[Congressional Bills 112th Congress]
[From the U.S. Government Publishing Office]
[H.R. 971 Introduced in House (IH)]

112th CONGRESS
  1st Session
                                H. R. 971

 To improve the understanding and coordination of critical care health 
                               services.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 9, 2011

 Ms. Baldwin (for herself, Mr. Paulsen, and Mr. Lance) introduced the 
   following bill; which was referred to the Committee on Energy and 
                                Commerce

_______________________________________________________________________

                                 A BILL


 
 To improve the understanding and coordination of critical care health 
                               services.

    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 ``Critical Care Assessment and 
Improvement Act of 2011''.

SEC. 2. FINDINGS; PURPOSES.

    (a) Findings.--Congress finds the following:
            (1) Critical care medicine is the care for patients whose 
        illnesses or injuries present a significant danger to life, 
        limb, or organ function and require comprehensive care and 
        constant monitoring, usually in intensive care units.
            (2) Each year, approximately five million Americans are 
        admitted into traditional, surgical, pediatric, or neo-natal 
        intensive care units.
            (3) Nearly 80 percent of all Americans will experience a 
        critical care injury or illness as a patient, family member, or 
        friend of a patient.
            (4) Critical care medicine consumes a significant amount of 
        financial resources, accounting for more than 13 percent of all 
        hospital costs.
            (5) According to a 2006 report by the Health Resources and 
        Services Administration (``HRSA''), demand in the United States 
        for critical care medical services is on the rise, due in part 
        to the growing elderly population, as individuals over the age 
        of 65 consume a large percentage of critical care services.
            (6) The HRSA report also found that the growing aging 
        population will further exacerbate an existing shortage of 
        intensivists, the physicians certified in critical care who 
        primarily deliver care in intensive care units, potentially 
        compromising the quality and availability of care.
            (7) The demand on critical services and trained personnel 
        increases exponentially in the event of a natural disaster or 
        pandemic outbreak such as the H1N1 virus.
            (8) Ensuring the strength of our critical care medical 
        delivery infrastructure is integral to the improvement of the 
        quality and delivery of health care in the United States.
    (b) Purpose.--The purpose of this Act is to assess the current 
state of the United States critical care medical delivery system and 
implement policies to improve the quality and effectiveness of care 
delivered to the critically ill and injured.

SEC. 3. STUDIES ON CRITICAL CARE.

    (a) Institute of Medicine Study.--
            (1) In general.--The Secretary of Health and Human Services 
        (in this Act referred to as the ``Secretary'') shall enter into 
        an agreement with the Institute of Medicine under which, not 
        later than 1 year after the date of the enactment of this Act, 
        the Institute will--
                    (A) conduct an analysis of the current state of 
                critical care health services in the United States;
                    (B) develop recommendations to bolster critical 
                care capabilities to meet future demand; and
                    (C) submit to Congress a report including the 
                analysis and recommendations under subparagraphs (A) 
                and (B).
            (2) Issues to be studied.--The agreement under paragraph 
        (1) shall, at a minimum, provide for the following:
                    (A) Analysis of the current critical care system in 
                the United States, including--
                            (i) the system's capacity and resources, 
                        including the size of the critical care 
                        workforce and the availability of health 
                        information technology and medical equipment;
                            (ii) the system's strengths, limitations, 
                        and future challenges; and
                            (iii) the system's ability to provide 
                        adequate care for the critically ill or injured 
                        in response to a national health emergency, 
                        including a pandemic or natural disaster.
                    (B) Analysis and recommendations regarding 
                regionalizing critical care systems.
                    (C) Analysis regarding the status of critical care 
                research in the United States and recommendations for 
                future research priorities.
    (b) Government Accountability Office Study.--Not later than 1 year 
after the date of the enactment of this Act, the Comptroller General of 
the United States shall issue a report including the following:
            (1) An inventory of all current and recent critical care 
        research and critical care-related programs of the Federal 
        Government and recommendations on how to better coordinate 
        critical care research efforts.
            (2) An economic analysis of critical care costs as a 
        percentage of overall Federal health care spending, and a 
        comparison of such percentage to the percentage of Federal 
        critical research expenditures relative to overall Federal 
        health research spending.
    (c) Health Resources and Services Administration Study.--
            (1) In general.--The Secretary, acting through the 
        Administrator of the Health Resources and Services 
        Administration, shall review and update the Administration's 
        2006 study entitled ``The Critical Care Workforce: A Study of 
        the Supply and Demand for Critical Care Physicians''.
            (2) Scope.--In carrying out paragraph (1), the Secretary 
        shall expand the scope of the study to address the supply and 
        demand of other providers within the spectrum of critical care 
        delivery, including critical care nurses, mid-level providers 
        (such as physician assistants and nurse practitioners), 
        intensive care unit pharmacists, and intensive care unit 
        respiratory care practitioners.

