[Congressional Record Volume 153, Number 53 (Tuesday, March 27, 2007)]
[House]
[Pages H3157-H3161]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
TRAUMA CARE SYSTEMS PLANNING AND DEVELOPMENT ACT OF 2007
Mr. GENE GREEN of Texas. Mr. Speaker, I move to suspend the rules and
pass the bill (H.R. 727) to amend the Public Health Service Act to add
requirements regarding trauma care, and for other purposes, as amended.
The Clerk read the title of the bill.
The text of the bill is as follows:
H.R. 727
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 2007''.
SEC. 2. ESTABLISHMENT.
Section 1201 of the Public Health Service Act (42 U.S.C.
300d) is amended to read as follows:
``SEC. 1201. ESTABLISHMENT.
``(a) In General.--The Secretary shall, with respect to
trauma care--
``(1) conduct and support research, training, evaluations,
and demonstration projects;
``(2) foster the development of appropriate, modern systems
of such care through the sharing of information among
agencies and individuals involved in the study and provision
of such care;
``(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;
``(4) provide to State and local agencies technical
assistance 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;
``(5) sponsor workshops and conferences; and
``(6) promote the collection and categorization of trauma
data in a consistent and standardized manner.
``(b) Grants, Cooperative Agreements, and Contracts.--The
Secretary may make grants, and enter into cooperative
agreements and contracts, for the purpose of carrying out
subsection (a).''.
SEC. 3. CLEARINGHOUSE ON TRAUMA CARE AND EMERGENCY MEDICAL
SERVICES.
The Public Health Service Act (42 U.S.C. 201 et seq.) is
amended--
(1) by striking section 1202; and
(2) by redesignating section 1203 as section 1202.
SEC. 4. ESTABLISHMENT OF PROGRAMS FOR IMPROVING TRAUMA CARE
IN RURAL AREAS.
Section 1202 of the Public Health Service Act, as
redesignated by section 3(2), is amended to read as follows:
``SEC. 1202. ESTABLISHMENT OF PROGRAMS FOR IMPROVING TRAUMA
CARE IN RURAL AREAS.
``(a) In General.--The Secretary may make grants to public
and nonprofit private entities for the purpose of carrying
out research and demonstration projects with respect to
improving the availability and quality of emergency medical
services in rural areas--
``(1) by developing innovative uses of communications
technologies and the use of new communications technology;
``(2) by developing model curricula, such as advanced
trauma life support, for training emergency medical services
personnel, including first responders, emergency medical
technicians, emergency nurses and physicians, and
paramedics--
``(A) in the assessment, stabilization, treatment,
preparation for transport, and resuscitation of seriously
injured patients, with special attention to problems that
arise during long transports and to methods of minimizing
delays in transport to the appropriate facility; and
``(B) in the management of the operation of the emergency
medical services system;
``(3) by making training for original certification, and
continuing education, in the provision and management of
emergency medical services more accessible to emergency
medical personnel in rural areas through telecommunications,
home studies, providing teachers and training at locations
accessible to such personnel, and other methods;
``(4) by developing innovative protocols and agreements to
increase access to prehospital care and equipment necessary
for the transportation of seriously injured patients to the
appropriate facilities;
``(5) by evaluating the effectiveness of protocols with
respect to emergency medical services and systems; and
``(6) by increasing communication and coordination with
State trauma systems.
``(b) Special Consideration for Certain Rural Areas.--In
making grants under subsection (a), the Secretary shall give
special consideration to any applicant for the grant that
will provide services under the grant in any rural area
identified by a State under section 1214(d)(1).
``(c) Requirement of Application.--The Secretary may not
make a grant under subsection (a) unless an application for
the grant is submitted to the Secretary and the application
is in such form, is made in such manner, and contains such
agreements, assurances, and information as the Secretary
determines to be necessary to carry out this section.''.
SEC. 5. COMPETITIVE GRANTS.
Part A of title XII of the Public Health Service Act, as
amended by section 3, is amended by adding at the end the
following:
``SEC. 1203. COMPETITIVE GRANTS FOR THE IMPROVEMENT OF TRAUMA
CARE.
``(a) In General.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, may make grants to States, political
subdivisions, or consortia of States or political
subdivisions for the purpose of improving access to and
enhancing the development of trauma care systems.
