IB 

Union Calendar No. 41 

110TH CONGRESS 

1ST SESSION H. R. 477 

[Report No. 110–75] 

To amend the Public Health Service Act to strengthen education, prevention, 

and treatment programs relating to stroke, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 16, 2007 

Mrs. CAPPS (for herself and Mr. PICKERING) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

MARCH 27, 2007 

Additional sponsors: Ms. SLAUGHTER, Mr. TAYLOR, Mr. HINOJOSA, Mr. JEFFERSON, Mr. MCNULTY, Mr. MOORE of Kansas, Ms. SCHAKOWSKY, Ms. 

NORTON, Mr. WAXMAN, Mr. UDALL of New Mexico, Mr. LEWIS of Georgia, Mr. COBLE, Mr. MCCOTTER, Ms. BORDALLO, Mr. CLEAVER, Mr. 

ENGEL, Mr. CLAY, Mrs. DAVIS of California, Mr. GENE GREEN of Texas, 

Mr. ABERCROMBIE, Mr. GONZALEZ, Mr. ALLEN, Mr. TERRY, Mr. 

LYNCH, Mr. GEORGE MILLER of California, Mr. GRIJALVA, Mr. GORDON

of Tennessee, Mr. WEXLER, Mr. MCGOVERN, Mr. KENNEDY, Mr. 

WEINER, Mr. LANTOS, Mrs. JONES of Ohio, Mr. PAYNE, Mr. PLATTS, 

Mr. GERLACH, Mr. JOHNSON of Georgia, Mr. MATHESON, Mr. 

LANGEVIN, Mr. WYNN, Mr. BOUCHER, Mr. BOREN, Mr. SERRANO, Mr. 

TANNER, Mr. MCINTYRE, Ms. WOOLSEY, Mr. CASTLE, Mr. DUNCAN, Ms. 

SUTTON, Mr. ROSS, Mr. FOSSELLA, Mr. MCDERMOTT, Mr. HALL of 

Texas, Mr. CUMMINGS, Mr. AL GREEN of Texas, Mr. SHIMKUS, Mr. 

YOUNG of Alaska, Mr. FARR, Mr. KING of New York, Ms. JACKSON-LEE

of Texas, Mr. OBERSTAR, Ms. HIRONO, Mr. ETHERIDGE, Mr. CRAMER, 

Mr. UDALL of Colorado, Ms. HOOLEY, Mr. TOWNS, Mr. EMANUEL, Ms. 

ESHOO, Mr. WALSH of New York, Mr. MILLER of North Carolina, Mr. 

BRADY of Pennsylvania, Mr. KNOLLENBERG, Mr. COHEN, Mr. REYES, 

Ms. CARSON, Mr. HILL, Mr. BOSWELL, Mr. HINCHEY, Mr. PASCRELL, 

Mr. DAVIS of Alabama, Mr. YOUNG of Florida, Mr. WALDEN of Oregon, 

Ms. LINDA T. SA ́NCHEZ of California, Ms. MCCOLLUM of Minnesota, Mr. 

JINDAL, and Mr. YARMUTH


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MARCH 27, 2007 

Reported with amendments, committed to the Committee of the Whole House 

on the State of the Union, and ordered to be printed 

[Omit the part struck through and insert the part printed in italic] 

A BILL 

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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Stroke Treatment and 

5 Ongoing Prevention Act’’. 

6 SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT 

7 REGARDING STROKE PROGRAMS. 

8 (a) STROKE EDUCATION AND INFORMATION PRO9 GRAMS.—Title III of the Public Health Service Act (42 

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

11 following: 

12 ‘‘PART R S—STROKE EDUCATION, INFORMATION, 

13 AND DATA COLLECTION PROGRAMS 

14 ‘‘SEC. 399AA 399FF. STROKE PREVENTION AND EDUCATION 

15 CAMPAIGN. 

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

17 education and information campaign to promote stroke 


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1 prevention and increase the number of stroke patients who 

2 seek immediate treatment. 

