1.This Act may be cited as
the Improving Emergency Medical Care
and Response Act of 2007
.
2.
(a)Congress
makes the following findings:
(1)Emergency medical
services play a critically important role in health care, public health, and
public safety by frequently providing immediate lifesustaining care and making
decisions with limited time and information.
(2)Between 1993 and
2003, the population of the United States grew by 12 percent and hospital
admissions increased by 13 percent, yet emergency department visits rose by
more than 25 percent during this same period of time, from 90,300,000 visits in
1993 to 113,900,000 visits in 2003.
(3)The demand for
emergency care in the United States continues to grow at a rapid pace.
(4)In 2003, hospital
emergency departments received nearly 114,000,000 visits, which is more than 1
visit for every 3 people in the United States, however, between 1993 and 2003,
the number of emergency departments declined by 425.
(5)Many emergency
medical services are highly fragmented, overburdened, poorly equipped, and
insufficiently prepared for day-to-day operations and response to major
disasters.
(6)There are more
than 6,000 Public Safety Answering Points that receive 9–1–1 calls.
(7)These Public
Safety Answering Points are often operated by police departments, fire
departments, city or county governments, or other local entities, which makes
attempts to coordinate efforts between locations very difficult.
(8)Regionalized,
accountable systems of emergency care show substantial promise in improving the
day-to-day system-wide coordination essential to assure that Public Safety
Answering Points, emergency medical services organizations, public safety
agencies, public health agencies, medical facilities, and others coordinate
their activities to ensure that patients receive the appropriate care at the
scene, are transported to the most appropriate facility in the shortest time,
and receive excellent care at the destination medical facility.
(9)Regionalized,
accountable systems of emergency care also show promise in management of the
special problems of disaster preparation and response, including management of
patient surge, tracking of patients, and coordination and allocation of medical
resources.
(10)While there are
potentially substantial benefits to be derived from regionalized, accountable
emergency care systems, little is known about the most effective and efficient
methods of regional emergency care system development.
(b)The
purposes of this Act are to design, implement, and evaluate regionalized,
comprehensive, and accountable systems of emergency care that—
(1)support and
improve the day-to-day operations and coordination of a regional emergency
medical care system;
(2)increase disaster
preparedness and medical surge capacity;
(3)include different
models of regionalized emergency care systems, including models for urban and
rural communities;
(4)can be
implemented by private or public entities; and
(5)meet quality and
accountability standards for the operation of emergency care systems and the
impact of such systems on patient outcomes.
3.Design and
Implementation of Regionalized Systems for Emergency CarePart B of title III of the Public Health
Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 314
the following:
315.Regionalized
Communication Systems for Emergency Care Response
(a)The Secretary, acting through the Assistant Secretary for
Preparedness and Response, shall award not fewer than 4 multiyear contracts or
competitive grants to eligible entities to support demonstration programs that
design, implement, and evaluate innovative models of regionalized,
comprehensive, and accountable emergency care systems.
(b)
(1)In this section, the term eligible entity
means a State or a partnership of 1 or more States and 1 or more local
governments.
(2)In
this section, the term region means an area within a State, an
area that lies within multiple States, or a similar area (such as a multicounty
area), as determined by the Secretary.
(c)The Secretary shall award a contract or grant under
subsection (a) to an eligible entity that proposes a demonstration program to
design, implement, and evaluate an emergency medical system that—
(1)coordinates with
public safety services, public health services, emergency medical services,
medical facilities, and other entities within a region;
(2)coordinates an
approach to emergency medical system access throughout the region, including
9–1–1 Public Safety Answering Points and emergency medical dispatch;
(3)includes a
mechanism, such as a regional medical direction or transport communications
system, that operates throughout the region to ensure that the correct patient
is taken to the medically appropriate facility (whether an initial facility or
a higher-level facility) in a timely fashion;
(4)allows for the
tracking of prehospital and hospital resources, including inpatient bed
capacity, emergency department capacity, on-call specialist coverage, ambulance
diversion status, and the coordination of such tracking with regional
communications and hospital destination decisions; and
(5)includes a
consistent region-wide prehospital, hospital, and interfacility data management
system that—
(A)complies with the
National EMS Information System, the National Trauma Data Bank, and
others;
(B)reports data to
appropriate Federal and State databanks and registries; and
(C)contains
information sufficient to evaluate key elements of prehospital care, hospital
destination decisions, including initial hospital and interfacility decisions,
and relevant outcomes of hospital care.