``(b) Use of Funds.--The Secretary may make a grant under
this section only if the applicant agrees to use the grant--
``(1) to integrate and broaden the reach of a trauma care
system, such as by developing innovative protocols to
increase access to prehospital care;
``(2) to strengthen, develop, and improve an existing
trauma care system;
``(3) to expand communications between the trauma care
system and emergency medical services through improved
equipment or a telemedicine system;
``(4) to improve data collection and retention; or
``(5) to increase education, training, and technical
assistance opportunities, such as training and continuing
education in the management of emergency medical services
accessible to emergency medical personnel in rural areas
through telehealth, home studies, and other methods.
[[Page H3158]]
``(c) Preference.--In selecting among States, political
subdivisions, and consortia of States or political
subdivisions for purposes of making grants under this
section, the Secretary shall give preference to applicants
that--
``(1) have developed a process, using national standards,
for designating trauma centers;
``(2) recognize protocols for the delivery of seriously
injured patients to trauma centers;
``(3) implement a process for evaluating the performance of
the trauma system; and
``(4) agree to participate in information systems described
in section 1202 by collecting, providing, and sharing
information.
``(d) Priority.--In making grants under this section, the
Secretary shall give priority to applicants that will use the
grants to focus on improving access to trauma care systems.
``(e) Special Consideration.--In awarding grants under this
section, the Secretary shall give special consideration to
projects that demonstrate strong State or local support,
including availability of non-Federal contributions.''.
SEC. 6. 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 to read as follows:
``SEC. 1212. REQUIREMENT OF MATCHING FUNDS FOR FISCAL YEARS
SUBSEQUENT TO FIRST FISCAL YEAR OF PAYMENTS.
``(a) Non-Federal Contributions.--
``(1) In general.--The Secretary may not make payments
under section 1211(a) unless the State involved agrees, with
respect to the costs described in paragraph (2), to make
available non-Federal contributions (in cash or in kind under
subsection (b)(1)) toward such costs in an amount that--
``(A) for the second and third fiscal years of such
payments to the State, is not less than $1 for each $1 of
Federal funds provided in such payments for such fiscal
years; and
``(B) for the fourth and subsequent fiscal years of such
payments to the State, is not less than $2 for each $1 of
Federal funds provided in such payments for such fiscal
years.
``(2) Program costs.--The costs referred to in paragraph
(1) are--
``(A) the costs to be incurred by the State in carrying out
the purpose described in section 1211(b); or
``(B) the costs of improving the quality and availability
of emergency medical services in rural areas of the State.
``(3) Initial year of payments.--The Secretary may not
require a State to make non-Federal contributions as a
condition of receiving payments under section 1211(a) for the
first fiscal year of such payments to the State.
``(b) Determination of Amount of Non-Federal
Contribution.--With respect to compliance with subsection (a)
as a condition of receiving payments under section 1211(a)--
``(1) a State may make the non-Federal contributions
required in such subsection in cash or in kind, fairly
evaluated, including plant, equipment, or services; and
``(2) the Secretary may not, in making a determination of
the amount of non-Federal contributions, include amounts
provided by the Federal Government or services assisted or
subsidized to any significant extent by the Federal
Government.''.
SEC. 7. 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 to read as follows:
``SEC. 1213. REQUIREMENTS WITH RESPECT TO CARRYING OUT
PURPOSE OF ALLOTMENTS.
