[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 3380 Introduced in Senate (IS)]
<DOC>
116th CONGRESS
2d Session
S. 3380
To improve patient safety by supporting State-based quality improvement
efforts and through enhanced data collection and reporting, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 3, 2020
Mr. Whitehouse introduced the following bill; which was read twice and
referred to the Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To improve patient safety by supporting State-based quality improvement
efforts and through enhanced data collection and reporting, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Patient Safety Improvement Act of
2020''.
SEC. 2. SUPPORTING STATE AND LOCAL COLLABORATIVES TO ADDRESS HEALTH
CARE-ASSOCIATED INFECTIONS.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by adding at the end the following:
``SEC. 320B. EFFORTS TO REDUCE HEALTH CARE-ASSOCIATED INFECTIONS.
``(a) Grant Program To Reduce Health Care-Associated Infections.--
``(1) In general.--The Secretary shall award competitive
grants to eligible entities to support State-based
collaboratives in implementing evidence-based, regional
approaches to infection prevention, control, and reporting.
``(2) Purpose.--Amount awarded under grants under paragraph
(1) may be used to support the following activities:
``(A) Inter-professional and inter-facility
learning activities.
``(B) Building statewide learning collaboratives.
``(C) Conducting a needs assessment to identify
gaps in health care-associated infection prevention and
reporting in a State or region.
``(D) Other activities determined appropriate by
the Secretary.
``(3) Eligibility.--To be eligible to receive a grant under
this subsection, an entity shall be a public or private
nonprofit entity that submits to the Secretary an application
at such time, in such manner, and containing such information
as the Secretary may require, including--
``(A) a description of the activities to be carried
out under the grant, including the participants in any
collaborative established to carry out such activities;
``(B) a list of the specific goals of the entity
for the regional or statewide reduction of health care-
associated infection rates;
``(C) an assurance that the entity will publicly
report performance on a set of quality and outcomes
measures in carrying out activities under the grant to
reduce health care-associated infections; and
``(D) any other information determined appropriate
by the Secretary.
``(4) Priority.--In awarding grants under this subsection,
the Secretary shall prioritize applicants that collaborate with
multiple stakeholders across a region or State.
``(5) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this subsection.
``(b) Prevention Epicenter Program Expansion Grants.--
``(1) In general.--The Centers for Disease Control and
Prevention shall expand the Prevent Epicenters Program to up to
five additional sites. New sites shall work with State or
regional prevention collaboratives to develop tools,
strategies, and evidence-based interventions to--
``(A) prevent or limit infection rates in health
care facilities across the continuum of care and in
community settings;
``(B) facilitate public health research on the
prevention and control of drug-resistant organisms and
emerging microbial threats; and
``(C) assess the feasibility, cost effectiveness,
and appropriateness of surveillance and prevention
programs in different health care settings.
``(2) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this subsection.''.
SEC. 3. IMPROVING COMMUNICATION DURING CARE TRANSITIONS.
(a) Improving Provider Communication Regarding Patient Infections
in Medicare and Medicaid.--
(1) In general.--The Secretary of Health and Human Services
(referred to in this Act as the ``Secretary'') shall award
competitive grants to support the development and evaluation of
programs aimed at improving inter-facility communication about
health care-associated infections, multidrug-resistant
organisms, emerging microbial threats, and antimicrobial use
during transitions of care.
(2) Eligibility.--To be eligible for a grant under
paragraph (1) an applicant for such grant shall be composed of
two or more health care providers or facilities that regularly
transfer or refer patients to each other.
(3) Report to congress.--Not later than 1 year after the
end of the grant period under this subsection, the Secretary
shall submit a report to Congress on lessons learned by grant
awardees, including best practices and recommendations for
guidelines, policies, or payment reforms to improve inter-
facility communication during care transitions.
(4) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this subsection.
(b) Guidance on Inter-Facility Communication.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, the Administrator of the Centers for
Medicare & Medicaid Services, in collaboration with the
Director of the Agency for Healthcare Research and Quality,
shall convene a working group to develop guidance for
standardized communication between health care facilities upon
the discharge and transfer of individuals who were diagnosed
and treated for health care-associated infections.
(2) Topics.--The working group convened under paragraph (1)
shall identify--
(A) types of information related to health care-
associated infections that should be communicated when
an individual is discharged and transferred from one
health care facility to another, including--
(i) the type of infection or colonization
acquired by an individual, including whether or
not such infection or colonization is caused by
a multidrug-resistant organism; and
(ii) the type of antimicrobial drugs, if
any, that the individual received for the
infection from the discharging or transferring
provider and the stop date for those drugs;
(B) methods for transmitting information;
(C) timeframes for transmitting information; and
(D) any other information determined appropriate.
(3) Working group participants.--The working group under
paragraph (1) shall be composed of representatives from--
(A) patient groups;
(B) hospitals;
(C) long-term care facilities;
(D) accreditation agencies;
(E) State and local health departments; and
(F) other stakeholders as determined appropriate by
the Secretary.
