I 
110TH CONGRESS 
1ST SESSION 
H. R. 727 
To amend the Public Health Service Act to add requirements regarding 
trauma care, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JANUARY 30, 2007 
Mr. GENE GREEN of Texas (for himself and Mr. BURGESS) introduced the 
following bill; which was referred to the Committee on Energy and Commerce 
A BILL 
To amend the Public Health Service Act to add requirements 
regarding trauma care, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Trauma Care Systems 
Planning and Development Act of 2007’’. 
SEC. 2. ESTABLISHMENT. 
Section 1201 of the Public Health Service Act (42 
U.S.C. 300d) is amended to read as follows: 
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‘‘SEC. 1201. ESTABLISHMENT. 
‘‘(a) IN GENERAL.—The Secretary shall, with respect 
to trauma care— 
‘‘(1) conduct and support research, training, 
evaluations, and demonstration projects; 
‘‘(2) foster the development of appropriate, 
modern systems of such care through the sharing of 
information among agencies and individuals involved 
in the study and provision of such care; 
‘‘(3) collect, compile, and disseminate informa-
tion on the achievements of, and problems experi-
enced by, State and local agencies and private enti-
ties in providing trauma care and emergency medical 
services and, in so doing, give special consideration 
to the unique needs of rural areas; 
‘‘(4) provide to State and local agencies tech-
nical assistance to enhance each State’s capability to 
develop, implement, and sustain the trauma care 
component of each State’s plan for the provision of 
emergency medical services; 
‘‘(5) sponsor workshops and conferences; and 
‘‘(6) promote the collection and categorization 
of trauma data in a consistent and standardized 
manner. 
‘‘(b) GRANTS, COOPERATIVE AGREEMENTS, AND 
CONTRACTS.—The Secretary may make grants, and enter 
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into cooperative agreements and contracts, for the purpose 
of carrying out subsection (a).’’. 
SEC. 3. CLEARINGHOUSE ON TRAUMA CARE AND EMER-
GENCY MEDICAL SERVICES. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended— 
(1) by striking section 1202; and 
(2) by redesignating section 1203 as section 
1202. 
SEC. 4. ESTABLISHMENT OF PROGRAMS FOR IMPROVING 
TRAUMA CARE IN RURAL AREAS. 
Section 1202 of the Public Health Service Act, as re-
designated by section 3(2), is amended to read as follows: 
‘‘SEC. 1202. ESTABLISHMENT OF PROGRAMS FOR IMPROV-
ING TRAUMA CARE IN RURAL AREAS. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to public and nonprofit private entities for the purpose of 
carrying out research and demonstration projects with re-
spect to improving the availability and quality of emer-
gency medical services in rural areas— 
‘‘(1) by developing innovative uses of commu-
nications technologies and the use of new commu-
nications technology; 
‘‘(2) by developing model curricula, such as ad-
vanced trauma life support, for training emergency 
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Administration, may make grants to States, political sub-
divisions, or consortia of States or political subdivisions 
for the purpose of improving access to and enhancing the 
development of trauma care systems. 
‘‘(b) USE OF FUNDS.—The Secretary may make a 
grant under this section only if the applicant agrees to 
use the grant— 
‘‘(1) to integrate and broaden the reach of a 
trauma care system, such as by developing innova-
tive protocols to increase access to prehospital care; 
‘‘(2) to strengthen, develop, and improve an ex-
isting trauma care system; 
‘‘(3) to expand communications between the 
trauma care system and emergency medical services 
through improved equipment or a telemedicine sys-
tem; 
‘‘(4) to improve data collection and retention; 
or 
‘‘(5) to increase education, training, and tech-
nical assistance opportunities, such as training and 
continuing education in the management of emer-
gency medical services accessible to emergency med-
ical personnel in rural areas through telehealth, 
home studies, and other methods. 
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‘‘(c) PREFERENCE.—In selecting among States, po-
litical subdivisions, and consortia of States or political 
subdivisions for purposes of making grants under this sec-
tion, the Secretary shall give preference to applicants 
that— 
‘‘(1) have developed a process, using national 
standards, for designating trauma centers; 
‘‘(2) recognize protocols for the delivery of seri-
ously injured patients to trauma centers; 
‘‘(3) implement a process for evaluating the 
performance of the trauma system; and 
‘‘(4) agree to participate in information systems 
described in section 1202 by collecting, providing, 
and sharing information. 
