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

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

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 striking `2001 through 2005' and inserting `2004 through 2008'.

END