59–006 

110TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 110–75 

STROKE TREATMENT AND ONGOING PREVENTION ACT 

MARCH 27, 2007.—Committed to the Committee of the Whole House on the State 

of the Union and ordered to be printed 

Mr. DINGELL, from the Committee on Energy and Commerce, 

submitted the following 

R E P O R T 

[To accompany H.R. 477] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 477) to amend the Public Health Service Act to 

strengthen education, prevention, and treatment programs relating 

to stroke, and for other purposes, having considered the same, report favorably thereon with amendments and recommend that the 

bill as amended do pass. 

CONTENTS 

Page 

Amendments ............................................................................................................ 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 

Earmarks and Tax and Tariff Benefits .................................................................. 4 

Committee Cost Estimate ....................................................................................... 4 

Congressional Budget Office Estimate ................................................................... 4 

Federal Mandates Statement ................................................................................. 5 

Advisory Committee Statement .............................................................................. 6 

Constitutional Authority Statement ...................................................................... 6 

Applicability to Legislative Branch ........................................................................ 6 

Section-by-Section Analysis of the Legislation ...................................................... 6 

Changes in Existing Law Made by the Bill, as Reported ..................................... 8 


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AMENDMENTS

The amendments (stated in terms of the page and line numbers 

of the introduced bill) are as follows: 

Page 2, line 3, redesignate part R as part S. 

In such part S (as so redesignated), redesignate sections 

399AA through 399DD as sections 399FF through 399II, 

respectively. 

PURPOSE AND SUMMARY

The purpose of H.R. 477, the ‘‘Stroke Treatment and Ongoing 

Prevention Act’’, is to amend the Public Health Service Act to 

strengthen education, prevention, and treatment programs to improve health outcomes for stroke patients. 

BACKGROUND AND NEED FOR LEGISLATION

Stroke is the third leading cause of death in America and a 

major contributor to long-term disability. A stroke occurs when the 

blood supply to part of the brain is suddenly interrupted (ischemic) 

or when a blood vessel in the brain bursts, spilling blood into the 

spaces surrounding brain cells (hemorrhagic). Brain cells die when 

they no longer receive oxygen and nutrients from the blood or there 

is sudden bleeding into or around the brain. 

The symptoms of a stroke include sudden numbness or weakness, especially on one side of the body; sudden confusion or trouble 

speaking or understanding speech; sudden trouble seeing in one or 

both eyes; sudden trouble with walking, dizziness, or loss of balance or coordination; or sudden severe headache with no known 

cause. 

Although stroke is a disease of the brain, it can affect the entire 

body. A common disability that results from stroke is complete paralysis on one side of the body, called hemiplegia. A related disability that is not as debilitating as paralysis is one-sided weakness 

or hemiparesis. Stroke may cause problems with thinking, awareness, attention, learning, judgment, and memory. Recurrent stroke 

is frequent; about 25 percent of people who recover from their first 

stroke will have another stroke within 5 years. 

When a stroke is diagnosed and treated within the first few 

hours, damaged cells can be saved, strengthening the chance of recovery. Recent studies have shown that stroke patients who received care in a timely manner at facilities with highly trained 

health care professionals are more likely to have better health outcomes. The American Heart Association reports that 700,000 Americans each year suffer a new or recurrent stroke and more than 

150,000 people die annually. They estimate that every 3 minutes 

someone dies from a stroke. Additionally, the American Heart Association estimates that Americans will pay approximately $62.7 

billion in 2007 for stroke-related medical costs and disability. 

H.R. 477 would authorize the Secretary of Health and Human 

Services to engage in activities designed to increase knowledge and 

awareness of stroke prevention and treatment. This legislation 

would require the Secretary to conduct educational campaigns, 

maintain a national stroke registry, and establish an information 

clearinghouse related to stroke. For these purposes, the bill would 


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authorize an appropriation of $5 million for each of the fiscal years 

2008 through 2012. 

