I 
111TH CONGRESS 
2D SESSION 
H. R. 6306 
To improve the understanding and coordination of critical care health services. 
IN THE HOUSE OF REPRESENTATIVES 
SEPTEMBER 29, 2010 
Ms. BALDWIN introduced the following bill; which was referred to the 
Committee on Energy and Commerce 
A BILL 
To improve the understanding and coordination of critical 
care health services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Critical Care Assess-
ment and Improvement Act of 2010’’. 
SEC. 2. FINDINGS; PURPOSES. 
(a) FINDINGS.—Congress finds the following: 
(1) Critical care medicine is the care for pa-
tients whose illnesses or injuries present a signifi-
cant danger to life, limb, or organ function and re-
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quire comprehensive care and constant monitoring, 
usually in intensive care units. 
(2) Each year, approximately five million Amer-
icans are admitted into traditional, surgical, pedi-
atric, or neo-natal intensive care units. 
(3) Nearly 80 percent of all Americans will ex-
perience a critical care injury or illness as a patient, 
family member, or friend of a patient. 
(4) Critical care medicine consumes a signifi-
cant amount of financial resources, accounting for 
more than 13 percent of all hospital costs. 
(5) According to a 2006 report by the Health 
Resources and Services Administration (‘‘HRSA’’), 
demand in the United States for critical care med-
ical services is on the rise, due in part to the grow-
ing elderly population, as individuals over the age of 
65 consume a large percentage of critical care serv-
ices. 
(6) The HRSA report also found that the grow-
ing aging population will further exacerbate an exist-
ing shortage of intensivists, the physicians certified 
in critical care who primarily deliver care in inten-
sive care units, potentially compromising the quality 
and availability of care. 
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(7) The demand on critical services and trained 
personnel increases exponentially in the event of a 
natural disaster or pandemic outbreak such as the 
H1N1 virus. 
(8) Ensuring the strength of our critical care 
medical delivery infrastructure is integral to the im-
provement of the quality and delivery of health care 
in the United States. 
(b) PURPOSE.—The purpose of this Act is to assess 
the current state of the United States critical care medical 
delivery system and implement policies to improve the 
quality and effectiveness of care delivered to the critically 
ill and injured. 
SEC. 3. STUDIES ON CRITICAL CARE. 
(a) INSTITUTE OF MEDICINE STUDY.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this Act referred to as the ‘‘Sec-
retary’’) shall enter into an agreement with the In-
stitute of Medicine under which, not later than 1 
year after the date of the enactment of this Act, the 
Institute will— 
(A) conduct an analysis of the current 
state of critical care health services in the 
United States; 
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(B) develop recommendations to bolster 
critical care capabilities to meet future demand; 
and 
(C) submit to Congress a report including 
the analysis and recommendations under sub-
paragraphs (A) and (B). 
(2) ISSUES TO BE STUDIED.—The agreement 
under paragraph (1) shall, at a minimum, provide 
for the following: 
(A) Analysis of the current critical care 
system in the United States, including— 
(i) the system’s capacity and re-
sources, including the size of the critical 
care workforce and the availability of 
health information technology and medical 
equipment; 
(ii) the system’s strengths, limitations, 
and future challenges; and 
(iii) the system’s ability to provide 
adequate care for the critically ill or in-
jured in response to a national health 
emergency, including a pandemic or nat-
ural disaster. 
(B) Analysis and recommendations regard-
ing regionalizing critical care systems. 
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(C) Analysis regarding the status of crit-
ical care research in the United States and rec-
ommendations for future research priorities. 
(b) 
GOVERNMENT
ACCOUNTABILITY
OFFICE 
STUDY.—Not later than 1 year after the date of the enact-
ment of this Act, the Comptroller General of the United 
States shall issue a report including the following: 
(1) An inventory of all current and recent crit-
ical care research and critical care-related programs 
of the Federal Government and recommendations on 
how to better coordinate critical care research ef-
forts. 
(2) An economic analysis of critical care costs 
as a percentage of overall Federal health care spend-
ing, and a comparison of such percentage to the per-
centage of Federal critical research expenditures rel-
ative to overall Federal health research spending. 
