II 110th CONGRESS 1st Session S. 60 IN THE SENATE OF THE UNITED STATES January 4, 2007 Mr. Reid (for Mr. Inouye) (for himself, Mr. Hatch, Mr. Kennedy, Mr. Conrad, Mr. Dorgan, and Mr. Akaka) 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.

1.

Short title

This Act may be cited as the Wakefield Act.

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. (2)Over 90 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. Only about 6 percent of hospitals have available all the pediatric supplies deemed essential by the American Academy of Pediatricians and the American College of Emergency Physicians for managing pediatric emergencies while about half of hospitals have at least 85 percent of those supplies. (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)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. (8)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. (9)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. (10)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. (11)The Institute of Medicine stated in its 2006 report, Emergency Care for Children: Growing Pains, that the EMSC Program boasts many accomplishments . . . and the work of the program continues to be relevant and vital. (12)The EMSC Program has proven effective over 2 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.

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: $25,000,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2009 through 2011; (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. .