Missouri Senate

Senate Committee Substitute

TIME CRITICAL DIAGNOSIS SYSTEM

Current law provides for the Department of Health and Senior Services to designate hospitals as adult, pediatric, or adult and pediatric trauma centers upon proper application and review. This act requires the department to also designate a hospital as a STEMI or stroke center when the hospital, upon proper application and review, has been found by the department to meet the applicable level of STEMI or stroke center criteria. Such criteria shall be promulgated by the department. No hospital shall hold itself out to the public as such a center unless it is so designated by the department. STEMI, or a ST-elevation myocardial infarction, is defined as a type of heart attack in which impaired blood flow to the patient's heart muscle is evidenced by ST-segment elevation in electrocardiogram analysis and as further defined by the department.

Patients who suffer a STEMI shall be transported by emergency medical services to a STEMI center. Patients who suffer a stroke shall be transported by emergency medical services to a stroke center. When initial transport from the scene of the SEMI or stroke would be prolonged, the patient may be transported to the nearest appropriate facility for stabilization prior to transport to a STEMI or stroke center. SECTIONS 190.176, 190.200, 190.241, 190.243, 190.245

These provisions are substantially similar to SB 1233 (2008).

CO-PAYMENTS FOR PRESCRIPTION DRUGS

This act provides that when the usual and customary retail price of a prescription drug is less than the co-payment applied by a health maintenance organization or health insurer, the enrollee is only required to pay the usual and customary retail price of the prescription drug. SECTION 354.535 AND 376.387

INFECTION CONTROL

This act modifies provisions regarding infection incidence rates reporting and control.

The requirements for when incidents of ventilator-associated pneumonia shall be reported to the Department of Health and Senior Services was modified to provide that upon the recommendation of the infection control advisory panel, one or more quality indicators designed to better measure the risk of acquiring ventilator-associated pneumonia may be substituted for a risk-adjusted nosocomial infection incident rate.

Also, beginning January 1, 2009, the department shall require every licensed hospital to establish a methicillin-resistant staphylococcus aureus (MRSA) control program. The program shall establish procedures to isolate MRSA-infected patients or use alternative methods when private rooms are not available. In addition the program shall establish procedures to educate staff and to establish MRSA-infection control protocols. SECTIONS 192.667 AND 197.150

ADRIANE CROUSE