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107TH CONGRESS
1ST SESSION
H. R. 3431
To amend the Public Health Service Act to provide programs for the
prevention, treatment, and rehabilitation of stroke.
IN THE HOUSE OF REPRESENTATIVES
DECEMBER 6, 2001
Mrs. CAPPS (for herself, Mr. PICKERING, Mr. DINGELL, Mr. GREENWOOD,
Mr. BROWN of Ohio, Mr. SHIMKUS, Mr. WAXMAN, Mr. FOLEY, Mr.
STARK, Mr. NORWOOD, Mr. RANGEL, Ms. DUNN of Washington, Mr.
TOWNS, Mr. WICKER, Mr. KENNEDY of Rhode Island, Mr. PLATTS, Mr.
FARR of California, Mr. BAKER, Mr. ENGEL, Mr. CUNNINGHAM, Mr.
GREEN of Texas, Mr. CALVERT, Mrs. MCCARTHY of New York, Mr.
WAMP, Mr. SERRANO, Mr. WOLF, Mr. GUTIERREZ, Mr. THUNE, Mrs.
MEEK of Florida, Mr. DICKS, Mr. LANTOS, Mr. WYNN, Mr. JEFFERSON,
Mr. MCGOVERN, Mr. MCNULTY, Ms. MCCOLLUM, Mr. ACKERMAN, Mr.
BALDACCI, 
Mr. 
PALLONE, 
Mr. 
MARKEY, 
Mr. 
ISRAEL, 
Mrs.
CHRISTENSEN, Ms. WATSON of California, Mr. HOLT, Mr. MATSUI, Mr.
LIPINSKI, Ms. CARSON of Indiana, Mr. PRICE of North Carolina, Ms.
LEE, Mr. KIND, Mr. MOORE, Ms. ESHOO, Ms. HARMAN, Mr. FILNER,
Mr. STENHOLM, Mr. FROST, Mr. JACKSON of Illinois, Ms. SCHAKOWSKY,
Mr. PASCRELL, Mrs. TAUSCHER, Ms. MCKINNEY, Mr. OBERSTAR, Mr.
UDALL of New Mexico, Mr. INSLEE, Mr. DAVIS of Florida, Ms.
DEGETTE, Mr. HALL of Texas, Mr. DAVIS of Illinois, Mr. ABERCROMBIE,
Mr. GORDON, Mr. POMEROY, and Mr. RUSH) introduced the following
bill; which was referred to the Committee on Energy and Commerce
A BILL
To amend the Public Health Service Act to provide programs
for the prevention, treatment, and rehabilitation of stroke.
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 ‘‘Stroke Treatment and
Ongoing Prevention Act of 2001’’.
SEC. 2. FINDINGS AND GOAL.
(a) FINDINGS.—Congress makes the following find-
ings:
(1) Stroke is the third leading cause of death
in the United States. Each year over 750,000 Amer-
icans suffer a new or recurrent stroke and 160,000
Americans die from stroke.
(2) 
Stroke 
costs 
the 
United 
States
$28,000,000,000 
in 
direct 
costs 
and
$17,400,000,000 in indirect costs, each year.
(3) Stroke is one of the leading causes of adult
disability in the United States. Between 15 percent
and 30 percent of stroke survivors are permanently
disabled. Presently, there are 4,400,000 stroke sur-
vivors living in the United States.
(4) Members of the general public have dif-
ficulty recognizing the symptoms of stroke and are
unaware that stroke is a medical emergency. Fifty-
eight percent of all stroke patients wait 24 hours or
more before presenting at the emergency room.
Forty-two percent of individuals over the age of 50
do not recognize numbness or paralysis in the face,
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arm, or leg as a sign of stroke and 17 percent of
them cannot name a single stroke symptom.
(5) Recent advances in stroke treatment can
significantly improve the outcome for stroke pa-
tients, but these therapies must be administered
properly and promptly. Only 3 percent of stroke pa-
tients who are candidates for acute stroke intra-
venous thrombolytic drug therapy receive the appro-
priate medication.
(6) New technologies, therapies, and diagnostic
approaches are currently being developed that will
extend the therapeutic timeframe and result in
greater treatment efficacy for stroke patients.
(7) Few States and communities have developed
and implemented stroke awareness programs, pre-
vention programs, or comprehensive stroke care sys-
tems.
(8) The degree of disability resulting from
stroke can be reduced substantially by educating the
general public about stroke and by improving the
systems for the provision of stroke care in the
United States.
