I 

110TH CONGRESS 

1ST SESSION H. R. 477 

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 

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 


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

2 following: 

3 ‘‘PART R—STROKE EDUCATION, INFORMATION, 

4 AND DATA COLLECTION PROGRAMS 

5 ‘‘SEC. 399AA. STROKE PREVENTION AND EDUCATION CAM6 PAIGN. 

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

8 education and information campaign to promote stroke 

9 prevention and increase the number of stroke patients who 

10 seek immediate treatment. 

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

12 education and information campaign under subsection (a), 

13 the Secretary may— 

14 ‘‘(1) make public service announcements about 

15 the warning signs of stroke and the importance of 

16 treating stroke as a medical emergency; 

17 ‘‘(2) provide education regarding ways to pre18 vent stroke and the effectiveness of stroke treat19 ment; and 

20 ‘‘(3) carry out other activities that the Sec21 retary determines will promote prevention practices 

22 among the general public and increase the number 

23 of stroke patients who seek immediate care. 


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1 ‘‘(c) MEASUREMENTS.—In implementing the edu2 cation and information campaign under subsection (a), the 

3 Secretary shall— 

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

5 of the campaign to provide baseline data that will be 

6 used to evaluate the effectiveness of the public 

7 awareness efforts; 

8 ‘‘(2) establish quantitative benchmarks to meas9 ure the impact of the campaign over time; and 

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

11 less than once every 2 years or, if determined appro12 priate by the Secretary, at shorter intervals. 

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

14 this section, the Secretary shall avoid duplicating existing 

15 stroke education efforts by other Federal Government 

16 agencies. 

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

18 the Secretary may consult with organizations and individ19 uals with expertise in stroke prevention, diagnosis, treat20 ment, and rehabilitation. 

21 ‘‘SEC. 399BB. PAUL COVERDELL NATIONAL ACUTE STROKE 

22 REGISTRY AND CLEARINGHOUSE. 

23 ‘‘The Secretary, acting through the Centers for Dis24 ease Control and Prevention, shall maintain the Paul 


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1 Coverdell National Acute Stroke Registry and Clearing2 house by— 

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

4 data points and appropriate benchmarks for ana5 lyzing care of acute stroke patients; 

6 ‘‘(2) collecting, compiling, and disseminating in7 formation on the achievements of, and problems ex8 perienced by, State and local agencies and private 

9 entities in developing and implementing emergency 

10 medical systems and hospital-based quality of care 

11 interventions; and 

12 ‘‘(3) carrying out any other activities the Sec13 retary determines to be useful to maintain the Paul 

14 Coverdell National Acute Stroke Registry and Clear15 inghouse to reflect the latest advances in all forms 

16 of stroke care. 

17 ‘‘SEC. 399CC. STROKE DEFINITION. 

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

19 a ‘brain attack’ in which blood flow to the brain is inter20 rupted or in which a blood vessel or aneurysm in the brain 

21 breaks or ruptures. 

22 ‘‘SEC. 399DD. AUTHORIZATION OF APPROPRIATIONS. 

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

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

25 2012.’’. 


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1 (b) EMERGENCY MEDICAL PROFESSIONAL DEVELOP2 MENT.—Section 1251 of the Public Health Service Act 

3 (42 U.S.C. 300d–51) is amended to read as follows: 

4 ‘‘SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN AD5 VANCED STROKE AND TRAUMATIC INJURY 

6 TREATMENT AND PREVENTION. 

7 ‘‘(a) RESIDENCY AND OTHER PROFESSIONAL TRAIN8 ING.—The Secretary may make grants to public and non9 profit entities for the purpose of planning, developing, and 

10 enhancing approved residency training programs and 

11 other professional training for appropriate health profes12 sions in emergency medicine, including emergency medical 

13 services professionals, to improve stroke and traumatic in14 jury prevention, diagnosis, treatment, and rehabilitation. 

15 ‘‘(b) CONTINUING EDUCATION ON STROKE AND

16 TRAUMATIC INJURY.— 

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

18 the Administrator of the Health Resources and Serv19 ices Administration, may make grants to qualified 

20 entities for the development and implementation of 

21 education programs for appropriate health care pro22 fessionals in the use of newly developed diagnostic 

23 approaches, technologies, and therapies for health 

24 professionals involved in the prevention, diagnosis, 


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1 treatment, and rehabilitation of stroke or traumatic 

2 injury. 

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

4 grants under this subsection, the Secretary shall give 

5 preference to qualified entities that will train health 

6 care professionals that serve areas with a significant 

7 incidence of stroke or traumatic injuries. 

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

9 a grant under this subsection shall submit to the 

10 Secretary an application at such time, in such man11 ner, and containing such information as the Sec12 retary may require, including a plan for the rigorous 

13 evaluation of activities carried out with amounts re14 ceived under the grant. 

15 ‘‘(4) DEFINITIONS.—For purposes of this sub16 section: 

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

18 consortium of public and private entities, such 

19 as universities, academic medical centers, hos20 pitals, and emergency medical systems that are 

21 coordinating education activities among pro22 viders serving in a variety of medical settings. 

23 ‘‘(B) The term ‘stroke’ means a ‘brain at24 tack’ in which blood flow to the brain is interVerDate Aug 31 2005 22:27 Jan 17, 2007 Jkt 059200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H477.IH H477

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1 rupted or in which a blood vessel or aneurysm 

2 in the brain breaks or ruptures. 

3 ‘‘(c) REPORT.—Not later than 1 year after the alloca4 tion of grants under this section, the Secretary shall sub5 mit to the Committee on Health, Education, Labor, and 

6 Pensions of the Senate and the Committee on Energy and 

7 Commerce of the House of Representatives a report on 

8 the results of activities carried out with amounts received 

9 under this section. 

