,,ii  #aaf? ,,congress  #b;d ,session   
,s4 #cchj  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,m>* #c1 #bjbj,mr4     
,:iteh\se introduc$ ! foll[+ bill2 :i* 0
 read twice & ref]r$ to ! ,committee on 
,heal?1 ,education1 ,labor1 & ,p5sions  
,a ,,bill  ,to improve pati5t safety by 
support+ ,/ate-bas$ quality improvem5t  
ef=ts & ?r\gh enhanc$ data collection & 
report+1 & = o!r purposes4  #a4 ,%ort   
title ,?is ,act may be cit$ z ! ,pati5t 
,safety ,improvem5t ,act ( #bjbj4  #b4  
,support+ ,/ate & local collaboratives  
to address heal? c>e-associat$          
infections ,"p ,b ( title ,,iii ( !     
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bdc et seq47 is am5d$ by add+
 at ! end ! foll[+3  #cbj;,b4 ,ef=ts to 
r$uce heal? c>e-associat$ infections    
7a7 ,grant program ,to r$uce heal?      
c>e-,associat$ infections  7#a7 ,9 g5]al
 ,! ,secret>y %all aw>d competitive     
grants to eligible entities to support  
,/ate-bas$ collaboratives 9 implem5t+   
evid5ce-bas$1 regional approa*es to     

infection prev5tion1 control1 & report+4
  7#b7 ,purpose ,am\nt aw>d$ "u grants  
"u p>agraph 7#a7 may be us$ to support !
 foll[+ activities3 7,a7                
,int]-pr(essional & int]-facility le>n+ 
activities4  7,b7 ,build+ /atewide le>n+
 collaboratives4  7,c7 ,conduct+ a ne$s 
assessm5t to id5tify gaps 9 heal?       
c>e-associat$ infection prev5tion &     
report+ 9 a ,/ate or region4  7,d7 ,o!r 
activities det]m9$ appropriate by !     
,secret>y4  7#c7 ,eligibility ,to be    
eligible to receive a grant "u ?is      
subsection1 an entity %all be a public  
or private nonpr(it entity t submits to 
! ,secret>y an application at su* "t1 9 
su* mann]1 & conta9+ su* in=mation z !  
,secret>y may require1 includ+-- 7,a7 a 
description ( ! activities to be c>ri$  
out "u ! grant1 includ+ ! p>ticipants 9 
any collaborative e/abli%$ to c>ry out  
su* activities2  7,b7 a li/ ( ! specific
 goals ( ! entity = ! regional or       
/atewide r$uction ( heal? c>e-associat$ 
infection rates2  7,c7 an assurance t ! 

entity w publicly report p]=mance on a  
set ( quality & outcomes measures 9     
c>ry+ out activities "u ! grant to r$uce
 heal? c>e-associat$ infections2 &  7,d7
 any o!r in=mation det]m9$ appropriate  
by ! ,secret>y4  7#d7 ,priority ,9 aw>d+
 grants "u ?is subsection1 ! ,secret>y  
%all prioritize applicants t collaborate
 ) multiple /akehold]s across a region  
or ,/ate4  7#e7 ,au?orization (         
appropriations ,!re is au?oriz$ to be   
appropriat$ su* sums z may be necess>y  
to c>ry out ?is subsection4  7b7        
,prev5tion epic5t] program expansion    
grants  7#a7 ,9 g5]al ,! ,c5t]s =       
,disease ,control & ,prev5tion %all exp&
 ! ,prev5t ,epic5t]s ,program to up to  
five additional sites4 ,new sites %all  
"w ) ,/ate or regional prev5tion        
collaboratives to develop tools1        
/rategies1 & evid5ce-bas$ int]v5tions   
to-- 7,a7 prev5t or limit infection     
rates 9 heal? c>e facilities across !   
cont9uum ( c>e & 9 community sett+s2    
7,b7 facilitate public heal? rese>* on !

