I 

108TH CONGRESS 

2D SESSION H. R. 3999

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

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 18, 2004

Mr. GREENWOOD (for himself, Mr. GREEN of Texas, Mr. BILIRAKIS, and Mr. 

BROWN of Ohio) introduced the following bill; which was referred to the 

Committee on Energy and Commerce 

A BILL

To amend the Public Health Service Act with respect to 

trauma care, and for other purposes.

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 ‘‘Trauma Research and 

5 Access to Urgent Medical Attention Act of 2004’’ or the 

6 ‘‘TRAUMA Act of 2004’’. 

7 SEC. 2. AMENDMENT TO TITLE XII OF PUBLIC HEALTH 

8 SERVICE ACT. 

9 Title XII of the Public Health Service Act (42 U.S.C. 

10 300d et seq.) is amended—
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1 (1) by striking part D; and 

2 (2) by amending parts A, B, and C to read as 

3 follows: 

4 ‘‘PART A—GENERAL AUTHORITY 

5 ‘‘SEC. 1201. GENERAL AUTHORITY AND DUTIES OF THE SEC6 RETARY. 

7 ‘‘(a) IN GENERAL.—The Secretary may, with respect 

8 to trauma care—

9 ‘‘(1) conduct and support research, training, 

10 evaluations, and demonstration projects; 

11 ‘‘(2) foster the development of appropriate, 

12 modern systems of trauma care through the sharing 

13 of information among agencies and individuals in14 volved in the study and provision of such care; 

15 ‘‘(3) provide to State and local agencies tech16 nical assistance, including the development of a 

17 model plan for the designation of trauma centers 

18 and for triage, transfer, and transportation policies; 

19 and 

20 ‘‘(4) sponsor workshops and conferences. 

21 ‘‘(b) CONSULTATION.—In carrying out this section, 

22 the Secretary shall consult with appropriate State and 

23 professional organizations. 
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1 ‘‘SEC. 1202. DATA COLLECTION. 

2 ‘‘(a) IN GENERAL.—The Director of the Centers for 

3 Disease Control and Prevention, directly or through 

4 grants or contracts, may establish and provide for the op5 eration of information systems and provide for the collec6 tion, coordination, and exchange of information related to 

7 trauma system development or operation. 

8 ‘‘(b) CONSULTATION.—In carrying out this section, 

9 the Director of the Centers for Disease Control and Pre10 vention shall consult with the Administrator of the Health 

11 Resources and Services Administration and such other 

12 persons outside of the Centers as the Director deems ap13 propriate. 

14 ‘‘SEC. 1203. GRANTS TO STATES TO IMPROVE TRAUMA CARE 

15 SYSTEMS. 

16 ‘‘(a) IN GENERAL.—The Secretary, acting through 

17 the Administrator of the Health Resources and Services 

18 Administration, shall make a grant, in the amount re19 ferred to in section 1208(c), to each State that submits 

20 an application and agrees to comply with the requirements 

21 of this section, for the purpose of improving access to and 

22 enhancing the development of trauma care systems. 

23 ‘‘(b) REQUIREMENTS.—The Secretary may make a 

24 grant to a State under this section only if the State has 

25 developed a plan that—
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1 ‘‘(1) specifies a public or private entity that will 

2 designate trauma care regions and trauma centers in 

3 the State; 

4 ‘‘(2) contains, for the designation of level I, 

5 level II, and level III trauma centers, standards and 

6 requirements developed by—

7 ‘‘(A) taking into account standards devel8 oped by professional organizations and any 

9 guidelines or model plans developed by the Sec10 retary with the goal of ensuring the greatest 

11 possible access to trauma care and providing 

12 the highest quality of trauma care; 

13 ‘‘(B) consulting with medical, surgical, and 

14 nursing speciality groups, hospital associations, 

15 emergency medical services State and local di16 rectors, concerned advocates, and other inter17 ested parties; and 

18 ‘‘(C) conducting public hearings on the 

19 proposed standards after providing adequate 

20 notice to the public concerning such hearings; 

21 ‘‘(3) contains standards and requirements for 

22 the implementation of regional trauma care systems, 

23 including standards and guidelines (consistent with 

24 the provisions of section 1867 of the Social Security 

25 Act) for medically directed triage and transportation 
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1 of trauma patients (including patients injured in 

