reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 187 - Requirements for Louisiana Stroke Center Recognition › Section I-18701 - Stroke Center Recognition

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  Louisiana Emergency Response Network Board (LERN) and the Louisiana Department
				  of Health recognize the following six levels of stroke facilities:
1. CSC: comprehensive stroke center (formerly
				  designated as level 1);
2. TSC:
				  thrombectomy capable stroke center;
3. PSC-E: primary stroke center with
				  endovascular capability;
4. PSC:
				  primary stroke center (formerly designated as level 2);
5. ASRH: acute stroke ready hospital
				  (formerly designated as level 3); and
6. stroke bypass hospital (formerly
				  designated as level 4).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 187 - Requirements for Louisiana Stroke Center Recognition › Section I-18705 - Attestation for Stroke Center Recognition

Current through Register Vol. 50, No. 6, June 20, 2024
A. A hospital seeking CSC, TSC, PSC-E, ASRH
				  or stroke bypass recognition will submit an affidavit of the hospital CEO to
				  LERN detailing compliance with the requirements designated herein.
1. A center or hospital seeking CSC
				  recognition which submits a copy of that level of certification by a
				  LERN-recognized organization, such as the joint commission or other LERN
				  approved accrediting/certification body, shall be assumed to meet the
				  requirements for recognition.
2. A
				  center or hospital seeking TSC stroke center recognition which submits a copy
				  of that level of certification by a LERN-recognized organization, such as the
				  joint commission, HFAP, or other LERN approved accrediting/certification body,
				  shall be assumed to meet the requirements for recognition.
3. A center or hospital seeking PSC-E stroke
				  center recognition which submits a copy of PSC certification by a
				  LERN-recognized organization, such as the joint commission, HFAP, or other LERN
				  approved accrediting/certification body, shall be assumed to meet the
				  requirements for recognition. In addition to a copy of the certification, the
				  CEO must also attest to meeting the additional board approved
				  requirements.
4. A center or
				  hospital seeking PSC stroke center recognition which submits a copy of that
				  level of certification by a LERN-recognized organization, such as the joint
				  commission, HFAP, or other LERN approved accrediting/certification body, shall
				  be assumed to meet the requirements for recognition.
5. A center or hospital seeking ASRH
				  recognition must submit data which, at a minimum, meets door to needle metric
				  for ASRH recognition for the two consecutive quarters immediately preceding the
				  submission date. Although a center or hospital seeking ASRH stroke center
				  recognition is not required to obtain certification by an external certifying
				  body, a hospital which submits a copy of ASRH certification by a
				  LERN-recognized organization, such as the joint commission, HFAP or other LERN
				  approved accrediting/certification body, shall be assumed to meet the
				  requirements for recognition. Hospitals must all meet LERN ASRH requirements
				  and approved data submission requirements.
6. Each center or hospital shall submit proof
				  of continued compliance every two years by submission of an affidavit by its
				  CEO. The CEO may submit a revised attestation at any point during the two year
				  period, as appropriate, when a change in resources or certification
				  occurs.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 187 - Requirements for Louisiana Stroke Center Recognition › Section I-18706 - Stroke Center Data Submission Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. All stroke centers, whether CSC, TSC,
				  PSC-E, PSC or ASRH are required to submit certain data to the board on a
				  quarterly basis.
B. The
				  requirements of and for data submission are posted on the LERN website,
http://lern.la.gov/lern-stroke-system/stroke-data-collection
.
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. 40:2846(A) and
					 48:2845(A)(7).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 187 - Requirements for Louisiana Stroke Center Recognition › Section I-18707 - Stroke Center Listing

Current through Register Vol. 50, No. 6, June 20, 2024
A. LERN will
				  publish a list on its website of hospitals or centers attesting to or meeting
				  stroke center criteria and their stroke center recognition. This list shall be
				  made available to LERN regional commissions for facilitation of EMS
				  transportation plans.
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. 40:2846(A) and
					 48:2845(A)(7).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 187 - Requirements for Louisiana Stroke Center Recognition › Section I-18708 - Failure to Submit Stroke Data to LERN

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Acute stroke ready hospitals not submitting data for one quarter or not
				  submitting the required action plan and/or mock code, if applicable, will
				  result in automatic probation, which will generate a warning letter to the CEO.
				  The letter will communicate LERN board expectation for data and (action plan
				  and/or mock code, if applicable) submission for the missed quarter and the
				  following quarter.
B. For an ASRH
				  not submitting data to the board for two consecutive quarters, the hospital
				  will automatically be demoted to a stroke bypass hospital.
C. Once an ASRH demotes to a stroke bypass
				  hospital for non-adherence with submission requirement, the hospital CEO cannot
				  re-attest until the hospital has submitted two consecutive quarters of data
				  meeting standards.
D. If an ASRH
				  fails to meet the performance metrics after two quarters of participation in
				  data review, the board appointed stroke committee may temporarily demote the
				  facility to a stroke bypass hospital until the next board meeting, when the
				  board appointed stroke subcommittee will present the blinded data to the board
				  for a vote on demotion to stroke bypass hospital versus continued
				  remediation.
AUTHORITY
					 NOTE: Promulgated in accordance with
					 R.S.
					 40:2846(A) and
					 48:2845(A)(7).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 187 - Requirements for Louisiana Stroke Center Recognition › Section I-18709 - Hospital Destination/Stroke System Transport