 prev5tion & control ( drug-resi/ant    
organisms & em]g+ microbial ?reats2 &   
7,c7 assess ! feasibility1 co/          
effectiv5ess1 & appropriat5ess (        
surveillance & prev5tion programs 9     
diff]5t heal? c>e sett+s4  7#b7         
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ su* sums z   
may be necess>y to c>ry out ?is         
subsection4  4  #c4 ,improv+            
communication dur+ c>e transitions  7a7 
,improv+ provid] communication reg>d+   
pati5t infections 9 m$ic>e & m$icaid    
7#a7 ,9 g5]al ,! ,secret>y ( ,heal? &   
,human ,s]vices 7ref]r$ to 9 ?is ,act z 
! ,secret>y7 %all aw>d competitive      
grants to support ! developm5t &        
evaluation ( programs aim$ at improv+   
int]-facility communication ab\t heal?  
c>e-associat$ infections1               
multidrug-resi/ant organisms1 em]g+     
microbial ?reats1 & antimicrobial use   
dur+ transitions ( c>e4  7#b7           
,eligibility ,to be eligible = a grant  
"u p>agraph 7#a7 an applicant = su*     

grant %all be compos$ ( two or m heal?  
c>e provid]s or facilities t regul>ly   
transf] or ref] pati5ts to ea* o!r4     
7#c7 ,report to congress ,n lat] ?an #a 
ye> aft] ! end ( ! grant p]iod "u ?is   
subsection1 ! ,secret>y %all submit a   
report to ,congress on lessons le>n$ by 
grant aw>dees1 includ+ be/ practices &  
recomm5dations = guidel9es1 policies1 or
 paym5t re=ms to improve int]-facility  
communication dur+ c>e transitions4     
7#d7 ,au?orization ( appropriations ,!re
 is au?oriz$ to be appropriat$ su* sums 
z may be necess>y to c>ry out ?is       
subsection4  7b7 ,guidance on           
int]-,facility communication  7#a7 ,9   
g5]al ,n lat] ?an #a ye> aft] ! date (  
enactm5t ( ?is ,act1 ! ,adm9i/rator ( ! 
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1 9  
collaboration ) ! ,director ( ! ,ag5cy =
 ,heal?c>e ,rese>* & ,quality1 %all     
conv5e a work+ gr\p to develop guidance 
= /&>diz$ communication betwe5 heal? c>e
 facilities ^u ! dis*>ge & transf] (    
individuals :o 7 diagnos$ & treat$ =    

heal? c>e-associat$ infections4  7#b7   
,topics ,! work+ gr\p conv5$ "u p>agraph
 7#a7 %all id5tify-- 7,a7 types (       
in=mation relat$ to heal? c>e-associat$ 
infections t %\ld be communicat$ :5 an  
individual is dis*>g$ & transf]r$ f "o  
heal? c>e facility to ano!r1 includ+--  
7i7 ! type ( infection or colonization  
acquir$ by an individual1 includ+ :e!r  
or n su* infection or colonization is   
caus$ by a multidrug-resi/ant organism2 
&  7ii7 ! type ( antimicrobial drugs1 if
 any1 t ! individual receiv$ = !        
infection f ! dis*>g+ or transf]r+      
provid] & ! /op date = ^? drugs2  7,b7  
me?ods = transmitt+ in=mation2  7,c7    
timeframes = transmitt+ in=mation2 &    
7,d7 any o!r in=mation det]m9$          
appropriate4  7#c7 ,work+ gr\p          
p>ticipants ,! work+ gr\p "u p>agraph   
7#a7 %all be compos$ ( repres5tatives   
f-- 7,a7 pati5t gr\ps2  7,b7 hospitals2 
7,c7 long-t]m c>e facilities2  7,d7     
accr$itation ag5cies2  7,e7 ,/ate &     
local heal? dep>tm5ts2 &  7,f7 o!r      

