IIB 

115TH CONGRESS 

2D SESSION H. R. 880 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 27, 2018 

Received; read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

AN ACT 

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. 

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


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1 SECTION 1. SHORT TITLE. 

2 This Act may be cited as the ‘‘Military Injury Sur3 gical Systems Integrated Operationally Nationwide to 

4 Achieve ZERO Preventable Deaths Act’’ or the ‘‘MIS5 SION ZERO Act’’. 

6 SEC. 2. MILITARY AND CIVILIAN PARTNERSHIP FOR TRAU7 MA READINESS GRANT PROGRAM. 

8 Title XII of the Public Health Service Act (42 U.S.C. 

9 300d et seq.) is amended by adding at the end the fol10 lowing new part: 

11 ‘‘PART I—MILITARY AND CIVILIAN PARTNERSHIP 

12 FOR TRAUMA READINESS GRANT PROGRAM 

13 ‘‘SEC. 1291. MILITARY AND CIVILIAN PARTNERSHIP FOR 

14 TRAUMA READINESS GRANT PROGRAM. 

15 ‘‘(a) MILITARY TRAUMA TEAM PLACEMENT PRO16 GRAM.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall award 

18 grants to not more than 20 eligible high-acuity trau19 ma centers to enable military trauma teams to pro20 vide, on a full-time basis, trauma care and related 

21 acute care at such trauma centers. 

22 ‘‘(2) LIMITATIONS.—In the case of a grant 

23 awarded under paragraph (1) to an eligible high24 acuity trauma center, such grant— 


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1 ‘‘(A) shall be for a period of at least 3 

2 years and not more than 5 years (and may be 

3 renewed at the end of such period); and 

4 ‘‘(B) shall be in an amount that does not 

5 exceed $1,000,000 per year. 

6 ‘‘(3) AVAILABILITY OF FUNDS AFTER PER7 FORMANCE PERIOD.—Notwithstanding section 1552 

8 of title 31, United States Code, or any other provi9 sion of law, funds available to the Secretary for obli10 gation for a grant under this subsection shall remain 

11 available for expenditure for 100 days after the last 

12 day of the performance period of such grant. 

13 ‘‘(b) MILITARY TRAUMA CARE PROVIDER PLACE14 MENT PROGRAM.— 

15 ‘‘(1) IN GENERAL.—The Secretary shall award 

16 grants to eligible trauma centers to enable military 

17 trauma care providers to provide trauma care and 

18 related acute care at such trauma centers. 

19 ‘‘(2) LIMITATIONS.—In the case of a grant 

20 awarded under paragraph (1) to an eligible trauma 

21 center, such grant— 

22 ‘‘(A) shall be for a period of at least 1 year 

23 and not more than 3 years (and may be re24 newed at the end of such period); and 


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1 ‘‘(B) shall be in an amount that does not 

2 exceed, in a year— 

3 ‘‘(i) $100,000 for each military trau4 ma care provider that is a physician at 

5 such eligible trauma center; and 

6 ‘‘(ii) $50,000 for each other military 

7 trauma care provider at such eligible trau8 ma center. 

9 ‘‘(c) GRANT REQUIREMENTS.— 

10 ‘‘(1) DEPLOYMENT.—As a condition of receipt 

11 of a grant under this section, a grant recipient shall 

12 agree to allow military trauma care providers pro13 viding care pursuant to such grant to be deployed by 

14 the Secretary of Defense for military operations, for 

15 training, or for response to a mass casualty incident. 

16 ‘‘(2) USE OF FUNDS.—Grants awarded under 

17 this section to an eligible trauma center may be used 

18 to train and incorporate military trauma care pro19 viders into such trauma center, including expendi20 tures for malpractice insurance, office space, infor21 mation technology, specialty education and super22 vision, trauma programs, research, and State license 

23 fees for such military trauma care providers. 

24 ‘‘(d) RULE OF CONSTRUCTION.—Nothing in this sec25 tion shall be construed to affect the extent to which State 


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1 licensing requirements for health care professionals are 

2 preempted by other Federal law from applying to military 

3 trauma care providers. 

4 ‘‘(e) REPORTING REQUIREMENTS.— 

5 ‘‘(1) REPORT TO THE SECRETARY AND THE

6 SECRETARY OF DEFENSE.—Each eligible trauma 

7 center or eligible high-acuity trauma center awarded 

8 a grant under subsection (a) or (b) for a year shall 

9 submit to the Secretary and the Secretary of De10 fense a report for such year that includes informa11 tion on— 

12 ‘‘(A) the number and types of trauma 

13 cases managed by military trauma teams or 

14 military trauma care providers pursuant to such 

15 grant during such year; 

16 ‘‘(B) the financial impact of such grant on 

17 the trauma center; 

18 ‘‘(C) the educational impact on resident 

19 trainees in centers where military trauma teams 

20 are assigned; 

21 ‘‘(D) any research conducted during such 

22 year supported by such grant; and 

23 ‘‘(E) any other information required by the 

24 Secretaries for the purpose of evaluating the ef25 fect of such grant. 


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1 ‘‘(2) REPORT TO CONGRESS.—Not less than 

2 once every 2 years, the Secretary, in consultation 

3 with the Secretary of Defense, shall submit a report 

4 to Congress that includes information on the effect 

5 of placing military trauma care providers in trauma 

6 centers awarded grants under this section on— 

7 ‘‘(A) maintaining readiness of military 

8 trauma care providers for battlefield injuries; 

9 ‘‘(B) providing health care to civilian trau10 ma patients in both urban and rural settings; 

11 ‘‘(C) the capability to respond to surges in 

12 trauma cases, including as a result of a large 

13 scale event; and 

14 ‘‘(D) the financial State of the trauma cen15 ters. 