(d)
(1)An eligible entity that seeks a contract or grant
described in subsection (a) shall submit to the Secretary an application at
such time and in such manner as the Secretary may require.
(2)Each application shall include—
(A)an assurance from
the eligible entity that the proposed system—
(i)has been
coordinated with the applicable State Office of Emergency Medical Services (or
equivalent State office);
(ii)is compatible
with the applicable State emergency medical services system;
(iii)includes
consistent indirect and direct medical oversight of prehospital, hospital, and
interfacility transport throughout the region;
(iv)coordinates
prehospital treatment and triage, hospital destination, and interfacility
transport throughout the region;
(v)includes a
categorization or designation system for special medical facilities throughout
the region that is—
(I)consistent with
State laws and regulations; and
(II)integrated with
the protocols for transport and destination throughout the region; and
(vi)includes a
regional medical direction system, a patient tracking system, and a resource
allocation system that—
(I)support
day-to-day emergency care system operation;
(II)can manage surge
capacity during a major event or disaster; and
(III)are integrated
with other components of the national and State emergency preparedness system;
and
(B)such other
information as the Secretary may require.
(e)The
Secretary shall give priority for the award of the contracts or grants
described subsection (a) to any eligible entity that serves a population in a
medically underserved area (as defined in section 330(b)(3)).
(f)Not
later than 90 days after the completion of a demonstration program under
subsection (a), the recipient of such contract or grant described in shall
submit to the Secretary a report containing the results of an evaluation of the
program, including an identification of—
(1)the impact of the
regional, accountable emergency care system on patient outcomes for various
critical care categories, such as trauma, stroke, cardiac emergencies, and
pediatric emergencies;
(2)the system
characteristics that contribute to the effectiveness and efficiency of the
program (or lack thereof);
(3)methods of
assuring the long-term financial sustainability of the emergency care
system;
(4)the State and
local legislation necessary to implement and to maintain the system; and
(5)the barriers to
developing regionalized, accountable emergency care systems, as well as the
methods to overcome such barriers.
(g)Dissemination
of FindingsThe Secretary shall, as appropriate, disseminate to
the public and to the appropriate Committees of the Congress, the information
contained in a report made under subsection (f).
(h)Authorization
of AppropriationsThere are authorized to be appropriated to
carry out this section $12,000,000 for each of fiscal years 2008 through
2013.
.
4.Support for
Emergency Medicine ResearchPart H of title IV of the Public Health
Service Act (42 U.S.C. 289 et seq.) is amended by inserting after the section
498C the following:
498D.Support for
Emergency Medicine Research
(a)Emergency
Medical ResearchThe Secretary shall support Federal programs
administered by the National Institutes of Health, the Agency for Healthcare
Research and Quality, the Health Resources and Services Administration, the
Centers for Disease Control and Prevention, and other agencies involved in
improving the emergency care system to expand and accelerate research in
emergency medical care systems and emergency medicine, including—
(1)the basic science
of emergency medicine;
(2)the model of
service delivery and the components of such models that contribute to enhanced
patient outcomes;
(3)the translation
of basic scientific research into improved practice; and
(4)the development
of timely and efficient delivery of health services.
(b)The Secretary shall support research to determine the
estimated economic impact of, and savings that result from, the implementation
of coordinated emergency care systems.
(c)Authorization
of AppropriationsThere are authorized to be appropriated to
carry out this section such sums as may be necessary for each of fiscal years
2008 through
2013.
.