IIB 

108TH CONGRESS 

2D SESSION H. R. 3658 

IN THE SENATE OF THE UNITED STATES 

JUNE 15, 2004 

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

Labor, and Pensions 

AN ACT 

To amend the Public Health Service Act to strengthen education, prevention, and treatment programs relating to 

stroke, 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 ‘‘Stroke Treatment and 

3 Ongoing Prevention Act’’. 

4 SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT 

5 REGARDING STROKE PROGRAMS. 

6 (a) STROKE EDUCATION AND INFORMATION PRO7 GRAMS.—Title III of the Public Health Service Act (42 

8 U.S.C. 241 et seq.) is amended by adding at the end the 

9 following: 

10 ‘‘PART R—STROKE EDUCATION, INFORMATION, 

11 AND DATA COLLECTION PROGRAMS 

12 ‘‘SEC. 399AA. STROKE PREVENTION AND EDUCATION CAM13 PAIGN. 

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

15 education and information campaign to promote stroke 

16 prevention and increase the number of stroke patients who 

17 seek immediate treatment. 

18 ‘‘(b) AUTHORIZED ACTIVITIES.—In implementing the 

19 education and information campaign under subsection (a), 

20 the Secretary may— 

21 ‘‘(1) make public service announcements about 

22 the warning signs of stroke and the importance of 

23 treating stroke as a medical emergency; 

24 ‘‘(2) provide education regarding ways to pre25 vent stroke and the effectiveness of stroke treat26 ment; and 
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1 ‘‘(3) carry out other activities that the Sec2 retary determines will promote prevention practices 

3 among the general public and increase the number 

4 of stroke patients who seek immediate care. 

5 ‘‘(c) MEASUREMENTS.—In implementing the edu6 cation and information campaign under subsection (a), the 

7 Secretary shall— 

8 ‘‘(1) measure public awareness before the start 

9 of the campaign to provide baseline data that will be 

10 used to evaluate the effectiveness of the public 

11 awareness efforts; 

12 ‘‘(2) establish quantitative benchmarks to meas13 ure the impact of the campaign over time; and 

14 ‘‘(3) measure the impact of the campaign not 

15 less than once every 2 years or, if determined appro16 priate by the Secretary, at shorter intervals. 

17 ‘‘(d) NO DUPLICATION OF EFFORT.—In carrying out 

18 this section, the Secretary shall avoid duplicating existing 

19 stroke education efforts by other Federal Government 

20 agencies. 

21 ‘‘(e) CONSULTATION.—In carrying out this section, 

22 the Secretary may consult with organizations and individ23 uals with expertise in stroke prevention, diagnosis, treat24 ment, and rehabilitation. 
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1 ‘‘SEC. 399BB. PAUL COVERDELL NATIONAL ACUTE STROKE 

2 REGISTRY AND CLEARINGHOUSE. 

3 ‘‘The Secretary, acting through the Centers for Dis4 ease Control and Prevention, shall maintain the Paul 

5 Coverdell National Acute Stroke Registry and Clearing6 house by— 

7 ‘‘(1) continuing to develop and collect specific 

8 data points and appropriate benchmarks for ana9 lyzing care of acute stroke patients; 

10 ‘‘(2) collecting, compiling, and disseminating in11 formation on the achievements of, and problems ex12 perienced by, State and local agencies and private 

13 entities in developing and implementing emergency 

14 medical systems and hospital-based quality of care 

15 interventions; and 

16 ‘‘(3) carrying out any other activities the Sec17 retary determines to be useful to maintain the Paul 

18 Coverdell National Acute Stroke Registry and Clear19 inghouse to reflect the latest advances in all forms 

20 of stroke care. 

21 ‘‘SEC. 399CC. STROKE DEFINITION. 

22 ‘‘For purposes of this part, the term ‘stroke’ means 

23 a ‘brain attack’ in which blood flow to the brain is inter24 rupted or in which a blood vessel or aneurysm in the brain 

25 breaks or ruptures. 
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1 ‘‘SEC. 399DD. AUTHORIZATION OF APPROPRIATIONS. 

2 ‘‘There is authorized to be appropriated to carry out 

3 this part $5,000,000 for each of fiscal years 2005 through 

4 2009.’’. 

5 (b) EMERGENCY MEDICAL PROFESSIONAL DEVELOP6 MENT.—Section 1251 of the Public Health Service Act 

7 (42 U.S.C. 300d–51) is amended to read as follows: 

8 ‘‘SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN AD9 VANCED STROKE AND TRAUMATIC INJURY 

10 TREATMENT AND PREVENTION. 

11 ‘‘(a) RESIDENCY AND OTHER PROFESSIONAL TRAIN12 ING.—The Secretary may make grants to public and non13 profit entities for the purpose of planning, developing, and 

14 enhancing approved residency training programs and 

15 other professional training for appropriate health profes16 sions in emergency medicine, including emergency medical 

17 services professionals, to improve stroke and traumatic in18 jury prevention, diagnosis, treatment, and rehabilitation. 