2 rural areas) prior to care in designated trauma cen3 ters; 

4 ‘‘(4) contains standards and requirements for 

5 medically directed triage and transport of severely 

6 injured children to designated trauma centers with 

7 specified capabilities and expertise in the care of the 

8 pediatric trauma patient; 

9 ‘‘(5) utilizes a program with procedures for the 

10 evaluation of designated trauma centers (including 

11 trauma centers described in paragraph (4)) and 

12 trauma care systems; 

13 ‘‘(6) provides for the establishment and collec14 tion of data from each designated trauma center in 

15 the State of a central data reporting and analysis 

16 system (to be transmitted to the Secretary in ac17 cordance with section 1202)—

18 ‘‘(A) to identify the number of severely in19 jured trauma patients and the number of 

20 deaths from trauma within trauma care sys21 tems in the State; 

22 ‘‘(B) to identify the cause of the injury 

23 and any factors contributing to the injury; 

24 ‘‘(C) to identify the nature and severity of 

25 the injury; 
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1 ‘‘(D) to monitor trauma patient care (in2 cluding prehospital care) in each designated 

3 trauma center within regional trauma care sys4 tems in the State (including relevant emer5 gency-department discharges and rehabilitation 

6 information) for the purpose of evaluating the 

7 diagnosis, treatment, and treatment outcome of 

8 such trauma patients; 

9 ‘‘(E) to identify the total amount of un10 compensated trauma care expenditures for each 

11 fiscal year by each designated trauma center in 

12 the State; and 

13 ‘‘(F) to identify patients transferred within 

14 a regional trauma system, including reasons for 

15 such transfer and the outcomes of such pa16 tients; 

17 ‘‘(7) provides for the use of procedures by para18 medics and emergency medical technicians to assess 

19 the severity of the injuries incurred by trauma pa20 tients; 

21 ‘‘(8) provides for appropriate transportation 

22 and transfer policies to ensure the delivery of pa23 tients to designated trauma centers and other facili24 ties within and outside of the jurisdiction of such 

25 system, including policies to ensure that only indi-
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1 viduals appropriately identified as trauma patients 

2 are transferred to designated trauma centers, and to 

3 provide periodic reviews of the transfers and the au4 diting of such transfers that are determined to be 

5 appropriate; 

6 ‘‘(9) conducts public education activities con7 cerning injury prevention and obtaining access to 

8 trauma care; 

9 ‘‘(10) with respect to the requirements estab10 lished in this subsection, provides for coordination 

11 and cooperation between the State and any other 

12 State with which the State shares any standard met13 ropolitan statistical area; and 

14 ‘‘(11) coordinates planning for trauma systems 

15 with State disaster emergency planning and bioter16 rorism hospital preparedness planning. 

17 ‘‘(c) TRAUMA PLAN.—

18 ‘‘(1) IN GENERAL.—For each fiscal year, the 

19 Secretary may not make payments to a State under 

20 this section unless, subject to paragraph (2), the 

21 State submits to the Secretary the trauma care com22 ponent of the State plan for the provision of emer23 gency medical services, including any changes to the 

24 trauma care component and any plans to address 

25 deficiencies in the trauma care component. 
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1 ‘‘(2) INTERIM PLAN OR DESCRIPTION OF EF2 FORTS.—For each fiscal year, if a State has not 

3 completed the trauma care component of the State 

4 plan described in paragraph (1), the State may pro5 vide, in lieu of such completed component, an in6 terim component or a description of efforts made to7 ward the completion of the component. 

8 ‘‘(3) INFORMATION RECEIVED BY STATE RE9 PORTING AND ANALYSIS SYSTEM.—The Secretary 

10 may not make payments to a State under this sec11 tion unless the State agrees that the State will, not 

12 less than once each year, provide to the Secretary 

13 the information received by the State pursuant to 

14 subsection (b)(6). 

