[Congressional Record Volume 153, Number 14 (Wednesday, January 24, 2007)]
[Extensions of Remarks]
[Pages E184-E185]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




SOCIAL SECURITY AND MEDICARE IMPROVED BURN INJURY TREATMENT ACCESS ACT 
                                OF 2007

                                 ______
                                 

                          HON. RICHARD E. NEAL

                            of massachusetts

                    in the house of representatives

                      Wednesday, January 24, 2007

  Mr. NEAL. Madam Speaker, I rise today to introduce the Social 
Security and Medicare Improved Burn Injury Treatment Access Act of 
2007. This legislation provides a waiver of the 24-month waiting period 
now required before an uninsured individual becomes eligible for 
Medicare coverage for disabling burn injuries, as well as the five-
month waiting period for Social Security disability benefits.
  Each year an estimated 500,000 people are treated for burn injuries. 
Of these 500,000 injuries, about 40,000 require hospitalization. Fire 
and burn deaths average about 4,000 per year.
  Burn care is highly specialized. While there are thousands of trauma 
centers in the United States, there are only 125 burn centers with a 
total burn-bed capacity of just over 1,800. These specialized burn 
centers treat about 25,000 or 200 admissions per year, out of the total 
40,000 admissions, while the other 5,000 U.S. hospitals without burn 
centers average less than three burn admissions per year.
  Medical care for serious burn injuries is very expensive, which 
places a great financial strain on burn centers, about 40 percent of 
whose patients are uninsured. Because of these financial challenges, 
burn centers in Pennsylvania, Mississippi, Iowa and South Carolina have 
closed in just the past two years.
  This is occurring at a time when the federal govemment is asking burn 
centers to expand their capacity to deal with mass casualty scenarios. 
The Departments of Health and Human Services and Homeland Security have 
included burn centers in the Critical Benchmark Surge Capacity Criteria 
in the funding continuation requirements for state plans administered 
through the Health Resources and Services Administration (HRSA). HSS, 
in conjunction with the American Burn Association,

[[Page E185]]

has created a real-time, web-based burn-bed capacity system in the 
national emergency preparedness center and funded Advanced Burn Life 
Support (ABLS) and clinical, on-site burn nurse training for 200 public 
health service nurses as a reserve capacity for potential mass burn 
casualty incidents, as well as supporting more than 20 ABLS courses 
with over 600 first-responders in ten key areas of the country.
  The 9/11 terrorist attacks on New York City and Washington, D.C., and 
major accidents like the Rhode Island nightclub fire and North Carolina 
chemical plant explosions demonstrate the substantial number of burn 
injuries that can result from such events. Over one-third of those 
hospitalized in New York on 9/11 had severe burn injuries. The 
Department of Homeland Security has recognized that there would be mass 
burn casualties in terrorist acts, and there is a need for appropriate 
preparedness activities. For example, if the United States should 
suffer further terrorist attacks using explosions, incendiary devices 
or chemical weapons, most victims would suffer severe burn injuries.
  Even a relatively modest number of burn injuries can consume large 
segments of the nation's burn bed capacity. For example, the victims of 
the Rhode Island nightclub fire absorbed the burn bed capacity of most 
of the northern East Coast of the United States. Mass burn casualties 
that reach into the hundreds or thousands would strain the system to 
the breaking point.
  It is clear that burn centers are a national resource and a critical 
link to public health emergency preparedness. Medicare coverage for 
serious, disabling burn injuries would enable these burn centers to 
remain financially viable and preserve an essential component of our 
public health emergency infrastructure.
  This legislation follows an approach already taken with respect to 
End Stage Renal Disease (ESRD) and amyotrophic lateral sclerosis (ALS 
or Lou Gehrig's disease), both of which result in waivers of the 24-
month waiting period for Medicare eligibility. While these two diseases 
tend to be progressive in nature, the very initial phase of a serious 
burn injury is when things are most acute.
  Providing immediate Medicare coverage for uninsured patients 
suffering serious, disabling burn injuries is a fully justified and 
necessary step. Although not all hospitalized burn injuries would 
qualify as ``disabling'' and thus result in immediate Medicare 
coverage, this legislation is about providing coverage for the many 
uninsured patients suffering from serious burn injuries and ensuring 
the survival of a vital national resource that already is in jeopardy, 
a situation we cannot accept as we seek to prepare the nation to deal 
with potential mass casualty terrorist events.

                          ____________________