[Congressional Record (Bound Edition), Volume 153 (2007), Part 6]
[House]
[Pages 7997-8001]
[From the U.S. Government Publishing Office, www.gpo.gov]




        TRAUMA CARE SYSTEMS PLANNING AND DEVELOPMENT ACT OF 2007

  Mr. GENE GREEN of Texas. Mr. Speaker, I move to suspend the rules and 
pass the bill (H.R. 727) to amend the Public Health Service Act to add 
requirements regarding trauma care, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 727

       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 ``Trauma Care Systems Planning 
     and Development Act of 2007''.

     SEC. 2. ESTABLISHMENT.

       Section 1201 of the Public Health Service Act (42 U.S.C. 
     300d) is amended to read as follows:

     ``SEC. 1201. ESTABLISHMENT.

       ``(a) In General.--The Secretary shall, with respect to 
     trauma care--
       ``(1) conduct and support research, training, evaluations, 
     and demonstration projects;
       ``(2) foster the development of appropriate, modern systems 
     of such care through the sharing of information among 
     agencies and individuals involved in the study and provision 
     of such care;
       ``(3) collect, compile, and disseminate information on the 
     achievements of, and problems experienced by, State and local 
     agencies and private entities in providing trauma care and 
     emergency medical services and, in so doing, give special 
     consideration to the unique needs of rural areas;
       ``(4) provide to State and local agencies technical 
     assistance to enhance each State's capability to develop, 
     implement, and sustain the trauma care component of each 
     State's plan for the provision of emergency medical services;
       ``(5) sponsor workshops and conferences; and
       ``(6) promote the collection and categorization of trauma 
     data in a consistent and standardized manner.
       ``(b) Grants, Cooperative Agreements, and Contracts.--The 
     Secretary may make grants, and enter into cooperative 
     agreements and contracts, for the purpose of carrying out 
     subsection (a).''.

     SEC. 3. CLEARINGHOUSE ON TRAUMA CARE AND EMERGENCY MEDICAL 
                   SERVICES.

       The Public Health Service Act (42 U.S.C. 201 et seq.) is 
     amended--
       (1) by striking section 1202; and
       (2) by redesignating section 1203 as section 1202.

     SEC. 4. ESTABLISHMENT OF PROGRAMS FOR IMPROVING TRAUMA CARE 
                   IN RURAL AREAS.

       Section 1202 of the Public Health Service Act, as 
     redesignated by section 3(2), is amended to read as follows:

     ``SEC. 1202. ESTABLISHMENT OF PROGRAMS FOR IMPROVING TRAUMA 
                   CARE IN RURAL AREAS.

       ``(a) In General.--The Secretary may make grants to public 
     and nonprofit private entities for the purpose of carrying 
     out research and demonstration projects with respect to 
     improving the availability and quality of emergency medical 
     services in rural areas--
       ``(1) by developing innovative uses of communications 
     technologies and the use of new communications technology;
       ``(2) by developing model curricula, such as advanced 
     trauma life support, for training emergency medical services 
     personnel, including first responders, emergency medical 
     technicians, emergency nurses and physicians, and 
     paramedics--
       ``(A) in the assessment, stabilization, treatment, 
     preparation for transport, and resuscitation of seriously 
     injured patients, with special attention to problems that 
     arise during long transports and to methods of minimizing 
     delays in transport to the appropriate facility; and
       ``(B) in the management of the operation of the emergency 
     medical services system;
       ``(3) by making training for original certification, and 
     continuing education, in the provision and management of 
     emergency medical services more accessible to emergency 
     medical personnel in rural areas through telecommunications, 
     home studies, providing teachers and training at locations 
     accessible to such personnel, and other methods;
       ``(4) by developing innovative protocols and agreements to 
     increase access to prehospital care and equipment necessary 
     for the transportation of seriously injured patients to the 
     appropriate facilities;
       ``(5) by evaluating the effectiveness of protocols with 
     respect to emergency medical services and systems; and
       ``(6) by increasing communication and coordination with 
     State trauma systems.
       ``(b) Special Consideration for Certain Rural Areas.--In 
     making grants under subsection (a), the Secretary shall give 
     special consideration to any applicant for the grant that 
     will provide services under the grant in any rural area 
     identified by a State under section 1214(d)(1).
       ``(c) Requirement of Application.--The Secretary may not 
     make a grant under subsection

[[Page 7998]]

     (a) unless an application for the grant is submitted to the 
     Secretary and the application is in such form, is made in 
     such manner, and contains such agreements, assurances, and 
     information as the Secretary determines to be necessary to 
     carry out this section.''.

