Current Legislative Bills

Updated Stroke Patient Protocol as passed in State Budget Summer 2023.

SECTION 90, AN OUTSIDE SECTION OF CHAPTER 28 OF THE ACTS OF 2023, THE FY’24 STATE BUDGET REQUIRES THE DEPARTMENT OF PUBLIC HEALTH TO UPDATE THE PROTOCOL FOR STROKE PATIENTS.  THIS LANGUAGE IS CONSISTENT WITH THE STANDALONE LEGISLATION THAT MACEP SUPPORTED IN WRITTEN TESTIMONY:
 
SUMMARY OF SECTION 90.
No later than 180 days after the effective date of this act, which is July 1, 2023, the Department of Public Health shall promulgate regulations that create:

1. A statewide standard pre-hospital care protocol related to the assessment, treatment and transport of stroke patients by emergency medical services providers to a hospitSeal designated by the department to care for stroke patients.

Such protocols must be based on national evidence-based guidelines for transport of stroke patients, consider transport that crosses state lines and include plans for the triage and transport of suspected stroke patients, including, but not limited to, those who may have an emergent large vessel occlusion, to an appropriate facility within a specified timeframe following the onset of symptoms and additional criteria to determine which level of care is the most appropriate destination;

2. Statewide criteria for designating hospitals in a tiered system, featuring advanced designations in addition to primary stroke services, to treat stroke patients based on patient acuity;

The tiers must be based on criteria from at least 1 nationally-recognized program and shall not permit self-designation.Also, in developing such criteria, the department shall consider:
(a) designation models and criteria developed by the Joint Commission, DNV GL Healthcare USA, Inc. or another national certifying body recognized by the Centers for Medicare and Medicaid Services;
(b) designation models and criteria adopted by other states and the differences in geography and health care resources of such other states;
(c) the clinical and operational capability of a facility to provide stroke services, including emergency and ancillary stroke services;
(d) limiting the routing of stroke patients to thrombectomy-capable facilities whenever a comprehensive stroke center is within a recommended timeframe to maximize technical competency and patient outcomes; and
(e) procedures to suspend or revoke a facility’s designation if the department determines that the facility is not in compliance with designation requirements and procedures to notify emergency medical services providers of any such suspension or revocation.
(iii)       Recommended national evidence-based quality and utilization measure sets for stroke care for use by the Massachusetts Center for Health Information and Analysis (CHIA). The law furthers requires DPH to consider measures in current use in national quality improvement programs, including, but not limited to, the CMS, the National Quality Forum, the Paul Coverdell National Acute Stroke Program or other nationally recognized data platforms.