‘‘(d) PRIORITY.—In making grants under this sec-
tion, the Secretary shall give priority to applicants that 
will use the grants to focus on improving access to trauma 
care systems. 
‘‘(e) SPECIAL CONSIDERATION.—In awarding grants 
under this section, the Secretary shall give special consid-
eration to projects that demonstrate strong State or local 
support, including availability of non-Federal contribu-
tions.’’. 
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SEC. 6. REQUIREMENT OF MATCHING FUNDS FOR FISCAL 
YEARS SUBSEQUENT TO FIRST FISCAL YEAR 
OF PAYMENTS. 
Section 1212 of the Public Health Service Act (42 
U.S.C. 300d–12) is amended to read as follows: 
‘‘SEC. 1212. REQUIREMENT OF MATCHING FUNDS FOR FIS-
CAL YEARS SUBSEQUENT TO FIRST FISCAL 
YEAR OF PAYMENTS. 
‘‘(a) NON-FEDERAL CONTRIBUTIONS.— 
‘‘(1) IN
GENERAL.—The Secretary may not 
make payments under section 1211(a) unless the 
State involved agrees, with respect to the costs de-
scribed in paragraph (2), to make available non-Fed-
eral contributions (in cash or in kind under sub-
section (b)(1)) toward such costs in an amount 
that— 
‘‘(A) for the second and third fiscal years 
of such payments to the State, is not less than 
$1 for each $1 of Federal funds provided in 
such payments for such fiscal years; and 
‘‘(B) for the fourth and subsequent fiscal 
years of such payments to the State, is not less 
than $2 for each $1 of Federal funds provided 
in such payments for such fiscal years. 
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The Secretary may not require any non-Federal con-
tributions for the first fiscal year of such payments 
to the State. 
‘‘(2) PROGRAM COSTS.—The costs referred to 
in paragraph (1) are— 
‘‘(A) the costs to be incurred by the State 
in carrying out the purpose described in section 
1211(b); or 
‘‘(B) the costs of improving the quality 
and availability of emergency medical services 
in rural areas of the State. 
‘‘(3) INITIAL YEAR OF PAYMENTS.—The Sec-
retary may not require a State to make non-Federal 
contributions as a condition of receiving payments 
under section 1211(a) for the first fiscal year of 
such payments to the State. 
‘‘(b) DETERMINATION OF AMOUNT OF NON-FED-
ERAL CONTRIBUTION.—With respect to compliance with 
subsection (a) as a condition of receiving payments under 
section 1211(a)— 
‘‘(1) a State may make the non-Federal con-
tributions required in such subsection in cash or in 
kind, fairly evaluated, including plant, equipment, or 
services; and 
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‘‘(2) the Secretary may not, in making a deter-
mination of the amount of non-Federal contribu-
tions, include amounts provided by the Federal Gov-
ernment or services assisted or subsidized to any sig-
nificant extent by the Federal Government.’’. 
SEC. 7. REQUIREMENTS WITH RESPECT TO CARRYING OUT 
PURPOSE OF ALLOTMENTS. 
Section 1213 of the Public Health Service Act (42 
U.S.C. 300d–13) is amended to read as follows: 
‘‘SEC. 1213. REQUIREMENTS WITH RESPECT TO CARRYING 
OUT PURPOSE OF ALLOTMENTS. 