19 ‘‘(b) CONTINUING EDUCATION ON STROKE AND

20 TRAUMATIC INJURY.— 

21 ‘‘(1) GRANTS.—The Secretary, acting through 

22 the Administrator of the Health Resources and Serv23 ices Administration, may make grants to qualified 

24 entities for the development and implementation of 

25 education programs for appropriate health care pro26 fessionals in the use of newly developed diagnostic 
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1 approaches, technologies, and therapies for health 

2 professionals involved in the prevention, diagnosis, 

3 treatment, and rehabilitation of stroke or traumatic 

4 injury. 

5 ‘‘(2) DISTRIBUTION OF GRANTS.—In awarding 

6 grants under this subsection, the Secretary shall give 

7 preference to qualified entities that will train health 

8 care professionals that serve areas with a significant 

9 incidence of stroke or traumatic injuries. 

10 ‘‘(3) APPLICATION.—A qualified entity desiring 

11 a grant under this subsection shall submit to the 

12 Secretary an application at such time, in such man13 ner, and containing such information as the Sec14 retary may require, including a plan for the rigorous 

15 evaluation of activities carried out with amounts re16 ceived under the grant. 

17 ‘‘(4) DEFINITIONS.—For purposes of this sub18 section: 

19 ‘‘(A) The term ‘qualified entity’ means a 

20 consortium of public and private entities, such 

21 as universities, academic medical centers, hos22 pitals, and emergency medical systems that are 

23 coordinating education activities among pro24 viders serving in a variety of medical settings. 
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1 ‘‘(B) The term ‘stroke’ means a ‘brain at2 tack’ in which blood flow to the brain is inter3 rupted or in which a blood vessel or aneurysm 

4 in the brain breaks or ruptures. 

5 ‘‘(c) REPORT.—Not later than 1 year after the alloca6 tion of grants under this section, the Secretary shall sub7 mit to the Committee on Health, Education, Labor, and 

8 Pensions of the Senate and the Committee on Energy and 

9 Commerce of the House of Representatives a report on 

10 the results of activities carried out with amounts received 

11 under this section. 

12 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

13 is authorized to be appropriated to carry out this section 

14 $4,000,000 for each of fiscal years 2005 through 2009. 

15 The Secretary shall equitably allocate the funds author16 ized to be appropriated under this section between efforts 

17 to address stroke and efforts to address traumatic in18 jury.’’. 

19 SEC. 3. PILOT PROJECT ON TELEHEALTH STROKE TREAT20 MENT. 

21 (a) ESTABLISHMENT.—Part D of title III of the Pub22 lic Health Service Act (42 U.S.C. 254b et seq.) is amended 

23 by inserting after section 330L the following: 
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1 ‘‘SEC. 330M. TELEHEALTH STROKE TREATMENT GRANT 

2 PROGRAM. 

3 ‘‘(a) GRANTS.—The Secretary may make grants to 

4 States, and to consortia of public and private entities lo5 cated in any State that is not a grantee under this section, 

6 to conduct a 5-year pilot project over the period of fiscal 

7 years 2005 through 2009 to improve stroke patient out8 comes by coordinating health care delivery through tele9 health networks. 

10 ‘‘(b) ADMINISTRATION.—The Secretary shall admin11 ister this section through the Director of the Office for 

12 the Advancement of Telehealth. 

13 ‘‘(c) CONSULTATION.—In carrying out this section, 

14 for the purpose of better coordinating program activities, 

15 the Secretary shall consult with— 

16 ‘‘(1) officials responsible for other Federal pro17 grams involving stroke research and care, including 

18 such programs established by the Stroke Treatment 

19 and Ongoing Prevention Act; and 

20 ‘‘(2) organizations and individuals with exper21 tise in stroke prevention, diagnosis, treatment, and 

22 rehabilitation. 

23 ‘‘(d) USE OF FUNDS.— 

24 ‘‘(1) IN GENERAL.—The Secretary may not 

25 make a grant to a State or a consortium under this 
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1 section unless the State or consortium agrees to use 

2 the grant for the purpose of— 

3 ‘‘(A) identifying entities with expertise in 

4 the delivery of high-quality stroke prevention, 

5 diagnosis, treatment, and rehabilitation; 

6 ‘‘(B) working with those entities to estab7 lish or improve telehealth networks to provide 

8 stroke treatment assistance and resources to 

9 health care professionals, hospitals, and other 

10 individuals and entities that serve stroke pa11 tients; 

12 ‘‘(C) informing emergency medical systems 

13 of the location of entities identified under sub14 paragraph (A) to facilitate the appropriate 

15 transport of individuals with stroke symptoms; 

16 ‘‘(D) establishing networks to coordinate 

17 collaborative activities for stroke prevention, di18 agnosis, treatment, and rehabilitation; 

19 ‘‘(E) improving access to high-quality 

20 stroke care, especially for populations with a 

21 shortage of stroke care specialists and popu22 lations with a high incidence of stroke; and 

23 ‘‘(F) conducting ongoing performance and 

24 quality evaluations to identify collaborative ac-
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1 tivities that improve clinical outcomes for stroke 

2 patients. 