(b) GOAL.—It is the goal of this Act to improve the
provision of stroke care in every State and territory and
in the District of Columbia, and to increase public aware-
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ness about the prevention, detection, and treatment of
stroke.
SEC. 3. SYSTEMS FOR STROKE PREVENTION, TREATMENT,
AND REHABILITATION.
The Public Health Service Act (42 U.S.C. 201 et
seq.) is amended by adding at the end the following:
‘‘TITLE 
XXVIII—SYSTEMS 
FOR
STROKE 
PREVENTION,
TREATMENT, AND REHABILI-
TATION
‘‘PART A—STROKE PREVENTION AND EDUCATION
CAMPAIGN
‘‘SEC. 2801. STROKE PREVENTION AND EDUCATION CAM-
PAIGN.
‘‘(a) IN GENERAL.—The Secretary shall carry out a
national education and information campaign to promote
stroke prevention and increase the number of stroke pa-
tients who seek immediate treatment. In implementing
such education and information campaign, the Secretary
shall avoid duplicating existing stroke education efforts by
other Federal Government agencies and may consult with
national and local associations that are dedicated to in-
creasing the public awareness of stroke, consumers of
stroke awareness products, and providers of stroke care.
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‘‘(b) USE
OF FUNDS.—The Secretary may use
amounts appropriated to carry out the campaign described
in subsection (a)—
‘‘(1) to make public service announcements
about the warning signs of stroke and the impor-
tance of treating stroke as a medical emergency;
‘‘(2) to provide education regarding ways to
prevent stroke and the effectiveness of stroke treat-
ment;
‘‘(3) to purchase media time and space;
‘‘(4) to pay for out-of-pocket advertising pro-
duction costs;
‘‘(5) to test and evaluate advertising and edu-
cational materials for effectiveness, especially among
groups at high risk for stroke, including women,
older adults, and African-Americans;
‘‘(6) to develop alternative campaigns that are
targeted to unique communities, including rural and
urban communities, and communities in the ‘Stroke
Belt’;
‘‘(7) to measure public awareness prior to the
start of the campaign on a national level and in tar-
geted communities to provide baseline data that will
be used to evaluate the effectiveness of the public
awareness efforts; and
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‘‘(8) to carry out other activities that the Sec-
retary determines will promote prevention practices
among the general public and increase the number
of stroke patients who seek immediate care.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out subsection
(b), $40,000,000 for fiscal year 2002, and such sums as
may be necessary for each of fiscal years 2003 through
2006.
‘‘PART B—GENERAL AUTHORITIES AND DUTIES OF THE
SECRETARY
‘‘SEC. 2811. ESTABLISHMENT.
‘‘(a) IN GENERAL.—The Secretary shall, with respect
to stroke care—
‘‘(1) make available, support, and evaluate a
grant program to enable a State to develop statewide
stroke care systems;
‘‘(2) foster the development of appropriate,
modern systems of stroke care through the sharing
of information among agencies and individuals in-
volved in the study and provision of such care; and
‘‘(3) provide to State and local agencies tech-
nical assistance.
‘‘(b) GRANTS, COOPERATIVE AGREEMENTS, AND
CONTRACTS.—The Secretary may make grants, and enter
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into cooperative agreements and contracts, for the purpose
of carrying out subsection (a).
‘‘SEC. 2812. PAUL COVERDELL NATIONAL ACUTE STROKE
REGISTRY AND CLEARINGHOUSE.
‘‘(a) IN GENERAL.—The Secretary shall maintain the
Paul Coverdell National Acute Stroke Registry and Clear-
inghouse by—
‘‘(1) continuing to develop and collect specific
data points as well as appropriate benchmarks for
analyzing care of acute stroke patients;
‘‘(2) continuing to design and pilot test proto-
types that will measure the delivery of care to pa-
tients with acute stroke in order to provide real-time
data and analysis to reduce death and disability
from stroke and improve the quality of life for acute
stroke survivors;
‘‘(3) fostering the development of effective,
modern stroke care systems (including the develop-
ment of policies related to emergency services sys-
tems) through the sharing of information among
agencies and individuals involved in planning, fur-
nishing, and studying such systems;
‘‘(4) collecting, compiling, and disseminating in-
formation on the achievements of, and problems ex-
perienced by, State and local agencies and private
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entities in developing and implementing stroke care
systems and, in carrying out this paragraph, giving
special consideration to the unique needs of rural fa-
cilities and those facilities with inadequate resources
for providing quality prevention, acute treatment,
post-acute treatment, and rehabilitation services for
stroke patients;
‘‘(5) providing technical assistance relating to
stroke care systems to State and local agencies; and
‘‘(6) carrying out any other activities the Sec-
retary determines to be useful to fulfill the purposes
of the Paul Coverdell National Acute Stroke Reg-
istry and Clearinghouse.
