In some states, ambulance crews who suspect a stroke are required to seek out a designated stroke center, unless the nearest one is an unreasonable distance away. Now health officials in Virginia and Washington, DC, are considering similar plans. Virginia Gov. Timothy M. Kaine has signed a bill requiring local health officials to rush stroke patients to Joint Commission-certified primary stroke centers. In Washington, DC, the medical director of Fire and Emergency Medical Services said he soon will issue a protocol requiring transport of suspected stroke patients to Joint Commission-certified stroke centers.