I 

111TH CONGRESS 

1ST SESSION H. R. 855 

To amend the Public Health Service Act to authorize medical simulation 

enhancement programs, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 4, 2009 

Mr. FORBES (for himself and Mr. KENNEDY) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to authorize medical 

simulation enhancement programs, 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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Enhancing Safety in 

5 Medicine Utilizing Leading Advanced Simulation Tech6 nologies to Improve Outcomes Now Act of 2009’’. 

7 SEC. 2. FINDINGS. 

8 The Congress finds as follows: 

9 (1) Simulation-based education and training in 

10 medicine, nursing, allied health, podiatry, osteopVerDate Nov 24 2008 04:31 Feb 06, 2009 Jkt 079200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H855.IH H855

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1 athy, dentistry, and emergency response teams can 

2 enhance procedural skills and reinforce best prac3 tices by allowing students, experienced clinicians, 

4 and health care professionals to practice procedures 

5 in a realistic setting. 

6 (2) The enhanced clinical skill development pro7 vided by simulation-based training benefits patients 

8 and health care consumers in the form of improved 

9 health outcomes, patient safety, and quality; reduced 

10 medical errors and deaths; and reduced costs associ11 ated with providing patient care. 

12 (3) Many educational institutions and health 

13 care providers, particularly those in urban and rural 

14 settings, have difficulty acquiring medical simulation 

15 technology. Financial assistance in the form of Fed16 eral grants would significantly enhance the ability of 

17 these entities to deploy medical simulation tech18 nology and incorporate such technology into training 

19 protocols. 

20 (4) The creation of medical simulation centers 

21 of excellence to provide guidance and leadership to 

22 educational institutions and health care entities will 

23 facilitate the deployment of medical simulation tech24 nologies and the commercialization of cutting-edge 

25 medical simulation research. 


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1 (5) A Federal medical simulation coordinating 

2 council would promote better communication and 

3 collaboration between the Federal entities with expe4 rience or interest in simulation-based education and 

5 medical simulation technology deployment. 

6 SEC. 3. MEDICAL SIMULATION ENHANCEMENT. 

7 Part B of title IX of the Public Health Service Act 

8 (42 U.S.C. 299b et seq.) is amended by adding at the end 

9 the following: 

10 ‘‘SEC. 918. MEDICAL SIMULATION ENHANCEMENT. 

11 ‘‘(a) IN GENERAL.—The Director shall conduct and 

12 support research, evaluations, initiatives, and demonstra13 tion projects, and provide grants or enter into contracts 

14 or cooperative agreements, to enhance the deployment of 

15 medical simulation technologies and the incorporation of 

16 such technologies and equipment into medical, nursing, al17 lied health, podiatric, osteopathic, and dental education 

18 and training protocols. 

19 ‘‘(b) PROGRAMS.—In carrying out subsection (a), the 

20 Director shall establish the following programs: 

21 ‘‘(1) MEDICAL SIMULATION CENTERS OF EX22 CELLENCE.— 

23 ‘‘(A) ESTABLISHMENT.—The Director 

24 shall establish medical simulation centers of ex25 cellence— 


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1 ‘‘(i) to provide leadership and conduct 

2 research with respect to enhancing and ex3 panding the utilization of medical simula4 tion technologies and simulation-based 

5 skills training for physicians, nurses, allied 

6 health professionals, and qualified stu7 dents; and 

8 ‘‘(ii) to improve the efficiency and ef9 fectiveness of medical simulation research 

10 and programs. 

11 ‘‘(B) PURPOSE.—Each medical simulation 

12 center of excellence established under sub13 section (a) shall— 

14 ‘‘(i) provide leadership in a specific 

15 area of medical simulation technology or 

16 knowledge; 

17 ‘‘(ii) enhance and expand the knowl18 edge base within the specific area of med19 ical simulation technology or knowledge in 

20 line with the program requirements and 

21 the long-term interests of the medical sim22 ulation community; and 

23 ‘‘(iii) serve as a resource center to in24 terested health professional schools and inVerDate Nov 24 2008 04:31 Feb 06, 2009 Jkt 079200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H855.IH H855

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1 dividuals who want to learn about medical 

2 simulation. 