15 ‘‘(4) AVAILABILITY OF EMERGENCY MEDICAL

16 SERVICES IN RURAL AREAS.—The Secretary may not 

17 make payments to a State under this section un18 less—

19 ‘‘(A) the State identifies any rural area in 

20 the State for which—

21 ‘‘(i) there is no system of access to 

22 emergency medical services through the 

23 telephone number 911; 

24 ‘‘(ii) there is no basic life-support sys25 tem; or 
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1 ‘‘(iii) there is no advanced life-support 

2 system; and 

3 ‘‘(B) the State submits to the Secretary a 

4 list of rural areas identified pursuant to sub5 paragraph (A) or, if there are no such areas, a 

6 statement that there are no such areas. 

7 ‘‘(d) REQUIREMENT OF MATCHING FUNDS.—

8 ‘‘(1) NON-FEDERAL CONTRIBUTIONS.—

9 ‘‘(A) IN GENERAL.—The Secretary may 

10 not make a grant to a State under this section 

11 unless the State agrees, with respect to the 

12 costs of carrying out the grant, to make avail13 able non-Federal contributions (in cash or in 

14 kind under paragraph (2)(A)) toward such 

15 costs in an amount equal to—

16 ‘‘(i) for the first and second fiscal 

17 year of payments under this section to the 

18 State after the date of the enactment of 

19 the Trauma Research and Access to Ur20 gent Medical Attention Act of 2004, not 

21 less than $1 for each $1 of Federal funds 

22 provided in such payments for such fiscal 

23 year; and 

24 ‘‘(ii) for any subsequent fiscal year of 

25 such payments to the State, not less than 
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1 $2 for each $1 of Federal funds provided 

2 in such payments for such fiscal year. 

3 ‘‘(2) DETERMINATION OF AMOUNT OF NON4 FEDERAL CONTRIBUTION.—With respect to compli5 ance with paragraph (1)—

6 ‘‘(A) a State may make the non-Federal 

7 contributions in cash or in kind, fairly evalu8 ated, including plant, equipment, or staff serv9 ices; and 

10 ‘‘(B) the Secretary may not, in making a 

11 determination of the amount of non-Federal 

12 contributions, include amounts provided by the 

13 Federal Government or services assisted or sub14 sidized to any significant extent by the Federal 

15 Government. 

16 ‘‘(e) RESTRICTIONS.—

17 ‘‘(1) IN GENERAL.—The Secretary may not 

18 make payments to a State under this section unless 

19 the State agrees that the payments will not be ex20 pended—

21 ‘‘(A) to make cash payments to intended 

22 recipients of services provided pursuant to this 

23 section; 
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1 ‘‘(B) to purchase or improve real property 

2 (other than minor remodeling of existing im3 provements to real property); or 

4 ‘‘(C) to satisfy any requirement for the ex5 penditure of non-Federal funds as a condition 

6 for the receipt of Federal funds. 

7 ‘‘(2) WAIVER.—The Secretary may waive a re8 striction under paragraph (1) only if the Secretary 

9 determines that the activities outlined by the State 

10 plan submitted under subsection (c)(1) by the State 

11 involved cannot otherwise be carried out. 

12 ‘‘(f) APPLICATION.—To seek a grant under this sec13 tion, a State shall submit to the Secretary an application 

14 in such form, in such manner, and containing such infor15 mation and assurances as the Secretary may require. 

16 ‘‘(g) REPORTS BY STATES.—A grant may be made 

17 to a State under this section only if the State agrees that, 

18 promptly after the end of the fiscal year for which the 

19 grant is made, the State will submit to the Secretary a 

20 report that describes the activities of the State under the 

21 grant. 

22 ‘‘SEC. 1204. GRANTS FOR THE IMPROVEMENT OF TRAUMA 

23 CARE. 

24 ‘‘(a) IN GENERAL.—The Secretary, acting through 

25 the Administrator of the Health Resources and Services 
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1 Administration, may make grants to States, political sub2 divisions, consortia of States or political subdivisions, and 

3 accredited schools of medicine for the purpose of improv4 ing access to and enhancing the development of trauma 

5 care systems. 

