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  • NJ A3423
  • Provides for designation of acute stroke ready hospitals; establishes Stroke Care Advisory Panel and Statewide stroke database; requires development of emergency services stroke care protocols; and mandates insurance coverage for telemedicine for stroke care.
Introduced
(3/7/2016)
In Committee
(3/7/2016)
Crossed OverPassedSignedDead/Failed/Vetoed
2016-2017 Regular Session
This bill establishes various requirements to revise and improve the Statewide system of stroke care by recognizing a new category of certified stroke care facilities, establishing a Statewide stroke care database, mandating stroke care standards and protocols for emergency services providers, establishing a Stroke Care Advisory Panel, and mandating insurance coverage for telemedicine. Specifically, the bill revises the requirements for designating primary and comprehensive stroke centers, and permits the designation of new acute stroke ready hospitals, by providing that the Commissioner of Health ("commissioner") is to designate any facility that has obtained the requisite certification from the Joint Commission, the American Heart Association, or any other organization approved by the commissioner that provides certifications for such facilities. Under current law, the commissioner is tasked with determining which facilities meet the requirements to be designated as a primary or comprehensive stroke center in accordance with certain criteria set forth in statute; the bill repeals the provisions detailing these criteria. Stroke care facilities designated pursuant to current law may retain that designation by obtaining and submitting documentation of the appropriate certification to the commissioner within one year after the effective date of the bill. The bill requires the commissioner to encourage designated stroke centers to enter into written agreements with acute stroke ready hospitals to provide for the transfer of patients to stroke centers for care that is unavailable at an acute stroke ready hospital. The commissioner will be required to prepare, maintain, and make available on the Department of Health ("DOH") website a list of designated stroke care facilities, which is to be transmitted to each emergency services provider in the State no later than June 1 of each year. Stroke centers and acute stroke ready hospitals will be required to annually submit to DOH data concerning information and statistics for stroke care, which DOH will compile into a Statewide stroke database that will be available on the DOH website. The submitted data will not contain any confidential or personal identifying information. The bill additionally establishes the Stroke Care Advisory Panel in DOH, which is to incorporate the duties, responsibilities, and membership of the Stroke Advisory Panel currently constituted in DOH. The 11-member panel will consist of the commissioner and the Director of the Office of Emergency Medical Services in DOH, or their designees, who will serve ex officio, and nine public members to be appointed by the Governor. The public members are to include representatives from the American Stroke Association, primary and comprehensive stroke centers, an acute stroke ready hospital, hospitals located in urban and rural areas of the State, physicians, and volunteer and non-volunteer emergency services providers. The public members will serve for a term of two years and will be eligible for reappointment. The public members serving on the current DOH advisory panel will be authorized to remain as public members on the panel created under the bill for up to one year, and will be eligible for reappointment. The advisory panel is to organize as soon as practicable but no later than 60 days after the effective date of the bill, and select a chairperson and a vice-chairperson from among its members, except that the chairperson and vice-chairperson of the current DOH advisory panel will be authorized to continue in those roles on the advisory panel created under the bill for up to one year, and will be eligible for reappointment to those roles. The chairperson will appoint a secretary who need not be a member of the advisory panel. The advisory panel will meet no less than four times per year and at such other times as may be necessary to discharge its duties. Members will serve without compensation but will be reimbursed for necessary expenses incurred in the performance of their duties within the limits of funds appropriated for that purpose. DOH will provide staff services to the panel. In addition to the duties and responsibilities of the current DOH advisory panel, the panel created under the bill will be charged with assessing the system of stroke care in New Jersey and identifying and recommending means of improving the provision of stroke care, including analyzing the Statewide stroke database established under the bill; encouraging information and data sharing among health care providers and facilities; developing evidence-based treatment guidelines for transitioning of patients to community-based follow-up care; establishing a data oversight process and implementing a plan for achieving continuous quality improvement in the quality of care provided; developing model protocols for the assessment, treatment, and transport of stroke patients for use by emergency services providers; and proposing ways to enhance the provision of stroke care in regions and communities of the State that are underserved by the current system of stroke care. The advisory panel is to submit an annual report to the Governor and the Legislature detailing its activities, findings, and proposals to improve and enhance the Statewide stroke system of care. The bill requires the Office of Emergency Medical Services in DOH to adopt a nationally recognized standardized stroke triage assessment tool, which is to be made available on the Department of Health website and transmitted to each emergency services provider no later than June 1 of each year. Emergency services providers are to develop and implement a stroke triage assessment tool that is substantially similar to the standardized stroke triage assessment tool. Emergency services providers are to additionally establish pre-hospital care protocols related to the assessment, treatment, and transport of stroke patients, which are to include, but not be limited to, plans for the triage and transport of acute stroke patients to the nearest primary or comprehensive stroke center or, when appropriate, acute stroke ready hospital, within a specified timeframe following the onset of symptoms. Emergency services providers will additionally be required to incorporate training on the assessment and treatment of stroke patients in their training requirements for emergency services personnel. As used in the bill, "emergency services provider" means a local law enforcement agency, emergency medical services unit, fire department or force, emergency communications provider, volunteer fire department, duly incorporated fire or first aid company, or volunteer emergency, ambulance, or rescue squad association or organization or company which provides emergency services. The bill additionally requires health insurance carriers, the State Health Benefits Program, and the School Employees' Health Benefits Program to provide coverage for telemedicine for patients with acute stroke delivered to a covered person in a health care facility to the same extent that the services would be covered if they were provided through an in-person consultation. As used in the bill, "telemedicine" means the diagnosis, consultation, or treatment of the symptoms of acute stroke through the use of live interactive audio and video over a secure connection that complies with the requirements of the "Health Insurance Portability and Accountability Act of 1996," Pub.L.104-191. Telemedicine will not include the use of audio-only telephone, e-mail, or facsimile. The bill specifies that a carrier, or the State programs, may charge a deductible, co-payment, or coinsurance for acute stroke care services provided through telemedicine, limit coverage to health care providers in the health benefits plan's network, and require originating site health care providers to document the reasons the acute stroke care services are being provided by telemedicine rather than in person.
Health and Senior Services
Reviewed by the Pension and Health Benefits Commission Recommend to not enact  (on 5/20/2016)
 
 

Date Chamber Action Description
5/20/2016 A Reviewed by the Pension and Health Benefits Commission Recommend to not enact
3/7/2016 A Introduced, Referred to Assembly Health and Senior Services Committee
Date Motion Yea Nay Other
None specified