Patient Safety Improvement Act of 2020

II 116TH CONGRESS 2D SESSION S. 3380 To improve patient safety by supporting State-based quality improvement efforts and through enhanced data collection and reporting, and for other purposes. IN THE SENATE OF THE UNITED STATES MARCH 3, 2020 Mr. WHITEHOUSE introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To improve patient safety by supporting State-based quality improvement efforts and through enhanced data collec- tion and reporting, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Patient Safety Im- 4 provement Act of 2020’’. 5 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 2 •S 3380 IS SEC. 2. SUPPORTING STATE AND LOCAL COLLABORATIVES 1 TO ADDRESS HEALTH CARE-ASSOCIATED IN- 2 FECTIONS. 3 Part B of title III of the Public Health Service Act 4 (42 U.S.C. 243 et seq.) is amended by adding at the end 5 the following: 6 ‘‘SEC. 320B. EFFORTS TO REDUCE HEALTH CARE-ASSOCI- 7 ATED INFECTIONS. 8 ‘‘(a) GRANT PROGRAM TO REDUCE HEALTH CARE- 9 ASSOCIATED INFECTIONS.— 10 ‘‘(1) IN GENERAL.—The Secretary shall award 11 competitive grants to eligible entities to support 12 State-based collaboratives in implementing evidence- 13 based, regional approaches to infection prevention, 14 control, and reporting. 15 ‘‘(2) PURPOSE.—Amount awarded under grants 16 under paragraph (1) may be used to support the fol- 17 lowing activities: 18 ‘‘(A) Inter-professional and inter-facility 19 learning activities. 20 ‘‘(B) Building statewide learning collabora- 21 tives. 22 ‘‘(C) Conducting a needs assessment to 23 identify gaps in health care-associated infection 24 prevention and reporting in a State or region. 25 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 3 •S 3380 IS ‘‘(D) Other activities determined appro- 1 priate by the Secretary. 2 ‘‘(3) ELIGIBILITY.—To be eligible to receive a 3 grant under this subsection, an entity shall be a 4 public or private nonprofit entity that submits to the 5 Secretary an application at such time, in such man- 6 ner, and containing such information as the Sec- 7 retary may require, including— 8 ‘‘(A) a description of the activities to be 9 carried out under the grant, including the par- 10 ticipants in any collaborative established to 11 carry out such activities; 12 ‘‘(B) a list of the specific goals of the enti- 13 ty for the regional or statewide reduction of 14 health care-associated infection rates; 15 ‘‘(C) an assurance that the entity will pub- 16 licly report performance on a set of quality and 17 outcomes measures in carrying out activities 18 under the grant to reduce health care-associ- 19 ated infections; and 20 ‘‘(D) any other information determined ap- 21 propriate by the Secretary. 22 ‘‘(4) PRIORITY.—In awarding grants under this 23 subsection, the Secretary shall prioritize applicants 24 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 4 •S 3380 IS that collaborate with multiple stakeholders across a 1 region or State. 2 ‘‘(5) AUTHORIZATION OF APPROPRIATIONS.— 3 There is authorized to be appropriated such sums as 4 may be necessary to carry out this subsection. 5 ‘‘(b) PREVENTION EPICENTER PROGRAM EXPANSION 6 GRANTS.— 7 ‘‘(1) IN GENERAL.—The Centers for Disease 8 Control and Prevention shall expand the Prevent 9 Epicenters Program to up to five additional sites. 10 New sites shall work with State or regional preven- 11 tion collaboratives to develop tools, strategies, and 12 evidence-based interventions to— 13 ‘‘(A) prevent or limit infection rates in 14 health care facilities across the continuum of 15 care and in community settings; 16 ‘‘(B) facilitate public health research on 17 the prevention and control of drug-resistant or- 18 ganisms and emerging microbial threats; and 19 ‘‘(C) assess the feasibility, cost effective- 20 ness, and appropriateness of surveillance and 21 prevention programs in different health care 22 settings. 23 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 5 •S 3380 IS ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 1 There is authorized to be appropriated such sums as 2 may be necessary to carry out this subsection.’’. 3 SEC. 3. IMPROVING COMMUNICATION DURING CARE TRAN- 4 SITIONS. 5 (a) IMPROVING PROVIDER COMMUNICATION RE- 6 GARDING PATIENT INFECTIONS IN MEDICARE AND MED- 7 ICAID.— 8 (1) IN GENERAL.—The Secretary of Health and 9 Human Services (referred to in this Act as the ‘‘Sec- 10 retary’’) shall award competitive grants to support 11 the development and evaluation of programs aimed 12 at improving inter-facility communication about 13 health care-associated infections, multidrug-resistant 14 organisms, emerging microbial threats, and anti- 15 microbial use during transitions of care. 16 (2) ELIGIBILITY.