``(a) Trauma Care Modifications to State Plan for Emergency
Medical Services.--With respect to the trauma care component
of a State plan for the provision of emergency medical
services, the modifications referred to in section 1211(b)
are such modifications to the State plan as may be necessary
for the State involved to ensure that the plan provides for
access to the highest possible quality of trauma care, and
that the plan--
``(1) specifies that the modifications required pursuant to
paragraphs (2) through (11) will be implemented by the
principal State agency with respect to emergency medical
services or by the designee of such agency;
``(2) specifies a public or private entity that will
designate trauma care regions and trauma centers in the
State;
``(3) subject to subsection (b), contains national
standards and requirements of the American College of
Surgeons or another appropriate entity for the designation of
level I and level II trauma centers, and in the case of rural
areas level III trauma centers (including trauma centers with
specified capabilities and expertise in the care of pediatric
trauma patients), by such entity, including standards and
requirements for--
``(A) the number and types of trauma patients for whom such
centers must provide care in order to ensure that such
centers will have sufficient experience and expertise to be
able to provide quality care for victims of injury;
``(B) the resources and equipment needed by such centers;
and
``(C) the availability of rehabilitation services for
trauma patients;
``(4) contains standards and requirements for the
implementation of regional trauma care systems, including
standards and guidelines (consistent with the provisions of
section 1867 of the Social Security Act) for medically
directed triage and transportation of trauma patients
(including patients injured in rural areas) prior to care in
designated trauma centers;
``(5) subject to subsection (b), contains national
standards and requirements, including those of the American
Academy of Pediatrics and the American College of Emergency
Physicians, for medically directed triage and transport of
severely injured children to designated trauma centers with
specified capabilities and expertise in the care of pediatric
trauma patients;
``(6) utilizes a program with procedures for the evaluation
of designated trauma centers (including trauma centers
described in paragraph (5)) and trauma care systems;
``(7) provides for the establishment and collection of data
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, from each
designated trauma center in the State of a central data
reporting and analysis system--
``(A) to identify the number of severely injured trauma
patients and the number of deaths from trauma within trauma
care systems in the State;
``(B) to identify the cause of the injury and any factors
contributing to the injury;
``(C) to identify the nature and severity of the injury;
``(D) to monitor trauma patient care (including prehospital
care) in each designated trauma center within regional trauma
care systems in the State (including relevant emergency-
department discharges and rehabilitation information) for the
purpose of evaluating the diagnosis, treatment, and treatment
outcome of such trauma patients;
``(E) to identify the total amount of uncompensated trauma
care expenditures for each fiscal year by each designated
trauma center in the State; and
``(F) to identify patients transferred within a regional
trauma system, including reasons for such transfer and the
outcomes of such patients;
``(8) provides for the use of procedures by paramedics and
emergency medical technicians to assess the severity of the
injuries incurred by trauma patients;
``(9) provides for appropriate transportation and transfer
policies to ensure the delivery of patients to designated
trauma centers and other facilities within and outside of the
jurisdiction of such system, including policies to ensure
that only individuals appropriately identified as trauma
patients are transferred to designated trauma centers, and to
provide periodic reviews of the transfers and the auditing of
such transfers that are determined to be appropriate;
``(10) conducts public education activities concerning
injury prevention and obtaining access to trauma care;
``(11) coordinates planning for trauma systems with State
disaster emergency planning and bioterrorism hospital
preparedness planning; and
``(12) with respect to the requirements established in this
subsection, provides for coordination and cooperation between
the State and any other State with which the State shares any
standard metropolitan statistical area.
``(b) Certain Standards With Respect to Trauma Care Centers
and Systems.--
``(1) In general.--The Secretary may not make payments
under section 1211(a) for a fiscal year unless the State
involved agrees that, in carrying out paragraphs (3) through
(5) of subsection (a), the State will adopt standards for the
designation of trauma centers, and for triage, transfer, and
transportation policies, and that the State will, in adopting
such standards--
``(A) take into account national standards that outline
resources for optimal care of injured patients;
``(B) consult with medical, surgical, and nursing
speciality groups, hospital associations, emergency medical
services State and local directors, concerned advocates, and
other interested parties;
``(C) conduct hearings on the proposed standards after
providing adequate notice to the public concerning such
hearing; and
``(D) beginning in fiscal year 2008, take into account the
model plan described in subsection (c).
``(2) Quality of trauma care.--The highest quality of
trauma care shall be the primary goal of State standards
adopted under this subsection.
``(3) Approval by the secretary.--The Secretary may not
make payments under section 1211(a) to a State if the
Secretary determines that--
``(A) in the case of payments for fiscal year 2008 and
subsequent fiscal years, the State has not taken into account
national standards, including those of the American College
of Surgeons, the American College of Emergency Physicians,
and the American Academy of Pediatrics, in adopting standards
under this subsection; or
``(B) in the case of payments for fiscal year 2008 and
subsequent fiscal years, the State has not, in adopting such
standards, taken into account the model plan developed under
subsection (c).
