IIB 

111TH CONGRESS 

1ST SESSION H. R. 479 

IN THE SENATE OF THE UNITED STATES 

MARCH 31, 2009 

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

Labor, and Pensions 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE. 

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

3 SEC. 2. FINDINGS AND PURPOSE. 

4 (a) FINDINGS.—Congress makes the following find5 ings: 

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

7 visits to the Nation’s emergency departments every 

8 year. 

9 (2) Over 90 percent of children requiring emer10 gency care are seen in general hospitals, not in free11 standing children’s hospitals, with one-quarter to 

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

13 general hospital emergency department. 

14 (3) Severe asthma and respiratory distress are 

15 the most common emergencies for pediatric patients, 

16 representing nearly one-third of all hospitalizations 

17 among children under the age of 15 years, while sei18 zures, shock, and airway obstruction are other com19 mon pediatric emergencies, followed by cardiac ar20 rest and severe trauma. 

21 (4) Up to 20 percent of children needing emer22 gency care have underlying medical conditions such 

23 as asthma, diabetes, sickle-cell disease, low birth 

24 weight, and bronchopulmonary dysplasia. 

25 (5) Significant gaps remain in emergency med26 ical care delivered to children. Only about 6 percent 


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1 of hospitals have available all the pediatric supplies 

2 deemed essential by the American Academy of Pedi3 atrics and the American College of Emergency Phy4 sicians for managing pediatric emergencies, while 

5 about half of hospitals have at least 85 percent of 

6 those supplies. 

7 (6) Providers must be educated and trained to 

8 manage children’s unique physical and psychological 

9 needs in emergency situations, and emergency sys10 tems must be equipped with the resources needed to 

11 care for this especially vulnerable population. 

12 (7) Systems of care must be continually main13 tained, updated, and improved to ensure that re14 search is translated into practice, best practices are 

15 adopted, training is current, and standards and pro16 tocols are appropriate. 

17 (8) The Emergency Medical Services for Chil18 dren (EMSC) Program under section 1910 of the 

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

20 the only Federal program that focuses specifically on 

21 improving the pediatric components of emergency 

22 medical care. 

23 (9) The EMSC Program promotes the nation24 wide exchange of pediatric emergency medical care 

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1 est in such care and is depended upon by Federal 

2 agencies and national organizations to ensure that 

3 this exchange of knowledge and collaboration takes 

4 place. 

5 (10) The EMSC Program also supports a 

6 multi-institutional network for research in pediatric 

7 emergency medicine, thus allowing providers to rely 

8 on evidence rather than anecdotal experience when 

9 treating ill or injured children. 

10 (11) The Institute of Medicine stated in its 

11 2006 report, ‘‘Emergency Care for Children: Grow12 ing Pains’’, that the EMSC Program ‘‘boasts many 

13 accomplishments . . . and the work of the program 

14 continues to be relevant and vital’’. 

15 (12) The EMSC Program is celebrating its 

16 25th anniversary, marking a quarter-century of driv17 ing key improvements in emergency medical services 

18 to children, and should continue its mission to re19 duce child and youth morbidity and mortality by 

20 supporting improvements in the quality of all emer21 gency medical and emergency surgical care children 

22 receive. 

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

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1 provements in the quality of all emergency medical care 

2 children receive. 

3 SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL 

4 SERVICES FOR CHILDREN PROGRAM. 

5 Section 1910 of the Public Health Service Act (42 

6 U.S.C. 300w–9) is amended— 

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

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

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

10 (2) in subsection (d)— 

11 (A) by striking ‘‘and such sums’’ and in12 serting ‘‘such sums’’; and 

13 (B) by inserting before the period the fol14 lowing: ‘‘, $25,000,000 for fiscal year 2010, 

15 $26,250,000 for fiscal year 2011, $27,562,500 

16 for fiscal year 2012, $28,940,625 for fiscal year 

17 2013, and $30,387,656 for fiscal year 2014’’; 

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

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

20 (4) by inserting after subsection (a) the fol21 lowing: 

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

23 under this section is to reduce child and youth morbidity 

24 and mortality by supporting improvements in the quality 

25 of all emergency medical care children receive, through the 


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1 promotion of projects focused on the expansion and im2 provement of such services, including those in rural areas 

3 and those for children with special health care needs. In 

4 carrying out this purpose, the Secretary shall support 

5 emergency medical services for children by supporting 

6 projects that— 

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

8 ‘‘(B) promote existing and innovative tech9 nologies appropriate for the care of children; or 

10 ‘‘(C) provide information on health outcomes 

11 and effectiveness and cost-effectiveness. 

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

13 shall— 

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

15 of emergency medical service systems originally de16 signed primarily for adults; and 

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

18 that Federal resources are used efficiently and effec19 tively, be coordinated with all research, evaluations, 

20 and awards related to emergency medical services 


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1 for children undertaken and supported by the 

2 Federal Government.’’. 

Passed the House of Representatives March 30, 

2009. 

Attest: LORRAINE C. MILLER, 

Clerk. 


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