IIB 
111TH CONGRESS 
1ST SESSION 
H. R. 479 
IN THE SENATE OF THE UNITED STATES 
MARCH 31, 2009 
Received; read twice and referred to the Committee on Health, Education, 
Labor, and Pensions 
AN ACT 
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, 
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SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Wakefield Act’’. 
SEC. 2. FINDINGS AND PURPOSE. 
(a) FINDINGS.—Congress makes the following find-
ings: 
(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 
general 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-
zures, shock, and airway obstruction are other com-
mon pediatric emergencies, followed by cardiac ar-
rest 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 
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of hospitals have available all the pediatric supplies 
deemed essential by the American Academy of Pedi-
atrics and the American College of Emergency Phy-
sicians 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 sys-
tems 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 re-
search is translated into practice, best practices are 
adopted, training is current, and standards and pro-
tocols are appropriate. 
(8) The Emergency Medical Services for Chil-
dren (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 
improving 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 inter-
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est in such care and is depended upon by Federal 
agencies and national organizations to ensure that 
this exchange of knowledge and collaboration takes 
place. 
(10) The EMSC Program also supports a 
multi-institutional network for research in pediatric 
emergency medicine, thus allowing providers to rely 
on evidence rather than anecdotal experience when 
treating ill or injured children. 
(11) The Institute of Medicine stated in its 
2006 report, ‘‘Emergency Care for Children: Grow-
ing Pains’’, that the EMSC Program ‘‘boasts many 
accomplishments . . . and the work of the program 
continues to be relevant and vital’’. 
(12) The EMSC Program is celebrating its 
25th anniversary, marking a quarter-century of driv-
ing key improvements in emergency medical services 
to children, and should continue its mission to re-
duce child and youth morbidity and mortality by 
supporting improvements in the quality of all emer-
gency 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-
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provements in the quality of all emergency medical care 
children receive. 
SEC. 3. REAUTHORIZATION OF EMERGENCY MEDICAL 
SERVICES 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 
(4) by inserting after subsection (a) the fol-
lowing: 
‘‘(b)(1) The purpose of the program established 
under this section is to reduce child and youth morbidity 
and mortality by supporting improvements in the quality 
of all emergency medical care children receive, through the 
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promotion of projects focused on the expansion and im-
provement of such services, including those in rural areas 
and those for children with special health care needs. In 
carrying out this purpose, the Secretary shall support 
emergency medical services for children by supporting 
projects that— 
‘‘(A) develop and present scientific evidence; 
‘‘(B) promote existing and innovative tech-
nologies appropriate for the care of children; or 
‘‘(C) provide information on health outcomes 
and effectiveness and cost-effectiveness. 
‘‘(2) The program established under this section 
shall— 
‘‘(A) strive to enhance the pediatric capability 
of emergency medical service systems originally de-
signed primarily for adults; and 
‘‘(B) in order to avoid duplication and ensure 
that Federal resources are used efficiently and effec-
tively, be coordinated with all research, evaluations, 
and awards related to emergency medical services 
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for children undertaken and supported by the 
Federal Government.’’. 
Passed the House of Representatives March 30, 
2009. 
Attest: 
LORRAINE C. MILLER, 
Clerk. 
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