     SEC. 5. COMPETITIVE GRANTS.

       Part A of title XII of the Public Health Service Act, as 
     amended by section 3, is amended by adding at the end the 
     following:

     ``SEC. 1203. COMPETITIVE GRANTS FOR THE IMPROVEMENT OF TRAUMA 
                   CARE.

       ``(a) In General.--The Secretary, acting through the 
     Administrator of the Health Resources and Services 
     Administration, may make grants to States, political 
     subdivisions, or consortia of States or political 
     subdivisions for the purpose of improving access to and 
     enhancing the development of trauma care systems.
       ``(b) Use of Funds.--The Secretary may make a grant under 
     this section only if the applicant agrees to use the grant--
       ``(1) to integrate and broaden the reach of a trauma care 
     system, such as by developing innovative protocols to 
     increase access to prehospital care;
       ``(2) to strengthen, develop, and improve an existing 
     trauma care system;
       ``(3) to expand communications between the trauma care 
     system and emergency medical services through improved 
     equipment or a telemedicine system;
       ``(4) to improve data collection and retention; or
       ``(5) to increase education, training, and technical 
     assistance opportunities, such as training and continuing 
     education in the management of emergency medical services 
     accessible to emergency medical personnel in rural areas 
     through telehealth, home studies, and other methods.
       ``(c) Preference.--In selecting among States, political 
     subdivisions, and consortia of States or political 
     subdivisions for purposes of making grants under this 
     section, the Secretary shall give preference to applicants 
     that--
       ``(1) have developed a process, using national standards, 
     for designating trauma centers;
       ``(2) recognize protocols for the delivery of seriously 
     injured patients to trauma centers;
       ``(3) implement a process for evaluating the performance of 
     the trauma system; and
       ``(4) agree to participate in information systems described 
     in section 1202 by collecting, providing, and sharing 
     information.
       ``(d) Priority.--In making grants under this section, the 
     Secretary shall give priority to applicants that will use the 
     grants to focus on improving access to trauma care systems.
       ``(e) Special Consideration.--In awarding grants under this 
     section, the Secretary shall give special consideration to 
     projects that demonstrate strong State or local support, 
     including availability of non-Federal contributions.''.

     SEC. 6. REQUIREMENT OF MATCHING FUNDS FOR FISCAL YEARS 
                   SUBSEQUENT TO FIRST FISCAL YEAR OF PAYMENTS.

       Section 1212 of the Public Health Service Act (42 U.S.C. 
     300d-12) is amended to read as follows:

     ``SEC. 1212. REQUIREMENT OF MATCHING FUNDS FOR FISCAL YEARS 
                   SUBSEQUENT TO FIRST FISCAL YEAR OF PAYMENTS.

       ``(a) Non-Federal Contributions.--
       ``(1) In general.--The Secretary may not make payments 
     under section 1211(a) unless the State involved agrees, with 
     respect to the costs described in paragraph (2), to make 
     available non-Federal contributions (in cash or in kind under 
     subsection (b)(1)) toward such costs in an amount that--
       ``(A) for the second and third fiscal years of such 
     payments to the State, is not less than $1 for each $1 of 
     Federal funds provided in such payments for such fiscal 
     years; and
       ``(B) for the fourth and subsequent fiscal years of such 
     payments to the State, is not less than $2 for each $1 of 
     Federal funds provided in such payments for such fiscal 
     years.
       ``(2) Program costs.--The costs referred to in paragraph 
     (1) are--
       ``(A) the costs to be incurred by the State in carrying out 
     the purpose described in section 1211(b); or
       ``(B) the costs of improving the quality and availability 
     of emergency medical services in rural areas of the State.
       ``(3) Initial year of payments.--The Secretary may not 
     require a State to make non-Federal contributions as a 
     condition of receiving payments under section 1211(a) for the 
     first fiscal year of such payments to the State.
       ``(b) Determination of Amount of Non-Federal 
     Contribution.--With respect to compliance with subsection (a) 
     as a condition of receiving payments under section 1211(a)--
       ``(1) a State may make the non-Federal contributions 
     required in such subsection in cash or in kind, fairly 
     evaluated, including plant, equipment, or services; and
       ``(2) the Secretary may not, in making a determination of 
     the amount of non-Federal contributions, include amounts 
     provided by the Federal Government or services assisted or 
     subsidized to any significant extent by the Federal 
     Government.''.

