I 

109TH CONGRESS 

1ST SESSION H. R. 2560 

To amend title XVIII of the Social Security Act to require, as a condition 

of participation in the Medicare Program, that hospitals make reasonable 

efforts to contact a family member, specified healthcare agent, or surrogate decisionmaker of a patient who arrives at a hospital emergency 

department unconscious or otherwise physically incapable of communicating with the attending health care practitioners of the hospital, 

and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 24, 2005 

Mr. JACKSON of Illinois introduced the following bill; which was referred to 

the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined 

by the Speaker, in each case for consideration of such provisions as fall 

within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to require, 

as a condition of participation in the Medicare Program, 

that hospitals make reasonable efforts to contact a family 

member, specified healthcare agent, or surrogate decisionmaker of a patient who arrives at a hospital emergency department unconscious or otherwise physically incapable of communicating with the attending health care 

practitioners of the hospital, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 
2 

•HR 2560 IH 

1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Elaine Sullivan Act’’. 

3 SEC. 2. REQUIREMENT FOR EMERGENCY DEPARTMENTS 

4 TO CONTACT FAMILY MEMBERS, SPECIFIED 

5 HEALTHCARE AGENT, OR SURROGATE DECI6 SIONMAKER OF INCAPACITATED PATIENTS 

7 WITHIN 24 HOURS OF ARRIVAL AT THE EMER8 GENCY DEPARTMENT. 

9 (a) IN GENERAL.—Section 1866(a)(1) of the Social 

10 Security Act (42 U.S.C. 1395cc(a)(1)) is amended— 

11 (1) in subparagraph (U), by striking ‘‘and’’ at 

12 the end; 

13 (2) in subparagraph (V), by striking the period 

14 at the end and inserting ‘‘, and’’; and 

15 (3) by inserting after subparagraph (V) the fol16 lowing new subparagraph: 

17 ‘‘(W) in the case of a hospital (as defined in 

18 section 1861(e)) with an emergency department, to 

19 adopt and enforce a policy to ensure compliance with 

20 the requirements of subsection (k) (relating to re21 quirements to make reasonable efforts to contact 

22 certain individuals in the case of a patient who is 

23 unconscious or physically unable to communicate 

24 with staff of the hospital).’’. 

25 (b) REQUIREMENT TO CONTACT FAMILY MEMBERS

26 OR OTHER INDIVIDUALS WITH AUTHORITY TO MAKE
3 

•HR 2560 IH 

1 HEALTH CARE DECISIONS.—Section 1866 of such Act 

2 (42 U.S.C. 1395cc) is amended by adding at the end the 

3 following new subsection: 

4 ‘‘(k)(1)(A) In the case of a hospital (as defined in 

5 section 1861(e)) with an emergency department, if any in6 dividual arrives at the emergency department requiring 

7 medical treatment and is unconscious or otherwise unable 

8 to communicate with a health care professional of the de9 partment, the hospital shall take reasonable measures (de10 scribed in paragraph (3)) to identify and contact a person 

11 the hospital reasonably believes has the authority to make 

12 health care decisions on behalf of the individual. 

13 ‘‘(B) A person referred to in subparagraph (A) is any 

14 of the following: 

15 ‘‘(i) An immediate family member. 

16 ‘‘(ii) A person authorized to make health care 

17 decisions for the individual under a durable power of 

18 attorney for health care, recognized under State law 

19 (whether by statute or as recognized by the courts 

20 of the State). 

21 ‘‘(2)(A) The hospital shall take the reasonable meas22 ures as soon as practicable, but, subject to subparagraph 

23 (B), in no case later than the end of the 24-hour period 

24 that begins at the point in time that a health care profes25 sional of the emergency department of the hospital deter-
4 

•HR 2560 IH 

1 mines that the individual is unconscious or otherwise un2 able to communicate. 

3 ‘‘(B)(i) The 24-hour period under subparagraph (A) 

4 shall not apply during any period in which the hospital 

5 implements a disaster and mass casualty program or a 

6 fire and internal disaster program, or during a declared 

7 state of emergency (as defined in clause (ii)) or other local 

8 mass casualty situation. 

