Improving Emergency Medical Care and Response Act of 2007 - Amends the Public Health Service Act to require the Secretary of Health and Human Services, acting though the Assistant Secretary for Preparedness and Response, to award contracts or competitive grants to support demonstration programs that design, implement, and evaluate innovative models of regionalized, comprehensive, and accountable emergency care systems. Requires the Secretary to give priority to entities that serve a population in a medically underserved area.
Directs the Secretary to: (1) support federal programs involved in improving the emergency care system to expand and accelerate research in emergency medical care systems and emergency medicine; and (2) support research to determine the estimated economic impact of, and savings that result from, the implementation of coordinated emergency care systems.
[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 1873 Introduced in Senate (IS)]
110th CONGRESS
1st Session
S. 1873
To amend the Public Health Service Act to establish demonstration
programs on regionalized systems for emergency care, to support
emergency medicine research, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
July 25, 2007
Mr. Obama introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to establish demonstration
programs on regionalized systems for emergency care, to support
emergency medicine research, and for other purposes.
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 ``Improving Emergency Medical Care and
Response Act of 2007''.
SEC. 2. FINDINGS AND PURPOSES.
(a) Findings.--Congress makes the following findings:
(1) Emergency medical services play a critically important
role in health care, public health, and public safety by
frequently providing immediate lifesustaining care and making
decisions with limited time and information.
(2) Between 1993 and 2003, the population of the United
States grew by 12 percent and hospital admissions increased by
13 percent, yet emergency department visits rose by more than
25 percent during this same period of time, from 90,300,000
visits in 1993 to 113,900,000 visits in 2003.
(3) The demand for emergency care in the United States
continues to grow at a rapid pace.
(4) In 2003, hospital emergency departments received nearly
114,000,000 visits, which is more than 1 visit for every 3
people in the United States, however, between 1993 and 2003,
the number of emergency departments declined by 425.
(5) Many emergency medical services are highly fragmented,
overburdened, poorly equipped, and insufficiently prepared for
day-to-day operations and response to major disasters.
(6) There are more than 6,000 Public Safety Answering
Points that receive 9-1-1 calls.
(7) These Public Safety Answering Points are often operated
by police departments, fire departments, city or county
governments, or other local entities, which makes attempts to
coordinate efforts between locations very difficult.
(8) Regionalized, accountable systems of emergency care
show substantial promise in improving the day-to-day system-
wide coordination essential to assure that Public Safety
Answering Points, emergency medical services organizations,
public safety agencies, public health agencies, medical
facilities, and others coordinate their activities to ensure
that patients receive the appropriate care at the scene, are
transported to the most appropriate facility in the shortest
time, and receive excellent care at the destination medical
facility.
(9) Regionalized, accountable systems of emergency care
also show promise in management of the special problems of
disaster preparation and response, including management of
patient surge, tracking of patients, and coordination and
allocation of medical resources.
(10) While there are potentially substantial benefits to be
derived from regionalized, accountable emergency care systems,
little is known about the most effective and efficient methods
of regional emergency care system development.
(b) Purposes.--The purposes of this Act are to design, implement,
and evaluate regionalized, comprehensive, and accountable systems of
emergency care that--
(1) support and improve the day-to-day operations and
coordination of a regional emergency medical care system;
(2) increase disaster preparedness and medical surge
capacity;
(3) include different models of regionalized emergency care
systems, including models for urban and rural communities;
(4) can be implemented by private or public entities; and
(5) meet quality and accountability standards for the
operation of emergency care systems and the impact of such
systems on patient outcomes.
SEC. 3. DESIGN AND IMPLEMENTATION OF REGIONALIZED SYSTEMS FOR EMERGENCY
CARE.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 314 the following:
``SEC. 315. REGIONALIZED COMMUNICATION SYSTEMS FOR EMERGENCY CARE
RESPONSE.
``(a) In General.--The Secretary, acting through the Assistant
Secretary for Preparedness and Response, shall award not fewer than 4
multiyear contracts or competitive grants to eligible entities to
support demonstration programs that design, implement, and evaluate
innovative models of regionalized, comprehensive, and accountable
emergency care systems.
``(b) Eligible Entity; Region.--
``(1) Eligible entity.--In this section, the term `eligible
entity' means a State or a partnership of 1 or more States and
1 or more local governments.
``(2) Region.--In this section, the term `region' means an
area within a State, an area that lies within multiple States,
or a similar area (such as a multicounty area), as determined
by the Secretary.