     SEC. 7. REQUIREMENTS WITH RESPECT TO CARRYING OUT PURPOSE OF 
                   ALLOTMENTS.

       Section 1213 of the Public Health Service Act (42 U.S.C. 
     300d-13) is amended to read as follows:

     ``SEC. 1213. REQUIREMENTS WITH RESPECT TO CARRYING OUT 
                   PURPOSE OF ALLOTMENTS.

       ``(a) Trauma Care Modifications to State Plan for Emergency 
     Medical Services.--With respect to the trauma care component 
     of a State plan for the provision of emergency medical 
     services, the modifications referred to in section 1211(b) 
     are such modifications to the State plan as may be necessary 
     for the State involved to ensure that the plan provides for 
     access to the highest possible quality of trauma care, and 
     that the plan--
       ``(1) specifies that the modifications required pursuant to 
     paragraphs (2) through (11) will be implemented by the 
     principal State agency with respect to emergency medical 
     services or by the designee of such agency;
       ``(2) specifies a public or private entity that will 
     designate trauma care regions and trauma centers in the 
     State;
       ``(3) subject to subsection (b), contains national 
     standards and requirements of the American College of 
     Surgeons or another appropriate entity for the designation of 
     level I and level II trauma centers, and in the case of rural 
     areas level III trauma centers (including trauma centers with 
     specified capabilities and expertise in the care of pediatric 
     trauma patients), by such entity, including standards and 
     requirements for--
       ``(A) the number and types of trauma patients for whom such 
     centers must provide care in order to ensure that such 
     centers will have sufficient experience and expertise to be 
     able to provide quality care for victims of injury;
       ``(B) the resources and equipment needed by such centers; 
     and
       ``(C) the availability of rehabilitation services for 
     trauma patients;
       ``(4) contains standards and requirements for the 
     implementation of regional trauma care systems, including 
     standards and guidelines (consistent with the provisions of 
     section 1867 of the Social Security Act) for medically 
     directed triage and transportation of trauma patients 
     (including patients injured in rural areas) prior to care in 
     designated trauma centers;
       ``(5) subject to subsection (b), contains national 
     standards and requirements, including those of the American 
     Academy of Pediatrics and the American College of Emergency 
     Physicians, for medically directed triage and transport of 
     severely injured children to designated trauma centers with 
     specified capabilities and expertise in the care of pediatric 
     trauma patients;
       ``(6) utilizes a program with procedures for the evaluation 
     of designated trauma centers (including trauma centers 
     described in paragraph (5)) and trauma care systems;
       ``(7) provides for the establishment and collection of data 
     in accordance with data collection requirements developed in 
     consultation with surgical, medical, and nursing specialty 
     groups, State and local emergency medical services directors, 
     and other trained professionals in trauma care, from each 
     designated trauma center in the State of a central data 
     reporting and analysis system--
       ``(A) to identify the number of severely injured trauma 
     patients and the number of deaths from trauma within trauma 
     care systems in the State;
       ``(B) to identify the cause of the injury and any factors 
     contributing to the injury;
       ``(C) to identify the nature and severity of the injury;
       ``(D) to monitor trauma patient care (including prehospital 
     care) in each designated trauma center within regional trauma 
     care systems in the State (including relevant emergency-
     department discharges and rehabilitation information) for the 
     purpose of evaluating the diagnosis, treatment, and treatment 
     outcome of such trauma patients;
       ``(E) to identify the total amount of uncompensated trauma 
     care expenditures for each fiscal year by each designated 
     trauma center in the State; and
       ``(F) to identify patients transferred within a regional 
     trauma system, including reasons for such transfer and the 
     outcomes of such patients;
       ``(8) provides for the use of procedures by paramedics and 
     emergency medical technicians to assess the severity of the 
     injuries incurred by trauma patients;
       ``(9) provides for appropriate transportation and transfer 
     policies to ensure the delivery of patients to designated 
     trauma centers and other facilities within and outside of the 
     jurisdiction of such system, including policies to ensure 
     that only individuals appropriately identified as trauma 
     patients are transferred to designated trauma centers, and to 
     provide periodic reviews of the transfers and the auditing of 
     such transfers that are determined to be appropriate;
       ``(10) conducts public education activities concerning 
     injury prevention and obtaining access to trauma care;
       ``(11) coordinates planning for trauma systems with State 
     disaster emergency planning and bioterrorism hospital 
     preparedness planning; and
       ``(12) with respect to the requirements established in this 
     subsection, provides for coordination and cooperation between 
     the State and any other State with which the State shares any 
     standard metropolitan statistical area.
       ``(b) Certain Standards With Respect to Trauma Care Centers 
     and Systems.--
       ``(1) In general.--The Secretary may not make payments 
     under section 1211(a) for a fiscal year unless the State 
     involved agrees that, in carrying out paragraphs (3) through 
     (5) of subsection (a), the State will adopt standards for the 
     designation of trauma centers, and for triage, transfer, and 
     transportation policies, and that the State will, in adopting 
     such standards--
       ``(A) take into account national standards that outline 
     resources for optimal care of injured patients;

