[House Report 113-458]
[From the U.S. Government Publishing Office]
113th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 113-458
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IMPROVING TRAUMA CARE ACT OF 2014
_______
May 20, 2014.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Upton, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 3548]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 3548) to amend title XII of the Public Health
Service Act to expand the definition of trauma to include
thermal, electrical, chemical, radioactive, and other extrinsic
agents, having considered the same, report favorably thereon
with an amendment and recommend that the bill as amended do
pass.
CONTENTS
Page
Amendment........................................................ 2
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 3
Committee Consideration.......................................... 3
Committee Votes.................................................. 3
Committee Oversight Findings..................................... 3
Statement of General Performance Goals and Objectives............ 3
New Budget Authority, Entitlement Authority, and Tax Expenditures 3
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 3
Committee Cost Estimate.......................................... 3
Congressional Budget Office Estimate............................. 4
Federal Mandates Statement....................................... 4
Duplication of Federal Programs.................................. 4
Disclosure of Directed Rule Makings.............................. 5
Advisory Committee Statement..................................... 5
Applicability to Legislative Branch.............................. 5
Section-by-Section Analysis of the Legislation................... 5
Changes in Existing Law Made by the Bill, as Reported............ 5
Amendment
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Improving Trauma Care Act of 2014''.
SEC. 2. TRAUMA DEFINITION.
(a) Revised Definition Under Trauma Systems Grants Programs.--
Paragraph (4) of section 1231 of the Public Health Service Act (42
U.S.C. 300d-31) is amended to read as follows:
``(4) Trauma.--The term `trauma' means an injury resulting
from exposure to--
``(A) a mechanical force; or
``(B) another extrinsic agent, including an extrinsic
agent that is thermal, electrical, chemical, or
radioactive.''.
(b) Revised Definition Under Interagency Program for Trauma
Research.--Paragraph (3) of section 1261(h) of the Public Health
Service Act (42 U.S.C. 300d-61(h)) is amended to read as follows:
``(3) The term `trauma' means an injury resulting from
exposure to--
``(A) a mechanical force; or
``(B) another extrinsic agent, including an extrinsic
agent that is thermal, electrical, chemical, or
radioactive.''.
Purpose and Summary
H.R. 3548, Improving Trauma Care Act, would amend the
Public Health Service Act to improve the definition of trauma
in Title 42, United States Code, section 300d-31(4) and section
300d-61(h)(3) by including injuries caused by thermal,
electrical, chemical, or radioactive force. These injuries
commonly are treated by burn centers. Clarifying the definition
of ``trauma'' to make it clear that ``trauma'' includes burn
injuries would allow burn centers to compete for trauma care
center grants under applicable Federal programs.
Background and Need for Legislation
Traumatic injuries are understood to include a variety of
circumstances including, crash, gunshot, and burn injuries. The
current system contains inconsistencies in the definition of
what constitutes ``trauma'' and fails to describe the full
range of ``traumatic'' injuries, which can result in gaps in
coverage and provision in care.
Although burn injuries should fall under the definition of
trauma, this is not currently the case. Title 42, United States
Code, section 300d-31(4), defines ``trauma'' as an ``injury
resulting from exposure to a mechanical force.'' A burn does
not fall into this definition. The issue is further complicated
by a second definition of ``trauma'' in 42 United States Code,
section 300d-61(h)(3), which states that the term ``trauma''
means ``any serious injury that could result in loss of life or
in significant disability and that would meet pre-hospital
triage criteria for transport to a designated trauma center.''
Some burns fall under this definition, but the more specific
definition in section 300d-31(4) makes it unclear whether they
all do.\1\
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\1\http://www.ameriburn.org/.
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The definition must be modernized to accurately reflect the
medical reality of trauma
Hearings
The Subcommittee on Health held no hearings on H.R. 3548.
Committee Consideration
On February 27, 2014, the Subcommittee on Health met in
open markup session and favorably forwarded H.R. 3548 to the
full Committee, as amended, by a voice vote.
On April 3, 2014, the Committee on Energy and Commerce met
in open markup session and approved H.R. 3548, as amended, by a
voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken in connection with ordering
H.R. 3548 reported. A motion by Mr. Upton to order H.R. 3548
reported to the House, was agreed to by a voice vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee has not held oversight
hearing on this legislation.
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII of the Rules of the
House of Representatives, the goal of this legislation is to
amend the Public Health Service Act to improve the definition
of trauma in Title 42, United States Code, section 300d-31(4)
and section 300d-61(h)(3) by including injuries caused by
thermal, electrical, chemical, or radioactive force.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
3548 would result in no new or increased budget authority,
entitlement authority, or tax expenditures or revenues.
Earmark, Limited Tax Benefits, and Limited Tariff Benefits
In compliance with clause 9(e), 9(f), and 9(g) of rule XXI
of the Rules of the House of Representatives, the Committee
finds that H.R. 3548 contains no earmarks, limited tax
benefits, or limited tariff benefits.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, April 15, 2014.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 3548, the
Improving Trauma Care Act of 2013.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
Sincerely,
Peter H. Fontaine
(For Douglas W. Elmendorf, Director).