Current through Register Vol. 50, No. 6, June 20, 2024
A. These rules are not intended to prevent
				  any hospital or medical facility from providing medical care to any patient but
				  rather to serve as a guideline to facilitate the timely and appropriate
				  delivery of stroke patients to the most appropriate care site for the
				  definitive treatment of stroke.
B.
				  Knowledge of statewide stroke capabilities and the use of a stroke pre-hospital
				  destination protocol will enable providers to make timely decisions, promote
				  appropriate utilization of the stroke care delivery system, and ultimately save
				  lives.
AUTHORITY NOTE:
					 Promulgated in accordance with R.S. 40:2846(A), 48:2845(A)(7) and La.
					 R.S.
					 9:2798.5.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 189 - Requirements for Louisiana STEMI Receiving/Referral Centers › Section I-18901 - STEMI Center Recognition

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  Louisiana Emergency Response Network Board (LERN), and the Louisiana Department
				  of Health and Hospitals recognize the following types of facilities for the
				  treatment of ST elevated myocardial infarction (STEMI):
1. STEMI receiving center; and
2. STEMI referral center.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 189 - Requirements for Louisiana STEMI Receiving/Referral Centers › Section I-18903 - Attestation for STEMI Center Recognition

Current through Register Vol. 50, No. 6, June 20, 2024
A. A hospital seeking STEMI Center
				  recognition will submit an affidavit of the hospital CEO to LERN detailing
				  compliance with LERN Approved STEMI Receiving center requirements.
1. Those hospitals which submit a copy of
				  certification by a LERN-recognized organization such as The American Heart
				  Association Mission:Lifeline, Society of Cardiovascular Patient Care or other
				  LERN approved accrediting/certification body shall be assumed to meet the
				  requirements for recognition.
2.
				  Each center or hospital shall submit proof of continued compliance every two
				  years by submission of an affidavit of its CEO.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 189 - Requirements for Louisiana STEMI Receiving/Referral Centers › Section I-18905 - STEMI Center Listing

Current through Register Vol. 50, No. 6, June 20, 2024
A. LERN will
				  publish a list on its website of hospitals or centers attesting to STEMI center
				  criteria for recognition as either a STEMI receiving center or STEMI referral
				  center. This list shall be made available to the LERN regional commissions for
				  facilitation of EMS transportation plans.
AUTHORITY NOTE:
					 Promulgated in accordance with La. R.S. 40:2846(A) and
					 48:2845(A)(7).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 189 - Requirements for Louisiana STEMI Receiving/Referral Centers › Section I-18907 - Hospital Destination/STEMI System Transport

Current through Register Vol. 50, No. 6, June 20, 2024
A. These rules are not intended to prevent
				  any hospital or medical facility from providing medical care to any patient but
				  rather to serve as a guideline to facilitate the timely and appropriate
				  delivery of STEMI patients to the most appropriate care site for the definitive
				  treatment of STEMI.
B. Knowledge of
				  STEMI capabilities and the use of a STEMI pre-hospital destination protocol
				  will enable providers to make timely decisions, promote appropriate utilization
				  of the STEMI care delivery system, and ultimately save lives.
AUTHORITY NOTE:
					 Promulgated in accordance with La. R.S. 40:2846(A), 48:2845(A)(7) and
					 R.S.
					 9:2798.5.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19103 - Region 7 LERN Entry and Destination Protocols

Current through Register Vol. 50, No. 6, June 20, 2024
A. On November 15, 2007, the Louisiana
				  Emergency Response Network Board [R.S.
				  40:2842(1)] adopted and
				  promulgated "Region 7 LERN Entry and Destination Protocol" for region 7 of the
				  Louisiana Emergency Response Network [R.S.
				  40:2842(3)], which region
				  includes the parishes of Bienville, Bossier, Caddo, Claiborne, DeSoto,
				  Natchitoches, Red River, Sabine and Webster, as follows.
1.
a.
				  Traumatic patients who meet the following criteria will be entered to LERN call
				  center and should be transported directly to LSUHSC in Shreveport, Louisiana,
				  if possible:
i. airway compromise (intubated,
				  apneic, or obstructed airway);
ii.
				  penetrating wound of head, neck, chest, abdomen, groin, or buttocks;
iii. blood pressure <=100 or signs of
				  shock;
iv. GCS 12 or
				  less;
v. new onset neurological
				  deficit associated with traumatic event;
vi. extremity wound with absent pulse or
				  amputation proximal to foot or hand.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19107 - Interregional Transfer Protocol

