[Congressional Record Volume 151, Number 9 (Wednesday, February 2, 2005)]
[Senate]
[Pages S894-S895]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. FRIST (for himself, Mr. Kennedy, Mr. Roberts, Mr. 
        Jeffords, Mr. Talent, Mrs. Murray, and Mrs. Clinton):
  S. 265. A bill to amend the Public Health Service 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 1 of every 10 Americans 
is injured and requires medical attention. Injuries are the fifth 
leading cause of death in the United States. Trauma kills more people 
between the ages of one and 44 than any other disease or illness.
  While injury prevention programs have greatly reduced death and 
disability, severe injuries will continue. Given the mass trauma 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 $224 
billion a year, according to the Centers for Disease Control and 
Prevention. The death rate from unintentional injury is more than 50 
percent higher in rural areas than in urban areas. Only one fourth of 
the U.S. population lives in an area served by a trauma care system. 
Studies of conventional trauma care show that as many as 35 percent of 
trauma patient deaths could have been prevented if optimal acute care 
had been available. It is essential that all Americans have access to a 
trauma system that provides needed care as quickly as possible.
  Since 1990, Congress has sought to improve care through the Trauma 
Care Systems Planning and Development Act. This Act provides grants for 
planning, implementing, and developing statewide trauma care systems. 
This critical program must be reauthorized. Therefore, I am introducing 
bipartisan legislation today, along with Senators Kennedy, Roberts, 
Jeffords, Talent, Clinton, and Murray to reauthorize this 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.''
  The ``Trauma Care Systems Planning and Development Act of 2005'', 
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, 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 the Institute of 
Medicine to study 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 support of my co-sponsors. I look forward to working 
with them, and with Senator Enzi, the Chairman of the Senate Health, 
Education, Labor, and Pensions Committee, to see this bill passed this 
year.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                 S. 265

       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 ``Trauma Care Systems Planning 
     and Development Act of 2005''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) The Federal Government and State governments have 
     established a history of cooperation in the development, 
     implementation, and monitoring of integrated, comprehensive 
     systems for the provision of emergency medical services.
       (2) Trauma is the leading cause of death of Americans 
     between the ages of 1 and 44 years and is the third leading 
     cause of death in the general population of the United 
     States.
       (3) In 1995, the total direct and indirect cost of 
     traumatic injury in the United States was estimated at 
     $260,000,000,000.
       (4) There are 40,000 fatalities and 5,000,000 nonfatal 
     injuries each year from motor vehicle-related trauma, 
     resulting in an aggregate annual cost of $230,000,000,000 in 
     medical expenses, insurance, lost wages, and property damage.
       (5) Barriers to the receipt of prompt and appropriate 
     emergency medical services exist in many areas of the United 
     States.
       (6) The number of deaths from trauma can be reduced by 
     improving the systems for the provision of emergency medical 
     services in the United States.
       (7) Trauma care systems are an important part of the 
     emergency preparedness system needed for homeland defense.

     SEC. 3. AMENDMENTS.

       (a) Establishment.--Section 1201 of the Public Health 
     Service Act (42 U.S.C. 300d) is amended--
       (1) in subsection (a)--
       (A) in the matter preceding paragraph (1), by inserting ``, 
     acting through the Administrator of the Health Resources and 
     Services Administration,'' after ``Secretary'';
       (B) by redesignating paragraphs (3) and (4) as paragraphs 
     (4) and (5), respectively;
       (C) by inserting after paragraph (2) the following:
       ``(3) collect, compile, and disseminate information on the 
     achievements of, and problems experienced by, State and local 
     agencies and private entities in providing trauma care and 
     emergency medical services and, in so doing, give special 
     consideration to the unique needs of rural areas;'';
       (D) in paragraph (4), as redesignated by subparagraph (B)--
       (i) by inserting ``to enhance each State's capability to 
     develop, implement, and sustain the trauma care component of 
     each State's plan for the provision of emergency medical 
     services'' after ``assistance''; and
       (ii) by striking ``and'' after the semicolon;
       (E) in paragraph (5), as redesignated by subparagraph (B), 
     by striking the period at the end and inserting ``; and''; 
     and
       (F) by adding at the end the following:
       ``(6) promote the collection and categorization of trauma 
     data in a consistent and standardized manner.'';
       (2) in subsection (b), by inserting ``, acting through the 
     Administrator of the Health Resources and Services 
     Administration,'' after ``Secretary''; and
       (3) by striking subsection (c).
       (b) Clearinghouse on Trauma Care and Emergency Medical 
     Services.--The Public Health Service Act (42 U.S.C. 201 et 
     seq.) is amended--

[[Page S895]]