6 ‘‘(b) USE OF FUNDS.—The Secretary may make a 

7 grant under this section only if—

8 ‘‘(1) in the case of an application by a State, 

9 political subdivision, or consortium, the applicant 

10 agrees to use the grant—

11 ‘‘(A) to integrate and broaden the reach of 

12 a trauma care system, such as by developing in13 novative protocols to increase access to 

14 prehospital care and equipment necessary for 

15 the transportation of seriously injured patients 

16 to the appropriate facilities; 

17 ‘‘(B) to strengthen, develop, and improve 

18 an existing trauma care system; 

19 ‘‘(C) to expand and improve emergency 

20 medical services for children who need treat21 ment for trauma or critical care; 

22 ‘‘(D) to expand communications between 

23 the trauma care system and emergency medical 

24 services through improved equipment or a tele25 medicine system; 
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1 ‘‘(E) to improve data collection and reten2 tion; or 

3 ‘‘(F) to increase education, training, and 

4 technical assistance opportunities, such as 

5 training and continuing education in the man6 agement of emergency medical services acces7 sible to emergency medical personnel in rural 

8 areas through telehealth, home studies, and 

9 other methods; or 

10 ‘‘(2) in the case of an application by an accred11 ited school of medicine, the applicant agrees to use 

12 the grant to expand and improve emergency medical 

13 services for children who need treatment for trauma 

14 or critical care. 

15 ‘‘(c) PREFERENCE.—In selecting among States, po16 litical subdivisions, and consortia of States or political 

17 subdivisions (but not accredited schools of medicine) for 

18 purposes of making grants under this section, the Sec19 retary shall give preference to applicants that—

20 ‘‘(A) have developed a process and adopted 

21 standards for designating trauma centers; 

22 ‘‘(B) recognize protocols for the delivery of seri23 ously injured patients to trauma centers; 

24 ‘‘(C) implement a process for evaluating the 

25 performance of the trauma system; and 
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1 ‘‘(D) agree to participate in information sys2 tems described in section 1202 by collecting, pro3 viding, and sharing information. 

4 ‘‘(d) PRIORITY.—In making grants under this sec5 tion, the Secretary shall give priority to applicants that 

6 will use the grants to focus on improving access to trauma 

7 care systems. 

8 ‘‘(e) DEFINITIONS.—For purposes of this section, the 

9 terms ‘accredited’ and ‘school of medicine’ have the mean10 ings given to those terms in section 799B. 

11 ‘‘SEC. 1205. REPORTS. 

12 ‘‘(a) REPORT BY SECRETARY.—Not later than the 

13 end of fiscal year 2006, the Secretary shall submit a re14 port to the appropriate committees of the Congress on the 

15 activities of the States carried out with assistance under 

16 this part. Such report—

17 ‘‘(1) shall include an assessment of the extent 

18 to which Federal and State efforts to develop sys19 tems of trauma care and to designate trauma cen20 ters have reduced the incidence of mortality, and the 

21 incidence of permanent disability, resulting from 

22 trauma; 

23 ‘‘(2) shall include an assessment of the grants 

24 awarded under section 1204; and 
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1 ‘‘(3) may include any recommendations of the 

2 Secretary to improve trauma care. 

3 ‘‘(b) EVALUATIONS BY COMPTROLLER GENERAL.—

4 The Comptroller General of the United States—

5 ‘‘(1) shall evaluate the expenditures by grantees 

6 of payments under section 1203 and section 1204 to 

7 assure that such expenditures are consistent with 

8 the provisions of such sections; and 

9 ‘‘(2) not later than December 1, 2006, shall 

10 submit to the Committee on Energy and Commerce 

11 of the House of Representatives and the Committee 

12 on Health, Education, Labor, and Pensions of the 

13 Senate a report concerning such evaluation. 

14 ‘‘SEC. 1206. RULE OF CONSTRUCTION. 

15 ‘‘Nothing in this title authorizes the Secretary to es16 tablish Federal standards for the treatment of patients or 

17 the licensure of health care professionals. 

18 ‘‘SEC. 1207. DEFINITIONS. 

19 ‘‘For purposes of this part: 

20 ‘‘(1) DESIGNATED TRAUMA CENTER.—The term 

21 ‘designated trauma center’ means a trauma center 

22 designated in accordance with the provisions of the 

23 State plan described in section 1203(b). 

24 ‘‘(2) STATE PLAN REGARDING EMERGENCY

25 MEDICAL SERVICES.—The term ‘State plan’, with re-
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1 spect to the provision of emergency medical services, 

2 means a plan for a comprehensive, organized system 

3 to provide for the access, response, triage, field sta4 bilization, transport, hospital stabilization, definitive 

5 care, and rehabilitation of patients of all ages with 

6 respect to emergency medical services. 