``(c) Model Trauma Care Plan.--
``(1) In general.--Not later than 1 year after the date of
the enactment of the Trauma Care Systems Planning and
Development Act of 2007, the Secretary shall update the model
plan for the designation of trauma centers and for triage,
transfer, and transportation policies that may be adopted for
guidance by the State. Such plan shall--
``(A) take into account national standards, including those
of the American College of Surgeons, American College of
Emergency Physicians, and the American Academy of Pediatrics;
``(B) take into account existing State plans;
``(C) be developed in consultation with medical, surgical,
and nursing speciality groups, hospital associations,
emergency medical services State directors and associations,
and other interested parties; and
[[Page H3159]]
``(D) include standards for the designation of rural health
facilities and hospitals best able to receive, stabilize, and
transfer trauma patients to the nearest appropriate
designated trauma center, and for triage, transfer, and
transportation policies as they relate to rural areas.
``(2) Applicability.--Standards described in paragraph
(1)(D) shall be applicable to all rural areas in the State,
including both non-metropolitan areas and frontier areas that
have populations of less than 6,000 per square mile.
``(d) Rule of Construction With Respect to Number of
Designated Trauma Centers.--With respect to compliance with
subsection (a) as a condition of the receipt of a grant under
section 1211(a), such subsection may not be construed to
specify the number of trauma care centers designated pursuant
to such subsection.''.
SEC. 8. REQUIREMENT OF SUBMISSION TO SECRETARY OF TRAUMA PLAN
AND CERTAIN INFORMATION.
Section 1214 of the Public Health Service Act (42 U.S.C.
300d-14) is amended to read as follows:
``SEC. 1214. REQUIREMENT OF SUBMISSION TO SECRETARY OF TRAUMA
PLAN AND CERTAIN INFORMATION.
``(a) In General.--For each fiscal year, the Secretary may
not make payments to a State under section 1211(a) unless,
subject to subsection (b), the State submits to the Secretary
the trauma care component of the State plan for the provision
of emergency medical services, including any changes to the
trauma care component and any plans to address deficiencies
in the trauma care component.
``(b) Interim Plan or Description of Efforts.--For each
fiscal year, if a State has not completed the trauma care
component of the State plan described in subsection (a), the
State may provide, in lieu of such completed component, an
interim component or a description of efforts made toward the
completion of the component.
``(c) Information Received by State Reporting and Analysis
System.--The Secretary may not make payments to a State under
section 1211(a) unless the State agrees that the State will,
not less than once each year, provide to the Secretary the
information received by the State pursuant to section
1213(a)(7).
``(d) Availability of Emergency Medical Services in Rural
Areas.--The Secretary may not make payments to a State under
section 1211(a) unless--
``(1) the State identifies any rural area in the State for
which--
``(A) there is no system of access to emergency medical
services through the telephone number 911;
``(B) there is no basic life-support system; or
``(C) there is no advanced life-support system; and
``(2) the State submits to the Secretary a list of rural
areas identified pursuant to paragraph (1) or, if there are
no such areas, a statement that there are no such areas.''.
SEC. 9. RESTRICTIONS ON USE OF PAYMENTS.
Section 1215 of the Public Health Service Act (42 U.S.C.
300d-15) is amended to read as follows:
``SEC. 1215. RESTRICTIONS ON USE OF PAYMENTS.
``(a) In General.--The Secretary may not, except as
provided in subsection (b), make payments under section
1211(a) for a fiscal year unless the State involved agrees
that the payments will not be expended--
``(1) for any purpose other than developing, implementing,
and monitoring the modifications required by section 1211(b)
to be made to the State plan for the provision of emergency
medical services;
``(2) to make cash payments to intended recipients of
services provided pursuant to this section;
``(3) to purchase or improve real property (other than
minor remodeling of existing improvements to real property);
``(4) to satisfy any requirement for the expenditure of
non-Federal funds as a condition for the receipt of Federal
funds; or
``(5) to provide financial assistance to any entity other
than a public or nonprofit private entity.
``(b) Waiver.--The Secretary may waive a restriction under
subsection (a) only if the Secretary determines that the
activities outlined by the State plan submitted under section
1214(a) by the State involved cannot otherwise be carried
out.''.
SEC. 10. REQUIREMENTS OF REPORTS BY STATES.
The Public Health Service Act (42 U.S.C. 201 et seq.) is
amended by striking section 1216.
SEC. 11. REPORT BY SECRETARY.
Section 1222 of the Public Health Service Act (42 U.S.C.
300d-22) is amended to read as follows:
``SEC. 1222. REPORT BY SECRETARY.
