I 
109TH CONGRESS 
1ST SESSION H. R. 2560 
To amend title XVIII of the Social Security Act to require, as a condition 
of participation in the Medicare Program, that hospitals make reasonable 
efforts to contact a family member, specified healthcare agent, or surro-
gate decisionmaker of a patient who arrives at a hospital emergency 
department unconscious or otherwise physically incapable of commu-
nicating with the attending health care practitioners of the hospital, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 24, 2005 
Mr. JACKSON of Illinois introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Com-
mittee on Ways and Means, for a period to be subsequently determined 
by the Speaker, in each case for consideration of such provisions as fall 
within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to require, 
as a condition of participation in the Medicare Program, 
that hospitals make reasonable efforts to contact a family 
member, specified healthcare agent, or surrogate deci-
sionmaker of a patient who arrives at a hospital emer-
gency department unconscious or otherwise physically in-
capable of communicating with the attending health care 
practitioners of the hospital, and for other purposes. 
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 ‘‘Elaine Sullivan Act’’. 
SEC. 2. REQUIREMENT FOR EMERGENCY DEPARTMENTS 
TO CONTACT FAMILY MEMBERS, SPECIFIED 
HEALTHCARE AGENT, OR SURROGATE DECI-
SIONMAKER OF INCAPACITATED PATIENTS 
WITHIN 24 HOURS OF ARRIVAL AT THE EMER-
GENCY DEPARTMENT. 
(a) IN GENERAL.—Section 1866(a)(1) of the Social 
Security Act (42 U.S.C. 1395cc(a)(1)) is amended— 
(1) in subparagraph (U), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (V), by striking the period 
at the end and inserting ‘‘, and’’; and 
(3) by inserting after subparagraph (V) the fol-
lowing new subparagraph: 
‘‘(W) in the case of a hospital (as defined in 
section 1861(e)) with an emergency department, to 
adopt and enforce a policy to ensure compliance with 
the requirements of subsection (k) (relating to re-
quirements to make reasonable efforts to contact 
certain individuals in the case of a patient who is 
unconscious or physically unable to communicate 
with staff of the hospital).’’. 
(b) REQUIREMENT TO CONTACT FAMILY MEMBERS 
OR OTHER INDIVIDUALS WITH AUTHORITY TO MAKE
HEALTH CARE DECISIONS.—Section 1866 of such Act 
(42 U.S.C. 1395cc) is amended by adding at the end the 
following new subsection: 
‘‘(k)(1)(A) In the case of a hospital (as defined in 
section 1861(e)) with an emergency department, if any in-
dividual arrives at the emergency department requiring 
medical treatment and is unconscious or otherwise unable 
to communicate with a health care professional of the de-
partment, the hospital shall take reasonable measures (de-
scribed in paragraph (3)) to identify and contact a person 
the hospital reasonably believes has the authority to make 
health care decisions on behalf of the individual. 
‘‘(B) A person referred to in subparagraph (A) is any 
of the following: 
‘‘(i) An immediate family member. 
‘‘(ii) A person authorized to make health care 
decisions for the individual under a durable power of 
attorney for health care, recognized under State law 
(whether by statute or as recognized by the courts 
of the State). 
‘‘(2)(A) The hospital shall take the reasonable meas-
ures as soon as practicable, but, subject to subparagraph 
(B), in no case later than the end of the 24-hour period 
that begins at the point in time that a health care profes-
sional of the emergency department of the hospital deter-
mines that the individual is unconscious or otherwise un-
able to communicate. 
‘‘(B)(i) The 24-hour period under subparagraph (A) 
shall not apply during any period in which the hospital 
implements a disaster and mass casualty program or a 
fire and internal disaster program, or during a declared 
state of emergency (as defined in clause (ii)) or other local 
mass casualty situation. 
‘‘(ii) For purposes of clause (i), the term ‘declared 
state of emergency’ means an officially designated state 
of emergency that has been declared by the Federal Gov-
ernment or a State or local government official having au-
thority to declare that the State, county, municipality, or 
locality is in a state of emergency. 
‘‘(3) Reasonable measures referred to in paragraph 
(1) include the following: 
‘‘(A) Contacting the emergency contact, family 
member, surrogate decision maker, or other health 
care agent identified from personal effects of the in-
dividual. 
‘‘(B) Examining medical records in the hos-
pital’s possession, including a review of any verbal or 
written report made by emergency medical techni-
cians or the police with respect to the individual.
‘‘(C) Insofar as actions under subparagraphs 
(A) and (B) are unsuccessful, contacting the hos-
pital’s social service department or the appropriate 
local law enforcement agency. 
‘‘(4) The provisions of this subsection do not preempt 
any State or local law requirement, except to the extent 
that the requirement directly conflicts with a requirement 
of this subsection.’’. 
(c) EFFECTIVE DATE.—The amendments made by 
this section shall apply to hospitals as of the date that 
is one year after the date of the enactment of this Act. 
SEC. 3. GRANT PROGRAM FOR THE ESTABLISHMENT OF 
NEXT OF KIN REGISTRIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services is authorized to make grants to qualified 
not-for-profit organizations for the purpose of assisting 
such organizations to establish and operate voluntary next 
of kin registries. 
(b) NEXT OF KIN REGISTRY DESCRIBED.—A next 
of kin registry is an electronic search service to help indi-
viduals, and family members of those individuals, who are 
missing, injured, or deceased. A next of kin registry is a 
free service to the public, health care providers and insti-
tutions, and governmental agencies using the search serv-
ice.
(c) AWARDING OF GRANTS.— 
(1) APPLICATION.—No grant may be made 
under this section except pursuant to a grant appli-
cation that is submitted and approved in a time, 
manner, and form specified by the Secretary. 
(2) LIMITATION
ON
GRANTS.—Only 1 grant 
may be awarded under this section with respect to 
any qualified not-for-profit organizations. 
(d) TERMS AND CONDITIONS.— 
(1) IN
GENERAL.—Grants under this section 
shall be made under such terms and conditions as 
the Secretary specifies consistent with this section. 
(2) USE OF GRANT FUNDS.—Funds provided 
under grants under this section may be used for any 
of the following: 
(A) For purchasing, leasing, and installing 
computer software and hardware. 
(B) Making upgrades and other improve-
ments to existing computer software and hard-
ware. 
(C) Providing education and training to el-
igible staff on the use of technology to imple-
ment next-of-kin registries. 
(3) PROVISION OF INFORMATION.—As a condi-
tion for the awarding of a grant under this section,
an applicant shall provide to the Secretary such in-
formation as the Secretary may require in order 
to— 
(A) evaluate the project for which the 
grant is made; and 
(B) ensure that funding provided under 
the grant is expended only for the purposes for 
which it is made. 
(4) AUDIT.—The Secretary shall conduct ap-
propriate audits of grants under this section. 
(e) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2006 through 2010. 
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