7 ‘‘(3) STATE.—The term ‘State’ means each of 

8 the several States, the District of Columbia, the 

9 Commonwealth of Puerto Rico, the Virgin Islands, 

10 Guam, American Samoa, and the Commonwealth of 

11 the Northern Mariana Islands. 

12 ‘‘(4) TRAUMA.—The term ‘trauma’ means an 

13 injury resulting from exposure to a mechanical force. 

14 ‘‘(5) TRAUMA CARE COMPONENT OF STATE

15 PLAN.—The term ‘trauma care component’, with re16 spect to components of the State plan for the provi17 sion of emergency medical services, means a plan for 

18 a comprehensive health care system, within rural 

19 and urban areas of the State, for the prompt rec20 ognition, prehospital care, emergency medical care, 

21 acute surgical and medical care, rehabilitation, and 

22 outcome evaluation of seriously injured patients. 

23 ‘‘SEC. 1208. AUTHORIZATION OF APPROPRIATIONS. 

24 ‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 

25 purpose of carrying out sections 1201, 1202, 1203, and 
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1 1204, there is authorized to be appropriated $31,000,000 

2 for each of fiscal years 2005 through 2009. 

3 ‘‘(b) ALLOCATION OF FUNDS.—Of the amount appro4 priated for each of fiscal years 2005 through 2009 under 

5 subsection (a)—

6 ‘‘(1) if such amount is $12,000,000 or less, the 

7 Secretary shall make available 100 percent of such 

8 amount for the purpose of carrying out sections 

9 1201, 1202, and 1204; or 

10 ‘‘(2) if such amount is greater than 

11 $12,000,000, the Secretary shall make available 50 

12 percent of such amount for the purpose of carrying 

13 out sections 1201, 1202, and 1204 and 50 percent 

14 of such amount for the purpose of carrying out sec15 tion 1203. 

16 ‘‘(c) DETERMINATION OF AMOUNT OF ALLOT17 MENT.—

18 ‘‘(1) IN GENERAL.—For purposes of section 

19 1203(a), the amount referred to in this subsection 

20 for a State for a fiscal year is the sum of—

21 ‘‘(A) an amount determined under para22 graph (2); 

23 ‘‘(B) an amount determined under para24 graph (3); and 
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1 ‘‘(C) any amount allotted to the State 

2 under paragraph (4). 

3 ‘‘(2) AMOUNT RELATING TO POPULATION.—The 

4 amount referred to in subparagraph (A) of para5 graph (1) for a State for a fiscal year is the product 

6 of—

7 ‘‘(A) an amount equal to 80 percent of the 

8 amounts appropriated under this section to 

9 carry out section 1203 for the fiscal year; and 

10 ‘‘(B) a percentage equal to the quotient 

11 of—

12 ‘‘(i) an amount equal to the popu13 lation of the State; divided by 

14 ‘‘(ii) an amount equal to the popu15 lation of all States. 

16 ‘‘(3) AMOUNT RELATING TO SQUARE MILE17 AGE.—The amount referred to in subparagraph (B) 

18 of paragraph (1) for a State for a fiscal year is the 

19 product of—

20 ‘‘(A) an amount equal to 20 percent of the 

21 amounts appropriated under this section to 

22 carry out section 1203 for the fiscal year; and 

23 ‘‘(B) a percentage equal to the quotient 

24 of—
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1 ‘‘(i) an amount equal to the lesser of 

2 266,807 or the amount of the square mile3 age of the State; divided by 

4 ‘‘(ii) an amount equal to the sum of 

5 the respective amounts determined for the 

6 States under clause (i). 

7 ‘‘(4) DISPOSITION OF CERTAIN FUNDS APPRO8 PRIATED FOR ALLOTMENTS.—

9 ‘‘(A) IN GENERAL.—Amounts described in 

10 subparagraph (B) shall, in accordance with sub11 paragraph (C), be allotted by the Secretary to 

12 States receiving payments under section 1203 

13 for the fiscal year (other than any State re14 ferred to in subparagraph (B)(iii)). 

