[House Report 110-75]
[From the U.S. Government Publishing Office]
110th Congress Report
HOUSE OF REPRESENTATIVES
1st Session 110-75
======================================================================
STROKE TREATMENT AND ONGOING PREVENTION ACT
_______
March 27, 2007.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Dingell, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 477]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 477) to amend the Public Health Service Act to
strengthen education, prevention, and treatment programs
relating to stroke, and for other purposes, having considered
the same, report favorably thereon with amendments and
recommend that the bill as amended do pass.
CONTENTS
Page
Amendments....................................................... 2
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 3
Committee Consideration.......................................... 3
Committee Votes.................................................. 3
Committee Oversight Findings..................................... 3
Statement of General Performance Goals and Objectives............ 3
New Budget Authority, Entitlement Authority, and Tax Expenditures 3
Earmarks and Tax and Tariff Benefits............................. 4
Committee Cost Estimate.......................................... 4
Congressional Budget Office Estimate............................. 4
Federal Mandates Statement....................................... 5
Advisory Committee Statement..................................... 6
Constitutional Authority Statement............................... 6
Applicability to Legislative Branch.............................. 6
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill, as Reported............ 8
Amendments
The amendments (stated in terms of the page and line
numbers of the introduced bill) are as follows:
Page 2, line 3, redesignate part R as part S.
In such part S (as so redesignated), redesignate
sections 399AA through 399DD as sections 399FF through
399II, respectively.
Purpose and Summary
The purpose of H.R. 477, the ``Stroke Treatment and Ongoing
Prevention Act'', is to amend the Public Health Service Act to
strengthen education, prevention, and treatment programs to
improve health outcomes for stroke patients.
Background and Need for Legislation
Stroke is the third leading cause of death in America and a
major contributor to long-term disability. A stroke occurs when
the blood supply to part of the brain is suddenly interrupted
(ischemic) or when a blood vessel in the brain bursts, spilling
blood into the spaces surrounding brain cells (hemorrhagic).
Brain cells die when they no longer receive oxygen and
nutrients from the blood or there is sudden bleeding into or
around the brain.
The symptoms of a stroke include sudden numbness or
weakness, especially on one side of the body; sudden confusion
or trouble speaking or understanding speech; sudden trouble
seeing in one or both eyes; sudden trouble with walking,
dizziness, or loss of balance or coordination; or sudden severe
headache with no known cause.
Although stroke is a disease of the brain, it can affect
the entire body. A common disability that results from stroke
is complete paralysis on one side of the body, called
hemiplegia. A related disability that is not as debilitating as
paralysis is one-sided weakness or hemiparesis. Stroke may
cause problems with thinking, awareness, attention, learning,
judgment, and memory. Recurrent stroke is frequent; about 25
percent of people who recover from their first stroke will have
another stroke within 5 years.
When a stroke is diagnosed and treated within the first few
hours, damaged cells can be saved, strengthening the chance of
recovery. Recent studies have shown that stroke patients who
received care in a timely manner at facilities with highly
trained health care professionals are more likely to have
better health outcomes. The American Heart Association reports
that 700,000 Americans each year suffer a new or recurrent
stroke and more than 150,000 people die annually. They estimate
that every 3 minutes someone dies from a stroke. Additionally,
the American Heart Association estimates that Americans will
pay approximately $62.7 billion in 2007 for stroke-related
medical costs and disability.
H.R. 477 would authorize the Secretary of Health and Human
Services to engage in activities designed to increase knowledge
and awareness of stroke prevention and treatment. This
legislation would require the Secretary to conduct educational
campaigns, maintain a national stroke registry, and establish
an information clearinghouse related to stroke. For these
purposes, the bill would authorize an appropriation of $5
million for each of the fiscal years 2008 through 2012.
The legislation would authorize the Secretary to make
grants to public and nonprofit entities for the purpose of
planning, developing, and enhancing approved residency training
programs and other professional training for appropriate health
professions in emergency medicine, including diagnosis,
treatment, and rehabilitation. For these purposes, the bill
would authorize an appropriation of $4 million for each of the
fiscal years 2008 through 2012.
