Current through Vol. 24-22, December 15, 2024
Rule 4.
(1) The
department, with the advice of the state EMS coordination committee and
statewide stroke care advisory subcommittee, shall do all the following:
(a) Implement an all-inclusive stroke system
throughout this state that allows for the care of all stroke patients in an
integrated system of healthcare in the pre-hospital and healthcare facility
environments by personnel that are well trained and equipped to care for stroke
patients.
(b) Perform all of
following:
(i) Establish regional systems of
care authorities comprised of the MCAs in each region currently approved as
regional trauma networks. The regional systems of care authority shall provide
oversight for the regional trauma system, regional stroke system and regional
STEMI system within the region.
(ii) Establish a statewide stroke care
quality improvement program using a statewide database.
(iii) Monitor the statewide stroke
system.
(iv) Ensure the
coordination and performance of the regional stroke systems.
(v) Set minimum standards for system
performance and stroke patient care.
(c) Develop a statewide process to establish
regional stroke systems comprised of the local MCAs within a region in a manner
that integrates the stroke system into existing regional trauma, EMS, and
medical control systems.
(d)
Develop, implement, and maintain a state stroke systems of care plan.
(e) Develop a statewide process for the
verification of stroke resources based on a stroke center's current
certification by a department-approved, CMS-recognized professional certifying
organization.
(f) Develop a
statewide process for the designation of stroke centers.
(g) Develop an appeals process for healthcare
facilities to contest their designation determination.
(h) Establish state stroke care
recommendations and approve regional stroke protocols that are established and
adopted by the local MCA.
(i)
Recognize the regional stroke systems providing system oversight of the stroke
care provided in each region of this state.
(j) Regional stroke systems must be
integrated into the established regional systems of care authority composed of
the collaborating local MCAs in a region.
(k) The regional systems of care authority
shall apply to the department for approval and recognition as a regional stroke
system. The department, with the statewide stroke care advisory subcommittee
and state EMS coordination committee, shall review the regional stroke system
application for approval every 3 years.
(l) The establishment of the regional stroke
system does not limit the transfer or transport of stoke patients between
regions of the state.
(m) Require
stroke triage protocols, which are established and adopted by local MCA and
regional stroke systems and developed based on triage criteria prescribed by
the department on the recommendation of the statewide stroke care advisory
subcommittee and state EMS coordination committee, and following the procedures
established by the department under section 20919(3) of the code, MCL
333.20919.
(n) Develop a statewide stroke verification
process based on the verification standards of a CMS recognized professional
certifying organization for a predetermined period of time.
(o) Establish a mechanism for periodic
re-designation of stroke centers.
(p) Develop a comprehensive statewide stroke
data collection system.
(q)
Formulate recommendations for the development of performance improvement plans
by the regional stroke systems, consistent with those in
R 330.260.
(r) Develop a process for stroke system
performance improvement, including responsibility for monitoring compliance
with standards, maintaining confidentiality, and providing periodic review of
stroke center standards set forth by nationally recognized professional review
organizations. The following standards are incorporated by reference in these
rules, as specified in
R 330.259, and
R 330.260.
(t) Develop a process for the evaluation of
stroke system effectiveness based on standards under
R 330.260.
(u) Coordinate and integrate appropriate
stroke risk reduction strategies and programs.
(v) Support the state stroke system of care
and provide resources to carry out its responsibilities and
functions.
(w) Support the training
and education needs and resources of stroke care personnel throughout this
state.
(2) The department
may deny, suspend, or revoke designation of a stroke center on a finding
including, but not limited to, any 1 of the following:
(a) Failure to comply with the rules or
healthcare facilities rules and regulations, or both.
(b) Willful preparation or filing of false
reports or records.
(c) Fraud or
deceit in obtaining or maintaining designation status.
(d) Failure to meet designation criteria
established in these rules.
(e)
Unauthorized disclosure of medical or other confidential information.
(f) Alteration or inappropriate destruction
of medical records.
(g) The
healthcare facility no longer has the resources required to comply with the
current level of designation conferred.
(h) The healthcare facility no longer cares
for stroke patients.
(i) A
department-approved stroke care verification body has determined that the
stroke center no longer meets their stroke center verification
criteria.
(j) Identified
deficiencies are not remediated in the allowable timeframe.
(3) The department shall provide a
notice of disciplinary action including, but not limited to an intent to deny,
suspend, or revoke a stroke center designation and provide for an appeals
process under sections 71 to 87 of the administrative procedure act of 1969,
1969 PA 306, MCL 24271 to
24.287.
(4) In developing a statewide stroke care
system, the department shall consider all the following factors:
(a) Efficient implementation and
operation.
(b) Decrease in
morbidity and mortality.
(c) Cost
effective implementation.
(d)
Incorporation of national standards.
(e) Availability of money for
implementation.