[Congressional Record Volume 164, Number 34 (Monday, February 26, 2018)]
[House]
[Pages H1236-H1238]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




MILITARY INJURY SURGICAL SYSTEMS INTEGRATED OPERATIONALLY NATIONWIDE TO 
                  ACHIEVE ZERO PREVENTABLE DEATHS ACT

  Mr. BURGESS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 880) to amend the Public Health Service Act to facilitate 
assignment of military trauma care providers to civilian trauma centers 
in order to maintain military trauma readiness and to support such 
centers, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 880

       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 ``Military Injury Surgical 
     Systems Integrated Operationally Nationwide to Achieve ZERO 
     Preventable Deaths Act'' or the ``MISSION ZERO Act''.

     SEC. 2. MILITARY AND CIVILIAN PARTNERSHIP FOR TRAUMA 
                   READINESS GRANT PROGRAM.

       Title XII of the Public Health Service Act (42 U.S.C. 300d 
     et seq.) is amended by adding at the end the following new 
     part:

``PART I--MILITARY AND CIVILIAN PARTNERSHIP FOR TRAUMA READINESS GRANT 
                                PROGRAM

     ``SEC. 1291. MILITARY AND CIVILIAN PARTNERSHIP FOR TRAUMA 
                   READINESS GRANT PROGRAM.

       ``(a) Military Trauma Team Placement Program.--
       ``(1) In general.--The Secretary shall award grants to not 
     more than 20 eligible high-acuity trauma centers to enable 
     military trauma teams to provide, on a full-time basis, 
     trauma care and related acute care at such trauma centers.
       ``(2) Limitations.--In the case of a grant awarded under 
     paragraph (1) to an eligible high-acuity trauma center, such 
     grant--
       ``(A) shall be for a period of at least 3 years and not 
     more than 5 years (and may be renewed at the end of such 
     period); and
       ``(B) shall be in an amount that does not exceed $1,000,000 
     per year.
       ``(3) Availability of funds after performance period.--
     Notwithstanding section 1552 of title 31, United States Code, 
     or any other provision of law, funds available to the 
     Secretary for obligation for a grant under this subsection 
     shall remain available for expenditure for 100 days after the 
     last day of the performance period of such grant.
       ``(b) Military Trauma Care Provider Placement Program.--
       ``(1) In general.--The Secretary shall award grants to 
     eligible trauma centers to enable military trauma care 
     providers to provide trauma care and related acute care at 
     such trauma centers.
       ``(2) Limitations.--In the case of a grant awarded under 
     paragraph (1) to an eligible trauma center, such grant--
       ``(A) shall be for a period of at least 1 year and not more 
     than 3 years (and may be renewed at the end of such period); 
     and
       ``(B) shall be in an amount that does not exceed, in a 
     year--
       ``(i) $100,000 for each military trauma care provider that 
     is a physician at such eligible trauma center; and
       ``(ii) $50,000 for each other military trauma care provider 
     at such eligible trauma center.
       ``(c) Grant Requirements.--
       ``(1) Deployment.--As a condition of receipt of a grant 
     under this section, a grant recipient shall agree to allow 
     military trauma care providers providing care pursuant to 
     such grant to be deployed by the Secretary of Defense for 
     military operations, for training, or for response to a mass 
     casualty incident.
       ``(2) Use of funds.--Grants awarded under this section to 
     an eligible trauma center may be used to train and 
     incorporate military trauma care providers into such trauma

[[Page H1237]]

