S.C.R. NO.


















     WHEREAS, stroke is the leading cause of chronic disability among adults in the State; and


     WHEREAS, rapid identification, diagnosis, and treatment of stroke can improve outcomes for stroke patients; and


     WHEREAS, Hawaii needs an effective system to support the rapid assessment and triage of stroke patients and provide appropriate stroke treatment in a timely manner; and


     WHEREAS, a stroke system of care will improve the overall care of stroke patients, increase patients' chances of survival, and decrease the incidence of long-term disabilities associated with stroke; and


     WHEREAS, such a system of care is recommended in Hawaii's Plan for the Prevention of Heart Disease and Stroke, issued by the Department of Health in November 2011; and


     WHEREAS, a stroke system of care should be established in the State to evaluate, stabilize, and provide emergency and inpatient care to patients with acute stroke; now, therefore,


     BE IT RESOLVED by the Senate of the Twenty-seventh Legislature of the State of Hawaii, Regular Session of 2013, the House of Representatives concurring, that the Department of Health is urged to convene a task force to establish a stroke system of care in the State that includes a statewide stroke database and registry by December 31, 2015; and
     BE IT FURTHER RESOLVED that the membership of the task force comprise government, non-profit, and private health care entities and include the following individuals:


(1)  The Director of Health or the Director's designee;


(2)  The Emergency Medical Services Directors of each county, or the Directors' designees;


(3)  A representative from the Neurotrauma Advisory Board established under section 321H-3, Hawaii Revised Statutes;


(4)  A representative from the American Heart Association or the American Stroke Association;


(5)  A member of the House of Representatives appointed by the Speaker of the House;


(6)  A member of the Senate appointed by the Senate President; and


(7)  Three representatives of the health care industry selected by the Healthcare Association of Hawaii; and


     BE IT FURTHER RESOLVED that in developing a stroke system of care, the task force is requested to:


(1)  Examine and identify barriers to quality care for stroke patients;


(2)  Review and assess national models, best practices, guidelines, and standards of stroke care, comparative to Hawaii's needs;


(3)  Update information regarding the stroke plan in the Hawaii Plan for the Prevention of Heart Disease and Stroke, issued by the Department of Health in November 2011, including a needs assessment that, in particular, assures that Neighbor Island issues are adequately addressed;


(4)  Focus on ensuring that patients at risk of stroke are provided care, at minimum, at a stroke support facility based on criteria developed and used by the American Heart Association, American Stroke Association, or Brain Attack Coalition;


(5)  Use uniform pre-hospital protocols for the assessment of stroke to alert appropriate hospitals to prepare for potential acute stroke patients prior to their arrival at the hospital;


(6)  Seek alignment with the State's Healthcare Transformation priorities, including the requirements of the Patient Protection and Affordable Care Act and federal meaningful use of health information technology priorities;


(7)  Include requirements for the measuring, reporting, and monitoring of stroke care performance through data collection;


(8)  Establish a statewide stroke database and registry in which all hospitals and healthcare facilities can participate and consider the feasibility of integrating the data registry component through American Heart Association or American Stroke Association super-user licensure for the Department of Health; and


(9)  Recommend protocols regarding direct transportation of stroke patients to appropriate hospitals by emergency medical personnel; and


BE IT FURTHER RESOLVED that the task force is requested to propose legislation necessary to support Hawaii's stroke care continuum; and


BE IT FURTHER RESOLVED that the statewide stroke database and registry include performance measurements obtained using a standardized stroke measure set containing data that is consistent with nationally-recognized guidelines on the treatment of individuals with confirmed stroke within the State, such as the American Heart Association's "Get With The Guidelines – Stroke" or The Joint Commission's "Stroke Performance Measurement Implementation Guide"; and
     BE IT FURTHER RESOLVED that the task force is requested to submit:


(1)  An initial report to the Legislature by December 31, 2013; and


(2)  A final report to the Legislature no later than 20 days prior to the convening of the Regular Session of 2015,


of the task force's actions taken and progress made, including findings, recommendations, and any proposed legislation and recommended funding levels, to establish a stroke system of care that includes the creation of a statewide stroke database and registry; and


     BE IT FURTHER RESOLVED that certified copies of this Concurrent Resolution be transmitted to the Governor, Director of Health, Senate President, Speaker of the House of Representatives, Chairperson of the Neurotrauma Advisory Board, Executive Director of the American Heart Association of Hawaii, and President and CEO of the Healthcare Association of Hawaii.









Report Title:  Stroke System of Care

Urging the Convening of a Task Force to Establish a Stroke System of Care in the State.