[Congressional Record Volume 154, Number 55 (Tuesday, April 8, 2008)]
[House]
[Pages H2027-H2029]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1515
                             WAKEFIELD ACT

  Mrs. CAPPS. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 2464) to amend the Public Health Service Act to provide a 
means for continued improvement in Emergency Medical Services for 
Children, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 2464

       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.
       (2) Over 90 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 birth weight, and bronchopulmonary 
     dysplasia.
       (5) Significant gaps remain in emergency medical care 
     delivered to children. Only about 6 percent of hospitals have 
     available all the pediatric supplies deemed essential by the 
     American Academy of Pediatrics and the American College of 
     Emergency Physicians for managing pediatric emergencies, 
     while about half of hospitals have at least 85 percent of 
     those supplies.
       (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) 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.
       (8) 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.
       (9) 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.
       (10) 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.
       (11) The Institute of Medicine stated in its 2006 report, 
     ``Emergency Care for Children: Growing Pains'', that the EMSC 
     Program ``boasts many accomplishments . . . and the work of 
     the program continues to be relevant and vital''.
       (12) 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

[[Page H2028]]

     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: ``, 
     $25,000,000 for fiscal year 2009, $26,250,000 for fiscal year 
     2010, $27,562,500 for fiscal year 2011, $28,940,625 for 
     fiscal year 2012, and $30,387,656 for fiscal year 2013'';
       (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.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
California (Mrs. Capps) and the gentleman from Georgia (Mr. Deal) each 
will control 20 minutes.
  The Chair recognizes the gentlewoman from California.


                             General Leave

  Mrs. CAPPS. I ask unanimous consent that all Members may have 5 
legislative days to revise and extend their remarks and include 
extraneous materials on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from California?
  There was no objection.
  Mrs. CAPPS. Madam Speaker, I yield myself such time as I may consume.
  Madam Speaker, I rise in strong support of H.R. 2464, the Wakefield 
Act. This legislation reauthorizes the Emergency Medical Services for 
Children ``EMSC'' program. The EMSC program ensures state-of-the-art 
emergency medical care for ill or injured children and adolescents.
  Since its establishment more than 20 years ago, the EMSC program has 
driven major improvements in emergency care for children. In fact, 
injury-related deaths among children have dropped by 40 percent over 
that time period. Enormous strides have been made in areas such as 
ensuring that all ambulances carry appropriate pediatric supplies and 
equipment, and in collecting data on pediatric emergency care to inform 
future quality improvement efforts. Although much progress has been 
achieved, more remains to be done.
  H.R. 2464 is an important piece of legislation that will work toward 
ensuring the best emergency medical care for children.
  I would like to congratulate my colleague on the Energy and Commerce 
Committee, Jim Matheson, and commend him for his hard work and 
dedication to this important piece of legislation.
  I encourage all of my colleagues to join me in support of H.R. 2464.
  Madam Speaker, I reserve the balance of my time.
  Mr. DEAL of Georgia. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I, too, rise in support of H.R. 2464, which 
reauthorizes the Emergency Medical Services for Children program. It 
is, indeed, the only Federal program dedicated to improving emergency 
care for children. Since its inception in 1984, death rates due to 
pediatric injury have dropped some 40 percent.
  The program provides grants to States to improve existing medical 
emergency services systems, and to evaluate pediatric emergency care 
data to improve future treatment efforts. Many emergency centers do not 
have all of the necessary supplies to treat pediatric emergencies, 
despite the fact that 18 percent of emergency department patients are 
children.
  The legislation also increases the authorization for this program by 
5 percent annually for the next 5 years starting at $25 million in FY 
2009. The bill also extends by 1 year the period that the Secretary of 
the Department of Health and Human Services may award grants under the 
program. The bill had broad bipartisan support in the committee, and I 
would urge its passage.
  Madam Speaker, I reserve the balance of my time.
  Mrs. CAPPS. Madam Speaker, I am very pleased to yield 5 minutes to 
the gentleman from Utah (Mr. Matheson).
  Mr. MATHESON. Madam Speaker, I rise today to speak in support of H.R. 
2464, the Wakefield Act. I am the lead sponsor of this legislation, 
along with Representative Peter T. King on the other side of the aisle.
  Today, the hospital emergency department is such a fundamental part 
of our health system that it's easy to forget that emergency medicine 
is a relatively new specialty. Emergency rooms were first established 
in the 1970s as medical personnel returned from the Vietnam War. The 
skills developed to save soldiers' lives on the battlefield were being 
put to use saving victims of car crashes and other traumas.
  However, the bodies of adult soldiers are very different from those 
of kids. By the early 1980s, doctors were seeing marked disparities in 
survival rates among adults and children with similar injuries. In 
fact, kids had twice the death rate in emergencies as adults.
  In 1984, the Emergency Medical Services for Children program was 
first 
created. This unique act has driven fundamental changes in America's 
emergency medical system. Since it was established, child injury death 
rates have dropped 40 percent. The research that resulted from this 
legislation helped establish pediatric emergency medicine as its own 
specialty.
  Program grants have provided seed money to every State and territory 
to help first responders and hospitals improve children's emergency 
care. In the mid-1980s, emergency personnel received little training in 
caring for children. Now, thanks to this program, paramedics can be 
exclusively trained, and their ambulances are stocked with the 
equipment and supplies needed by seriously injured kids.
  Nowhere has this been more critical than in rural areas where the 
closest emergency room is often many miles from the scene of an 
accident. Getting it right for these small patients in the first 
critical minutes often means the difference between life and death.
  Data collection and training seminars offered under this program, 
including from the Emergency Medical Services for Children Data 
Analysis Resource Center based in my district at the University of 
Utah, help ensure that best practices are developed and disseminated 
across the country.
  The Emergency Medical Services for Children program's authorization 
expired in September 2005. In the summer of 2006, the Institutes of 
Medicine released a report which documented the value of this program. 
It noted the gaps that still remain in providing quality emergency care 
for children. And there is still a serious gap between the percentage 
of kids who end up in the emergency room and the percentage of 
emergency rooms staffed, trained and equipped to respond appropriately. 
The report said this program is ``well positioned to assume a 
leadership role'' in closing this gap.
  I am pleased that H.R. 2464, the Wakefield Act, has bipartisan and 
bicameral support, including support from 75 of my colleagues in the 
House of Representatives. The bill is endorsed by over 50 
organizations, including the American Academy of Pediatrics, the 
American College of Emergency Physicians, the American Medical 
Association, the Emergency Nurses Association, and many more.
  Madam Speaker, this legislation enhances the program by authorizing 
the appropriate funding needed to ensure

