BILL ANALYSIS

C.S.H.B. 2356

By: Johnson, Ann

Public Health

Committee Report (Substituted)

BACKGROUND AND PURPOSE

Strokes are one of the most common causes of disability among individuals over the age of 50. According to the American Heart Association, studies have shown that stroke victims who are treated by mobile stroke units rather than standard EMS units are treated faster and are significantly more likely to recover without any permanent disability. Mobile stroke units allow stroke treatment to begin on-scene, as opposed to the emergency room, and have traditionally been provided through philanthropic funding. Mobile stroke units are specialized EMS units that are equipped with a mobile computed tomography scanner and other medical equipment necessary for diagnosing and treating stroke victims. These units are also staffed with personnel trained to diagnose and treat stroke victims outside of a hospital setting, and have a neurologist available either on board the vehicle or via consultation through a telemedicine medical service. C.S.H.B. 2356 seeks to establish a grant program through the Health and Human Services Commission to provide financial assistance to stroke facilities and increase the availability of mobile stroke units in Texas.

CRIMINAL JUSTICE IMPACT

It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is expressly granted to the executive commissioner of the Health and Human Services Commission in SECTION 1 of this bill.

ANALYSIS

C.S.H.B. 2356 amends the Health and Safety Code to require the executive commissioner of the Health and Human Services Commission (HHSC) to establish by rule a mobile stroke unit grant program to improve health care outcomes for individuals who suffer a stroke by providing financial assistance to stroke facilities and increase the availability of mobile stroke units in Texas. The bill authorizes the following entities to apply to HHSC to receive money under the grant program:

·         a local health department or a public health district;

·         an emergency medical services department of a municipality or county;

·         a fire department of a municipality or county that provides emergency medical services;

·         an emergency services district; and

·         a stroke facility.

The bill requires HHSC to administer the program and requires HHSC to award grants from available money and any additional money appropriated for purposes of the grant program. The bill authorizes HHSC to accept gifts, grants, and donations from any source for purposes of the grant program.

C.S.H.B. 2356 authorizes a qualifying facility to apply to HHSC to receive money under the grant program and requires the executive commissioner to establish by rule the eligibility criteria and a scoring system for awarding the grants. The bill authorizes HHSC to award grants to eligible applicants and restricts use of grant money to covering the recipient's capital costs associated with procuring equipment necessary to operate a mobile stroke unit, including the following:

·         a specialized emergency medical services vehicle;

·         a mobile computed tomography scanner;

·         medical equipment used in diagnosing or treating an individual who suffers a stroke; and

·         any other equipment HHSC considers necessary or appropriate.

The bill requires a grant recipient to coordinate the use of money under the grant program with a facility designated by the Department of State Health Services as a comprehensive Level 1 stroke facility. The bill requires a recipient to annually submit to HHSC a report on the recipient's use of the grant money, including the health outcomes of individuals treated by the recipient's mobile stroke units and the recipient's operating expenses associated with operating those units.

C.S.H.B. 2356 defines "mobile stroke unit" to mean a specialized emergency medical services vehicle that:

·         is equipped with a mobile computed tomography scanner and other necessary medical equipment and medications for diagnosing and treating an individual who suffers a stroke;

·         is staffed with personnel trained to diagnose and provide acute stroke treatment to an individual outside of a hospital setting; and

·         has a neurologist on board the vehicle or available for consultation with the vehicle's personnel through a telemedicine medical service.

The bill defines "stroke facility" by reference.

C.S.H.B. 2356 requires the executive commissioner, not later than January 1, 2024, to adopt the rules necessary to implement the bill's provisions.

EFFECTIVE DATE

September 1, 2023.

COMPARISON OF INTRODUCED AND SUBSTITUTE

While C.S.H.B. 2356 may differ from the introduced in minor or nonsubstantive ways, the following summarizes the substantial differences between the introduced and committee substitute versions of the bill.

Whereas the introduced authorized a stroke facility that holds a comprehensive Level 1 stroke designation from the Department of State Health Services (DSHS) to apply to HHSC to receive money under the grant program, the substitute authorizes specified entities to do so.

The substitute includes provisions absent from the introduced requiring a grant recipient to coordinate the use of money awarded under the grant program with a facility designated by DSHS as a comprehensive Level 1 stroke facility.

The substitute includes a provision absent from the introduced defining "stroke facility" by reference.