16 ‘‘(f) DEFINITIONS.—For purposes of this part: 

17 ‘‘(1) ELIGIBLE TRAUMA CENTER.—The term 

18 ‘eligible trauma center’ means a Level I, II, or III 

19 trauma center that satisfies each of the following: 

20 ‘‘(A) Such trauma center has an agree21 ment with the Secretary of Defense to enable 

22 military trauma care providers to provide trau23 ma care and related acute care at such trauma 

24 center. 


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1 ‘‘(B) Such trauma center utilizes a risk-ad2 justed benchmarking system to measure per3 formance and outcomes, such as the Trauma 

4 Quality Improvement Program of the American 

5 College of Surgeons. 

6 ‘‘(C) Such trauma center demonstrates a 

7 need for integrated military trauma care pro8 viders to maintain or improve the trauma clin9 ical capability of such trauma center. 

10 ‘‘(2) ELIGIBLE HIGH-ACUITY TRAUMA CEN11 TER.—The term ‘eligible high-acuity trauma center’ 

12 means a Level I trauma center that satisfies each of 

13 the following: 

14 ‘‘(A) Such trauma center has an agree15 ment with the Secretary of Defense to enable 

16 military trauma teams to provide trauma care 

17 and related acute care at such trauma center. 

18 ‘‘(B) At least 20 percent of patients of 

19 such trauma center in the most recent 3-month 

20 period for which data is available are treated 

21 for a major trauma at such trauma center. 

22 ‘‘(C) Such trauma center utilizes a risk-ad23 justed benchmarking system to measure per24 formance and outcomes, such as the Trauma 


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1 Quality Improvement Program of the American 

2 College of Surgeons. 

3 ‘‘(D) Such trauma center is an academic 

4 training center— 

5 ‘‘(i) affiliated with a medical school; 

6 ‘‘(ii) that maintains residency pro7 grams and fellowships in critical trauma 

8 specialties and subspecialties, and provides 

9 education and supervision of military trau10 ma team members according to those spe11 cialties and subspecialties; and 

12 ‘‘(iii) that undertakes research in the 

13 prevention and treatment of traumatic in14 jury. 

15 ‘‘(E) Such trauma center serves as a dis16 aster response leader for its community, such 

17 as by participating in a partnership for State 

18 and regional hospital preparedness established 

19 under section 319C–2. 

20 ‘‘(3) MAJOR TRAUMA.—The term ‘major trau21 ma’ means an injury that is greater than or equal 

22 to 15 on the injury severity score. 

23 ‘‘(4) MILITARY TRAUMA TEAM.—The term 

24 ‘military trauma team’ means a complete military 


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1 trauma team consisting of military trauma care pro2 viders. 

3 ‘‘(5) MILITARY TRAUMA CARE PROVIDER.—The 

4 term ‘military trauma care provider’ means a mem5 ber of the Armed Forces who furnishes emergency, 

6 critical care, and other trauma acute care, including 

7 a physician, military surgeon, physician assistant, 

8 nurse, respiratory therapist, flight paramedic, com9 bat medic, or enlisted medical technician. 

10 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 

11 are authorized to be appropriated to carry out this sec12 tion— 

13 ‘‘(1) $7,000,000 for fiscal year 2018, of 

14 which— 

15 ‘‘(A) $4,500,000 shall be for carrying out 

16 subsection (a); and 

17 ‘‘(B) $2,500,000 shall be for carrying out 

18 subsection (b); 

19 ‘‘(2) $12,000,000 for fiscal year 2019, of 

20 which— 

21 ‘‘(A) $8,000,000 shall be for carrying out 

22 subsection (a); and 

23 ‘‘(B) $4,000,000 shall be for carrying out 

24 subsection (b); and 


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1 ‘‘(3) $15,000,000 for each of fiscal years 2020 

2 through 2022, of which— 

3 ‘‘(A) $10,000,000 shall be for carrying out 

4 subsection (a); and 

5 ‘‘(B) $5,000,000 shall be for carrying out 

6 subsection (b).’’. 

7 SEC. 3. CUT-GO COMPLIANCE. 

8 Subsection (f) of section 319D of the Public Health 

9 Service Act (42 U.S.C. 247d–4) is amended by striking 

10 ‘‘through 2018’’ and inserting ‘‘through 2017, and 

11 $75,300,000 for fiscal year 2018’’. 

Passed the House of Representatives February 26, 

2018. 

Attest: KAREN L. HAAS, 

Clerk. 


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