IIB 

110TH CONGRESS 

2D SESSION H. R. 2464 

IN THE SENATE OF THE UNITED STATES 

APRIL 9, 2008 

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

Labor, and Pensions 

AN ACT 

To amend the Public Health Service Act to provide a means 

for continued improvement in emergency medical services 

for children. 

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 ‘‘Wakefield Act’’. 

3 SEC. 2. FINDINGS AND PURPOSE. 

4 (a) FINDINGS.—Congress makes the following find5 ings: 

6 (1) There are 31,000,000 child and adolescent 

7 visits to the Nation’s emergency departments every 

8 year. 

9 (2) Over 90 percent of children requiring emer10 gency care are seen in general hospitals, not in free11 standing children’s hospitals, with one-quarter to 

12 one-third of the patients being children in the typical 

13 general hospital emergency department. 

14 (3) Severe asthma and respiratory distress are 

15 the most common emergencies for pediatric patients, 

16 representing nearly one-third of all hospitalizations 

17 among children under the age of 15 years, while sei18 zures, shock, and airway obstruction are other com19 mon pediatric emergencies, followed by cardiac ar20 rest and severe trauma. 

21 (4) Up to 20 percent of children needing emer22 gency care have underlying medical conditions such 

23 as asthma, diabetes, sickle-cell disease, low birth 

24 weight, and bronchopulmonary dysplasia. 

25 (5) Significant gaps remain in emergency med26 ical care delivered to children. Only about 6 percent 


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1 of hospitals have available all the pediatric supplies 

2 deemed essential by the American Academy of Pedi3 atrics and the American College of Emergency Phy4 sicians for managing pediatric emergencies, while 

5 about half of hospitals have at least 85 percent of 

6 those supplies. 

7 (6) Providers must be educated and trained to 

8 manage children’s unique physical and psychological 

9 needs in emergency situations, and emergency sys10 tems must be equipped with the resources needed to 

11 care for this especially vulnerable population. 

12 (7) Systems of care must be continually main13 tained, updated, and improved to ensure that re14 search is translated into practice, best practices are 

15 adopted, training is current, and standards and pro16 tocols are appropriate. 

17 (8) The Emergency Medical Services for Chil18 dren (EMSC) Program under section 1910 of the 

19 Public Health Service Act (42 U.S.C. 300w–9) is 

20 the only Federal program that focuses specifically on 

21 improving the pediatric components of emergency 

22 medical care. 

23 (9) The EMSC Program promotes the nation24 wide exchange of pediatric emergency medical care 

25 knowledge and collaboration by those with an interVerDate Aug 31 2005 03:48 Apr 10, 2008 Jkt 069200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H2464.RFS H2464

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1 est in such care and is depended upon by Federal 

2 agencies and national organizations to ensure that 

3 this exchange of knowledge and collaboration takes 

4 place. 

5 (10) The EMSC Program also supports a 

6 multi-institutional network for research in pediatric 

7 emergency medicine, thus allowing providers to rely 

8 on evidence rather than anecdotal experience when 

9 treating ill or injured children. 

10 (11) The Institute of Medicine stated in its 

11 2006 report, ‘‘Emergency Care for Children: Grow12 ing Pains’’, that the EMSC Program ‘‘boasts many 

13 accomplishments . . . and the work of the program 

14 continues to be relevant and vital’’. 

15 (12) The EMSC Program has proven effective 

16 over two decades in driving key improvements in 

17 emergency medical services to children, and should 

18 continue its mission to reduce child and youth mor19 bidity and mortality by supporting improvements in 

20 the quality of all emergency medical and emergency 

21 surgical care children receive. 

22 (b) PURPOSE.—It is the purpose of this Act to reduce 

23 child and youth morbidity and mortality by supporting im24 provements in the quality of all emergency medical care 

25 children receive. 


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1 SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL 

2 SERVICES FOR CHILDREN PROGRAM. 

3 Section 1910 of the Public Health Service Act (42 

4 U.S.C. 300w–9) is amended— 

5 (1) in subsection (a), by striking ‘‘3-year period 

6 (with an optional 4th year’’ and inserting ‘‘4-year 

7 period (with an optional 5th year’’; 

8 (2) in subsection (d)— 

9 (A) by striking ‘‘and such sums’’ and in10 serting ‘‘such sums’’; and 

11 (B) by inserting before the period the fol12 lowing: ‘‘, $25,000,000 for fiscal year 2009, 

13 $26,250,000 for fiscal year 2010, $27,562,500 

14 for fiscal year 2011, $28,940,625 for fiscal year 

15 2012, and $30,387,656 for fiscal year 2013’’; 

16 (3) by redesignating subsections (b) through (d) 

17 as subsections (c) through (e), respectively; and 

18 (4) by inserting after subsection (a) the fol19 lowing: 

20 ‘‘(b)(1) The purpose of the program established 

21 under this section is to reduce child and youth morbidity 

22 and mortality by supporting improvements in the quality 

23 of all emergency medical care children receive, through the 

24 promotion of projects focused on the expansion and im25 provement of such services, including those in rural areas 

26 and those for children with special healthcare needs. In 


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1 carrying out this purpose, the Secretary shall support 

2 emergency medical services for children by supporting 

3 projects that— 

4 ‘‘(A) develop and present scientific evidence; 

5 ‘‘(B) promote existing and innovative tech6 nologies appropriate for the care of children; or 

7 ‘‘(C) provide information on health outcomes 

8 and effectiveness and cost-effectiveness. 

9 ‘‘(2) The program established under this section 

10 shall— 

11 ‘‘(A) strive to enhance the pediatric capability 

12 of emergency medical service systems originally de13 signed primarily for adults; and 

14 ‘‘(B) in order to avoid duplication and ensure 

15 that Federal resources are used efficiently and effec16 tively, be coordinated with all research, evaluations, 

17 and awards related to emergency medical services 

18 for children undertaken and supported by the Fed19 eral Government.’’. 

Passed the House of Representatives April 8, 2008. 

Attest: LORRAINE C. MILLER, 

Clerk. 


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