/akehold]s z det]m9$ appropriate by !   
,secret>y4  7#d7 ,guidance ,n lat] ?an  
#a ye> aft] ! work+ gr\p has be5 conv5$ 
"u p>agraph 7#a71 ! ,adm9i/rator ( !    
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices %all
 issue guidance on /&>diz$ cont5t &     
/ructure = transmitt+ in=mation reg>d+  
individuals :o 7 diagnos$ & treat$ =    
heal? c>e-associat$ infections4  #d4    
,improv+ data accuracy & surveillance   
,subp>t ,,ii ( "p ,d ( title ,,ix ( !   
,public ,heal? ,s]vice ,act 7#db        
,u4,s4,c4 #bii;b-#cc et seq47 is am5d$  
by add+ at ! end ! foll[+3  #ich4 ,heal?
 c>e-associat$ infections &             
antimicrobial use  7a7 ,id5tify+ be/    
practices ,! ,c5t]s = ,disease ,control 
& ,prev5tion1 9 collaboration ) ! ,ag5cy
 = ,heal?c>e ,rese>* & ,quality & !     
,c5t]s = ,m$ic>e  ,m$icaid ,s]vices1    
%all conv5e /akehold]s to id5tify be/   
practices = ! collection & electronic   
report+ ( data on heal? c>e-associat$   
infections to ! ,national ,heal?c>e     
,safety ,network by a subsection 7d7    

hospital 7z def9$ 9 section             
#ahhf7;d77#a77;,b7 ( ! ,social ,security
 ,act 7#db ,u4,s4,c4                    
#acieww7d77#a77;,b7774  7b7 ,data       
collection pilot program  7#a7 ,9 g5]al 
,! ,director ( ! ,ag5cy = ,heal?c>e     
,rese>* & ,quality1 9 consultation ) !  
,director ( ! ,c5t]s = ,disease ,control
 & ,prev5tion1 %all e/abli% & implem5t a
 pilot program to id5tify be/ practices 
& innovative approa*es = ! collection & 
electronic report+ ( data on ! incid5ce 
( heal? c>e-associat$ infections by     
long-t]m c>e facilities1 ambulatory     
surgical c5t]s1 & dialysis facilities4  
,su* pilot program %\ld incorporate     
applicable data validation me?odologies 
& o!r recomm5dations describ$ 9 !       
framework develop$ "u subsection 7c74   
7#b7 ,report ,n lat] ?an #f mon?s aft] !
 completion ( ! pilot program "u        
p>agraph 7#a71 ! ,director %all submit  
to ! ,secret>y & ! appropriate          
committees ( ,congress a report on ! be/
 practices id5tifi$ ?r\gh ! pilot       

program1 includ+ ! lessons le>n$ &      
*all5ges enc\nt]$ ) respect to data     
collection & electronic report+ 9       
long-t]m c>e sett+s1 ambulatory surgical
 c5t]s1 & dialysis facilities z well z  
any recomm5d$ heal? c>e-associat$       
infections surveillance me?ods = ^?     
sett+s4  7#c7 ,au?orization (           
appropriations ,!re is au?oriz$ to be   
appropriat$ su* sums z may be necess>y  
to c>ry out ?is subsection4  7c7 ,data  
validation me?odology ,! ,c5t]s =       
,disease ,control & ,prev5tion %all "w )
 ,/ate & local heal? dep>tm5ts to       
develop a /&>d me?odology = validat+    
data report$ by long-t]m c>e facilities 
to ! ,national ,heal?c>e ,safety        
,network4  7d7 ,/udy & report  7#a7 ,9  
g5]al ,! ,comptroll] ,g5]al ( ! ,unit$  
,/ates %all conduct a /udy to evaluate !
 adequacy ( ,/ate heal? dep>tm5ts' & o!r
 ,/ate ov]sight ag5cies' me?ods =       
ext]nal validation ( data report$ to !  
,national ,heal?c>e ,safety ,network by 
heal? c>e facilities4  7#b7 ,cont5ts ,9 