The legislation would authorize the Secretary to make grants to 

public and nonprofit entities for the purpose of planning, developing, and enhancing approved residency training programs and 

other professional training for appropriate health professions in 

emergency medicine, including diagnosis, treatment, and rehabilitation. For these purposes, the bill would authorize an appropriation of $4 million for each of the fiscal years 2008 through 2012. 

Finally, H.R. 477 would authorize the Secretary to make grants 

to States and other public and private entities to develop medical 

professional training programs and telehealth networks that seek 

to coordinate stroke care and improve patient outcomes. For these 

purposes, the bill would authorize appropriations of $10 million for 

fiscal year 2008; $13 million for fiscal year 2009; $15 million for fiscal year 2010; $8 million for fiscal year 2011; and $4 million for fiscal year 2012. 

H.R. 477 has 86 cosponsors and is supported by the American 

Heart Association, the American Stroke Association, the American 

Physical Therapy Association, and the STOP Stroke Coalition. 

HEARINGS

The Committee on Energy and Commerce has not held hearings 

on the legislation. 

COMMITTEE CONSIDERATION

On Tuesday, March 13, 2007, the Subcommittee on Health met 

in open markup session and approved H.R. 477 for full Committee 

consideration by voice vote. On Thursday, March 15, 2007, the full 

Committee met in open markup session and ordered H.R. 477 favorably reported to the House, amended, by voice vote. 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list any record votes on the motion 

to report legislation and amendments thereto. There were no 

record votes taken on amendments or in connection with ordering 

H.R. 477 reported. A motion by Mr. Dingell to order H.R. 477 favorably reported to the House, amended, was agreed to by voice 

vote. 

COMMITTEE OVERSIGHT FINDINGS

Regarding clause 3(c)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee has not held oversight or legislative hearings on this legislation. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

H.R. 477 seeks to improve health outcomes for stroke patients. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

Regarding compliance with clause 3(c)(2) of rule XIII of the Rules 

of the House of Representatives, the Committee finds that H.R. 477 


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would result in no new or increased budget authority, entitlement 

activity, or tax expenditures or revenues. 

EARMARKS AND TAX AND TARIFF BENEFITS

Regarding compliance with clause 9 of rule XXI of the Rules of 

the House of Representatives, H.R. 477 does not contain any congressional earmarks, limited tax benefits, or limited tariff benefits 

as defined in clause 9(d), 9(e), or 9(f) of rule XXI. 

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, March 23, 2007. 

Hon. JOHN D. DINGELL, 

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. 477, the Stroke Treatment and Ongoing Prevention Act. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Tim Gronniger. 

Sincerely, 

PETER R. ORSZAG. 

Enclosure. 

H.R. 477—Stroke Treatment and Ongoing Prevention Act 

Summary: H.R. 477 would amend the Public Health Service Act 

to direct the Health Resources and Services Administration and the 

Centers for Disease Control and Prevention (CDC) to administer 

several programs related to education, prevention, and treatment of 

stroke. The bill would authorize the appropriation for those purposes of $19 million for 2008 and $95 million over the 2008–2012 

period. Assuming appropriation of the specified amounts, CBO estimates that implementing H.R. 477 would cost $7 million in 2008 

and $82 million over the 2008–2012 period. Enacting the bill would 

not affect direct spending or revenues. 

H.R. 477 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA) 

and could benefit state, local, and tribal governments. 

Estimated cost to the Federal Government: The estimated budgetary impact of H.R. 477 is shown in the following table. The costs 

of this legislation fall within budget function 550 (health). 


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By fiscal year, in millions of dollars— 

2008 2009 2010 2011 2012 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Authorization Level ........................................................................................ 19 22 24 17 13 

Estimated Outlays ......................................................................................... 7 16 21 21 17 

Basis of estimate: H.R. 477 would modify the Public Health Service Act to authorize the appropriation of $19 million for 2008 and 

$95 million over the 2008–2012 period for several activities related 

to stroke prevention and treatment. Based on historical patterns of 

spending for similar activities, CBO estimates that implementing 

H.R. 477 would cost $7 million in 2008 and $82 million over the 

2008–2012 period, assuming appropriation of the specified 

amounts. 