‘‘(b) RESEARCH ON STROKE.—The Secretary shall,
not earlier than 1 year after the date of enactment of the
Stroke Treatment and Ongoing Prevention Act of 2001,
ensure the availability of published research on stroke or,
where necessary, conduct research concerning—
‘‘(1) best practices in the prevention, diagnosis,
treatment, and rehabilitation of stroke;
‘‘(2) barriers to access to currently approved
stroke prevention, treatment, and rehabilitation serv-
ices;
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‘‘(3) barriers to access to newly developed diag-
nostic approaches, technologies, and therapies for
stroke patients;
‘‘(4) the effectiveness of existing public aware-
ness campaigns regarding stroke; and
‘‘(5) disparities in the prevention, diagnosis,
treatment, and rehabilitation of stroke among dif-
ferent populations.
‘‘(c) CERTAIN RESEARCH ACTIVITIES.—In carrying
out the activities described in subsection (b), the Secretary
may conduct—
‘‘(1) studies with respect to all phases of stroke
care, including prehospital, acute, post-acute and re-
habilitation care;
‘‘(2) studies with respect to patient access to
currently approved and newly developed stroke pre-
vention and treatment services, including a review of
the effect of coverage, coding, and reimbursement
practices on access;
‘‘(3) studies with respect to the effect of exist-
ing public awareness campaigns on stroke; and
‘‘(4) any other studies that the Secretary deter-
mines are necessary or useful to conduct a thorough
and effective research program regarding stroke.
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‘‘(d) MECHANISMS OF SUPPORT.—In carrying out
the activities described in subsection (b), the Secretary
may make grants to public and private non-profit entities.
‘‘(e) COORDINATION
OF EFFORT.—The Secretary
shall ensure the adequate coordination of the activities
carried out under this section.
‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated such sums as may be nec-
essary for each of fiscal years 2002 through 2006 to carry
out this section.
‘‘PART C—GRANTS WITH RESPECT TO STATE STROKE
CARE SYSTEMS
‘‘SEC. 2821. ESTABLISHMENT OF PROGRAM FOR IMPROV-
ING STROKE CARE.
‘‘(a) GRANTS.—The Secretary shall award grants to
States for the purpose of establishing statewide stroke pre-
vention, treatment, and rehabilitation systems.
‘‘(b) USE OF FUNDS.—
‘‘(1) IN GENERAL.—The Secretary shall make
available grants under subsection (a) for the devel-
opment and implementation of statewide stroke care
systems that provide stroke prevention services and
quality acute, post-acute, and rehabilitation care for
stroke patients through the development of sufficient
resources and infrastructure, including personnel
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with appropriate training, acute stroke teams, equip-
ment, and procedures necessary to prevent stroke
and to treat and rehabilitate stroke patients. In de-
veloping and implementing statewide stroke care sys-
tems, each State that is awarded such a grant
shall—
‘‘(A) oversee the design and implementa-
tion of the statewide stroke care system;
‘‘(B) enhance, develop, and implement
model curricula for training emergency medical
services personnel, including dispatchers, first
responders, emergency medical technicians, and
paramedics in the identification, assessment,
stabilization, and prehospital treatment of
stroke patients;
‘‘(C) ensure that stroke patients in the
State have access to quality care that is con-
sistent with the standards established by the
Secretary under section 2823(c);
‘‘(D) establish a support network to pro-
vide assistance to facilities with smaller popu-
lations of stroke patients or less advanced on-
site stroke treatment resources; and
‘‘(E) carry out any other activities that the
State-designated agency determines are useful
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or necessary for the implementation of the
statewide stroke care system.
