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Strengthening Our National Trauma System 

On Tuesday, July 12, 2016 witnesses testified before the House Energy and Commerce Subcommittee on Health on H.R. 4365, Protecting Patient Access to Emergency Medications Act of 2016 and a proposed bill to facilitate the assignment of military trauma teams to civilian trauma centers to ensure military trauma readiness. The hearing commenced with opening statements from various members including Representative Hudson (R-NC) and Representative Butterfield (D-NC). Hudson and Butterfield launched the Pediatric Trauma Caucus in May. Attendees also heard statements from Representative Burgess (R-TX) and Representative Green (D-TX). The two recently published the op-ed regarding the importance of strengthening access to trauma care drafted by the TCAA advocacy team. 









Jorie Klein, BSN, RN on  behalf of TCAA before the   Subcommittee on Health 







Jorie Klein, Director, Trauma Program, Rees-Jones Trauma Center at Parkland led with testimony on behalf of TCAA followed by testimony from others members of the NASEM Committee on Military Trauma Care's Health System including Dr. David Marcozzi MD and Dr. C. William Schwab MD, FACS. In addition, the Subcommittee heard testimony from Dr. Craig Manifold DO, FACEP, Committee Chair, American College of Emergency Physicians and Dr. Brent Myers MD, MPH, FACE, President-Elect, National Association of EMS Physicians.

Click here for video from the hearing and other supporting documents. 







L-R Marcozzi, Schwab, Manifold and Myers before the Subcommittee on Health 







In Praise of Trauma Care 

In the wake of the tragedy in Orlando, FL, Representative Burgess (R-TX) and Representative Green (D-TX), of the House Energy and Commerce Subcommittee on Health, published the op-ed regarding the importance of strengthening access to trauma care and legislation passed in the House and pending action in the Senate ensuring all Americans have access to trauma care. The op-ed is a direct result of TCAA’s advocacy efforts.


Click here for the full text.


Helping Hospitals Improve Patient Care Act (HIP-C) passed by House Ways and Means

The House Ways and Means Committee voted to pass H.R. 5273, the Helping Hospitals Improve Patient Care Act.  Sponsors of the legislation aim to promote greater access to care, to increase choices and to improve the quality of health care. The Secretary may consider removal as a readmission of an admission that is classified within one or more of the following; transplants, end stage, renal disease, burns, trauma, psychosis or substance abuse. Passage of this legislation would benefit TCAA members as our advocacy resulted in trauma being included in the readmission study. The House voted to pass the bill and it was introduced in the Senate and referred to the Committee on Finance on June 8th. Click below for the legislative text. 




TCAA Supports House Bill on Standing Orders

The Controlled Substances Act prohibits emergency medical personnel from delivering or administering controlled substances through standing orders.  Congressman Richard Hudson of North Carolina introduced H.R. 4365, the Protecting Patient Access to Emergency Medications Act of 2016 on behalf of the National Association of EMS Physicians (NAEMSP) to amend the Controlled Substances Act.  The bill, which currently has 77 cosponsors, was introduced in an effort to protect standing orders which provide pre-set protocols established by Medical Directors with regard to the administration and delivery of controlled substances in the practice of EMS medicine.  Standing orders are necessary to ensure medications are available to EMS personnel and administered in a timely manner to patients who are sick or seriously injured.   TCAA supports NAEMSP in their efforts to safeguard standing orders and EMS access to medications to be administered in emergency situations. On May 16, 2016, Senator Bill Cassidy of Louisiana introduced the companion bill, S.2932.  The bill was referred to the Senate Health, Education, Labor and Pension Committee with minor modifications which will not affect the impact of the bill.  Click below for the legislative text. 






TCAA has been working on developing an innovative concept around modernizing trauma center

reimbursement. Under the conceptual framework, reimbursement for trauma services provided by trauma centers for hospital services would be replaced with an episode based payment model, in which reimbursement to the trauma center would promote the delivery of high quality and value based care to all trauma patients through quality measures specifically designed for the unique and unpredictable nature of trauma care.

  • Click here for TCAA's conceptual paper on development of longer term reimbursement methodology for trauma centers

CMS released the Calendar Year (CY) 2014 Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule. The substantial changes

discussed in the proposed rule would affect outpatient services furnished by hospital outpatient

departments (HOPDs) and ASCs. TCAA has serious concerns with the agency's proposal to collapse five levels of outpatient visit codes, replacing them with a single health care common procedure coding system (HCPCS) code for each unique type of outpatient hospital visit, including clinic and emergency

department visits.

  • Click here for TCAA's comment letter on the consolidation of ED codes

Trauma Program Funding


TCAA requested that Congress include $28 million of implementation funding in the FY 2015 Labor, Health and Human Services, and Education (LHHS) Appropriations Act for the trauma and emergency medical services programs and activities that are authorized under Sections 1201-4, 1211-32, 1241-46 and 1281-2 of the Public Health Service Act (PHSA). While many Members of Congress submitted our request to their colleagues on the appropriations committee, it was unfortunately not included in the Senate FY 2015 Senate LHHS Appropriations Act.


On Tuesday, June 7th, Senator Mark Kirk of Illinois was successful in having language related to Trauma Service Availability and Systems Development included in the Senate Labor, Health and Human Services, Education, and Related Agencies final report on FY2017 Appropriations. Although the Subcommittee eliminated trauma program funding from the bill, they encourage continued support of trauma sustainability and availability.  See report language below.

  • Trauma Service Availability and Systems Development.—The Committee continues to support efforts to improve trauma center sustainability and service availability in rural, exurban, suburban, and urban locations. The Committee encourages ASPR to develop a proposal for how trauma center improvements could be made in these areas to address problems with trauma care resiliency and reach to unserved populations. In doing so, ASPR should incorporate its analysis of the ability of existing trauma care infrastructure to respond to mass casualty events in a variety of geographic locations previously requested by the Committee.

Click her for the full text of the report

It is unclear when the House will move their Labor-HHS appropriations bill. As these budgetary debates go on, TCAA is focused on solutions to ensure the future reliability and accessibility of trauma care for all Americans. TCAA pressed upon appropriators the need to provide funding for our trauma grant programs as part of any appropriations bill considered during the lame duck session.  

  • Click here for explanation of the Trauma Programs in the Public Health Service Act
  • Funding and Reauthorization of Regionalized Emergency Care Programs letter to Appropriators (Click here for House / Click here for Senate)

Gun Violence

TCAA supports ensuring access to life-saving trauma care for all victims of traumatic injury, including as part of mass casualty events. Click here to see TCAA's position statement on gun violence.

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