The bill would authorize the appropriation of $5 million a year 

for 2008 through 2012 for the Centers for Disease Control and Prevention to conduct stroke education campaigns and to maintain an 

existing stroke registry. Assuming appropriation of the specified 

amounts, CBO estimates those activities would cost $2 million in 

2008 and $22 million over the 2008–2012 period. 

The bill would authorize the appropriation of $4 million a year 

for 2008 through 2012 to the Health Resources and Services Administration for grants to train physicians in treating stroke and 

traumatic injury. Assuming appropriation of the specified amounts, 

CBO estimates those activities would cost $1 million in 2008 and 

$16 million over the 2008–2012 period. 

The bill also would authorize the appropriation of $10 million for 

2008 and $50 million over the 2008–2012 period for grants to fund 

pilot projects through the Office for the Advancement of Telehealth. 

Those pilot projects would attempt to improve stroke treatment delivered through telehealth communications networks. Assuming appropriation of the specified amounts, CBO estimates those activities would cost $4 million in 2008 and $44 million over the 2008–

2012 period. 

Intergovernmental and private-sector impact: H.R. 477 contains 

no intergovernmental or private-sector mandates as defined in the 

Unfunded Mandates Reform Act. State, local, and tribal governments may qualify for grants authorized by the bill. Any costs 

those governments would incur in order to meet requirements of 

the grants would be conditions of assistance and would be incurred 

voluntarily. 

Estimate prepared by: Federal costs: Tim Gronniger. Impact on 

state, local, and tribal governments: Leo Lex. Impact on the private 

sector: Paige Shevlin. 

Estimate approved by: Peter H. Fontaine, 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. 


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ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act were created by this legislation. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that the Constitutional authority for this legislation is provided in the provisions of Article 

I, section 8, clause 1 that relate to expending funds to provide for 

the general welfare of the United States. 

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 establishes the short title of the bill as the ‘‘Stroke 

Treatment and Ongoing Prevention Act.’’

Section 2. Amendments to Public Health Service Act regarding 

stroke programs 

Section 2 amends the Public Health Service Act to strengthen 

education, prevention, and treatment programs to improve health 

outcomes for stroke patients. 

To increase public awareness of the signs of stroke, section 2 

amends title III of the Public Health Service Act (42 U.S.C. 241 et 

seq.) to authorize the Secretary of Health and Human Services to 

carry out an education and information campaign to promote 

stroke prevention and increase the number of stroke patients who 

seek immediate treatment. The Secretary is authorized to (1) make 

public service announcements about the warning signs of stroke 

and the importance of treating stroke as a medical emergency; (2) 

provide education regarding ways to prevent stroke and the effectiveness of stroke treatment; and (3) carry out other activities that 

the Secretary determines will promote prevention practices among 

the general public and increase the number of stroke patients who 

seek immediate care. The Secretary is required to measure public 

awareness before the start of the campaign to provide baseline data 

that can be used to establish quantitative benchmarks to measure 

the impact of the campaign over time. The Secretary must report 

on these measurements not less than once every two years, or at 

shorter intervals. The Secretary must avoid duplicating existing 

stroke education efforts by other Federal government agencies. The 

Secretary may also consult with organizations and individuals with 

expertise in stroke prevention, diagnosis, treatment, and rehabilitation. 

To expand research information about stroke patients, section 2 

also reauthorizes the Paul Coverdell National Acute Stroke Registry and Clearinghouse of the Centers for Disease Control and 

Prevention (CDC). For purposes of this part, the term ‘‘stroke’’


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means a ‘‘brain attack’’ in which blood flow to the brain is interrupted or in which a blood vessel or aneurysm in the brain breaks 

or ruptures. For the public education and registry provisions, section 2 authorizes appropriations of $5 million for each of fiscal 

years 2008 through 2012. 

