[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3658 Reported in House (RH)]

                                                 Union Calendar No. 260
108th CONGRESS
  2d Session
                                H. R. 3658

                          [Report No. 108-453]

    To amend the Public Health Service Act to strengthen education, 
 prevention, and treatment programs relating to stroke, and for other 
                               purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            December 8, 2003

  Mrs. Capps (for herself, Mr. Pickering, Mr. Dingell, Mr. Barton of 
Texas, Mr. Brown of Ohio, Mr. Deal of Georgia, Mr. Waxman, Mr. Shimkus, 
 Mr. Pallone, Mr. Gordon, Mr. Engel, Mr. Wynn, Mr. Green of Texas, Mr. 
    Doyle, Mr. Allen, Ms. Schakowsky, and Ms. Solis) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

                             March 30, 2004

 Additional sponsors: Mr. Norwood, Mr. Davis of Florida, Mr. Young of 
Florida, Mr. Towns, Mr. Isakson, Mr. Davis of Illinois, Ms. Eshoo, Mr. 
Leach, Mr. Stark, Mr. John, Mr. Kennedy of Rhode Island, Mr. Ford, Mr. 
 McNulty, Mr. Grijalva, Mr. Acevedo-Vila, Ms. Kaptur, Mr. Lantos, Mr. 
Udall of New Mexico, Mr. Snyder, Mr. Kind, Mr. Cummings, Mr. Hall, Mr. 
   Walsh, Mr. Tanner, Mr. Wexler, Mr. Turner of Texas, Mr. Lucas of 
Kentucky, Mr. Smith of New Jersey, Mr. Frost, Mr. Terry, Mr. Lynch, Mr. 
 Strickland, Mr. Price of North Carolina, Mr. Moore, Mr. Sandlin, Mr. 
Schiff, Ms. Baldwin, Mr. Burr, Mr. Fossella, Mr. Stenholm, Mr. LaHood, 
  Mr. Van Hollen, Mr. Ramstad, Mr. Nethercutt, Mrs. Christensen, Mr. 
    Quinn, Mr. Frank of Massachusetts, Mr. Rothman, Mr. Jackson of 
 Illinois, Mr. Ballance, Mr. Matheson, Ms. McCollum, Mr. Hulshof, Mr. 
Meehan, Mr. Holden, Mr. Wu, Mr. Taylor of Mississippi, Mr. Hinchey, Mr. 
George Miller of California, Mr. Linder, Mr. Kildee, Mr. Serrano, Mrs. 
   Napolitano, Mr. Langevin, Mr. Walden of Oregon, Ms. Woolsey, Mr. 
Emanuel, Mr. Boswell, Mr. Issa, Mr. King of New York, Mr. Hoeffel, Mr. 
 McDermott, Mr. Bishop of Georgia, Mr. Burns, Mr. Sanders, Mr. Putnam, 
Mr. Inslee, Mr. Owens, Mr. Jenkins, Mr. Ross, Mr. Nadler, Mr. Doggett, 
Mr. Clay, Mr. Rogers of Michigan, Mr. LoBiondo, Ms. DeLauro, Mr. Levin, 
Ms. McCarthy of Missouri, Mr. Gonzalez, Mr. Larson of Connecticut, Mr. 
 Foley, Mr. Payne, Mr. Hinojosa, Mr. Honda, Mrs. Tauscher, Mr. Filner, 
Mr. Skelton, Mr. Cramer, Mr. Visclosky, Ms. Berkley, Mr. Rodriguez, Mr. 
  Sessions, Mr. Peterson of Minnesota, Mr. Boehlert, Mr. Spratt, Mrs. 
 Kelly, Mr. Lincoln Diaz-Balart of Florida, Mrs. Davis of California, 
                       and Mr. Davis of Tennessee

                             March 30, 2004

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]
    [For text of introduced bill, see copy of bill as introduced on 
                           December 8, 2003]

_______________________________________________________________________

                                 A BILL


 
    To amend the Public Health Service Act to strengthen education, 
 prevention, and treatment programs relating to stroke, 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 ``Stroke Treatment and Ongoing 
Prevention Act''.

SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT REGARDING STROKE 
              PROGRAMS.

    (a) Stroke Education and Information Programs.--Title III of the 
Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding 
at the end the following:

 ``PART R--STROKE EDUCATION, INFORMATION, AND DATA COLLECTION PROGRAMS

``SEC. 399AA. STROKE PREVENTION AND EDUCATION CAMPAIGN.

    ``(a) In General.--The Secretary shall carry out an education and 
information campaign to promote stroke prevention and increase the 
number of stroke patients who seek immediate treatment.
    ``(b) Authorized Activities.--In implementing the education and 
information campaign under subsection (a), the Secretary may--
            ``(1) make public service announcements about the warning 
        signs of stroke and the importance of treating stroke as a 
        medical emergency;
            ``(2) provide education regarding ways to prevent stroke 
        and the effectiveness of stroke treatment; and
            ``(3) carry out other activities that the Secretary 
        determines will promote prevention practices among the general 
        public and increase the number of stroke patients who seek 
        immediate care.
    ``(c) Measurements.--In implementing the education and information 
campaign under subsection (a), the Secretary shall--
            ``(1) measure public awareness before the start of the 
        campaign to provide baseline data that will be used to evaluate 
        the effectiveness of the public awareness efforts;
            ``(2) establish quantitative benchmarks to measure the 
        impact of the campaign over time; and
            ``(3) measure the impact of the campaign not less than once 
        every 2 years or, if determined appropriate by the Secretary, 
        at shorter intervals.
    ``(d) No Duplication of Effort.--In carrying out this section, the 
Secretary shall avoid duplicating existing stroke education efforts by 
other Federal Government agencies.
    ``(e) Consultation.--In carrying out this section, the Secretary 
may consult with organizations and individuals with expertise in stroke 
prevention, diagnosis, treatment, and rehabilitation.

``SEC. 399BB. PAUL COVERDELL NATIONAL ACUTE STROKE REGISTRY AND 
              CLEARINGHOUSE.

    ``The Secretary, acting through the Centers for Disease Control and 
Prevention, shall maintain the Paul Coverdell National Acute Stroke 
Registry and Clearinghouse by--
            ``(1) continuing to develop and collect specific data 
        points and appropriate benchmarks for analyzing care of acute 
        stroke patients;
            ``(2) collecting, compiling, and disseminating information 
        on the achievements of, and problems experienced by, State and 
        local agencies and private entities in developing and 
        implementing emergency medical systems and hospital-based 
        quality of care interventions; and
            ``(3) carrying out any other activities the Secretary 
        determines to be useful to maintain the Paul Coverdell National 
        Acute Stroke Registry and Clearinghouse to reflect the latest 
        advances in all forms of stroke care.

``SEC. 399CC. STROKE DEFINITION.

    ``For purposes of this part, the term `stroke' means a `brain 
attack' in which blood flow to the brain is interrupted or in which a 
blood vessel or aneurysm in the brain breaks or ruptures.

``SEC. 399DD. AUTHORIZATION OF APPROPRIATIONS.

    ``There is authorized to be appropriated to carry out this part 
$5,000,000 for each of fiscal years 2005 through 2009.''.
    (b) Emergency Medical Professional Development.--Section 1251 of 
the Public Health Service Act (42 U.S.C. 300d-51) is amended to read as 
follows:

``SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN ADVANCED STROKE AND 
              TRAUMATIC INJURY TREATMENT AND PREVENTION.

