[House Report 113-559]
[From the U.S. Government Publishing Office]
113th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 113-559
======================================================================
WAKEFIELD ACT OF 2014
_______
July 24, 2014.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Upton, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 4290]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 4290) to amend the Public Health Service Act to
reauthorize the Emergency Medical Services for Children
Program, having considered the same, report favorably thereon
with an amendment and recommend that the bill as amended do
pass.
CONTENTS
Page
Purpose and Summary.............................................. 2
Background and Need for Legislation.............................. 2
Hearings......................................................... 2
Committee Consideration.......................................... 2
Committee Votes.................................................. 3
Committee Oversight Findings..................................... 3
Statement of General Performance Goals and Objectives............ 3
New Budget Authority, Entitlement Authority, and Tax Expenditures 3
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 3
Committee Cost Estimate.......................................... 3
Congressional Budget Office Estimate............................. 3
Federal Mandates Statement....................................... 5
Duplication of Federal Programs.................................. 5
Disclosure of Directed Rule Makings.............................. 5
Advisory Committee Statement..................................... 5
Applicability to Legislative Branch.............................. 5
Section-by-Section Analysis of the Legislation................... 5
Changes in Existing Law Made by the Bill, as Reported............ 6
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Wakefield Act of 2014''.
SEC. 2. REAUTHORIZATION OF EMERGENCY MEDICAL SERVICES FOR CHILDREN
PROGRAM.
Section 1910(d) of the Public Health Service Act (42 U.S.C. 300w-
9(d)) is amended by striking ``fiscal year 2014'' and inserting ``each
of fiscal years 2015 through 2019''.
Purpose and Summary
H.R. 4290, the ``Wakefield Act of 2014'' was introduced on
March 25, 2014, by Rep. Matheson (D-UT) and Rep. King (R-NY) to
reauthorize the Emergency Medical Services for Children
Program.
Background and Need for Legislation
Children have special health care needs, especially in the
field of emergency medical services (EMS). Despite that need,
the emergency and trauma care system has been slow to develop
an adequate response. Some of the problems are endemic to
emergency services in general, such as fragmentation and poor
coordination among pre-hospital services, hospitals, and public
health. The problem is worse for children when hospitals lack
the appropriate medical personnel, pediatric supplies, or
transfer agreements that lead to better care within the
``golden hour,'' when chances of survival are higher. Evidence
indicates that pediatric treatment patterns vary widely among
emergency care providers. Many providers do not properly
stabilize seriously injured children and even undertreat
children in comparison with adults. These shortcomings are
worse in rural areas, where necessary resources are scarcer.\1\
---------------------------------------------------------------------------
\1\http://www.iom.edu/reports/2006/emergency-care-for-children-
growing-pains.aspx.
---------------------------------------------------------------------------
In 1984, Congress passed the Emergency Medical Services for
Children (EMSC) as part of the Preventive Health Amendments of
1984. Last reauthorized in 2010, the program aims to reduce
child and youth mortality and morbidity caused by severe
illness or trauma. EMSC was designed to ensure that pediatric
service is well integrated into an emergency medical service
system and that the entire spectrum of emergency services is
provided to children and adolescents as well as adults.\2\
---------------------------------------------------------------------------
\2\http://mchb.hrsa.gov/programs/emergencymedical/.
---------------------------------------------------------------------------
H.R. 4290 would reauthorize EMSC through 2019. The program
supports the training and education of EMS providers and
identifies innovative models that can increase pediatric care
in rural and tribal communities. The bill supports the
Pediatric Emergency Care Applied Research Network (PECARN) that
facilitates collaborative research on pediatric EMSC. Data
collection and quality improvements projects that help identify
and address gaps in services are also a part of the EMSC.
Hearings
The Committee on Energy and Commerce has not held hearings
on the legislation.
Committee Consideration
On June 19, 2014, the Subcommittee on Health met in open
markup session and forwarded H.R. 4290 to the full Committee,
as amended, by a voice vote. On July 15, 2014, the Committee on
Energy and Commerce met in open markup session and ordered H.R.
4290 to be reported to the House, as amended, by a voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken in connection with ordering
approved H.R. 4290. A motion by Mr. Upton to order H.R. 4290
reported to the House, as amended, was agreed to by a voice
vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee has not held hearings
on this legislation.
