[Congressional Record Volume 149, Number 16 (Wednesday, January 29, 2003)]
[Senate]
[Pages S1744-S1745]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FRIST (for himself, Mr. Kennedy, Mr. Enzi, Mrs. Murray, 
        Mr. Roberts, and Mr. Graham of South Carolina):
  S. 239. A bill to amend the Public Health Services Act to add 
requirements regarding trauma care, and for other purposes; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. FRIST. Mr. President, each year, nearly one of every four 
Americans are injured and require medical attention.
  Among Americans younger than age 44, trauma is the leading killer. 
While injury prevention programs have greatly reduced death and 
disability, severe injuries will continue. Given the events of 
September 11, 2001 and our Nation's renewed focus on enhancing disaster 
preparedness, it is critical that the Federal Government increase its 
commitment to strengthening programs governing trauma care system 
planning and development.
  The direct and indirect cost of injury is estimated to be about $260 
billion a year. The death rate from unintentional injury is more than 
50 percent higher in rural areas than in urban areas. It is essential 
that all Americans

[[Page S1745]]

have access to a trauma system that provides definitive care as quickly 
as possible.
  In recent years, Congress has sought to address this issue through 
the Trauma Care Systems Planning and Development Act, which provides 
grants for the purpose of planning, implementing, and developing 
statewide trauma care systems. However, this important program expired 
last year before Congress could reauthorize it. Therefore, I am 
introducing bipartisan legislation today, along with Senators Kennedy, 
Enzi, Murray, Roberts and Graham of South Carolina to reauthorize this 
important program.
  Despite our past investments, one-half of the states in the country 
are still without a statewide trauma care system. Clearly we can do 
better. We must respond to the goals put forth by the Institute of 
Medicine in 1999 that Congress ``support a greater national commitment 
to, and support of, trauma care systems at the federal, state, and 
local levels.''
  Today's bill, the ``Trauma Care Systems Planning and Development Act 
of 2003'', reauthorizes this program with several improvements: First, 
it improves the collection and analysis of trauma patient data with the 
goal of improving the overall system of care for these patients; 
second, at this time of increasing pressure on state budgets, the bill 
reduces the amount of matching funds that states will have to provide 
to participate in the program so that we can extend quality trauma care 
systems across the nation; third, the legislation provides a self-
evaluation mechanism to assist states in assessing and improving their 
trauma care systems; fourth, it authorizes an Institute of Medicine 
study on the state of trauma care and trauma research; and; finally, it 
doubles the funding available for this program to allow additional 
states to participate.
  I appreciate the assistance of Senators Kennedy, Enzi, Murray, 
Roberts and Graham of South Carolina on this important legislation, and 
look forward to working with them, and with Senator Gregg, the Chairman 
of the Senate Health, Education, Labor and Pensions Committee, to see 
this bill passed this year.
  Mr. KENNEDY. Mr. President, it is an honor to join Senator Frist in 
introducing the Trauma Care Systems Planning and Development Act. Our 
goal in this bipartisan legislation is to enable all States to develop 
more effective trauma care systems.
  Trauma is the No. 1 killer of Americans under age 44. Traumatic 
injuries robs, devastate families and cost the Nation an estimated $60 
billion every year. In 1995 alone, injuries were responsible for 
148,000 deaths, 2.6 million hospitalizations, and over 36 million 
emergency room visits.
  Despite this toll, we have done little in recent years to prevent 
trauma or improve the chance of recovery from traumatic injury. Part of 
the problem is the widespread view that trauma is an accident, an 
unfortunate and often unavoidable injury. But this is often not the 
case.
  Proven preventive measures could save up to 25,000 lives every year. 
Better treatment systems can give victims a better chance of recovery, 
by delivering quality care as quickly as possible.
  A trauma system is a coordinated effort to provide the full range of 
care to all injured patients. Treatment begins at the site of injury, 
and continues from prehospital to hospital to rehabilitative services. 
Resources, supporting equipment, and personnel are ready and trained to 
go into action.
  The skills and knowledge of health care experts are not enough. 
Optimal care is the result of advance planning, preparation, and 
coordination to produce smooth transitions and the proper sequence of 
interventions. Effective trauma systems accomplish all this, saves 
lives, and reduces costs.
  Much of the progress in developing trauma systems has occurred as a 
result of Federal funding and involvement. In 1973, Congress passed the 
Emergency Medical Services Act, providing $300 million to States and 
communities over an 8-year period. Without that funding, patients in 
hundreds of regions in the Nation might not have had prompt access to 
emergency care. Even today, there are parts of the Nation without 911 
access and immediate emergency transportation.
  In 1990, Congress passed the Trauma Care Systems Planning and 
Development Act, authorizing Federal grants to States to develop 
statewide trauma care systems. Funding for this program has been 
inadequate. From 1995 to 2000, States received no funding at all. Last 
year, only $3.5 million was appropriated for the entire country. As a 
result, only half of all States today have fully functional statewide 
trauma systems. Clearly, we must do better in providing needed trauma 
care.
  Our legislation reauthorizes and strengthens the trauma care program 
to establish effective trauma systems in all States. It asks the 
Institutes of Medicine to investigate the quality of trauma care and 
identify areas for improvement. Surprisingly, given the burden of 
trauma on society, less than 1 percent of resources at the NIH are 
devoted to trauma research.
  Our legislation is supported by the Coalition for American Trauma 
Care, the American College of Surgeons, and the American Trauma 
Society. Its enactment is important to public safety, and I urge the 
Senate to approve it.
                                 ______