‘‘(a) TRAUMA CARE MODIFICATIONS TO STATE PLAN 
FOR EMERGENCY MEDICAL SERVICES.—With respect to 
the trauma care component of a State plan for the provi-
sion of emergency medical services, the modifications re-
ferred to in section 1211(b) are such modifications to the 
State plan as may be necessary for the State involved to 
ensure that the plan provides for access to the highest pos-
sible quality of trauma care, and that the plan— 
‘‘(1) specifies that the modifications required 
pursuant to paragraphs (2) through (11) will be im-
plemented by the principal State agency with respect 
to emergency medical services or by the designee of 
such agency; 
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‘‘(2) specifies a public or private entity that will 
designate trauma care regions and trauma centers in 
the State; 
‘‘(3) subject to subsection (b), contains national 
standards and requirements of the American College 
of Surgeons or another appropriate entity for the 
designation of level I and level II trauma centers, 
and in the case of rural areas level III trauma cen-
ters (including trauma centers with specified capa-
bilities and expertise in the care of pediatric trauma 
patient), by such entity, including standards and re-
quirements for— 
‘‘(A) the number and types of trauma pa-
tients for whom such centers must provide care 
in order to ensure that such centers will have 
sufficient experience and expertise to be able to 
provide quality care for victims of injury; 
‘‘(B) the resources and equipment needed 
by such centers; and 
‘‘(C) the availability of rehabilitation serv-
ices for trauma patients; 
‘‘(4) contains standards and requirements for 
the implementation of regional trauma care systems, 
including standards and guidelines (consistent with 
the provisions of section 1867 of the Social Security 
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‘‘(8) provides for the use of procedures by para-
medics and emergency medical technicians to assess 
the severity of the injuries incurred by trauma pa-
tients; 
‘‘(9) provides for appropriate transportation 
and transfer policies to ensure the delivery of pa-
tients to designated trauma centers and other facili-
ties within and outside of the jurisdiction of such 
system, including policies to ensure that only indi-
viduals appropriately identified as trauma patients 
are transferred to designated trauma centers, and to 
provide periodic reviews of the transfers and the au-
diting of such transfers that are determined to be 
appropriate; 
‘‘(10) conducts public education activities con-
cerning injury prevention and obtaining access to 
trauma care; 
‘‘(11) coordinates planning for trauma systems 
with State disaster emergency planning and bioter-
rorism hospital preparedness planning; and 
‘‘(12) with respect to the requirements estab-
lished in this subsection, provides for coordination 
and cooperation between the State and any other 
State with which the State shares any standard met-
ropolitan statistical area. 
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‘‘(b) CERTAIN STANDARDS WITH RESPECT TO TRAU-
MA CARE CENTERS AND SYSTEMS.— 
‘‘(1) IN
GENERAL.—The Secretary may not 
make payments under section 1211(a) for a fiscal 
year unless the State involved agrees that, in car-
rying out paragraphs (3) through (5) of subsection 
(a), the State will adopt standards for the designa-
tion of trauma centers, and for triage, transfer, and 
transportation policies, and that the State will, in 
adopting such standards— 
‘‘(A) take into account national standards 
concerning that outline resources for optimal 
care of the injured patient; 
‘‘(B) consult with medical, surgical, and 
nursing speciality groups, hospital associations, 
emergency medical services State and local di-
rectors, concerned advocates and other inter-
ested parties; 
‘‘(C) conduct hearings on the proposed 
standards after providing adequate notice to the 
public concerning such hearing; and 
‘‘(D) beginning in fiscal year 2007, take 
into account the model plan described in sub-
section (c). 
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‘‘(2) QUALITY OF TRAUMA CARE.—The highest 
quality of trauma care shall be the primary goal of 
State standards adopted under this subsection. 
‘‘(3) APPROVAL BY THE SECRETARY.—The Sec-
retary may not make payments under section 
1211(a) to a State if the Secretary determines 
that— 
‘‘(A) in the case of payments for fiscal 
year 2008 and subsequent fiscal years, the 
State has not taken into account national 
standards, including those of the American Col-
lege of Surgeons, the American College of 
Emergency Physicians, and the American Acad-
emy of Pediatrics, in adopting standards under 
this subsection; or 
‘‘(B) in the case of payments for fiscal 
year 2008 and subsequent fiscal years, the 
State has not, in adopting such standards, 
taken into account the model plan developed 
under subsection (c). 
‘‘(c) MODEL TRAUMA CARE PLAN.— 
‘‘(1) IN GENERAL.—Not later than 1 year after 
the date of the enactment of the Trauma Care Sys-
tems Planning and Development Act of 2007, the 
Secretary shall update the model plan for the des-
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ignation of trauma centers and for triage, transfer, 
and transportation policies that may be adopted for 
guidance by the State. Such plan shall— 
‘‘(A) take into account national standards, 
including those of the American College of Sur-
geons, American College of Emergency Physi-
cians, and the American Academy of Pediatrics; 
‘‘(B) take into account existing State 
plans; 
‘‘(C) be developed in consultation with 
medical, surgical, and nursing speciality groups, 
hospital associations, emergency medical serv-
ices State directors and associations, and other 
interested parties; and 
‘‘(D) include standards for the designation 
of rural health facilities and hospitals best able 
to receive, stabilize, and transfer trauma pa-
tients to the nearest appropriate designated 
trauma center, and for triage, transfer, and 
transportation policies as they relate to rural 
areas. 
‘‘(2) APPLICABILITY.—Standards described in 
paragraph (1)(D) shall be applicable to all rural 
areas in the State, including both non-metropolitan 
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areas and frontier areas that have populations of 
less than 6,000 per square mile. 
