,,ii #aac? ,,congress #b;d ,session ,s4 #biff ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,novemb] #bj1 #bjad ,ms4 ,baldw9 7= h]self & ,mr4 ,portman7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,f9ance ,a ,,bill ,to improve ! und]/&+ & coord9ation ( critical c>e heal? s]vices4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,critical ,c>e ,assessm5t & ,improvem5t ,act ( #bjad4 #b4 ,f9d+s2 purposes 7a7 ,f9d+s ,congress f9ds ! foll[+3 7#a7 ,critical c>e m$ic9e is ! c>e = pati5ts ^: illnesses or injuries pres5t a significant dang] to life1 limb1 or organ function & require compreh5sive c>e & con/ant monitor+1 usually 9 int5sive c>e units 7,i,c,us74 7#b7 ,ea* ye>1 approximately #e1jjj1jjj p 9 ! ,unit$ ,/ates are admitt$ into adult m$ical1 surgical1 p$iatric1 or neonatal ,i,c,us4 7#c7 ,critical c>e m$ic9e encompasses a wide array ( diseases & heal? issues4 ,! c>e provid$ 9 ! ,,icu is highly specializ$ & complex due to ! extreme sev]ity ( illness ( its pati5t population1 (t5 involv+ multiple disease processes 9 diff]5t organ sy/ems at ! same "t4 7#d7 ,critical c>e m$ic9e consumes a significant am\nt ( f9ancial res\rces1 acc\nt+ = m ?an #ag p]c5t ( all hospital co/s4 7#e7 ,accord+ to a #bjjf report by ! ,heal? ,res\rces & ,s]vices ,adm9i/ration 7ref]r$ to 9 ?is section z ,,hrsa71 dem& 9 ! ,unit$ ,/ates = critical c>e m$ical s]vices is on ! rise1 due 9 "p to ! gr[+ eld]ly population1 z individuals ov] ! age ( #fe consume a l>ge p]c5tage ( critical c>e s]vices4 7#f7 ,! ,,hrsa report also f\nd t ! gr[+ ag+ population w fur!r exac]bate an exi/+ %ortage ( int5sivi/s1 ! physicians c]tifi$ 9 critical c>e :o prim>ily deliv] c>e 9 int5sive c>e units1 pot5tially compromis+ ! quality & availability ( c>e4 ,today1 int5sivi/-l$ teams treat only "o-?ird ( critically ill pati5ts despite sub/antial evid5ce t ^! teams lead to improv$ outcomes4 7#g7 ,ensur+ ! /r5g? ( our critical c>e m$ical deliv]y infra/ructure is integral to ! improvem5t ( ! quality & deliv]y ( heal? c>e 9 ! ,unit$ ,/ates4 7b7 ,purpose ,! purpose ( ?is ,act is to assess ! curr5t /ate ( ! ,unit$ ,/ates critical c>e m$ical deliv]y sy/em & implem5t policies to improve ! quality & effectiv5ess ( c>e deliv]$ to ! critically ill & injur$4 #c4 ,/udies on critical c>e 7a7 ,in/itute ( ,m$ic9e /udy 7#a7 ,9 g5]al ,! ,secret>y ( ,heal? & ,human ,s]vices 79 ?is ,act ref]r$ to z ! ,secret>y7 %all ent] into an agreem5t ) ! ,in/itute ( ,m$ic9e "u :i*1 n lat] ?an #a ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,in/itute w-- 7,a7 conduct an analysis ( ! curr5t /ate ( critical c>e heal? s]vices 9 ! ,unit$ ,/ates2 7,b7 develop recomm5dations to bol/] critical c>e capabilities to meet future dem&2 & 7,c7 submit to ,congress a report includ+ ! analysis & recomm5dations "u subp>agraphs 7,a7 & 7,b74 7#b7 ,issues to be /udi$ ,! agreem5t "u p>agraph 7#a7 %all1 at a m9imum1 provide = ! foll[+3 7,a7 ,analysis ( ! curr5t critical c>e sy/em 9 ! ,unit$ ,/ates1 includ+-- 7i7 ! sy/em's capacity & res\rces1 includ+ ! size ( ! critical c>e work=ce & ! availability ( heal? in=mation te*nology & m$ical equipm5t2 7ii7 ! sy/em's /r5g?s1 limitations1 & future *all5ges2 & 7iii7 ! sy/em's ability to provide adequate c>e = ! critically ill or injur$ 9 response to a national heal? em]g5cy1 includ+ a p&emic or natural disa/]4 7,b7 ,analysis & recomm5dations reg>d+ regionaliz+ critical c>e sy/ems4 7,c7 ,analysis reg>d+ ! /atus ( critical c>e rese>* 9 ! ,unit$ ,/ates & recomm5dations = future rese>* priorities4 7b7 ,heal? ,res\rces & ,s]vices ,adm9i/ration /udy 7#a7 ,9 g5]al ,! ,secret>y %all review & update ! ,heal? ,res\rces & ,s]vices ,adm9i/ration's #bjjf /udy entitl$ ,! ,critical ,c>e ,work=ce3 ,a ,/udy ( ! ,supply & ,dem& = ,critical ,c>e ,physicians4 7#b7 ,scope ,9 c>ry+ out p>agraph 7#a71 ! ,secret>y %all exp& ! scope ( ! /udy to address ! supply & dem& ( o!r provid]s )9 ! spectrum ( critical c>e deliv]y1 su* z critical c>e nurses1 mid-level provid]s 7su* z physician assi/ants & nurse practition]s71 int5sive c>e unit ph>maci/s1 & int5sive c>e unit respiratory c>e practition]s4 #d4 ,,nih ,critical ,c>e ,coord9at+ ,work+ ,gr\p 7a7 ,e/abli%m5t ,! ,secret>y %all e/abli% a work+ gr\p )9 ! ,national ,in/itutes ( ,heal? to be kn[n z ! ,critical ,c>e ,coord9at+ ,work+ ,gr\p 79 ?is section ref]r$ to z ! ,work+ ,gr\p74 7b7 ,memb]%ip ,! ,secret>y %all ensure t ! memb]%ip ( ! ,work+ ,gr\p includes repres5tatives ?r\gh\t ! ,national ,in/itutes ( ,heal? & any o!r compon5t ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 z ! ,secret>y det]m9es appropriate to increase ag5cy coord9ation on critical c>e1 & bas$ on exi/+ res\rces1 su* z-- 7#a7 ! ,national ,he>t1 ,lung1 & ,blood ,in/itute2 7#b7 ! ,national ,in/itute ( ,nurs+ ,rese>*2 7#c7 ! ,eunice ,k5n$y ,%riv] ,national ,in/itute ( ,*ild ,heal? & ,human ,developm5t2 7#d7 ! ,national ,in/itute ( ,g5]al ,m$ical ,sci5ces2 7#e7 ! ,national ,in/itute on ,ag+2 & 7#f7 ! ,national ,in/itute ( ,m9ority ,heal?4 7c7 ,duties ,! ,work+ ,gr\p %all-- 7#a7 s]ve z ! focal po9t & cataly/ across ! ,national ,in/itutes ( ,heal? & any o!r compon5t ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 z ! ,secret>y det]m9es appropriate = advanc+ rese>* & rese>* tra9+ 9 ! critical c>e sett+2 7#b7 coord9ate fund+ opportunities t involve multiple compon5ts ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices2 7#c7 catalyze ! developm5t ( new fund+ opportunities2 7#d7 in=m inve/igators ab\t fund+ opportunities 9 _! areas ( int]e/2 7#e7 repres5t ! ,national ,in/itutes ( ,heal? 9 gov]nm5t-wide ef=ts to improve ! ,nation's critical c>e sy/em2 7#f7 coord9ate ! collection & analysis ( in=mation on curr5t rese>* ( ! ,national ,in/itutes ( ,heal? relat+ to ! c>e ( ! critically ill & injur$ & id5tify gaps 9 su* rese>*2 7#g7 provide an annual report to ! ,director ( ! ,national ,in/itutes ( ,heal? reg>d+ rese>* ef=ts ( ! ,in/itutes relat+ to ! c>e ( ! critically ill & injur$2 & 7#h7 make recomm5dations 9 ea* su* report on h[ to /r5g!n p>tn]%ips )9 ! ,national ,in/itutes ( ,heal? & betwe5 ! ,dep>tm5t ( ,heal? & ,human ,s]vices & public & private entities to exp& collaborative1 cross-cutt+ rese>*4 #e4 ,c5t]s = ,m$ic>e & ,m$icaid ,innovation ,critical ,c>e ,demon/ration project 7a7 ,9 g5]al ,n lat] ?an "o ye> aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y %all c>ry out a demon/ration project "u ,section #aaae;,a ( ! ,social ,security ,act 7#db ,u4,s4,c4 #acae;a71 design$ to improve ! quality & effici5cy ( c>e provid$ to critically ill & injur$ pati5ts receiv+ critical c>e 9 int5sive c>e units or o!r areas ( acute c>e hospitals4 7b7 ,activities "u demon/ration project ,! activities conduct$ "u ! demon/ration project "u subsection 7a7 may1 9 addition to any o!r activity specifi$ by ! ,c5t] = ,m$ic>e & ,m$icaid ,innovation1 include activities t seek to-- 7#a7 improve ! coord9ation & transitions ( c>e to & f an int5sive c>e unit & ! next po9t ( c>e2 7#b7 incorporate value-bas$ pur*as+ me?odologies or novel in=matics1 monitor+1 or o!r me?odologies to elim9ate error1 improve outcomes1 & r$uce wa/e f ! deliv]y ( critical c>e2 7#c7 improve pr$iction models t help heal? c>e provid]s & hospitals id5tify pati5ts at high risk = requir+ critical c>e s]vices & /reaml9e c>e deliv]y to prev5t unexpect$ hospital readmissions = critical illnesses2 & 7#d7 utilize bundl$ paym5t approa*es & inc5tive c>e r$esign1 su* z ef=ts to facilitate & support compreh5sive team deliv]$ c>e4