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

4 education and information campaign under subsection (a), 

5 the Secretary may— 

6 ‘‘(1) make public service announcements about 

7 the warning signs of stroke and the importance of 

8 treating stroke as a medical emergency; 

9 ‘‘(2) provide education regarding ways to pre10 vent stroke and the effectiveness of stroke treat11 ment; and 

12 ‘‘(3) carry out other activities that the Sec13 retary determines will promote prevention practices 

14 among the general public and increase the number 

15 of stroke patients who seek immediate care. 

16 ‘‘(c) MEASUREMENTS.—In implementing the edu17 cation and information campaign under subsection (a), the 

18 Secretary shall— 

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

20 of the campaign to provide baseline data that will be 

21 used to evaluate the effectiveness of the public 

22 awareness efforts; 

23 ‘‘(2) establish quantitative benchmarks to meas24 ure the impact of the campaign over time; and 


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

2 less than once every 2 years or, if determined appro3 priate by the Secretary, at shorter intervals. 

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

5 this section, the Secretary shall avoid duplicating existing 

6 stroke education efforts by other Federal Government 

7 agencies. 

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

9 the Secretary may consult with organizations and individ10 uals with expertise in stroke prevention, diagnosis, treat11 ment, and rehabilitation. 

12 ‘‘SEC. 399BB 399GG. PAUL COVERDELL NATIONAL ACUTE 

13 STROKE REGISTRY AND CLEARINGHOUSE. 

14 ‘‘The Secretary, acting through the Centers for Dis15 ease Control and Prevention, shall maintain the Paul 

16 Coverdell National Acute Stroke Registry and Clearing17 house by— 

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

19 data points and appropriate benchmarks for ana20 lyzing care of acute stroke patients; 

21 ‘‘(2) collecting, compiling, and disseminating in22 formation on the achievements of, and problems ex23 perienced by, State and local agencies and private 

24 entities in developing and implementing emergency 


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1 medical systems and hospital-based quality of care 

2 interventions; and 

3 ‘‘(3) carrying out any other activities the Sec4 retary determines to be useful to maintain the Paul 

5 Coverdell National Acute Stroke Registry and Clear6 inghouse to reflect the latest advances in all forms 

7 of stroke care. 

8 ‘‘SEC. 399CC 399HH. STROKE DEFINITION. 

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

10 a ‘brain attack’ in which blood flow to the brain is inter11 rupted or in which a blood vessel or aneurysm in the brain 

12 breaks or ruptures. 

13 ‘‘SEC. 399DD 399II. AUTHORIZATION OF APPROPRIATIONS. 

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

15 this part $5,000,000 for each of fiscal years 2008 through 

16 2012.’’. 

17 (b) EMERGENCY MEDICAL PROFESSIONAL DEVELOP18 MENT.—Section 1251 of the Public Health Service Act 

19 (42 U.S.C. 300d–51) is amended to read as follows: 

20 ‘‘SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN AD21 VANCED STROKE AND TRAUMATIC INJURY 

22 TREATMENT AND PREVENTION. 

23 ‘‘(a) RESIDENCY AND OTHER PROFESSIONAL TRAIN24 ING.—The Secretary may make grants to public and non25 profit entities for the purpose of planning, developing, and 


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1 enhancing approved residency training programs and 

2 other professional training for appropriate health profes3 sions in emergency medicine, including emergency medical 

4 services professionals, to improve stroke and traumatic in5 jury prevention, diagnosis, treatment, and rehabilitation. 

6 ‘‘(b) CONTINUING EDUCATION ON STROKE AND

7 TRAUMATIC INJURY.— 

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

9 the Administrator of the Health Resources and Serv10 ices Administration, may make grants to qualified 

11 entities for the development and implementation of 

12 education programs for appropriate health care pro13 fessionals in the use of newly developed diagnostic 

14 approaches, technologies, and therapies for health 

15 professionals involved in the prevention, diagnosis, 

16 treatment, and rehabilitation of stroke or traumatic 

17 injury. 