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  On June 18, 2009, the Louisiana Emergency Response Network Board [R.S.
				  40:2842(1)] adopted and
				  promulgated "Interregional Transfer Protocol" for the Louis iana Emergency
				  Response Network [R.S.
				  40:2842(3)], as follows.
1. The LERN interregional transfer protocol
				  only applies to those regions and (hospitals/EMS) that are participating in the
				  LERN network.
2. The interregional
				  transfer protocol will be tested over a 90 day period. At the end of the 90
				  days all interregional transfers will be reviewed for compliance with
				  protocols, quality, patient safety and standards of care. This information will
				  be shared with commissions of the regions participating as well as the LERN
				  board and the "design the system group". Decisions regarding the interregional
				  transfer protocol will be made at the end of the 90 days trial
				  period.
3. Interregional Transfer
				  Protocol
a. All patients whose condition
				  exceeds the regionally available resources provided by local area hospitals may
				  be transferred from one region to another following LERN interregional transfer
				  protocol. Destination to the definitive care hospital in the receiving region
				  will follow the LERN standard protocol (all laws regarding EMTALA
				  apply).
b. Only regions operating
				  with the LERN standard protocol will be involved in the LERN interregional
				  transfer protocol.
c. Patients
				  being transferred via the LERN interregional transfer protocol must:
i. be assessed at a local area hospital for
				  treatment and stabilized by a physician and meet the entry criteria as
				  determined by LERN standard protocol;
ii. treating physician will call LERN to
				  request a transfer to another hospital;
iii. LCC (LERN call center) will determine
				  the closest and most appropriate facility available following LERN standard
				  protocol;
iv. if there are no
				  available resources in the region then the LCC will locate an appropriate
				  facility outside the region, and an interregional transfer will be considered.
				  (All LERN interregional transfers will be reviewed by LERN medical directors
				  and data will be collected for QI/PI.)
d. Exceptions
i. EMS requesting LERN for patients located
				  on or close to borders between two regions will and can be directed to either
				  region based on the patient needs and available resources.
ii. Air-med at the scene that is able to
				  mitigate the time of transfer of long distances will and can be directed to
				  hospitals outside the region they originate from based on patients needs and
				  available resources.
iii. LERN
				  medical directors will be involved in the decision making (real time) in all
				  patients that fall into the exception category.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19111 - Interregional Transfer Protocol

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  On January 20, 2011, the Louisiana Emergency Response Network Board
				  (R.S. 40:2842(1) and
				  (3)) adopted and promulgated "LERN Hospital
				  Interregional Transfer Guidelines" and "LERN Hospital Interregional Transfer
				  Protocol", replacing "Interregional Transfer Protocol" adopted June 18, 2009,
				  as follows.
1. LERN Hospital Interregional
				  Transfer Guidelines
a. All patients whose
				  conditions exceed the regionally available resources provided by local area
				  hospitals may be transferred from one region to another following LERN
				  interregional transfer protocol.
b.
				  The LERN hospital interregional transfer protocol only applies to hospitals
				  that are participating in the LERN network.
c. Regions or individual parishes that have
				  MOUs (which include medical control and destination guidelines), between an ACS
				  verified level 1 trauma center and a local parish medical society(ies) will be
				  incorporated into the LCC standard operating procedure for the effected
				  region(s).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19113 - LERN Entry Criteria: Trauma; LERN Destination Protocol: Trauma

