Michigan Office of Administrative Hearings and Rules  
MOAHR-Rules@michigan.gov  
AGENCY REPORT TO THE  
JOINT COMMITEE ON ADMNINISTRATIVE RULES (JCAR)  
1. Agency Information  
Agency name:  
Health and Human Services  
Division/Bureau/Office:  
Public Health Administration  
Name of person completing this form:  
Talisa Gauthier  
Phone number of person completing this form:  
517-241-0048  
E-mail of person completing this form:  
gauthiert1@michigan.gov  
Name of Department Regulatory Affairs Officer reviewing this form:  
Mary Brennan  
2. Rule Set Information  
MOAHR assigned rule set number:  
2022-61 HS  
Title of proposed rule set:  
Statewide ST-Elevation Myocardial Infarction (STEMI) System  
3. Purpose for the proposed rules and background:  
The proposed rules describe the structure, organization, and components of the STEMI system and  
how that will integrate into the existing trauma system. The rules outline the responsibilities of the  
department and the participants in the system and describe the process of STEMI program  
verification and designation; triage and transport and transfer; system evaluation; data collection;  
STEMI registry establishment; and STEMI performance improvement. The proposed rules will  
provide structure, clarity, and detail to operationalize the existing boilerplate language that briefly  
outlines the system. The rules represent a stakeholder supported approach to system development that  
is practical, needed, and designed to optimize quality care and positive outcomes for Michigan  
residents who have had a STEMI. Outside of this rule set, there is not an organized effort in the state  
to ensure that those encountering a time intensive event like a STEMI get to the right resource in the  
right amount of time to salvage as much heart tissue as possible.  
4. Summary of proposed rules:  
MCL 24.242 and 24.245  
Agency Report to JCAR-Page 2  
The general purpose of the Statewide Stroke System rules describe the process of stroke program  
verification and designation; triage and transport and transfer; system evaluation; data collection;  
stroke registry establishment; and stroke performance improvement. The requested rules will provide  
structure, clarity, and detail to operationalize the existing boilerplate language that briefly outlines the  
system. They represent a stakeholder supported approach to system development that is practical,  
needed and designed to optimize quality care and positive outcomes for Michigan residents who have  
had a stroke.  
5. List names of newspapers in which the notice of public hearing was published and  
publication dates:  
Oakland Press, July 14, 2023.  
Battle Creek Enquirer, July 19, 2023.  
Marquette Mining Journal, July 19, 2023.  
6. Date of publication of rules and notice of public hearing in Michigan Register:  
8/15/2023  
7. Date, time, and location of public hearing:  
8/22/2023 01:00 PM at JAR Conference Room , 1001 Terminal Road, Lansing, MI 48909  
8. Provide the link the agency used to post the regulatory impact statement and cost-benefit  
analysis on its website:  
https://ARS.apps.lara.state.mi.us/Transaction/RFRTransaction?TransactionID=1420  
9. List of the name and title of agency representative(s) who attended the public hearing:  
Mary E Brennan, Regulatory Affairs Officer for MDHHS.  
Emily Berquist, State Division Administrator, Systems of Care - Stroke and STEMI.  
Eileen Worden, Section Manager, Systems of Care - Stroke and STEMI.  
Aaron Brown; Systems of Care Coordinator.  
Katelyn Schlable, Department Manager, Systems of Care - Stroke and STEMI.  
10. Persons submitting comments of support:  
None.  
11. Persons submitting comments of opposition:  
None.  
12. Persons submitting other comments:  
MCL 24.242 and 24.245  
Agency Report to JCAR-Page 3  
Dr. Abed Asfour, Corewell Health.  
Eric Jakovac, Director of Heart and Vascular Services at Corewell Health and Beaumont University  
Hospital.  
Dr. Samir Dabbous, MD, Interventional Cardiologist, Corewell Health East.  
Colin McDonough, Michigan Government Relations Director for the American Heart Association.  
Karen Halfman and David Fuller, Corazon.  
Alex Bou Chebl, MD, FSVIN Director, Harris Comprehensive Stroke Center Director, Division  
Vascular Neurology Chair, System Stroke Council Henry Ford Health.  
Ryan J. Reece, MD, EMT-P, FACEP, Assistant Professor of Emergency Medicine, Hurley Medical  
Center Division, University of Michigan.  
Frank Edward Ryan, JD, Senior Advisor, State Government Affairs-American College of Cardiology.  
David A. Walker, MPA, Government Affairs Advisor-Corewell Health.  
Michael Church, Director-Corazon, Inc.  
Henry E. Kim, MD, MPH, FACC, System Chief of Cardiology, Henry Ford Health Division Head,  
Cardiology, Frank and Barbara Darin Chair, Edith and Benson Ford Heart and Vascular Institute,  
Henry Ford Hospital.  
Dr. Ivan Hansen, Medical Director of Cardiac Catheterization Laboratory at William Beaumont  
University Hospital, Corewell East.  
Rosalie Tocco Bradley, Chief Clinical Officer, Trinity Health  
Natalie L. Baggio, SVP, Patient Care Services, Corewell Health South  
Joshua Kooistra Chief Medical Officer Corewell Health Westen Hartman, President & CEO,  
Corazon, Inc.  
David H. Fuller, Executive Vice President, Accreditation Corazon, Inc.  
Karen Hartman, President & CEO, Corazon, Inc.  
13. Identify any changes made to the proposed rules based on comments received during the  
public comment period:  
MCL 24.242 and 24.245  
Agency Report to JCAR-Page 4  
Name &  
Organization public hearing  
Comments made at Written  
Agency Rationale Rule number  
for Rule Change & citation  
and Description changed  
of Change(s)  
Comments  
Made  
1
Alex Bou  
Chebl, MD,  
FSVIN  
Director, Harris  
Comprehensive  
Stroke Center  
Director,  
In both rules,  
there does not  
appear to be a  
Rule 4. We  
Numbering error. R 330.204  
This will be  
corrected in the  
final rule set.  
request  
clarification  
whether this is  
due to a missing  
section or simply  
a numbering  
error.  
Division  
Vascular  
Neurology  
Chair, System  
Stroke Council  
Henry Ford  
Health  
MCL 24.242 and 24.245  
Agency Report to JCAR-Page 5  
2
Dr. Natalie L.  
Baggio  
SVP, Patient  
Care Services  
Corewell  
Health South  
Joshua Kooistra  
Chief Medical  
Officer  
Corewell Health DHHS has  
Accrediting  
Bodies  
Language - R  
330.206 Rule  
appreciates the  
Bureau of  
Emergency  
Preparedness,  
EMS, and  
changed these  
rules to the  
following  
language: 206(4) 6(4)(a); R  
(a): ...or a Corazon 330.206 Rule  
Systems of Care’s PCI/Catheterizatio 6(4)(b).  
efforts to offer  
broad language  
related to  
n program[.] and  
206(4)(b) : or a  
Corazon chest  
pain center[.}  
Corewell  
Health West  
approved  
accrediting  
bodies. We also  
understand that  
no final decisions  
have been made  
related to the  
accrediting  
bodies. However,  
we believe that  
the Corazon  
accreditation  
should be  
recognized as a  
valid and  
valuable  
alternative, for  
facilities without  
on-site Open-  
Heart Surgery  
(OHS) services.  
14.Date report completed:  
10/12/2023  
MCL 24.242 and 24.245  
;