IIB 
108TH CONGRESS 
2D SESSION 
H. R. 3658 
IN THE SENATE OF THE UNITED STATES 
JUNE 15, 2004 
Received; read twice and referred to the Committee on Health, Education, 
Labor, and Pensions 
AN ACT 
To amend the Public Health Service Act to strengthen edu-
cation, prevention, and treatment programs relating to 
stroke, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled,
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Stroke Treatment and 
Ongoing Prevention Act’’. 
SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT 
REGARDING STROKE PROGRAMS. 
(a) STROKE EDUCATION AND INFORMATION PRO-
GRAMS.—Title III of the Public Health Service Act (42 
U.S.C. 241 et seq.) is amended by adding at the end the 
following: 
‘‘PART R—STROKE EDUCATION, INFORMATION, 
AND DATA COLLECTION PROGRAMS 
‘‘SEC. 399AA. STROKE PREVENTION AND EDUCATION CAM-
PAIGN. 
‘‘(a) IN GENERAL.—The Secretary shall carry out an 
education and information campaign to promote stroke 
prevention and increase the number of stroke patients who 
seek immediate treatment. 
‘‘(b) AUTHORIZED ACTIVITIES.—In implementing the 
education and information campaign under subsection (a), 
the Secretary may— 
‘‘(1) make public service announcements about 
the warning signs of stroke and the importance of 
treating stroke as a medical emergency; 
‘‘(2) provide education regarding ways to pre-
vent stroke and the effectiveness of stroke treat-
ment; and
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‘‘(3) carry out other activities that the Sec-
retary determines will promote prevention practices 
among the general public and increase the number 
of stroke patients who seek immediate care. 
‘‘(c) MEASUREMENTS.—In implementing the edu-
cation and information campaign under subsection (a), the 
Secretary shall— 
‘‘(1) measure public awareness before the start 
of the campaign to provide baseline data that will be 
used to evaluate the effectiveness of the public 
awareness efforts; 
‘‘(2) establish quantitative benchmarks to meas-
ure the impact of the campaign over time; and 
‘‘(3) measure the impact of the campaign not 
less than once every 2 years or, if determined appro-
priate by the Secretary, at shorter intervals. 
‘‘(d) NO DUPLICATION OF EFFORT.—In carrying out 
this section, the Secretary shall avoid duplicating existing 
stroke education efforts by other Federal Government 
agencies. 
‘‘(e) CONSULTATION.—In carrying out this section, 
the Secretary may consult with organizations and individ-
uals with expertise in stroke prevention, diagnosis, treat-
ment, and rehabilitation.
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‘‘SEC. 399BB. PAUL COVERDELL NATIONAL ACUTE STROKE 
REGISTRY AND CLEARINGHOUSE. 
‘‘The Secretary, acting through the Centers for Dis-
ease Control and Prevention, shall maintain the Paul 
Coverdell National Acute Stroke Registry and Clearing-
house by— 
‘‘(1) continuing to develop and collect specific 
data points and appropriate benchmarks for ana-
lyzing care of acute stroke patients; 
‘‘(2) collecting, compiling, and disseminating in-
formation on the achievements of, and problems ex-
perienced by, State and local agencies and private 
entities in developing and implementing emergency 
medical systems and hospital-based quality of care 
interventions; and 
‘‘(3) carrying out any other activities the Sec-
retary determines to be useful to maintain the Paul 
Coverdell National Acute Stroke Registry and Clear-
inghouse to reflect the latest advances in all forms 
of stroke care. 
‘‘SEC. 399CC. STROKE DEFINITION. 
‘‘For purposes of this part, the term ‘stroke’ means 
a ‘brain attack’ in which blood flow to the brain is inter-
rupted or in which a blood vessel or aneurysm in the brain 
breaks or ruptures.
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‘‘SEC. 399DD. AUTHORIZATION OF APPROPRIATIONS. 
‘‘There is authorized to be appropriated to carry out 
this part $5,000,000 for each of fiscal years 2005 through 
2009.’’. 
(b) EMERGENCY MEDICAL PROFESSIONAL DEVELOP-
MENT.—Section 1251 of the Public Health Service Act 
(42 U.S.C. 300d–51) is amended to read as follows: 
‘‘SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN AD-
VANCED STROKE AND TRAUMATIC INJURY 
TREATMENT AND PREVENTION. 