[[Page H2029]]

the program can drive improvements in emergency and disaster care for 
children.
  Madam Speaker, I want to acknowledge the bipartisan nature in which 
this bill moved through our committee, working on both sides of the 
aisle within the Energy and Commerce Committee. We worked together to 
make this bill as good as it can be.
  Madam Speaker, nobody likes to see a child get hurt. Together, we can 
assure that when that happens, children have the best possible chance 
for recovery and a good outcome. I strongly urge the adoption of this 
legislation.
  Mr. DEAL of Georgia. Madam Speaker, I urge the adoption of this 
resolution.
  I yield back the balance of my time.
  Mrs. CAPPS. Madam Speaker, I am pleased to yield 3 minutes to the 
gentleman from North Dakota (Mr. Pomeroy).
  Mr. POMEROY. I thank the gentlelady for yielding, and I am also very 
pleased to speak in favor of H.R. 2464, the Wakefield Act.
  I wanted to bring you just a little bit of perspective in terms of 
the difference this act has made in one young man's life, and I think 
it's reflective of a number of children who have been saved by having 
medical appropriate services for traumatic and life-threatening 
injuries of kids.
  The Wakefield Act is called the Wakefield Act in recognition of a 
living memory of a family, the family of Tom Wakefield, who was 
involved in a horrible head-on traffic accident as they drove to the 
airport for a winter's vacation. A vehicle crossed the median and 
struck this vehicle head on, killing Tom and two of his children, one 
age three and one age seven. Twelve-year-old Lucas lost his arm in the 
accident and was almost lost as well.
  Emergency responders on the scene and thereafter saved his life and 
the life of his mother, Loy. I know this family, and I know their 
survivors, and I care deeply about them. They have certainly impressed 
upon me, as they would impress upon any of you, just how vitally 
important it is that we equip our emergency response to deal with any 
who may be hurt. And the 40 percent improvement in saving lives of 
children since the act was initially passed in 1984 shows just how 
critically important this reauthorization is. I'm very pleased that the 
Commerce Committee has done the work to bring it to the floor today, 
and I am grateful for the chance to speak on the bill.
  I was at an event just this weekend where Lucas, now fully 
recovering, adapted to his new circumstance. This is a young man that 
makes me very, very proud. And I believe the Wakefield Act, named in 
honor of his family, is a very appropriate commendation of the ongoing 
efforts to keep all our children safe.
  Mrs. CAPPS. Madam Speaker, I have no further requests for time. And 
following that eloquent testimony to the value of this legislation, we 
can all recognize that H.R. 2464 is an important measure that will work 
toward ensuring the best emergency medical care for all children.
  I again want to congratulate my colleague on the Energy and Commerce 
Committee, Jim Matheson, and all of those who have spoken today, 
including the ranking member of the subcommittee, for all the hard work 
and dedication to this important piece of legislation. I urge all of my 
colleagues to join in support of H.R. 2464.
  Mr. KING of New York. Madam Speaker, today I rise as a strong 
supporter of H.R. 2464, the Wakefield Act, which will reauthorize the 
Emergency Medical Services for Children program for an additional 4 
years.
  Since the program began in 1984, EMSC grants have helped all 50 
States to better prepare their health systems to treat children in an 
emergency. The EMSC program has improved the availability of child-
appropriate equipment in ambulances and emergency departments, 
supported hundreds of programs to prevent injuries, and provided 
thousands of hours of training to EMTs, paramedics, and other emergency 
medical care providers.
  In my home State of New York, EMSC funds are going toward the 
development of a statewide, standardized system that recognizes 
hospitals capable of managing pediatric emergencies, both trauma and 
medical. This will enhance the State's ability to transfer injured 
children to the hospital best suited to their treatment. New York is 
also utilizing EMSC funds to ensure that all ambulances have the 
essential pediatric equipment and supplies for prehospital pediatric 
emergency care.
  Across the country, EMSC is enabling State and local emergency care 
providers to better treat children. The projects funded under EMSC are 
vital for the safety and well-being of America's children and have 
saved countless lives throughout the program's existence. During a time 
when a terrorist attack or natural disaster may occur at any moment, it 
is essential that we ensure that we are adequately prepared to care for 
every infant, toddler, and child in an emergency situation.
  I would like to thank Representative Matheson for his hard work and 
continued leadership on this issue, and I urge you to support the 
Wakefield Act.
  Mrs. CAPPS. Madam Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from California (Mrs. Capps) that the House suspend the 
rules and pass the bill, H.R. 2464, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. MATHESON. Madam Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

                          ____________________