I 
112TH CONGRESS 
1ST SESSION 
H. R. 971 
To improve the understanding and coordination of critical care health services. 
IN THE HOUSE OF REPRESENTATIVES 
MARCH 9, 2011 
Ms. BALDWIN (for herself, Mr. PAULSEN, and Mr. LANCE) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To improve the understanding and coordination of critical 
care health services. 
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 ‘‘Critical Care Assess-
ment and Improvement Act of 2011’’. 
SEC. 2. FINDINGS; PURPOSES. 
(a) FINDINGS.—Congress finds the following: 
(1) Critical care medicine is the care for pa-
tients whose illnesses or injuries present a signifi-
cant danger to life, limb, or organ function and re-
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quire comprehensive care and constant monitoring, 
usually in intensive care units. 
(2) Each year, approximately five million Amer-
icans are admitted into traditional, surgical, pedi-
atric, or neo-natal intensive care units. 
(3) Nearly 80 percent of all Americans will ex-
perience a critical care injury or illness as a patient, 
family member, or friend of a patient. 
(4) Critical care medicine consumes a signifi-
cant amount of financial resources, accounting for 
more than 13 percent of all hospital costs. 
(5) According to a 2006 report by the Health 
Resources and Services Administration (‘‘HRSA’’), 
demand in the United States for critical care med-
ical services is on the rise, due in part to the grow-
ing elderly population, as individuals over the age of 
65 consume a large percentage of critical care serv-
ices. 
(6) The HRSA report also found that the grow-
ing aging population will further exacerbate an exist-
ing shortage of intensivists, the physicians certified 
in critical care who primarily deliver care in inten-
sive care units, potentially compromising the quality 
and availability of care. 
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(7) The demand on critical services and trained 
personnel increases exponentially in the event of a 
natural disaster or pandemic outbreak such as the 
H1N1 virus. 
(8) Ensuring the strength of our critical care 
medical delivery infrastructure is integral to the im-
provement of the quality and delivery of health care 
in the United States. 
(b) PURPOSE.—The purpose of this Act is to assess 
the current state of the United States critical care medical 
delivery system and implement policies to improve the 
quality and effectiveness of care delivered to the critically 
ill and injured. 
SEC. 3. STUDIES ON CRITICAL CARE. 
(a) INSTITUTE OF MEDICINE STUDY.— 
(1) IN GENERAL.—The Secretary of Health and 
Human Services (in this Act referred to as the ‘‘Sec-
retary’’) shall enter into an agreement with the In-
stitute of Medicine under which, not later than 1 
year after the date of the enactment of this Act, the 
Institute will— 
(A) conduct an analysis of the current 
state of critical care health services in the 
United States; 
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(B) develop recommendations to bolster 
critical care capabilities to meet future demand; 
and 
(C) submit to Congress a report including 
the analysis and recommendations under sub-
paragraphs (A) and (B). 
(2) ISSUES TO BE STUDIED.—The agreement 
under paragraph (1) shall, at a minimum, provide 
for the following: 
(A) Analysis of the current critical care 
system in the United States, including— 
(i) the system’s capacity and re-
sources, including the size of the critical 
care workforce and the availability of 
health information technology and medical 
equipment; 
(ii) the system’s strengths, limitations, 
and future challenges; and 
(iii) the system’s ability to provide 
adequate care for the critically ill or in-
jured in response to a national health 
emergency, including a pandemic or nat-
ural disaster. 
(B) Analysis and recommendations regard-
ing regionalizing critical care systems. 
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(C) Analysis regarding the status of crit-
ical care research in the United States and rec-
ommendations for future research priorities. 
(b) 
GOVERNMENT
ACCOUNTABILITY
OFFICE 
STUDY.—Not later than 1 year after the date of the enact-
ment of this Act, the Comptroller General of the United 
States shall issue a report including the following: 
(1) An inventory of all current and recent crit-
ical care research and critical care-related programs 
of the Federal Government and recommendations on 
how to better coordinate critical care research ef-
forts. 
(2) An economic analysis of critical care costs 
as a percentage of overall Federal health care spend-
ing, and a comparison of such percentage to the per-
centage of Federal critical research expenditures rel-
ative to overall Federal health research spending. 
(c) HEALTH RESOURCES AND SERVICES ADMINIS-
TRATION STUDY.— 
(1) 
IN
GENERAL.—The 
Secretary, 
acting 
through the Administrator of the Health Resources 
and Services Administration, shall review and update 
the Administration’s 2006 study entitled ‘‘The Crit-
ical Care Workforce: A Study of the Supply and De-
mand for Critical Care Physicians’’. 
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(2) SCOPE.—In carrying out paragraph (1), the 
Secretary shall expand the scope of the study to ad-
dress the supply and demand of other providers 
within the spectrum of critical care delivery, includ-
ing critical care nurses, mid-level providers (such as 
physician assistants and nurse practitioners), inten-
sive care unit pharmacists, and intensive care unit 
respiratory care practitioners. 
SEC. 4. NIH CRITICAL CARE COORDINATING COUNCIL. 
(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Director of the National Institutes of Health, 
shall establish a council within the Institutes to be known 
as the Critical Care Coordinating Council (in this section 
referred to as the ‘‘Council’’). 
(b) MEMBERSHIP.—The Secretary shall ensure that 
the membership of the Council includes representatives of 
each of— 
(1) the National Heart, Lung, and Blood Insti-
tute; 
(2) the National Institute of Nursing Research; 
(3) the Eunice Kennedy Shriver National Insti-
tute of Child Health and Human Development; 
(4) the National Institute of General Medical 
Sciences; 
(5) the National Institute on Aging; and 
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