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<dc:title>115 HR 880 EH: Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="no">I</distribution-code> 
<congress display="yes">115th CONGRESS</congress><session display="yes">2d Session</session> 
<legis-num display="yes">H. R. 880</legis-num> 
<current-chamber display="no">IN THE HOUSE OF REPRESENTATIVES</current-chamber> 
<legis-type>AN ACT</legis-type> 
<official-title display="yes">To amend the Public Health Service Act to facilitate assignment of military trauma care providers to civilian trauma centers in order to maintain military trauma readiness and to support such centers, and for other purposes.</official-title> 
</form> 
<legis-body id="HBDDEF152A36E4EF0B6F201B51DFE39E8" style="OLC"> 
<section id="HF2FC81B3C6224E28A672A5A17E649F86" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Military Injury Surgical Systems Integrated Operationally Nationwide to Achieve ZERO Preventable Deaths Act</short-title></quote> or the <quote><short-title>MISSION ZERO Act</short-title></quote>.</text></section> <section id="H23E0F64903C54F468F10C0FB0B11478E"><enum>2.</enum><header>Military and civilian partnership for trauma readiness grant program</header><text display-inline="no-display-inline">Title XII of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/300d">42 U.S.C. 300d</external-xref> et seq.) is amended by adding at the end the following new part:</text> 
<quoted-block display-inline="no-display-inline" id="HD81A91677D94462B9EA7D8301C715BBF" style="OLC"> 
<part id="H71934FB0FD754C4DA94687BE9DAA811F"><enum>I</enum><header>Military and Civilian Partnership for Trauma Readiness Grant Program</header> 
<section id="HA359ED6D091F440ABAC188E6EB7B4ED9"><enum>1291.</enum><header>Military and Civilian Partnership for Trauma Readiness Grant Program</header> 
<subsection id="HD364E98CE8F2451188EC625200331F3F"><enum>(a)</enum><header>Military trauma team placement program</header> 
<paragraph id="HC3494D16675F45FDB9E23D262394FDA0"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall award grants to not more than 20 eligible high-acuity trauma centers to enable military trauma teams to provide, on a full-time basis, trauma care and related acute care at such trauma centers.</text></paragraph> <paragraph id="HD83B6AD469A14B0ABC1D9835E5C94F25"><enum>(2)</enum><header>Limitations</header><text>In the case of a grant awarded under paragraph (1) to an eligible high-acuity trauma center, such grant—</text> 
<subparagraph id="H1D4E39EAE2DE4E798514ADA4DF4F0409"><enum>(A)</enum><text>shall be for a period of at least 3 years and not more than 5 years (and may be renewed at the end of such period); and</text></subparagraph> <subparagraph id="HCF16F05B531446A587B30227153098EA"><enum>(B)</enum><text>shall be in an amount that does not exceed $1,000,000 per year.</text></subparagraph></paragraph> 
<paragraph id="HD8B24A682F3E4B6C8B61F23EE120CBFC" commented="no"><enum>(3)</enum><header>Availability of funds after performance period</header><text display-inline="yes-display-inline">Notwithstanding section 1552 of title 31, United States Code, or any other provision of law, funds available to the Secretary for obligation for a grant under this subsection shall remain available for expenditure for 100 days after the last day of the performance period of such grant.</text></paragraph></subsection> <subsection id="H12B1CA5DD03A46BF83B1AC9C5132B44D"><enum>(b)</enum><header>Military trauma care provider placement program</header> <paragraph id="HCEBE3F0889F24F27B25C07CC65630BB7"><enum>(1)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary shall award grants to eligible trauma centers to enable military trauma care providers to provide trauma care and related acute care at such trauma centers.</text></paragraph> 
