Section R. 330.254 - Powers and duties of departmentRule 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.Mich. Admin. Code R. 330.254
2023 MR 21, Eff. 11/6/2023