Current through Register Vol. 50, No. 6, June 20, 2024
A. On January 20,
				  2011, the Louisiana Emergency Response Network Board [R.S. 40:2842(1) and
				  (3)] adopted and promulgated "LERN ENTRY
				  CRITERIA: Trauma; Pre-Hospital and Hospital Triage Protocol" and "LERN
				  DESTINATION PROTOCOL: Trauma" replacing the "Standard LERN Entry Trauma
				  Criteria" and "Standard LERN Entry Trauma Criteria Destination Protocol"
				  adopted and promulgated January 20, 2011, as follows.
1. LERN Entry Criteria: Trauma
a. Pre-Hospital and Hospital Triage
				  Protocol
Call LERN Communications Center
								for:
* Unmanageable Airway
* Tension Pneumothorax
* Traumatic cardiac arrest
* Burn Patient without patent airway
* Burn patient >40 percent BSA without IV
Physiologic
* GCS <14
* SBP <90 (adults and >9 y/o)
<70 + 2 [age (yrs)] (age 1 to 8 y/o)
<70 (age 1 to 12 months)
<60 (term neonate)
* RR <10 or >29 (adults & >=9
								y/o)
<15 or >30 (age 1 to 8 y/o)
<25 or >50 (<12 m/o)
Anatomic
* Open or depressed skull fractures
* Open head injury with or without CSF leak
* Lateralizing signs or paralysis (i.e., one-sided
								weakness, motor, or sensory deficit)
* All penetrating injuries to head, neck, torso,
								and extremities proximal to elbow and knee
* Flail Chest
* 2 or more proximal long-bone fractures
* Crush, degloved or mangled extremity
* Amputation proximal to wrist and ankle
* Pelvic Fractures
* Hip Fractures (hip tenderness, deformity, lateral
								deviation of foot) excluding isolated hip fractures from same level
								falls
* Major joint dislocations (hip, knee, ankle,
								elbow)
* Open Fractures
* Fractures with neurovascular compromise
								(decreased peripheral
Call LERN Communications Center
								for:
Mechanism
* Falls >20 ft. adults
>10 ft. (child) or 2 to 3 times height
* Auto vs. pedestrian/bicyclist thrown, run over or
								significant
(>20 MPH) impact
* Motorcycle crash >20 MPH
* High-risk auto crash
* Intrusion >12 in, occupant site
>18 in. any site
* Ejection, partial or complete from
								automobile
* Death in same passenger compartment
Other
* Pregnancy >20 weeks
* Burns (follow ABA guidelines)
* Age >=55 y/o or <8 y/o
* Anticoagulation and bleeding disorders
* End stage renal disease
* Transplant patients
Multi/Mass Casualty Incident (MCI)
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 191 - Trauma Protocols › Section I-19115 - LERN Destination Protocol: TRAUMA

Current through Register Vol. 50, No. 6, June 20, 2024
A. On April 26, 2012, the Louisiana Emergency
				  Response Network Board [R.S.
				  40:2842(1) and (3)] adopted
				  and promulgated "LERN Destination Protocol: Trauma" replacing the "LERN
				  Destination Protocol: Trauma" adopted and promulgated April 21, 2011, as
				  follows.
* Unmanageable Airway
[RIGHTWARDS ARROW]
Closest ED
* Tension Pneumothorax
* Traumatic cardiac arrest
* Burn Patient without patent airway
* Burn patient >40 percent BSA without IV
Physiologic
* GCS <14
[RIGHTWARDS ARROW]
Level I, II, or III*
* SBP <90 (adults and >9 y/o)
<70 + 2 [age (yrs)] (age 1 to 8 y/o)
<70 (age 1 to 12 months)
<60 (term neonate)
* RR <10 or >29 (adults and=9 y/o)
<15 or >30 (age 1 to 8 y/o)
<25 or >50 (<12 m/o)
Anatomic
* Open or depressed skull fractures
[RIGHTWARDS ARROW]
Level I, II, or III*
* Open head injury with or without CSF leak
* Lateralizing signs or paralysis (i.e., one -sided
								weakness, motor, or sensory deficit)
* All penetrating injuries to head, neck, torso,
								& extremities proximal to elbow & knee
* Flail Chest
* 2 or more proximal long-bone fractures
* Crush, degloved or mangled extremity
* Amputation proximal to wrist & ankle
* Pelvic Fractures
* Hip Fractures (hip tenderness, deformity, lateral
								deviation of foot) excluding isolated hip fractures from same level
								falls
* Major joint dislocations (hip, knee, ankle,
								elbow)
* Open Fractures
* Fractures with neurovascular compromise
								(decreased peripheral pulses or prolonged capillary refill, motor or sensory
								deficits distal to fracture)
Mechanism
* Falls >20 ft. adults
>10 ft. (child) or 2 to 3 times height
[RIGHTWARDS ARROW]
Level I, II, or III*
* High -risk auto crash
* Intrusion >12 in. occupant site
>18 in. any site
* Ejection, partial or complete from
								automobile
* Death in same passenger compartment
* Auto vs. pedestrian/bicyclist thrown, run over or
								significant (>20 MPH) impact
* Motorcycle crash >20 MPH
Other
* Pregnancy >20 weeks
[RIGHTWARDS ARROW]
Level II, or III*
* Burns (follow ABA guidelines)
* Age >=55 y/o or <8 y/o
* Anticoagulation and bleeding disorders -patients
								w/ head injuries are at high risk for rapid deterioration
MULTI/MASS CASUALTY INCIDENT (MCI)
[RIGHTWARDS ARROW]
Level I, II, or III*
*Refers to ACS Verified Level Trauma Center Where trauma
					 center not available, patient will be routed to facility with appropriate
					 resource which may not need be the highest level facility.
B. This protocol was published at LR
				  38:1462-1463 (June 20, 2012).
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 9:2798.5 and
					 R.S.
					 40:2846(A).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 192 - Burn Protocols › Section I-19201 - LERN Destination Protocol: BURN