—To be eligible for a grant 17 under paragraph (1) an applicant for such grant 18 shall be composed of two or more health care pro- 19 viders or facilities that regularly transfer or refer 20 patients to each other. 21 (3) REPORT TO CONGRESS.—Not later than 1 22 year after the end of the grant period under this 23 subsection, the Secretary shall submit a report to 24 Congress on lessons learned by grant awardees, in- 25 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 6 •S 3380 IS cluding best practices and recommendations for 1 guidelines, policies, or payment reforms to improve 2 inter-facility communication during care transitions. 3 (4) AUTHORIZATION OF APPROPRIATIONS.— 4 There is authorized to be appropriated such sums as 5 may be necessary to carry out this subsection. 6 (b) GUIDANCE ON INTER-FACILITY COMMUNICA- 7 TION.— 8 (1) IN GENERAL.—Not later than 1 year after 9 the date of enactment of this Act, the Administrator 10 of the Centers for Medicare & Medicaid Services, in 11 collaboration with the Director of the Agency for 12 Healthcare Research and Quality, shall convene a 13 working group to develop guidance for standardized 14 communication between health care facilities upon 15 the discharge and transfer of individuals who were 16 diagnosed and treated for health care-associated in- 17 fections. 18 (2) TOPICS.—The working group convened 19 under paragraph (1) shall identify— 20 (A) types of information related to health 21 care-associated infections that should be com- 22 municated when an individual is discharged and 23 transferred from one health care facility to an- 24 other, including— 25 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 7 •S 3380 IS (i) the type of infection or colonization 1 acquired by an individual, including wheth- 2 er or not such infection or colonization is 3 caused by a multidrug-resistant organism; 4 and 5 (ii) the type of antimicrobial drugs, if 6 any, that the individual received for the in- 7 fection from the discharging or transfer- 8 ring provider and the stop date for those 9 drugs; 10 (B) methods for transmitting information; 11 (C) timeframes for transmitting informa- 12 tion; and 13 (D) any other information determined ap- 14 propriate. 15 (3) WORKING GROUP PARTICIPANTS.—The 16 working group under paragraph (1) shall be com- 17 posed of representatives from— 18 (A) patient groups; 19 (B) hospitals; 20 (C) long-term care facilities; 21 (D) accreditation agencies; 22 (E) State and local health departments; 23 and 24 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 8 •S 3380 IS (F) other stakeholders as determined ap- 1 propriate by the Secretary. 2 (4) GUIDANCE.—Not later than 1 year after 3 the working group has been convened under para- 4 graph (1), the Administrator of the Centers for 5 Medicare & Medicaid Services shall issue guidance 6 on standardized content and structure for transmit- 7 ting information regarding individuals who were di- 8 agnosed and treated for health care-associated infec- 9 tions. 10 SEC. 4. IMPROVING DATA ACCURACY AND SURVEILLANCE. 11 Subpart II of part D of title IX of the Public Health 12 Service Act (42 U.S.C. 299b–33 et seq.) is amended by 13 adding at the end the following: 14 ‘‘SEC. 938. HEALTH CARE-ASSOCIATED INFECTIONS AND 15 ANTIMICROBIAL USE. 16 ‘‘(a) IDENTIFYING BEST PRACTICES.—The Centers 17 for Disease Control and Prevention, in collaboration with 18 the Agency for Healthcare Research and Quality and the 19 Centers for Medicare & Medicaid Services, shall convene 20 stakeholders to identify best practices for the collection 21 and electronic reporting of data on health care-associated 22 infections to the National Healthcare Safety Network by 23 a subsection (d) hospital (as defined in section 24 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 9 •S 3380 IS 1886(d)(1)(B) of the Social Security Act (42 U.S.C. 1 1395ww(d)(1)(B))). 2 ‘‘(b) DATA COLLECTION PILOT PROGRAM.— 3 ‘‘(1) IN GENERAL.—The Director of the Agency 4 for Healthcare Research and Quality, in consultation 5 with the Director of the Centers for Disease Control 6 and Prevention, shall establish and implement a 7 pilot program to identify best practices and innova- 8 tive approaches for the collection and electronic re- 9 porting of data on the incidence of health care-asso- 10 ciated infections by long-term care facilities, ambula- 11 tory surgical centers, and dialysis facilities. Such 12 pilot program should incorporate applicable data val- 13 idation methodologies and other recommendations 14 described in the framework developed under sub- 15 section (c). 