II 

117TH CONGRESS 

2D SESSION S. 3566 

To amend the Public Health Service Act with respect to trauma care. 

IN THE SENATE OF THE UNITED STATES 

FEBRUARY 2, 2022 

Mr. REED (for himself and Mr. MORAN) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To amend the Public Health Service Act with respect to 

trauma care. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Improving Trauma 

5 Systems and Emergency Care Act’’. 

6 SEC. 2. TRAUMA CARE REAUTHORIZATION. 

7 (a) IN GENERAL.—Section 1201 of the Public Health 

8 Service Act (42 U.S.C. 300d) is amended— 

9 (1) in subsection (a)— 

10 (A) in paragraph (3)— 


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1 (i) by inserting ‘‘analyze,’’ after ‘‘com2 pile,’’; and 

3 (ii) by inserting ‘‘and medically under4 served areas’’ before the semicolon; 

5 (B) in paragraph (4), by adding ‘‘and’’ 

6 after the semicolon; 

7 (C) by striking paragraph (5); and 

8 (D) by redesignating paragraph (6) as 

9 paragraph (5); 

10 (2) by redesignating subsection (b) as sub11 section (c); and 

12 (3) by inserting after subsection (a) the fol13 lowing: 

14 ‘‘(b) TRAUMA CARE READINESS AND COORDINA15 TION.—The Secretary, acting through the Assistant Sec16 retary for Preparedness and Response, shall support the 

17 efforts of States and consortia of States to coordinate and 

18 improve emergency medical services and trauma care dur19 ing a public health emergency declared by the Secretary 

20 pursuant to section 319 or a major disaster or emergency 

21 declared by the President under section 401 or 501, re22 spectively, of the Robert T. Stafford Disaster Relief and 

23 Emergency Assistance Act. Such support may include— 

24 ‘‘(1) developing, issuing, and updating guid25 ance, as appropriate, to support the coordinated 


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1 medical triage and evacuation to appropriate medical 

2 institutions based on patient medical need, taking 

3 into account regionalized systems of care; 

4 ‘‘(2) disseminating, as appropriate, information 

5 on evidence-based or evidence-informed trauma care 

6 practices, taking into consideration emergency med7 ical services and trauma care systems, including 

8 such practices identified through activities conducted 

9 under subsection (a) and which may include the 

10 identification and dissemination of performance 

11 metrics, as applicable and appropriate; and 

12 ‘‘(3) other activities, as appropriate, to optimize 

13 a coordinated and flexible approach to the emer14 gency response and medical surge capacity of hos15 pitals, other health care facilities, critical care, and 

16 emergency medical systems.’’. 

17 (b) GRANTS TO IMPROVE TRAUMA CARE IN RURAL

18 AREAS.—Section 1202 of the Public Health Service Act 

19 (42 U.S.C. 300d–3) is amended— 

20 (1) by amending the section heading to read as 

21 follows: ‘‘GRANTS TO IMPROVE TRAUMA CARE

22 IN RURAL AREAS’’; 

23 (2) by amending subsections (a) and (b) to read 

24 as follows: 


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1 ‘‘(a) IN GENERAL.—The Secretary shall award 

2 grants to eligible entities for the purpose of carrying out 

3 research and demonstration projects to support the im4 provement of emergency medical services and trauma care 

5 in rural areas through the development of innovative uses 

6 of technology, training and education, transportation of 

7 seriously injured patients for the purposes of receiving 

8 such emergency medical services, access to prehospital 

9 care, evaluation of protocols for the purposes of improve10 ment of outcomes and dissemination of any related best 

11 practices, activities to facilitate clinical research, as appli12 cable and appropriate, and increasing communication and 

13 coordination with applicable State or Tribal trauma sys14 tems. 

15 ‘‘(b) ELIGIBLE ENTITIES.— 

16 ‘‘(1) IN GENERAL.—To be eligible to receive a 

17 grant under this section, an entity shall be a public 

18 or private entity that provides trauma care in a 

19 rural area. 

