IB 
Union Calendar No. 13 
111TH CONGRESS 
1ST SESSION 
H. R. 479 
[Report No. 111–43] 
To amend the Public Health Service Act to provide a means for continued 
improvement in emergency medical services for children. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 13, 2009 
Mr. MATHESON (for himself, Mr. KING of New York, Mrs. CAPPS, Mr. 
REICHERT, and Ms. CASTOR of Florida) introduced the following bill; 
which was referred to the Committee on Energy and Commerce 
MARCH 23, 2009 
Additional sponsors: Mr. BISHOP of Georgia, Mr. SNYDER, Mr. YOUNG of 
Florida, Mr. CONNOLLY of Virginia, Mr. GENE GREEN of Texas, Ms. 
DEGETTE, Mr. THOMPSON of California, Mrs. BONO MACK, Mr. KIND, 
Mr. HINCHEY, Ms. BALDWIN, Mr. COHEN, Ms. CORRINE BROWN of Flor-
ida, Mr. HINOJOSA, Mr. GONZALEZ, Mr. CARNAHAN, Mr. POMEROY, Ms. 
MCCOLLUM, Ms. HARMAN, Ms. SCHAKOWSKY, Mr. SESTAK, Mr. GORDON 
of Tennessee, Mr. CARNEY, Ms. SUTTON, Mr. STUPAK, Mr. MARKEY of 
Massachusetts, Ms. HERSETH SANDLIN, Mr. INSLEE, Ms. MATSUI, Mr. 
MCDERMOTT, Mr. HILL, Mr. ENGEL, Ms. SLAUGHTER, and Mr. 
BUTTERFIELD 
MARCH 23, 2009 
Committed to the Committee of the Whole House on the State of the Union 
and ordered to be printed 
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[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on January 13, 2009] 
A BILL 
To amend the Public Health Service Act to provide a means 
for continued improvement in emergency medical services 
for children. 
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 ‘‘Wakefield Act’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—Congress makes the following findings: 
(1) There are 31,000,000 child and adolescent 
visits to the Nation’s emergency departments every 
year. 
(2) Over 90 percent of children requiring emer-
gency care are seen in general hospitals, not in free- 
standing children’s hospitals, with one-quarter to one- 
third of the patients being children in the typical gen-
eral hospital emergency department. 
(3) Severe asthma and respiratory distress are 
the most common emergencies for pediatric patients, 
representing nearly one-third of all hospitalizations 
among children under the age of 15 years, while sei-
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zures, shock, and airway obstruction are other com-
mon pediatric emergencies, followed by cardiac arrest 
and severe trauma. 
(4) Up to 20 percent of children needing emer-
gency care have underlying medical conditions such 
as asthma, diabetes, sickle-cell disease, low birth 
weight, and bronchopulmonary dysplasia. 
(5) Significant gaps remain in emergency med-
ical care delivered to children. Only about 6 percent 
of hospitals have available all the pediatric supplies 
deemed essential by the American Academy of Pediat-
rics and the American College of Emergency Physi-
cians for managing pediatric emergencies, while 
about half of hospitals have at least 85 percent of 
those supplies. 
(6) Providers must be educated and trained to 
manage children’s unique physical and psychological 
needs in emergency situations, and emergency systems 
must be equipped with the resources needed to care for 
this especially vulnerable population. 
(7) Systems of care must be continually main-
tained, updated, and improved to ensure that research 
is translated into practice, best practices are adopted, 
training is current, and standards and protocols are 
appropriate. 
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(8) The Emergency Medical Services for Children 
(EMSC) Program under section 1910 of the Public 
Health Service Act (42 U.S.C. 300w–9) is the only 
Federal program that focuses specifically on improv-
ing the pediatric components of emergency medical 
care. 
(9) The EMSC Program promotes the nation-
wide exchange of pediatric emergency medical care 
knowledge and collaboration by those with an interest 
in such care and is depended upon by Federal agen-
cies and national organizations to ensure that this ex-
change of knowledge and collaboration takes place. 
(10) The EMSC Program also supports a multi- 
institutional network for research in pediatric emer-
gency medicine, thus allowing providers to rely on 
evidence rather than anecdotal experience when treat-
ing ill or injured children. 
(11) The Institute of Medicine stated in its 2006 
report, ‘‘Emergency Care for Children: Growing 
Pains’’, that the EMSC Program ‘‘boasts many ac-
complishments . . . and the work of the program con-
tinues to be relevant and vital’’. 
(12) The EMSC Program is celebrating its 25th 
anniversary, marking a quarter-century of driving 
key improvements in emergency medical services to 
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children, and should continue its mission to reduce 
child and youth morbidity and mortality by sup-
porting improvements in the quality of all emergency 
medical and emergency surgical care children receive. 
(b) PURPOSE.—It is the purpose of this Act to reduce 
child and youth morbidity and mortality by supporting im-
provements in the quality of all emergency medical care 
children receive. 
SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL SERV-
ICES FOR CHILDREN PROGRAM. 
Section 1910 of the Public Health Service Act (42 
U.S.C. 300w–9) is amended— 
(1) in subsection (a), by striking ‘‘3-year period 
(with an optional 4th year’’ and inserting ‘‘4-year 
period (with an optional 5th year’’; 
(2) in subsection (d)— 
(A) by striking ‘‘and such sums’’ and in-
serting ‘‘such sums’’; and 
(B) by inserting before the period the fol-
lowing: ‘‘, $25,000,000 for fiscal year 2010, 
$26,250,000 for fiscal year 2011, $27,562,500 for 
fiscal year 2012, $28,940,625 for fiscal year 
2013, and $30,387,656 for fiscal year 2014’’; 
(3) by redesignating subsections (b) through (d) 
as subsections (c) through (e), respectively; and 
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