,,ii #aafth ,,congress #b;d ,session ,s4 #cchj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #c1 #bjbj,mr4 ,whitehouse introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to improve patient safety by supporting ,state-based quality improvement efforts and through enhanced data collection and reporting1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,patient ,safety ,improvement ,act of #bjbj4 #b4 ,supporting ,state and local collaboratives to address health care-associated infections ,part ,b of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bdc et seq47 is amended by adding at the end the following3 #cbj;,b4 ,efforts to reduce health care-associated infections 7a7 ,grant program ,to reduce health care-,associated infections 7#a7 ,in general ,the ,secretary shall award competitive grants to eligible entities to support ,state-based collaboratives in implementing evidence-based1 regional approaches to infection prevention1 control1 and reporting4 7#b7 ,purpose ,amount awarded under grants under paragraph 7#a7 may be used to support the following activities3 7,a7 ,inter-professional and inter-facility learning activities4 7,b7 ,building statewide learning collaboratives4 7,c7 ,conducting a needs assessment to identify gaps in health care-associated infection prevention and reporting in a ,state or region4 7,d7 ,other activities determined appropriate by the ,secretary4 7#c7 ,eligibility ,to be eligible to receive a grant under this subsection1 an entity shall be a public or private nonprofit entity that submits to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including-- 7,a7 a description of the activities to be carried out under the grant1 including the participants in any collaborative established to carry out such activities2 7,b7 a list of the specific goals of the entity for the regional or statewide reduction of health care-associated infection rates2 7,c7 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 infections2 and 7,d7 any other information determined appropriate by the ,secretary4 7#d7 ,priority ,in awarding grants under this subsection1 the ,secretary shall prioritize applicants that collaborate with multiple stakeholders across a region or ,state4 7#e7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection4 7b7 ,prevention epicenter program expansion grants 7#a7 ,in general ,the ,centers for ,disease ,control and ,prevention shall expand the ,prevent ,epicenters ,program to up to five additional sites4 ,new sites shall work with ,state or regional prevention collaboratives to develop tools1 strategies1 and evidence-based interventions to-- 7,a7 prevent or limit infection rates in health care facilities across the continuum of care and in community settings2 7,b7 facilitate public health research on the prevention and control of drug-resistant organisms and emerging microbial threats2 and 7,c7 assess the feasibility1 cost effectiveness1 and appropriateness of surveillance and prevention programs in different health care settings4 7#b7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection4 4 #c4 ,improving communication during care transitions 7a7 ,improving provider communication regarding patient infections in medicare and medicaid 7#a7 ,in general ,the ,secretary of ,health and ,human ,services 7referred to in this ,act as the ,secretary7 shall award competitive grants to support the development and evaluation of programs aimed at improving inter-facility communication about health care-associated infections1 multidrug-resistant organisms1 emerging microbial threats1 and antimicrobial use during transitions of care4 7#b7 ,eligibility ,to be eligible for a grant under paragraph 7#a7 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 other4 7#c7 ,report to congress ,not later than #a year after the end of the grant period under this subsection1 the ,secretary shall submit a report to ,congress on lessons learned by grant awardees1 including best practices and recommendations for guidelines1 policies1 or payment reforms to improve inter-facility communication during care transitions4 7#d7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection4 7b7 ,guidance on inter-,facility communication 7#a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,administrator of the ,centers for ,medicare ,medicaid ,services1 in collaboration with the ,director of the ,agency for ,healthcare ,research and ,quality1 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 infections4 7#b7 ,topics ,the working group convened under paragraph 7#a7 shall identify-- 7,a7 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 another1 including-- 7i7 the type of infection or colonization acquired by an individual1 including whether or not such infection or colonization is caused by a multidrug-resistant organism2 and 7ii7 the type of antimicrobial drugs1 if any1 that the individual received for the infection from the discharging or transferring provider and the stop date