‘‘(a) RESIDENCY AND OTHER PROFESSIONAL TRAIN-
ING.—The Secretary may make grants to public and non-
profit entities for the purpose of planning, developing, and 
enhancing approved residency training programs and 
other professional training for appropriate health profes-
sions in emergency medicine, including emergency medical 
services professionals, to improve stroke and traumatic in-
jury prevention, diagnosis, treatment, and rehabilitation. 
‘‘(b) CONTINUING EDUCATION
ON STROKE
AND 
TRAUMATIC INJURY.— 
‘‘(1) GRANTS.—The Secretary, acting through 
the Administrator of the Health Resources and Serv-
ices Administration, may make grants to qualified 
entities for the development and implementation of 
education programs for appropriate health care pro-
fessionals in the use of newly developed diagnostic
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approaches, technologies, and therapies for health 
professionals involved in the prevention, diagnosis, 
treatment, and rehabilitation of stroke or traumatic 
injury. 
‘‘(2) DISTRIBUTION OF GRANTS.—In awarding 
grants under this subsection, the Secretary shall give 
preference to qualified entities that will train health 
care professionals that serve areas with a significant 
incidence of stroke or traumatic injuries. 
‘‘(3) APPLICATION.—A qualified entity desiring 
a grant under this subsection shall submit to the 
Secretary an application at such time, in such man-
ner, and containing such information as the Sec-
retary may require, including a plan for the rigorous 
evaluation of activities carried out with amounts re-
ceived under the grant. 
‘‘(4) DEFINITIONS.—For purposes of this sub-
section: 
‘‘(A) The term ‘qualified entity’ means a 
consortium of public and private entities, such 
as universities, academic medical centers, hos-
pitals, and emergency medical systems that are 
coordinating education activities among pro-
viders serving in a variety of medical settings.
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‘‘(B) The term ‘stroke’ means a ‘brain at-
tack’ in which blood flow to the brain is inter-
rupted or in which a blood vessel or aneurysm 
in the brain breaks or ruptures. 
‘‘(c) REPORT.—Not later than 1 year after the alloca-
tion of grants under this section, the Secretary shall sub-
mit to the Committee on Health, Education, Labor, and 
Pensions of the Senate and the Committee on Energy and 
Commerce of the House of Representatives a report on 
the results of activities carried out with amounts received 
under this section. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$4,000,000 for each of fiscal years 2005 through 2009. 
The Secretary shall equitably allocate the funds author-
ized to be appropriated under this section between efforts 
to address stroke and efforts to address traumatic in-
jury.’’. 
SEC. 3. PILOT PROJECT ON TELEHEALTH STROKE TREAT-
MENT. 
(a) ESTABLISHMENT.—Part D of title III of the Pub-
lic Health Service Act (42 U.S.C. 254b et seq.) is amended 
by inserting after section 330L the following:
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‘‘SEC. 330M. TELEHEALTH STROKE TREATMENT GRANT 
PROGRAM. 
‘‘(a) GRANTS.—The Secretary may make grants to 
States, and to consortia of public and private entities lo-
cated in any State that is not a grantee under this section, 
to conduct a 5-year pilot project over the period of fiscal 
years 2005 through 2009 to improve stroke patient out-
comes by coordinating health care delivery through tele-
health networks. 
‘‘(b) ADMINISTRATION.—The Secretary shall admin-
ister this section through the Director of the Office for 
the Advancement of Telehealth. 
‘‘(c) CONSULTATION.—In carrying out this section, 
for the purpose of better coordinating program activities, 
the Secretary shall consult with— 
‘‘(1) officials responsible for other Federal pro-
grams involving stroke research and care, including 
such programs established by the Stroke Treatment 
and Ongoing Prevention Act; and 
‘‘(2) organizations and individuals with exper-
tise in stroke prevention, diagnosis, treatment, and 
rehabilitation. 