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

11 is authorized to be appropriated to carry out this section 

12 $4,000,000 for each of fiscal years 2008 through 2012. 

13 The Secretary shall equitably allocate the funds author14 ized to be appropriated under this section between efforts 

15 to address stroke and efforts to address traumatic in16 jury.’’. 

17 SEC. 3. PILOT PROJECT ON TELEHEALTH STROKE TREAT18 MENT. 

19 (a) ESTABLISHMENT.—Part D of title III of the Pub20 lic Health Service Act (42 U.S.C. 254b et seq.) is amended 

21 by inserting after section 330L the following: 

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

23 PROGRAM. 

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

25 States, and to consortia of public and private entities loVerDate Aug 31 2005 22:27 Jan 17, 2007 Jkt 059200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H477.IH H477

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1 cated in any State that is not a grantee under this section, 

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

3 years 2008 through 2012 to improve stroke patient out4 comes by coordinating health care delivery through tele5 health networks. 

6 ‘‘(b) ADMINISTRATION.—The Secretary shall admin7 ister this section through the Director of the Office for 

8 the Advancement of Telehealth. 

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

10 for the purpose of better coordinating program activities, 

11 the Secretary shall consult with— 

12 ‘‘(1) officials responsible for other Federal pro13 grams involving stroke research and care, including 

14 such programs established by the Stroke Treatment 

15 and Ongoing Prevention Act; and 

16 ‘‘(2) organizations and individuals with exper17 tise in stroke prevention, diagnosis, treatment, and 

18 rehabilitation. 

19 ‘‘(d) USE OF FUNDS.— 

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

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

22 section unless the State or consortium agrees to use 

23 the grant for the purpose of— 


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1 ‘‘(A) identifying entities with expertise in 

2 the delivery of high-quality stroke prevention, 

3 diagnosis, treatment, and rehabilitation; 

4 ‘‘(B) working with those entities to estab5 lish or improve telehealth networks to provide 

6 stroke treatment assistance and resources to 

7 health care professionals, hospitals, and other 

8 individuals and entities that serve stroke pa9 tients; 

10 ‘‘(C) informing emergency medical systems 

11 of the location of entities identified under sub12 paragraph (A) to facilitate the appropriate 

13 transport of individuals with stroke symptoms; 

14 ‘‘(D) establishing networks to coordinate 

15 collaborative activities for stroke prevention, di16 agnosis, treatment, and rehabilitation; 

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

18 stroke care, especially for populations with a 

19 shortage of stroke care specialists and popu20 lations with a high incidence of stroke; and 

21 ‘‘(F) conducting ongoing performance and 

22 quality evaluations to identify collaborative ac23 tivities that improve clinical outcomes for stroke 

24 patients. 


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

2 Secretary may not make a grant to a State under 

3 this section unless the State agrees to establish a 

4 consortium of public and private entities, including 

5 universities and academic medical centers, to carry 

6 out the activities described in paragraph (1). 

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

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

9 an existing telehealth network that is or may be 

10 used for improving stroke prevention, diagnosis, 

11 treatment, and rehabilitation, or to a consortium lo12 cated in such a State, unless the State or consor13 tium agrees that— 

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

15 existing telehealth network to achieve the pur16 pose of the grant; and 

17 ‘‘(B) the State or consortium will not es18 tablish a separate network for such purpose. 

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

20 this section, the Secretary shall give priority to any appli21 cant that submits a plan demonstrating how the applicant, 

22 and where applicable the members of the consortium de23 scribed in subsection (d)(2), will use the grant to improve 

24 access to high-quality stroke care for populations with 


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1 shortages of stroke-care specialists and populations with 

2 a high incidence of stroke. 

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

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

5 any period that— 

6 ‘‘(1) is greater than 3 years; or 

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

8 2012. 

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

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

11 the Secretary may not award more than 7 grants. 

12 ‘‘(h) APPLICATION.—To seek a grant under this sec13 tion, a State or a consortium of public and private entities 

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

15 in such manner, and containing such information as the 

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

17 require each such application to outline how the State or 

18 consortium will establish baseline measures and bench19 marks to evaluate program outcomes. 

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

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

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

23 the brain breaks or ruptures. 

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

25 are authorized to be appropriated to carry out this section 


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1 $10,000,000 for fiscal year 2008, $13,000,000 for fiscal 

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

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

4 2012.’’. 

5 (b) STUDY; REPORTS.— 

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

7 2013, the Secretary of Health and Human Services 

8 shall conduct a study of the results of the telehealth 

9 stroke treatment grant program under section 330M 

10 of the Public Health Service Act (added by sub11 section (a)) and submit to the Congress a report on 

12 such results that includes the following: 

13 (A) An evaluation of the grant program 

14 outcomes, including quantitative analysis of 

15 baseline and benchmark measures. 

16 (B) Recommendations on how to promote 

17 stroke networks in ways that improve access to 

18 clinical care in rural and urban areas and re19 duce the incidence of stroke and the debilitating 

20 and costly complications resulting from stroke. 

21 (C) Recommendations on whether similar 

22 telehealth grant programs could be used to im23 prove patient outcomes in other public health 

24 areas. 


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1 (2) INTERIM REPORTS.—The Secretary of 

2 Health and Human Services may provide interim re3 ports to the Congress on the telehealth stroke treat4 ment grant program under section 330M of the 

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

6 at such intervals as the Secretary determines to be 

7 appropriate. 

8 SEC. 4. RULE OF CONSTRUCTION. 

9 Nothing in this Act shall be construed to authorize 

10 the Secretary of Health and Human Services to establish 

11 Federal standards for the treatment of patients or the li12 censure of health care professionals. 

Æ 


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