9 ‘‘(ii) For purposes of clause (i), the term ‘declared 

10 state of emergency’ means an officially designated state 

11 of emergency that has been declared by the Federal Gov12 ernment or a State or local government official having au13 thority to declare that the State, county, municipality, or 

14 locality is in a state of emergency. 

15 ‘‘(3) Reasonable measures referred to in paragraph 

16 (1) include the following: 

17 ‘‘(A) Contacting the emergency contact, family 

18 member, surrogate decision maker, or other health 

19 care agent identified from personal effects of the in20 dividual. 

21 ‘‘(B) Examining medical records in the hos22 pital’s possession, including a review of any verbal or 

23 written report made by emergency medical techni24 cians or the police with respect to the individual. 
5 

•HR 2560 IH 

1 ‘‘(C) Insofar as actions under subparagraphs 

2 (A) and (B) are unsuccessful, contacting the hos3 pital’s social service department or the appropriate 

4 local law enforcement agency. 

5 ‘‘(4) The provisions of this subsection do not preempt 

6 any State or local law requirement, except to the extent 

7 that the requirement directly conflicts with a requirement 

8 of this subsection.’’. 

9 (c) EFFECTIVE DATE.—The amendments made by 

10 this section shall apply to hospitals as of the date that 

11 is one year after the date of the enactment of this Act. 

12 SEC. 3. GRANT PROGRAM FOR THE ESTABLISHMENT OF 

13 NEXT OF KIN REGISTRIES. 

14 (a) IN GENERAL.—The Secretary of Health and 

15 Human Services is authorized to make grants to qualified 

16 not-for-profit organizations for the purpose of assisting 

17 such organizations to establish and operate voluntary next 

18 of kin registries. 

19 (b) NEXT OF KIN REGISTRY DESCRIBED.—A next 

20 of kin registry is an electronic search service to help indi21 viduals, and family members of those individuals, who are 

22 missing, injured, or deceased. A next of kin registry is a 

23 free service to the public, health care providers and insti24 tutions, and governmental agencies using the search serv25 ice. 
6 

•HR 2560 IH 

1 (c) AWARDING OF GRANTS.— 

2 (1) APPLICATION.—No grant may be made 

3 under this section except pursuant to a grant appli4 cation that is submitted and approved in a time, 

5 manner, and form specified by the Secretary. 

6 (2) LIMITATION ON GRANTS.—Only 1 grant 

7 may be awarded under this section with respect to 

8 any qualified not-for-profit organizations. 

9 (d) TERMS AND CONDITIONS.— 

10 (1) IN GENERAL.—Grants under this section 

11 shall be made under such terms and conditions as 

12 the Secretary specifies consistent with this section. 

13 (2) USE OF GRANT FUNDS.—Funds provided 

14 under grants under this section may be used for any 

15 of the following: 

16 (A) For purchasing, leasing, and installing 

17 computer software and hardware. 

18 (B) Making upgrades and other improve19 ments to existing computer software and hard20 ware. 

21 (C) Providing education and training to el22 igible staff on the use of technology to imple23 ment next-of-kin registries. 

24 (3) PROVISION OF INFORMATION.—As a condi25 tion for the awarding of a grant under this section, 
7 

•HR 2560 IH 

1 an applicant shall provide to the Secretary such in2 formation as the Secretary may require in order 

3 to— 

4 (A) evaluate the project for which the 

5 grant is made; and 

6 (B) ensure that funding provided under 

7 the grant is expended only for the purposes for 

8 which it is made. 

9 (4) AUDIT.—The Secretary shall conduct ap10 propriate audits of grants under this section. 

11 (e) AUTHORIZATION OF APPROPRIATIONS.—There 

12 are authorized to be appropriated to carry out this section 

13 such sums as may be necessary for each of fiscal years 

14 2006 through 2010. 

Æ