I 
110TH CONGRESS 
1ST SESSION H. R. 3886 
To optimize the delivery of critical care medicine and expand the critical 
care workforce. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 18, 2007 
Ms. SCHAKOWSKY (for herself and Mr. CANTOR) introduced the following bill; 
which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Agriculture, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To optimize the delivery of critical care medicine and expand 
the critical care workforce. 
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 ‘‘Patient-Focused Crit-
ical Care Enhancement Act’’. 
SEC. 2. PURPOSE. 
The purpose of this Act is to optimize the delivery 
of critical care medicine and expand the critical care work-
force. 
VerDate Aug 31 2005 
05:57 Oct 19, 2007
Jkt 069200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H3886.IH
H3886
bajohnson on PROD1PC71 with BILLS
SEC. 3. FINDINGS. 
Based on the Health Resources and Services Admin-
istration’s May 2006 Report to Congress, The Critical 
Care Workforce: A Study of the Supply and Demand for 
Critical Care Physicians, the Senate makes the following 
findings: 
(1) In 2000, an estimated 18,000,000 inpatient 
days of ICU care were provided in the United States 
through approximately 59,000 ICU beds in 3,200 
hospitals. 
(2) Patient outcomes and the quality of care in 
the ICU are related to who delivers that care and 
how care is organized. 
(3) The demand in the United States for crit-
ical care medical services is rising sharply and will 
continue to rise sharply largely as a result of the fol-
lowing 3 factors: 
(A) 
There 
is 
strong 
evidence 
dem-
onstrating improvements in outcomes and effi-
ciency when intensive care services are provided 
by nurses and intensivist physicians who have 
advanced specialty training in critical care med-
icine. 
(B) The Leapfrog Group, health care 
payors, and providers are encouraging greater 
use of such personnel in intensive care settings. 
VerDate Aug 31 2005 
05:57 Oct 19, 2007
Jkt 069200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H3886.IH
H3886
bajohnson on PROD1PC71 with BILLS
(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 
VerDate Aug 31 2005 
05:57 Oct 19, 2007
Jkt 069200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H3886.IH
H3886
bajohnson on PROD1PC71 with BILLS
(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 
VerDate Aug 31 2005 
05:57 Oct 19, 2007
Jkt 069200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H3886.IH
H3886
bajohnson on PROD1PC71 with BILLS