[[Page 7999]]

       ``(B) consult with medical, surgical, and nursing 
     speciality groups, hospital associations, emergency medical 
     services State and local directors, concerned advocates, and 
     other interested parties;
       ``(C) conduct hearings on the proposed standards after 
     providing adequate notice to the public concerning such 
     hearing; and
       ``(D) beginning in fiscal year 2008, take into account the 
     model plan described in subsection (c).
       ``(2) Quality of trauma care.--The highest quality of 
     trauma care shall be the primary goal of State standards 
     adopted under this subsection.
       ``(3) Approval by the secretary.--The Secretary may not 
     make payments under section 1211(a) to a State if the 
     Secretary determines that--
       ``(A) in the case of payments for fiscal year 2008 and 
     subsequent fiscal years, the State has not taken into account 
     national standards, including those of the American College 
     of Surgeons, the American College of Emergency Physicians, 
     and the American Academy of Pediatrics, in adopting standards 
     under this subsection; or
       ``(B) in the case of payments for fiscal year 2008 and 
     subsequent fiscal years, the State has not, in adopting such 
     standards, taken into account the model plan developed under 
     subsection (c).
       ``(c) Model Trauma Care Plan.--
       ``(1) In general.--Not later than 1 year after the date of 
     the enactment of the Trauma Care Systems Planning and 
     Development Act of 2007, the Secretary shall update the model 
     plan for the designation of trauma centers and for triage, 
     transfer, and transportation policies that may be adopted for 
     guidance by the State. Such plan shall--
       ``(A) take into account national standards, including those 
     of the American College of Surgeons, American College of 
     Emergency Physicians, and the American Academy of Pediatrics;
       ``(B) take into account existing State plans;
       ``(C) be developed in consultation with medical, surgical, 
     and nursing speciality groups, hospital associations, 
     emergency medical services State directors and associations, 
     and other interested parties; and
       ``(D) include standards for the designation of rural health 
     facilities and hospitals best able to receive, stabilize, and 
     transfer trauma patients to the nearest appropriate 
     designated trauma center, and for triage, transfer, and 
     transportation policies as they relate to rural areas.
       ``(2) Applicability.--Standards described in paragraph 
     (1)(D) shall be applicable to all rural areas in the State, 
     including both non-metropolitan areas and frontier areas that 
     have populations of less than 6,000 per square mile.
       ``(d) Rule of Construction With Respect to Number of 
     Designated Trauma Centers.--With respect to compliance with 
     subsection (a) as a condition of the receipt of a grant under 
     section 1211(a), such subsection may not be construed to 
     specify the number of trauma care centers designated pursuant 
     to such subsection.''.