     center, including expenditures for malpractice insurance, 
     office space, information technology, specialty education and 
     supervision, trauma programs, research, and State license 
     fees for such military trauma care providers.
       ``(d) Rule of Construction.--Nothing in this section shall 
     be construed to affect the extent to which State licensing 
     requirements for health care professionals are preempted by 
     other Federal law from applying to military trauma care 
     providers.
       ``(e) Reporting Requirements.--
       ``(1) Report to the secretary and the secretary of 
     defense.--Each eligible trauma center or eligible high-acuity 
     trauma center awarded a grant under subsection (a) or (b) for 
     a year shall submit to the Secretary and the Secretary of 
     Defense a report for such year that includes information on--
       ``(A) the number and types of trauma cases managed by 
     military trauma teams or military trauma care providers 
     pursuant to such grant during such year;
       ``(B) the financial impact of such grant on the trauma 
     center;
       ``(C) the educational impact on resident trainees in 
     centers where military trauma teams are assigned;
       ``(D) any research conducted during such year supported by 
     such grant; and
       ``(E) any other information required by the Secretaries for 
     the purpose of evaluating the effect of such grant.
       ``(2) Report to congress.--Not less than once every 2 
     years, the Secretary, in consultation with the Secretary of 
     Defense, shall submit a report to Congress that includes 
     information on the effect of placing military trauma care 
     providers in trauma centers awarded grants under this section 
     on--
       ``(A) maintaining readiness of military trauma care 
     providers for battlefield injuries;
       ``(B) providing health care to civilian trauma patients in 
     both urban and rural settings;
       ``(C) the capability to respond to surges in trauma cases, 
     including as a result of a large scale event; and
       ``(D) the financial State of the trauma centers.
       ``(f) Definitions.--For purposes of this part:
       ``(1) Eligible trauma center.--The term `eligible trauma 
     center' means a Level I, II, or III trauma center that 
     satisfies each of the following:
       ``(A) Such trauma center has an agreement with the 
     Secretary of Defense to enable military trauma care providers 
     to provide trauma care and related acute care at such trauma 
     center.
       ``(B) Such trauma center utilizes a risk-adjusted 
     benchmarking system to measure performance and outcomes, such 
     as the Trauma Quality Improvement Program of the American 
     College of Surgeons.
       ``(C) Such trauma center demonstrates a need for integrated 
     military trauma care providers to maintain or improve the 
     trauma clinical capability of such trauma center.
       ``(2) Eligible high-acuity trauma center.--The term 
     `eligible high-acuity trauma center' means a Level I trauma 
     center that satisfies each of the following:
       ``(A) Such trauma center has an agreement with the 
     Secretary of Defense to enable military trauma teams to 
     provide trauma care and related acute care at such trauma 
     center.
       ``(B) At least 20 percent of patients of such trauma center 
     in the most recent 3-month period for which data is available 
     are treated for a major trauma at such trauma center.
       ``(C) Such trauma center utilizes a risk-adjusted 
     benchmarking system to measure performance and outcomes, such 
     as the Trauma Quality Improvement Program of the American 
     College of Surgeons.
       ``(D) Such trauma center is an academic training center--
       ``(i) affiliated with a medical school;
       ``(ii) that maintains residency programs and fellowships in 
     critical trauma specialties and subspecialties, and provides 
     education and supervision of military trauma team members 
     according to those specialties and subspecialties; and
       ``(iii) that undertakes research in the prevention and 
     treatment of traumatic injury.
       ``(E) Such trauma center serves as a disaster response 
     leader for its community, such as by participating in a 
     partnership for State and regional hospital preparedness 
     established under section 319C-2.
       ``(3) Major trauma.--The term `major trauma' means an 
     injury that is greater than or equal to 15 on the injury 
     severity score.
       ``(4) Military trauma team.--The term `military trauma 
     team' means a complete military trauma team consisting of 
     military trauma care providers.
       ``(5) Military trauma care provider.--The term `military 
     trauma care provider' means a member of the Armed Forces who 
     furnishes emergency, critical care, and other trauma acute 
     care, including a physician, military surgeon, physician 
     assistant, nurse, respiratory therapist, flight paramedic, 
     combat medic, or enlisted medical technician.
       ``(g) Authorization of Appropriations.--There are 
     authorized to be appropriated to carry out this section--
       ``(1) $7,000,000 for fiscal year 2018, of which--
       ``(A) $4,500,000 shall be for carrying out subsection (a); 
     and
       ``(B) $2,500,000 shall be for carrying out subsection (b);
       ``(2) $12,000,000 for fiscal year 2019, of which--
       ``(A) $8,000,000 shall be for carrying out subsection (a); 
     and
       ``(B) $4,000,000 shall be for carrying out subsection (b); 
     and
       ``(3) $15,000,000 for each of fiscal years 2020 through 
     2022, of which--
       ``(A) $10,000,000 shall be for carrying out subsection (a); 
     and
       ``(B) $5,000,000 shall be for carrying out subsection 
     (b).''.