Finally, H.R. 477 would authorize the Secretary to make
grants to States and other public and private entities to
develop medical professional training programs and telehealth
networks that seek to coordinate stroke care and improve
patient outcomes. For these purposes, the bill would authorize
appropriations of $10 million for fiscal year 2008; $13 million
for fiscal year 2009; $15 million for fiscal year 2010; $8
million for fiscal year 2011; and $4 million for fiscal year
2012.
H.R. 477 has 86 cosponsors and is supported by the American
Heart Association, the American Stroke Association, the
American Physical Therapy Association, and the STOP Stroke
Coalition.
Hearings
The Committee on Energy and Commerce has not held hearings
on the legislation.
Committee Consideration
On Tuesday, March 13, 2007, the Subcommittee on Health met
in open markup session and approved H.R. 477 for full Committee
consideration by voice vote. On Thursday, March 15, 2007, the
full Committee met in open markup session and ordered H.R. 477
favorably reported to the House, amended, by voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list any record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken on amendments or in connection
with ordering H.R. 477 reported. A motion by Mr. Dingell to
order H.R. 477 favorably reported to the House, amended, was
agreed to by voice vote.
Committee Oversight Findings
Regarding clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee has not held oversight
or legislative hearings on this legislation.
Statement of General Performance Goals and Objectives
H.R. 477 seeks to improve health outcomes for stroke
patients.
New Budget Authority, Entitlement Authority, and Tax Expenditures
Regarding compliance with clause 3(c)(2) of rule XIII of
the Rules of the House of Representatives, the Committee finds
that H.R. 477 would result in no new or increased budget
authority, entitlement activity, or tax expenditures or
revenues.
Earmarks and Tax and Tariff Benefits
Regarding compliance with clause 9 of rule XXI of the Rules
of the House of Representatives, H.R. 477 does not contain any
congressional earmarks, limited tax benefits, or limited tariff
benefits as defined in clause 9(d), 9(e), or 9(f) of rule XXI.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, March 23, 2007.
Hon. John D. Dingell,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 477, the Stroke
Treatment and Ongoing Prevention Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Tim
Gronniger.
Sincerely,
Peter R. Orszag.
Enclosure.
H.R. 477--Stroke Treatment and Ongoing Prevention Act
Summary: H.R. 477 would amend the Public Health Service Act
to direct the Health Resources and Services Administration and
the Centers for Disease Control and Prevention (CDC) to
administer several programs related to education, prevention,
and treatment of stroke. The bill would authorize the
appropriation for those purposes of $19 million for 2008 and
$95 million over the 2008-2012 period. Assuming appropriation
of the specified amounts, CBO estimates that implementing H.R.
477 would cost $7 million in 2008 and $82 million over the
2008-2012 period. Enacting the bill would not affect direct
spending or revenues.
H.R. 477 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA)
and could benefit state, local, and tribal governments.
Estimated cost to the Federal Government: The estimated
budgetary impact of H.R. 477 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
--------------------------------------------
2008 2009 2010 2011 2012
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATION
Authorization Level................................................ 19 22 24 17 13
Estimated Outlays.................................................. 7 16 21 21 17
----------------------------------------------------------------------------------------------------------------
Basis of estimate: H.R. 477 would modify the Public Health
Service Act to authorize the appropriation of $19 million for
2008 and $95 million over the 2008-2012 period for several
activities related to stroke prevention and treatment. Based on
historical patterns of spending for similar activities, CBO
estimates that implementing H.R. 477 would cost $7 million in
2008 and $82 million over the 2008-2012 period, assuming
appropriation of the specified amounts.
The bill would authorize the appropriation of $5 million a
year for 2008 through 2012 for the Centers for Disease Control
and Prevention to conduct stroke education campaigns and to
maintain an existing stroke registry. Assuming appropriation of
the specified amounts, CBO estimates those activities would
cost $2 million in 2008 and $22 million over the 2008-2012
period.
The bill would authorize the appropriation of $4 million a
year for 2008 through 2012 to the Health Resources and Services
Administration for grants to train physicians in treating
stroke and traumatic injury. Assuming appropriation of the
specified amounts, CBO estimates those activities would cost $1
million in 2008 and $16 million over the 2008-2012 period.
The bill also would authorize the appropriation of $10
million for 2008 and $50 million over the 2008-2012 period for
grants to fund pilot projects through the Office for the
Advancement of Telehealth. Those pilot projects would attempt
to improve stroke treatment delivered through telehealth
communications networks. Assuming appropriation of the
specified amounts, CBO estimates those activities would cost $4
million in 2008 and $44 million over the 2008-2012 period.
