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S. 23 (is) To promote a new urban agenda, and for other purposes. [Introduced in Senate] ...


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108th CONGRESS
  1st Session
                                 S. 239

 To amend the Public Health Service Act to add requirements regarding 
                  trauma care, and for other purposes.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            January 29, 2003

    Mr. Frist (for himself, Mr. Kennedy, Mr. Enzi, Mrs. Murray, Mr. 
  Roberts, and Mr. Graham of South Carolina) introduced the following 
  bill; which was read twice and referred to the Committee on Health, 
                     Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act to add requirements regarding 
                  trauma care, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Trauma Care Systems Planning and 
Development Act of 2003''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) The Federal Government and State governments have 
        established a history of cooperation in the development, 
        implementation, and monitoring of integrated, comprehensive 
        systems for the provision of emergency medical services.
            (2) Trauma is the leading cause of death of Americans 
        between the ages of 1 and 44 years and is the third leading 
        cause of death in the general population of the United States.
            (3) In 1995, the total direct and indirect cost of 
        traumatic injury in the United States was estimated at 
        $260,000,000,000.
            (4) There are 40,000 fatalities and 5,000,000 nonfatal 
        injuries each year from motor vehicle-related trauma, resulting 
        in an aggregate annual cost of $230,000,000,000 in medical 
        expenses, insurance, lost wages, and property damage.
            (5) Barriers to the receipt of prompt and appropriate 
        emergency medical services exist in many areas of the United 
        States.
            (6) The number of deaths from trauma can be reduced by 
        improving the systems for the provision of emergency medical 
        services in the United States.
            (7) Trauma care systems are an important part of the 
        emergency preparedness system needed for homeland defense.

SEC. 3. AMENDMENTS.