conduct+ ! /udy "u p>agraph 7#a71 !     
,comptroll] ,g5]al %all-- 7,a7 assess ! 
types & frequ5cy ( ext]nal validation   
/rategies conduct$ by ,/ate dep>tm5ts ( 
heal?2  7,b7 id5tify b>ri]s to adh]5ce )
 ! ,c5t]s = ,disease ,control &         
,prev5tion's ext]nal validation         
guidance2 &  7,c7 recomm5d /rategies to 
improve ! consi/5cy & reliability ( data
 t is report$ to ! ,national ,heal?c>e  
,safety ,network4  7#c7 ,report ,n lat] 
?an #ah mon?s aft] ! date ( enactm5t (  
?is section1 ! ,comptroll] ,g5]al %all  
submit to ,congress a report conta9+ !  
results ( ! /udy conduct$ "u p>agraph   
7#a71 toge!r ) recomm5dations1 if any1 =
 su* legislation & adm9i/ration action z
 ! ,comptroll] ,g5]al det]m9es          
appropriate4  4  #e4 ,/r5g!n+           
antimicrobial /ew>d%ip  7a7 ,9 g5]al    
,section #cbj;,b ( ! ,public ,heal?     
,s]vice ,act1 z add$ by section #b1 is  
am5d$ by add+ at ! end ! foll[+3  7c7   
,grant program = ,/ate antimicrobial    
/ew>d%ip action plans  7#a7 ,9 g5]al ,! 

,secret>y1 act+ ?r\gh ! ,director ( !   
,c5t]s = ,disease ,control & ,prev5tion1
 %all aw>d grants to ,/ates = !         
developm5t & implem5tation ( ,/ate      
antimicrobial /ew>d%ip action plans4    
7#b7 ,eligibility ,to be eligible to    
receive a grant "u ?is subsection1 a    
,/ate %all submit to ! ,secret>y an     
application at su* "t1 9 su* mann]1 &   
conta9+ su* in=mation z ! ,secret>y may 
require1 includ+-- 7,a7 an assurance t  
developm5t ( ! plan "u ! grant w be l$  
by an infecti\s disease-tra9$ physician 
) exp]i5ce 9 antimicrobial /ew>d%ip or a
 ph>maci/ ) exp]tise 9 infecti\s disease
 & antimicrobial /ew>d%ip2 &  7,b7 an   
assurance t ! plan w focus on           
collaboration across heal? c>e sett+s & 
include a summ>y ( res\rce gaps &       
*all5ges4  7#c7 ,au?orization (         
appropriations ,!re is au?oriz$ to be   
appropriat$ su* sums z may be necess>y  
to c>ry out ?is subsection4  4  7b7     
,advanc+ hospital report+ on antibiotic 
use & antimicrobial resi/ance ,n lat]   

?an #a ye> aft] ! date ( enactm5t ( ?is 
,act1 ! ,adm9i/rator ( ! ,c5t]s =       
,m$ic>e  ,m$icaid ,s]vices %all issue a 
notice ( propos$ rulemak+ t requires    
acute c>e hospitals to report antibiotic
 use & antimicrobial resi/ance us+ !    
,national ,heal?c>e ,safety ,network's  
,antimicrobial ,use & ,resi/ance ,module
 z "p ( ! ,hospital ,inpati5t ,quality  
,report+ ,program4  7c7 ,9 g5]al        
,section #cbj;,b ( ! ,public ,heal?     
,s]vice ,act1 z add$ by section #b &    
am5d$ by subsection 7a71 is fur!r am5d$ 
by add+ at ! end ! foll[+3  7d7 ,promot+
 ! appropriate use ( antibiotics  7#a7  
,9 g5]al ,beg9n+ on ,janu>y #a1 #bjba1 &
 annually !reaft]1 ! ,c5t]s = ,disease  
,control & ,prev5tion %all conduct at   
lea/ "o antimicrobial /ew>d%ip work%op 9
 a ,/ate or region :]e annual           
prescriptions = antimicrobial drugs p]  
capita exce$ ! national av]age4  7#b7   
,requirem5ts ,! work%op "u p>agraph 7#a7
 %all id5tify regional /rategies to     
support collaboration across ! c>e      

