1 South Carolina General Assembly 2 117th Session, 2007-2008 3 4 H. 4928 5 6 STATUS INFORMATION 7 8 Joint Resolution 9 Sponsors: Reps. Jefferson, Lowe, Howard, G.M. Smith, Crawford, Cobb-Hunter, Alexander, Moss, 10 Kennedy, Brantley, Williams, J.H. Neal, Clyburn, Hosey, Barfield, Breeland, Haskins, Hodges, Loftis, 11 Miller, Allen, Jennings, R. Brown, Whipper, Knight, Erickson, Hart and Mitchell 12 Document Path: l:\council\bills\nbd\12216ac08.doc 13 Companion/Similar bill(s): 1276 14 15 Introduced in the House on April 1, 2008 16 Introduced in the Senate on June 3, 2008 17 Last Amended on May 28, 2008 18 Currently residing in the Senate Committee on Medical Affairs 19 20 Summary: Stroke Systems of Care Study Committee 21 22 23 HISTORY OF LEGISLATIVE ACTIONS 24 25 Date Body Action Description with journal page number 26 4/1/2008 House Introduced and read first time HJ-10 27 4/1/2008 House Referred to Committee on Medical, Military, Public and Municipal Affairs HJ-10 28 4/8/2008 House Member(s) request name added as sponsor: Allen, Jennings, R.Brown, Whipper, 29 Knight 30 4/9/2008 House Member(s) request name added as sponsor: Erickson 31 4/16/2008 House Member(s) request name added as sponsor: Hart 32 5/21/2008 House Committee report: Favorable with amendment Medical, Military, Public and 33 Municipal Affairs HJ-205 34 5/27/2008 House Member(s) request name added as sponsor: Mitchell 35 5/28/2008 House Amended HJ-29 36 5/28/2008 House Read second time HJ-30 37 5/29/2008 House Read third time and sent to Senate HJ-17 38 6/3/2008 Senate Introduced and read first time SJ-11 39 6/3/2008 Senate Referred to Committee on Medical Affairs SJ-11 40 41 42 VERSIONS OF THIS BILL 43 44 4/1/2008 45 5/21/2008 46 5/28/2008 47 1 AMENDED 2 May 28, 2008 3 4 H. 4928 5 6 Introduced by Reps. Jefferson, Lowe, Howard, G.M. Smith, 7 Crawford, Cobb-Hunter, Alexander, Moss, Kennedy, Brantley, 8 Williams, J.H. Neal, Clyburn, Hosey, Barfield, Breeland, Haskins, 9 Hodges, Loftis, Miller, Allen, Jennings, R. Brown, Whipper, 10 Knight, Erickson, Hart and Mitchell 11 12 S. Printed 5/28/08--H. 13 Read the first time April 1, 2008. 14 15

1 [4928-1] 1 2 3 4 5 6 7 8 9 A JOINT RESOLUTION 10 11 TO ESTABLISH THE STROKE SYSTEMS OF CARE STUDY 12 COMMITTEE TO DEVELOP RECOMMENDATIONS FOR A 13 STATE STROKE SYSTEMS OF CARE COMPREHENSIVE 14 SERVICE DELIVERY SYSTEM AND TO PROVIDE FOR THE 15 MEMBERSHIP, DUTIES, AND RESPONSIBILITIES OF THE 16 STUDY COMMITTEE. 17 Amend Title To Conform 18 19 Be it enacted by the General Assembly of the State of South 20 Carolina: 21 22 Whereas, stroke is the third leading cause of death in South 23 Carolina resulting in 2,449 death and 14,381 hospitalizations that 24 cost $391 million in 2005, and South Carolina is among a group of 25 Southeastern states with high stroke death rates commonly referred 26 to as the “Stroke Belt”; and 27 28 Whereas, the highest stroke rates within the State are clustered in 29 counties along the Interstate 95 corridor, known as the “stroke 30 buckle”, in which the African American population is in excess of 31 the State’s average and members of which are 46 percent more 32 likely to die from a stroke than Caucasians in South Carolina; and 33 34 Whereas, the Institute of Medicine of the National Academy of 35 Science has concluded that fragmentation of health care service 36 delivery frequently results in sub-optimal treatment, safety 37 concerns, and inefficient use of health care resources and, 38 accordingly, recommends the establishment of coordinated 39 systems of care that integrate preventive and treatment services 40 and promote patient access to evidence-based care; and 41