       (1) by striking section 1202; and
       (2) by redesignating section 1203 as section 1202.
       (c) Establishment of Programs for Improving Trauma Care in 
     Rural Areas.--Section 1202(a) of the Public Health Service 
     Act, as such section was redesignated by subsection (b), is 
     amended--
       (1) in paragraph (2), in the matter preceding subparagraph 
     (A), by inserting ``, such as advanced trauma life support,'' 
     after ``model curricula'';
       (2) in paragraph (4), by striking ``and'' after the 
     semicolon;
       (3) in paragraph (5), by striking the period and inserting 
     ``; and''; and
       (4) by adding at the end the following:
       ``(6) by increasing communication and coordination with 
     State trauma systems.''.
       (d) Requirement of Matching Funds for Fiscal Years 
     Subsequent to First Fiscal Year of Payments.--Section 1212 of 
     the Public Health Service Act (42 U.S.C. 300d-12) is 
     amended--
       (1) in subsection (a)(1)--
       (A) in subparagraph (A), by striking ``and'' after the 
     semicolon; and
       (B) by striking subparagraph (B) and inserting the 
     following:
       ``(B) for the third fiscal year of such payments to the 
     State, not less than $1 for each $1 of Federal funds provided 
     in such payments for such fiscal year;
       ``(C) for the fourth fiscal year of such payments to the 
     State, not less than $2 for each $1 of Federal funds provided 
     in such payments for such fiscal year; and
       ``(D) for the fifth fiscal year of such payments to the 
     State, not less than $2 for each $1 of Federal funds provided 
     in such payments for such fiscal year.''; and
       (2) in subsection (b)--
       (A) in paragraph (1), by adding ``and'' after the 
     semicolon;
       (B) in paragraph (2), by striking ``; and'' and inserting a 
     period; and
       (C) by striking paragraph (3).
       (e) Requirements With Respect To Carrying Out Purpose of 
     Allotments.--Section 1213 of the Public Health Service Act 
     (42 U.S.C. 300d-13) is amended--
       (1) in subsection (a)--
       (A) in paragraph (3), in the matter preceding subparagraph 
     (A), by inserting ``nationally recognized'' after 
     ``contains'';
       (B) in paragraph (5), by inserting ``nationally 
     recognized'' after ``contains'';
       (C) in paragraph (6), by striking ``specifies procedures 
     for the evaluation of designated'' and inserting ``utilizes a 
     program with procedures for the evaluation of'';
       (D) in paragraph (7)--
       (i) in the matter preceding subparagraph (A), by inserting 
     ``in accordance with data collection requirements developed 
     in consultation with surgical, medical, and nursing specialty 
     groups, State and local emergency medical services directors, 
     and other trained professionals in trauma care'' after 
     ``collection of data'';
       (ii) in subparagraph (A), by inserting ``and the number of 
     deaths from trauma'' after ``trauma patients''; and
       (iii) in subparagraph (F), by inserting ``and the outcomes 
     of such patients'' after ``for such transfer'';
       (E) by redesignating paragraphs (10) and (11) as paragraphs 
     (11) and (12), respectively; and
       (F) by inserting after paragraph (9) the following:
       ``(10) coordinates planning for trauma systems with State 
     disaster emergency planning and bioterrorism hospital 
     preparedness planning;'';
       (2) in subsection (b)--
       (A) in paragraph (1)--
       (i) in subparagraph (A), by striking ``concerning such'' 
     and inserting ``that outline resources for optimal care of 
     the injured patient''; and
       (ii) in subparagraph (D), by striking ``1992'' and 
     inserting ``2005''; and
       (B) in paragraph (3)--
       (i) in subparagraph (A), by striking ``1991'' and inserting 
     ``2005''; and
       (ii) in subparagraph (B), by striking ``1992'' and 
     inserting ``2005''; and
       (3) in subsection (c), by striking ``1990, the Secretary 
     shall develop a model plan'' and inserting ``2005, the 
     Secretary shall update the model plan''.
       (f) Requirement of Submission to Secretary of Trauma Plan 
     and Certain Information.--Section 1214(a) of the Public 
     Health Service Act (42 U.S.C. 300d-14(a)) is amended--
       (1) in paragraph (1)--
       (A) by striking ``1991'' and inserting ``2005''; and
       (B) by inserting ``that includes changes and improvements 
     made and plans to address deficiencies identified'' after 
     ``medical services''; and
       (2) in paragraph (2), by striking ``1991'' and inserting 
     ``2005''.
       (g) Restrictions on Use of Payments.--Section 1215(a)(1) of 
     the Public Health Service Act (42 U.S.C. 300d-15(a)(1)) is 
     amended by striking the period at the end and inserting a 
     semicolon.
       (h) Requirements of Reports by States.--The Public Health 
     Service Act (42 U.S.C. 201 et seq.) is amended by striking 
     section 1216 and inserting the following:

     ``SEC. 1216. [RESERVED].''.

