I 
114TH CONGRESS 
2D SESSION 
H. R. 6132 
To establish a task force to develop a national trauma care system, to 
improve the trauma care system of the Department of Defense, and 
for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 22, 2016 
Ms. DUCKWORTH introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce, and in addition to the Committee on 
Armed Services, for a period to be subsequently determined by the Speak-
er, in each case for consideration of such provisions as fall within the ju-
risdiction of the committee concerned 
A BILL 
To establish a task force to develop a national trauma care 
system, to improve the trauma care system of the De-
partment of Defense, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE; FINDINGS AND SENSE OF CON-
GRESS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘National Trauma Care System Act’’. 
(b) FINDINGS.—Congress finds the following: 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(1) Trauma is the leading killer of Americans 
under the age of 46 in the United States, killing 
more than 192,000 Americans each year. 
(2) The National Research Council has indi-
cated since 1966 that Federal funding for trauma 
research was inadequate—leading the Institute of 
Medicine in 1999 to conclude that, ‘‘The nation’s 
current investment in injury [trauma] research is 
not commensurate with the magnitude of the prob-
lem.’’. 
(3) The National Academies of Sciences found 
that between 200,000 and 300,000 Americans may 
have died from survivable traumatic injuries between 
2001 and 2011. 
(4) According to the Centers for Disease Con-
trol and Prevention, the economic burden of trauma 
was more than $671,000,000,000 in 2013 and it is 
one of the most expensive health care problems in 
the country. 
(5) According to the National Trauma Center, 
the National Institutes of Health spends less than 
$200 each year on trauma research for each year of 
potential life lost. 
VerDate Sep 11 2014 
20:48 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(6) The Institute of Medicine has recommended 
greater consideration of a disease’s societal and eco-
nomic burden when allocating research funding. 
(7) Nearly all combat deaths in the Armed 
Forces are due to trauma-related incidents, and be-
tween 2001 and 2011, nearly 25 percent of battle-
field deaths were caused by survivable injuries. 
(8) The 75th Ranger Regiment of the Army 
nearly eliminated its preventable fatalities by imple-
menting data-driven performance improvement poli-
cies and taking command-ownership of treatment 
outcomes. 
(9) Military and civilian trauma practitioners 
must be able to share data, techniques, and proce-
dures easily so they can institutionalize advances in 
care within their respective organizations. 
(10) The National Academy of Sciences con-
cluded ‘‘that a national strategy and joint military– 
civilian approach for improving trauma care is lack-
ing, placing lives unnecessarily at risk . . . that a 
unified effort is needed to address this gap and en-
sure the delivery of optimal trauma care to save the 
lives of Americans injured within the United States 
and on the battlefield.’’. 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(c) SENSE OF CONGRESS.—It is the sense of Con-
gress that— 
(1) the President should establish and articu-
late a goal of achieving zero preventable deaths after 
injury and minimizing trauma-related disability and 
direct efforts towards that end; 
(2) the Federal Government should promote the 
development of a learning health system that enables 
a continuous improvement of military and civilian 
trauma systems through evidence-based initiatives; 
and 
(3) the Federal Government should promote 
greater collaboration between, and integration of, 
military and civilian trauma systems, including with 
respect to the permanent assignment of military 
trauma teams in civilian trauma centers, to prepare 
for mass trauma incidents in the homeland. 
SEC. 2. TASK FORCE ON ELIMINATING PREVENTABLE 
DEATHS OR DISABILITIES DUE TO TRAU-
MATIC INJURIES. 
(a) ESTABLISHMENT.—There is established a task 
force to be known as the ‘‘Task Force on Eliminating Pre-
ventable Deaths or Disabilities due to Traumatic Injuries’’ 
(in this section referred to as the ‘‘Task Force’’). 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(b) MEMBERSHIP.—The Task Force shall be com-
posed of the following: 
(1) The Director of the Office of Management 
and Budget, who shall serve as the chairperson of 
the Task Force. 
(2) The Secretary of Defense. 
(3) The Secretary of Health and Human Serv-
ices. 
(4) The Secretary of Transportation. 
(5) The Secretary of Veterans Affairs. 
