[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.
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