       (i) Report by the Secretary.--Section 1222 of the Public 
     Health Service Act (42 U.S.C. 300d-22) is amended by striking 
     ``1995'' and inserting ``2007''.
       (j) Funding.--Section 1232(a) of the Public Health Service 
     Act (42 U.S.C. 300d-32(a)) is amended to read as follows:
       ``(a) Authorization of Appropriations.--For the purpose of 
     carrying out parts A and B, there are authorized to be 
     appropriated $12,000,000 for fiscal year 2005, and such sums 
     as may be necessary for each of the fiscal years 2006 through 
     2009.''.
       (k) Conforming Amendment.--Section 1232(b)(2) of the Public 
     Health Service Act (42 U.S.C. 300d-32(b)(2)) is amended by 
     striking ``1204'' and inserting ``1202''.
       (l) Institute of Medicine Study.--Part E of title XII of 
     the Public Health Service Act (20 U.S.C. 300d-51 et seq.) is 
     amended--
       (1) by striking the part heading and inserting the 
     following:

                  ``Part E--Miscellaneous Programs'';

     and
       (2) by adding at the end the following:

     ``SEC. 1254. INSTITUTE OF MEDICINE STUDY.

       ``(a) In General.--The Secretary shall enter into a 
     contract with the Institute of Medicine of the National 
     Academy of Sciences, or another appropriate entity, to 
     conduct a study on the state of trauma care and trauma 
     research.
       ``(b) Content.--The study conducted under subsection (a) 
     shall--
       ``(1) examine and evaluate the state of trauma care and 
     trauma systems research (including the role of Federal 
     entities in trauma research) on the date of enactment of this 
     section, and identify trauma research priorities;
       ``(2) examine and evaluate the clinical effectiveness of 
     trauma care and the impact of trauma care on patient 
     outcomes, with special attention to high-risk groups, such as 
     children, the elderly, and individuals in rural areas;
       ``(3) examine and evaluate trauma systems development and 
     identify obstacles that prevent or hinder the effectiveness 
     of trauma systems and trauma systems development;
       ``(4) examine and evaluate alternative strategies for the 
     organization, financing, and delivery of trauma care within 
     an overall systems approach; and
       ``(5) examine and evaluate the role of trauma systems and 
     trauma centers in preparedness for mass casualties.
       ``(c) Report.--Not later than 2 years after the date of 
     enactment of this section, the Secretary shall submit to the 
     appropriate committees of Congress a report containing the 
     results of the study conducted under this section.
       ``(d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $750,000 for 
     each of fiscal years 2005 and 2006.''.
       (m) Residency Training Programs in Emergency Medicine.--
     Section 1251(c) of the Public Health Service Act (42 U.S.C. 
     300d-51(c)) is amended by striking ``1993 through 1995'' and 
     inserting ``2005 through 2009''.
       (n) State Grants for Projects Regarding Traumatic Brain 
     Injury.--Section 1252 of the Public Health Service Act (42 
     U.S.C. 300d-52) is amended in the section heading by striking 
     ``DEMONSTRATION''.
       (o) Interagency Program for Trauma Research.--Section 1261 
     of the Public Health Service Act (42 U.S.C. 300d-61) is 
     amended--
       (1) in subsection (a), by striking ``conducting basic'' and 
     all that follows through the period at the end of the second 
     sentence and inserting ``basic and clinical research on 
     trauma (in this section referred to as the `Program'), 
     including the prevention, diagnosis, treatment, and 
     rehabilitation of trauma-related injuries.'';
       (2) by striking subsection (b) and inserting the following:
       ``(b) Plan for Program.--The Director shall establish and 
     implement a plan for carrying out the activities of the 
     Program, taking into consideration the recommendations 
     contained within the report of the NIH Trauma Research Task 
     Force. The plan shall be periodically reviewed, and revised 
     as appropriate.'';
       (3) in subsection (d)--
       (A) in paragraph (4)(B), by striking ``acute head injury'' 
     and inserting ``traumatic brain injury''; and
       (B) in subparagraph (D), by striking ``head'' and inserting 
     ``traumatic'';
       (4) by striking subsection (g);
       (5) by redesignating subsections (h) and (i) as subsections 
     (g) and (h), respectively; and
       (6) in subsection (h), as redesignated by paragraph (5), by 
     striking ``2001 through 2005'' and inserting ``2005 through 
     2009''.
                                 ______