[Congressional Record Volume 153, Number 1 (Thursday, January 4, 2007)]
[Senate]
[Pages S78-S79]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REID (for Mr. Inouye):
  S. 60. A bill to amend the Public Health Service Act to provide a 
means for continued improvement in emergency medical services for 
children; to the Committee on Health, Education, Labor, and Pensions.
  Mr. INOUYE. Mr. President, today, along with my colleagues; Senators 
Akaka, Kennedy, Conrad and Dorgan, I introduce ``The Wakefield Act,'' 
also known as the ``Emergency Medical Services for Children Act of 
2007.'' Since Senator Hatch and I worked toward authorization of EMSC 
in 1984, this program has become the impetus for improving children's 
emergency services Nationwide. From specialized training for emergency 
care providers to ensuring ambulances and emergency departments have 
state-of-the-art pediatric sized equipment, EMSC has served as the 
vehicle for improving survival of our smallest and most vulnerable 
citizens when accidents or medical emergencies threatened their lives.
  It remains no secret that children present unique anatomic, 
physiologic, emotional and developmental challenges to our primarily 
adult-oriented emergency medical system. As has been said many times 
before, children are not little adults. Evaluation and treatment must 
take into account their special needs, or we risk letting them fall 
through the gap between adult and pediatric care. The EMSC has bridged 
that gap while fostering collaborative relationships among emergency 
medical technicians, paramedics, nurses, emergency physicians, 
surgeons, and pediatricians.
  The Institute of Medicine's recently released study on Emergency Care 
for

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Children, indicated that our Nation is not as well prepared as once we 
thought. Only 6 percent of all emergency departments have the essential 
pediatric supplies and equipment necessary to manage pediatric 
emergencies. Many of the providers of emergency care have received 
fragmented and little training in the skills necessary to resuscitate 
this specialized population. Even our disaster preparedness plans have 
not fully addressed the unique needs posed by children injured in such 
events.
  EMSC remains the only federal program dedicated to examining the best 
ways to deliver various forms of care to children in emergency 
settings. Re-authorization of EMSC will ensure that children's needs 
will be given the due attention they deserve and that coordination and 
expansion of services for victims of life-threatening illnesses and 
injuries will be available throughout the United States.
  I look forward to re-authorization of this important legislation and 
the continued advances in our emergency healthcare delivery system.
  I ask unanimous consent that the text of this bill be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 60

       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 ``Wakefield Act''.

     SEC. 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, with children 
     under the age of 3 years accounting for most of these visits.
       (2) Ninety 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, with 43 percent of hospitals lacking 
     cervical collars (used to stabilize spinal injuries) for 
     infants, less than half (47 percent) of hospitals with no 
     pediatric intensive care unit having a written transfer 
     agreement with a hospital that does have such a unit, one-
     third of States lacking a physician available on-call 24 
     hours a day to provide medical direction to emergency medical 
     technicians or other non-physician emergency care providers, 
     and even those States with such availability lacking full 
     State coverage.
       (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) 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.
       (8) 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.
       (9) 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.
       (10) States are better equipped to handle occurrences of 
     critical or traumatic injury due to advances fostered by the 
     EMSC program, with--
       (A) forty-eight States identifying and requiring all EMSC-
     recommended pediatric equipment on Advanced Life Support 
     ambulances;
       (B) forty-four States employing pediatric protocols for 
     medical direction;
       (C) forty-one States utilizing pediatric guidelines for 
     acute care facility identification, ensuring that children 
     get to the right hospital in a timely manner; and
       (D) thirty-six of the forty-two States having statewide 
     computerized data collection systems now producing reports on 
     pediatric emergency medical services using statewide data.
       (11) 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.
       (12) Now celebrating its twentieth anniversary, the EMSC 
     Program has proven effective over two 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.

     SEC. 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: 
     ``$23,000,000 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.''.
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