S.B. NO.



S.D. 1
















     SECTION 1.  The legislature finds that the rapid identification, diagnosis, and treatment of strokes can save the lives of stroke patients and, in some cases, can reverse neurological damage such as speech and language impairments or paralysis, leaving stroke patients with few or no neurological deficits.  Despite significant advances in diagnosis, treatment, and prevention, stroke is a leading cause of death nationally and in Hawaii. An estimated 795,000 new and recurrent strokes occur each year in this country.  With the aging of the population, the number of persons who have strokes is projected to increase.  Although treatments are available to improve the clinical outcomes of stroke, acute care hospitals need sufficient trained staff and equipment to optimally triage and treat stroke patients.  A system is needed in our communities to ensure the provision of optimal, safe, and effective emergency care in a timely manner to improve the overall treatment of stroke patients in order to increase survival and decrease incidents of disabilities associated with stroke.  The legislature further finds that the establishment of a stroke coalition and a stroke database will build on the work and infrastructure developed through S.C.R. No. 155 S.D. 1 (2013).

     SECTION 1.  Chapter 321, Hawaii Revised Statutes, is amended by adding a new part to be appropriately designated and to read as follows:

"Part    .  stroke care

     §   -1  Definitions.  The following terms shall have the meanings:

     "Department" means the department of health.

     "Stroke coalition" means a multi-organizational process of public, private, and nonprofit organizations working together for a common purpose to improve stroke outcomes throughout the State.

     §   -2  Stroke system of care; department duties.  The department shall establish a systematic process to evaluate and improve stroke care throughout the State to reduce death and disability from stroke.  The stroke system of care shall include:

     (1)  The requirement that hospitals meet specific stroke patient treatment capabilities that will ensure that stroke patients receive safe and effective care;

     (2)  The development of the State's emergency medical services system to ensure that stroke patients are quickly identified, transported to, and treated in facilities that have specialized programs for providing timely and effective treatment for stroke patients to improve outcomes; and

     (3)  The establishment of a statewide stroke coalition to provide a mechanism to evaluate and improve stroke care in the State.

     §   -3  Stroke coalition.  (a)  The department shall convene a stroke coalition to ensure sustainability of a process and system to evaluate and develop effective statewide stroke patient care.  The stroke coalition shall:

     (1)  Identify issues related to early identification, triage, treatment, and transport of possible acute stroke patients;

     (2)  Facilitate the collection, analysis, and communication of health information and data among the health care professionals providing care for individuals with stroke;

     (3)  Encourage sharing of information and data among health care providers on ways to improve the quality of care of stroke patients in this State;

     (4)  Develop and implement strategies to improve stroke early identification and treatment, including identifying specific hospital capabilities to receive, treat, and transfer stroke patients;

     (5)  Establish an oversight process to assess and validate hospital capabilities;

     (6)  Include statewide representation from government and nonprofit and private healthcare entities that have a role in reducing death and morbidities from stroke.

     (b)  The director of health shall be the chairperson of the stroke coalition and shall select its other members, who shall serve without compensation but be reimbursed for necessary expenses, including travel expenses, incurred in the performance of their official duties.

     §   -4  Stroke database.  The department shall establish a stroke database to support evaluation of stroke care in the State for performance improvement.  The department shall:

     (1)  Utilize an existing nationally recognized and validated data platform available to all participating hospitals and that has features to maintain confidentiality standards and data security.  Hospitals and emergency medical services agencies shall report data consistent with nationally recognized guidelines on the treatment of individuals within the State with a suspected or confirmed stroke;

     (2)  Maintain a statewide stroke database that compiles information and statistics on stroke care that aligns with the consensus stroke metrics developed and approved by national subject-matter organizations such as the American Heart Association, American Stroke Association, and the Brain Attack Coalition;

     (3)  Establish an oversight process to ensure data integrity, quality, and security, timely collection, and the generation of reports;

     (4)  Analyze data generated by the stroke database to identify potential interventions to improve stroke response and treatment; and

     (5)  Provide agreed upon state level reports of de-identified and aggregated data to the stroke coalition, government agencies, or contractors of government agencies, hospitals, researchers, and other interested parties that have a role in improving stroke care.

     §   -5  Confidential information.  This part shall not be construed to require disclosure of any confidential information or other data in violation of the federal and state privacy regulations."

     SECTION 3.  This Act shall take effect upon its approval.



Report Title:

Strokes; Coalition; Database



Establishes a stroke coalition and a stroke database in the DOH.  (SD1)




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