``(c) Demonstration Program.--The Secretary shall award a contract
or grant under subsection (a) to an eligible entity that proposes a
demonstration program to design, implement, and evaluate an emergency
medical system that--
``(1) coordinates with public safety services, public
health services, emergency medical services, medical
facilities, and other entities within a region;
``(2) coordinates an approach to emergency medical system
access throughout the region, including 9-1-1 Public Safety
Answering Points and emergency medical dispatch;
``(3) includes a mechanism, such as a regional medical
direction or transport communications system, that operates
throughout the region to ensure that the correct patient is
taken to the medically appropriate facility (whether an initial
facility or a higher-level facility) in a timely fashion;
``(4) allows for the tracking of prehospital and hospital
resources, including inpatient bed capacity, emergency
department capacity, on-call specialist coverage, ambulance
diversion status, and the coordination of such tracking with
regional communications and hospital destination decisions; and
``(5) includes a consistent region-wide prehospital,
hospital, and interfacility data management system that--
``(A) complies with the National EMS Information
System, the National Trauma Data Bank, and others;
``(B) reports data to appropriate Federal and State
databanks and registries; and
``(C) contains information sufficient to evaluate
key elements of prehospital care, hospital destination
decisions, including initial hospital and interfacility
decisions, and relevant outcomes of hospital care.
``(d) Application.--
``(1) In general.--An eligible entity that seeks a contract
or grant described in subsection (a) shall submit to the
Secretary an application at such time and in such manner as the
Secretary may require.
``(2) Application information.--Each application shall
include--
``(A) an assurance from the eligible entity that
the proposed system--
``(i) has been coordinated with the
applicable State Office of Emergency Medical
Services (or equivalent State office);
``(ii) is compatible with the applicable
State emergency medical services system;
``(iii) includes consistent indirect and
direct medical oversight of prehospital,
hospital, and interfacility transport
throughout the region;
``(iv) coordinates prehospital treatment
and triage, hospital destination, and
interfacility transport throughout the region;
``(v) includes a categorization or
designation system for special medical
facilities throughout the region that is--
``(I) consistent with State laws
and regulations; and
``(II) integrated with the
protocols for transport and destination
throughout the region; and
``(vi) includes a regional medical
direction system, a patient tracking system,
and a resource allocation system that--
``(I) support day-to-day emergency
care system operation;
``(II) can manage surge capacity
during a major event or disaster; and
``(III) are integrated with other
components of the national and State
emergency preparedness system; and
``(B) such other information as the Secretary may
require.
``(e) Priority.--The Secretary shall give priority for the award of
the contracts or grants described subsection (a) to any eligible entity
that serves a population in a medically underserved area (as defined in
section 330(b)(3)).
``(f) Report.--Not later than 90 days after the completion of a
demonstration program under subsection (a), the recipient of such
contract or grant described in shall submit to the Secretary a report
containing the results of an evaluation of the program, including an
identification of--
``(1) the impact of the regional, accountable emergency
care system on patient outcomes for various critical care
categories, such as trauma, stroke, cardiac emergencies, and
pediatric emergencies;
``(2) the system characteristics that contribute to the
effectiveness and efficiency of the program (or lack thereof);
``(3) methods of assuring the long-term financial
sustainability of the emergency care system;
``(4) the State and local legislation necessary to
implement and to maintain the system; and
``(5) the barriers to developing regionalized, accountable
emergency care systems, as well as the methods to overcome such
barriers.
``(g) Dissemination of Findings.--The Secretary shall, as
appropriate, disseminate to the public and to the appropriate
Committees of the Congress, the information contained in a report made
under subsection (f).
``(h) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $12,000,000 for each of fiscal
years 2008 through 2013.''.
SEC. 4. SUPPORT FOR EMERGENCY MEDICINE RESEARCH.
Part H of title IV of the Public Health Service Act (42 U.S.C. 289
et seq.) is amended by inserting after the section 498C the following:
``SEC. 498D. SUPPORT FOR EMERGENCY MEDICINE RESEARCH.
``(a) Emergency Medical Research.--The Secretary shall support
Federal programs administered by the National Institutes of Health, the
Agency for Healthcare Research and Quality, the Health Resources and
Services Administration, the Centers for Disease Control and
Prevention, and other agencies involved in improving the emergency care
system to expand and accelerate research in emergency medical care
systems and emergency medicine, including--
``(1) the basic science of emergency medicine;
``(2) the model of service delivery and the components of
such models that contribute to enhanced patient outcomes;
``(3) the translation of basic scientific research into
improved practice; and
``(4) the development of timely and efficient delivery of
health services.
``(b) Impact Research.--The Secretary shall support research to
determine the estimated economic impact of, and savings that result
from, the implementation of coordinated emergency care systems.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2008 through 2013.''.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
Sponsor introductory remarks on measure. (CR S10143)
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