Intergovernmental and private-sector impact: H.R. 477
contains no intergovernmental or private-sector mandates as
defined in the Unfunded Mandates Reform Act. State, local, and
tribal governments may qualify for grants authorized by the
bill. Any costs those governments would incur in order to meet
requirements of the grants would be conditions of assistance
and would be incurred voluntarily.
Estimate prepared by: Federal costs: Tim Gronniger. Impact
on state, local, and tribal governments: Leo Lex. Impact on the
private sector: Paige Shevlin.
Estimate approved by: Peter H. Fontaine, Deputy Assistant
Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Constitutional Authority Statement
Pursuant to clause 3(d)(1) of rule XIII of the Rules of the
House of Representatives, the Committee finds that the
Constitutional authority for this legislation is provided in
the provisions of Article I, section 8, clause 1 that relate to
expending funds to provide for the general welfare of the
United States.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 establishes the short title of the bill as the
``Stroke Treatment and Ongoing Prevention Act.''
Section 2. Amendments to Public Health Service Act regarding stroke
programs
Section 2 amends the Public Health Service Act to
strengthen education, prevention, and treatment programs to
improve health outcomes for stroke patients.
To increase public awareness of the signs of stroke,
section 2 amends title III of the Public Health Service Act (42
U.S.C. 241 et seq.) to authorize the Secretary of Health and
Human Services to carry out an education and information
campaign to promote stroke prevention and increase the number
of stroke patients who seek immediate treatment. The Secretary
is authorized to (1) make public service announcements about
the warning signs of stroke and the importance of treating
stroke as a medical emergency; (2) provide education regarding
ways to prevent stroke and the effectiveness of stroke
treatment; and (3) carry out other activities that the
Secretary determines will promote prevention practices among
the general public and increase the number of stroke patients
who seek immediate care. The Secretary is required to measure
public awareness before the start of the campaign to provide
baseline data that can be used to establish quantitative
benchmarks to measure the impact of the campaign over time. The
Secretary must report on these measurements not less than once
every two years, or at shorter intervals. The Secretary must
avoid duplicating existing stroke education efforts by other
Federal government agencies. The Secretary may also consult
with organizations and individuals with expertise in stroke
prevention, diagnosis, treatment, and rehabilitation.
To expand research information about stroke patients,
section 2 also reauthorizes the Paul Coverdell National Acute
Stroke Registry and Clearinghouse of the Centers for Disease
Control and Prevention (CDC). For purposes of this part, the
term ``stroke'' means a ``brain attack'' in which blood flow to
the brain is interrupted or in which a blood vessel or aneurysm
in the brain breaks or ruptures. For the public education and
registry provisions, section 2 authorizes appropriations of $5
million for each of fiscal years 2008 through 2012.
To improve medical professional development in advanced
stroke and traumatic injury treatment and prevention, section 2
amends section 1251 of the Public Health Service Act (42 U.S.C.
300d-51) to authorize two new grant programs. The first grant
program created in this section authorizes the Secretary to
make grants to public and nonprofit entities for the purposes
of planning, developing, and enhancing approved residency
training programs and other training for appropriate health
professions in emergency medicine to improve stroke and
traumatic injury prevention, diagnosis, treatment, and
rehabilitation.
The second grant program authorizes the Secretary, acting
through the Administrator of the Health Resources and Services
Administration (HRSA), to make grants to a consortium of public
and private entities for the development and implementation of
education programs for appropriate health care professionals in
the use of newly developed diagnostic approaches, technologies,
and therapies to treat stroke or traumatic injury. The
Secretary must give preference to qualified entities that will
train health care professionals that serve areas with a
significant incidence of stroke or traumatic injuries. The term
``qualified entity'' is defined as a consortium of public and
private entities, such as universities, academic medical
centers, hospitals, and emergency medical systems that are
coordinating education activities among providers serving in a
variety of medical settings. The Committee does not intend for
the examples outlined in the statute to be an exhaustive list
of entities. Further, the Committee expects HRSA to award these
grants to real consortiums, groups of organizations formed to
undertake the continuing education activities to a level that
no one organization could accomplish by itself. The Committee
strongly encourages HRSA to recognize the diverse training of
health care professionals who treat stroke patients when
awarding grants. For example, interventional radiologists who
employ minimally invasive stroke treatments and therapies
should be considered as well as all other health care
professionals who directly treat stroke patients.
