In 2007, House Joint Resolution 635 (O’Bannon) directed JCHC to study and develop strategies that address “stroke prevention and care across the Commonwealth" and to identify and propose solutions to barriers for optimal stroke care, such as:

• Public awareness initiatives
• Emergency response protocols
• Primordial, primary and secondary prevention of stroke
• Rehabilitation of stroke patients
• Continuous quality improvement initiatives and
• Availability of public support to treat indigent and uninsured stroke victims.

Although HJR 635 was left in the House Committee on Rules, JCHC included the study in its work plan.

In response to the findings of this study, six options were adopted by the Commission. Five options involved requests by letter of the Chairman including:

• Virginia Department of Health (VDH) to convene a standing Stroke Systems Task Force.
• Virginia Hospital and Healthcare Association to assist in encouraging all hospitals to establish a protocol for the rapid evaluation and subsequent admission or transfer of the stroke patient.
• VDH Office of Emergency Medical Services to report to JCHC regarding progress in developing a centralized data collection system for electronic medical records.
• Department of Medical Assistance Services (DMAS) to investigate the option for care coordination service payments for those who have had a stroke.
• Department of Social Services (DSS) and DMAS to investigate an expedited Medicaid determination review for acute stroke patients.

The sixth option was to introduce legislation to amend the Code of Virginia to require each regional EMS Council to create a uniform destination plan for prehospital stroke patients.

On behalf of the Joint Commission and staff, I would like to thank the numerous workgroup members and other participants who assisted in this effort to improve stroke care in Virginia.

Kim Snead
Executive Director
April 2008