(6) The Secretary of Homeland Security. 
(7) The Commissioner of Food and Drugs. 
(8) The Director of the Domestic Policy Coun-
cil. 
(9) The Director of the National Institutes of 
Health. 
(10) The Administrator of the Centers for 
Medicare & Medicaid Services. 
(11) The Director of the Centers for Disease 
Control and Prevention. 
(12) The Assistant Secretary of Health of the 
Department of Health and Human Services. 
(13) The Assistant Secretary of Preparedness 
and Response of the Department of Health and 
Human Services. 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(14) The head of the Office of the National Co-
ordinator for Health Information Technology of the 
Department of Health and Human Services. 
(15) A representative from the National Acad-
emies of Sciences, Engineering, and Medicine. 
(c) PLAN.— 
(1) DEVELOPMENT.—The Task Force shall de-
velop a plan to establish a national trauma care sys-
tem to facilitate the ability of the United States to— 
(A) eliminate the occurrence of preventable 
deaths related to injuries; 
(B) eliminate the occurrence of trauma-re-
lated disabilities; and 
(C) respond to mass trauma incidents. 
(2) GOALS.—The Task Force shall establish 
specific goals and milestones, and responsibilities for 
heads of departments and agencies of the Federal 
Government to meet such goals and milestones, to 
carry out the plan under paragraph (1). 
(3) ELEMENTS.—The plan under paragraph (1) 
shall include the following elements: 
(A) Establishing a national trauma care 
system capable of continuous learning and im-
provement. 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(B) Fostering of greater collaboration and 
uniformity of standards of care. 
(C) Promoting access to patient-level data 
from across the continuum of care and just-in- 
time access to high-quality knowledge for trau-
ma care teams and personnel who support such 
teams. 
(d) ESTABLISHMENT OF NATIONAL TRAUMA CARE 
SYSTEM.— 
(1) GOVERNANCE.—The Task Force shall col-
laborate with representatives of State and local gov-
ernments, the private sector, and academia to— 
(A) establish the national trauma care sys-
tem pursuant to the plan developed under sub-
section (c), including by developing and car-
rying out the aims, design, and governance of 
the national trauma care system; and 
(B) jointly define a framework for the na-
tional trauma care system, including the des-
ignation of the roles, responsibilities, authori-
ties, and accountabilities of stakeholders. 
(2) CRITERIA.—The Task Force shall ensure 
the following: 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(A) The national trauma care system de-
scribed in subsection (c)(3)(A) includes mecha-
nisms for accountability. 
(B) Each budget of the President sub-
mitted to Congress under section 1105(a) of 
title 31, United States Code, requests funding 
in amounts necessary to develop and support 
the national trauma care system. 
(C) The national trauma care system in-
cludes a data-driven research agenda. 
(D) The national trauma care system— 
(i) ensures military and civilian trau-
ma systems collect and share common data 
covering the entire continuum of care; and 
(ii) is capable of disseminating data 
related to prevention, mortality, disability, 
mental health, patient experience, and 
other intermediate and final clinical and 
cost outcomes. 
(E) The national trauma care system is 
developed and carried out in a manner that re-
duces regulatory and legal barriers to the full 
integration of the trauma continuum of care 
from the point of injury, to acute hospitaliza-
tion, and through rehabilitation and recovery. 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(F) The national trauma care system is ca-
pable of responding domestically to any inten-
tional or unintentional mass casualty incident. 
(e) NATIONAL TRAUMA RESEARCH ACTION PLAN.— 
(1) IN GENERAL.—The Task Force shall de-
velop and implement a national trauma research ac-
tion plan to carry out a coordinated approach to 
trauma care research conducted by the Federal Gov-
ernment (including by the Department of Defense, 
the Department of Health and Human Services, the 
Department of Veterans Affairs, and the National 
Institutes of Health) and academia and other private 
institutions. 
(2) ELEMENTS.—The plan under paragraph (1) 
shall include the following elements: 
(A) An analysis of the performance gaps 
with respect to trauma care provided by the 
Armed Forces and trauma care provided by ci-
vilian health care providers, including with re-
spect to the full continuum of care and with re-
spect to needs specific to intentional or uninten-
tional mass casualty incidents and specific pa-
tient populations. 
