From the Washington Office

From the Washington Office: ACS Works to Establish Joint Trauma System in NDAA


I am frequently asked for examples of successes from the College’s advocacy efforts in DC. While many of our successes come in the form of legislation or regulation we are either able to significantly modify into more favorable form or to outright prevent from being enacted, this month’s topic provides an example of how our advocacy efforts are equally successful in obtaining specific provisions in legislation.

Over a year ago, staff of the Division of Advocacy and Health Policy were approached by members and staff of the Military Health System Strategic Partnership American College of Surgeons to assist them in their effort toward the establishment of both a Joint Trauma System (JTS) within the Defense Health Agency (to promote continuous improvement of trauma care provided to members of the Armed Forces) and a Joint Trauma Education and Training Directorate (JTETD) (to ensure military traumatologists maintain readiness with regard to critical surgical skills). I am pleased and proud to report that when the U.S. House of Representatives, on December 2, and the Senate, on December 8, passed the National Defense Authorization Act (NDAA), provisions for both the JTS and the JTETD, in nearly the precise wording as was proposed by ACS, were included in the legislation.

Dr. Patrick V. Bailey

Dr. Patrick V. Bailey

Our success in this effort was strongly supported by both Rep. Joe Heck, DO (R-Nev.), Chairman of the House Armed Services Subcommittee on Military Personnel, and Rep. Brad Wenstrup, DPM (R-Ohio). Rep. Heck, who is a Brigadier General in the Army Reserve, ensured that the language establishing the JTS within the U.S. Department of Defense and the JTETD were included in the House version of the NDAA. Rep. Wenstrup, who also serves in the Army Reserve, was key to securing language providing for review of the military trauma system under the JTS by a “non-government entity with subject matter experts.” This is an activity that the ACS Committee on Trauma Verification, Review, and Consultation Program conducts on a regular basis.

The Joint Trauma System will standardize trauma care in the military by establishing uniform standards for all military medical treatment facilities. The Joint Trauma Education and Training Directorate is charged with ensuring that trauma providers of the U.S. Armed Forces maintain a state of readiness. Under this provision, partnerships will be established with level one trauma centers in civilian academic medical centers and large metropolitan teaching hospitals where combat casualty care teams will embed to provide military surgeons with regular exposure to critically injured patients.

The Senate version of the NDAA did not contain language specifically outlining provisions for either the JTS or the JTETD. Because the House and Senate versions of the NDAA were different, a conference committee from both legislative bodies was appointed to settle the differences between the two versions of the legislation. Over the several months duration of the conference committee process, members of the ACS legislative affairs team met regularly with the offices of several key senators who serve on the Senate Armed Services Committee as well as with committee staff for both the Republican and Democrat members of the committee. During these meetings, we repeatedly “made the case” relative to the critically important nature of these provisions and were able to answer questions and address concerns relative to why ACS felt it was vitally important to include the House language in the final version of the bill. No doubt, these efforts were key in the decision of the Senate negotiators to recede their position and agree to the House language in the final version of the bill relative to these specific provisions.

Prior to the final House vote on the conference committee language of the NDAA, Rep. Wenstrup spoke on the House floor in support of the JTETD.

As I write, the legislation is awaiting signature by President Obama and it is expected he will do so in the coming days.

ACS’ successful efforts toward the establishment of the Joint Trauma System and the Joint Trauma Education and Training Directorate represent a significant achievement toward ensuring that our soldiers, sailors, airmen, Marines and guardsmen continue to receive the best of the best in trauma care while in the service of our nation.

Until next month ….

Dr. Bailey is a pediatric surgeon, and Medical Director, Advocacy, for the Division of Advocacy and Health Policy in the ACS offices in Washington, D.C.

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