SEC. 4. NIH CRITICAL CARE COORDINATING COUNCIL.

    (a) Establishment.--The Secretary, acting through the Director of 
the National Institutes of Health, shall establish a council within the 
Institutes to be known as the Critical Care Coordinating Council (in 
this section referred to as the ``Council'').
    (b) Membership.--The Secretary shall ensure that the membership of 
the Council includes representatives of each of--
            (1) the National Heart, Lung, and Blood Institute;
            (2) the National Institute of Nursing Research;
            (3) the Eunice Kennedy Shriver National Institute of Child 
        Health and Human Development;
            (4) the National Institute of General Medical Sciences;
            (5) the National Institute on Aging; and
            (6) any other national research institute or national 
        center of the National Institutes of Health that Secretary 
        deems appropriate.
    (c) Duties.--The Council shall--
            (1) coordinate the collection and analysis of information 
        on current research of the National Institutes of Health 
        relating to the care of the critically ill and injured, 
        identify gaps in such research, and make recommendations to the 
        Director of such Institutes on how to improve such research; 
        and
            (2) provide annual reports to the Director regarding 
        research efforts of the National Institutes of Health relating 
        to the care of the critically ill and injured, and make 
        recommendations in such reports on how to strengthen 
        partnerships within the National Institutes of Health and 
        between the National Institutes of Health and public and 
        private entities to expand collaborative, cross-cutting 
        research.

SEC. 5. IMPROVING FEDERAL DISASTER PREPAREDNESS EFFORTS TO CARE FOR THE 
              CRITICALLY ILL AND INJURED.

    (a) Report on Availability of Critical Care Practitioners.--Not 
later than 1 year after the date of the enactment of this Act, the 
Secretary shall submit a report to the Congress on the adequacy of the 
number of critical care practitioners in disaster medical assistance 
teams, the Medical Reserve Corps, and the Public Health Service 
Commissioned Corps. Such report shall include recommendations, as 
necessary, for addressing any shortages in the number of such 
practitioners.
    (b) Guidelines or Best Practices for Emergency ICU Evacuation 
Practices.--
            (1) Development.--Not later than 1 year after the date of 
        the enactment of this Act, the Secretary, acting through the 
        Director of the Agency for Healthcare Research and Quality and 
        the Assistant Secretary for Preparedness and Response, in 
        consultation with critical care practitioners, shall develop 
        guidelines or best practices for the evacuation of intensive 
        care units during a national health emergency, including a 
        pandemic or natural disaster.
            (2) Requirement.--The Secretary shall design the guidelines 
        and best practices under paragraph (1) so as to ensure the safe 
        and effective evacuation of all individuals regardless of age, 
        disability, or life expectancy.
    (c) Panel on Emergency Preparedness Databases.--
            (1) Establishment.--The Secretary shall establish a panel 
        of emergency preparedness experts to be known as the Panel on 
        Emergency Preparedness Databases (in this section referred to 
        as the ``Panel'').
            (2) Membership.--The Secretary shall ensure that the 
        membership of the Panel includes experts from the public and 
        private sector and experts from the critical care community.
            (3) Duties.--The Panel shall--
                    (A) assess the adequacy of existing national 
                preparedness databases in facilitating effective and 
                coordinated local, State, and Federal medical responses 
                during a national health emergency, including a 
                pandemic or natural disaster;
                    (B) identify gaps in existing information networks;
                    (C) recommend specific ways to improve awareness of 
                the availability of resources before, during, and after 
                an incident; and
                    (D) submit to the Secretary a report including the 
                assessment, identification, and recommendations made 
                under subparagraphs (A) through (C), respectively.

SEC. 6. LIMITATION ON USE OF FINDINGS AND RECOMMENDATIONS IN OTHER 
              PROGRAMS.

    (a) Prohibition.--In making coverage, reimbursement, or incentive 
determinations under any program, the Secretary may not use any finding 
or recommendation developed under this Act--
            (1) in a manner that precludes an individual from choosing 
        a health care treatment based on how the individual values the 
        tradeoff between extending the length of life and the risk of 
        disability; or
            (2) with an intent to discourage an individual from so 
        choosing a health care treatment.
    (b) Rule of Construction.--Subsection (a) shall not be construed to 
prevent the issuance by the Secretary of a finding or recommendation 
addressing differences due to a patient's age, disability, or terminal 
illness in the effectiveness of alternative health care treatments that 
may extend the patient's life.
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