    ``(a) Residency and Other Professional Training.--The Secretary may 
make grants to public and nonprofit entities for the purpose of 
planning, developing, and enhancing approved residency training 
programs and other professional training for appropriate health 
professions in emergency medicine, including emergency medical services 
professionals, to improve stroke and traumatic injury prevention, 
diagnosis, treatment, and rehabilitation.
    ``(b) Continuing Education on Stroke and Traumatic Injury.--
            ``(1) Grants.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration, may make grants to qualified entities for the 
        development and implementation of education programs for 
        appropriate health care professionals in the use of newly 
        developed diagnostic approaches, technologies, and therapies 
        for health professionals involved in the prevention, diagnosis, 
        treatment, and rehabilitation of stroke or traumatic injury.
            ``(2) Distribution of grants.--In awarding grants under 
        this subsection, the Secretary shall give preference to 
        qualified entities that will train health care professionals 
        that serve areas with a significant incidence of stroke or 
        traumatic injuries.
            ``(3) Application.--A qualified entity desiring a grant 
        under this subsection shall submit to the Secretary an 
        application at such time, in such manner, and containing such 
        information as the Secretary may require, including a plan for 
        the rigorous evaluation of activities carried out with amounts 
        received under the grant.
            ``(4) Definitions.--For purposes of this subsection:
                    ``(A) The term `qualified entity' means a 
                consortium of public and private entities, such as 
                universities, academic medical centers, hospitals, and 
                emergency medical systems that are coordinating 
                education activities among providers serving in a 
                variety of medical settings.
                    ``(B) The term `stroke' means a `brain attack' in 
                which blood flow to the brain is interrupted or in 
                which a blood vessel or aneurysm in the brain breaks or 
                ruptures.
    ``(c) Report.--Not later than 1 year after the allocation of grants 
under this section, the Secretary shall submit to the Committee on 
Health, Education, Labor, and Pensions of the Senate and the Committee 
on Energy and Commerce of the House of Representatives a report on the 
results of activities carried out with amounts received under this 
section.
    ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $4,000,000 for each of fiscal 
years 2005 through 2009. The Secretary shall equitably allocate the 
funds authorized to be appropriated under this section between efforts 
to address stroke and efforts to address traumatic injury.''.

SEC. 3. PILOT PROJECT ON TELEHEALTH STROKE TREATMENT.

    (a) Establishment.--Part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by inserting after 
section 330L the following:

``SEC. 330M. TELEHEALTH STROKE TREATMENT GRANT PROGRAM.