<paragraph id="H8256B43401AE4769B645476E8E22A346"><enum>(2)</enum><header>Limitations</header><text>In the case of a grant awarded under paragraph (1) to an eligible trauma center, such grant—</text> <subparagraph display-inline="no-display-inline" id="HBF6C5A44F7EC44D69ED98FE33717C9A9"><enum>(A)</enum><text>shall be for a period of at least 1 year and not more than 3 years (and may be renewed at the end of such period); and</text></subparagraph> 
<subparagraph id="HFC0EB82B365D4574AB3725AE8A9EE0B5"><enum>(B)</enum><text>shall be in an amount that does not exceed, in a year—</text> <clause id="HEA571D6BCAD94303B5F4961915E5EA45"><enum>(i)</enum><text display-inline="yes-display-inline">$100,000 for each military trauma care provider that is a physician at such eligible trauma center; and</text></clause> 
<clause id="HEABB10D16EE846C0A0E80AA8DFD8970C"><enum>(ii)</enum><text display-inline="yes-display-inline">$50,000 for each other military trauma care provider at such eligible trauma center.</text></clause></subparagraph></paragraph></subsection> <subsection id="H117FB9C1C36D4FE9ABBF7C96BA894206"><enum>(c)</enum><header>Grant requirements</header> <paragraph display-inline="no-display-inline" id="H845CD209C6C04C3E96684447917717FC"><enum>(1)</enum><header>Deployment</header><text display-inline="yes-display-inline">As a condition of receipt of a grant under this section, a grant recipient shall agree to allow military trauma care providers providing care pursuant to such grant to be deployed by the Secretary of Defense for military operations, for training, or for response to a mass casualty incident.</text></paragraph> 
<paragraph id="H61F4DE735C8645CD8A4E192853F3CC27"><enum>(2)</enum><header>Use of funds</header><text display-inline="yes-display-inline">Grants awarded under this section to an eligible trauma center may be used to train and incorporate military trauma care providers into such trauma center, including expenditures for malpractice insurance, office space, information technology, specialty education and supervision, trauma programs, research, and State license fees for such military trauma care providers.</text></paragraph></subsection> <subsection id="H47BF0F4E16C14DA1869AC8695BC2246A"><enum>(d)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">Nothing in this section shall be construed to affect the extent to which State licensing requirements for health care professionals are preempted by other Federal law from applying to military trauma care providers.</text></subsection> 
<subsection id="H7EC2C702C66B4A7D8073BDE02C69BC75"><enum>(e)</enum><header>Reporting requirements</header> 
<paragraph id="HA2EE4584A3D74E38A32D0B20CDE4E3E3"><enum>(1)</enum><header>Report to the Secretary and the Secretary of Defense</header><text>Each eligible trauma center or eligible high-acuity trauma center awarded a grant under subsection (a) or (b) for a year shall submit to the Secretary and the Secretary of Defense a report for such year that includes information on—</text> <subparagraph id="HEDFFCBC899DC4AE1B572093ED77D8625"><enum>(A)</enum><text>the number and types of trauma cases managed by military trauma teams or military trauma care providers pursuant to such grant during such year;</text></subparagraph> 
<subparagraph id="HEF004CFCFA454831B2DB906CE7167541"><enum>(B)</enum><text>the financial impact of such grant on the trauma center;</text></subparagraph> <subparagraph id="HAB08614B6CB2458ABBCC91DB8075CA4B"><enum>(C)</enum><text>the educational impact on resident trainees in centers where military trauma teams are assigned;</text></subparagraph> 
<subparagraph id="HD75CD2AEEA8E476898CA12ACE24E506E"><enum>(D)</enum><text>any research conducted during such year supported by such grant; and</text></subparagraph> <subparagraph id="H41BC7F01C9E446ED8E7DAF9A2B2AC6E8"><enum>(E)</enum><text>any other information required by the Secretaries for the purpose of evaluating the effect of such grant.</text></subparagraph></paragraph> 