     SEC. 3. CUT-GO COMPLIANCE.

       Subsection (f) of section 319D of the Public Health Service 
     Act (42 U.S.C. 247d-4) is amended by striking ``through 
     2018'' and inserting ``through 2017, and $75,300,000 for 
     fiscal year 2018''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Texas (Mr. Burgess) and the gentleman from Texas (Mr. Gene Green) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Texas (Mr. Burgess).


                             General Leave

  Mr. BURGESS. Mr. Speaker, I ask unanimous consent that all Members 
may have 5 legislative days to revise and extend their remarks and 
insert extraneous material into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.
  Mr. BURGESS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, 40 years ago I was an intern and resident at Parkland 
Hospital in Dallas. Any intern or resident will tell you the month of 
July is significant in the life of an intern or resident. You were last 
week's medical student, and you are this week's intern managing the 
emergency room; or you were last year's intern, and you are this week's 
house officer managing perhaps a busy practice, perhaps a busy 
emergency room. As such, every intern and resident remembers the end of 
that first week of their internship or residency. It is just something 
that you do. You got through the first week of what was a very trying 
time. So I remember well July 7 of my internship, July 7 of my 
residency.
  Mr. Speaker, in 2016, July 7 also took on additional significance in 
Dallas, Texas. Five police officers were killed and 9 more were injured 
during a shooting in downtown Dallas. In the immediate aftermath of the 
attack, area hospitals sprang into action and activated their disaster 
plans. I am proud to say that the staff at Parkland Hospital, the staff 
at Baylor University Hospital, and other medical professionals provided 
excellent emergency care to the victims of the attack.
  Mr. Speaker, it is critical that we have people who are able to 
respond when called. Now, additionally, I have long believed that the 
American military is the arsenal of democracy and that it is critical 
for upholding freedom in the world. Each member of the United States 
Armed Forces has an important role in a collective team effort. This is 
especially true in a combat zone, where trauma surgeons are some of the 
most crucial members of the Armed Forces. These medical professionals 
are trained to save the lives of soldiers who sustain traumatic 
injuries on the battlefield, and they are some of the best in the 
business.
  However, as wars wind down and our soldiers come home, the experience 
that military trauma surgeons have gained overseas may be diminished or 
lost unless these surgeons continue to train and to prepare for their 
next possible deployment. To let this expertise and skill drift away 
would be a significant loss to trauma patients, both at home and 
abroad. Trauma, Mr. Speaker, is not limited to the battlefields and 
active conflicts. Unfortunately, no community is immune from the threat 
of traumatic injury, and community doctors must be prepared to give 
lifesaving care to trauma victims.
  However, there is a way that we can ensure trained combat surgeons' 
skills are utilized to help American patients here in the homeland who 
need it. The MISSION ZERO Act seeks to connect American patients with 
battle-tested trauma care through the craft of military trauma care 
providers. The bill provides grants to allow military trauma care 
providers and teams to offer care in our Nation's leading trauma 
centers and systems.
  Here is the bottom line: the MISSION ZERO Act is a win for both 
civilian patients and military trauma doctors.
  Mr. Speaker, I am grateful that this bipartisan legislation has 
finally come

[[Page H1238]]

to the floor. Along with my fellow Texan, Mr. Gene Green, I introduced 
this bill in 2016 following that particularly traumatic incident that 
struck so close to home.
  Texas is not unique in its need for this expertise. Over the last few 
months alone, our Nation has witnessed a need for trauma care hospitals 
across the country. One such incident was the Amtrak derailment near 
Dupont, Washington, on December 18, 2017. That incident resulted in 3 
passenger fatalities and 70 injuries over a busy freeway.
  As we have seen, having access to experienced trauma care can become 
the difference between life and death for a critically injured patient. 
There is no doubt that integrating military physicians into the trauma 
and disaster system is beneficial not only for American patients, but 
also for American soldiers.
  I am encouraged by the bipartisan effort to support both our 
servicemen and our Nation's trauma system, and I thank the cosponsors 
from both sides of the aisle for their support of this important 
legislation.
  Quite simply, the MISSION ZERO Act is common sense, and I urge 
Members to join me in supporting this lifesaving legislation.
  Mr. Speaker, I reserve the balance of my time.

