Paul Coverdell National Acute Stroke Program - Through Health Research, Inc., the New York State Department of Health (NYSDOH) proposes statewide and regional activities in areas with the highest burden of stroke to 1) improve HTN detection and control to prevent stroke, 2) enhance data collection and use of data in quality improvement (QI) to improve stroke care, and 3) promote standard procedures to assess clinical and social needs and make referrals to strengthen linkages between clinical and community resources for those at the highest risk of stroke. Regional work will be focused within counties with a crude stroke mortality rate of more than 55.9 per 100,000 in the population and Census Tracts with rates of stroke prevalence more the 1.5 the average for the county. Proposed activities will track, monitor, and assess clinical and social services and support needs, promote team-based care for patients with stroke, or undiagnosed or uncontrolled hypertension, and strengthen referrals to link individuals to community resources and clinical services. Over the 5-year performance period, the statewide and regional activities are expected to contribute to increase the use of health information technology in stroke care and prevention, increase the assessment of social services and support needs, expand the collection and use of data in quality improvement across the continuum of care for stroke, increase team-based care and the engagement of the community-based workforce in stroke care and prevention. Ongoing evaluation and performance measurement will track progress toward these outcomes and measure progress toward addressing disparities in stroke care. The achievement of short- and intermediate outcomes is expected to contribute to long-term outcomes of improved cardiovascular health and reduced disparities. To support the implementation of proposed activities NY will expand a learning collaborative (LC) made up of diverse partners representing hospitals, emergency medical services (EMS), outpatient and community-based providers committed to improving stroke care and prevention. To advance regional activities in areas experiencing the highest burden of stroke, NY will convene regional health care, emergency care, health information and community partners to define priorities and shape QI activities.