     SEC. 8. REQUIREMENT OF SUBMISSION TO SECRETARY OF TRAUMA PLAN 
                   AND CERTAIN INFORMATION.

       Section 1214 of the Public Health Service Act (42 U.S.C. 
     300d-14) is amended to read as follows:

     ``SEC. 1214. REQUIREMENT OF SUBMISSION TO SECRETARY OF TRAUMA 
                   PLAN AND CERTAIN INFORMATION.

       ``(a) In General.--For each fiscal year, the Secretary may 
     not make payments to a State under section 1211(a) unless, 
     subject to subsection (b), the State submits to the Secretary 
     the trauma care component of the State plan for the provision 
     of emergency medical services, including any changes to the 
     trauma care component and any plans to address deficiencies 
     in the trauma care component.
       ``(b) Interim Plan or Description of Efforts.--For each 
     fiscal year, if a State has not completed the trauma care 
     component of the State plan described in subsection (a), the 
     State may provide, in lieu of such completed component, an 
     interim component or a description of efforts made toward the 
     completion of the component.
       ``(c) Information Received by State Reporting and Analysis 
     System.--The Secretary may not make payments to a State under 
     section 1211(a) unless the State agrees that the State will, 
     not less than once each year, provide to the Secretary the 
     information received by the State pursuant to section 
     1213(a)(7).
       ``(d) Availability of Emergency Medical Services in Rural 
     Areas.--The Secretary may not make payments to a State under 
     section 1211(a) unless--
       ``(1) the State identifies any rural area in the State for 
     which--
       ``(A) there is no system of access to emergency medical 
     services through the telephone number 911;
       ``(B) there is no basic life-support system; or
       ``(C) there is no advanced life-support system; and
       ``(2) the State submits to the Secretary a list of rural 
     areas identified pursuant to paragraph (1) or, if there are 
     no such areas, a statement that there are no such areas.''.

     SEC. 9. RESTRICTIONS ON USE OF PAYMENTS.

       Section 1215 of the Public Health Service Act (42 U.S.C. 
     300d-15) is amended to read as follows:

     ``SEC. 1215. RESTRICTIONS ON USE OF PAYMENTS.

       ``(a) In General.--The Secretary may not, except as 
     provided in subsection (b), make payments under section 
     1211(a) for a fiscal year unless the State involved agrees 
     that the payments will not be expended--
       ``(1) for any purpose other than developing, implementing, 
     and monitoring the modifications required by section 1211(b) 
     to be made to the State plan for the provision of emergency 
     medical services;
       ``(2) to make cash payments to intended recipients of 
     services provided pursuant to this section;
       ``(3) to purchase or improve real property (other than 
     minor remodeling of existing improvements to real property);
       ``(4) to satisfy any requirement for the expenditure of 
     non-Federal funds as a condition for the receipt of Federal 
     funds; or
       ``(5) to provide financial assistance to any entity other 
     than a public or nonprofit private entity.
       ``(b) Waiver.--The Secretary may waive a restriction under 
     subsection (a) only if the Secretary determines that the 
     activities outlined by the State plan submitted under section 
     1214(a) by the State involved cannot otherwise be carried 
     out.''.

     SEC. 10. REQUIREMENTS OF REPORTS BY STATES.

       The Public Health Service Act (42 U.S.C. 201 et seq.) is 
     amended by striking section 1216.

     SEC. 11. REPORT BY SECRETARY.

       Section 1222 of the Public Health Service Act (42 U.S.C. 
     300d-22) is amended to read as follows:

     ``SEC. 1222. REPORT BY SECRETARY.

       ``Not later than October 1, 2008, the Secretary shall 
     report to the appropriate committees of Congress on the 
     activities of the States carried out pursuant to section 
     1211. Such report shall include an assessment of the extent 
     to which Federal and State efforts to develop systems of 
     trauma care and to designate trauma centers have reduced the 
     incidence of mortality, and the incidence of permanent 
     disability, resulting from trauma. Such report may include 
     any recommendations of the Secretary for appropriate 
     administrative and legislative initiatives with respect to 
     trauma care.''.

     SEC. 12. FUNDING.

