE  CARE  IN
GEOGRAPHIC AREAS OR REGIONS OF THE STATE; AND
  (III)  PROVIDE  RECOMMENDATIONS  TO THE DEPARTMENT AND THE LEGISLATURE
FOR THE IMPROVEMENT OF STROKE CARE AND DELIVERY IN THE STATE.
  2. ALL DATA REPORTED UNDER THIS SECTION SHALL BE MADE AVAILABLE TO THE
DEPARTMENT AND ALL OTHER GOVERNMENT AGENCIES OR CONTRACTORS  OF  GOVERN-
MENT  AGENCIES  THAT HAVE RESPONSIBILITY FOR THE MANAGEMENT AND ADMINIS-
TRATION OF EMERGENCY MEDICAL SERVICES THROUGHOUT THE STATE.
  3. BY JUNE FIRST EACH YEAR THE  DEPARTMENT  SHALL  PROVIDE  A  SUMMARY
REPORT OF THE DATA COLLECTED PURSUANT TO THIS SECTION. ALL DATA SHALL BE
REPORTED  IN  THE AGGREGATE FORM AND SHALL BE POSTED ON THE DEPARTMENT'S
WEBSITE AND PRESENTED TO THE GOVERNOR, THE TEMPORARY  PRESIDENT  OF  THE
SENATE AND THE SPEAKER OF THE ASSEMBLY TO SHOW STATEWIDE PROGRESS TOWARD
IMPROVING QUALITY OF CARE AND PATIENT OUTCOMES.
  4.  THIS  SECTION  DOES NOT REQUIRE THE DISCLOSURE OF ANY CONFIDENTIAL
INFORMATION OR OTHER DATA IN VIOLATION OF THE FEDERAL  HEALTH  INSURANCE
PORTABILITY AND ACCOUNTABILITY ACT OF 1996, P.L. 104-191.
  S  2899-H. COVERAGE FOR TELEMEDICINE SERVICES. 1. EACH INSURER, CORPO-
RATION OR HEALTH MAINTENANCE ORGANIZATION PROVIDING A HEALTH  CARE  PLAN
SHALL  PROVIDE  COVERAGE  FOR TELEMEDICINE SERVICES FOR THE TREATMENT OF
ACUTE STROKE.

A. 7410                             4

  2. AS USED IN THIS SECTION, "TELEMEDICINE SERVICES",  SHALL  MEAN  THE
USE  OF INTERACTIVE AUDIO, VIDEO AND OTHER ELECTRONIC MEDIA USED FOR THE
PURPOSE OF DIAGNOSIS, CONSULTATION, OR TREATMENT OF ACUTE STROKE.
  3.  AN  INSURER, CORPORATION, OR HEALTH MAINTENANCE ORGANIZATION SHALL
REIMBURSE THE TREATING PROVIDER OR THE CONSULTING PROVIDER FOR THE DIAG-
NOSIS, CONSULTATION, OR TREATMENT OF THE INSURED DELIVERED THROUGH TELE-
MEDICINE SERVICES ON THE SAME BASIS THAT THE  INSURER,  CORPORATION,  OR
HEALTH  MAINTENANCE  ORGANIZATION  IS  RESPONSIBLE  FOR COVERAGE FOR THE
PROVISION OF THE  SAME  SERVICE  THROUGH  FACE-TO-FACE  CONSULTATION  OR
CONTACT.
  4. THE REQUIREMENTS OF THIS SECTION SHALL APPLY TO ALL INSURANCE POLI-
CIES,  CONTRACTS, AND PLANS DELIVERED, ISSUED FOR DELIVERY, REISSUED, OR
EXTENDED WITHIN THE STATE ON AND AFTER ONE HUNDRED EIGHTY DAYS AFTER THE
EFFECTIVE DATE OF THIS ARTICLE, OR AT ANY TIME THEREAFTER WHEN ANY  TERM
OF THE POLICY, CONTRACT, OR PLAN IS CHANGED OR ANY PREMIUM ADJUSTMENT IS
MADE.
  S  2899-I.  USE OF DESIGNATION IN ADVERTISING. NO PERSON OR ENTITY MAY
ADVERTISE TO THE PUBLIC THAT A HOSPITAL IS A COMPREHENSIVE STROKE CENTER
OR A PRIMARY STROKE CENTER UNLESS THE HOSPITAL HAS  BEEN  DESIGNATED  AS
SUCH BY THE DEPARTMENT PURSUANT TO THIS ARTICLE.
  S 2899-J. DISCLAIMER. THIS ARTICLE IS NOT A MEDICAL PRACTICE GUIDELINE
AND SHALL NOT BE USED TO RESTRICT THE AUTHORITY OF A HOSPITAL TO PROVIDE
SERVICES FOR WHICH IT HAS RECEIVED A LICENSE UNDER STATE LAW. THE LEGIS-
LATURE  INTENDS  THAT ALL PATIENTS BE TREATED INDIVIDUALLY BASED ON EACH
PATIENT'S NEEDS AND CIRCUMSTANCES.
  S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law; provided that the addition, amendment and/or
repeal of any rule or regulation necessary  for  the  implementation  of
this act on its effective date is authorized and directed to be made and
completed before such effective date.