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H.R.3886 - Patient-Focused Critical Care Enhancement Act
To optimize the delivery of critical care medicine and expand the critical care workforce.
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October 18, 2007
Ms. SCHAKOWSKY (for herself and Mr. CANTOR) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Agriculture, 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 concernedCommentsClose CommentsPermalink
SECTION 1. SHORT TITLE.
SEC. 2. PURPOSE.
SEC. 3. FINDINGS.
Based on the Health Resources and Services Administration's May 2006 Report to Congress, The Critical Care Workforce: A Study of the Supply and Demand for Critical Care Physicians, the Senate makes the following findings:CommentsClose CommentsPermalink
(3) The demand in the United States for critical care medical services is rising sharply and will continue to rise sharply largely as a result of the following 3 factors:CommentsClose CommentsPermalink
(A) There is strong evidence demonstrating improvements in outcomes and efficiency when intensive care services are provided by nurses and intensivist physicians who have advanced specialty training in critical care medicine.CommentsClose CommentsPermalink
(C) Critical care services are overwhelmingly consumed by patients over the age of 65 and the aging of the United States population is driving demand for these services.CommentsClose CommentsPermalink
SEC. 4. RESEARCH.
(3) coordinated community and regional approaches to providing critical care services, including approaches whereby critical care patients are assessed and provided care based upon intensity of services required.CommentsClose CommentsPermalink
(b) Report- Not later than 18 months after the date of enactment of this Act, the Agency for Healthcare Research and Quality shall submit a report to Congress, that, based on the review under subsection (a), evaluates and makes recommendations regarding best practices in critical care medicine.CommentsClose CommentsPermalink
SEC. 5. INNOVATIVE APPROACHES TO CRITICAL CARE SERVICES.
(A) IN GENERAL- The Administrator of the Centers for Medicare & Medicaid Services shall solicit proposals submitted by inpatient providers of critical care services who propose to demonstrate methods to optimize the provision of critical care services to Medicare beneficiaries through innovations in such areas as staffing, ICU arrangement, and utilization of technology.CommentsClose CommentsPermalink
(B) FUNDING OF PROPOSALS- The Administrator of the Centers for Medicare & Medicaid Services shall fund not more than 5 proposals, not less than 1 of which shall focus on the training of hospital-based physicians in rural or community, or both, hospital facilities in the provision of critical care medicine. Such projects shall emphasize outcome measures based on the Institute of Medicine's following 6 domains of quality care:CommentsClose CommentsPermalink
(A) IN GENERAL- The Secretary of Health and Human Services shall solicit proposals and make an award to support a consortium consisting of 1 or more providers of inpatient critical care services and a medical specialty society involved in the education and training of critical care providers.CommentsClose CommentsPermalink
(B) MEASUREMENT AND EVALUATION- A provider that receives support under subparagraph (A) shall measure and evaluate outcomes derived from a `family-centered' approach to the provision of inpatient critical care services that includes direct and sustained communication and contact with beneficiary family members, involvement of family members in the critical care decisionmaking process, and responsiveness of critical care providers to family requests. Such project shall evaluate the impact of a family-centered, multiprofessional team approach on, and the correlation between--CommentsClose CommentsPermalink
(C) OUTCOME MEASURES- A provider that receives support under subparagraph (A) shall emphasize outcome measures based on the Institute of Medicine's following 6 domains of quality care:CommentsClose CommentsPermalink
SEC. 6. USE OF TELEMEDICINE TO ENHANCE CRITICAL CARE SERVICES IN RURAL AREAS.
(a) Amendment to Rural Utilities Service Distance Learning and Telemedicine Program- Chapter 1 of subtitle D of title XXIII of the Food, Agriculture, Conservation, and Trade Act of 1990 (
`SEC. 2335B. ADDITIONAL AUTHORIZATION OF APPROPRIATIONS FOR TELEMEDICINE CRITICAL CARE INITIATIVES.
`In addition to amounts authorized under section 2335A, there is authorized to be appropriated $5,000,000 in each of fiscal years 2008 through 2013 to carry out telemedicine initiatives under this chapter whereby 1 or more rural providers of inpatient critical care services propose, through collaboration with other providers, to augment the delivery of critical care services in the rural inpatient setting through the use of telecommunications systems that allow for consultation with critical care providers not located in the rural facility regarding the care of such patients.'.CommentsClose CommentsPermalink
(b) Amendment to Telehealth Network Grant Program- Section 330I(i)(1)(B) of the Public Health Service Act (
SEC. 7. INCREASING THE SUPPLY OF CRITICAL CARE PROVIDERS.
`(1) ESTABLISHMENT- The Secretary shall undertake an initiative that has as its goal the annual recruitment of not less than 50 providers of critical care services into the National Health Service Corps Loan Repayment Program. Providers recruited pursuant to this initiative shall be additional to, and not detract from, existing recruitment activities otherwise authorized by this section.CommentsClose CommentsPermalink
`(B) `an approved graduate training program' as that term is used in subsection (b)(1)(B) shall be limited to pulmonary fellowships or critical care fellowships, or both, for physicians.'.CommentsClose CommentsPermalink
SEC. 8. AUTHORIZATION OF APPROPRIATIONS.
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