The Secretary must report on these results of the
activities of the two medical professional development grant
programs no later than one year after the allocation of grants.
This section authorizes appropriations of $4 million for each
of the fiscal years 2008 through 2012 for the two medical
professional development grant programs. The Secretary must
equitably allocate the funds appropriated between efforts to
address stroke and efforts to address traumatic injury.
Section 3. Pilot project on telehealth stroke treatment
Section 3 amends part D of title II of the Public Health
Service Act (42 U.S.C. 254b et seq.) to establish a five-year
pilot project to improve stroke patient outcomes by
coordinating health care delivery through telehealth networks.
The Secretary, acting through the Director of the Office for
the Advancement of Telehealth, is authorized to make up to
seven grants to states or a consortium of states or political
subdivisions for a period of up to three years during fiscal
years 2008 through 2012.
Grant recipients must use the funding to accomplish all of
the following activities: (1) Identify entities with expertise
in the delivery of high-quality stroke prevention, diagnosis,
treatment, and rehabilitation. (2) Work with these entities to
establish or improve telehealth networks to provide stroke
treatment assistance and resources to health care
professionals, hospitals, and other individuals and entities
that serve stroke patients. (3) Inform emergency medical
systems of the location of entities identified to facilitate
appropriate transportation. (4) Establish networks to
coordinate collaborative activities for stroke prevention,
diagnosis, treatment, and rehabilitation. (5) Improve access to
high-quality stroke care, especially for populations with a
shortage of stroke care specialists and populations with a high
incidence of stroke. (6) Conduct ongoing performance and
quality evaluations to identify collaborative activities that
improve clinical outcomes for stroke patients. The Secretary
may not award a grant to a State unless the State agrees to
establish a consortium of public and private entities to carry
out the activities of the grant. Additionally, the Secretary
may not make a grant to a State that has an existing telehealth
network that is or may be used for the purposes of the grant
unless the State agrees to use the existing telehealth network
to achieve the purpose of the grant and the State will not
establish a separate network for the same purpose. The
Secretary must give priority to any applicant that submits a
plan detailing specifically how the grant will improve access
to high-quality stroke care for populations with shortages of
stroke care specialists and populations with a high incidence
of stroke.
The Secretary is required to consult with officials
responsible for other Federal programs involving stroke
research and care and organizations and individuals with
expertise in stroke prevention, diagnosis, treatment, and
rehabilitation to better coordinate program activities. Grant
recipients are required to establish baselines measures and
benchmarks to evaluate program outcomes. Not later than March
31, 2013, the Secretary of HHS is required to report to
Congress on the pilot project outcomes, including
recommendations on whether similar telehealth grant programs
could be used to improve patient outcomes in other public
health areas and how to promote stroke networks in ways that
improve access to clinical care in rural and urban areas and
reduce the incidence of stroke and the debilitating and costly
complications resulting from stroke.
The pilot project authorizes appropriations of $10 million
for fiscal year 2008; $13 million for fiscal year 2009; $15
million for fiscal year 2010; $8 million for fiscal year 2011;
and $4 million for fiscal year 2012.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part D--Primary Health Care
Subpart I--Health Centers
* * * * * * *
SEC. 330M. TELEHEALTH STROKE TREATMENT GRANT PROGRAM.
(a) Grants.--The Secretary may make grants to States, and
to consortia of public and private entities located in any
State that is not a grantee under this section, to conduct a 5-
year pilot project over the period of fiscal years 2008 through
2012 to improve stroke patient outcomes by coordinating health
care delivery through telehealth networks.
(b) Administration.--The Secretary shall administer this
section through the Director of the Office for the Advancement
of Telehealth.
(c) Consultation.--In carrying out this section, for the
purpose of better coordinating program activities, the
Secretary shall consult with--
(1) officials responsible for other Federal
programs involving stroke research and care, including
such programs established by the Stroke Treatment and
Ongoing Prevention Act; and
(2) organizations and individuals with expertise in
stroke prevention, diagnosis, treatment, and
rehabilitation.
