19 CSR 30-40.770 - Community-based or Regional Plan for Emergency Medical Services for Trauma, ST-Segment Elevation Myocardial Infarction (STEMI), or Stroke

Current through Register Vol. 47, No. 7, April 1, 2022

PURPOSE: This rule establishes the procedures for the submission of a community-based or regional plan for the transportation of patients to stroke, STEMI, or trauma centers.

(1) A community or region developing its own transportation plan for stroke, STEMI, and trauma patients may submit a plan at any time and shall ensure that it complies with section 190.200.3, RSMo. Such a plan shall also-
(A) Identify the geographic boundaries of the area covered by the plan;
(B) Designate, and provide contact information for, an individual, plan's designee who will serve as the plan's point of contact throughout the plan's approval and administration process; and
(C) Identify individuals involved in the drafting, planning, and/or consultation of the plan, who shall collectively be known as the "planning committee."
(2) Upon completion of a community-based or regional plan, the plan shall be submitted to the chair of the regional emergency medical services advisory committee defined by section 190.102, RSMo, and the regional emergency medical services medical director defined by section 190.103, RSMo, for the geographic area covered by the plan. Upon receipt of a plan submitted pursuant to the provisions of section 190.200, RSMo, the chair and medical director shall forward the plan to the emergency medical services medical director's advisory committee (the committee) as defined by section 190.103, RSMo, for consideration. Within forty-five (45) days of receipt of a community-based or regional plan, the committee shall meet and complete its review of the plan. Upon a finding of good cause, the chair of the committee may grant the committee a reasonable extension of time for review of the plan.
(3) In reviewing a community-based or regional plan, the committee shall determine whether the plan meets the requirements of section 190.200.3, RSMo, and this rule.
(4) At the conclusion of its review, the committee shall vote on the question of whether to recommend or not recommend the plan for approval. If a majority of the committee votes to recommend the plan for approval, said recommendation shall constitute prima facie evidence that the plan meets the requirements of section 190.200.3, RSMo, and should be approved. The committee shall attach such conditions (such as regular analysis and reporting of medical outcomes to the committee) to its recommendation for approval as it deems appropriate to ensure that the plan continues to meet the requirements of Chapter 190, RSMo. If a majority of the committee votes to not recommend the plan, that decision, with an explanation of the reason(s) for the decision, shall be provided in writing to the plan's designee. A community or region receiving a non-recommendation by the committee may modify its plan according to the committee's reason(s) for non-recommendation and resubmit the plan within thirty (30) days directly to the committee.
(5) Following recommendation of a community-based or regional plan, the committee shall forward the plan to the Director of the Department of Health and Senior Services (director) for approval. The director shall have thirty (30) days to review the plan for its compliance with section 190.200.3, RSMo. At the conclusion of the review, the director shall approve or disapprove the plan. If the director disapproves the plan, the reason(s) for disapproval shall be provided in writing to the plan's designee along with the right to appeal the director's decision. The director's decision shall be the final agency action. A community or region whose plan is not approved by the director may modify its plan according to the director's reason(s) for disapproval and resubmit the plan within thirty (30) days directly to the committee and follow the approval process as outlined herein.
(6) Once a plan is approved by the director, the planning committee shall-
(A) Notify all agencies impacted by the plan of the manner in which emergency medical care is modified within the region based on the plan;
(B) Monitor per the plan the related medical and system outcomes and regional resources and capacity;
(C) Revise the plan when indicated based on medical and system outcomes, emerging clinical research or guidelines, or when revision is indicated based on changes in capacity or other related issues and submit through the approval process as outlined herein; and
(D) Notify the committee and department at least thirty (30) days before ceasing to use the plan.

Notes

19 CSR 30-40.770
AUTHORITY: section 192.006, RSMo 2000, and sections 190.185 and 190.241, RSMo Supp. 2012.* Original rule filed Nov. 15, 2012, effective June 30, 2013.

*Original authority: 192.006, RSMo 1993, amended 1995; 190.185, RSMo 1973, amended 1989, 1993, 1995, 1998, 2002; and 190.241, RSMo 1987, amended 1998, 2008.

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