(4) Guidance.--Not later than 1 year after the working
group has been convened under paragraph (1), the Administrator
of the Centers for Medicare & Medicaid Services shall issue
guidance on standardized content and structure for transmitting
information regarding individuals who were diagnosed and
treated for health care-associated infections.
SEC. 4. IMPROVING DATA ACCURACY AND SURVEILLANCE.
Subpart II of part D of title IX of the Public Health Service Act
(42 U.S.C. 299b-33 et seq.) is amended by adding at the end the
following:
``SEC. 938. HEALTH CARE-ASSOCIATED INFECTIONS AND ANTIMICROBIAL USE.
``(a) Identifying Best Practices.--The Centers for Disease Control
and Prevention, in collaboration with the Agency for Healthcare
Research and Quality and the Centers for Medicare & Medicaid Services,
shall convene stakeholders to identify best practices for the
collection and electronic reporting of data on health care-associated
infections to the National Healthcare Safety Network by a subsection
(d) hospital (as defined in section 1886(d)(1)(B) of the Social
Security Act (42 U.S.C. 1395ww(d)(1)(B))).
``(b) Data Collection Pilot Program.--
``(1) In general.--The Director of the Agency for
Healthcare Research and Quality, in consultation with the
Director of the Centers for Disease Control and Prevention,
shall establish and implement a pilot program to identify best
practices and innovative approaches for the collection and
electronic reporting of data on the incidence of health care-
associated infections by long-term care facilities, ambulatory
surgical centers, and dialysis facilities. Such pilot program
should incorporate applicable data validation methodologies and
other recommendations described in the framework developed
under subsection (c).
``(2) Report.--Not later than 6 months after the completion
of the pilot program under paragraph (1), the Director shall
submit to the Secretary and the appropriate committees of
Congress a report on the best practices identified through the
pilot program, including the lessons learned and challenges
encountered with respect to data collection and electronic
reporting in long-term care settings, ambulatory surgical
centers, and dialysis facilities as well as any recommended
health care-associated infections surveillance methods for
those settings.
``(3) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this subsection.
``(c) Data Validation Methodology.--The Centers for Disease Control
and Prevention shall work with State and local health departments to
develop a standard methodology for validating data reported by long-
term care facilities to the National Healthcare Safety Network.
``(d) Study and Report.--
``(1) In general.--The Comptroller General of the United
States shall conduct a study to evaluate the adequacy of State
health departments' and other State oversight agencies' methods
for external validation of data reported to the National
Healthcare Safety Network by health care facilities.
``(2) Contents.--In conducting the study under paragraph
(1), the Comptroller General shall--
``(A) assess the types and frequency of external
validation strategies conducted by State departments of
health;
``(B) identify barriers to adherence with the
Centers for Disease Control and Prevention's external
validation guidance; and
``(C) recommend strategies to improve the
consistency and reliability of data that is reported to
the National Healthcare Safety Network.
``(3) Report.--Not later than 18 months after the date of
enactment of this section, the Comptroller General shall submit
to Congress a report containing the results of the study
conducted under paragraph (1), together with recommendations,
if any, for such legislation and administration action as the
Comptroller General determines appropriate.''.
SEC. 5. STRENGTHENING ANTIMICROBIAL STEWARDSHIP.
(a) In General.--Section 320B of the Public Health Service Act, as
added by section 2, is amended by adding at the end the following:
``(c) Grant Program for State Antimicrobial Stewardship Action
Plans.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall award grants to States for the development and
implementation of State antimicrobial stewardship action plans.
``(2) Eligibility.--To be eligible to receive a grant under
this subsection, a State shall submit to the Secretary an
application at such time, in such manner, and containing such
information as the Secretary may require, including--
``(A) an assurance that development of the plan
under the grant will be led by an infectious disease-
trained physician with experience in antimicrobial
stewardship or a pharmacist with expertise in
infectious disease and antimicrobial stewardship; and
``(B) an assurance that the plan will focus on
collaboration across health care settings and include a
summary of resource gaps and challenges.
``(3) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this subsection.''.
(b) Advancing Hospital Reporting on Antibiotic Use and
Antimicrobial Resistance.--Not later than 1 year after the date of
enactment of this Act, the Administrator of the Centers for Medicare &
Medicaid Services shall issue a notice of proposed rulemaking that
requires acute care hospitals to report antibiotic use and
antimicrobial resistance using the National Healthcare Safety Network's
Antimicrobial Use and Resistance Module as part of the Hospital
Inpatient Quality Reporting Program.
(c) In General.--Section 320B of the Public Health Service Act, as
added by section 2 and amended by subsection (a), is further amended by
adding at the end the following:
``(d) Promoting the Appropriate Use of Antibiotics.--
``(1) In general.--Beginning on January 1, 2021, and
annually thereafter, the Centers for Disease Control and
Prevention shall conduct at least one antimicrobial stewardship
workshop in a State or region where annual prescriptions for
antimicrobial drugs per capita exceed the national average.