‘‘(2) ACCESS TO CARE.—A State may meet the
requirement of paragraph (1)(C) by—
‘‘(A) identifying acute stroke centers with
personnel, equipment, and procedures adequate
to provide quality treatment to patients in the
acute phase of stroke consistent with the stand-
ards established by the Secretary under section
2823(c);
‘‘(B) identifying comprehensive stroke cen-
ters with advanced personnel, equipment, and
procedures to prevent stroke and to treat stroke
patients in the acute and post-acute phases of
stroke and to provide assistance to area facili-
ties with less advanced stroke treatment re-
sources;
‘‘(C) identifying stroke rehabilitation cen-
ters with personnel, equipment, and procedures
to provide quality rehabilitative care to stroke
patients consistent with the standards estab-
lished by the Secretary under section 2823(c);
or
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‘‘(D) carrying out any other activities that
the designated State agency determines are nec-
essary or useful.
‘‘(3) SUPPORT NETWORK.—A facility that pro-
vides care to stroke patients and that receives sup-
port through a support network established under
paragraph (1)(E) shall meet the standards and re-
quirements outlined by the State application under
paragraphs (4), (5), (6), (7), and (8) of section
2823(a). The support network may include—
‘‘(A) the use of telehealth technology con-
necting facilities described in such paragraph to
more advanced stroke care facilities;
‘‘(B) the provision of neuroimaging, lab,
and any other equipment necessary to facilitate
the establishment of a telehealth network;
‘‘(C) the use of phone consultation, where
useful;
‘‘(D) the use of referral links when a pa-
tient needs more advanced care than is avail-
able at the facility providing initial care; and
‘‘(E) any other assistance determined ap-
propriate by the State.
‘‘(c) PLANNING GRANTS.—
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‘‘(1) IN GENERAL.—The Secretary may award
a grant to a State to assist such State in formu-
lating a plan to develop a statewide stroke care sys-
tem or in otherwise meeting the conditions described
in subsection (b) with respect to a grant under this
section.
‘‘(2) SUBMISSION
TO
SECRETARY.—The gov-
ernor of a State that receives a grant under para-
graph (1) shall submit to the Secretary a copy of the
plan developed using the amounts provided under
such grant. Such plan shall be submitted to the Sec-
retary as soon as practicable after the plan has been
developed.
‘‘(3) SINGLE GRANT LIMITATION.—To be eligi-
ble to receive a grant under paragraph (1), a State
shall not have previously received a grant under such
paragraph.
‘‘(d) MODEL CURRICULUM.—
‘‘(1) DEVELOPMENT.—The Secretary shall de-
velop a model curriculum for training emergency
medical services personnel, including dispatchers,
first responders, emergency medical technicians, and
paramedics in the identification, assessment, sta-
bilization, and prehospital treatment of stroke pa-
tients.
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‘‘(2) IMPLEMENTATION.—The model curriculum
developed under paragraph (1) may be implemented
by a State to fulfill the requirements of subsection
(b)(1)(B).
‘‘SEC. 2822. REQUIREMENT OF MATCHING FUNDS FOR FIS-
CAL YEARS SUBSEQUENT TO FIRST FISCAL
YEAR OF PAYMENTS.
‘‘(a) NON-FEDERAL CONTRIBUTIONS.—
‘‘(1) IN
GENERAL.—The Secretary may not
award grants under section 2821(a) unless the State
involved agrees, with respect to the costs described
in paragraph (2), to make available for each year
during which the State receives funding under such
section, non-Federal contributions (in cash or in
kind under subsection (b)(1)) toward such costs in
an amount equal to—
‘‘(A) for the second and third fiscal years
of such payments to the State, not less than $1
for each $3 of Federal funds provided in such
payments for each such fiscal year;
‘‘(B) for the fourth fiscal year of such pay-
ments to the State, not less than $1 for each
$2 of Federal funds provided in such payments
for such fiscal year; and
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‘‘(C) for any subsequent fiscal year of such
payments to the State, not less than $1 for
each $1 of Federal funds provided in such pay-
ments for such fiscal year.
‘‘(2) PROGRAM COSTS.—The costs referred to
in paragraph (1) are the costs to be incurred by the
State in carrying out the purpose described in sec-
tion 2821(b).
‘‘(3) INITIAL YEAR OF PAYMENTS.—The Sec-
retary may not require a State to make non-Federal
contributions as a condition of receiving payments
under section 2821(a) for the first fiscal year of
such payments to the State.
