[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 760 Introduced in Senate (IS)]







109th CONGRESS
  1st Session
                                 S. 760

To amend the Public Health Service Act to provide a means for continued 
        improvement in emergency medical services for children.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             April 11, 2005

Mr. Inouye (for himself, Mr. Hatch, Mr. Kennedy, Mr. Dodd, Mr. DeWine, 
and Mr. Conrad) 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 provide a means for continued 
        improvement in emergency medical services for children.

    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 ``Wakefield Act''.

SEC. 2. FINDINGS AND PURPOSE.

    (a) Findings.--Congress makes the following findings:
            (1) There are 31,000,000 child and adolescent visits to the 
        nation's emergency departments every year, with children under 
        the age of 3 years accounting for most of these visits.
            (2) Ninety percent of children requiring emergency care are 
        seen in general hospitals, not in free-standing children's 
        hospitals, with one-quarter to one-third of the patients being 
        children in the typical general hospital emergency department.
            (3) Severe asthma and respiratory distress are the most 
        common emergencies for pediatric patients, representing nearly 
        one-third of all hospitalizations among children under the age 
        of 15 years, while seizures, shock, and airway obstruction are 
        other common pediatric emergencies, followed by cardiac arrest 
        and severe trauma.
            (4) Up to 20 percent of children needing emergency care 
        have underlying medical conditions such as asthma, diabetes, 
        sickle-cell disease, low birthweight, and bronchopulmonary 
        dysplasia.
            (5) Significant gaps remain in emergency medical care 
        delivered to children, with 43 percent of hospitals lacking 
        cervical collars (used to stabilize spinal injuries) for 
        infants, less than half (47 percent) of hospitals with no 
        pediatric intensive care unit having a written transfer 
        agreement with a hospital that does have such a unit, one-third 
        of States lacking a physician available on-call 24 hours a day 
        to provide medical direction to emergency medical technicians 
        or other non-physician emergency care providers, and even those 
        States with such availability lacking full State coverage.
            (6) Providers must be educated and trained to manage 
        children's unique physical and psychological needs in emergency 
        situations, and emergency systems must be equipped with the 
        resources needed to care for this especially vulnerable 
        population.
            (7) The Emergency Medical Services for Children (EMSC) 
        Program under section 1910 of the Public Health Service Act (42 
        U.S.C. 300w-9) is the only Federal program that focuses 
        specifically on improving the pediatric components of emergency 
        medical care.
            (8) The EMSC Program promotes the nationwide exchange of 
        pediatric emergency medical care knowledge and collaboration by 
        those with an interest in such care and is depended upon by 
        Federal agencies and national organizations to ensure that this 
        exchange of knowledge and collaboration takes place.
            (9) The EMSC Program also supports a multi-institutional 
        network for research in pediatric emergency medicine, thus 
        allowing providers to rely on evidence rather than anecdotal 
        experience when treating ill or injured children.
            (10) States are better equipped to handle occurrences of 
        critical or traumatic injury due to advances fostered by the 
        EMSC program, with--
                    (A) forty-eight States identifying and requiring 
                all EMSC-recommended pediatric equipment on Advanced 
                Life Support ambulances;
                    (B) forty-four States employing pediatric protocols 
                for medical direction;
                    (C) forty-one States utilizing pediatric guidelines 
                for acute care facility identification, ensuring that 
                children get to the right hospital in a timely manner; 
                and
                    (D) thirty-six of the forty-two States having 
                statewide computerized data collection systems now 
                producing reports on pediatric emergency medical 
                services using statewide data.
            (11) Systems of care must be continually maintained, 
        updated, and improved to ensure that research is translated 
        into practice, best practices are adopted, training is current, 
        and standards and protocols are appropriate.
            (12) Now celebrating its twentieth anniversary, the EMSC 
        Program has proven effective over two decades in driving key 
        improvements in emergency medical services to children, and 
        should continue its mission to reduce child and youth morbidity 
        and mortality by supporting improvements in the quality of all 
        emergency medical and emergency surgical care children receive.
    (b) Purpose.--It is the purpose of this Act to reduce child and 
youth morbidity and mortality by supporting improvements in the quality 
of all emergency medical care children receive.

SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL SERVICES FOR CHILDREN 
              PROGRAM.

    Section 1910 of the Public Health Service Act (42 U.S.C. 300w-9) is 
amended--
            (1) in subsection (a), by striking ``3-year period (with an 
        optional 4th year'' and inserting ``4-year period (with an 
        optional 5th year'';
            (2) in subsection (d)--
                    (A) by striking ``and such sums'' and inserting 
                ``such sums''; and
                    (B) by inserting before the period the following: 
                ``$23,000,000 for fiscal year 2006, and such sums as 
                may be necessary for each of fiscal years 2007 through 
                2010'';
            (3) by redesignating subsections (b) through (d) as 
        subsections (c) through (e), respectively; and
            (4) by inserting after subsection (a) the following:
    ``(b)(1) The purpose of the program established under this section 
is to reduce child and youth morbidity and mortality by supporting 
improvements in the quality of all emergency medical care children 
receive, through the promotion of projects focused on the expansion and 
improvement of such services, including those in rural areas and those 
for children with special healthcare needs. In carrying out this 
purpose, the Secretary shall support emergency medical services for 
children by supporting projects that--
            ``(A) develop and present scientific evidence;
            ``(B) promote existing and innovative technologies 
        appropriate for the care of children: or
            ``(C) provide information on health outcomes and 
        effectiveness and cost-effectiveness.
    ``(2) The program established under this section shall--
            ``(A) strive to enhance the pediatric capability of 
        emergency medical service systems originally designed primarily 
        for adults; and
            ``(B) in order to avoid duplication and ensure that Federal 
        resources are used efficiently and effectively, be coordinated 
        with all research, evaluations, and awards related to emergency 
        medical services for children undertaken and supported by the 
        Federal Government.''.
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