<paragraph id="H1235E2F3457D4274BCC56EEBB170C7F9"><enum>(2)</enum><header>Report to Congress</header><text>Not less than once every 2 years, the Secretary, in consultation with the Secretary of Defense, shall submit a report to Congress that includes information on the effect of placing military trauma care providers in trauma centers awarded grants under this section on—</text> <subparagraph id="H1BCFA9E91FAB4518BD079DBFE44DE21D"><enum>(A)</enum><text>maintaining readiness of military trauma care providers for battlefield injuries;</text></subparagraph> 
<subparagraph id="H9C8A588419104B3D8E2E3DF371F11148"><enum>(B)</enum><text>providing health care to civilian trauma patients in both urban and rural settings;</text></subparagraph> <subparagraph id="H863462F72BF345EC80C405B7B78E957B"><enum>(C)</enum><text>the capability to respond to surges in trauma cases, including as a result of a large scale event; and</text></subparagraph> 
<subparagraph id="H98A0139F428D42AB943F975643C66BD9"><enum>(D)</enum><text>the financial State of the trauma centers.</text></subparagraph></paragraph></subsection> <subsection id="H546A886883C048D1AC5B5190304C427A"><enum>(f)</enum><header>Definitions</header><text display-inline="yes-display-inline">For purposes of this part:</text> 
<paragraph id="HF187DD89523340CC971548B3438F4F2F"><enum>(1)</enum><header>Eligible trauma center</header><text display-inline="yes-display-inline">The term <term>eligible trauma center</term> means a Level I, II, or III trauma center that satisfies each of the following:</text> <subparagraph id="H2767603EC3D64BAB81A16C92E8740BB4"><enum>(A)</enum><text display-inline="yes-display-inline">Such trauma center has an agreement with the Secretary of Defense to enable military trauma care providers to provide trauma care and related acute care at such trauma center.</text></subparagraph> 
<subparagraph id="HA09517278658442F81610ED5816DA6E7"><enum>(B)</enum><text>Such trauma center utilizes a risk-adjusted benchmarking system to measure performance and outcomes, such as the Trauma Quality Improvement Program of the American College of Surgeons.</text></subparagraph> <subparagraph id="H78A3269D1ECB460682DFF6A95DD4E5FE"><enum>(C)</enum><text>Such trauma center demonstrates a need for integrated military trauma care providers to maintain or improve the trauma clinical capability of such trauma center.</text></subparagraph></paragraph> 
<paragraph id="H425DC366E53A41D195C1AB37531FF8BD"><enum>(2)</enum><header>Eligible high-acuity trauma center</header><text display-inline="yes-display-inline">The term <term>eligible high-acuity trauma center</term> means a Level I trauma center that satisfies each of the following:</text> <subparagraph id="H0ABA9741CCD64B02A820F47AAFE4679A"><enum>(A)</enum><text display-inline="yes-display-inline">Such trauma center has an agreement with the Secretary of Defense to enable military trauma teams to provide trauma care and related acute care at such trauma center.</text></subparagraph> 
<subparagraph display-inline="no-display-inline" id="HD619960A86FD4BCF8422FDBB708F5B07"><enum>(B)</enum><text>At least 20 percent of patients of such trauma center in the most recent 3-month period for which data is available are treated for a major trauma at such trauma center.</text></subparagraph> <subparagraph id="HB90F9CC701B7401983E0BB89048DEB50"><enum>(C)</enum><text>Such trauma center utilizes a risk-adjusted benchmarking system to measure performance and outcomes, such as the Trauma Quality Improvement Program of the American College of Surgeons.</text></subparagraph> 
<subparagraph id="H6BB6331474824A3BBA0D9948ED26E33D"><enum>(D)</enum><text>Such trauma center is an academic training center—</text> <clause id="H2298627DAF2A4E2F8E69D6D7AB09CC60"><enum>(i)</enum><text>affiliated with a medical school;</text></clause> 
<clause id="H20D36EEC83D14F799E38CAF9872962F6"><enum>(ii)</enum><text>that maintains residency programs and fellowships in critical trauma specialties and subspecialties, and provides education and supervision of military trauma team members according to those specialties and subspecialties; and</text></clause> <clause id="H20A24DBE547D4FCBBC25C542297E25C1"><enum>(iii)</enum><text>that undertakes research in the prevention and treatment of traumatic injury.</text></clause></subparagraph> 
