[House Report 115-330]
[From the U.S. Government Publishing Office]


115th Congress    }                                    {        Report
                        HOUSE OF REPRESENTATIVES
 1st Session      }                                    {       115-330

======================================================================



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

                                _______
                                

 September 25, 2017.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Walden, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 880]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
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, 
having considered the same, report favorably thereon with an 
amendment and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     4
Committee Action.................................................     4
Committee Votes..................................................     4
Oversight Findings and Recommendations...........................     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     6
Statement of General Performance Goals and Objectives............     6
Duplication of Federal Programs..................................     6
Committee Cost Estimate..........................................     6
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     6
Disclosure of Directed Rule Makings..............................     6
Advisory Committee Statement.....................................     7
Applicability to Legislative Branch..............................     7
Section-by-Section Analysis of the Legislation...................     7
Changes in Existing Law Made by the Bill, as Reported............     7

    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 ``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 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.--For each of fiscal years 2018 
through 2022, there are authorized to be appropriated--
          ``(1) $10,000,000 for carrying out subsection (a); and
          ``(2) $5,000,000 for carrying out subsection (b).''.

                          Purpose and Summary

    H.R. 880 was introduced on February 6, 2017, by Rep. 
Michael C. Burgess (R-TX). The bill establishes a grant program 
for military-civilian partnerships in trauma care, which will 
allow both sectors to benefit from the others' expertise and 
experience.

                  Background and Need for Legislation

    Traumatic injury imposes an incredible burden on the 
nation's health system. The military has made significant 
strides in improving trauma care based on wartime lessons 
learned. Unfortunately, these lessons are often not translated 
to civilian trauma care or are not sustained during peacetime.
    Increasing military civilian partnerships is a critical 
step toward achieving the goal of zero preventable injury 
deaths, as highlighted in the 2016 National Academies of 
Sciences, Engineering and Medicine (NASEM) report, ``A National 
Trauma Care System: Integrating Military and Civilian Trauma 
Systems to Achieve Zero Preventable Deaths After Injury.'' By 
utilizing civilian trauma centers as opportunities for military 
trauma providers to practice skills prior to deployment and/or 
to maintain skills after returning home from service, both 
military readiness is achieved and access to civilian trauma 
care is improved by assigning more trauma providers to domestic 
hospitals.

                            Committee Action

    During the 114th Congress, on July 12, 2016, the 
Subcommittee on Health held a hearing on a discussion draft 
entitled ``Military, Civilian, and Mass Casualty Trauma 
Readiness Partnership Act,'' which was substantially similar to 
H.R. 880. The hearing was entitled ``Strengthening our National 
Trauma System.'' The Subcommittee received testimony from:
           Jorie Klein, BSN, RN; Director, Trauma 
        Program, Rees-Jones Trauma Center at Parkland;
           David Marcozzi, MD; University of Maryland 
        Department of Emergency Medicine;
           C. William Schwab, MD, FACS; Professor of 
        Surgery, Penn Presbyterian Medical Center;
           Craig Manifold, DO, FACEP; Committee Chair, 
        American College of Emergency Physicians; and,
           J. Brent Myers, MD, MPH, FACEP; President-
        Elect, National Association of EMS Physicians.
    On June 29, 2017, the Subcommittee on Health met in open 
markup session and forwarded H.R. 880, as amended, to the full 
Committee by a voice vote. On July 27, 2017, the full Committee 
on Energy and Commerce met in open markup session and ordered 
H.R. 880, as amended, favorably reported to the House by a 
voice vote.

                            Committee Votes

    Clause 3(b) of rule XIII 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. 880 reported.

                 Oversight Findings and Recommendations

    Pursuant to clause 2(b)(1) of rule X and clause 3(c)(1) of 
rule XIII, the Committee has not held hearings on this 
legislation.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to clause 3(c)(2) of rule XIII, the Committee 
finds that H.R. 880 would result in no new or increased budget 
authority, entitlement authority, or tax expenditures or 
revenues.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII, the following is 
the cost estimate provided by the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.