``Not later than October 1, 2008, the Secretary shall
report to the appropriate committees of Congress on the
activities of the States carried out pursuant to section
1211. Such report shall include an assessment of the extent
to which Federal and State efforts to develop systems of
trauma care and to designate trauma centers have reduced the
incidence of mortality, and the incidence of permanent
disability, resulting from trauma. Such report may include
any recommendations of the Secretary for appropriate
administrative and legislative initiatives with respect to
trauma care.''.
SEC. 12. FUNDING.
Section 1232 of the Public Health Service Act (42 U.S.C.
300d-32) is amended to read as follows:
``SEC. 1232. FUNDING.
``(a) Authorization of Appropriations.--For the purpose of
carrying out parts A and B, subject to subsections (b) and
(c), there are authorized to be appropriated $12,000,000 for
fiscal year 2008, $10,000,000 for fiscal year 2009, and
$8,000,000 for each of the fiscal years 2010 through 2012.
``(b) Reservation of Funds.--If the amount appropriated
under subsection (a) for a fiscal year is equal to or less
than $1,000,000, such appropriation is available only for the
purpose of carrying out part A. If the amount so appropriated
is greater than $1,000,000, 50 percent of such appropriation
shall be made available for the purpose of carrying out part
A and 50 percent shall be made available for the purpose of
carrying out part B.
``(c) Allocation of Part A Funds.--Of the amounts
appropriated under subsection (a) for a fiscal year to carry
out part A--
``(1) 10 percent of such amounts for such year shall be
allocated for administrative purposes; and
``(2) 10 percent of such amounts for such year shall be
allocated for the purpose of carrying out section 1202.''.
SEC. 13. RESIDENCY TRAINING PROGRAMS IN EMERGENCY MEDICINE.
Section 1251 of the Public Health Service Act (42 U.S.C.
300d-51) is amended to read as follows:
``SEC. 1251. RESIDENCY TRAINING PROGRAMS IN EMERGENCY
MEDICINE.
``(a) In General.--The Secretary may make grants to public
and nonprofit private entities for the purpose of planning
and developing approved residency training programs in
emergency medicine.
``(b) Identification and Referral of Domestic Violence.--
The Secretary may make a grant under subsection (a) only if
the applicant involved agrees that the training programs
under subsection (a) will provide education and training in
identifying and referring cases of domestic violence.
``(c) Authorization of Appropriations.--For the purpose of
carrying out this section, there is authorized to be
appropriated $400,000 for each of the fiscal years 2008
though 2012.''.
SEC. 14. STATE GRANTS FOR CERTAIN PROJECTS.
Section 1252 of the Public Health Service Act (42 U.S.C.
300d-52) is amended in the section heading by striking
``demonstration''.
The SPEAKER pro tempore. Pursuant to the rule, the gentleman from
Texas (Mr. Gene Green) and the gentleman from Texas (Mr. Burgess) each
will control 20 minutes.
The Chair recognizes the gentleman from Texas (Mr. Gene Green).
General Leave
Mr. GENE GREEN of Texas. Mr. Speaker, I ask unanimous consent that
all Members have 5 legislative days to revise and extend their remarks
and include extraneous material on the bill under consideration.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from Texas?
There was no objection.
Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I
may consume.
I rise today in support of H.R. 727, legislation to reauthorize the
Trauma Systems Planning and Development Act. This program, under the
Public Health Service Act, was first authorized in 1990 to improve and
coordinate trauma care in our country.
Since then, this program has provided $30 million to States to
establish state-wide and regional trauma systems. Injury related to
trauma is the leading cause of death for younger Americans, ages 1
through 44. Trauma also causes more than 300,000 permanent disabilities
each year.
For seriously injured individuals, the first hour after an injury is
when medical care is most effective in saving lives and function. This
hour is also often referred to as the ``golden hour,'' during which
trauma and emergency systems must respond both quickly and efficiently.
This golden hour is also the goal that our military has for getting
medical attention to our soldiers injured on the battlefield. The
military has an impressive, streamlined trauma system that my
colleagues Dr. Burgess; our ranking member at that time, Congressman
Deal from Georgia; and our late colleague Dr. Norwood from Georgia and
I marveled at during our trip last summer to Iraq, where we toured the
military's trauma facilities in Balad.
Unfortunately, the military's trauma system is not replicated in
civilian health care, and too many Americans do not benefit from trauma
systems that facilitate medical intervention during this critical time
frame.