‘‘(b) DETERMINATION OF AMOUNT OF NON-FED-
ERAL
CONTRIBUTIONS.—With respect to compliance
under subsection (a) as a condition of receiving payments
under section 2811(a)—
‘‘(1) a State may make the non-Federal con-
tributions required in such subsection in cash or in
kind, fairly evaluated, including plant, equipment, or
services; and
‘‘(2) the Secretary may not, in making a deter-
mination of the amount of non-Federal contribu-
tions, include amounts provided by the Federal Gov-
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ernment or services assisted or subsidized by a sig-
nificant extent by the Federal Government.
‘‘SEC. 2823. APPLICATION REQUIREMENTS.
‘‘(a) REQUIREMENT
OF APPLICATION.—The Sec-
retary may not award a grant to a State under section
2821(b) unless an application for the grant is submitted
by the State to the Secretary.
‘‘(b) APPLICATION PROCESS AND GUIDELINES.—The
Secretary shall provide for an application process and de-
velop guidelines to assist States in submitting an applica-
tion under this section that—
‘‘(1) outlines the stroke care system and ex-
plains how such system will ensure that stroke pa-
tients throughout the State have access to quality
care in all phases of stroke, consistent with the
standards established by the Secretary under sub-
section (c);
‘‘(2) contains standards and requirements for
facilities in the State that provide basic preventive
services, advanced preventive services, acute stroke
care, post-acute stroke care, and rehabilitation serv-
ices to stroke patients; and
‘‘(3) provides for the establishment of a central
data reporting and analysis system and for the col-
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lection of data from each facility that will provide di-
rect care to stroke patients in the State—
‘‘(A) to identify the number of stroke pa-
tients treated in the State;
‘‘(B) to monitor patient care in the State
for stroke patients at all phases of stroke for
the purpose of evaluating the diagnosis, treat-
ment, and treatment outcome of such stroke
patients;
‘‘(C) to identify the total amount of un-
compensated and under-compensated stroke
care expenditures for each fiscal year by each
stroke care facility in the State;
‘‘(D) to identify the number of acute
stroke patients who receive advanced drug ther-
apy;
‘‘(E) to identify patients transferred within
the statewide stroke care system, including rea-
sons for such transfer; and
‘‘(F) to communicate to the greatest extent
practicable with the Paul Coverdell National
Acute Stroke Registry and Clearinghouse.
‘‘(b) CERTAIN
STANDARDS
WITH
RESPECT
TO
STATEWIDE STROKE CARE SYSTEM.—
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‘‘(1) IN
GENERAL.—The Secretary may not
award a grant to a State under section 2821(a) for
a fiscal year unless the State agrees that, in car-
rying out paragraphs (2) and (3), the State will—
‘‘(A) adopt standards of care for stroke pa-
tients in the acute, post-acute, and rehabilita-
tion phases of stroke; and
‘‘(B) in adopting the standards described
in subparagraph (A)—
‘‘(i) consult with medical, surgical,
and nursing specialty groups, hospital as-
sociations, voluntary health organizations,
State offices of rural health, emergency
medical services State and local directors,
experts in the use of telecommunications
technology to provide stroke care, con-
cerned advocates, and other interested par-
ties;
‘‘(ii) conduct hearings on the proposed
standards providing adequate notice to the
public concerning such hearing; and
‘‘(iii) beginning in fiscal year 2004,
take into account the national standards of
care.
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‘‘(2) QUALITY OF STROKE CARE.—The highest
quality of stroke care shall be the primary goal of
the State standards adopted under this subsection.
‘‘(3) APPROVAL
BY
SECRETARY.—The Sec-
retary may not make payments to a State under sec-
tion 2821(a) if the Secretary determines that—
‘‘(A) the State has not taken into account
national standards in adopting standards under
this subsection;
‘‘(B) in the case of payments for fiscal
year 2004 and subsequent fiscal years, the
State has not, in adopting such standards,
taken into account the national standards of
care and the model system plan developed
under subsection (c); or
‘‘(C) in the case of payments for fiscal
year 2004 and subsequent fiscal years, the
State has not provided to the Secretary the in-
formation received by the State pursuant to
paragraphs (9) and (10) of subsection (a).
‘‘(c) MODEL STROKE CARE SYSTEM PLAN.—Not
later than 1 year after the date of enactment of the Stroke
Treatment and Ongoing Prevention Act of 2001, the Sec-
retary shall develop standards of care for stroke patients
in all phases of stroke that may be adopted for guidance
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by the State and a model plan for the establishment of
statewide stroke care systems. Such plan shall—
‘‘(1) take into account national standards;
‘‘(2) take into account existing State systems
and plans; and
‘‘(3) take into account the unique needs of
urban and rural communities, different regions of
the Nation, and States with varying degrees of es-
tablished stroke care infrastructures;
‘‘SEC. 2824. REQUIREMENT OF SUBMISSION OF APPLICA-
TION CONTAINING CERTAIN AGREEMENTS
AND ASSURANCES.
