The Missouri Legislature passed HB 1790 during the 94th Legislative Session that recently ended. HB 1790 changes the law regarding hospital designations by the Department of Health and Senior Services to include a STEMI center and stroke center if the hospital meets the department's applicable level of STEMI and stroke center criteria. Our thanks go to Dr. George Kichura who chaired the Time Critical Task Force that developed the framework for the legislation. Over 100 stakeholders were involved in setting up the STEMI and stroke criteria. It is believed that Missouri is the first in the nation to legislatively create a STEMI and stroke system. Here is a summary of the bill. HB 1790 -- MUNICIPAL HEALTH CARE FACILITIES AND HOSPITAL DESIGNATIONS This bill changes the laws regarding municipal health care facilities and hospital designations. MUNICIPAL HEALTH CARE FACILITIES Currently, an ordinance providing for a larger board of trustees for municipal health care facilities requires that three-fifths of the trustees be citizens of the city. The bill specifies that some or all of the trustees do not have to be citizens of the city. HOSPITAL DESIGNATIONS Currently, a hospital can be designated as a trauma center and severely injured patients will be transported to the nearest designated trauma center. The bill changes the laws regarding hospital designations by the Department of Health and Senior Services to include a STEMI center and a stroke center if it meets the department's applicable level of STEMI or stroke center criteria. "ST-elevation myocardial infarction" (STEMI) is defined as a type of heart attack in which impaired blood flow to the heart is evidenced by findings in electrocardiogram analysis. The department is required to: (1) Compile and assess peer-reviewed and evidence-based clinical research and guidelines that provide or support recommended treatment standards; (2) Assess the capacity of the emergency medical services system and hospitals to deliver recommended treatments in a timely fashion; (3) Establish protocols for transporting STEMI patients to STEMI centers and stroke patients to stroke centers; (4) Establish regions within the state for coordinating the delivery of STEMI and stroke care; (5) Promote the development of regional or community-based plans for transporting STEMI and stroke patients to STEMI and stroke centers; and (6) Establish procedures for the submission of community-based or regional plans for department approval. A community-based or regional plan must be submitted to the department for approval. Plans must be based on clinical research and guidelines and the capacity assessment of emergency medical services. Patients who suffer a STEMI or stroke will be transported to the nearest STEMI or stroke center. The summaries are prepared by the Research Staff of the Missouri House of Representatives and are used by permission. All other uses of the summaries must have specific written permission. Address requests for such permission to the Chief Clerk, Missouri House of Representatives, Jefferson City, MO 65101.