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Home My WebLink AboutMINUTES - 05032011 - C.43RECOMMENDATION(S): SUPPORT Assembly Bill 861 (Hill and Nestande): California Stroke Registry, a bill that establishes the California Stroke Registry, to be administered by the State Department of Health to serve as a centralized repository for stroke data to promote quality improvement for acute stroke treatment, as recommended by the Legislation Committee. FISCAL IMPACT: One-time start-up costs, likely in the range of $200,000 to $400,000, and ongoing costs of around $800,000 annually to fund stroke registry operations. Although a federal grant program exists to fund state stroke registries, only six states have received funding through this program. If federal or private funds are not identified, the establishment in statute of an unfunded program would result in cost pressure to the State General Fund. BACKGROUND: In January 2012 Contra Costa EMS will be starting a Stroke System for the County. EMS has been working closely with all our hospitals, the California Stroke Registry and the APPROVE OTHER RECOMMENDATION OF CNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE Action of Board On: 05/03/2011 APPROVED AS RECOMMENDED OTHER Clerks Notes: VOTE OF SUPERVISORS AYE:John Gioia, District I Supervisor Gayle B. Uilkema, District II Supervisor Mary N. Piepho, District III Supervisor Karen Mitchoff, District IV Supervisor Federal D. Glover, District V Supervisor Contact: L. DeLaney, 925-335-1097 I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. ATTESTED: May 3, 2011 David J. Twa, County Administrator and Clerk of the Board of Supervisors By: Carrie Del Bonta, Deputy cc: C. 43 To:Board of Supervisors From:Legislation Committee Date:May 3, 2011 Contra Costa County Subject:SUPPORT AB 861 (Hill and Nestande): California Stroke Registry American Heart Association as part of this process. The California Stroke Registry is a data registry that helps EMS Systems and Hospitals work collaboratively to improve stroke outcomes for communities. This bill is supported by Dr. Walker and Dr. Brunner. Stroke is a top cause of death in Contra Costa County. Contra Costa Health Services and Contra Costa EMS recommend support for this bill, as it will provide access to a statewide registry at no cost, and will be a valuable tool in our future Stroke System. The bill does not carry any cost for our county and would clear the way for federal and private funding. At its March 21, 2011 meeting, the Legislation Committee acted to recommend the Board support this bill. BACKGROUND: (CONT'D) Specifically, this bill: 1) Requires the State Department of Public Health (DPH) to create the registry, and specifies operating details including: where the program is housed, which national organizations must inform the effort, and that DPH may contract out the registry function. 2) Assigns responsibility to the director of DPH to carry out various activities related to maintenance of the registry, outreach, communication with stakeholders, and improvement in the quality of stroke care. 3) Provides for access to stroke registry data for scientific and epidemiological purposes, and specifies how confidential data is to be protected. 4) Prohibits the provisions of the bill from being construed as a medical practice guideline, and specifies that it does not preempt the authority of facilities to maintain their own stroke registries. COMMENTS 1) According to the author, a voluntary stroke registry was established at DPH in 2007 and approximately 42 hospitals across the state have participated. The author maintains that codifying the voluntary registry will likely lead to a much greater rate of participation and that increasing the amount of information that can be collected on strokes, the types of treatment victims receive, and the impacts of those treatments will provide medical professionals with a roadmap to improved care. Additionally, the author maintains that establishment of a stroke registry in statute will improve the potential for California to receive and accept federal grants through the Center for Disease Control (CDC). According to the author, a new round of CDC funding is forthcoming but absent a stroke registry in statute, California will be ineligible to receive those federal funds. 2) Stroke is a Significant Population Health Problem, But Stroke Care Needs Improvement. According to the CDC, a stroke, or "brain attack," occurs when the blood supply to part of the brain is blocked or when a blood vessel in the brain bursts. In either case, parts of the brain become damaged or die when blood circulation to brain cells fails. A significant percentage of stroke victims are permanently disabled by the stroke incident. DPH reports that approximately 20,000 Californians die of stroke annually, and stroke accounts for approximately 200,000 hospital discharges per year. CDC notes that while evidence-based medical guidelines for stroke care have been developed, as well as new and improved diagnostic and treatment tools, many hospitals still do not have the organization, staff, and equipment to effectively diagnose and treat acute stroke patients. 3) Paul Coverdell National Acute Stroke Registry. In 2001, Congress charged CDC with implementing state-based registries to track acute stroke care and to use data from the registries to improve the quality of care. The purpose of a stroke registry is to develop and implement systems for collecting data on acute stroke care provided to patients, analyze the collected data, and use the results of those analyses to guide quality improvement interventions at the hospital level through partnerships with hospitals, doctors, stroke-care teams, and administrators. In 2001 and 2002, CDC funded prototype projects in several states, including California. These projects showed that large gaps existed between generally recommended guidelines for treating stroke patients and actual hospital practices. In 2004, four states were awarded funds to implement and operate stroke registries, and in 2007, six states received funding for this purpose. STATUS: 02/17/2011 INTRODUCED. 03/10/2011 To ASSEMBLY Committee on HEALTH. 03/29/2011 From ASSEMBLY Committee on HEALTH: Do pass to Committee on APPROPRIATIONS. 04/06/2011 In ASSEMBLY Committee on APPROPRIATIONS: To Suspense File. VOTES: 03/29/2011 Assembly Health Committee P 16-0 DISPOSITION: Pending LOCATION: Assembly Appropriations Committee CONSEQUENCE OF NEGATIVE ACTION: The County will not be on record in support of the bill and cannot advocate for its enactment. ATTACHMENTS AB 861 (Hill) Stroke Registry