       Section 1232 of the Public Health Service Act (42 U.S.C. 
     300d-32) is amended to read as follows:

     ``SEC. 1232. FUNDING.

       ``(a) Authorization of Appropriations.--For the purpose of 
     carrying out parts A and B, subject to subsections (b) and 
     (c), there are authorized to be appropriated $12,000,000 for 
     fiscal year 2008, $10,000,000 for fiscal year 2009, and 
     $8,000,000 for each of the fiscal years 2010 through 2012.
       ``(b) Reservation of Funds.--If the amount appropriated 
     under subsection (a) for a fiscal year is equal to or less 
     than $1,000,000, such appropriation is available only for the 
     purpose of carrying out part A. If the amount so appropriated 
     is greater than $1,000,000, 50 percent of such appropriation 
     shall be made available for the purpose of carrying out part 
     A and 50 percent shall be made available for the purpose of 
     carrying out part B.
       ``(c) Allocation of Part A Funds.--Of the amounts 
     appropriated under subsection (a) for a fiscal year to carry 
     out part A--
       ``(1) 10 percent of such amounts for such year shall be 
     allocated for administrative purposes; and
       ``(2) 10 percent of such amounts for such year shall be 
     allocated for the purpose of carrying out section 1202.''.

     SEC. 13. RESIDENCY TRAINING PROGRAMS IN EMERGENCY MEDICINE.

       Section 1251 of the Public Health Service Act (42 U.S.C. 
     300d-51) is amended to read as follows:

     ``SEC. 1251. RESIDENCY TRAINING PROGRAMS IN EMERGENCY 
                   MEDICINE.

       ``(a) In General.--The Secretary may make grants to public 
     and nonprofit private entities for the purpose of planning 
     and developing approved residency training programs in 
     emergency medicine.
       ``(b) Identification and Referral of Domestic Violence.--
     The Secretary may make a grant under subsection (a) only if 
     the applicant involved agrees that the training programs 
     under subsection (a) will provide education and training in 
     identifying and referring cases of domestic violence.
       ``(c) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there is authorized to be 
     appropriated $400,000 for each of the fiscal years 2008 
     though 2012.''.

     SEC. 14. STATE GRANTS FOR CERTAIN PROJECTS.

       Section 1252 of the Public Health Service Act (42 U.S.C. 
     300d-52) is amended in the section heading by striking 
     ``demonstration''.

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


                             General Leave

  Mr. GENE GREEN of Texas. Mr. Speaker, I ask unanimous consent that 
all Members have 5 legislative days to revise and extend their remarks 
and include extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Texas?
  There was no objection.

[[Page 8000]]