Current through Register Vol. 50, No. 6, June 20, 2024
A. Call
				  LERN Communication Center at 1-866-320-8293 for patients meeting the following
				  criteria.
Burn Patient with Trauma
YES [RIGHTWARDS ARROW]
See LERN Trauma Destination Protocol
No
*
*
*
Burn patient without patent airway
Patients with facial / airway burns or anticipated
								airway compromise
Burn patient with 40 %
BSA without IV or IO access
Yes [RIGHTWARDS ARROW]
Transport to Closest ED
No
1
*
*
*
*
*
*
*
2nd and
								3rd degree burns involving:
> 10% BSA
Face, hands, feet, genitalia, perineum, or major
								joints
Circumferential Burns
Electrical burns, including lightning
								injury
Chemical burns
Or
Inhalation injury
All Third Degree Burns
Yes [RIGHTWARDS ARROW]
Transport to Closest
Burn
Center
* If distance or patient condition impedes
								transport to burn center, consider transport to most appropriate resourced
								hospital.
No
Transport per Local EMS Protocols
*
*
In the event of a burn disaster, each burn center
								should immediately contact LERN. LERN Call Center (LCC) will conduct a bed
								poll.
In the event of a burn disaster and excess beyond
								capacity, the next geographically closest burn center should be alerted
								immediately by LERN.
Click Here To View
					 Image
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 40:2846(A),
					 R.S.
					 40:2845(A)(1) and
					 R.S.
					 9:2798.5.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 193 - Stroke Protocols › Section I-19301 - LERN Destination Protocol: Stroke

Current through Register Vol. 50, No. 6, June 20, 2024
A. On November 21, 2013, the Louisiana
				  Emergency Response Network Board [R.S.
				  40:2842(1) and (3)] adopted
				  and promulgated "LERN Destination Protocol: STROKE," as follows.
1. The following protocol applies to patients
				  with suspected stroke.
Compromise Of:
* Airway
* Breathing
* Circulation
[RIGHTWARDS ARROW]
Closest ED
NO
[DOWNWARDS ARROW]
* All other patients with suspected stroke Patients
								with seizure with focal deficit, extended window (4-8 hrs from onset), and
								patients with unknown onset may benefit from evaluation at Level I or II
								hospital with on-site stroke expertise.
[RIGHTWARDS ARROW]
Transport to LERN Stroke Level I, II, or III
NO
[DOWNWARDS ARROW]
Terminally Ill or Palliative Care Patient
[RIGHTWARDS ARROW]
Transport to LERN
Stroke Level I, II,
III, or IV
Guiding principles:
* Time is the critical variable in acute stroke
								care.
* Protocols that include pre -hospital notification
								while en route by EMS should be used for patients with suspected acute stroke
								to facilitate primary destination efficiency.
* Treatment with intravenous tPA is the only FDA
								approved acute therapy for stroke.
* EMS should identify the geographically closest
								facility capable of providing tPA treatment.
* Transfer patient to the nearest hospital equipped
								to provide tPA treatment.
* Secondary transfer to facilities equipped to
								provide tertiary care and interventional treatments should not prevent
								administration of tPA to appropriate patients.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 193 - Stroke Protocols › Section I-19303 - LERN Destination Protocol: Stroke

Current through Register Vol. 50, No. 6, June 20, 2024
A. On
				  April 21, 2017, the Louisiana Emergency Response Network Board [R.S. 40:2842(1) and
				  (3)] adopted and promulgated "LERN
				  Designation Protocol: Stroke", amending and replacing the previous "LERN
				  Designation Protocol: Stroke" adopted on November 21, 2013 and set out in
				  Section 19301, as follows.
LERN Destination Protocol: Stroke LERN Call Center:
					 (866) 320-8293
The following protocol applies to patients with suspected
					 stroke:
Click
					 here to view image
Click
					 here to view image
* The LSN < 6hrs should include patients without a
					 definite time of LSN, but who could reasonably be assumed to be within 6 hrs of
					 onset, including patients who wake-up with stroke symptoms.
Guiding Principles:
* Time is the critical variable in acute stroke
							 care
* Protocols that include pre-hospital notification
							 while en route by EMS should be used for patients with suspected acute stroke
							 to facilitate initial destination efficiency.
* Treatment with intravenous tPA is the only FDA
							 approved medication therapy for hyperacute stroke.
* EMS should identify the geographically closest
							 hospital capable of providing tPA treatment.
* Transfer patient to the nearest hospital equipped
							 to provide tPA treatment.
* Secondary transfer to facilities equipped to
							 provide tertiary care and interventional treatm ents should not prevent
							 administration of tPA to appropriate patients.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 9:2798.5 and
					 R.S.
					 40:2846(A).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 193 - Stroke Protocols › Section I-19305 - LERN Destination Protocol: Stroke