3 ‘‘(2) MEDICAL SIMULATION INNOVATION.—The 

4 Director shall promote innovation in medical simula5 tion technologies and encourage development and de6 ployment of challenging and complex medical simula7 tion technologies and applications by— 

8 ‘‘(A) conducting and supporting research 

9 on the development and deployment of complex 

10 or challenging medical simulation and inter11 disciplinary simulation technologies; 

12 ‘‘(B) identifying, in consultation with the 

13 Telemedicine and Advanced Technology Re14 search Center, particularly challenging or com15 plex medical simulation technologies and appli16 cations; and 

17 ‘‘(C) developing, in consultation with the 

18 National Library of Medicine, an electronic 

19 clearinghouse of medical simulation technologies 

20 currently available and those being developed. 

21 ‘‘(3) MEDICAL SIMULATION TECHNOLOGY AC22 QUISITION.— 

23 ‘‘(A) GRANTS.—The Director shall award 

24 grants to eligible entities for the purchase of 

25 medical simulation technologies for use in the 


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1 training of physicians, nurses, allied health pro2 fessionals, and qualified students. 

3 ‘‘(B) DEFINITION.—In this paragraph, the 

4 term ‘eligible entity’ means a hospital, an aca5 demic medical center, or a school of allied 

6 health, dentistry, medicine, nursing, osteopathic 

7 medicine, or podiatric medicine. 

8 ‘‘(4) MEDICAL AND INTERDISCIPLINARY SIM9 ULATION CURRICULA.— 

10 ‘‘(A) GRANTS.—The Director shall award 

11 grants to eligible entities to incorporate medical 

12 simulation and interdisciplinary simulation 

13 technologies into curricula and training of phy14 sicians, nurses, and allied health professionals. 

15 ‘‘(B) DEFINITION.—In this subsection, the 

16 term ‘eligible entity’ means an academic med17 ical center or a school of medicine, osteopathy, 

18 podiatry, dentistry, nursing, or allied health. 

19 ‘‘(5) GRANTS TO PROFESSIONAL ORGANIZA20 TIONS.— 

21 ‘‘(A) GRANTS.—The Director shall award 

22 grants to eligible entities to deploy medical sim23 ulation technologies for the purpose of pro24 viding training to health care providers. 


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1 ‘‘(B) DEFINITION.—In this paragraph, the 

2 term ‘eligible entity’ means an academic med3 ical center, a professional organization that pro4 vides accreditation or quality assurance to 

5 health care professionals, a health profession li6 censing board, or an agency studying utilization 

7 of simulation-based methods in credentialing 

8 and accreditation in health care. 

9 ‘‘(6) FEDERAL MEDICAL SIMULATION COORDI10 NATING COUNCIL.— 

11 ‘‘(A) ESTABLISHMENT.—There is estab12 lished within the Department of Health and 

13 Human Services the Federal Medical Simula14 tion Coordinating Council (in this paragraph re15 ferred to as the ‘Coordinating Council’). 

16 ‘‘(B) PURPOSE.—The Coordinating Coun17 cil shall coordinate the Federal Government’s 

18 activities regarding the research on and devel19 opment, deployment, and utilization of medical 

20 simulation technologies. 

21 ‘‘(C) VOTING MEMBERS.—The voting 

22 members of the Coordinating Council shall con23 sist of representatives of Federal agencies with 

24 responsibility for improving health care delivery 

25 to patients, as follows: 


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1 ‘‘(i) A majority of the voting members 

2 of the Coordinating Council shall be rep3 resentatives of the Department of Health 

4 and Human Services. Such majority shall 

5 consist of the Director and such individ6 uals as may be appointed by the Secretary 

7 of Health and Human Services. At a min8 imum, the Secretary shall appoint rep9 resentatives of— 

10 ‘‘(I) the Agency for Healthcare 

11 Research and Quality; 

12 ‘‘(II) the National Institutes of 

13 Health; 

14 ‘‘(III) the Health Resources and 

15 Services Administration; 

16 ‘‘(IV) the Centers for Medicare & 

17 Medicaid Services; and 

18 ‘‘(V) the Food and Drug Admin19 istration. 