20 ‘‘(2) PRIORITY.—In awarding grants under this 

21 section, the Secretary shall give priority to eligible 

22 entities that will provide services under the grant in 

23 any rural area identified by a State under section 

24 1214(d)(1).’’; and 

25 (3) by adding at the end the following: 


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1 ‘‘(d) REPORTS.—An entity that receives a grant 

2 under this section shall submit to the Secretary such re3 ports as the Secretary may require to inform administra4 tion of the program under this section.’’. 

5 (c) PILOT GRANTS FOR TRAUMA CENTERS.—Section 

6 1204 of the Public Health Service Act (42 U.S.C. 300d– 

7 6) is amended— 

8 (1) by amending the section heading to read as 

9 follows: ‘‘PILOT GRANTS FOR TRAUMA CEN10 TERS’’; 

11 (2) in subsection (a)— 

12 (A) by striking ‘‘not fewer than 4’’ and in13 serting ‘‘10’’; 

14 (B) by striking ‘‘that design, implement, 

15 and evaluate’’ and inserting ‘‘to design, imple16 ment, and evaluate new or existing’’; 

17 (C) by striking ‘‘emergency care’’ and in18 serting ‘‘emergency medical’’; and 

19 (D) by inserting ‘‘, and improve access to 

20 trauma care within such systems’’ before the 

21 period; 

22 (3) in subsection (b)(1), by striking subpara23 graphs (A) and (B) and inserting the following: 

24 ‘‘(A) a State or consortia of States; 


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1 ‘‘(B) an Indian Tribe or Tribal organiza2 tion (as defined in section 4 of the Indian Self3 Determination and Education Assistance Act); 

4 ‘‘(C) a consortium of level I, II, or III 

5 trauma centers designated by applicable State 

6 or local agencies within an applicable State or 

7 region, and, as applicable, other emergency 

8 services providers; or 

9 ‘‘(D) a consortium or partnership of non10 profit Indian Health Service, Indian Tribal, and 

11 urban Indian trauma centers.’’; 

12 (4) in subsection (c)— 

13 (A) in the matter preceding paragraph 

14 (1)— 

15 (i) by striking ‘‘that proposes a pilot 

16 project’’; and 

17 (ii) by striking ‘‘an emergency medical 

18 and trauma system that—’’ and inserting 

19 ‘‘a new or existing emergency medical and 

20 trauma system. Such eligible entity shall 

21 use amounts awarded under this sub22 section to carry out 2 or more of the fol23 lowing activities:’’; 

24 (B) in paragraph (1)— 


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1 (i) by striking ‘‘coordinates’’ and in2 serting ‘‘Strengthening coordination and 

3 communication’’; and 

4 (ii) by striking ‘‘an approach to emer5 gency medical and trauma system access 

6 throughout the region, including 9–1–1 

7 Public Safety Answering Points and emer8 gency medical dispatch;’’ and inserting 

9 ‘‘approaches to improve situational aware10 ness and emergency medical and trauma 

11 system access, including distribution of pa12 tients during a mass casualty incident, 

13 throughout the region.’’; 

14 (C) in paragraph (2)— 

15 (i) by striking ‘‘includes’’ and insert16 ing ‘‘Providing’’; 

17 (ii) by inserting ‘‘support patient 

18 movement to’’ after ‘‘region to’’; and 

19 (iii) by striking the semicolon and in20 serting a period; 

21 (D) in paragraph (3)— 

22 (i) by striking ‘‘allows for’’ and insert23 ing ‘‘Improving’’; and 

24 (ii) by striking ‘‘; and’’ and inserting 

25 a period; 


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1 (E) in paragraph (4), by striking ‘‘includes 

2 a consistent’’ and inserting ‘‘Supporting a con3 sistent’’; and 

4 (F) by adding at the end the following: 

5 ‘‘(5) Establishing, implementing, and dissemi6 nating, or utilizing existing, as applicable, evidence7 based or evidence-informed practices across facilities 

8 within such emergency medical and trauma system 

9 to improve health outcomes, including such practices 

10 related to management of injuries, and the ability of 

11 such facilities to surge. 

