MISSION ZERO Reauthorization and Funding
MISSION ZERO builds on the recommendations of the 2016 National Academies of Science, Engineering, and Medicine (NASEM) report titled, “A National Trauma Care System: Integrating Military and Civilian Trauma Systems to Achieve Zero Preventable Deaths After Injury,” to create a grant program to cover the administrative costs of embedding military trauma professionals in civilian trauma centers. These military-civilian trauma care partnerships allow military trauma care teams and providers to gain exposure to treating critically injured patients and increase readiness for when these units are deployed. Additionally, best practices from the battlefield are brought home to further advance trauma care and provide greater civilian access.
The MISSION ZERO Act was signed into law on June 24, 2019, as part of the Pandemic and All Hazards Preparedness and Advancing Innovation (PAHPAI) Act (Public Law No:116-22). However, PAHPA expired on September 30, 2023, and must be reauthorized. The ACS encourages Congress to reauthorize PAHPA, including MISSION ZERO, and fully fund the program at $11.5 million for fiscal year 2026.
Trauma Coalition Letter to Leadership on PAHPA Reauthorization (2/4/2025)
ACS Letter to Leadership on PAHPA Passage (11/14/2024)
Stop the Bleed
The American College of Surgeons Committee on Trauma (ACS COT) is leading the effort to save lives by teaching the civilian population to provide vital initial response to stop uncontrolled bleeding in emergency situations. This effort is being accomplished by the development of a comprehensive and sustainable bleeding control educational and informational program targeted to civilians that will inform, educate, and empower the more than 300 million citizens of the United States. The ACS is also supportive of legislation that will assist civilians to take life-saving action when the need arises.
Firearm Morbidity and Mortality Prevention Efforts
Firearm injury remains a high-profile topic in the national debate. The American College of Surgeons Committee on Trauma (ACS COT) has worked to advocate and promote a nonpartisan public health approach to firearm injury prevention. This includes implementing evidence-based violence prevention programs through ACS COT trauma centers and fostering a civil dialogue within professional organizations to create a consensus around reducing firearm injury and death.
Research Funding
Federally funded research from the perspective of public health has contributed to reductions in motor vehicle crashes, smoking, and Sudden Infant Death Syndrome. The ACS believes this same approach should be applied to firearm-related injuries and gun safety. The ACS has repeatedly supported funding for the Centers for Disease Control and Prevention (CDC) to conduct public health research into firearm morbidity and prevention, most recently for fiscal year 2025
In 2019, the CDC and the National Institutes of Health (NIH) each received $12.5 million to study firearm injury and prevention—the first time in more than 20 years funding was allocated specifically to firearm violence research. This legislative victory followed ACS grassroots efforts as well as testimony given by Ronald M. Stewart, MD, FACS, before the House Appropriations Subcommittee on Labor, Health and Human Services in March 2019.
The ACS will continue to advocate strongly for this research funding to be maintained.
Bipartisan Background Checks Act
In 2018, the ACS COT released a set of 13 recommendations from its Firearm Strategy Team (FAST) Workgroup. These proposals include strategies and tactics to reduce firearm injury, death, and disability in the United States. One of these recommendations includes support for a robust and accurate background check for all firearm purchases and transfers. The ACS supports legislative efforts to expand background checks for gun purchasers.
Cyclical Violence Efforts
Trauma centers stand on the front lines of the interpersonal violence epidemic. With injury recidivism rates as high as 55 percent, trauma surgeons and other advocates are exploring ways to close this revolving door to decrease violent injury, similar to the methods that have been used effectively to reduce the incidence of cardiovascular disease and cancer.
Hospital-based violence intervention programs (HVIPs) are multidisciplinary programs that identify patients at risk of repeat violent injury and link them with hospital- and community-based resources aimed to address underlying risk factors for violence, such as mental health and social determinants of health. Data indicate the HVIPs reduce violent injury recidivism, as well as hospital costs, but more research is needed to better target these efforts and help spread them to areas of need around the country. The ACS supports legislative efforts to develop and expand these successful programs.
