II 

★(Star Print)

110TH CONGRESS 

1ST SESSION S. 60 

To amend the Public Health Service Act to provide a means for continued 

improvement in emergency medical services for children. 

IN THE SENATE OF THE UNITED STATES 

JANUARY 4, 2007 

Mr. REID (for Mr. INOUYE) (for himself, Mr. HATCH, Mr. KENNEDY, Mr. 

CONRAD, Mr. DORGAN, and Mr. AKAKA) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

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, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Wakefield Act’’. 

5 SEC. 2. FINDINGS AND PURPOSE. 

6 (a) FINDINGS.—Congress makes the following find7 ings: 

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

2 visits to the nation’s emergency departments every 

3 year. 

4 (2) Over 90 percent of children requiring emer5 gency care are seen in general hospitals, not in free6 standing children’s hospitals, with one-quarter to 

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

8 general hospital emergency department. 

9 (3) Severe asthma and respiratory distress are 

10 the most common emergencies for pediatric patients, 

11 representing nearly one-third of all hospitalizations 

12 among children under the age of 15 years, while sei13 zures, shock, and airway obstruction are other com14 mon pediatric emergencies, followed by cardiac ar15 rest and severe trauma. 

16 (4) Up to 20 percent of children needing emer17 gency care have underlying medical conditions such 

18 as asthma, diabetes, sickle-cell disease, low birth19 weight, and bronchopulmonary dysplasia. 

20 (5) Significant gaps remain in emergency med21 ical care delivered to children. Only about 6 percent 

22 of hospitals have available all the pediatric supplies 

23 deemed essential by the American Academy of Pedi24 atricians and the American College of Emergency 

25 Physicians for managing pediatric emergencies while 

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1 about half of hospitals have at least 85 percent of 

2 those supplies. 

3 (6) Providers must be educated and trained to 

4 manage children’s unique physical and psychological 

5 needs in emergency situations, and emergency sys6 tems must be equipped with the resources needed to 

7 care for this especially vulnerable population. 

8 (7) Systems of care must be continually main9 tained, updated, and improved to ensure that re10 search is translated into practice, best practices are 

11 adopted, training is current, and standards and pro12 tocols are appropriate. 

13 (8) The Emergency Medical Services for Chil14 dren (EMSC) Program under section 1910 of the 

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

16 the only Federal program that focuses specifically on 

17 improving the pediatric components of emergency 

18 medical care. 

19 (9) The EMSC Program promotes the nation20 wide exchange of pediatric emergency medical care 

21 knowledge and collaboration by those with an inter22 est in such care and is depended upon by Federal 

23 agencies and national organizations to ensure that 

24 this exchange of knowledge and collaboration takes 

25 place. 

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1 (10) The EMSC Program also supports a 

2 multi-institutional network for research in pediatric 

3 emergency medicine, thus allowing providers to rely 

4 on evidence rather than anecdotal experience when 

5 treating ill or injured children. 

6 (11) The Institute of Medicine stated in its 

7 2006 report, ‘‘Emergency Care for Children: Grow8 ing Pains’’, that the EMSC Program ‘‘boasts many 

9 accomplishments . . . and the work of the program 

10 continues to be relevant and vital’’. 

11 (12) The EMSC Program has proven effective 

12 over 2 decades in driving key improvements in emer13 gency medical services to children, and should con14 tinue its mission to reduce child and youth morbidity 

15 and mortality by supporting improvements in the 

16 quality of all emergency medical and emergency sur17 gical care children receive. 

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

19 child and youth morbidity and mortality by supporting im20 provements in the quality of all emergency medical care 

21 children receive. 

22 SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL 

23 SERVICES FOR CHILDREN PROGRAM. 

24 Section 1910 of the Public Health Service Act (42 

25 U.S.C. 300w–9) is amended— 

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

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

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

4 (2) in subsection (d)— 

5 (A) by striking ‘‘and such sums’’ and in6 serting ‘‘such sums’’; and 

7 (B) by inserting before the period the fol8 lowing: ‘‘$25,000,000 for fiscal year 2008, and 

9 such sums as may be necessary for each of fis10 cal years 2009 through 2011’’; 

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

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

13 (4) by inserting after subsection (a) the fol14 lowing: 

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

16 under this section is to reduce child and youth morbidity 

17 and mortality by supporting improvements in the quality 

18 of all emergency medical care children receive, through the 

19 promotion of projects focused on the expansion and im20 provement of such services, including those in rural areas 

21 and those for children with special healthcare needs. In 

22 carrying out this purpose, the Secretary shall support 

23 emergency medical services for children by supporting 

24 projects that— 

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

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1 ‘‘(B) promote existing and innovative tech2 nologies appropriate for the care of children; or 

3 ‘‘(C) provide information on health outcomes 

4 and effectiveness and cost-effectiveness. 

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

6 shall— 

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

8 of emergency medical service systems originally de9 signed primarily for adults; and 

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

11 that Federal resources are used efficiently and effec12 tively, be coordinated with all research, evaluations, 

13 and awards related to emergency medical services 

14 for children undertaken and supported by the Fed15 eral Government.’’. 

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