15 ‘‘(B) TYPE OF AMOUNTS.—The amounts 

16 referred to in subparagraph (A) are any 

17 amounts that are made available pursuant to 

18 this section to carry out section 1203, but are 

19 not paid to a State as a result of—

20 ‘‘(i) the failure of the State to submit 

21 an application under section 1203; 

22 ‘‘(ii) the failure, in the determination 

23 of the Secretary, of the State to prepare 

24 within a reasonable period of time such ap-
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1 plication in compliance with such section; 

2 or 

3 ‘‘(iii) the State informing the Sec4 retary that the State does not intend to ex5 pend the full amount of the allotment 

6 made for the State. 

7 ‘‘(C) AMOUNT.—The amount of an allot8 ment under subparagraph (A) for a State for a 

9 fiscal year shall be an amount equal to the 

10 product of—

11 ‘‘(i) an amount equal to the amounts 

12 described in subparagraph (B) for the fis13 cal year involved; and 

14 ‘‘(ii) the percentage equal to the 

15 quotient of an amount equal to the popu16 lation of the State, divided by an amount 

17 equal to the population of all States (other 

18 than any State referred to in subparagraph 

19 (B)(iii)). 

20 ‘‘(d) FAILURE TO COMPLY WITH AGREEMENTS.—

21 ‘‘(1) REPAYMENT OF PAYMENTS.—

22 ‘‘(A) REQUIREMENT.—The Secretary may, 

23 in accordance with paragraph (2), require a 

24 State to repay any payments received by the 

25 State under section 1203 that the Secretary de-
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1 termines were not expended by the State in ac2 cordance with the agreements required to be 

3 made by the State as a condition of the receipt 

4 of payments under such section. 

5 ‘‘(B) OFFSET OF AMOUNTS.—If a State 

6 fails to make a repayment required in subpara7 graph (A), the Secretary may offset the amount 

8 of the repayment against any amount due to be 

9 paid to the State under section 1203. 

10 ‘‘(2) OPPORTUNITY FOR A HEARING.—Before 

11 requiring repayment of payments under paragraph 

12 (1)(A), the Secretary shall provide to the State an 

13 opportunity for a hearing.’’. 

14 SEC. 3. INTERAGENCY PROGRAM FOR TRAUMA RESEARCH. 

15 Title IV of the Public Health Service Act (42 U.S.C. 

16 281 et seq.) is amended by inserting after section 494A 

17 the following: 

18 ‘‘INTERAGENCY PROGRAM FOR TRAUMA RESEARCH

19 ‘‘SEC. 494B. (a) IN GENERAL.—The Secretary, act20 ing through the Director of NIH, shall establish a com21 prehensive program of basic and clinical research on trau22 ma (in this section referred to as the ‘Program’), including 

23 the prevention, diagnosis, treatment, and rehabilitation of 

24 trauma-related injuries. 

25 ‘‘(b) PLAN FOR PROGRAM.—The Director of NIH 

26 shall establish and implement a plan for carrying out the 
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1 activities of the Program, taking into consideration the 

2 recommendations contained in the report of the NIH 

3 Trauma Research Taskforce. The plan shall be periodi4 cally reviewed, and revised as appropriate. 

5 ‘‘(c) PARTICIPATING AGENCIES; COORDINATION AND

6 COLLABORATION.—The Director of NIH—

7 ‘‘(1) shall provide for the conduct of activities 

8 under the Program by the directors of the agencies 

9 of the National Institutes of Health involved in re10 search with respect to trauma; 

11 ‘‘(2) shall ensure that the activities of the Pro12 gram are coordinated among such agencies; and 

13 ‘‘(3) shall, as appropriate, provide for collabora14 tion among such agencies in carrying out such ac15 tivities. 