Current through Register Vol. 50, No. 6, June 20, 2024
A. On
				  November 17, 2023, to be effective January 1, 2024, the Louisiana Emergency
				  Response Network Board [R,S, 40:2842(1) and (3)] adopted and promulgated "LERN
				  Destination Protocol: Stroke", amending and replacing the previous "LERN
				  Destination Protocol: Stroke" adopted on April 21, 2017, and set out in Section
				  19303, as follows:
1. LERN Destination
				  Protocol: Stroke for Known Time of Stroke Onset
Click
					 here to view image
2. LERN Destination Protocol: Stroke for
				  Unknown Time of Stroke Onset
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Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 195 - STEMI Protocols › Section I-19501 - STEMI Triage Protocol for Pre-Hospital Providers

Current through Register Vol. 50, No. 6, June 20, 2024
A. On November 21, 2013, the Louisiana
				  Emergency Response Network Board [R.S.
				  40:2842(1) and (3)] adopted
				  and promulgated "STEMI Triage Protocol for Pre-Hospital Providers," as follows.
Acute coronary symptoms >=15 minutes and < 12
								hours
AND
12 lead ECG criteria of 1 mm ST elevation in 2 or
								more contiguous leads
OR LBBB NOT KNOWN to be present in the past
EMS ECG interpreted or transmitted to hospital for
								MD consult for bypass and activation
[DOWNWARDS ARROW]
STEMI-Receiving Center with medical
								contact-to-device (PCI) <=90 minutes (by ground or air)?
YES [RIGHTWARDS ARROW]
Transport to nearest STEMI-Receiving Center with
								pre-hospital notification/activation
Goal medical contact to device (PCI) time of 90
								minutes or less
NO
[DOWNWARDS ARROW]
Transport to closest STEMI-Referral Hospital with
								Pre-hospital notification/activation Goal medical contact to fibrinolytic
								needle time of 30 minutes or less
[RIGHTWARDS ARROW]
Transport to nearest STEMI-Receiving Center for
								subsequent PCI
*O'Gara PT, Kushner FG, Ascheim DD, et all. 2013 ACCF/AHA
					 Guideline for the Management of ST -Elevation Myocardial Infraction: A Report
					 of the American College of Cardiology Foundation/American Heart Association
					 Task Force on Practice Guidelines. Journal of the American College of
					 Cardiology. 2013;61(4):e78.
B. This protocol was published at LR 50:192
				  (January 20, 2014).
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 9:2798.5 and
					 R.S.
					 40:2846(A).
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 197 - Trauma Program Recognition › Section I-19701 - Generally

Current through Register Vol. 50, No. 6, June 20, 2024
A. The goal of the
				  Louisiana Emergency Response Network Board is to establish a trauma system that
				  includes one verified trauma center in each region of the state. Trauma program
				  recognition in excess of this goal will be determined utilizing a needs based
				  assessment. The LERN Communication Center coordinates access to the trauma
				  system by providing accurate and professional routing of patients experiencing
				  time sensitive illness to the definitive care facility, which includes trauma
				  programs recognized according to these rules.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 40:2846(A),
					 R.S.
					 40:2845(A)(1) and
					 R.S.
					 9:2798.5.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 197 - Trauma Program Recognition › Section I-19703 - Purpose

Current through Register Vol. 50, No. 6, June 20, 2024
A. LERN recognizes
				  the opportunity to reduce the morbidity and mortality of trauma patients in
				  Louisiana in areas without an existing Level I or Level II trauma center or an
				  existing Level II or Level III trauma program through this process which
				  recognizes the achievement of specific benchmarks in hospitals actively
				  pursuing Levels II or III trauma center verification through the American
				  College of Surgeons (ACS).
B. The
				  purpose of this Chapter is to define the qualifications, procedure, and
				  requirements for hospitals seeking trauma center verification by the ACS to be
				  recognized by LERN as achieving the core components of a trauma program and
				  thus qualified for recognition as a trauma program.
C. The criteria for trauma program
				  recognition are drawn from
Resources for Optimal Care of Injured
				  Patient 2014
published by the ACS.
D. Trauma program recognition is distinct and
				  different from the Trauma Center certification by the state. To be certified as
				  a trauma center, a hospital must satisfy the requirements of
				  R.S.
				  40:2172 and 2173.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 40:2846(A),
					 R.S.
					 40:2845(A)(1) and
					 R.S.
					 9:2798.5.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 197 - Trauma Program Recognition › Section I-19705 - Qualifications for LERN Trauma Program Recognition