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

19 grants under this subsection, the Secretary shall give 

20 preference to qualified entities that will train health 

21 care professionals that serve areas with a significant 

22 incidence of stroke or traumatic injuries. 

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

24 a grant under this subsection shall submit to the 

25 Secretary an application at such time, in such manVerDate Aug 31 2005 00:29 Mar 28, 2007 Jkt 059196 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H477.RH H477

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1 ner, and containing such information as the Sec2 retary may require, including a plan for the rigorous 

3 evaluation of activities carried out with amounts re4 ceived under the grant. 

5 ‘‘(4) DEFINITIONS.—For purposes of this sub6 section: 

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

8 consortium of public and private entities, such 

9 as universities, academic medical centers, hos10 pitals, and emergency medical systems that are 

11 coordinating education activities among pro12 viders serving in a variety of medical settings. 

13 ‘‘(B) The term ‘stroke’ means a ‘brain at14 tack’ in which blood flow to the brain is inter15 rupted or in which a blood vessel or aneurysm 

16 in the brain breaks or ruptures. 

17 ‘‘(c) REPORT.—Not later than 1 year after the alloca18 tion of grants under this section, the Secretary shall sub19 mit to the Committee on Health, Education, Labor, and 

20 Pensions of the Senate and the Committee on Energy and 

21 Commerce of the House of Representatives a report on 

22 the results of activities carried out with amounts received 

23 under this section. 

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

25 is authorized to be appropriated to carry out this section 


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1 $4,000,000 for each of fiscal years 2008 through 2012. 

2 The Secretary shall equitably allocate the funds author3 ized to be appropriated under this section between efforts 

4 to address stroke and efforts to address traumatic in5 jury.’’. 

6 SEC. 3. PILOT PROJECT ON TELEHEALTH STROKE TREAT7 MENT. 

8 (a) ESTABLISHMENT.—Part D of title III of the Pub9 lic Health Service Act (42 U.S.C. 254b et seq.) is amended 

10 by inserting after section 330L the following: 

11 ‘‘SEC. 330M. TELEHEALTH STROKE TREATMENT GRANT 

12 PROGRAM. 

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

14 States, and to consortia of public and private entities lo15 cated in any State that is not a grantee under this section, 

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

17 years 2008 through 2012 to improve stroke patient out18 comes by coordinating health care delivery through tele19 health networks. 

20 ‘‘(b) ADMINISTRATION.—The Secretary shall admin21 ister this section through the Director of the Office for 

22 the Advancement of Telehealth. 

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

24 for the purpose of better coordinating program activities, 

25 the Secretary shall consult with— 


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1 ‘‘(1) officials responsible for other Federal pro2 grams involving stroke research and care, including 

3 such programs established by the Stroke Treatment 

4 and Ongoing Prevention Act; and 

5 ‘‘(2) organizations and individuals with exper6 tise in stroke prevention, diagnosis, treatment, and 

7 rehabilitation. 

8 ‘‘(d) USE OF FUNDS.— 

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

10 make a grant to a State or a consortium under this 

11 section unless the State or consortium agrees to use 

12 the grant for the purpose of— 

13 ‘‘(A) identifying entities with expertise in 

14 the delivery of high-quality stroke prevention, 

15 diagnosis, treatment, and rehabilitation; 

16 ‘‘(B) working with those entities to estab17 lish or improve telehealth networks to provide 

18 stroke treatment assistance and resources to 

19 health care professionals, hospitals, and other 

20 individuals and entities that serve stroke pa21 tients; 

22 ‘‘(C) informing emergency medical systems 

23 of the location of entities identified under sub24 paragraph (A) to facilitate the appropriate 

25 transport of individuals with stroke symptoms; 


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1 ‘‘(D) establishing networks to coordinate 

2 collaborative activities for stroke prevention, di3 agnosis, treatment, and rehabilitation; 

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

5 stroke care, especially for populations with a 

6 shortage of stroke care specialists and popu7 lations with a high incidence of stroke; and 

8 ‘‘(F) conducting ongoing performance and 

9 quality evaluations to identify collaborative ac10 tivities that improve clinical outcomes for stroke 

11 patients. 