                              {time}  1715

  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise in strong support of H.R. 880, the Military 
Injury Surgical Systems Integrated Operationally Nationwide to Achieve 
ZERO Preventable Deaths Act, or MISSION ZERO Act.
  I am proud to have worked closely with Energy and Commerce 
Subcommittee on Health Chairman Burgess and my colleagues from Florida 
and North Carolina, Representative Castor and Representative Hudson, on 
this legislation.
  The MISSION ZERO Act will help us move towards a trauma system that 
achieves the goal of zero preventable traumatic deaths.
  Whether in response to a gruesome sports injury, a car accident on 
the highway, or, unfortunately, a tragic event like the recent school 
shooting in Parkland, Florida, Americans of all ages and backgrounds 
depend on our trauma care system to respond with skilled experts to 
provide the services necessary to save lives and prevent disability.
  The MISSION ZERO Act will help us ensure access to quality trauma 
care based on the best available evidence by establishing a grant 
program to assist civilian trauma centers to partner with military 
trauma professionals. This partnership will benefit our civilian trauma 
centers by increasing the availability of trauma professionals to serve 
in trauma centers across the United States.
  This partnership will benefit our military trauma system by allowing 
trauma professionals to maintain their trauma care capabilities during 
times of peace and help ensure they are prepared to meet the needs of 
our heroes on the battlefield.
  I urge my colleagues to support this legislation and help ensure that 
Americans in need of trauma services, whether civilian or in the Armed 
Forces, receive the highest quality of care possible.
  Mr. Speaker, I yield such time as she may consume to the gentlewoman 
from Florida (Ms. Castor), the cosponsor of the bill, and I thank the 
cosponsors of this bill for serving on the Energy and Commerce 
Committee.
  Ms. CASTOR of Florida. Mr. Speaker, I rise in strong support of the 
MISSION ZERO Act, H.R. 880, and I would like to thank Chairman Burgess, 
Ranking Member Gene Green from Texas, and Mr. Hudson from North 
Carolina for sponsoring this legislation with me.
  The MISSION ZERO Act will assist the Department of Defense in 
assigning trauma surgeons to our civilian trauma centers. It will help 
fill the gap that we currently have in care recently examined by the 
National Academies of Sciences, Engineering, and Medicine.
  The MISSION ZERO Act will establish grant initiatives for eligible 
trauma systems to incorporate full military trauma teams or individual 
military trauma providers into our hospitals--the ones that have busy 
emergency rooms.
  This mutually beneficial partnership will allow civilian doctors and 
nurses and care providers the chance to learn more about military best 
practices and will give our military trauma care providers the 
opportunity to utilize their cutting-edge expertise without leaving the 
military.

  I have seen this initiative in action already back home in Tampa at 
Tampa General Hospital, located just a few miles down the road from 
MacDill Air Force Base, which is home to U.S. Central Command, U.S. 
Special Operations Command, and the 6th Air Mobility Wing, which is 
also home to the 6th Air Medical Group.
  Since about 2011, they have had an ongoing partnership to do just 
what this bill provides: create a lot of energy and shared expertise in 
the civilian trauma center at Tampa General Hospital and bring in the 
military specialists so they can continue to hone their caregiving and 
craft. They use nurses, surgeons, and all sorts of specialists.
  The initiative allows military and civilian medical teams to work in 
the most intense trauma environments--that is, our level one trauma 
center--and take very good care of folks all across central Florida. 
These partnerships are vital for continued training for our community 
and our military.
  I think Dr. Burgess and Mr. Gene Green from Texas are doing a great 
service by replicating this in other trauma centers across the United 
States.
  The MISSION ZERO Act is endorsed by the American Congress of 
Neurological Surgeons, American College of Emergency Physicians, 
American College of Surgeons, and the Trauma Care Association of 
America.
  Again, I thank Dr. Burgess, Ranking Member Gene Green from Texas, Mr. 
Hudson, and all my Energy and Commerce colleagues, and I urge everyone 
here in the House to support this important bill.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield back the balance of my 
time.
  Mr. BURGESS. Mr. Speaker, this is an important bill. I urge my 
colleagues to support it, 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. Burgess) that the House suspend the rules and 
pass the bill, H.R. 880, 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.

                          ____________________