To improve medical professional development in advanced stroke 

and traumatic injury treatment and prevention, section 2 amends 

section 1251 of the Public Health Service Act (42 U.S.C. 300d–51) 

to authorize two new grant programs. The first grant program created in this section authorizes the Secretary to make grants to public and nonprofit entities for the purposes of planning, developing, 

and enhancing approved residency training programs and other 

training for appropriate health professions in emergency medicine 

to improve stroke and traumatic injury prevention, diagnosis, treatment, and rehabilitation. 

The second grant program authorizes the Secretary, acting 

through the Administrator of the Health Resources and Services 

Administration (HRSA), to make grants to a consortium of public 

and private entities for the development and implementation of 

education programs for appropriate health care professionals in the 

use of newly developed diagnostic approaches, technologies, and 

therapies to treat stroke or traumatic injury. The Secretary must 

give preference to qualified entities that will train health care professionals that serve areas with a significant incidence of stroke or 

traumatic injuries. The term ‘‘qualified entity’’ is defined as a consortium of public and private entities, such as universities, academic medical centers, hospitals, and emergency medical systems 

that are coordinating education activities among providers serving 

in a variety of medical settings. The Committee does not intend for 

the examples outlined in the statute to be an exhaustive list of entities. Further, the Committee expects HRSA to award these grants 

to real consortiums, groups of organizations formed to undertake 

the continuing education activities to a level that no one organization could accomplish by itself. The Committee strongly encourages 

HRSA to recognize the diverse training of health care professionals 

who treat stroke patients when awarding grants. For example, 

interventional radiologists who employ minimally invasive stroke 

treatments and therapies should be considered as well as all other 

health care professionals who directly treat stroke patients. 

The Secretary must report on these results of the activities of the 

two medical professional development grant programs no later than 

one year after the allocation of grants. This section authorizes appropriations of $4 million for each of the fiscal years 2008 through 

2012 for the two medical professional development grant programs. 

The Secretary must equitably allocate the funds appropriated between efforts to address stroke and efforts to address traumatic injury. 

Section 3. Pilot project on telehealth stroke treatment 

Section 3 amends part D of title II of the Public Health Service 

Act (42 U.S.C. 254b et seq.) to establish a five-year pilot project to 

improve stroke patient outcomes by coordinating health care delivery through telehealth networks. The Secretary, acting through the 

Director of the Office for the Advancement of Telehealth, is authorized to make up to seven grants to states or a consortium of states 


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or political subdivisions for a period of up to three years during fiscal years 2008 through 2012. 

Grant recipients must use the funding to accomplish all of the 

following activities: (1) Identify entities with expertise in the delivery of high-quality stroke prevention, diagnosis, treatment, and rehabilitation. (2) Work with these entities to establish or improve 

telehealth networks to provide stroke treatment assistance and resources to health care professionals, hospitals, and other individuals and entities that serve stroke patients. (3) Inform emergency 

medical systems of the location of entities identified to facilitate appropriate transportation. (4) Establish networks to coordinate collaborative activities for stroke prevention, diagnosis, treatment, 

and rehabilitation. (5) Improve access to high-quality stroke care, 

especially for populations with a shortage of stroke care specialists 

and populations with a high incidence of stroke. (6) Conduct ongoing performance and quality evaluations to identify collaborative 

activities that improve clinical outcomes for stroke patients. The 

Secretary may not award a grant to a State unless the State agrees 

to establish a consortium of public and private entities to carry out 

the activities of the grant. Additionally, the Secretary may not 

make a grant to a State that has an existing telehealth network 

that is or may be used for the purposes of the grant unless the 

State agrees to use the existing telehealth network to achieve the 

purpose of the grant and the State will not establish a separate 

network for the same purpose. The Secretary must give priority to 

any applicant that submits a plan detailing specifically how the 

grant will improve access to high-quality stroke care for populations with shortages of stroke care specialists and populations 

with a high incidence of stroke. 