16 ‘‘(2) REPORT.—Not later than 6 months after 17 the completion of the pilot program under paragraph 18 (1), the Director shall submit to the Secretary and 19 the appropriate committees of Congress a report on 20 the best practices identified through the pilot pro- 21 gram, including the lessons learned and challenges 22 encountered with respect to data collection and elec- 23 tronic reporting in long-term care settings, ambula- 24 tory surgical centers, and dialysis facilities as well as 25 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 10 •S 3380 IS any recommended health care-associated infections 1 surveillance methods for those settings. 2 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 3 There is authorized to be appropriated such sums as 4 may be necessary to carry out this subsection. 5 ‘‘(c) DATA VALIDATION METHODOLOGY.—The Cen- 6 ters for Disease Control and Prevention shall work with 7 State and local health departments to develop a standard 8 methodology for validating data reported by long-term 9 care facilities to the National Healthcare Safety Network. 10 ‘‘(d) STUDY AND REPORT.— 11 ‘‘(1) IN GENERAL.—The Comptroller General of 12 the United States shall conduct a study to evaluate 13 the adequacy of State health departments’ and other 14 State oversight agencies’ methods for external vali- 15 dation of data reported to the National Healthcare 16 Safety Network by health care facilities. 17 ‘‘(2) CONTENTS.—In conducting the study 18 under paragraph (1), the Comptroller General 19 shall— 20 ‘‘(A) assess the types and frequency of ex- 21 ternal validation strategies conducted by State 22 departments of health; 23 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 11 •S 3380 IS ‘‘(B) identify barriers to adherence with 1 the Centers for Disease Control and Preven- 2 tion’s external validation guidance; and 3 ‘‘(C) recommend strategies to improve the 4 consistency and reliability of data that is re- 5 ported to the National Healthcare Safety Net- 6 work. 7 ‘‘(3) REPORT.—Not later than 18 months after 8 the date of enactment of this section, the Comp- 9 troller General shall submit to Congress a report 10 containing the results of the study conducted under 11 paragraph (1), together with recommendations, if 12 any, for such legislation and administration action 13 as the Comptroller General determines appro- 14 priate.’’. 15 SEC. 5. STRENGTHENING ANTIMICROBIAL STEWARDSHIP. 16 (a) IN GENERAL.—Section 320B of the Public 17 Health Service Act, as added by section 2, is amended by 18 adding at the end the following: 19 ‘‘(c) GRANT PROGRAM FOR STATE ANTIMICROBIAL 20 STEWARDSHIP ACTION PLANS.— 21 ‘‘(1) IN GENERAL.—The Secretary, acting 22 through the Director of the Centers for Disease 23 Control and Prevention, shall award grants to States 24 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBBXCHB2PROD with BILLS 12 •S 3380 IS for the development and implementation of State 1 antimicrobial stewardship action plans. 2 ‘‘(2) ELIGIBILITY.—To be eligible to receive a 3 grant under this subsection, a State shall submit to 4 the Secretary an application at such time, in such 5 manner, and containing such information as the Sec- 6 retary may require, including— 7 ‘‘(A) an assurance that development of the 8 plan under the grant will be led by an infectious 9 disease-trained physician with experience in 10 antimicrobial stewardship or a pharmacist with 11 expertise in infectious disease and antimicrobial 12 stewardship; and 13 ‘‘(B) an assurance that the plan will focus 14 on collaboration across health care settings and 15 include a summary of resource gaps and chal- 16 lenges. 17 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 18 There is authorized to be appropriated such sums as 19 may be necessary to carry out this subsection.’’. 20 (b) ADVANCING HOSPITAL REPORTING ON ANTI- 21 BIOTIC USE AND ANTIMICROBIAL RESISTANCE.—Not 22 later than 1 year after the date of enactment of this Act, 23 the Administrator of the Centers for Medicare & Medicaid 24 Services shall issue a notice of proposed rulemaking that 25 VerDate Sep 11 2014 01:22 Mar 07, 2020 Jkt 099200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\S3380.IS S3380 SSpencer on DSKBB [Text truncated for display. 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