    ``(a) Grants.--The Secretary may make grants to States, and to 
consortia of public and private entities located in any State that is 
not a grantee under this section, to conduct a 5-year pilot project 
over the period of fiscal years 2005 through 2009 to improve stroke 
patient outcomes by coordinating health care delivery through 
telehealth networks.
    ``(b) Administration.--The Secretary shall administer this section 
through the Director of the Office for the Advancement of Telehealth.
    ``(c) Consultation.--In carrying out this section, for the purpose 
of better coordinating program activities, the Secretary shall consult 
with--
            ``(1) officials responsible for other Federal programs 
        involving stroke research and care, including such programs 
        established by the Stroke Treatment and Ongoing Prevention Act; 
        and
            ``(2) organizations and individuals with expertise in 
        stroke prevention, diagnosis, treatment, and rehabilitation.
    ``(d) Use of Funds.--
            ``(1) In general.--The Secretary may not make a grant to a 
        State or a consortium under this section unless the State or 
        consortium agrees to use the grant for the purpose of--
                    ``(A) identifying entities with expertise in the 
                delivery of high-quality stroke prevention, diagnosis, 
                treatment, and rehabilitation;
                    ``(B) working with those entities to establish or 
                improve telehealth networks to provide stroke treatment 
                assistance and resources to health care professionals, 
                hospitals, and other individuals and entities that 
                serve stroke patients;
                    ``(C) informing emergency medical systems of the 
                location of entities identified under subparagraph (A) 
                to facilitate the appropriate transport of individuals 
                with stroke symptoms;
                    ``(D) establishing networks to coordinate 
                collaborative activities for stroke prevention, 
                diagnosis, treatment, and rehabilitation;
                    ``(E) improving access to high-quality stroke care, 
                especially for populations with a shortage of stroke 
                care specialists and populations with a high incidence 
                of stroke; and
                    ``(F) conducting ongoing performance and quality 
                evaluations to identify collaborative activities that 
                improve clinical outcomes for stroke patients.
            ``(2) Establishment of consortium.--The Secretary may not 
        make a grant to a State under this section unless the State 
        agrees to establish a consortium of public and private 
        entities, including universities and academic medical centers, 
        to carry out the activities described in paragraph (1).
            ``(3) Prohibition.--The Secretary may not make a grant 
        under this section to a State that has an existing telehealth 
        network that is or may be used for improving stroke prevention, 
        diagnosis, treatment, and rehabilitation, or to a consortium 
        located in such a State, unless the State or consortium agrees 
        that--
                    ``(A) the State or consortium will use an existing 
                telehealth network to achieve the purpose of the grant; 
                and
                    ``(B) the State or consortium will not establish a 
                separate network for such purpose.
    ``(e) Priority.--In selecting grant recipients under this section, 
the Secretary shall give priority to any applicant that submits a plan 
demonstrating how the applicant, and where applicable the members of 
the consortium described in subsection (d)(2), will use the grant to 
improve access to high-quality stroke care for populations with 
shortages of stroke-care specialists and populations with a high 
incidence of stroke.
    ``(f) Grant Period.--The Secretary may not award a grant to a State 
or a consortium under this section for any period that--
            ``(1) is greater than 3 years; or
            ``(2) extends beyond the end of fiscal year 2009.
    ``(g) Restriction on Number of Grants.--In carrying out the 5-year 
pilot project under this section, the Secretary may not award more than 
7 grants.
    ``(h) Application.--To seek a grant under this section, a State or 
a consortium of public and private entities shall submit an application 
to the Secretary in such form, in such manner, and containing such 
information as the Secretary may require. At a minimum, the Secretary 
shall require each such application to outline how the State or 
consortium will establish baseline measures and benchmarks to evaluate 
program outcomes.
    ``(i) Definition.--In this section, the term `stroke' means a 
`brain attack' in which blood flow to the brain is interrupted or in 
which a blood vessel or aneurysm in the brain breaks or ruptures.
    ``(j) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $10,000,000 for fiscal year 
2005, $13,000,000 for fiscal year 2006, $15,000,000 for fiscal year 
2007, $8,000,000 for fiscal year 2008, and $4,000,000 for fiscal year 
2009.''.
    (b) Study; Reports.--
            (1) Final report.--Not later than March 31, 2010, the 
        Secretary of Health and Human Services shall conduct a study of 
        the results of the telehealth stroke treatment grant program 
        under section 330M of the Public Health Service Act (added by 
        subsection (a)) and submit to the Congress a report on such 
        results that includes the following:
                    (A) An evaluation of the grant program outcomes, 
                including quantitative analysis of baseline and 
                benchmark measures.
                    (B) Recommendations on how to promote stroke 
                networks in ways that improve access to clinical care 
                in rural and urban areas and reduce the incidence of 
                stroke and the debilitating and costly complications 
                resulting from stroke.
                    (C) Recommendations on whether similar telehealth 
                grant programs could be used to improve patient 
                outcomes in other public health areas.
            (2) Interim reports.--The Secretary of Health and Human 
        Services may provide interim reports to the Congress on the 
        telehealth stroke treatment grant program under section 330M of 
        the Public Health Service Act (added by subsection (a)) at such 
        intervals as the Secretary determines to be appropriate.

SEC. 4. RULE OF CONSTRUCTION.

    Nothing in this Act shall be construed to authorize the Secretary 
of Health and Human Services to establish Federal standards for the 
treatment of patients or the licensure of health care professionals.




                                                 Union Calendar No. 260

108th CONGRESS

  2d Session

                               H. R. 3658

                          [Report No. 108-453]

_______________________________________________________________________

                                 A BILL

    To amend the Public Health Service Act to strengthen education, 
 prevention, and treatment programs relating to stroke, and for other 
                               purposes.

_______________________________________________________________________

                             March 30, 2004

  Reported with an amendment, committed to the Committee of the Whole 
       House on the State of the Union, and ordered to be printed