The Secretary is required to consult with officials responsible for 

other Federal programs involving stroke research and care and organizations and individuals with expertise in stroke prevention, diagnosis, treatment, and rehabilitation to better coordinate program 

activities. Grant recipients are required to establish baselines 

measures and benchmarks to evaluate program outcomes. Not later 

than March 31, 2013, the Secretary of HHS is required to report 

to Congress on the pilot project outcomes, including recommendations on whether similar telehealth grant programs could be used 

to improve patient outcomes in other public health areas and how 

to promote stroke networks in ways that improve access to clinical 

care in rural and urban areas and reduce the incidence of stroke 

and the debilitating and costly complications resulting from stroke. 

The pilot project authorizes appropriations of $10 million for fiscal year 2008; $13 million for fiscal year 2009; $15 million for fiscal 

year 2010; $8 million for fiscal year 2011; and $4 million for fiscal 

year 2012. 

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): 


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PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

TITLE III—GENERAL POWERS AND DUTIES OF PUBLIC 

HEALTH SERVICE 

* * * * * * * 

PART D—PRIMARY HEALTH CARE

Subpart I—Health Centers 

* * * * * * * 

SEC. 330M. TELEHEALTH STROKE TREATMENT GRANT PROGRAM. 

(a) GRANTS.—The Secretary may make grants to States, and to 

consortia of public and private entities located in any State that is 

not a grantee under this section, to conduct a 5-year pilot project 

over the period of fiscal years 2008 through 2012 to improve stroke 

patient outcomes by coordinating health care delivery through telehealth networks. 

(b) ADMINISTRATION.—The Secretary shall administer this section through the Director of the Office for the Advancement of Telehealth. 

(c) CONSULTATION.—In carrying out this section, for the purpose 

of better coordinating program activities, the Secretary shall consult 

with— (1) officials responsible for other Federal programs involving stroke research and care, including such programs established by the Stroke Treatment and Ongoing Prevention Act; 

and 

(2) organizations and individuals with expertise in stroke 

prevention, diagnosis, treatment, and rehabilitation. 

(d) USE OF FUNDS.— (1) IN GENERAL.—The Secretary may not make a grant to 

a State or a consortium under this section unless the State or 

consortium agrees to use the grant for the purpose of— (A) identifying entities with expertise in the delivery of 

high-quality stroke prevention, diagnosis, treatment, and 

rehabilitation; 

(B) working with those entities to establish or improve 

telehealth networks to provide stroke treatment assistance 

and resources to health care professionals, hospitals, and 

other individuals and entities that serve stroke patients; 

(C) informing emergency medical systems of the location of entities identified under subparagraph (A) to facilitate the appropriate transport of individuals with stroke 

symptoms; 

(D) establishing networks to coordinate collaborative 

activities for stroke prevention, diagnosis, treatment, and 

rehabilitation; 

(E) improving access to high-quality stroke care, especially for populations with a shortage of stroke care specialists and populations with a high incidence of stroke; and 

(F) conducting ongoing performance and quality evaluations to identify collaborative activities that improve clinical outcomes for stroke patients. 


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(2) ESTABLISHMENT OF CONSORTIUM.—The Secretary may 

not make a grant to a State under this section unless the State 

agrees to establish a consortium of public and private entities, 

including universities and academic medical centers, to carry 

out the activities described in paragraph (1). 

(3) PROHIBITION.—The Secretary may not make a grant 

under this section to a State that has an existing telehealth network that is or may be used for improving stroke prevention, diagnosis, treatment, and rehabilitation, or to a consortium located in such a State, unless the State or consortium agrees 

that—

(A) the State or consortium will use an existing telehealth network to achieve the purpose of the grant; and 

(B) the State or consortium will not establish a separate network for such purpose. 