While the death rate from trauma is 50 percent higher in rural areas
than in urban locations, trauma affects each corner of this country. In
fact, nearly 25 percent of all Americans sustain injuries each year
that require medical attention. Yet without coordinated trauma systems
and quick access to care, injuries are too often fatal.
In Houston, we learned this lesson the hard way when the lack of
trauma
[[Page H3160]]
coordination forced a young man to wait more than 4 hours to receive
care after he was hit by a car on Halloween night in 2001. With serious
head, chest and leg injuries, this patient was clearly medically
unstable and should have received immediate care at one of Houston's
two level-one trauma centers. But with the trauma centers increasingly
on diversion, this young man was transported to Austin where he died
the next day.
It was clear that we needed better trauma systems in the Houston
area, and we quickly learned that the problem was felt throughout our
Nation. We also learned that the effective trauma systems would help
prevent nearly 25,000 deaths each year.
As a response, we developed this legislation to build on the
program's initial success since 1990, and we authorized it through
2012.
This bill includes changes to the program to ensure that scarce
health care dollars go to the communities most in need, ensuring that
Federal funds are utilized to strengthen trauma systems and improve
communication and coordination among different trauma systems.
It specifically ensures that grants go to States that coordinate
planning for trauma systems with State disaster emergency planning and
bioterrorism hospital preparedness planning.
In addition, this legislation would require the Secretary to update
the model plan for the designation of trauma centers and set triage,
transfer, and transportation policies.
The legislation also reauthorizes the Residency Training Program in
Emergency Medicine in an effort to ensure an adequate level of ER
physicians to treat patients in need of care from America's trauma
centers.
I would like to thank Mr. Burgess from Texas for his leadership on
this legislation and for helping to craft the compromise before us
today.
I would also like to thank Chairman Dingell and our Health
Subcommittee Chairman Pallone for their interest in this issue. We have
been working on this bill for 5 years.
Until now, this important issue failed to receive the attention it
deserved, so I appreciate my chairman including this bill on our first
markup in this Congress.
I also appreciate the hard work that John Ford, William Garner and
Pete Goodloe of the committee staff put in to guide this bill through
the committee to ensure that we have a consensus product to approve
today, and also my own staff who has worked on this for at least 3
years.
{time} 2030
I also appreciate the support of the American College of Surgeons,
the American Osteopathic Association, the American Academy of
Pediatrics, the American Association of Neurological Surgeons, the
American Trauma Society, the Coalition for American Trauma Care and the
Emergency Nurses Association.
The members of these groups are on the front lines and know that
coordinated trauma systems can literally save lives. We thank them for
all they do for our communities.
I urge my colleagues to vote for this important legislation.
Mr. Speaker, I reserve the balance of my time.
Mr. BURGESS. Mr. Speaker, at this point, I yield such time as he may
consume to the gentleman from Louisiana (Mr. Boustany), who has
intimate, firsthand knowledge of this issue.
Mr. BOUSTANY. I thank my colleague from Texas for yielding time to
me.
Mr. Speaker, prior to coming to Congress, I was a practicing
cardiovascular and thoracic surgeon with extensive experience in open
heart surgery, as well as trauma surgery. But I want to speak about the
importance of this bill not as a physician but as a parent of a son who
was in a severe car accident.
About 6 years ago, I will never forget this, this was a Wednesday
night, about 11:30 in the evening, and I received a phone call from the
hospital from a friend of mine who is an emergency room physician who
told me, was your son driving a black Alero? I said, what do you mean,
``was''? He went on to say, ``Well, I think he's going to be okay.'' He
started to read off the litany of injuries that my son had.
So I immediately rushed over to the hospital, and I didn't think
about it, but I happened to be on call for chest trauma that night, so
I was worried that I might have to operate on my own son. I get to the
hospital and found out that he was in the emergency room, sitting there
for about 3 to 4 hours. He was in shock. There was no organization with
regard to prioritization of his injuries.
I immediately jumped in and started kind of prioritizing things, and
we managed to get him stabilized. He went through some extensive
surgery that night. He subsequently had to be transferred to another
hospital 180 miles away for further treatment of his extensive
orthopedic injuries.