20 ‘‘(ii) The remainder of the voting 

21 members of the Coordinating Council shall 

22 consist of— 

23 ‘‘(I) representatives of the De24 partment of Defense, appointed by the 

25 Secretary of Defense; and 


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1 ‘‘(II) representatives of the De2 partment of Veterans Affairs, ap3 pointed by the Secretary of Veterans 

4 Affairs. 

5 ‘‘(D) LIAISONS.—In addition to the voting 

6 members appointed pursuant to subparagraph 

7 (C), the membership of the Coordinating Coun8 cil shall include 2 representatives of the advi9 sory panel established under subsection (c) 

10 who— 

11 ‘‘(i) shall be selected by the Secretary 

12 of Health and Human Services, the Sec13 retary of Defense, and the Secretary of 

14 Veterans Affairs acting jointly; 

15 ‘‘(ii) shall be nonvoting members; and 

16 ‘‘(iii) shall serve as liaisons between 

17 the advisory panel and the Coordinating 

18 Council. 

19 ‘‘(E) LEADERSHIP.—The Director shall 

20 serve as the Chair of the Coordinating Council 

21 and shall be responsible for the leadership and 

22 oversight of the activities of the Coordinating 

23 Council. 

24 ‘‘(F) CONSULTATION.—In carrying out the 

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1 ordinating Council shall consult with outside or2 ganizations on ways to improve medical simula3 tion policy and access. 

4 ‘‘(G) MEETINGS.— 

5 ‘‘(i) IN GENERAL.—The Coordinating 

6 Council shall meet regularly and no less 

7 than 2 times each year. 

8 ‘‘(ii) NOTICE.—Notice of any upcom9 ing meeting of the Coordinating Council 

10 shall be published in the Federal Register. 

11 ‘‘(iii) PUBLIC ACCESS.—Any meeting 

12 of the Coordinating Council shall be open 

13 to the public. 

14 ‘‘(c) ADVISORY PANEL.—The Director shall establish 

15 an advisory panel to make recommendations on how to 

16 structure the programs under subsection (b). The mem17 bers of such advisory panel shall consist of a total of at 

18 least 10 representatives of the medical simulation commu19 nity, including representatives of— 

20 ‘‘(1) academic medical centers or schools of 

21 medicine, osteopathy, podiatry, dentistry, nursing, or 

22 allied health; 

23 ‘‘(2) health care professionals who are actively 

24 involved in medical simulation centers; and 


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1 ‘‘(3) at least 2 multidisciplinary associations 

2 which are recognized as having a primary focus on 

3 medical simulation. 

4 ‘‘(d) DEFINITIONS.— 

5 ‘‘(1) MEDICAL SIMULATION.—The term ‘med6 ical simulation’ means the use of a device, such as 

7 a mannequin, a task trainer, virtual reality, or a 

8 standardized patient, to emulate a real device, pa9 tient, or patient care situation or environment to 

10 teach therapeutic and diagnostic procedures, proc11 esses, medical concepts, and decisionmaking to a 

12 health care professional. 

13 ‘‘(2) QUALIFIED STUDENT.—The term ‘quali14 fied student’ means a student enrolled full-time or 

15 part-time in— 

16 ‘‘(A) a school of allied health, a school of 

17 dentistry, a school of medicine, a school of os18 teopathic medicine, or a school of podiatric 

19 medicine (as such terms are defined in section 

20 799B); or 

21 ‘‘(B) a school of nursing (as such term is 

22 defined in section 801). 

23 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

24 carry out this section, there are authorized to be appro25 priated— 


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1 ‘‘(1) $50,000,000 for fiscal year 2010; and 

2 ‘‘(2) such sums as may be necessary for fiscal 

3 years 2011 through 2014.’’. 

Æ 


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