  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  I rise today in support of H.R. 727, legislation to reauthorize the 
Trauma Systems Planning and Development Act. This program, under the 
Public Health Service Act, was first authorized in 1990 to improve and 
coordinate trauma care in our country.
  Since then, this program has provided $30 million to States to 
establish state-wide and regional trauma systems. Injury related to 
trauma is the leading cause of death for younger Americans, ages 1 
through 44. Trauma also causes more than 300,000 permanent disabilities 
each year.
  For seriously injured individuals, the first hour after an injury is 
when medical care is most effective in saving lives and function. This 
hour is also often referred to as the ``golden hour,'' during which 
trauma and emergency systems must respond both quickly and efficiently.
  This golden hour is also the goal that our military has for getting 
medical attention to our soldiers injured on the battlefield. The 
military has an impressive, streamlined trauma system that my 
colleagues Dr. Burgess; our ranking member at that time, Congressman 
Deal from Georgia; and our late colleague Dr. Norwood from Georgia and 
I marveled at during our trip last summer to Iraq, where we toured the 
military's trauma facilities in Balad.
  Unfortunately, the military's trauma system is not replicated in 
civilian health care, and too many Americans do not benefit from trauma 
systems that facilitate medical intervention during this critical time 
frame.
  While the death rate from trauma is 50 percent higher in rural areas 
than in urban locations, trauma affects each corner of this country. In 
fact, nearly 25 percent of all Americans sustain injuries each year 
that require medical attention. Yet without coordinated trauma systems 
and quick access to care, injuries are too often fatal.
  In Houston, we learned this lesson the hard way when the lack of 
trauma coordination forced a young man to wait more than 4 hours to 
receive care after he was hit by a car on Halloween night in 2001. With 
serious head, chest and leg injuries, this patient was clearly 
medically unstable and should have received immediate care at one of 
Houston's two level-one trauma centers. But with the trauma centers 
increasingly on diversion, this young man was transported to Austin 
where he died the next day.
  It was clear that we needed better trauma systems in the Houston 
area, and we quickly learned that the problem was felt throughout our 
Nation. We also learned that the effective trauma systems would help 
prevent nearly 25,000 deaths each year.
  As a response, we developed this legislation to build on the 
program's initial success since 1990, and we authorized it through 
2012.
  This bill includes changes to the program to ensure that scarce 
health care dollars go to the communities most in need, ensuring that 
Federal funds are utilized to strengthen trauma systems and improve 
communication and coordination among different trauma systems.
  It specifically ensures that grants go to States that coordinate 
planning for trauma systems with State disaster emergency planning and 
bioterrorism hospital preparedness planning.
  In addition, this legislation would require the Secretary to update 
the model plan for the designation of trauma centers and set triage, 
transfer, and transportation policies.
  The legislation also reauthorizes the Residency Training Program in 
Emergency Medicine in an effort to ensure an adequate level of ER 
physicians to treat patients in need of care from America's trauma 
centers.
  I would like to thank Mr. Burgess from Texas for his leadership on 
this legislation and for helping to craft the compromise before us 
today.
  I would also like to thank Chairman Dingell and our Health 
Subcommittee Chairman Pallone for their interest in this issue. We have 
been working on this bill for 5 years.
  Until now, this important issue failed to receive the attention it 
deserved, so I appreciate my chairman including this bill on our first 
markup in this Congress.
  I also appreciate the hard work that John Ford, William Garner and 
Pete Goodloe of the committee staff put in to guide this bill through 
the committee to ensure that we have a consensus product to approve 
today, and also my own staff who has worked on this for at least 3 
years.

                              {time}  2030

  I also appreciate the support of the American College of Surgeons, 
the American Osteopathic Association, the American Academy of 
Pediatrics, the American Association of Neurological Surgeons, the 
American Trauma Society, the Coalition for American Trauma Care and the 
Emergency Nurses Association.
  The members of these groups are on the front lines and know that 
coordinated trauma systems can literally save lives. We thank them for 
all they do for our communities.
  I urge my colleagues to vote for this important legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. BURGESS. Mr. Speaker, at this point, I yield such time as he may 
consume to the gentleman from Louisiana (Mr. Boustany), who has 
intimate, firsthand knowledge of this issue.
  Mr. BOUSTANY. I thank my colleague from Texas for yielding time to 
me.
  Mr. Speaker, prior to coming to Congress, I was a practicing 
cardiovascular and thoracic surgeon with extensive experience in open 
heart surgery, as well as trauma surgery. But I want to speak about the 
importance of this bill not as a physician but as a parent of a son who 
was in a severe car accident.
  About 6 years ago, I will never forget this, this was a Wednesday 
night, about 11:30 in the evening, and I received a phone call from the 
hospital from a friend of mine who is an emergency room physician who 
told me, was your son driving a black Alero? I said, what do you mean, 
``was''? He went on to say, ``Well, I think he's going to be okay.'' He 
started to read off the litany of injuries that my son had.
  So I immediately rushed over to the hospital, and I didn't think 
about it, but I happened to be on call for chest trauma that night, so 
I was worried that I might have to operate on my own son. I get to the 
hospital and found out that he was in the emergency room, sitting there 
for about 3 to 4 hours. He was in shock. There was no organization with 
regard to prioritization of his injuries.
  I immediately jumped in and started kind of prioritizing things, and 
we managed to get him stabilized. He went through some extensive 
surgery that night. He subsequently had to be transferred to another 
hospital 180 miles away for further treatment of his extensive 
orthopedic injuries.
  Because of lack of trauma coordination at that hospital, he developed 
severe malnutrition, lost about 50 pounds, had a lack of coordination 
with his antibiotics, developed infections, and spent nearly 6 or 7 
weeks in the hospital, followed by about 3 to 4 to 5 months of further 
care to get him back to where he could walk with crutches. Thankfully 
now, today, he is doing well.
  But if it wouldn't have been for my personal experience as a 
physician, overseeing the care of my son, he would not have gotten the 
appropriate care, and that is because we didn't have a coordinated 
trauma center.
  Trauma cannot be fragmented. It requires a coordinated effort by a 
team of experts.
  As was mentioned, the mortality rate from trauma is significantly 
higher in rural areas than it is in urban areas. There are nearly 20- 
to 25,000 trauma deaths each year that are preventable if we had the 
proper coordination.
  We have learned much from the military. Much of trauma surgery has 
evolved from military activity and stream of the wounded afterwards. 
There have been tremendous advances, but this does not translate to 
civilian area, where we do not have trauma centers.

