(C) Critical care services are overwhelm-
ingly consumed by patients over the age of 65 
and the aging of the United States population 
is driving demand for these services. 
(4) The future growth in the number of critical 
care physicians in ICU settings will be insufficient 
to keep pace with growing demand. 
(5) This growing shortage of critical care physi-
cians presents a serious threat to the quality and 
availability of health care services in the United 
States. 
(6) This shortage will disproportionately impact 
rural and other areas of the United States that al-
ready often suffer from a suboptimal level of critical 
care services. 
SEC. 4. RESEARCH. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, through the Agency for Healthcare Re-
search and Quality, shall conduct research to assess— 
(1) the standardization of critical care proto-
cols, intensive care unit layout, equipment interoper-
ability, and medical informatics; 
(2) the impact of differences in staffing, organi-
zation, size, and structure of intensive care units on 
access, quality, and efficiency of care; and 
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(3) coordinated community and regional ap-
proaches to providing critical care services, including 
approaches whereby critical care patients are as-
sessed and provided care based upon intensity of 
services required. 
(b) REPORT.—Not later than 18 months after the 
date of enactment of this Act, the Agency for Healthcare 
Research and Quality shall submit a report to Congress, 
that, based on the review under subsection (a), evaluates 
and makes recommendations regarding best practices in 
critical care medicine. 
SEC. 5. INNOVATIVE APPROACHES TO CRITICAL CARE 
SERVICES. 
The Secretary of Health and Human Services shall 
undertake the following demonstration projects: 
(1) OPTIMIZATION
OF
CRITICAL
CARE
SERV-
ICES.— 
(A) IN GENERAL.—The Administrator of 
the Centers for Medicare & Medicaid Services 
shall solicit proposals submitted by inpatient 
providers of critical care services who propose 
to demonstrate methods to optimize the provi-
sion of critical care services to Medicare bene-
ficiaries through innovations in such areas as 
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staffing, ICU arrangement, and utilization of 
technology. 
(B) FUNDING
OF
PROPOSALS.—The Ad-
ministrator of the Centers for Medicare & Med-
icaid Services shall fund not more than 5 pro-
posals, not less than 1 of which shall focus on 
the training of hospital-based physicians in 
rural or community, or both, hospital facilities 
in the provision of critical care medicine. Such 
projects shall emphasize outcome measures 
based on the Institute of Medicine’s following 6 
domains of quality care: 
(i) Care should be safe. 
(ii) Care should be effective. 
(iii) Care should be patient-centered. 
(iv) Care should be timely. 
(v) Care should be efficient. 
(vi) Care should be equitable. 
(2) FAMILY ASSISTANCE PROGRAMS FOR THE 
CRITICALLY ILL.— 
(A) 
IN
GENERAL.—The 
Secretary 
of 
Health and Human Services shall solicit pro-
posals and make an award to support a consor-
tium consisting of 1 or more providers of inpa-
tient critical care services and a medical spe-
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cialty society involved in the education and 
training of critical care providers. 
(B) MEASUREMENT AND EVALUATION.—A 
provider that receives support under subpara-
graph (A) shall measure and evaluate outcomes 
derived from a ‘‘family-centered’’ approach to 
the provision of inpatient critical care services 
that includes direct and sustained communica-
tion and contact with beneficiary family mem-
bers, involvement of family members in the crit-
ical care decisionmaking process, and respon-
siveness of critical care providers to family re-
quests. Such project shall evaluate the impact 
of a family-centered, multiprofessional team ap-
proach on, and the correlation between— 
(i) family satisfaction; 
(ii) staff satisfaction; 
(iii) length of patient stay in an inten-
sive care unit; and 
(iv) cost of care. 
(C) OUTCOME
MEASURES.—A provider 
that receives support under subparagraph (A) 
shall emphasize outcome measures based on the 
Institute of Medicine’s following 6 domains of 
quality care: 
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(i) Care should be safe. 
(ii) Care should be effective. 
(iii) Care should be patient-centered. 
(iv) Care should be timely. 
(v) Care should be efficient. 
(vi) Care should be equitable. 
SEC. 6. USE OF TELEMEDICINE TO ENHANCE CRITICAL 
CARE SERVICES IN RURAL AREAS. 
(a) AMENDMENT TO RURAL UTILITIES SERVICE DIS-
TANCE
LEARNING
AND
TELEMEDICINE
PROGRAM.— 
Chapter 1 of subtitle D of title XXIII of the Food, Agri-
culture, Conservation, and Trade Act of 1990 (7 U.S.C. 
950aaa et seq.) is amended by adding at the end the fol-
lowing: 
‘‘SEC. 2335B. ADDITIONAL AUTHORIZATION OF APPROPRIA-
TIONS FOR TELEMEDICINE CRITICAL CARE 
INITIATIVES. 
‘‘In addition to amounts authorized under section 
2335A, there is authorized to be appropriated $5,000,000 
in each of fiscal years 2010 through 2012 to carry out 
telemedicine initiatives under this chapter whereby 1 or 
more rural providers of inpatient critical care services pro-
pose, through collaboration with other providers, to aug-
ment the delivery of critical care services in the rural inpa-
tient setting through the use of telecommunications sys-
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