(B) Requirements-driven and patient-cen-
tered research strategies and priorities for ad-
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
dressing the gaps identified under subpara-
graph (A). 
(C) An integrated strategy for the Armed 
Forces and civilians with short, intermediate 
and long-term steps for— 
(i) ensuring that appropriate military 
and civilian resources are directed toward 
efforts to fill the gaps identified under sub-
paragraph (A) (particularly between peri-
ods in which the Armed Forces are en-
gaged in conflicts or contingency oper-
ations); and 
(ii) designating the responsibilities 
and milestones for implementing the strat-
egy by the Armed Forces, the Federal Gov-
ernment, and industry stakeholders. 
(D) The promotion of military-civilian re-
search partnerships to ensure that knowledge is 
transferred to and from the Armed Forces and 
that lessons learned from combat can be refined 
during periods in which the Armed Forces are 
not engaged in conflicts or contingency oper-
ations. 
(f) STAFF.— 
VerDate Sep 11 2014 
20:48 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(1) DETAILEES.—Upon request of the chair-
person of the Task Force, the head of any Federal 
department or agency may detail, on a reimbursable 
basis, any of the personnel of that department or 
agency to the Task Force to assist it in carrying out 
its duties under this section. 
(2) 
APPOINTMENT
OF
ADDITIONAL
PER-
SONNEL.—With the approval of the Task Force, the 
Chairperson may appoint and fix the pay of addi-
tional personnel of the Task Force. 
(g) REPORTS.—Not later than 540 days after the 
date of the enactment of this Act, and annually thereafter, 
the Task Force shall submit to Congress a report on the 
activities of the Task Force, including— 
(1) the plan under subsection (c); 
(2) the national trauma research action plan 
under subsection (e); and 
(3) any recommendations regarding legislative 
action required to fully implement such plans and to 
carry out this Act. 
(h) TRAUMA CARE SYSTEM DEFINED.—In this sec-
tion, the term ‘‘trauma care system’’ means an organized, 
inclusive approach to facilitating and coordinating a multi-
disciplinary system response to severely injured patients 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
that encompasses a continuum of care provision and inclu-
sive of— 
(1) injury prevention and control; 
(2) public health; 
(3) emergency medical services field interven-
tion; 
(4) emergency department care; 
(5) surgical interventions; 
(6) intensive and general surgical in-hospital 
care; 
(7) rehabilitative services; and 
(8) social services and support groups that as-
sist injured people and significant others of such in-
jured people with returning to society at the most 
productive level possible. 
SEC. 3. TRAUMA STANDARDS AND POLICIES FOR THE DE-
PARTMENT OF HEALTH AND HUMAN SERV-
ICES. 
The Secretary of Health and Human Services shall— 
(1) not later than 540 days after the date of 
the enactment of this Act, develop and publish 
standards for trauma care in pre-hospital and hos-
pital settings; 
(2) identify, evaluate, and, to the extent prac-
ticable, implement policies to ensure coordination be-
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
tween prehospital trauma care and trauma care at 
trauma centers and hospitals; 
(3) work with the Secretary of Defense, the 
Secretary of Veterans Affairs, and other stake-
holders as the Secretary of Health and Human Serv-
ices determines necessary to facilitate the collection 
and sharing of data among trauma systems of the 
Federal Government and non-governmental trauma 
systems across the continuum of care, to the extent 
practicable pursuant to the regulations described in 
paragraph (4); 
(4) revise regulations and clarify existing regu-
lations through policy statements to clarify the scope 
and applicability of regulations and guidance issued 
pursuant to the Health Insurance Portability and 
Accountability Act with respect to trauma care such 
that barriers to the use and disclosure of protected 
health information across the continuum of care are 
minimized; 
(5) ensure the civilian trauma systems partici-
pate in a structured trauma quality improvement 
process; 
(6) not later than one year after the date of the 
enactment of this Act, submit a report to Congress 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
that identifies statutory or regulatory changes need-
ed to— 
(A) ensure that emergency medical services 
are appropriately compensated under Federal 
law; 
(B) condition reimbursement under Fed-
eral law of ambulance services on the quality of 
care provided; 
(C) waive or modify the requirement of in-
formed consent for minimal-risk research in the 
emergency medical service context; and 
(D) improve data collection in health care 
settings where practical and ethical concerns 
constrain the use of randomized control trials, 
including settings in which emergency medical 
services are provided; and 
(7) in developing the report in paragraph (6), 
consult with relevant stakeholders in the private and 
public sectors and provide an analysis of the effects 
of any proposed statutory or regulatory changes, in-
cluding— 
(A) the costs of delivery of trauma care in 
different care settings; and 
(B) anticipated changes in treatment out-
comes for emergency medical services. 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
SEC. 4. JOINT TRAUMA SYSTEM OF THE DEPARTMENT OF 
DEFENSE. 