(e) PRIORITY.—In selecting grant recipients under this section, 

the Secretary shall give priority to any applicant that submits a 

plan demonstrating how the applicant, and where applicable the 

members of the consortium described in subsection (d)(2), will use 

the grant to improve access to high-quality stroke care for populations with shortages of stroke-care specialists and populations 

with a high incidence of stroke. 

(f) GRANT PERIOD.—The Secretary may not award a grant to a 

State or a consortium under this section for any period that—

(1) is greater than 3 years; or 

(2) extends beyond the end of fiscal year 2012. 

(g) RESTRICTION ON NUMBER OF GRANTS.—In carrying out the 

5-year pilot project under this section, the Secretary may not award 

more than 7 grants. 

(h) APPLICATION.—To seek a grant under this section, a State 

or a consortium of public and private entities shall submit an application to the Secretary in such form, in such manner, and containing such information as the Secretary may require. At a minimum, the Secretary shall require each such application to outline 

how the State or consortium will establish baseline measures and 

benchmarks to evaluate program outcomes. 

(i) DEFINITION.—In this section, the term ‘‘stroke’’ means a 

‘‘brain attack’’ in which blood flow to the brain is interrupted or in 

which a blood vessel or aneurysm in the brain breaks or ruptures. 

(j) AUTHORIZATION OF APPROPRIATIONS.—There are authorized 

to be appropriated to carry out this section $10,000,000 for fiscal 

year 2008, $13,000,000 for fiscal year 2009, $15,000,000 for fiscal 

year 2010, $8,000,000 for fiscal year 2011, and $4,000,000 for fiscal 

year 2012. 

* * * * * * * 

Subpart III—Grants for Home Visiting Services for At-Risk 

Families 

* * * * * * * 


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PART S—STROKE EDUCATION, INFORMATION, 

AND DATA COLLECTION PROGRAMS 

SEC. 399FF. STROKE PREVENTION AND EDUCATION CAMPAIGN. 

(a) IN GENERAL.—The Secretary shall carry out an education 

and information campaign to promote stroke prevention and increase the number of stroke patients who seek immediate treatment. 

(b) AUTHORIZED ACTIVITIES.—In implementing the education 

and information campaign under subsection (a), the Secretary 

may—

(1) make public service announcements about the warning 

signs of stroke and the importance of treating stroke as a medical emergency; 

(2) provide education regarding ways to prevent stroke and 

the effectiveness of stroke treatment; and 

(3) carry out other activities that the Secretary determines 

will promote prevention practices among the general public and 

increase the number of stroke patients who seek immediate care. 

(c) MEASUREMENTS.—In implementing the education and information campaign under subsection (a), the Secretary shall—

(1) measure public awareness before the start of the campaign to provide baseline data that will be used to evaluate the 

effectiveness of the public awareness efforts; 

(2) establish quantitative benchmarks to measure the impact of the campaign over time; and 

(3) measure the impact of the campaign not less than once 

every 2 years or, if determined appropriate by the Secretary, at 

shorter intervals. 

(d) NO DUPLICATION OF EFFORT.—In carrying out this section, 

the Secretary shall avoid duplicating existing stroke education efforts by other Federal Government agencies. 

(e) CONSULTATION.—In carrying out this section, the Secretary 

may consult with organizations and individuals with expertise in 

stroke prevention, diagnosis, treatment, and rehabilitation. 

SEC. 399GG. PAUL COVERDELL NATIONAL ACUTE STROKE REGISTRY 

AND CLEARINGHOUSE. 