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

13 Secretary may not make a grant to a State under 

14 this section unless the State agrees to establish a 

15 consortium of public and private entities, including 

16 universities and academic medical centers, to carry 

17 out the activities described in paragraph (1). 

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

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

20 an existing telehealth network that is or may be 

21 used for improving stroke prevention, diagnosis, 

22 treatment, and rehabilitation, or to a consortium lo23 cated in such a State, unless the State or consor24 tium agrees that— 


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

2 existing telehealth network to achieve the pur3 pose of the grant; and 

4 ‘‘(B) the State or consortium will not es5 tablish a separate network for such purpose. 

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

7 this section, the Secretary shall give priority to any appli8 cant that submits a plan demonstrating how the applicant, 

9 and where applicable the members of the consortium de10 scribed in subsection (d)(2), will use the grant to improve 

11 access to high-quality stroke care for populations with 

12 shortages of stroke-care specialists and populations with 

13 a high incidence of stroke. 

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

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

16 any period that— 

17 ‘‘(1) is greater than 3 years; or 

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

19 2012. 

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

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

22 the Secretary may not award more than 7 grants. 

23 ‘‘(h) APPLICATION.—To seek a grant under this sec24 tion, a State or a consortium of public and private entities 

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


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1 in such manner, and containing such information as the 

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

3 require each such application to outline how the State or 

4 consortium will establish baseline measures and bench5 marks to evaluate program outcomes. 

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

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

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

9 the brain breaks or ruptures. 

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

11 are authorized to be appropriated to carry out this section 

12 $10,000,000 for fiscal year 2008, $13,000,000 for fiscal 

13 year 2009, $15,000,000 for fiscal year 2010, $8,000,000 

14 for fiscal year 2011, and $4,000,000 for fiscal year 

15 2012.’’. 

16 (b) STUDY; REPORTS.— 

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

18 2013, the Secretary of Health and Human Services 

19 shall conduct a study of the results of the telehealth 

20 stroke treatment grant program under section 330M 

21 of the Public Health Service Act (added by sub22 section (a)) and submit to the Congress a report on 

23 such results that includes the following: 


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1 (A) An evaluation of the grant program 

2 outcomes, including quantitative analysis of 

3 baseline and benchmark measures. 

4 (B) Recommendations on how to promote 

5 stroke networks in ways that improve access to 

6 clinical care in rural and urban areas and re7 duce the incidence of stroke and the debilitating 

8 and costly complications resulting from stroke. 

9 (C) Recommendations on whether similar 

10 telehealth grant programs could be used to im11 prove patient outcomes in other public health 

12 areas. 

13 (2) INTERIM REPORTS.—The Secretary of 

14 Health and Human Services may provide interim re15 ports to the Congress on the telehealth stroke treat16 ment grant program under section 330M of the 

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

18 at such intervals as the Secretary determines to be 

19 appropriate. 

20 SEC. 4. RULE OF CONSTRUCTION. 

21 Nothing in this Act shall be construed to authorize 

22 the Secretary of Health and Human Services to establish 

23 Federal standards for the treatment of patients or the li24 censure of health care professionals. 


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Union Calendar No. 41 

110TH CONGRESS 

1ST SESSION H. R. 477 

[Report No. 110

–75] 

A BILL 

To amend the Public Health Service Act to 

poses. programs relating to stroke, and for other purstrengthen education, prevention, and treatment 

MARCH 27, 2007 

Reported with amendments, committed to the Committee 

dered to be printed of the Whole House on the State of the Union, and orVerDate Aug 31 2005 00:29 Mar 28, 2007 Jkt 059196 PO 00000 Frm 00014 Fmt 6651 Sfmt 6651 E:\BILLS\H477.RH H477

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