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Union Calendar No. 13 

111TH CONGRESS 

1ST SESSION H. R. 479 

[Report No. 111–43] 

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

improvement in emergency medical services for children. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 13, 2009 

Mr. MATHESON (for himself, Mr. KING of New York, Mrs. CAPPS, Mr. 

REICHERT, and Ms. CASTOR of Florida) introduced the following bill; 

which was referred to the Committee on Energy and Commerce 

MARCH 23, 2009 

Additional sponsors: Mr. BISHOP of Georgia, Mr. SNYDER, Mr. YOUNG of 

Florida, Mr. CONNOLLY of Virginia, Mr. GENE GREEN of Texas, Ms. 

DEGETTE, Mr. THOMPSON of California, Mrs. BONO MACK, Mr. KIND, 

Mr. HINCHEY, Ms. BALDWIN, Mr. COHEN, Ms. CORRINE BROWN of Florida, Mr. HINOJOSA, Mr. GONZALEZ, Mr. CARNAHAN, Mr. POMEROY, Ms. 

MCCOLLUM, Ms. HARMAN, Ms. SCHAKOWSKY, Mr. SESTAK, Mr. GORDON

of Tennessee, Mr. CARNEY, Ms. SUTTON, Mr. STUPAK, Mr. MARKEY of 

Massachusetts, Ms. HERSETH SANDLIN, Mr. INSLEE, Ms. MATSUI, Mr. 

MCDERMOTT, Mr. HILL, Mr. ENGEL, Ms. SLAUGHTER, and Mr. 

BUTTERFIELD

MARCH 23, 2009 

Committed to the Committee of the Whole House on the State of the Union 

and ordered to be printed 


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[Strike out all after the enacting clause and insert the part printed in italic] 

[For text of introduced bill, see copy of bill as introduced on January 13, 2009] 

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 findings: 

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

8 visits to the Nation’s emergency departments every 

9 year. 

10 (2) Over 90 percent of children requiring emer11 gency care are seen in general hospitals, not in free12 standing children’s hospitals, with one-quarter to one13 third of the patients being children in the typical gen14 eral hospital emergency department. 

15 (3) Severe asthma and respiratory distress are 

16 the most common emergencies for pediatric patients, 

17 representing nearly one-third of all hospitalizations 

18 among children under the age of 15 years, while seiVerDate Nov 24 2008 00:29 Mar 24, 2009 Jkt 079200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6203 E:\BILLS\H479.RH H479

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•HR 479 RH

1 zures, shock, and airway obstruction are other com2 mon pediatric emergencies, followed by cardiac arrest 

3 and severe trauma. 

4 (4) Up to 20 percent of children needing emer5 gency care have underlying medical conditions such 

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

7 weight, and bronchopulmonary dysplasia. 

8 (5) Significant gaps remain in emergency med9 ical care delivered to children. Only about 6 percent 

10 of hospitals have available all the pediatric supplies 

11 deemed essential by the American Academy of Pediat12 rics and the American College of Emergency Physi13 cians for managing pediatric emergencies, while 

14 about half of hospitals have at least 85 percent of 

15 those supplies. 

16 (6) Providers must be educated and trained to 

17 manage children’s unique physical and psychological 

18 needs in emergency situations, and emergency systems 

19 must be equipped with the resources needed to care for 

20 this especially vulnerable population. 

21 (7) Systems of care must be continually main22 tained, updated, and improved to ensure that research 

23 is translated into practice, best practices are adopted, 

24 training is current, and standards and protocols are 

25 appropriate. 


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1 (8) The Emergency Medical Services for Children 

2 (EMSC) Program under section 1910 of the Public 

3 Health Service Act (42 U.S.C. 300w–9) is the only 

4 Federal program that focuses specifically on improv5 ing the pediatric components of emergency medical 

6 care. 

7 (9) The EMSC Program promotes the nation8 wide exchange of pediatric emergency medical care 

9 knowledge and collaboration by those with an interest 

10 in such care and is depended upon by Federal agen11 cies and national organizations to ensure that this ex12 change of knowledge and collaboration takes place. 

13 (10) The EMSC Program also supports a multi14 institutional network for research in pediatric emer15 gency medicine, thus allowing providers to rely on 

16 evidence rather than anecdotal experience when treat17 ing ill or injured children. 

18 (11) The Institute of Medicine stated in its 2006 

19 report, ‘‘Emergency Care for Children: Growing 

20 Pains’’, that the EMSC Program ‘‘boasts many ac21 complishments . . . and the work of the program con22 tinues to be relevant and vital’’. 

23 (12) The EMSC Program is celebrating its 25th 

24 anniversary, marking a quarter-century of driving 

25 key improvements in emergency medical services to 


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1 children, and should continue its mission to reduce 

2 child and youth morbidity and mortality by sup3 porting improvements in the quality of all emergency 

4 medical and emergency surgical care children receive. 

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

6 child and youth morbidity and mortality by supporting im7 provements in the quality of all emergency medical care 

8 children receive. 

9 SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL SERV10 ICES FOR CHILDREN PROGRAM. 

11 Section 1910 of the Public Health Service Act (42 

12 U.S.C. 300w–9) is amended— 

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

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

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

16 (2) in subsection (d)— 

17 (A) by striking ‘‘and such sums’’ and in18 serting ‘‘such sums’’; and 

19 (B) by inserting before the period the fol20 lowing: ‘‘, $25,000,000 for fiscal year 2010, 

21 $26,250,000 for fiscal year 2011, $27,562,500 for 

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

23 2013, and $30,387,656 for fiscal year 2014’’; 

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

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


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1 (4) by inserting after subsection (a) the fol2 lowing: 

3 ‘‘(b)(1) The purpose of the program established under 

4 this section is to reduce child and youth morbidity and 

5 mortality by supporting improvements in the quality of all 

6 emergency medical care children receive, through the pro7 motion of projects focused on the expansion and improve8 ment of such services, including those in rural areas and 

9 those for children with special health care needs. In car10 rying out this purpose, the Secretary shall support emer11 gency medical services for children by supporting projects 

12 that— 

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

14 ‘‘(B) promote existing and innovative tech15 nologies appropriate for the care of children; or 

16 ‘‘(C) provide information on health outcomes 

17 and effectiveness and cost-effectiveness. 

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

19 shall— 

20 ‘‘(A) strive to enhance the pediatric capability of 

21 emergency medical service systems originally designed 

22 primarily for adults; and 

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

24 that Federal resources are used efficiently and effec25 tively, be coordinated with all research, evaluations, 


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1 and awards related to emergency medical services for 

2 children undertaken and supported by the Federal 

3 Government.’’. 


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Union Calendar No. 13 

111TH CONGRESS 

1ST SESSION H. R. 479 

[Report No. 111–43] 

A BILL 

To amend the Public Health Service Act to provide 

medical services for children. a means for continued improvement in emergency 

MARCH 23, 2009 

Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 


smartinez on PRODPC75 with BILLS