    (a) Establishment.--Section 1201 of the Public Health Service Act 
(42 U.S.C. 300d) is amended--
            (1) in subsection (a)--
                    (A) in the matter preceding paragraph (1), by 
                inserting ``, acting through the Administrator of the 
                Health Resources and Services Administration,'' after 
                ``Secretary'';
                    (B) by redesignating paragraphs (3) and (4) as 
                paragraphs (4) and (5), respectively;
                    (C) by inserting after paragraph (2) the following:
            ``(3) collect, compile, and disseminate information on the 
        achievements of, and problems experienced by, State and local 
        agencies and private entities in providing trauma care and 
        emergency medical services and, in so doing, give special 
        consideration to the unique needs of rural areas;'';
                    (D) in paragraph (4), as redesignated by 
                subparagraph (B)--
                            (i) by inserting ``to enhance each State's 
                        capability to develop, implement, and sustain 
                        the trauma care component of each State's plan 
                        for the provision of emergency medical 
                        services'' after ``assistance''; and
                            (ii) by striking ``and'' after the 
                        semicolon;
                    (E) in paragraph (5), as redesignated by 
                subparagraph (B), by striking the period at the end and 
                inserting ``; and''; and
                    (F) by adding at the end the following:
            ``(6) promote the collection and categorization of trauma 
        data in a consistent and standardized manner.'';
            (2) in subsection (b), by inserting ``, acting through the 
        Administrator of the Health Resources and Services 
        Administration,'' after ``Secretary''; and
            (3) by striking subsection (c).
    (b) Clearinghouse on Trauma Care and Emergency Medical Services.--
The Public Health Service Act (42 U.S.C. 201 et seq.) is amended--
            (1) by striking section 1202; and
            (2) by redesignating section 1203 as section 1202.
    (c) Establishment of Programs for Improving Trauma Care in Rural 
Areas.--Section 1202(a) of the Public Health Service Act, as such 
section was redesignated by subsection (b), is amended--
            (1) in paragraph (2), in the matter preceding subparagraph 
        (A), by inserting ``, such as advanced trauma life support,'' 
        after ``model curricula'';
            (2) in paragraph (4), by striking ``and'' after the 
        semicolon;
            (3) in paragraph (5), by striking the period and inserting 
        ``; and''; and
            (4) by adding at the end the following:
            ``(6) by increasing communication and coordination with 
        State trauma systems.''.
    (d) Requirement of Matching Funds for Fiscal Years Subsequent to 
First Fiscal Year of Payments.--Section 1212 of the Public Health 
Service Act (42 U.S.C. 300d-12) is amended--
            (1) in subsection (a)(1)--
                    (A) in subparagraph (A), by striking ``and'' after 
                the semicolon; and
                    (B) by striking subparagraph (B) and inserting the 
                following:
                    ``(B) for the third fiscal year of such payments to 
                the State, not less than $1 for each $1 of Federal 
                funds provided in such payments for such fiscal year;
                    ``(C) for the fourth fiscal year of such payments 
                to the State, not less than $2 for each $1 of Federal 
                funds provided in such payments for such fiscal year; 
                and
                    ``(D) for the fifth fiscal year of such payments to 
                the State, not less than $2 for each $1 of Federal 
                funds provided in such payments for such fiscal 
                year.''; and
            (2) in subsection (b)--
                    (A) in paragraph (1), by adding ``and'' after the 
                semicolon;
                    (B) in paragraph (2), by striking ``; and'' and 
                inserting a period; and
                    (C) by striking paragraph (3).
    (e) Requirements With Respect to Carrying Out Purpose of 
Allotments.--Section 1213 of the Public Health Service Act (42 U.S.C. 
300d-13) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (3), in the matter preceding 
                subparagraph (A), by inserting ``nationally 
                recognized'' after ``contains'';
                    (B) in paragraph (5), by inserting ``nationally 
                recognized'' after ``contains'';
                    (C) in paragraph (6), by striking ``specifies 
                procedures for the evaluation of designated'' and 
                inserting ``utilizes a program with procedures for the 
                evaluation of'';
                    (D) in paragraph (7)--
                            (i) in the matter preceding subparagraph 
                        (A), by inserting ``in accordance with data 
                        collection requirements developed in 
                        consultation with surgical, medical, and 
                        nursing specialty groups, State and local 
                        emergency medical services directors, and other 
                        trained professionals in trauma care'' after 
                        ``collection of data'';
                            (ii) in subparagraph (A), by inserting 
                        ``and the number of deaths from trauma'' after 
                        ``trauma patients''; and
                            (iii) in subparagraph (F), by inserting 
                        ``and the outcomes of such patients'' after 
                        ``for such transfer'';
                    (E) by redesignating paragraphs (10) and (11) as 
                paragraphs (11) and (12), respectively; and
                    (F) by inserting after paragraph (9) the following:
            ``(10) coordinates planning for trauma systems with State 
        disaster emergency planning and bioterrorism hospital 
        preparedness planning;'';
            (2) in subsection (b)--
                    (A) in paragraph (1)--
                            (i) in subparagraph (A), by striking 
                        ``concerning such'' and inserting ``that 
                        outline resources for optimal care of the 
                        injured patient''; and
                            (ii) in subparagraph (D), by striking 
                        ``1992'' and inserting ``2004''; and
                    (B) in paragraph (3)--
                            (i) in subparagraph (A), by striking 
                        ``1991'' and inserting ``2004''; and
                            (ii) in subparagraph (B), by striking 
                        ``1992'' and inserting ``2004''; and
            (3) in subsection (c), by striking ``1990, the Secretary 
        shall develop a model plan'' and inserting ``2003, the 
        Secretary shall update the model plan''.
    (f) Requirement of Submission to Secretary of Trauma Plan and 
Certain Information.--Section 1214(a) of the Public Health Service Act 
(42 U.S.C. 300d-14(a)) is amended--
            (1) in paragraph (1)--
                    (A) by striking ``1991'' and inserting ``2004''; 
                and
                    (B) by inserting ``that includes changes and 
                improvements made and plans to address deficiencies 
                identified'' after ``medical services''; and
            (2) in paragraph (2), by striking ``1991'' and inserting 
        ``2004''.
    (g) Restrictions on Use of Payments.--Section 1215(a)(1) of the 
Public Health Service Act (42 U.S.C. 300d-15(a)(1)) is amended by 
striking the period at the end and inserting a semicolon.
    (h) Requirements of Reports by States.--The Public Health Service 
Act (42 U.S.C. 201 et seq.) is amended by striking section 1216 and 
inserting the following:

``SEC. 1216. [RESERVED].''.