<subparagraph commented="no" id="HDCAEBC00DD7B4081A8E41CCC43A84484"><enum>(E)</enum><text display-inline="yes-display-inline">Such trauma center serves as a disaster response leader for its community, such as by participating in a partnership for State and regional hospital preparedness established under section 319C–2.</text></subparagraph></paragraph> <paragraph id="HAB599F48E984492A83A79D9667936A7C"><enum>(3)</enum><header>Major trauma</header><text>The term <term>major trauma</term> means an injury that is greater than or equal to 15 on the injury severity score.</text></paragraph> 
<paragraph id="HBF38A455F7C145939044E60657DFCE2A"><enum>(4)</enum><header>Military trauma team</header><text>The term <term>military trauma team</term> means a complete military trauma team consisting of military trauma care providers.</text></paragraph> <paragraph display-inline="no-display-inline" id="H3121FE84FBF54658A1D67BDA3E07CED3"><enum>(5)</enum><header>Military trauma care provider</header><text display-inline="yes-display-inline">The term <term>military trauma care provider</term> means a member of the Armed Forces who furnishes emergency, critical care, and other trauma acute care, including a physician, military surgeon, physician assistant, nurse, respiratory therapist, flight paramedic, combat medic, or enlisted medical technician.</text></paragraph></subsection> 
<subsection id="H11C2956F66D744B5AE11B4DCF4BF8AAC"><enum>(g)</enum><header>Authorization of appropriations</header><text>There are authorized to be appropriated to carry out this section—</text> <paragraph id="H991EFA95572640B48C4AC3C9DDCBADBE"><enum>(1)</enum><text>$7,000,000 for fiscal year 2018, of which—</text> 
<subparagraph id="H2F7F03BA39E94CA3A63116B49CDC3F0E"><enum>(A)</enum><text>$4,500,000 shall be for carrying out subsection (a); and</text></subparagraph> <subparagraph id="H377F048A664645A89A65854E47DEC902"><enum>(B)</enum><text>$2,500,000 shall be for carrying out subsection (b);</text></subparagraph></paragraph> 
<paragraph id="H6E31199B34B4461BB2AC675750DD6D89"><enum>(2)</enum><text>$12,000,000 for fiscal year 2019, of which—</text> <subparagraph id="HFBF60E91204B4905B90F6154D550FF0C"><enum>(A)</enum><text>$8,000,000 shall be for carrying out subsection (a); and</text></subparagraph> 
<subparagraph id="H4FB4949323CC44949D7D3994B24B8B7E"><enum>(B)</enum><text>$4,000,000 shall be for carrying out subsection (b); and</text></subparagraph></paragraph> <paragraph id="H38B89C1913AD428A97A01F4B058B1C95"><enum>(3)</enum><text>$15,000,000 for each of fiscal years 2020 through 2022, of which—</text> 
<subparagraph id="H1F8F2B08DF99490CAA41ADFBFD019F4A"><enum>(A)</enum><text>$10,000,000 shall be for carrying out subsection (a); and</text></subparagraph> <subparagraph id="HAFCE63E9F08242719A2560061C2C63EA"><enum>(B)</enum><text>$5,000,000 shall be for carrying out subsection (b).</text></subparagraph></paragraph></subsection></section></part><after-quoted-block>.</after-quoted-block></quoted-block></section> 
<section id="HDC7DE66ED14B4DBA9B81D89009250B1A"><enum>3.</enum><header>Cut-Go Compliance</header><text display-inline="no-display-inline">Subsection (f) of section 319D of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247d-4">42 U.S.C. 247d–4</external-xref>) is amended by striking <quote>through 2018</quote> and inserting <quote>through 2017, and $75,300,000 for fiscal year 2018</quote>.</text> </section> </legis-body> <attestation><attestation-group><attestation-date date="20180226" chamber="House">Passed the House of Representatives February 26, 2018.</attestation-date><attestor display="no">Karen L. Haas,</attestor><role>Clerk.</role></attestation-group></attestation> <endorsement display="yes"></endorsement> </bill> 

