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:  
2023-2 HS  
Title of proposed rule set:  
Statewide Stroke System  
3. Purpose for the proposed rules and background:  
The rules describe the structure, organization, and components of the stroke system and how it will  
integrate into the existing trauma system. They outline the responsibilities of the department and the  
participants in the system. The rules describe the process of stroke program verification and  
designation; triage, 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. 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 stroke.  
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 stroke get to the right resource in the right amount of time to salvage as  
much brain 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 ST-Elevation Myocardial Infarction (STEMI) System 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 budgetary  
language and 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.  
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 09:00 AM 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=1429  
9. List of the name and title of agency representative(s) who attended the public hearing:  
Mary Brennan, Regulatory Affairs Officer.  
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:  
Geoff Lassers, AAS, Paramedic I/C.  
Neeraj Chaudhary, MD, University of Michigan Hospitals Ann Arbor.  
Aditya Pandey, MD, University of Michigan Hospitals Ann Arbor.  
Max Kole, MD, Henry Ford Hospital Detroit.  
Justin Singer, MD Corewell Health Butterworth Hospital Grand Rapids.  
Julius Griauzde, MD, Ascension Providence, Novi.  
Joseph Gemmete, MD, University of Michigan Hospitals Ann Arbor.  
Zach Wilsek, MD, University of Michigan Hospitals.  
Horia Marin, MD, Henry Ford Hospital Detroit.  
Paul Mazaris, MD, Corewell Health Butterworth Hospital Grand Rapids.  
Chris Kazmierczak, MD, Corewell Health East Royal Oak.  
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. Alex Chebl, Henry Ford Health  
Ryan J Reece, MD, FACEP.  
Douglas J. Apple, MD, MS, FHM- Chief Clinical Officer, Ascension Michigan.  
Colin McDonough, American Heart Association  
13. Identify any changes made to the proposed rules based on comments received during the  
public comment period:  
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
Dr. Alex Chebl,  
Henry Ford  
Health  
In the stroke rule, STEMI struck  
under section R from rule;  
330.254. Rule 5 replaced with  
R 330.254(1)  
(l)  
(1)(1), the  
"stroke".  
wording should  
be "establishment  
of the regional  
stroke system ... "  
instead of the  
currently written  
"STEMI" system.  
This will remove  
confusion going  
forward.  
2
Dr. Alex Chebl,  
Henry Ford  
Health  
In both rules,  
there does not  
appear to be a  
Rule 4. We  
Rules renumbered R 330.254 - R  
correctly. 330.263  
request  
clarification  
whether this is  
due to a missing  
section or simply  
a numbering  
error.  
14.Date report completed:  
9/19/2023  
MCL 24.242 and 24.245  
;