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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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