(d) Use of Funds.--
(1) In general.--The Secretary may not make a grant
to a State or a consortium under this section unless
the State or consortium agrees to use the grant for the
purpose of--
(A) identifying entities with expertise in
the delivery of high-quality stroke prevention,
diagnosis, treatment, and rehabilitation;
(B) working with those entities to
establish or improve telehealth networks to
provide stroke treatment assistance and
resources to health care professionals,
hospitals, and other individuals and entities
that serve stroke patients;
(C) informing emergency medical systems of
the location of entities identified under
subparagraph (A) to facilitate the appropriate
transport of individuals with stroke symptoms;
(D) establishing networks to coordinate
collaborative activities for stroke prevention,
diagnosis, treatment, and rehabilitation;
(E) improving access to high-quality stroke
care, especially for populations with a
shortage of stroke care specialists and
populations with a high incidence of stroke;
and
(F) conducting ongoing performance and
quality evaluations to identify collaborative
activities that improve clinical outcomes for
stroke patients.
(2) Establishment of consortium.--The Secretary may
not make a grant to a State under this section unless
the State agrees to establish a consortium of public
and private entities, including universities and
academic medical centers, to carry out the activities
described in paragraph (1).
(3) Prohibition.--The Secretary may not make a
grant under this section to a State that has an
existing telehealth network that is or may be used for
improving stroke prevention, diagnosis, treatment, and
rehabilitation, or to a consortium located in such a
State, unless the State or consortium agrees that--
(A) the State or consortium will use an
existing telehealth network to achieve the
purpose of the grant; and
(B) the State or consortium will not
establish a separate network for such purpose.
(e) Priority.--In selecting grant recipients under this
section, the Secretary shall give priority to any applicant
that submits a plan demonstrating how the applicant, and where
applicable the members of the consortium described in
subsection (d)(2), will use the grant to improve access to
high-quality stroke care for populations with shortages of
stroke-care specialists and populations with a high incidence
of stroke.
(f) Grant Period.--The Secretary may not award a grant to a
State or a consortium under this section for any period that--
(1) is greater than 3 years; or
(2) extends beyond the end of fiscal year 2012.
(g) Restriction on Number of Grants.--In carrying out the
5-year pilot project under this section, the Secretary may not
award more than 7 grants.
(h) Application.--To seek a grant under this section, a
State or a consortium of public and private entities shall
submit an application to the Secretary in such form, in such
manner, and containing such information as the Secretary may
require. At a minimum, the Secretary shall require each such
application to outline how the State or consortium will
establish baseline measures and benchmarks to evaluate program
outcomes.
(i) Definition.--In this section, the term ``stroke'' means
a ``brain attack'' in which blood flow to the brain is
interrupted or in which a blood vessel or aneurysm in the brain
breaks or ruptures.
(j) Authorization of Appropriations.--There are authorized
to be appropriated to carry out this section $10,000,000 for
fiscal year 2008, $13,000,000 for fiscal year 2009, $15,000,000
for fiscal year 2010, $8,000,000 for fiscal year 2011, and
$4,000,000 for fiscal year 2012.
* * * * * * *
Subpart III--Grants for Home Visiting Services for At-Risk Families
* * * * * * *
PART S--STROKE EDUCATION, INFORMATION, AND DATA COLLECTION PROGRAMS
SEC. 399FF. STROKE PREVENTION AND EDUCATION CAMPAIGN.
(a) In General.--The Secretary shall carry out an education
and information campaign to promote stroke prevention and
increase the number of stroke patients who seek immediate
treatment.
(b) Authorized Activities.--In implementing the education
and information campaign under subsection (a), the Secretary
may--
(1) make public service announcements about the
warning signs of stroke and the importance of treating
stroke as a medical emergency;
(2) provide education regarding ways to prevent
stroke and the effectiveness of stroke treatment; and
(3) carry out other activities that the Secretary
determines will promote prevention practices among the
general public and increase the number of stroke
patients who seek immediate care.
(c) Measurements.--In implementing the education and
information campaign under subsection (a), the Secretary
shall--
(1) measure public awareness before the start of
the campaign to provide baseline data that will be used
to evaluate the effectiveness of the public awareness
efforts;
(2) establish quantitative benchmarks to measure
the impact of the campaign over time; and
(3) measure the impact of the campaign not less
than once every 2 years or, if determined appropriate
by the Secretary, at shorter intervals.