cont9uum to promote ! appropriate use ( 
antimicrobials4 ,9 implem5t+ su*        
work%op1 ! ,director ( ! ,c5t]s =       
,disease ,control & ,prev5tion %\ld seek
 p>ticipation f relevant public &       
private /akehold]s ) exp]tise 9 heal?   
c>e1 quality improvem5t1 & consum]      
engagem5t4  7#c7 ,au?orization (        
appropriations ,!re is au?oriz$ to be   
appropriat$ su* sums z may be necess>y  
to c>ry out ?is subsection4  7e7 ,/udy  
on prescription drug monitor+ programs  
7#a7 ,9 g5]al ,! ,c5t]s = ,disease      
,control & ,prev5tion %all conduct a    
/udy on ! feasibility ( requir+         
ambulatory & outpati5t heal? c>e        
provid]s to report prescriptions =      
antimicrobial drugs to a ,/ate          
prescription drug monitor+ program1 if  
su* a program is available 9 !          
practition]s' ,/ates4  7#b7 ,report ,!  
,c5t]s = ,disease ,control & ,prev5tion 
%all submit a report to ,congress on !  
f9d+s ( ! /udy "u p>agraph 7#a7 & make  
recomm5dations = ! use1 improvem5t1 or  

expansion ( ,/ate prescription drug     
monitor+ programs to capture in=mation  
on prescriptions = antimicrobial drugs4 
4  #f4 ,improv+ safety 9 p$iatric c>e   
7a7 ,p$iatric safety advisory c\ncil ,! 
,secret>y %all e/abli% a ,p$iatric      
,safety ,advisory ,c\ncil 7ref]r$ to 9  
?is section z ! ,c\ncil7 to advise &    
make recomm5dations on policies to      
improve p$iatric safety & r$uce !       
incid5ce ( heal? c>e-acquir$ conditions 
9 *ildr5's hospitals & o!r p$iatric c>e 
sett+s4 7#a7 ,memb]%ip ,! ,c\ncil %all  
include at lea/ "o ( ea* ( ! foll[+     
provid]s3 7,a7 ,neonatologi/4  7,b7     
,p$iatrician4  7,c7 ,p$iatric infecti\s 
disease speciali/4  7,d7 ,p$iatric      
int5sive c>e speciali/4  7,e7 ,p$iatric 
hospitali/4  7b7 ,/udy on ! feasibility 
( *ildr5's hospitals report+ to !       
nationalheal? c>e safety network  7#a7  
,9 g5]al ,! ,c5t]s = ,disease ,control &
 ,prev5tion %all conduct a /udy on !    
appropriat5ess & feasibility ( requir+  
free/&+ *ildr5's hospitals to report    

in=mation on heal? c>e-associat$        
infections to ! ,national ,heal?c>e     
,safety ,network4  7#b7 ,cont5t ,! /udy 
"u p>agraph 7#a7 %all evaluate !        
applicability ( ,national ,heal?c>e     
,safety ,network modules1 risk adju/m5t 
me?odologies1 & case def9itions to      
free/&+ *ildr5's hospitals4  7#c7       
,report ,! ,c5t]s = ,disease ,control & 
,prev5tion %all submit a report to      
,congress on ! f9d+s ( ! /udy "u        
p>agraph 7#a7 & make recomm5dations =-- 
7,a7 increas+ ! numb] ( *ildr5's        
hospitals t report to ! ,national       
,heal?c>e ,safety ,network2 &  7,b7 an  
alt]native means to collect data on     
heal? c>e-associat$ infections t occur  
dur+ a pati5t's /ay at a *ildr5's       
hospital4  #g4 ,o!r pati5t safety       
improvem5ts  7a7 ,9 g5]al ,section      
#cbj;,b ( ! ,public ,heal? ,s]vice ,act1
 z add$ by section #b & am5d$ by section
 #e1 is fur!r am5d$ by add+ at ! end !  
foll[+3  7f7 ,cont9u+ education on      
infection control & pati5t safety  7#a7 