Enclosure.
H.R. 3548--Improving Trauma Care Act of 2013
H.R. 3548 would amend the Public Health Service Act to
revise the definition of trauma as it applies to grants and
activities authorized to provide support for trauma and
emergency care. Under current law, the definition of trauma
means an injury resulting from exposure to a mechanical force.
The bill would expand the definition of trauma to also include
an injury resulting from exposure to an extrinsic agent that is
thermal, electrical, chemical, or radioactive.
CBO estimates that implementing the legislation would have
no significant effect on the federal budget. Enacting H.R. 3548
would not affect direct spending or revenues; therefore, pay-
as-you-go procedures do not apply.
The bill would not impose intergovernmental or private-
sector mandates as defined in the Unfunded Mandates Reform Act
and would impose no costs on state, local, or tribal
governments.
The CBO staff contact for this estimate is Lisa Ramirez-
Branum. The estimate was approved by Holly Harvey, Deputy
Assistant Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Duplication of Federal Programs
No provision of H.R. 3548 establishes or reauthorizes a
program of the Federal Government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Disclosure of Directed Rule Makings
The Committee estimates that enacting H.R. 3548 would not
specifically direct to be completed a rulemaking within the
meaning of 5 U.S.C. 551.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 of the legislation cites the bill as the
``Improving Trauma Care Act of 2013.''
Section 2. Trauma definition
Section 2 would revise the definition under the Trauma
Systems Grant Programs and under Interagency Program for Trauma
Research to define trauma as ``an injury resulting from
exposure to a mechanical force; or another extrinsic agent,
including an extrinsic agent that is thermal, electrical,
chemical, or radioactive.''
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
FEDERAL HOME LOAN BANK ACT
* * * * * * *
eligibility of members and nonmember borrowers
Sec. 4. (a) Criteria for Eligibility.--
(1) * * *
* * * * * * *
(5) Certain privately insured credit unions.--
(A) In general.--Subject to the requirements
of subparagraph (B), a credit union shall be
treated as an insured depository institution
for purposes of determining the eligibility of
such credit union for membership in a Federal
home loan bank under paragraphs (1), (2), and
(3).
(B) Certification by appropriate
supervisor.--
(i) In general.--For purposes of this
paragraph and subject to clause (ii), a
credit union which lacks Federal
deposit insurance and which has applied
for membership in a Federal home loan
bank may be treated as meeting all the
eligibility requirements for Federal
deposit insurance only if the
appropriate supervisor of the State in
which the credit union is chartered has
determined that the credit union meets
all the eligibility requirements for
Federal deposit insurance as of the
date of the application for membership.
(ii) Certification deemed valid.--If,
in the case of any credit union to
which clause (i) applies, the
appropriate supervisor of the State in
which such credit union is chartered
fails to make a determination pursuant
to such clause by the end of the 6-
month period beginning on the date of
the application, the credit union shall
be deemed to have met the requirements
of clause (i).
(C) Security interests of federal home loan
bank not avoidable.--Notwithstanding any
provision of State law authorizing a
conservator or liquidating agent of a credit
union to repudiate contracts, no such provision
shall apply with respect to--
(i) any extension of credit from any
Federal home loan bank to any credit
union which is a member of any such
bank pursuant to this paragraph; or
(ii) any security interest in the
assets of such credit union securing
any such extension of credit.
(D) Conditions on advances.--Before making an
advance pursuant to section 10 to a credit
union which lacks Federal deposit insurance, a
Bank shall--
(i) determine the concentration risk
exposure of the Bank to such a credit
union, including all advances of the
Bank to other such credit unions;
(ii) ensure that the advance will not
result in a significant risk of
insolvency to the Bank; and
(iii) ensure that the Bank--
(I) has sufficient reserves
to withstand any potential
losses of making such advance;
(II) has priority over the
claims and rights of the State
in which the credit union is
chartered or a conservator or a
liquidating agent of the credit
union; and
(III) has secure access to
the collateral obtained from
such credit union in the event
of material financial distress
or failure of such credit
union.
* * * * * * *
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FEDERAL DEPOSIT INSURANCE ACT
* * * * * * *
SEC. 43. DEPOSITORY INSTITUTIONS LACKING FEDERAL DEPOSIT INSURANCE.
(a) Annual Independent Audit of Private Deposit Insurers.--
(1) * * *
(2) Providing copies of audit report.--
(A) Private deposit insurer.--The private
deposit insurer shall provide a copy of the
audit report--
(i) to each depository institution
the deposits of which are insured by
the private deposit insurer, not later
than 14 days after the audit is
completed; [and]
(ii) to the appropriate supervisory
agency of each State in which such an
institution receives deposits, not
later than 7 days after the audit is
completed[.];
(iii) in the case of depository
institutions described in subsection
(e)(2)(A) the deposits of which are
insured by the private insurer which
are members of a Federal home loan
bank, to the Federal Housing Finance
Agency, not later than 7 days after the
audit is completed.
* * * * * * *