‘‘(d) USE OF FUNDS.— 
‘‘(1) IN
GENERAL.—The Secretary may not 
make a grant to a State or a consortium under this
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section unless the State or consortium agrees to use 
the grant for the purpose of— 
‘‘(A) identifying entities with expertise in 
the delivery of high-quality stroke prevention, 
diagnosis, treatment, and rehabilitation; 
‘‘(B) working with those entities to estab-
lish or improve telehealth networks to provide 
stroke treatment assistance and resources to 
health care professionals, hospitals, and other 
individuals and entities that serve stroke pa-
tients; 
‘‘(C) informing emergency medical systems 
of the location of entities identified under sub-
paragraph (A) to facilitate the appropriate 
transport of individuals with stroke symptoms; 
‘‘(D) establishing networks to coordinate 
collaborative activities for stroke prevention, di-
agnosis, treatment, and rehabilitation; 
‘‘(E) improving access to high-quality 
stroke care, especially for populations with a 
shortage of stroke care specialists and popu-
lations with a high incidence of stroke; and 
‘‘(F) conducting ongoing performance and 
quality evaluations to identify collaborative ac-
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tivities that improve clinical outcomes for stroke 
patients. 
‘‘(2) ESTABLISHMENT
OF
CONSORTIUM.—The 
Secretary may not make a grant to a State under 
this section unless the State agrees to establish a 
consortium of public and private entities, including 
universities and academic medical centers, to carry 
out the activities described in paragraph (1). 
‘‘(3) PROHIBITION.—The Secretary may not 
make a grant under this section to a State that has 
an existing telehealth network that is or may be 
used for improving stroke prevention, diagnosis, 
treatment, and rehabilitation, or to a consortium lo-
cated in such a State, unless the State or consor-
tium agrees that— 
‘‘(A) the State or consortium will use an 
existing telehealth network to achieve the pur-
pose of the grant; and 
‘‘(B) the State or consortium will not es-
tablish a separate network for such purpose. 
‘‘(e) PRIORITY.—In selecting grant recipients under 
this section, the Secretary shall give priority to any appli-
cant that submits a plan demonstrating how the applicant, 
and where applicable the members of the consortium de-
scribed in subsection (d)(2), will use the grant to improve
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access to high-quality stroke care for populations with 
shortages of stroke-care specialists and populations with 
a high incidence of stroke. 
‘‘(f) GRANT PERIOD.—The Secretary may not award 
a grant to a State or a consortium under this section for 
any period that— 
‘‘(1) is greater than 3 years; or 
‘‘(2) extends beyond the end of fiscal year 
2009. 
‘‘(g) RESTRICTION
ON NUMBER
OF GRANTS.—In 
carrying out the 5-year pilot project under this section, 
the Secretary may not award more than 7 grants. 
‘‘(h) APPLICATION.—To seek a grant under this sec-
tion, a State or a consortium of public and private entities 
shall submit an application to the Secretary in such form, 
in such manner, and containing such information as the 
Secretary may require. At a minimum, the Secretary shall 
require each such application to outline how the State or 
consortium will establish baseline measures and bench-
marks to evaluate program outcomes. 
‘‘(i) DEFINITION.—In this section, the term ‘stroke’ 
means a ‘brain attack’ in which blood flow to the brain 
is interrupted or in which a blood vessel or aneurysm in 
the brain breaks or ruptures.
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‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$10,000,000 for fiscal year 2005, $13,000,000 for fiscal 
year 2006, $15,000,000 for fiscal year 2007, $8,000,000 
for fiscal year 2008, and $4,000,000 for fiscal year 
2009.’’. 
(b) STUDY; REPORTS.— 
(1) FINAL REPORT.—Not later than March 31, 
2010, the Secretary of Health and Human Services 
shall conduct a study of the results of the telehealth 
stroke treatment grant program under section 330M 
of the Public Health Service Act (added by sub-
section (a)) and submit to the Congress a report on 
such results that includes the following: 
(A) An evaluation of the grant program 
outcomes, including quantitative analysis of 
baseline and benchmark measures. 
(B) Recommendations on how to promote 
stroke networks in ways that improve access to 
clinical care in rural and urban areas and re-
duce the incidence of stroke and the debilitating 
and costly complications resulting from stroke. 
(C) Recommendations on whether similar 
telehealth grant programs could be used to im-