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(1) of rule XIII of the House of
Representatives, the goal of H.R. 4290 is to reauthorize the
EMSC.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
4290, ``The Wakefield Act of 2014'' would result in no new or
increased budget authority, entitlement authority, or tax
expenditures or revenues.
Earmark, Limited Tax Benefits, and Limited Tariff Benefits
In compliance with clause 9(e), 9(f), and 9(g) of rule XXI,
the Committee finds that H.R. 4290 contains no earmarks,
limited tax benefits, or limited tariff benefits.
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, July 22, 2014.
Hon. Fred Upton,
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. 4290, the
Wakefield Act of 2014.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
H.R. 4290--Wakefield Act of 2014
Summary: H.R. 4290 would amend the Public Health Service
Act to reauthorize activities intended to reduce child
morbidity and mortality by improving emergency medical services
for children. Those activities are supported by grants
administered by the Health Resources and Services
Administration (HRSA).
The bill would authorize appropriations of about $30
million in 2015 and $152 million over the 2015-2019 period. CBO
estimates that implementing H.R. 4290 would cost $135 million
over the 2015-2019 period, assuming appropriation of the
authorized amounts. Pay-as-you-go procedures do not apply to
this legislation because it would not affect direct spending or
revenues.
The bill contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary effect of H.R. 4290 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
-----------------------------------------------------
2015-
2015 2016 2017 2018 2019 2019
----------------------------------------------------------------------------------------------------------------
CHANGES IN SPENDING SUBJECT TO APPROPRIATION
Authorization Level....................................... 30 30 30 30 30 152
Estimated Outlays......................................... 15 25 30 30 30 135
----------------------------------------------------------------------------------------------------------------
Note: Numbers may not sum to totals because of rounding.
Basis of estimate: For this estimate, CBO assumes that H.R.
4290 will be enacted before the end of fiscal year 2014, that
the Congress will appropriate the authorized amounts, and that
spending will follow historical patterns for HRSA activities.
H.R. 4290 would authorize the appropriation of about $30
million a year for fiscal years 2015 through 2019 for HRSA to
provide grants to states, territories, and institutions of
higher education. Those grants support research and training to
improve the quality of emergency care services provided to
children. In fiscal year 2014, the HRSA allocated $20 million
of its appropriation for such activities. CBO estimates that
implementing the bill would cost $135 million over the 2015-
2019 period.
Pay-As-You-Go considerations: None.
Intergovernmental and private-sector impact: H.R. 4290
contains no intergovernmental or private-sector mandates as
defined in UMRA and would impose no costs on state, local, or
tribal governments. The bill would reauthorize grant funding to
expand and improve emergency medical services for children in
need of treatment for trauma or critical care. State, local, or
tribal governments that choose to apply for those grants would
benefit from the additional support.
Estimate prepared by: Federal costs: Lisa Ramirez-Branum;
Impact on state, local, and tribal governments: J'nell L.
Blanco; Impact on the private sector: Alexia Diorio.
Estimate approved by: Holly Harvey, 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.
Duplication of Federal Programs
No provision of H.R. 4290 establishes or reauthorizes a
program of the Federal government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Disclosure of Directed Rule Makings
The Committee estimates that enacting H.R. 4290 would not
specifically direct a rulemaking within the meaning of 5 U.S.C.
551.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
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 states the legislation may be cited as the
``Wakefield Act of 2014''.
Section 2. Reauthorization of Emergency Medical Services for Children
Program
Section 2 would reauthorize grants programs that support
demonstration projects for the expansion and improvement of
emergency medical services for children at $30,387,656 for each
of fiscal years 2015 through 2019.
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 XIX--BLOCK GRANTS
Part A--Preventive Health and Health Services Block Grant
* * * * * * *
emergency medical services for children
Sec. 1910. (a) * * *
* * * * * * *
(d) To carry out this section, there are authorized to be
appropriated $2,000,000 for fiscal year 1985 and for each of
the two succeeding fiscal years, $3,000,000 for fiscal year
1989, $4,000,000 for fiscal year 1990, $5,000,000 for each of
the fiscal years 1991 and 1992, such sums as may be necessary
for each of the fiscal years 1993 through 2005, $25,000,000 for
fiscal year 2010, $26,250,000 for fiscal year 2011, $27,562,500
for fiscal year 2012, $28,940,625 for fiscal year 2013, and
$30,387,656 for [fiscal year 2014] each of fiscal years 2015
through 2019.
* * * * * * *