[[Page 8001]]

  Clearly, this is a bill that is important, and I appreciate the 
committee for bringing this forward and the hard work that has been 
done.
  This bill will ensure that severely injured patients get coordinated 
care, get care by experts, by a team of experts, not just in the 
emergency room and the operating room but in the aftermath, where it's 
so critical to full recovery and full rehabilitation.
  This bill will award grants to the States for planning, implementing 
and developing trauma care systems. The Institute of Medicine has said 
the availability of Federal funds through the Trauma Care Systems and 
Planning Development Act appears to have helped increase the number of 
trauma centers and urged, in 1999, the reauthorization of the Trauma 
Care Act.
  This bill is absolutely necessary. It's critical, and it also will 
serve to build a trauma registry, which is so important, so that we can 
catalog these injuries and learn from these things so that we can 
actually improve trauma care further in the civilian arena.
  I urge my colleagues to support this bill. It's a superb bill. It's 
an excellent bill.
  Mr. GENE GREEN of Texas. Mr. Speaker, we reserve the balance of our 
time.
  Mr. BURGESS. Mr. Speaker, as we have just heard, this is an important 
bill. Trauma is one of the most expensive illnesses that we treat in 
this country. I am so pleased today to stand in support of H.R. 727, 
the Trauma Care Systems Planning and Development Act of 2007.
  In 1990, the Trauma Care Systems Planning and Development Act created 
title XII of the Public Health Service Act. This program was borne out 
of a report in which it was found that severely injured individuals in 
a majority of both urban and rural areas of the United States were not 
receiving the benefit of trauma systems, despite considerable evidence 
that a trauma system would improve survival rates.
  H.R. 727 requires the Health Resources and Services Administration to 
work with each State to help establish advanced trauma life support 
systems and to train EMS personnel for rural areas. Likewise, the 
program will help to make improvements in communication and 
coordination with the larger State trauma systems.
  For Americans between the ages of 1 and 44, trauma is the leading 
cause of death. Traumatic injury in the United States, largely due to 
motor-related trauma, totals $260 billion in costs. By reauthorizing 
this program, we will achieve the goal of ensuring that all areas of 
the United States have appropriate emergency medical services.
  As the legislation is structured, entities, either States or 
independent agencies, may compete for planning and development grants 
to help improve the trauma system and coordination in a given region. 
That is a distinct difference from the trauma bill that existed before.
  This bill is an improvement over the previous authorization because 
it will allow both States and other political subdivisions to work 
cooperatively to improve trauma systems. This bill also represents a 
more realistic authorization that will essentially act as start-up 
Federal funding for enhanced communication, enhanced coordination and 
data collection for States and other eligible grantees.
  Certainly, I need to join my colleague from Texas in thanking 
Congressman Barton and Congressman Dingell for their hard work on this 
legislation. Mr. Speaker, this has been a work in process for some 
time.
  My personal staff, Josh Martin, worked diligently on this bill last 
year. There were a number of issues with the other body which took some 
time to resolve, but happily they were resolved before the end of the 
year. We are now able to support H.R. 727 in this Congress, get the 
bill passed and get this coordination of service where it is so badly 
needed.
  Mr. Speaker, I yield back the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I urge passage of the bill, 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. Gene Green) that the House suspend the rules 
and pass the bill, H.R. 727, 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.

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