8
recommendation of the stroke network system and notification to the statewide stroke advisory
committee.
(10) The department may, with the advice and recommendations of the statewide stroke care
advisory committee and state EMS coordination committee, modify the criteria or establish
additional levels of stroke care resources as appropriate to maintain an effective state stroke
system of care and protect the public welfare. The department shall not establish criteria for the
purpose of limiting the number of healthcare facilities that qualify for a particular stroke center
level of designation under these rules.
R 330.256 Triage and transport.
Rule 6. (1) The department, with the advice and recommendations of the statewide stroke care
advisory subcommittee and state EMS coordinating committee, shall develop recommendations,
based on standards in these rules, R 330.254, R 330.261, R 330.262, and R 330.263 for protocols
that are established and adopted by local MCAs for the triage, transport, and inter-facility
transfer of stroke patients to the appropriate stroke centers.
(2) The standards under R 330.254, R 330.261, R 330.262, and R 330.263 for the triage,
transport, and the inter-facility transfer of stroke patients must provide recommended minimum
standards of care for protocols that are established and adopted by local MCAs and that must be
utilized in the care during transport of stroke patients. On an annual basis, or as needed, the
department shall review and update these recommended minimum standards with the advice and
recommendations of the statewide stroke care advisory subcommittee and the state EMS
coordination committee.
(3) The department, with the advice and recommendations of the statewide stroke care advisory
subcommittee and state EMS coordinating committee, shall create regional stroke systems that
are responsible for developing triage and transport procedures within that geographical area. The
triage and transport procedures must include both of the following:
(a) Each regional stroke system must be integrated into the regional systems of care authority
created within the existing trauma regions under R 325.132.
(b) Each regional stroke system may create its own triage and transport criteria and protocols,
destination criteria and protocols, and inter-facility transfer criteria and protocols, established
and adopted by local MCAs, provided they meet or exceed the standards that are incorporated
under R 330.261, R 330.262, and R 330.263, and are reviewed by the quality assurance task
force and approved by the department. This may include coordination of triage and transport
criteria and protocols, established, and adopted by local MCAs, across geographic regions, if in
the best interest of providing optimal stroke care to patients.
R 330.257 Stroke care regions.
Rule 7. (1) The department, with the advice and recommendations of the statewide stroke care
advisory subcommittee and state EMS coordination committee, shall support the establishment
and operational activities of the regional stroke system of care through the commitment of
resources.
(2) Each region shall establish a regional stroke system of care as prescribed by this part.
(3) All MCA areas or regions shall participate in the regional stroke care system, and life
support agencies that care for stroke patients shall be offered membership on the regional stroke
care advisory council. Regional stroke care advisory councils must be operated in a manner that
maximizes inclusion of their constituents. The following requirements must be met: