II 

114TH CONGRESS 

2D SESSION S. 3407 

To amend the Public Health Service Act to facilitate assignment of military 

trauma care providers to civilian trauma centers in order to maintain 

military trauma readiness and to support such centers, and for other 

purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 28, 2016 

Mr. KIRK (for himself, Mr. ISAKSON, and Mr. CORNYN) 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 facilitate assignment of military trauma care providers to civilian trauma 

centers in order to maintain military trauma readiness 

and to support such centers, 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 ‘‘Military Injury Sur5 gical Systems Integrated Operationally Nationwide to 

6 Achieve ZERO Preventable Deaths Act’’ or the ‘‘MIS7 SION ZERO Act’’. 


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1 SEC. 2. MILITARY AND CIVILIAN PARTNERSHIP FOR TRAU2 MA READINESS GRANT PROGRAM. 

3 Title XII of the Public Health Service Act (42 U.S.C. 

4 300d et seq.) is amended by adding at the end the fol5 lowing new part: 

6 ‘‘PART I—MILITARY AND CIVILIAN PARTNERSHIP 

7 FOR TRAUMA READINESS GRANT PROGRAM 

8 ‘‘SEC. 1291. MILITARY AND CIVILIAN PARTNERSHIP FOR 

9 TRAUMA READINESS GRANT PROGRAM. 

10 ‘‘(a) MILITARY TRAUMA TEAM PLACEMENT PRO11 GRAM.— 

12 ‘‘(1) IN GENERAL.—The Secretary, acting 

13 through the Assistant Secretary for Preparedness 

14 and Response and in consultation with the Secretary 

15 of Defense, shall award grants to not more than 20 

16 eligible high acuity trauma centers to enable military 

17 trauma teams to provide, on a full-time basis, trau18 ma care and related acute care at such trauma cen19 ters. 

20 ‘‘(2) LIMITATIONS.—In the case of a grant 

21 awarded under paragraph (1) to an eligible high 

22 acuity trauma center, such grant— 

23 ‘‘(A) shall be for a period of not fewer 

24 than 3 fiscal years and not more than 5 fiscal 

25 years (and may be renewed at the end of such 

26 period); and 


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1 ‘‘(B) shall be in an amount that does not 

2 exceed $1,000,000 per fiscal year. 

3 ‘‘(b) MILITARY TRAUMA CARE PROVIDER PLACE4 MENT PROGRAM.— 

5 ‘‘(1) IN GENERAL.—The Secretary, acting 

6 through the Assistant Secretary for Preparedness 

7 and Response and in consultation with the Secretary 

8 of Defense, shall award grants to eligible trauma 

9 centers to enable military trauma care providers to 

10 provide trauma care and related acute care at such 

11 trauma centers. 

12 ‘‘(2) LIMITATIONS.—In the case of a grant 

13 awarded under paragraph (1) to an eligible trauma 

14 center, such grant— 

15 ‘‘(A) shall be for a period of at least 1 fis16 cal year and not more than 3 fiscal years (and 

17 may be renewed at the end of such period); 

18 ‘‘(B) shall be in an amount that does not 

19 exceed, in a fiscal year— 

20 ‘‘(i) $100,000 for each military trau21 ma care provider that is a physician at 

22 such eligible trauma center; and 

23 ‘‘(ii) $50,000 for each other military 

24 trauma care provider at such eligible trau25 ma center. 


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1 ‘‘(c) GRANT REQUIREMENTS.— 

2 ‘‘(1) DEPLOYMENT.—As a condition of receipt 

3 of a grant under this section, a grant recipient shall 

4 agree to allow military trauma care providers pro5 viding care pursuant to such grant to be deployed by 

6 the Secretary of Defense for military operations, for 

7 training, or for response to a mass casualty incident. 

8 ‘‘(2) USE OF FUNDS.—Grants awarded under 

9 this section to an eligible trauma center may be used 

10 to train and incorporate military trauma care pro11 viders into such trauma center, including expendi12 tures for malpractice insurance, office space, infor13 mation technology, specialty education and super14 vision, trauma programs, and State license fees for 

15 such military trauma care providers. 

16 ‘‘(d) REPORTING REQUIREMENTS.— 

17 ‘‘(1) REPORT TO THE SECRETARY AND THE

18 SECRETARY OF DEFENSE.—Each eligible trauma 

19 center or eligible high acuity trauma center awarded 

20 a grant under subsection (a) or (b) for a fiscal year 

21 shall submit to the Secretary and the Secretary of 

22 Defense a report for such fiscal year that includes 

23 information on— 

24 ‘‘(A) the number and types of trauma 

25 cases managed by military trauma teams or 


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1 military trauma care providers pursuant to such 

2 grant during such fiscal year; 

3 ‘‘(B) the financial impact of such grant on 

4 the trauma center; 

5 ‘‘(C) the educational impact on resident 

6 trainees in centers where military trauma teams 

7 are assigned; 

8 ‘‘(D) any research conducted during such 

9 fiscal year supported by such grant; and 

10 ‘‘(E) any other information required by the 

11 Secretaries for the purpose of evaluating the ef12 fect of such grant. 

13 ‘‘(2) REPORT TO CONGRESS.—Not less than 

14 once every 2 fiscal years, the Secretary, in consulta15 tion with the Secretary of Defense, shall submit a 

16 report to Congress that includes information on the 

17 effect of placing military trauma care providers in 

18 trauma centers awarded grants under this section 

19 on— 

20 ‘‘(A) maintaining readiness of military 

21 trauma care providers for battlefield injuries; 

22 ‘‘(B) providing health care to civilian trau23 ma patients; 


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1 ‘‘(C) the capability to respond to surges in 

2 trauma cases, including as a result of a large 

3 scale event; and 

4 ‘‘(D) the financial State of the trauma cen5 ters. 

6 ‘‘(e) DEFINITIONS.—For purposes of this part: 

7 ‘‘(1) ELIGIBLE TRAUMA CENTER.—The term 

8 ‘eligible trauma center’ means a Level I, II, or III 

9 trauma center that satisfies each of the following: 

10 ‘‘(A) Such trauma center has an agree11 ment with the Secretary of Defense to enable 

12 military trauma care providers to provide trau13 ma care and related acute care at such trauma 

14 center. 

15 ‘‘(B) Such trauma center utilizes a risk-ad16 justed benchmarking system to measure per17 formance and outcomes, such as the Trauma 

18 Quality Improvement Program of the American 

19 College of Surgeons. 

20 ‘‘(C) Such trauma center demonstrates a 

21 need for integrated military trauma care pro22 viders to maintain or improve the trauma clin23 ical capability of such trauma center. 

24 ‘‘(2) ELIGIBLE HIGH ACUITY TRAUMA CEN25 TER.—The term ‘eligible high acuity trauma center’ 


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1 means a Level I trauma center that satisfies each of 

2 the following: 

3 ‘‘(A) Such trauma center has an agree4 ment with the Secretary of Defense to enable 

5 military trauma teams to provide trauma care 

6 and related acute care at such trauma center. 

7 ‘‘(B) At least 20 percent of patients of 

8 such trauma center in the most recent 3-month 

9 period for which data is available are treated 

10 for a major trauma at such trauma center. 

11 ‘‘(C) Such trauma center utilizes a risk-ad12 justed benchmarking system to measure per13 formance and outcomes, such as the Trauma 

14 Quality Improvement Program of the American 

15 College of Surgeons. 

16 ‘‘(D) Such trauma center is an academic 

17 training center— 

18 ‘‘(i) affiliated with a medical school; 

19 ‘‘(ii) that maintains residency pro20 grams and fellowships in critical trauma 

21 specialties and subspecialties, and provides 

22 education and supervision of military trau23 ma team members according to those spe24 cialties and subspecialties; and 


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1 ‘‘(iii) that undertakes research in the 

2 prevention and treatment of traumatic in3 jury. 

4 ‘‘(E) Such trauma center serves as a dis5 aster response leader for its community, such 

6 as by participating in a partnership for State 

7 and regional hospital preparedness established 

8 under section 319C–2. 

9 ‘‘(3) MAJOR TRAUMA.—The term ‘major trau10 ma’ means an injury that is greater than or equal 

11 to 15 on the injury severity score. 

12 ‘‘(4) MILITARY TRAUMA TEAM.—The term 

13 ‘military trauma team’ means a complete military 

14 trauma team consisting of military trauma care pro15 viders. 

16 ‘‘(5) MILITARY TRAUMA CARE PROVIDER.—The 

17 term ‘military trauma care provider’ means a mem18 ber of the Armed Forces who furnishes emergency, 

19 critical care, and other trauma acute care, including 

20 a physician, military surgeon, physician assistant, 

21 nurse, respiratory therapist, flight paramedic, com22 bat medic, or enlisted medical technician. 

23 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For 

24 each of fiscal years 2017 through 2021, there are author25 ized to be appropriated— 


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1 ‘‘(1) $20,000,000 for carrying out subsection 

2 (a); and 

3 ‘‘(2) $20,000,000 for carrying out subsection 

4 (b).’’. 

Æ 


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