12 ‘‘(6) Conducting activities to facilitate clinical 

13 research, as applicable and appropriate.’’; 

14 (5) in subsection (d)(2)— 

15 (A) in subparagraph (A)— 

16 (i) in the matter preceding clause (i), 

17 by striking ‘‘the proposed’’ and inserting 

18 ‘‘the applicable emergency medical and 

19 trauma system’’; 

20 (ii) in clause (i), by inserting ‘‘or 

21 Tribal entity’’ after ‘‘equivalent State of22 fice’’; and 

23 (iii) in clause (vi), by striking ‘‘; and’’ 

24 and inserting a semicolon; 


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1 (B) by redesignating subparagraph (B) as 

2 subparagraph (C); and 

3 (C) by inserting after subparagraph (A) 

4 the following: 

5 ‘‘(B) for eligible entities described in sub6 paragraph (C) or (D) of subsection (b)(1), a de7 scription of, and evidence of, coordination with 

8 the applicable State Office of Emergency Med9 ical Services (or equivalent State Office) or ap10 plicable such office for a Tribe or Tribal organi11 zation; and’’; 

12 (6) in subsection (e)— 

13 (A) in paragraph (1), by striking ‘‘$1 for 

14 each $3’’ and inserting ‘‘$1 for each $5’’; and 

15 (B) by adding at the end the following: 

16 ‘‘(3) WAIVER.—The Secretary may waive all or 

17 part of the matching requirement described in para18 graph (1) for any fiscal year for a State, consortia 

19 of States, Indian Tribe or Tribal organization, or 

20 trauma center, if the Secretary determines that ap21 plying such matching requirement would result in 

22 serious hardship or an inability to carry out the pur23 poses of the pilot program.’’; 


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1 (7) in subsection (f), by striking ‘‘population in 

2 a medically underserved area’’ and inserting ‘‘medi3 cally underserved population’’; 

4 (8) in subsection (g)— 

5 (A) in the matter preceding paragraph (1), 

6 by striking ‘‘described in’’; 

7 (B) in paragraph (2), by striking ‘‘the sys8 tem characteristics that contribute to’’ and in9 serting ‘‘opportunities for improvement, includ10 ing recommendations for how to improve’’; 

11 (C) by striking paragraph (4); 

12 (D) by redesignating paragraphs (5) and 

13 (6) as paragraphs (4) and (5), respectively; 

14 (E) in paragraph (4), as so redesignated, 

15 by striking ‘‘; and’’ and inserting a semicolon; 

16 (F) in paragraph (5), as so redesignated, 

17 by striking the period and inserting ‘‘; and’’; 

18 and 

19 (G) by adding at the end the following: 

20 ‘‘(6) any evidence-based or evidence-informed 

21 strategies developed or utilized pursuant to sub22 section (c)(5).’’; and 

23 (9) by amending subsection (h) to read as fol24 lows: 


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1 ‘‘(h) DISSEMINATION OF FINDINGS.—Not later than 

2 1 year after the completion of the final project under sub3 section (a), the Secretary shall submit to the Committee 

4 on Health, Education, Labor, and Pensions of the Senate 

5 and the Committee on Energy and Commerce of the 

6 House of Representatives a report describing the informa7 tion contained in each report submitted pursuant to sub8 section (g) and any additional actions planned by the Sec9 retary related to regionalized emergency care and trauma 

10 systems.’’. 

11 (d) PROGRAM FUNDING.—Section 1232(a) of the 

12 Public Health Service Act (42 U.S.C. 300d–32(a)) is 

13 amended by striking ‘‘2010 through 2014’’ and inserting 

14 ‘‘2023 through 2027’’. 

Æ 


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