‘‘(d) RULE OF CONSTRUCTION WITH RESPECT TO 
NUMBER OF DESIGNATED TRAUMA CENTERS.—With re-
spect to compliance with subsection (a) as a condition of 
the receipt of a grant under section 1211(a), such sub-
section may not be construed to specify the number of 
trauma care centers designated pursuant to such sub-
section.’’. 
SEC. 8. REQUIREMENT OF SUBMISSION TO SECRETARY OF 
TRAUMA PLAN AND CERTAIN INFORMATION. 
Section 1214 of the Public Health Service Act (42 
U.S.C. 300d–14) is amended to read as follows: 
‘‘SEC. 1214. REQUIREMENT OF SUBMISSION TO SECRETARY 
OF TRAUMA PLAN AND CERTAIN INFORMA-
TION. 
‘‘(a) IN GENERAL.—For each fiscal year, the Sec-
retary may not make payments to a State under section 
1211(a) unless, subject to subsection (b), the State sub-
mits to the Secretary the trauma care component of the 
State plan for the provision of emergency medical services, 
including any changes to the trauma care component and 
any plans to address deficiencies in the trauma care com-
ponent. 
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‘‘(b) INTERIM
PLAN
OR
DESCRIPTION
OF
EF-
FORTS.—For each fiscal year, if a State has not completed 
the trauma care component of the State plan described 
in subsection (a), the State may provide, in lieu of such 
completed component, an interim component or a descrip-
tion of efforts made toward the completion of the compo-
nent. 
‘‘(c) INFORMATION RECEIVED BY STATE REPORTING 
AND ANALYSIS SYSTEM.—The Secretary may not make 
payments to a State under section 1211(a) unless the 
State agrees that the State will, not less than once each 
year, provide to the Secretary the information received by 
the State pursuant to section 1213(a)(7). 
‘‘(d) AVAILABILITY OF EMERGENCY MEDICAL SERV-
ICES IN RURAL AREAS.—The Secretary may not make 
payments to a State under section 1211(a) unless— 
‘‘(1) the State identifies any rural area in the 
State for which— 
‘‘(A) there is no system of access to emer-
gency medical services through the telephone 
number 911; 
‘‘(B) there is no basic life-support system; 
or 
‘‘(C) there is no advanced life-support sys-
tem; and 
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‘‘(2) the State submits to the Secretary a list 
of rural areas identified pursuant to subparagraph 
(A) or, if there are no such areas, a statement that 
there are no such areas.’’. 
SEC. 9. RESTRICTIONS ON USE OF PAYMENTS. 
Section 1215 of the Public Health Service Act (42 
U.S.C. 300d–15) is amended to read as follows: 
‘‘SEC. 1215. RESTRICTIONS ON USE OF PAYMENTS. 
‘‘(a) IN GENERAL.—The Secretary may not, except 
as provided in subsection (b), make payments under sec-
tion 1211(a) for a fiscal year unless the State involved 
agrees that the payments will not be expended— 
‘‘(1) for any purpose other than developing, im-
plementing, and monitoring the modifications re-
quired by section 1211(b) to be made to the State 
plan for the provision of emergency medical services; 
‘‘(2) to make cash payments to intended recipi-
ents of services provided pursuant to this section; 
‘‘(3) to purchase or improve real property 
(other than minor remodeling of existing improve-
ments to real property); 
‘‘(4) to satisfy any requirement for the expendi-
ture of non-Federal funds as a condition for the re-
ceipt of Federal funds; or 
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‘‘(5) to provide financial assistance to any enti-
ty other than a public or nonprofit private entity. 
‘‘(b) WAIVER.—The Secretary may waive a restric-
tion under subsection (a) only if the Secretary determines 
that the activities outlined by the State plan submitted 
under section 1214(a)(1) by the State involved cannot oth-
erwise be carried out.’’. 
SEC. 10. REQUIREMENTS OF REPORTS BY STATES. 
The Public Health Service Act (42 U.S.C. 201 et 
seq.) is amended by striking section 1216. 
SEC. 11. REPORT BY SECRETARY. 
Section 1222 of the Public Health Service Act (42 
U.S.C. 300d–22) is amended to read as follows: 
‘‘SEC. 1222. REPORT BY SECRETARY. 
