HOUSE 3rd Reading Unamended April 11, 2016 HOUSE Amended 2nd Reading April 7, 2016Second Regular Session Seventieth General Assembly STATE OF COLORADO REENGROSSED This Version Includes All Amendments Adopted in the House of Introduction LLS NO. 16-0682.01 Christy Chase x2008 HOUSE BILL 16-1357 HOUSE SPONSORSHIP Primavera, SENATE SPONSORSHIP Garcia and Cooke, House Committees Senate Committees Public Health Care & Human Services A BILL FOR AN ACT Concerning implementation of the STEMI task force recommendations for the development of a system to improve the quality of care to patients who suffer heart attacks. Bill Summary (Note: This summary applies to this bill as introduced and does not reflect any amendments that may be subsequently adopted. If this bill passes third reading in the house of introduction, a bill summary that applies to the reengrossed version of this bill will be available at http://www.leg.state.co.us/billsummaries.) In 2013, the general assembly enacted SB 13-225, which established a task force in the department of public health and environment (department) to study and make recommendations for developing a statewide plan to improve quality of care to STEMI heart attack patients. ("STEMI" is an acronym for ST-elevation myocardial infarctions.) The study was to explore, among other things, the creation of a database for collecting data on STEMI care and access to aggregated STEMI data from the database for purposes of improving STEMI heart attack care. The bill implements the following recommendations of the task force, with some modifications: Requires hospitals that are recognized as heart attack receiving centers to report to a specified national heart attack database data that is consistent with nationally recognized guidelines on individuals with confirmed heart attacks within the state; Upon receipt of quarterly reports from the heart attack database, requires hospitals to submit those reports to the department for Colorado-specific data analysis; Establishes a heart attack advisory committee in the department to provide general technical expertise on matters related to heart attack care and data analysis; and Allows the department to share blinded data from the database with the heart attack advisory committee. Be it enacted by the General Assembly of the State of Colorado: SECTION 1. In Colorado Revised Statutes, 25-3-100.5, add (2), (3), (4), (5), (6), and (7) as follows: 25-3-100.5. Definitions. As used in this article, unless the context otherwise requires: (2) "Department" means the department of public health and environment. (3) "Heart attack advisory committee" means the heart attack advisory committee created in section 25-3-114. (4) "Heart attack database" means the NCDR action registry. (5) "NCDR action registry" means a national registry designed for heart attack data that is a product of the national cardiovascular data registry (NCDR) developed by the American College of Cardiology or its successor entity. (6) "PCI center" means a hospital that performs percutaneous coronary intervention (PCI), commonly known as coronary angioplasty, for acute myocardial infarction. (7) "RETAC" has the same meaning as set forth in section 25-3.5-703 (6.8). SECTION 2. In Colorado Revised Statutes, recreate and reenact, with amendments, 25-3-114 as follows: 25-3-114. Heart attack advisory committee - creation - membership - duties - definitions - repeal. (1) (a) There is hereby created in the department the heart attack advisory committee. No later than November 1, 2016, the governor shall appoint ten members to the advisory committee as follows: (I) One member who is an interventional cardiologist practicing in the state; (II) One member who is a practicing cardiologist in the state and who represents a statewide association of physicians; (III) One member representing an emergency physicians association; (IV) Two members who are emergency medical service providers, as defined in section 25-3.5-103 (8), none of whom may be from the same RETAC geographic area and one of whom provides services in a rural area of the state; (V) One member who is a registered nurse or physician assistant involved in cardiac care; (VI) One representative of a hospital located in a rural area of the state; (VII) One representative of a hospital located in an urban area of the state; (VIII) One member of the public who has suffered a heart attack; and (IX) One member with expertise in cardiovascular data registries. (b) Members of the heart attack advisory committee serve without compensation and are not entitled to reimbursement of expenses incurred in serving on or performing duties of the advisory committee. (c) (I) Members of the heart attack advisory committee shall serve four-year terms of office; except that of the members initially appointed, five members shall serve initial three-year terms and five members shall serve initial two-year terms. No member shall serve more than two consecutive four-year terms. (II) If a vacancy occurs on the heart attack advisory committee, the governor shall appoint a new member who meets the qualifications of the member being replaced, and the new member shall serve for the remainder of the vacating member's unexpired term. (III) Members of the heart attack advisory committee serve at the pleasure of the governor and continue in office until the member's successor is appointed. (d) The heart attack advisory committee shall elect a chair and vice chair from among its members. (e) The heart attack advisory committee shall meet at least quarterly and more frequently as necessary to fulfill