,9 g5]al ,! ,secret>y %all e/abli% a    
program to provide inc5tives 79 ! =m (  
grants or o!r assi/ance7 to ,/ate m$ical
 bo>ds t require heal? c>e pr(essionals 
7z def9$ by ! m$ical bo>d7 to complete  
accr$it$ c\rse"w or tra9+ 9 infection   
control or o!r pati5t safety topics z a 
condition ( receiv+ a new or r5ew$      
lic5se to practice 9 ! ,/ate4  7#b7     
,exemption ,a ,/ate m$ical bo>d t       
receives assi/ance "u p>agraph 7#a7 may 
provide an exemption f ! c\rsework or   
tra9+ requirem5t "u su* p>agraph = ^?   
heal? c>e pr(essionals :o h specializ$  
tra9+ 9 infection control 7su* z an     
infecti\s disease speciali/ or c]tifi$  
infection control practition]71 :o are n
 actively practic+ 9 ! ,/ate1 & :o d n  
provide direct pati5t c>e4  7#c7        
,au?orization ( appropriations ,!re is  
au?oriz$ to be appropriat$ su* sums z   
may be necess>y to c>ry out ?is         
subsection4  4  7b7 ,engag+ hospital    
lead]%ip 9 pati5t safety 9 ,m$ic>e &    
,m$icaid  7#a7 ,m$ic>e ,section         

#ahff7;a77#a7 ( ! ,social ,security ,act
 7#db ,u4,s4,c4 #acie;cc7a77#a77 is     
am5d$-- 7,a7 9 subp>agraph 7,x71 by     
/rik+ & at ! end2  7,b7 9 subp>agraph   
7,y71 by /rik+ ! p]iod & ins]t+ 2 &2 &  
7,c7 by add+ at ! end ! foll[+ new      
subp>agraph3  7,z7 9 ! case ( hospitals1
 includ+ critical access hospitals1 to  
require t1 n less ?an once e #e ye>s1   
all memb]s ( ! bo>d ( su* hospital      
receive tra9+ 7:i* may include c\rsework
 at an accr$it$ in/itution ( high]      
education7 on pati5t safety topics      
relevant to a hospital 7or critical     
access hospital1 z ! case may be7 sett+4
  4  7#b7 ,effective date ,9 ! case ( ! 
requirem5t impos$ by ! am5dm5ts made by 
p>agraph 7#a71 su* requirem5t %all apply
 to agreem5ts ent]$ into or r5ew$ on or 
aft] ! date t is #cj days aft] ! date ( 
! enactm5t ( ?is ,act4  7c7 ,core       
quality measures collaborative  7#a7 ,9 
g5]al ,! ,adm9i/rator = ! ,c5t]s =      
,m$ic>e  ,m$icaid ,s]vices %all e/abli% 
a ,core ,quality ,measures              

,collaborative to h>monize quality      
measure report+ requirem5ts across      
public & comm]cial quality improvem5t & 
report+ programs4  7#b7 ,/akehold] input
 ,adm9i/rator = ! ,c5t]s = ,m$ic>e      
,m$icaid ,s]vices %all seek input f a   
broad array ( /akehold]s to id5tify     
priorities = cl9ical areas & c>e sett+s 
t c\ld b5efit f core quality measure    
sets & to in=m ! quality measures t are 
includ$ 9 core sets4 ,/akehold]s %all   
include-- 7,a7 comm]cial heal? plans2   
7,b7 ,m$ic>e & ,m$icaid manag$ c>e      
plans2  7,c7 physician & o!r provid]    
organizations2  7,d7 pati5t gr\ps2 &    
7,e7 quality improvem5t gr\ps4  7#c7    
,framework & goals ,n lat] ?an #a ye>   
aft] ! date ( enactm5t ( ?is ,act1 !    
,adm9i/rator = ! ,c5t]s = ,m$ic>e       
,m$icaid ,s]vices %all publi% a         
framework & goals = ! ,collaborative "u 
p>agraph 7#a74