‘‘The Secretary may not award grants under section
2821(a) to a State for a fiscal year unless—
‘‘(1) the State submits an application for the
payments containing agreements in accordance with
this part;
‘‘(2) the agreements are made through certifi-
cation from the chief executive officer of the State;
‘‘(3) with respect to such agreements, the appli-
cation provides assurances of compliance satisfactory
to the Secretary;
‘‘(4) the application contains the plan provi-
sions and the information required to be submitted
to the Secretary pursuant to section 2823; and
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‘‘(5) the application otherwise is in such form,
is made in such manner, and contains such agree-
ments, assurances, and information as the Secretary
determines to be necessary to carry out this part.
‘‘SEC. 2825. RESTRICTIONS ON USE OF PAYMENTS.
‘‘(a) IN GENERAL.—The Secretary may not, except
as provided in subsection (b), make payments to a State
under section 2821(a) for a fiscal year unless the State
involved agrees that the payments will not be expended—
‘‘(1) to make cash payments to intended recipi-
ents of services provided pursuant to such section;
‘‘(2) to satisfy any requirement for the expendi-
ture of non-Federal funds as a condition for the re-
ceipt of Federal funds; or
‘‘(3) to provide financial assistance to any enti-
ty other than a public or nonprofit private entity.
‘‘(b) EXCEPTION.—If the Secretary finds that the
purpose described in section 2821(b) cannot otherwise be
carried out, the Secretary may, with respect to an other-
wise qualified State, waive the restriction established in
subsection (a)(3).
‘‘SEC. 2826. FAILURE TO COMPLY WITH AGREEMENTS.
‘‘(a) REPAYMENT OF PAYMENTS.—
‘‘(1) REQUIREMENT.—The Secretary may, in
accordance with subsection (b), require a State to
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repay any payments received by the State pursuant
to section 2821(a) that the Secretary determines
were not expended by the State in accordance with
the agreements required to be made by the State as
a condition of the receipt of payments under such
section.
‘‘(2) OFFSET OF AMOUNTS.—If a State fails to
make a repayment required in paragraph (1), the
Secretary may offset the amount of the repayment
against any amount due to be paid to the State
under section 2821(a).
‘‘(b) OPPORTUNITY FOR A HEARING.—Before requir-
ing repayment of payments under subsection (a)(1), the
Secretary shall provide to the State an opportunity for a
hearing.
‘‘SEC. 2827. SPECIAL CONSIDERATION.
‘‘In awarding grants under this part, the Secretary
shall give special consideration to any State that has sub-
mitted an application for carrying out programs under
such a grant—
‘‘(1) in geographic areas in which there is—
‘‘(A) a substantial rate of disability result-
ing from stroke; or
‘‘(B) a substantial incidence of stroke; or
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‘‘(2) that demonstrates a significant need for
assistance in establishing a comprehensive stroke
care system.
‘‘SEC. 2828. TECHNICAL ASSISTANCE AND PROVISION BY
SECRETARY OF SUPPLIES AND SERVICES IN
LIEU OF GRANT FUNDS.
‘‘(a) TECHNICAL ASSISTANCE.—The Secretary shall,
without charge to a State receiving payments under sec-
tion 2821(a), provide to the State (or to any public or
nonprofit entity designated by the State) technical assist-
ance with respect to the planning, development, and oper-
ation of any program carried out pursuant to section
2821(b). The Secretary may provide such technical assist-
ance directly, through contract, or through grants.
‘‘(b) PROVISION BY SECRETARY OF SUPPLIES AND
SERVICES IN LIEU OF GRANT FUNDS.—
‘‘(1) IN
GENERAL.—Upon the request of a
State receiving payments under section 2821(a), the
Secretary may, subject to paragraph (2), provide
supplies, equipment, and services for the purpose of
aiding the State in carrying out section 2821(b) and,
for such purpose, may detail to the State any officer
or employee of the Department of Health and
Human Services.