``(2) Requirements.--The workshop under paragraph (1) shall
identify regional strategies to support collaboration across
the care continuum to promote the appropriate use of
antimicrobials. In implementing such workshop, the Director of
the Centers for Disease Control and Prevention should seek
participation from relevant public and private stakeholders
with expertise in health care, quality improvement, and
consumer engagement.
``(3) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this subsection.
``(e) Study on Prescription Drug Monitoring Programs.--
``(1) In general.--The Centers for Disease Control and
Prevention shall conduct a study on the feasibility of
requiring ambulatory and outpatient health care providers to
report prescriptions for antimicrobial drugs to a State
prescription drug monitoring program, if such a program is
available in the practitioners' States.
``(2) Report.--The Centers for Disease Control and
Prevention shall submit a report to Congress on the findings of
the study under paragraph (1) and make recommendations for the
use, improvement, or expansion of State prescription drug
monitoring programs to capture information on prescriptions for
antimicrobial drugs.''.
SEC. 6. IMPROVING SAFETY IN PEDIATRIC CARE.
(a) Pediatric Safety Advisory Council.--The Secretary shall
establish a Pediatric Safety Advisory Council (referred to in this
section as the ``Council'') to advise and make recommendations on
policies to improve pediatric safety and reduce the incidence of health
care-acquired conditions in children's hospitals and other pediatric
care settings.
(1) Membership.--The Council shall include at least one of
each of the following providers:
(A) Neonatologist.
(B) Pediatrician.
(C) Pediatric infectious disease specialist.
(D) Pediatric intensive care specialist.
(E) Pediatric hospitalist.
(b) Study on the Feasibility of Children's Hospitals Reporting to
the Nationalhealth Care Safety Network.--
(1) In general.--The Centers for Disease Control and
Prevention shall conduct a study on the appropriateness and
feasibility of requiring freestanding children's hospitals to
report information on health care-associated infections to the
National Healthcare Safety Network.
(2) Content.--The study under paragraph (1) shall evaluate
the applicability of National Healthcare Safety Network
modules, risk adjustment methodologies, and case definitions to
freestanding children's hospitals.
(3) Report.--The Centers for Disease Control and Prevention
shall submit a report to Congress on the findings of the study
under paragraph (1) and make recommendations for--
(A) increasing the number of children's hospitals
that report to the National Healthcare Safety Network;
and
(B) an alternative means to collect data on health
care-associated infections that occur during a
patient's stay at a children's hospital.
SEC. 7. OTHER PATIENT SAFETY IMPROVEMENTS.
(a) In General.--Section 320B of the Public Health Service Act, as
added by section 2 and amended by section 5, is further amended by
adding at the end the following:
``(f) Continuing Education on Infection Control and Patient
Safety.--
``(1) In general.--The Secretary shall establish a program
to provide incentives (in the form of grants or other
assistance) to State medical boards that require health care
professionals (as defined by the medical board) to complete
accredited coursework or training in infection control or other
patient safety topics as a condition of receiving a new or
renewed license to practice in the State.
``(2) Exemption.--A State medical board that receives
assistance under paragraph (1) may provide an exemption from
the coursework or training requirement under such paragraph for
those health care professionals who have specialized training
in infection control (such as an infectious disease specialist
or certified infection control practitioner), who are not
actively practicing in the State, and who do not provide direct
patient care.
``(3) Authorization of appropriations.--There is authorized
to be appropriated such sums as may be necessary to carry out
this subsection.''.
(b) Engaging Hospital Leadership in Patient Safety in Medicare and
Medicaid.--
(1) Medicare.--Section 1866(a)(1) of the Social Security
Act (42 U.S.C. 1395cc(a)(1)) is amended--
(A) in subparagraph (X), by striking ``and'' at the
end;
(B) in subparagraph (Y), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following new
subparagraph:
``(Z) in the case of hospitals, including critical
access hospitals, to require that, not less than once
every 5 years, all members of the board of such
hospital receive training (which may include coursework
at an accredited institution of higher education) on
patient safety topics relevant to a hospital (or
critical access hospital, as the case may be)
setting.''.
(2) Effective date.--In the case of the requirement imposed
by the amendments made by paragraph (1), such requirement shall
apply to agreements entered into or renewed on or after the
date that is 30 days after the date of the enactment of this
Act.
(c) Core Quality Measures Collaborative.--
(1) In general.--The Administrator for the Centers for
Medicare & Medicaid Services shall establish a Core Quality
Measures Collaborative to harmonize quality measure reporting
requirements across public and commercial quality improvement
and reporting programs.
(2) Stakeholder input.--Administrator for the Centers for
Medicare & Medicaid Services shall seek input from a broad
array of stakeholders to identify priorities for clinical areas
and care settings that could benefit from core quality measure
sets and to inform the quality measures that are included in
core sets. Stakeholders shall include--
(A) commercial health plans;
(B) Medicare and Medicaid managed care plans;
(C) physician and other provider organizations;
(D) patient groups; and
(E) quality improvement groups.
(3) Framework and goals.--Not later than 1 year after the
date of enactment of this Act, the Administrator for the
Centers for Medicare & Medicaid Services shall publish a
framework and goals for the Collaborative under paragraph (1).
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