for those drugs2 7,b7 methods for transmitting information2 7,c7 timeframes for transmitting information2 and 7,d7 any other information determined appropriate4 7#c7 ,working group participants ,the working group under paragraph 7#a7 shall be composed of representatives from-- 7,a7 patient groups2 7,b7 hospitals2 7,c7 long-term care facilities2 7,d7 accreditation agencies2 7,e7 ,state and local health departments2 and 7,f7 other stakeholders as determined appropriate by the ,secretary4 7#d7 ,guidance ,not later than #a year after the working group has been convened under paragraph 7#a71 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 infections4 #d4 ,improving data accuracy and surveillance ,subpart ,,ii of part ,d of title ,,ix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bii;b-#cc et seq47 is amended by adding at the end the following3 #ich4 ,health care-associated infections and antimicrobial use 7a7 ,identifying best practices ,the ,centers for ,disease ,control and ,prevention1 in collaboration with the ,agency for ,healthcare ,research and ,quality and the ,centers for ,medicare ,medicaid ,services1 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 7d7 hospital 7as defined in section #ahhf7;d77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acieww7d77#a77;,b7774 7b7 ,data collection pilot program 7#a7 ,in general ,the ,director of the ,agency for ,healthcare ,research and ,quality1 in consultation with the ,director of the ,centers for ,disease ,control and ,prevention1 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 facilities1 ambulatory surgical centers1 and dialysis facilities4 ,such pilot program should incorporate applicable data validation methodologies and other recommendations described in the framework developed under subsection 7c74 7#b7 ,report ,not later than #f months after the completion of the pilot program under paragraph 7#a71 the ,director shall submit to the ,secretary and the appropriate committees of ,congress a report on the best practices identified through the pilot program1 including the lessons learned and challenges encountered with respect to data collection and electronic reporting in long-term care settings1 ambulatory surgical centers1 and dialysis facilities as well as any recommended health care-associated infections surveillance methods for those settings4 7#c7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection4 7c7 ,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 ,network4 7d7 ,study and report 7#a7 ,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 facilities4 7#b7 ,contents ,in conducting the study under paragraph 7#a71 the ,comptroller ,general shall-- 7,a7 assess the types and frequency of external validation strategies conducted by ,state departments of health2 7,b7 identify barriers to adherence with the ,centers for ,disease ,control and ,prevention's external validation guidance2 and 7,c7 recommend strategies to improve the consistency and reliability of data that is reported to the ,national ,healthcare ,safety ,network4 7#c7 ,report ,not later than #ah months after the date of enactment of this section1 the ,comptroller ,general shall submit to ,congress a report containing the results of the study conducted under paragraph 7#a71 together with recommendations1 if any1 for such legislation and administration action as the ,comptroller ,general determines appropriate4 4 #e4 ,strengthening antimicrobial stewardship 7a7 ,in general ,section #cbj;,b of the ,public ,health ,service ,act1 as added by section #b1 is amended by adding at the end the following3 7c7 ,grant program for ,state antimicrobial stewardship action plans 7#a7 ,in general ,the ,secretary1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 shall award grants to ,states for the development and implementation of ,state antimicrobial stewardship action plans4 7#b7 ,eligibility ,to be eligible to receive a grant under this subsection1 a ,state shall submit to the ,secretary an application at such time1 in such manner1 and containing such information as the ,secretary may require1 including-- 7,a7 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 stewardship2 and 7,b7 an assurance that the plan will focus on collaboration across health care settings and include a summary of resource gaps and challenges4 7#c7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection4 4 7b7 ,advancing hospital reporting on antibiotic use and antimicrobial resistance ,not later than #a year after the date of enactment of this ,act1 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 ,program4 7c7 ,in general ,section #cbj;,b of the ,public ,health ,service ,act1 as added by section #b and amended by subsection 7a71 is further amended by adding at the end the following3 7d7 ,promoting the appropriate use of antibiotics 7#a7 ,in general ,beginning on ,january #a1 #bjba1 and annually thereafter1 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 average4 7#b7 ,requirements ,the workshop under paragraph 7#a7 shall identify regional strategies to support collaboration across the care continuum to promote the appropriate use of antimicrobials4 ,in implementing such workshop1 the ,director of the ,centers for ,disease ,control and ,prevention should seek participation from relevant public and private stakeholders with expertise in health care1 quality improvement1 and consumer engagement4 7#c7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection4 7e7 ,study on prescription drug monitoring programs 7#a7 ,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 program1 if such a program is available in the practitioners' ,states4 7#b7 ,report ,the ,centers for ,disease ,control and ,prevention shall submit a report to ,congress on the findings of the study under paragraph 7#a7 and make recommendations for the use1 improvement1 or expansion of ,state prescription drug monitoring programs to capture information on prescriptions for antimicrobial drugs4 4 #f4 ,improving safety in pediatric care 7a7 ,pediatric safety advisory council ,the ,secretary shall establish a ,pediatric ,safety ,advisory ,council 7referred to in this section as the ,council7 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 settings4 7#a7 ,membership ,the ,council shall include at least one of each of the following providers3 7,a7 ,neonatologist4 7,b7 ,pediatrician4 7,c7 ,pediatric infectious disease specialist4 7,d7 ,pediatric intensive care specialist4 7,e7 ,pediatric hospitalist4 7b7 ,study on the feasibility of children's hospitals reporting to the nationalhealth care safety network 7#a7 ,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 ,network4 7#b7 ,content ,the study under paragraph 7#a7 shall evaluate the applicability of ,national ,healthcare ,safety ,network modules1 risk adjustment methodologies1 and case definitions to freestanding children's hospitals4 7#c7 ,report ,the ,centers for ,disease ,control and ,prevention shall submit a report to ,congress on the findings of the study under paragraph 7#a7 and make recommendations for-- 7,a7 increasing the number of children's hospitals that report to the ,national ,healthcare ,safety ,network2 and 7,b7 an alternative means to collect data on health care-associated infections that occur during a patient's stay at a children's hospital4 #g4 ,other patient safety improvements 7a7 ,in general ,section #cbj;,b of the ,public ,health ,service ,act1 as added by section #b and amended by section #e1 is further amended by adding at the end the following3 7f7 ,continuing education on infection control and patient safety 7#a7 ,in general ,the ,secretary shall establish a program to provide incentives 7in the form of grants or other assistance7 to ,state medical boards that require health care professionals 7as defined by the medical board7 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 ,state4 7#b7 ,exemption ,a ,state medical board that receives assistance under paragraph 7#a7 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 7such as an infectious disease specialist or certified infection control practitioner71 who are not actively practicing in the ,state1 and who do not provide direct patient care4 7#c7 ,authorization of appropriations ,there is authorized to be appropriated such sums as may be necessary to carry out this subsection4 4 7b7 ,engaging hospital leadership in patient safety in ,medicare and ,medicaid 7#a7 ,medicare ,section #ahff7;a77#a7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acie;cc7a77#a77 is amended-- 7,a7 in subparagraph 7,x71 by striking and at the end2 7,b7 in subparagraph 7,y71 by striking the period and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,z7 in the case of hospitals1 including critical access hospitals1 to require that1 not less than once every #e years1 all members of the board of such hospital receive training 7which may include coursework at an accredited institution of higher education7 on patient safety topics relevant to a hospital 7or critical access hospital1 as the case may be7 setting4 4 7#b7 ,effective date ,in the case of the requirement imposed by the amendments made by paragraph 7#a71 such requirement shall apply to agreements entered into or renewed on or after the date that is #cj days after the date of the enactment of this ,act4 7c7 ,core quality measures collaborative 7#a7 ,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 programs4 7#b7 ,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 sets4 ,stakeholders shall include-- 7,a7 commercial health plans2 7,b7 ,medicare and ,medicaid managed care plans2 7,c7 physician and other provider organizations2 7,d7 patient groups2 and 7,e7 quality improvement groups4 7#c7 ,framework and goals ,not later than #a year after the date of enactment of this ,act1 the ,administrator for the ,centers for ,medicare ,medicaid ,services shall publish a framework and goals for the ,collaborative under paragraph 7#a74