1 [4928] 1 1 Whereas, the fragmented approach to stroke care that exists in 2 most regions of the United States fails to provide an effective, 3 integrated system for stroke prevention, treatment, and 4 rehabilitation because of inadequate linkages and coordination 5 among the fundamental components of stroke care, which may be 6 well developed but often operate in isolation; and 7 8 Whereas, the problem of access to coordinated stroke care may be 9 exacerbated in rural or neurologically-underserved areas due to 10 inadequate access to neurological expertise; and 11 12 Whereas, a stroke system of care should coordinate and promote 13 patient access to the full range of activities and services associated 14 with stroke prevention, treatment, and rehabilitation, including the 15 following key components: primordial and primary prevention, 16 community education, notification and response of emergency 17 medical services, acute stroke treatment, including the hyper-acute 18 and emergency department phases, sub-continuous quality 19 improvement activities; and 20 21 Whereas, it is in the best interest of this State and its residents to 22 create a study committee to conduct a review of state resources to 23 account for access to the most advanced treatment in centers that 24 are best designed and equipped to deal with the critical and time 25 sensitive needs of stroke patients and make recommended actions 26 for an effective comprehensive stroke system of care. Now, 27 therefore, 28 29 Be it enacted by the General Assembly of the State of South 30 Carolina: 31 32 SECTION 1. (A) There is created the Stroke Systems of Care 33 Study Committee composed of the following members who must 34 be appointed by the Governor and who must represent the 35 geographic regions of the State and be demographically diverse: 36 (1) one physician actively involved in stroke care upon the 37 recommendation of the South Carolina Medical Association from 38 each of the following fields: 39 (a) neurology; 40 (b) neuroradiology; 41 (c) internal medicine, general practice, or family practice 42 actively involved in stroke care; 43 (d) emergency medical services; and

1 [4928] 2 1 (e) cardiology recommended by the South Carolina 2 Chapter of the American College of Cardiology; 3 (2) one registered professional nurse actively involved in 4 direct stroke care upon the recommendation of the South Carolina 5 Nurses Association; 6 (3) one representative of the South Carolina Office of Rural 7 Health; 8 (4) one representative of the South Carolina Hospital 9 Association; 10 (5) the director of the South Carolina Department of Health 11 and Environmental Control or a designee; 12 (6) the director of the South Carolina Department of Health 13 and Environmental Control Emergency Medical Services; 14 (7) one physician or representative of an organization 15 actively involved in addressing minority health issues; 16 (8) one administrator of an acute stroke rehabilitation 17 facility; 18 (9) one stroke survivor or caregiver; 19 (10) one representative of the American Stroke Association. 20 (B) The Governor shall appoint the chairman of the South 21 Carolina Stroke Systems of Care Study Committee from among 22 the members of the committee upon the recommendation of the 23 American Stroke Association. 24 (C) Vacancies occurring on the committee must be filled in the 25 same manner as the original appointment. 26 (D) The study committee shall accept committee staffing and 27 coordination as volunteered by the American Heart Association. 28 (E) Members of the study committee shall serve without 29 mileage, per diem, and subsistence. 30 31 SECTION 2. (A) The committee shall develop a plan for a 32 statewide stroke system of care using the resources of both the 33 public and private sectors incorporating flexibility to best fit the 34 needs of each region or locality. The plan must address, but is not 35 limited to: 36 (1) effective prevention, treatment, and rehabilitation of 37 stroke through a standardized case management system, utilizing 38 best patient care transcending geo-political boundaries or corporate 39 affiliations; 40 (a) interaction and collaboration among health care 41 workers; 42 (b) performance and continuous quality improvement 43 measures;

1 [4928] 3 1 (2) development and implementation of an urgent response 2 system to provide appropriate care to stroke patients in the initial 3 ninety minutes post-event that may dramatically reduce risk for 4 lifelong disability through improved response, diagnosis, and 5 treatment of stroke; 6 (3) a data system in which stroke can be identified from 7 existing data sources to continually track and monitor the 8 incidence and prevalence of stroke, including mortality and 9 morbidity; 10 (4) public education programs; 11 (5) strategy to reduce stroke disparities among minority, 12 rural, uninsured, and underinsured populations; 13 (6) recommendations for policy and legislative changes that 14 may be needed including, but not limited to, appropriations, 15 definition of a stroke center, program development, and state 16 standards of stroke care. 17 (B) In carrying out its responsibilities under this joint 18 resolution, the chairman of the committee may appoint 19 subcommittees as appropriate and may utilize the knowledge and 20 expertise of any individual as appropriate. 21 (C) The committee shall meet at least twice as a full body with 22 the first meeting to take place no later than September 15, 2008, 23 and shall submit its report to the General Assembly and Governor 24 no later than May 5, 2009, at which time the Stroke Systems of 25 Care Study Committee is abolished. 26 27 SECTION 3. This joint resolution takes effect upon approval by 28 the Governor. 29 ----XX---- 30

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