(c) HEALTH RESOURCES AND SERVICES ADMINIS-
TRATION STUDY.— 
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Administrator of the Health Resources 
and Services Administration, shall review and update 
the Administration’s 2006 study entitled ‘‘The Crit-
ical Care Workforce: A Study of the Supply and De-
mand for Critical Care Physicians’’. 
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(2) SCOPE.—In carrying out paragraph (1), the 
Secretary shall expand the scope of the study to ad-
dress the supply and demand of other providers 
within the spectrum of critical care delivery, includ-
ing critical care nurses, mid-level providers (such as 
physician assistants and nurse practitioners), inten-
sive care unit pharmacists, and intensive care unit 
respiratory care practitioners. 
SEC. 4. NIH CRITICAL CARE COORDINATING COUNCIL. 
(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Director of the National Institutes of Health, 
shall establish a council within the Institutes to be known 
as the Critical Care Coordinating Council (in this section 
referred to as the ‘‘Council’’). 
(b) MEMBERSHIP.—The Secretary shall ensure that 
the membership of the Council includes representatives of 
each of— 
(1) the National Heart, Lung, and Blood Insti-
tute; 
(2) the National Institute of Nursing Research; 
(3) the Eunice Kennedy Shriver National Insti-
tute of Child Health and Human Development; and 
(4) any other national research institute or na-
tional center of the National Institutes of Health 
that Secretary deems appropriate. 
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(c) DUTIES.—The Council shall— 
(1) coordinate the collection and analysis of in-
formation on current research of the National Insti-
tutes of Health relating to the care of the critically 
ill and injured, identify gaps in such research, and 
make recommendations to the Director of such Insti-
tutes on how to improve such research; and 
(2) provide annual reports to the Director re-
garding research efforts of the National Institutes of 
Health relating to the care of the critically ill and 
injured, and make recommendations in such reports 
on how to strengthen partnerships within the Na-
tional Institutes of Health and between the National 
Institutes of Health and public and private entities 
to expand collaborative, cross-cutting research. 
SEC. 5. IMPROVING FEDERAL DISASTER PREPAREDNESS 
EFFORTS TO CARE FOR THE CRITICALLY ILL 
AND INJURED. 
(a) REPORT ON AVAILABILITY OF CRITICAL CARE 
PRACTITIONERS.—Not later than 1 year after the date of 
the enactment of this Act, the Secretary shall submit a 
report to the Congress on the adequacy of the number of 
critical care practitioners in disaster medical assistance 
teams, the Medical Reserve Corps, and the Public Health 
Service Commissioned Corps. Such report shall include 
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recommendations, as necessary, for addressing any short-
ages in the number of such practitioners. 
(b) RECOMMENDATIONS
FOR
EMERGENCY
ICU 
EVACUATION PRACTICES.—Not later than 1 year after the 
date of the enactment of this Act, the Secretary, acting 
through the Director of the Agency for Healthcare Re-
search and Quality, in consultation with critical care prac-
titioners, shall develop guidelines or best practices for the 
evacuation of intensive care units during a national health 
emergency, including a pandemic or natural disaster. 
(c) PANEL ON EMERGENCY PREPAREDNESS DATA-
BASES.— 
(1) ESTABLISHMENT.—The Secretary shall es-
tablish a panel of emergency preparedness experts to 
be known as the Panel on Emergency Preparedness 
Databases (in this section referred to as the 
‘‘Panel’’). 
(2) MEMBERSHIP.—The Secretary shall ensure 
that the membership of the Panel includes experts 
from the public and private sector and experts from 
the critical care community. 
(3) DUTIES.—The Panel shall— 
(A) assess the adequacy of existing na-
tional preparedness databases in facilitating ef-
fective and coordinated local, State, and Fed-
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eral medical responses during a national health 
emergency, including a pandemic or natural dis-
aster; 
(B) identify gaps in existing information 
networks; 
(C) recommend specific ways to improve 
awareness of the availability of resources before, 
during, and after an incident; and 
(D) submit to the Director of the National 
Institutes of Health a report including the as-
sessment, identification, and recommendations 
made under subparagraphs (A) through (C), re-
spectively. 
Æ 
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