16 ‘‘(d) CERTAIN ACTIVITIES OF PROGRAM.—The Pro17 gram shall include—

18 ‘‘(1) studies with respect to all phases of trau19 ma care, including prehospital, resuscitation, sur20 gical intervention, critical care, infection control, 

21 wound healing, nutritional care and support, and 

22 medical rehabilitation care; 

23 ‘‘(2) basic and clinical research regarding the 

24 response of the body to trauma and the acute treat-
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1 ment and medical rehabilitation of individuals who 

2 are the victims of trauma; 

3 ‘‘(3) basic and clinical research regarding trau4 ma care for pediatric and geriatric patients; and 

5 ‘‘(4) the authority to make awards of grants or 

6 contracts to public or nonprofit private entities for 

7 the conduct of basic and applied research regarding 

8 traumatic brain injury, which research may in9 clude—

10 ‘‘(A) the development of new methods and 

11 modalities for the more effective diagnosis, 

12 measurement of degree of brain injury, post-in13 jury monitoring, and prognostic assessment of 

14 head injury for acute, subacute, and later 

15 phases of care; 

16 ‘‘(B) the development, modification, and 

17 evaluation of therapies that retard, prevent, or 

18 reverse brain damage after traumatic brain in19 jury, that arrest further deterioration following 

20 injury, and that provide the restitution of func21 tion for individuals with long-term injuries; 

22 ‘‘(C) the development of research on a con23 tinuum of care from acute care through reha24 bilitation, designed, to the extent practicable, to 
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1 integrate rehabilitation and long-term outcome 

2 evaluation with acute care research; 

3 ‘‘(D) the development of programs that in4 crease the participation of academic centers of 

5 excellence in traumatic brain injury treatment 

6 and rehabilitation research and training; and 

7 ‘‘(E) carrying out subparagraphs (A) 

8 through (D) with respect to cognitive disorders 

9 and neurobehavioral consequences arising from 

10 traumatic brain injury, including the develop11 ment, modification, and evaluation of therapies 

12 and programs of rehabilitation toward reaching 

13 or restoring normal capabilities in areas such as 

14 reading, comprehension, speech, reasoning, and 

15 deduction. 

16 ‘‘(e) MECHANISMS OF SUPPORT.—In carrying out the 

17 Program, the Director of NIH, acting through the direc18 tors of the agencies referred to in subsection (c)(1), may 

19 make grants to public and nonprofit entities, including 

20 designated trauma centers. 

21 ‘‘(f) RESOURCES.—The Director of NIH shall assure 

22 the availability of appropriate resources to carry out the 

23 Program, including the plan established under subsection 

24 (b) and the activities described in subsection (d). 

25 ‘‘(g) DEFINITIONS.—For purposes of this section: 
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1 ‘‘(1) The term ‘designated trauma center’ has 

2 the meaning given such term in section 1207. 

3 ‘‘(2) The term ‘trauma’ means any serious in4 jury that could result in loss of life or in significant 

5 disability and that would meet prehospital triage cri6 teria for transport to a designated trauma center. 

7 ‘‘(3) The term ‘traumatic brain injury’ means 

8 an acquired injury to the brain. Such term does not 

9 include brain dysfunction caused by congenital or 

10 degenerative disorders, nor birth trauma, but may 

11 include brain injuries caused by anoxia due to trau12 ma. The Secretary may revise the definition of such 

13 term as the Secretary determines necessary, after 

14 consultation with States and other appropriate pub15 lic or nonprofit private entities. 

16 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 

17 purpose of carrying out this section, there are authorized 

18 to be appropriated such sums as may be necessary for 

19 each of the fiscal years 2005 through 2009.’’. 

20 SEC. 4. CONFORMING AMENDMENTS. 

21 (a) TITLE XII OF PUBLIC HEALTH SERVICE ACT.—

22 Title XII of the Public Health Service Act (42 U.S.C. 

23 300d et seq.) is amended—
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1 (1) in part E, by resdesignating sections 1251 

2 through 1253 as sections 1221 through 1223, re3 spectively; 

4 (2) by redesignating part E as part B; 

5 (3) by striking part F; 

6 (4) in part G, by redesignating sections 1271 

7 through 1274 as sections 1231 through 1234, re8 spectively; and 

9 (5) by redesignating part G as part C. 

10 (b) TITLE XIX OF PUBLIC HEALTH SERVICE ACT.—

11 Title XIX of the Public Health Service Act (42 U.S.C. 

12 300w et seq.) is amended—

13 (1) in subparagraph (C) of section 1904(a)(1), 

14 by striking ‘‘section 1213(a)’’ and inserting ‘‘section 

15 1203’’; and 

16 (2) by striking section 1910.

Æ