its duties. (2) The heart attack advisory committee shall provide general technical expertise to the department on matters related to heart attack care and data analysis and shall: (a) Review quarterly reports of blinded data generated by the heart attack database and provided to the advisory committee by the department in accordance with section 25-3-117; (b) Continuously evaluate and make recommendations to improve heart attack care in geographic areas or regions of the state; and (c) Provide recommendations to the department and the general assembly for improving the system of heart attack care and delivery at the state level. (3) The department shall: (a) Facilitate the recognition and publication system under section 25-3-116; and (b) Facilitate the heart attack advisory committee's data review pursuant to paragraph (a) of subsection (2) of this section. (4) This section is repealed, effective September 1, 2026. Prior to the repeal, the department of regulatory agencies shall review the functions of the heart attack advisory committee in accordance with section 2-3-1203, C.R.S. SECTION 3. In Colorado Revised Statutes, 25-3-116, amend (1) and (3); and repeal (4) (a) as follows: 25-3-116. Department recognition of national certification - suspension or revocation of recognition - definitions. (1) A hospital that has an accreditation, certification, or designation in stroke or STEMI care from a nationally recognized accrediting body, including but not limited to a certification as a comprehensive stroke center or primary stroke center by the joint commission on accreditation of health care organizations and programs or its successor organization, or an accreditation as a STEMI receiving center or STEMI referral center by the Society for of Cardiovascular Patient Care or its successor organization, may send information and supporting documentation to the department. The department shall make a hospital's national accreditation, certification, or designation available to the public in a manner determined by the department. (3) Whether a hospital attains a national accreditation, certification, or designation in stroke or STEMI care has no bearing on, or connection with, the licensing or certification of the hospital by the department pursuant to section 25-1.5-103 (1) (a). (4) As used in this section, unless the context otherwise requires: (a) "Department" means the department of public health and environment. SECTION 4. In Colorado Revised Statutes, add 25-3-117 as follows: 25-3-117. Heart attack database - hospitals to report data on heart attack care - department to analyze data. (1) (a) Hospitals that are accredited by the Society of Cardiovascular Patient Care or its successor organization as a STEMI receiving center shall report to the heart attack database data that is consistent with nationally recognized guidelines on individuals with confirmed heart attacks within the state. Within thirty days after receiving a quarterly report of a hospital's heart attack data from the heart attack database, a hospital accredited as a STEMI receiving center shall submit the report to the department. (b) Hospitals that are recognized as STEMI referral centers pursuant to section 25-3-116 and PCI centers that are not accredited as heart attack receiving centers are encouraged to report data to the heart attack database and provide quarterly database reports to the department. (2) (a) Information obtained by the department pursuant to this section: (I) Is privileged and strictly confidential; (II) Is not subject to civil subpoena, not discoverable, and not admissible in a civil, criminal, or administrative proceeding against a health care facility or health care professional; (III) Is not directly available to the public; and (IV) Shall be used only for the evaluation and improvement of hospital STEMI care. (b) With regard to information obtained pursuant to this section, the department shall protect the confidentiality of patient records in accordance with state and federal laws and shall not disclose publicly or to the heart attack advisory committee any identifying or proprietary information of any hospital, hospital administrator, health care professional, or employee. (3) Upon receipt of quarterly reports specified in subsection (1) of this section and subject to the limitations specified in subsection (2) of this section, the department shall: (a) Share heart attack data from the quarterly reports, in aggregated format excluding any identifying or confidential information, with the heart attack advisory committee; and (b) With the heart attack advisory committee, utilize the data to conduct colorado-specific analyses of gaps in care using the NCDR action registry standards for data use. (4) The department shall sign a letter of commitment with the American College of Cardiology or its successor body to ensure compliance with confidentiality requirements and, as part of the letter of commitment, request reporting measures and metrics at the national level for benchmarking purposes. SECTION 5. In Colorado Revised Statutes, 2-3-1203, add (3) (mm) (II) as follows: 2-3-1203. Sunset review of advisory committees. (3) The following dates are the dates on which the statutory authorization for the designated advisory committee is scheduled for repeal: (mm) September 1, 2026: (II) The heart attack advisory committee created in section 25-3-114, C.R.S. SECTION 6. Safety clause. The general assembly hereby finds, determines, and declares that this act is necessary for the immediate preservation of the public peace, health, and safety.