[Congressional Record Volume 155, Number 27 (Tuesday, February 10, 2009)]
[Senate]
[Page S2084]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. INOUYE (for himself, Mr. Hatch, Mr. Kennedy, Mr. Conrad, 
        Mr. Dorgan, and Mr. Akaka):
  S. 408. 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 
Hatch, Kennedy, Conrad, Dorgan, and Akaka, I introduce The Wakefield 
Act, also known as the Emergency Medical Services for Children Act of 
2009. 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 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 limited 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. Reauthorization 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 reauthorization of this important legislation and 
the continued advances in our emergency healthcare delivery system.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
placed in the Record, as follows:

                                 S. 408

       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 the 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 is celebrating its 25th anniversary, 
     marking a quarter-century of 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''; and
       (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 2010, $26,250,000 for fiscal year 
     2011, $27,562,500 for fiscal year 2012, $28,940,625 for 
     fiscal year 2013, and $30,387,656 for fiscal year 2014''.

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