The Secretary, acting through the Centers for Disease Control 

and Prevention, shall maintain the Paul Coverdell National Acute 

Stroke Registry and Clearinghouse by—

(1) continuing to develop and collect specific data points 

and appropriate benchmarks for analyzing care of acute stroke 

patients; 

(2) collecting, compiling, and disseminating information on 

the achievements of, and problems experienced by, State and 

local agencies and private entities in developing and implementing emergency medical systems and hospital-based quality 

of care interventions; and 

(3) carrying out any other activities the Secretary determines to be useful to maintain the Paul Coverdell National 

Acute Stroke Registry and Clearinghouse to reflect the latest advances in all forms of stroke care. 


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SEC. 399HH. STROKE DEFINITION. 

For purposes of this part, the term ‘‘stroke’’ means a ‘‘brain attack’’ in which blood flow to the brain is interrupted or in which 

a blood vessel or aneurysm in the brain breaks or ruptures. 

SEC. 399II. AUTHORIZATION OF APPROPRIATIONS. 

There is authorized to be appropriated to carry out this part $5,000,000 for each of fiscal years 2008 through 2012. 

* * * * * * * 

TITLE XII—TRAUMA CARE 

* * * * * * * 

Part E—Miscellaneous Programs 

øSEC. 1251. RESIDENCY TRAINING PROGRAMS IN EMERGENCY MEDICINE. 

ø(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. 

ø(b) IDENTIFICATION AND REFERRAL OF DOMESTIC VIOLENCE.— The Secretary may make a grant under subsection (a) only if the 

applicant involved agrees that training programs under subsection 

(a) will provide education and training in identifying and referring 

cases of domestic violence. 

ø(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 1993 through 1995.¿ 

SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN ADVANCED 

STROKE AND TRAUMATIC INJURY TREATMENT AND PREVENTION. 

(a) RESIDENCY AND OTHER PROFESSIONAL TRAINING.—The Secretary may make grants to public and nonprofit entities for the purpose of planning, developing, and enhancing approved residency 

training programs and other professional training for appropriate 

health professions in emergency medicine, including emergency 

medical services professionals, to improve stroke and traumatic injury prevention, diagnosis, treatment, and rehabilitation. 

(b) CONTINUING EDUCATION ON STROKE AND TRAUMATIC INJURY.—

(1) GRANTS.—The Secretary, acting through the Administrator of the Health Resources and Services Administration, 

may make grants to qualified entities for the development and 

implementation of education programs for appropriate health 

care professionals in the use of newly developed diagnostic approaches, technologies, and therapies for health professionals 

involved in the prevention, diagnosis, treatment, and rehabilitation of stroke or traumatic injury. 

(2) DISTRIBUTION OF GRANTS.—In awarding grants under 

this subsection, the Secretary shall give preference to qualified 

entities that will train health care professionals that serve areas 

with a significant incidence of stroke or traumatic injuries. 

(3) APPLICATION.—A qualified entity desiring a grant under 

this subsection shall submit to the Secretary an application at 


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such time, in such manner, and containing such information as 

the Secretary may require, including a plan for the rigorous 

evaluation of activities carried out with amounts received under 

the grant. 

(4) DEFINITIONS.—For purposes of this subsection: 

(A) The term ‘‘qualified entity’’ means a consortium of 

public and private entities, such as universities, academic 

medical centers, hospitals, and emergency medical systems 

that are coordinating education activities among providers 

serving in a variety of medical settings. 

(B) The term ‘‘stroke’’ means a ‘‘brain attack’’ in which 

blood flow to the brain is interrupted or in which a blood 

vessel or aneurysm in the brain breaks or ruptures. 

(c) REPORT.—Not later than 1 year after the allocation of grants 

under this section, the Secretary shall submit to the Committee on 

Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a 

report on the results of activities carried out with amounts received 

under this section. 

(d) AUTHORIZATION OF APPROPRIATIONS.—There is authorized 

to be appropriated to carry out this section $4,000,000 for each of 

fiscal years 2008 through 2012. The Secretary shall equitably allocate the funds authorized to be appropriated under this section between efforts to address stroke and efforts to address traumatic injury. 

* * * * * * * 

Æ 


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