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‘‘(2) REDUCTION IN PAYMENTS.—With respect
to a request described in paragraph (1), the Sec-
retary shall reduce the amount of payments to the
State under section 2821(a) by an amount equal to
the costs of detailing personnel and the fair market
value of any supplies, equipment, or services pro-
vided by the Secretary. The Secretary shall, for the
payment of expenses incurred in complying with
such request, expend the amounts withheld.
‘‘SEC. 2829. REPORT BY SECRETARY.
‘‘Not later than 3 years after the date of enactment
of the Stroke Treatment and Ongoing Prevention Act of
2001, the Secretary shall report to the appropriate com-
mittees of Congress on the activities of the States carried
out pursuant to section 2821. Such report shall include
an assessment of the extent to which Federal and State
efforts to develop stroke care systems, including the estab-
lishment of support networks and the identification of
acute, comprehensive, and rehabilitation stroke centers,
where applicable, have increased the number of stroke pa-
tients who have received acute stroke consultation or ther-
apy within the appropriate timeframe and reduced the
level of disability due to stroke. Such report may include
any recommendations of the Secretary for appropriate ad-
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ministrative and legislative initiatives with respect to
stroke care.
‘‘SEC. 2830. FUNDING.
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this part,
$50,000,000 for fiscal year 2002, $75,000,000 for fiscal
year 
2003, 
$75,000,000 
for 
fiscal 
year 
2004,
$100,000,000 for fiscal year 2005, and $125,000,000 for
fiscal year 2006.
‘‘(b) LIMITATION ON ADMINISTRATIVE EXPENSES.—
A State may use not to exceed 10 percent of amounts re-
ceived under a grant awarded under section 2821(a) for
administrative expenses.
‘‘PART D—MISCELLANEOUS PROGRAMS
‘‘SEC. 2831. MEDICAL PROFESSIONAL DEVELOPMENT IN AD-
VANCED STROKE TREATMENT AND PREVEN-
TION.
‘‘(a) IN GENERAL.—The Secretary may make grants
to public and non-profit private entities for the develop-
ment and implementation of education programs for ap-
propriate medical personnel including medical students,
emergency physicians, primary care providers, neurolo-
gists, neurosurgeons, and physical therapists in the use
of newly developed diagnostic approaches, technologies,
and therapies for the prevention and treatment of stroke.
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‘‘(b) DISTRIBUTION
OF
GRANTS.—In awarding
grants under subsection (a), the Secretary shall ensure
that such grants are equitably distributed among the geo-
graphical regions of the United States and between urban
and rural populations.
‘‘(c) APPLICATION.—A public or non-profit private
entity desiring a grant under subsection (a) shall prepare
and submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require, including a plan for the rigorous
evaluation of activities carried out with amounts received
under such a grant.
‘‘(d) USE OF FUNDS.—A public or non-profit private
entity shall use amounts received under a grant under this
section for the continuing education of appropriate med-
ical personnel in the use of newly developed diagnostic ap-
proaches, technologies, and therapies for the prevention
and treatment of stroke.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There
is authorized to be appropriated to carry out this section,
such sums as may be necessary for each of fiscal years
2002 through 2006.
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‘‘PART E—GENERAL PROVISIONS REGARDING PARTS A,
B, C, AND D
‘‘SEC. 2841. DEFINITIONS.
‘‘In this title:
‘‘(1) STATE.—The term ‘State’ means each of
the several States, the District of Columbia, the
Commonwealth of Puerto Rico, the Indian tribes,
the Virgin Islands, Guam, American Samoa, and the
Commonwealth of the Northern Mariana Islands.
‘‘(2) STROKE CARE SYSTEM.—The term ‘stroke
care system’ means a statewide system to provide
for the diagnosis, prehospital care, hospital definitive
care, and rehabilitation of stroke patients.
‘‘(3) STROKE.—The term ‘stroke’ means a
‘brain attack’ in which blood flow to the brain is in-
terrupted or in which a blood vessel or aneurysm in
the brain breaks or ruptures.
‘‘SEC. 2842. CONSULTATIONS.
‘‘In carrying out this title, the Secretary shall consult
with medical, surgical, rehabilitation, and nursing spe-
cialty groups, hospital associations, voluntary health orga-
nizations, emergency medical services, State directors, and
associations, experts in the use of telecommunication tech-
nology to provide stroke care, national disability and con-
sumer organizations representing individuals with disabil-
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ities and chronic illnesses, concerned advocates, and other
interested parties.’’.
Æ