H.R. 880--MISSION ZERO Act

    Summary: H.R. 880 would establish a grant program for 
qualified military personnel to provide trauma care in civilian 
trauma centers. The bill would provide a total of $15 million 
annually for grants to eligible trauma centers through fiscal 
year 2022.
    CBO estimates that implementing H.R. 880 would cost $63 
million over the 2018-2022 period, assuming appropriation of 
the specified amounts.
    Pay-as-you-go procedures do not apply to this legislation 
because it would not affect direct spending or revenues. CBO 
estimates that enacting H.R. 880 would not increase net direct 
spending or on-budget deficits in any of the four consecutive 
10-year periods beginning in 2028.
    H.R. 880 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments.
    Estimated cost to the Federal Government: The estimated 
budgetary effect of H.R. 880 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                                By fiscal year, in millions of dollars--
                                                      ----------------------------------------------------------
                                                        2017    2018    2019    2020    2021    2022   2017-2022
----------------------------------------------------------------------------------------------------------------
                                 INCREASES IN SPENDING SUBJECT TO APPROPRIATION
 
Authorization Level..................................       0      15      15      15      15      15        75
Estimated Outlays....................................       0       7      12      15      15      15        63
----------------------------------------------------------------------------------------------------------------
Note: Components may not add to totals because of rounding.

    Basis of estimate: H.R. 880 would authorize the Secretary 
of Health and Human Services to award grants to trauma centers 
for the purpose of training and incorporating military trauma 
providers into civilian trauma centers. The bill would 
authorize a total of $15 million per year for fiscal years 
2018-2022 for such grants. Assuming appropriation of the 
authorized amounts, the Military Trauma Team Placement Program 
would award $10 million annually, through up to 20 grants, to 
Level I trauma centers that meet certain eligibility criteria. 
The Military Trauma Care Provider Placement Program would award 
$5 million in grants annually to eligible Level I, II, or III 
trauma centers.
    Based on historical spending patterns for similar 
activities, CBO estimates that implementing H.R. 880 would cost 
$63 million over the 2018-2022 period; the remaining amounts 
would be spent in years after 2022. For this estimate, CBO 
assumes that the legislation will be enacted near the beginning 
of fiscal year 2018 and that the specified amounts will be 
appropriated.
    Pay-As-You-Go Considerations: None.
    Increase in long-term direct spending and deficits: CBO 
estimates that enacting H.R. 880 would not increase net direct 
spending or on-budget deficits in any of the four consecutive 
10-year periods beginning in 2028.
    Intergovernmental and private-sector impact: H.R. 880 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would impose no costs on state, local, or 
tribal governments.
    Estimate prepared by: Federal Costs: Emily King; Impact on 
state, local, and tribal governments: Zach Byrum; Impact on the 
private sector: Amy Petz.
    Estimate 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.

         Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to 
establish a grant program that bolsters access to high quality 
domestic trauma care.

                    Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 880 is known to be duplicative of another Federal program, 
including any program that was included in a report to Congress 
pursuant to section 21 of Public Law 111-139 or the most recent 
Catalog of Federal Domestic Assistance.

                        Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, 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.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 880 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                  Disclosure of Directed Rule Makings

    Pursuant to section 3(i) of H. Res. 5, the Committee finds 
that H.R. 880 contains no directed rule makings.

                      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 provides that the Act may be cited as the 
``Military Injury Surgical Systems Integrated Operationally 
Nationwide to Achieve ZERO Preventable Deaths Act'' or the 
``MISSION ZERO Act.''

Section 2. Military and civilian partnership for trauma readiness grant 
        program

    Section 2 authorizes the appropriation of $15 million for 
each of fiscal years 2018 to 2022 to establish a grant program 
to assist civilian trauma centers in partnering with military 
trauma professionals. Grants may be used to train and integrate 
military trauma practitioners into trauma center staffs in 
order to maintain battlefield currency and to help translate 
military trauma care lessons to the civilian trauma system. The 
Secretary of Health and Human Services, in consultation with 
the Secretary of Defense, is required to report on the effects 
of military-civilian trauma integration, including its impacts 
on military readiness, the civilian community, and the 
financial impacts of trauma care.

         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 (new matter is 
printed in italics and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE XII--TRAUMA CARE

           *       *       *       *       *       *       *



 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 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.--For each of fiscal 
years 2018 through 2022, there are authorized to be 
appropriated--
          (1) $10,000,000 for carrying out subsection (a); and
          (2) $5,000,000 for carrying out subsection (b).

           *       *       *       *       *       *       *


                                  [all]