‘‘Not later than October 1, 2008, the Secretary shall 
report to the appropriate committees of Congress on the 
activities of the States carried out pursuant to section 
1211. Such report shall include an assessment of the ex-
tent to which Federal and State efforts to develop systems 
of trauma care and to designate trauma centers have re-
duced the incidence of mortality, and the incidence of per-
manent disability, resulting from trauma. Such report 
may include any recommendations of the Secretary for ap-
propriate administrative and legislative initiatives with re-
spect to trauma care.’’. 
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SEC. 12. FUNDING. 
Section 1232 of the Public Health Service Act (42 
U.S.C. 300d–32) is amended to read as follows: 
‘‘SEC. 1232. FUNDING. 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out parts A and B, there are author-
ized to be appropriated $12,000,000 for fiscal year 2008, 
$10,000,000 for fiscal year 2009, and $8,000,000 for each 
of the fiscal years 2010 through 2012. 
‘‘(b) RESERVATION OF FUNDS.—If the amount ap-
propriated under subsection (a) for a fiscal year is equal 
to or less than $1,000,000, such appropriation is available 
only for making grants under part A. If the amount so 
appropriated is greater than $1,000,000, 50 percent of 
such appropriation shall be made available for grants 
under part A and 50 percent shall be made available for 
grants under part B. 
‘‘(c) ALLOCATION OF FUNDS BY SECRETARY.— 
‘‘(1) GENERAL AUTHORITY.—For the purpose 
of carrying out part A, the Secretary shall make 
available 10 percent of the amounts appropriated for 
a fiscal year under subsection (a). 
‘‘(2) RURAL GRANTS.—For the purpose of car-
rying out section 1202, the Secretary shall make 
available 10 percent of the amounts appropriated for 
a fiscal year under subsection (a).’’. 
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SEC. 13. INSTITUTE OF MEDICINE STUDY. 
Part E of title XII of the Public Health Service Act 
(20 U.S.C. 300d–51 et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 1254. INSTITUTE OF MEDICINE STUDY. 
‘‘(a) IN GENERAL.—The Secretary shall enter into 
a contract with the Institute of Medicine of the National 
Academy of Sciences, or another appropriate entity, to 
conduct a study on the state of trauma care and trauma 
research. 
‘‘(b) CONTENT.—The study conducted under sub-
section (a) shall— 
‘‘(1) examine and evaluate the state of trauma 
care and trauma systems research (including the 
role of Federal entities in trauma research) on the 
date of enactment of this section, and identify trau-
ma research priorities; 
‘‘(2) examine and evaluate the clinical effective-
ness of trauma care and the impact of trauma care 
on patient outcomes, with special attention to high- 
risk groups, such as children, the elderly, and indi-
viduals in rural areas; 
‘‘(3) examine and evaluate trauma systems de-
velopment and identify obstacles that prevent or 
hinder the effectiveness of trauma systems and trau-
ma systems development; 
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‘‘(4) examine and evaluate alternative strategies 
for the organization, financing, and delivery of trau-
ma care within an overall systems approach; and 
‘‘(5) examine and evaluate the role of trauma 
systems and trauma centers in preparedness for 
mass casualties. 
‘‘(c) REPORT.—Not later than 2 years after the date 
of enactment of this section, the Secretary shall submit 
to the appropriate committees of Congress a report con-
taining the results of the study conducted under this sec-
tion. 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$750,000 for fiscal year 2008.’’. 
SEC. 14. RESIDENCY TRAINING PROGRAMS IN EMERGENCY 
MEDICINE. 
Section 1251 of the Public Health Service Act (42 
U.S.C. 300d–51) is amended to read as follows: 
‘‘SEC. 1251. RESIDENCY TRAINING PROGRAMS IN EMER-
GENCY MEDICINE. 
‘‘(a) IN GENERAL.—The Secretary may make grants 
to public and nonprofit private entities for the purpose of 
planning and developing approved residency training pro-
grams in emergency medicine. 
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‘‘(b) IDENTIFICATION AND REFERRAL OF DOMESTIC 
VIOLENCE.—The Secretary may make a grant under sub-
section (a) only in the applicant involved agrees that the 
training programs under subsection (a) will provide edu-
cation and training in identifying and referring cases of 
domestic violence. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated $400,000 for each of the fiscal years 
2008 though 2012.’’. 
SEC. 15. STATE GRANTS FOR CERTAIN PROJECTS. 
Section 1252 of the Public Health Service Act (42 
U.S.C. 300d–52) is amended in the section heading by 
striking ‘‘DEMONSTRATION’’. 
Æ 
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