[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.
____________________