II 

109TH CONGRESS 

1ST SESSION S. 760 

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 

APRIL 11, 2005 

Mr. INOUYE (for himself, Mr. HATCH, Mr. KENNEDY, Mr. DODD, Mr. 

DEWINE, and Mr. CONRAD) 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: 

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

9 visits to the nation’s emergency departments every 
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1 year, with children under the age of 3 years account2 ing for most of these visits. 

3 (2) Ninety percent of children requiring emer4 gency care are seen in general hospitals, not in free5 standing children’s hospitals, with one-quarter to 

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

7 general hospital emergency department. 

8 (3) Severe asthma and respiratory distress are 

9 the most common emergencies for pediatric patients, 

10 representing nearly one-third of all hospitalizations 

11 among children under the age of 15 years, while sei12 zures, shock, and airway obstruction are other com13 mon pediatric emergencies, followed by cardiac ar14 rest and severe trauma. 

15 (4) Up to 20 percent of children needing emer16 gency care have underlying medical conditions such 

17 as asthma, diabetes, sickle-cell disease, low birth18 weight, and bronchopulmonary dysplasia. 

19 (5) Significant gaps remain in emergency med20 ical care delivered to children, with 43 percent of 

21 hospitals lacking cervical collars (used to stabilize 

22 spinal injuries) for infants, less than half (47 per23 cent) of hospitals with no pediatric intensive care 

24 unit having a written transfer agreement with a hos25 pital that does have such a unit, one-third of States 
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1 lacking a physician available on-call 24 hours a day 

2 to provide medical direction to emergency medical 

3 technicians or other non-physician emergency care 

4 providers, and even those States with such avail5 ability lacking full State coverage. 

6 (6) Providers must be educated and trained to 

7 manage children’s unique physical and psychological 

8 needs in emergency situations, and emergency sys9 tems must be equipped with the resources needed to 

10 care for this especially vulnerable population. 

11 (7) The Emergency Medical Services for Chil12 dren (EMSC) Program under section 1910 of the 

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

14 the only Federal program that focuses specifically on 

15 improving the pediatric components of emergency 

16 medical care. 

17 (8) The EMSC Program promotes the nation18 wide exchange of pediatric emergency medical care 

19 knowledge and collaboration by those with an inter20 est in such care and is depended upon by Federal 

21 agencies and national organizations to ensure that 

22 this exchange of knowledge and collaboration takes 

23 place. 

24 (9) The EMSC Program also supports a multi25 institutional network for research in pediatric emer-
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1 gency medicine, thus allowing providers to rely on 

2 evidence rather than anecdotal experience when 

3 treating ill or injured children. 

4 (10) States are better equipped to handle occur5 rences of critical or traumatic injury due to ad6 vances fostered by the EMSC program, with— 

7 (A) forty-eight States identifying and re8 quiring all EMSC-recommended pediatric equip9 ment on Advanced Life Support ambulances; 

10 (B) forty-four States employing pediatric 

11 protocols for medical direction; 

12 (C) forty-one States utilizing pediatric 

13 guidelines for acute care facility identification, 

14 ensuring that children get to the right hospital 

15 in a timely manner; and 

16 (D) thirty-six of the forty-two States hav17 ing statewide computerized data collection sys18 tems now producing reports on pediatric emer19 gency medical services using statewide data. 

20 (11) Systems of care must be continually main21 tained, updated, and improved to ensure that re22 search is translated into practice, best practices are 

23 adopted, training is current, and standards and pro24 tocols are appropriate. 
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1 (12) Now celebrating its twentieth anniversary, 

2 the EMSC Program has proven effective over two 

3 decades in driving key improvements in emergency 

4 medical services to children, and should continue its 

5 mission to reduce child and youth morbidity and 

6 mortality by supporting improvements in the quality 

7 of all emergency medical and emergency surgical 

8 care children receive. 

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

10 child and youth morbidity and mortality by supporting im11 provements in the quality of all emergency medical care 

12 children receive. 

13 SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL 

14 SERVICES FOR CHILDREN PROGRAM. 

15 Section 1910 of the Public Health Service Act (42 

16 U.S.C. 300w–9) is amended— 

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

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

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

20 (2) in subsection (d)— 

21 (A) by striking ‘‘and such sums’’ and in22 serting ‘‘such sums’’; and 

23 (B) by inserting before the period the fol24 lowing: ‘‘$23,000,000 for fiscal year 2006, and 
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1 such sums as may be necessary for each of fis2 cal years 2007 through 2010’’; 

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

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

5 (4) by inserting after subsection (a) the fol6 lowing: 

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

8 under this section is to reduce child and youth morbidity 

9 and mortality by supporting improvements in the quality 

10 of all emergency medical care children receive, through the 

11 promotion of projects focused on the expansion and im12 provement of such services, including those in rural areas 

13 and those for children with special healthcare needs. In 

14 carrying out this purpose, the Secretary shall support 

15 emergency medical services for children by supporting 

16 projects that— 

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

18 ‘‘(B) promote existing and innovative tech19 nologies appropriate for the care of children: or 

20 ‘‘(C) provide information on health outcomes 

21 and effectiveness and cost-effectiveness. 

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

23 shall— 
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1 ‘‘(A) strive to enhance the pediatric capability 

2 of emergency medical service systems originally de3 signed primarily for adults; and 

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

5 that Federal resources are used efficiently and effec6 tively, be coordinated with all research, evaluations, 

7 and awards related to emergency medical services 

8 for children undertaken and supported by the Fed9 eral Government.’’. 

Æ