    (i) Report by the Secretary.--Section 1222 of the Public Health 
Service Act (42 U.S.C. 300d-22) is amended by striking ``1995'' and 
inserting ``2006''.
    (j) Funding.--Section 1232(a) of the Public Health Service Act (42 
U.S.C. 300d-32(a)) is amended to read as follows:
    ``(a) Authorization of Appropriations.--For the purpose of carrying 
out parts A and B, there are authorized to be appropriated $12,000,000 
for fiscal year 2004, and such sums as may be necessary for each of the 
fiscal years 2005 through 2008.''.
    (k) Conforming Amendment.--Section 1232(b)(2) of the Public Health 
Service Act (42 U.S.C. 300d-32(b)(2)) is amended by striking ``1204'' 
and inserting ``1202''.
    (l) Institute of Medicine Study.--Part E of title XII of the Public 
Health Service Act (20 U.S.C. 300d-51 et seq.) is amended--
            (1) by striking the part heading and inserting the 
        following:

                  ``Part E--Miscellaneous Programs'';

        and
            (2) by adding at the end the following:

``SEC. 1254. INSTITUTE OF MEDICINE STUDY.

    ``(a) In General.--The Secretary shall enter into a contract with 
the Institute of Medicine of the National Academy of Sciences, or 
another appropriate entity, to conduct a study on the state of trauma 
care and trauma research.
    ``(b) Content.--The study conducted under subsection (a) shall--
            ``(1) examine and evaluate the state of trauma care and 
        trauma systems research (including the role of Federal entities 
        in trauma research) on the date of enactment of this section, 
        and identify trauma research priorities;
            ``(2) examine and evaluate the clinical effectiveness of 
        trauma care and the impact of trauma care on patient outcomes, 
        with special attention to high-risk groups, such as children, 
        the elderly, and individuals in rural areas;
            ``(3) examine and evaluate trauma systems development and 
        identify obstacles that prevent or hinder the effectiveness of 
        trauma systems and trauma systems development;
            ``(4) examine and evaluate alternative strategies for the 
        organization, financing, and delivery of trauma care within an 
        overall systems approach; and
            ``(5) examine and evaluate the role of trauma systems and 
        trauma centers in preparedness for mass casualties.
    ``(c) Report.--Not later than 2 years after the date of enactment 
of this section, the Secretary shall submit to the appropriate 
committees of Congress a report containing the results of the study 
conducted under this section.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $750,000 for each of fiscal 
years 2004 and 2005.''.
    (m) Residency Training Programs in Emergency Medicine.--Section 
1251(c) of the Public Health Service Act (42 U.S.C. 300d-51(c)) is 
amended by striking ``1993 through 1995'' and inserting ``2004 through 
2008''.
    (n) State Grants for Projects Regarding Traumatic Brain Injury.--
Section 1252 of the Public Health Service Act (42 U.S.C. 300d-52) is 
amended in the section heading by striking ``demonstration''.
    (o) Interagency Program for Trauma Research.--Section 1261 of the 
Public Health Service Act (42 U.S.C. 300d-61) is amended--
            (1) in subsection (a), by striking ``conducting basic'' and 
        all that follows through the period at the end of the second 
        sentence and inserting ``basic and clinical research on trauma 
        (in this section referred to as the `Program'), including the 
        prevention, diagnosis, treatment, and rehabilitation of trauma-
        related injuries.'';
            (2) by striking subsection (b) and inserting the following:
    ``(b) Plan for Program.--The Director shall establish and implement 
a plan for carrying out the activities of the Program, taking into 
consideration the recommendations contained within the report of the 
NIH Trauma Research Task Force. The plan shall be periodically 
reviewed, and revised as appropriate.'';
            (3) in subsection (d)--
                    (A) in paragraph (4)(B), by striking ``acute head 
                injury'' and inserting ``traumatic brain injury''; and
                    (B) in subparagraph (D), by striking ``head'' and 
                inserting ``traumatic'';
            (4) by striking subsection (g);
            (5) by redesignating subsections (h) and (i) as subsections 
        (g) and (h), respectively; and
            (6) in subsection (h), as redesignated by paragraph (5), by 

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