(a) PLAN.— 
(1) IN
GENERAL.—Not later than 180 days 
after the date of the enactment of this Act, the Sec-
retary of Defense shall submit to the Committees on 
Armed Services of the House of Representatives and 
the Senate an implementation plan to establish a 
Joint Trauma System within the Defense Health 
Agency that promotes improved trauma care to 
members of the Armed Forces and other individuals 
who are eligible to be treated for trauma at a mili-
tary medical treatment facility. 
(2) IMPLEMENTATION.—The Secretary shall 
implement the plan under paragraph (1) after a 90- 
day period has elapsed following the date on which 
the Comptroller General of the United States is re-
quired to submit to the Committees on Armed Serv-
ices of the House of Representatives and the Senate 
the review under subsection (c). In implementing 
such plan, the Secretary shall take into account any 
recommendation made by the Comptroller General 
under such review. 
(b) ELEMENTS.—The Joint Trauma System de-
scribed in subsection (a)(1) shall include the following ele-
ments: 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(1) Serve as the reference body for all trauma 
care provided across the military health system. 
(2) Establish standards of care for trauma 
services provided at military medical treatment fa-
cilities. 
(3) Coordinate the translation of research from 
the centers of excellence of the Department of De-
fense into standards of clinical trauma care. 
(4) Coordinate the incorporation of lessons 
learned from the trauma education and training 
partnerships pursuant to section 5 into clinical prac-
tice. 
(5) Participate in a structured trauma quality 
improvement process. 
(c) REVIEW.—Not later than 120 days after the date 
on which the Secretary submits to the Committees on 
Armed Services of the House of Representatives and the 
Senate the implementation plan under subsection (a)(1), 
the Comptroller General of the United States shall submit 
to such committees a review of such plan to determine if 
each element under subsection (b) is included in such plan. 
(d) REVIEW OF MILITARY TRAUMA SYSTEM.—In es-
tablishing a Joint Trauma System, the Secretary of De-
fense shall seek to enter into an agreement with a non- 
governmental entity with subject matter experts to— 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS
(1) conduct a system-wide review of the military 
trauma system; and 
(2) not later than 180 days after the date of 
the enactment of this Act, make publicly available a 
report containing such review and recommendations 
to establish a comprehensive trauma system for the 
Armed Forces. 
SEC. 5. JOINT TRAUMA EDUCATION AND TRAINING DIREC-
TORATE OF THE DEPARTMENT OF DEFENSE. 
(a) ESTABLISHMENT.—The Secretary of Defense 
shall establish a Joint Trauma Education and Training 
Directorate (in this section referred to as the ‘‘Direc-
torate’’) to ensure that the military trauma care providers 
maintain readiness and are able to be rapidly deployed for 
future armed conflicts. The Secretary shall carry out this 
section in collaboration with the Secretaries of the military 
departments. 
(b) DUTIES.—The duties of the Directorate are as 
follows: 
(1) To enter into and coordinate the partner-
ships under subsection (c). 
(2) To establish the goals of such partnerships 
necessary for military trauma teams led by military 
trauma care providers to maintain professional com-
petency in trauma care. 
VerDate Sep 11 2014 
02:26 Sep 27, 2016
Jkt 059200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H6132.IH
H6132
SSpencer on DSK4SPTVN1PROD with BILLS