Current through Register Vol. 50, No. 6, June 20, 2024
A. The hospital must be located in a LERN
				  region that does not have an existing ACS verified Level I or Level II trauma
				  center.
B. A hospital providing
				  care to trauma patients in a LERN region without an existing ACS verified Level
				  I or Level II trauma center or without an existing Level II or Level III trauma
				  program is eligible for trauma program recognition upon meeting the
				  requirements of this rule.
C. If
				  there is an existing LERN recognized Level II or Level III trauma program in
				  the LERN region, the hospital must complete the most current version of the ACS
				  needs based assessment of trauma systems tool (ACS NBATS). If the number of
				  trauma centers allocated by the tool is less than or equal to the number of
				  existing trauma programs in the region, the hospital is not eligible for trauma
				  program recognition.
D. A hospital
				  must be in the process of working toward ACS verification to be eligible for
				  trauma program recognition.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 40:2846(A),
					 R.S.
					 40:2845(A)(1) and
					 R.S.
					 9:2798.5.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 15 - Emergency Response Network › Chapter 197 - Trauma Program Recognition › Section I-19707 - Procedure for Trauma Program Recognition

Current through Register Vol. 50, No. 6, June 20, 2024
A. A hospital must complete the LERN approved
				  form, "Application for Recognition of Trauma Program".
B. The hospital CEO must complete and sign
				  the LERN approved trauma program checklist/attestation for the applicable
				  trauma program level.
1. By this attestation,
				  the hospital CEO ensures 24/7/365 availability of the resources
				  listed.
2. The attestation must be
				  validated by a site visit by LERN staff.
3. Upon CEO attestation and/or site visit, if
				  it is determined by the LERN executive committee in conjunction with the LERN
				  trauma medical director, that the required benchmarks are not in place the
				  hospital will not be eligible for trauma program
				  verification.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20101 - Mission [Formerly LAC 67:VII.1101]

Current through Register Vol. 50, No. 6, June 20, 2024
A. General Statement. The legislature of
				  Louisiana recognizes the right of people with significant physical disabilities
				  to lead independent and productive lives and further recognizes that persons
				  with significant disabilities require personal assistance to meet tasks of
				  daily living and, in many cases to avoid costly institutionalization. The
				  creation of the State Personal Assistance Services Program, hereafter referred
				  to as the SPAS Program, is to provide state personal assistance services to
				  persons with significant disabilities in order to support and enhance their
				  employability and/or to avoid inappropriate and unnecessary
				  institutionalization. The mission of the SPAS Program is to provide for an
				  orderly sequence of services to those persons who are determined eligible for
				  the program.
B. Program
				  Administration. The Department of Health and Hospitals, through Office of Aging
				  and Adult Services (OAAS), is responsible for the administration of the SPAS
				  Program.
C. Purpose of this Rule.
				  This Rule sets forth the policies of OAAS in carrying out the agency's mission,
				  specifically as this mission relates to the SPAS Program.
D. Exceptions. The secretary or secretary's
				  designee shall have the sole responsibility for any exceptions to this policy
				  manual.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 46:2116.2.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20103 - Enabling Legislation [Formerly LAC 67:VII.1103]

Current through Register Vol. 50, No. 6, June 20, 2024
A. House Bill Number 1198, Act 939 of the
				  2010 Regular Session, LAC Title 48, Chapter 201,
Revised
				  Statute
46:2116.2.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 46:2116.2.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20105 - Definitions [Formerly LAC 67:VII.1105]

Current through Register Vol. 50, No. 6, June 20, 2024
A. The following terms, when used in this
				  manual, shall have the meaning, unless the context clearly indicates
				  otherwise.
Self-Directed
-the participant or
					 legal/personal representative will direct, supervise, hire and discharge
					 his/her personal attendant and be able to
self-direct
all
					 goods/services needed.
Management Contractor/Fiscal
					 Agent
-contracted entity which may be responsible for day to day
					 program activities including but not limited to eligibility requirements,
					 etc.
Department
-the Department of Health and
					 Hospitals.
Individual with Significant
					 Disabilities
-an individual with loss of sensory or motor functions
					 interfering with activities of daily living to the extent that the person
					 requires assistance with non-medical personal care needs, domestic or cleaning
					 needs, dressing and undressing, moving into and out of bed, transferring,
					 ambulation, related services including but not limited to meal preparation,
					 laundry, and grocery shopping, and/or other similar activities of daily
					 living.
PA
-personal assistance.
Secretary
-the
secretary
of the Department of Health and Hospitals.
State Personal Assistance Services (SPAS)
					 Program
- services means goods and services which are required by a
					 person with significant disabilities age 18 eighteen or older to increase a
					 persons independence or substitute for a persons dependence on human
					 assistance.
Intentional Program Violation
-made a false
					 or misleading statement, or misrepresented, concealed or withheld fact; or
					 committed any act that constitutes a violation of the SPAS Program or SPAS
					 policy and/or procedures.
AUTHORITY NOTE;
					 Promulgated in accordance with 46:2116.2.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20107 - General Requirements [Formerly LAC 67:VII.1107]