3 ‘‘(2) ESTABLISHMENT OF CONSORTIUM.—The 

4 Secretary may not make a grant to a State under 

5 this section unless the State agrees to establish a 

6 consortium of public and private entities, including 

7 universities and academic medical centers, to carry 

8 out the activities described in paragraph (1). 

9 ‘‘(3) PROHIBITION.—The Secretary may not 

10 make a grant under this section to a State that has 

11 an existing telehealth network that is or may be 

12 used for improving stroke prevention, diagnosis, 

13 treatment, and rehabilitation, or to a consortium lo14 cated in such a State, unless the State or consor15 tium agrees that— 

16 ‘‘(A) the State or consortium will use an 

17 existing telehealth network to achieve the pur18 pose of the grant; and 

19 ‘‘(B) the State or consortium will not es20 tablish a separate network for such purpose. 

21 ‘‘(e) PRIORITY.—In selecting grant recipients under 

22 this section, the Secretary shall give priority to any appli23 cant that submits a plan demonstrating how the applicant, 

24 and where applicable the members of the consortium de25 scribed in subsection (d)(2), will use the grant to improve 
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1 access to high-quality stroke care for populations with 

2 shortages of stroke-care specialists and populations with 

3 a high incidence of stroke. 

4 ‘‘(f) GRANT PERIOD.—The Secretary may not award 

5 a grant to a State or a consortium under this section for 

6 any period that— 

7 ‘‘(1) is greater than 3 years; or 

8 ‘‘(2) extends beyond the end of fiscal year 

9 2009. 

10 ‘‘(g) RESTRICTION ON NUMBER OF GRANTS.—In 

11 carrying out the 5-year pilot project under this section, 

12 the Secretary may not award more than 7 grants. 

13 ‘‘(h) APPLICATION.—To seek a grant under this sec14 tion, a State or a consortium of public and private entities 

15 shall submit an application to the Secretary in such form, 

16 in such manner, and containing such information as the 

17 Secretary may require. At a minimum, the Secretary shall 

18 require each such application to outline how the State or 

19 consortium will establish baseline measures and bench20 marks to evaluate program outcomes. 

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

22 means a ‘brain attack’ in which blood flow to the brain 

23 is interrupted or in which a blood vessel or aneurysm in 

24 the brain breaks or ruptures. 
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1 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to carry out this section 

3 $10,000,000 for fiscal year 2005, $13,000,000 for fiscal 

4 year 2006, $15,000,000 for fiscal year 2007, $8,000,000 

5 for fiscal year 2008, and $4,000,000 for fiscal year 

6 2009.’’. 

7 (b) STUDY; REPORTS.— 

8 (1) FINAL REPORT.—Not later than March 31, 

9 2010, the Secretary of Health and Human Services 

10 shall conduct a study of the results of the telehealth 

11 stroke treatment grant program under section 330M 

12 of the Public Health Service Act (added by sub13 section (a)) and submit to the Congress a report on 

14 such results that includes the following: 

15 (A) An evaluation of the grant program 

16 outcomes, including quantitative analysis of 

17 baseline and benchmark measures. 

18 (B) Recommendations on how to promote 

19 stroke networks in ways that improve access to 

20 clinical care in rural and urban areas and re21 duce the incidence of stroke and the debilitating 

22 and costly complications resulting from stroke. 

23 (C) Recommendations on whether similar 

24 telehealth grant programs could be used to im-
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1 prove patient outcomes in other public health 

2 areas. 

3 (2) INTERIM REPORTS.—The Secretary of 

4 Health and Human Services may provide interim re5 ports to the Congress on the telehealth stroke treat6 ment grant program under section 330M of the 

7 Public Health Service Act (added by subsection (a)) 

8 at such intervals as the Secretary determines to be 

9 appropriate. 

10 SEC. 4. RULE OF CONSTRUCTION. 

11 Nothing in this Act shall be construed to authorize 

12 the Secretary of Health and Human Services to establish 

13 Federal standards for the treatment of patients or the li14 censure of health care professionals. 

Passed the House of Representatives June 14, 2004. 

Attest: JEFF TRANDAHL, 

Clerk.