Because of lack of trauma coordination at that hospital, he developed
severe malnutrition, lost about 50 pounds, had a lack of coordination
with his antibiotics, developed infections, and spent nearly 6 or 7
weeks in the hospital, followed by about 3 to 4 to 5 months of further
care to get him back to where he could walk with crutches. Thankfully
now, today, he is doing well.
But if it wouldn't have been for my personal experience as a
physician, overseeing the care of my son, he would not have gotten the
appropriate care, and that is because we didn't have a coordinated
trauma center.
Trauma cannot be fragmented. It requires a coordinated effort by a
team of experts.
As was mentioned, the mortality rate from trauma is significantly
higher in rural areas than it is in urban areas. There are nearly 20-
to 25,000 trauma deaths each year that are preventable if we had the
proper coordination.
We have learned much from the military. Much of trauma surgery has
evolved from military activity and stream of the wounded afterwards.
There have been tremendous advances, but this does not translate to
civilian area, where we do not have trauma centers.
Clearly, this is a bill that is important, and I appreciate the
committee for bringing this forward and the hard work that has been
done.
This bill will ensure that severely injured patients get coordinated
care, get care by experts, by a team of experts, not just in the
emergency room and the operating room but in the aftermath, where it's
so critical to full recovery and full rehabilitation.
This bill will award grants to the States for planning, implementing
and developing trauma care systems. The Institute of Medicine has said
the availability of Federal funds through the Trauma Care Systems and
Planning Development Act appears to have helped increase the number of
trauma centers and urged, in 1999, the reauthorization of the Trauma
Care Act.
This bill is absolutely necessary. It's critical, and it also will
serve to build a trauma registry, which is so important, so that we can
catalog these injuries and learn from these things so that we can
actually improve trauma care further in the civilian arena.
I urge my colleagues to support this bill. It's a superb bill. It's
an excellent bill.
Mr. GENE GREEN of Texas. Mr. Speaker, we reserve the balance of our
time.
Mr. BURGESS. Mr. Speaker, as we have just heard, this is an important
bill. Trauma is one of the most expensive illnesses that we treat in
this country. I am so pleased today to stand in support of H.R. 727,
the Trauma Care Systems Planning and Development Act of 2007.
In 1990, the Trauma Care Systems Planning and Development Act created
title XII of the Public Health Service Act. This program was borne out
of a report in which it was found that severely injured individuals in
a majority of both urban and rural areas of the United States were not
receiving the benefit of trauma systems, despite considerable evidence
that a trauma system would improve survival rates.
H.R. 727 requires the Health Resources and Services Administration to
work with each State to help establish advanced trauma life support
systems and to train EMS personnel for rural areas. Likewise, the
program will help to make improvements in communication and
coordination with the larger State trauma systems.
For Americans between the ages of 1 and 44, trauma is the leading
cause of death. Traumatic injury in the United States, largely due to
motor-related
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trauma, totals $260 billion in costs. By reauthorizing this program, we
will achieve the goal of ensuring that all areas of the United States
have appropriate emergency medical services.
As the legislation is structured, entities, either States or
independent agencies, may compete for planning and development grants
to help improve the trauma system and coordination in a given region.
That is a distinct difference from the trauma bill that existed before.
This bill is an improvement over the previous authorization because
it will allow both States and other political subdivisions to work
cooperatively to improve trauma systems. This bill also represents a
more realistic authorization that will essentially act as start-up
Federal funding for enhanced communication, enhanced coordination and
data collection for States and other eligible grantees.
Certainly, I need to join my colleague from Texas in thanking
Congressman Barton and Congressman Dingell for their hard work on this
legislation. Mr. Speaker, this has been a work in process for some
time.
My personal staff, Josh Martin, worked diligently on this bill last
year. There were a number of issues with the other body which took some
time to resolve, but happily they were resolved before the end of the
year. We are now able to support H.R. 727 in this Congress, get the
bill passed and get this coordination of service where it is so badly
needed.
Mr. Speaker, I yield back the balance of my time.
Mr. GENE GREEN of Texas. Mr. Speaker, I urge passage of the bill, and
I yield back the balance of my time.
The SPEAKER pro tempore. The question is on the motion offered by the
gentleman from Texas (Mr. Gene Green) that the House suspend the rules
and pass the bill, H.R. 727, as amended.
The question was taken; and (two-thirds being in the affirmative) the
rules were suspended and the bill, as amended, was passed.
A motion to reconsider was laid on the table.
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