Current through Register Vol. 50, No. 6, June 20, 2024
A. Cost-Effective Service Provision. All
				  services shall be provided in a cost-effective manner.
B. This program shall be considered as a
				  source of last resort for personal assistance services after private and
				  governmental sources have been expended.
C. Case File Documentation. All SPAS Program
				  management contractors/fiscal agents must maintain a case file for each SPAS
				  Program participant. The case file shall contain documentation to support the
				  decision to provide, deny, or amend services. Documentation of the amounts and
				  dates of each service provided to support all claims for reimbursement must
				  also be included in the case file.
D. The department is under no obligation to
				  perform any of the services described in
				  R.S 46:2116 et
				  seq., and can utilize other sources to provide these services. Additionally,
				  funds appropriated for state plan personal assistance services may be used as
				  match for available funds.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 46:2116.2.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20109 - Applicant and Participant Appeal Rights [Formerly LAC 67:VII.1111]

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any individual
				  whose request is denied for goods/services, denied eligibility or discharged
				  from the program may appeal said decision in accordance with the provisions of
				  R.S.
				  46:107. Such appeal shall be conducted in
				  accordance with the Administrative Procedure Act and shall be subject to
				  judicial review.
B. A participants
				  current services shall remain in place during the appeals process until a final
				  administrative decision is reached. A decision is final when the Division of
				  Administrative of Law renders a decision on the appeal.
AUTHORITY NOTE;
					 Promulgated in accordance with
					 R.S.
					 46:2116.2.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20111 - Eligibility Decisions [Formerly LAC 67:VII.1113]

Current through Register Vol. 50, No. 6, June 20, 2024
A. An individual can be determined eligible
				  for services as set forth in
				  R.S.
				  46:2116.2 if that individual meets all of the
				  following criteria:
1. is an individual with
				  significant disabilities;
2. is age
				  18 or older;
3. needs goods and/or
				  personal assistance services from this program to prevent or remove the
				  individual from inappropriate placement in an institutional setting or enhance
				  or maintain individuals employability;
4. provides verification of the disability
				  from the treating physician;
5. is
				  capable or has legal/personal representation capable of self-direction.
				  Although the participant is capable of self-directing they may chose a
				  qualified provider agency for services; and
6. has unique economic and social
				  needs.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20113 - Economic Need [Formerly LAC 67:VII.1115]

Current through Register Vol. 50, No. 6, June 20, 2024
A. In determining an individual's financial
				  need for services, the management contractor will use a system based upon the
				  current federal poverty guidelines. The economic need status of each
				  participant for the SPAS Program shall be considered in the initial
				  determination of eligibility for services and at least annually thereafter. The
				  participant must provide verification of income.
B. The total monthly income of the SPAS
				  applicant and/or spouse shall be considered in determining the amount of
				  available income in the determination of eligibility for services. Current
				  income received on a regular basis must be considered regardless of its
				  source.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 46:2116.2.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20115 - Plan for State Personal Assistance Services [Formerly LAC 67:VII.1117]

Current through Register Vol. 50, No. 6, June 20, 2024
A. Following a
				  determination of eligibility for services, an appropriate individualized
				  assessment will be completed to determine the scope of services. After a
				  case-by-case assessment of needs, a service plan will be developed,
				  implemented, and updated as appropriate. The service plan will be
				  individualized and outcome oriented.
B. A state personal assistance services plan
				  is to be developed between the participant and the management contractor to
				  determine the specific goods/services needed. A SPAS plan shall be initiated
				  annually or more often, if indicated. The SPAS plan and all updated plans shall
				  be contained in the participants case record.
C. The participant is to cooperate fully in
				  the development of the SPAS plan, including all changes and amendments. The
				  participants signature is required for the personal assistance plan and any
				  amendments.
D. Minimum content of
				  the personal assistance plan:
1.
				  identification of specific goods/services to be delivered;
2. the frequency of goods/services with
				  flexibility;
3. the beginning date
				  and service review dates.
Louisiana Administrative Code › Title 48 - PUBLIC HEALTH-GENERAL › Part I - General Administration › Subpart 17 - Personal Assistance Services › Chapter 201 - State Personal Assistance Services Program › Section I-20117 - Financial [Formerly LAC 67:VII.1119]

Current through Register Vol. 50, No. 6, June 20, 2024
A. Prior Authorization. A participant shall
				  obtain prior authorization from contract manager for goods and/or services
				  before they can begin. Failure to obtain prior authorization will result in a
				  denial of goods or services. If an emergency situation exists where goods or
				  services are needed to begin prior to the management contractors receipt of
				  written acceptance, management contractor may provide verbal authorization for
				  services to begin. The management contractor must amend the SPAS plan before
				  service can begin.
B. The
				  participant of SPAS will invoice the management contractor bi- monthly in
				  arrears for personal assistance services purchased and include copies of time
				  sheets as verification of the services being provided. The invoice shall
				  contain the following:
1. dates of
				  services;
2. description of goods/
				  services provided along with the number of hours of personal assistance
				  services per day and/or number of goods received;
3. rate of pay;
4. signature of direct service worker;
				  and
5. signature of participant of
				  the SPAS Program.