(d) No Duplication of Effort.--In carrying out this
section, the Secretary shall avoid duplicating existing stroke
education efforts by other Federal Government agencies.
(e) Consultation.--In carrying out this section, the
Secretary may consult with organizations and individuals with
expertise in stroke prevention, diagnosis, treatment, and
rehabilitation.
SEC. 399GG. PAUL COVERDELL NATIONAL ACUTE STROKE REGISTRY AND
CLEARINGHOUSE.
The Secretary, acting through the Centers for Disease
Control and Prevention, shall maintain the Paul Coverdell
National Acute Stroke Registry and Clearinghouse by--
(1) continuing to develop and collect specific data
points and appropriate benchmarks for analyzing care of
acute stroke patients;
(2) collecting, compiling, and disseminating
information on the achievements of, and problems
experienced by, State and local agencies and private
entities in developing and implementing emergency
medical systems and hospital-based quality of care
interventions; and
(3) carrying out any other activities the Secretary
determines to be useful to maintain the Paul Coverdell
National Acute Stroke Registry and Clearinghouse to
reflect the latest advances in all forms of stroke
care.
SEC. 399HH. STROKE DEFINITION.
For purposes of this part, the term ``stroke'' means a
``brain attack'' in which blood flow to the brain is
interrupted or in which a blood vessel or aneurysm in the brain
breaks or ruptures.
SEC. 399II. AUTHORIZATION OF APPROPRIATIONS.
There is authorized to be appropriated to carry out this
part $5,000,000 for each of fiscal years 2008 through 2012.
* * * * * * *
TITLE XII--TRAUMA CARE
* * * * * * *
Part E--Miscellaneous Programs
[SEC. 1251. RESIDENCY TRAINING PROGRAMS IN EMERGENCY MEDICINE.
[(a) In General.--The Secretary may make grants to public
and nonprofit private entities for the purpose of planning and
developing approved residency training programs in emergency
medicine.
[(b) Identification and Referral of Domestic Violence.--The
Secretary may make a grant under subsection (a) only if the
applicant involved agrees that training programs under
subsection (a) will provide education and training in
identifying and referring cases of domestic violence.
[(c) Authorization of Appropriations.--For the purpose of
carrying out this section, there is authorized to be
appropriated $400,000 for each of the fiscal years 1993 through
1995.]
SEC. 1251. MEDICAL PROFESSIONAL DEVELOPMENT IN ADVANCED STROKE AND
TRAUMATIC INJURY TREATMENT AND PREVENTION.
(a) Residency and Other Professional Training.--The
Secretary may make grants to public and nonprofit entities for
the purpose of planning, developing, and enhancing approved
residency training programs and other professional training for
appropriate health professions in emergency medicine, including
emergency medical services professionals, to improve stroke and
traumatic injury prevention, diagnosis, treatment, and
rehabilitation.
(b) Continuing Education on Stroke and Traumatic Injury.--
(1) Grants.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, may make grants to qualified entities
for the development and implementation of education
programs for appropriate health care professionals in
the use of newly developed diagnostic approaches,
technologies, and therapies for health professionals
involved in the prevention, diagnosis, treatment, and
rehabilitation of stroke or traumatic injury.
(2) Distribution of grants.--In awarding grants
under this subsection, the Secretary shall give
preference to qualified entities that will train health
care professionals that serve areas with a significant
incidence of stroke or traumatic injuries.
(3) Application.--A qualified entity desiring a
grant under this subsection shall 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
the grant.
(4) Definitions.--For purposes of this subsection:
(A) The term ``qualified entity'' means a
consortium of public and private entities, such
as universities, academic medical centers,
hospitals, and emergency medical systems that
are coordinating education activities among
providers serving in a variety of medical
settings.
(B) The term ``stroke'' means a ``brain
attack'' in which blood flow to the brain is
interrupted or in which a blood vessel or
aneurysm in the brain breaks or ruptures.
(c) Report.--Not later than 1 year after the allocation of
grants under this section, the Secretary shall submit to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives a report on the results of activities carried
out with amounts received under this section.
(d) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $4,000,000 for
each of fiscal years 2008 through 2012. The Secretary shall
equitably allocate the funds authorized to be appropriated
under this section between efforts to address stroke and
efforts to address traumatic injury.
* * * * * * *