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.
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 Research and 
Access to Urgent Medical Attention Act of 2004’’ or the 
‘‘TRAUMA Act of 2004’’. 
SEC. 2. AMENDMENT TO TITLE XII OF PUBLIC HEALTH 
SERVICE ACT. 
Title XII of the Public Health Service Act (42 U.S.C. 
300d et seq.) is amended—
(1) by striking part D; and 
(2) by amending parts A, B, and C to read as 
follows: 
‘‘PART A—GENERAL AUTHORITY 
‘‘SEC. 1201. GENERAL AUTHORITY AND DUTIES OF THE SEC-
RETARY. 
‘‘(a) IN GENERAL.—The Secretary may, with respect 
to trauma care—
‘‘(1) conduct and support research, training, 
evaluations, and demonstration projects; 
‘‘(2) foster the development of appropriate, 
modern systems of trauma care through the sharing 
of information among agencies and individuals in-
volved in the study and provision of such care; 
‘‘(3) provide to State and local agencies tech-
nical assistance, including the development of a 
model plan for the designation of trauma centers 
and for triage, transfer, and transportation policies; 
and 
‘‘(4) sponsor workshops and conferences. 
‘‘(b) CONSULTATION.—In carrying out this section, 
the Secretary shall consult with appropriate State and 
professional organizations.
‘‘SEC. 1202. DATA COLLECTION. 
‘‘(a) IN GENERAL.—The Director of the Centers for 
Disease Control and Prevention, directly or through 
grants or contracts, may establish and provide for the op-
eration of information systems and provide for the collec-
tion, coordination, and exchange of information related to 
trauma system development or operation. 
‘‘(b) CONSULTATION.—In carrying out this section, 
the Director of the Centers for Disease Control and Pre-
vention shall consult with the Administrator of the Health 
Resources and Services Administration and such other 
persons outside of the Centers as the Director deems ap-
propriate. 
‘‘SEC. 1203. GRANTS TO STATES TO IMPROVE TRAUMA CARE 
SYSTEMS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
Administration, shall make a grant, in the amount re-
ferred to in section 1208(c), to each State that submits 
an application and agrees to comply with the requirements 
of this section, for the purpose of improving access to and 
enhancing the development of trauma care systems. 
‘‘(b) REQUIREMENTS.—The Secretary may make a 
grant to a State under this section only if the State has 
developed a plan that—
‘‘(1) specifies a public or private entity that will 
designate trauma care regions and trauma centers in 
the State; 
‘‘(2) contains, for the designation of level I, 
level II, and level III trauma centers, standards and 
requirements developed by—
‘‘(A) taking into account standards devel-
oped by professional organizations and any 
guidelines or model plans developed by the Sec-
retary with the goal of ensuring the greatest 
possible access to trauma care and providing 
the highest quality of trauma care; 
‘‘(B) consulting with medical, surgical, and 
nursing speciality groups, hospital associations, 
emergency medical services State and local di-
rectors, concerned advocates, and other inter-
ested parties; and 
‘‘(C) conducting public hearings on the 
proposed standards after providing adequate 
notice to the public concerning such hearings; 
‘‘(3) 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 
Act) for medically directed triage and transportation
of trauma patients (including patients injured in 
rural areas) prior to care in designated trauma cen-
ters; 
‘‘(4) contains standards and requirements for 
medically directed triage and transport of severely 
injured children to designated trauma centers with 
specified capabilities and expertise in the care of the 
pediatric trauma patient; 
‘‘(5) utilizes a program with procedures for the 
evaluation of designated trauma centers (including 
trauma centers described in paragraph (4)) and 
trauma care systems; 
‘‘(6) provides for the establishment and collec-
tion of data from each designated trauma center in 
the State of a central data reporting and analysis 
system (to be transmitted to the Secretary in ac-
cordance with section 1202)—
‘‘(A) to identify the number of severely in-
jured trauma patients and the number of 
deaths from trauma within trauma care sys-
tems in the State; 
‘‘(B) to identify the cause of the injury 
and any factors contributing to the injury; 
‘‘(C) to identify the nature and severity of 
the injury;
‘‘(D) to monitor trauma patient care (in-
cluding prehospital care) in each designated 
trauma center within regional trauma care sys-
tems in the State (including relevant emer-
gency-department discharges and rehabilitation 
information) for the purpose of evaluating the 
diagnosis, treatment, and treatment outcome of 
such trauma patients; 
‘‘(E) to identify the total amount of un-
compensated trauma care expenditures for each 
fiscal year by each designated trauma center in 
the State; and 
‘‘(F) to identify patients transferred within 
a regional trauma system, including reasons for 
such transfer and the outcomes of such pa-
tients; 
‘‘(7) 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; 
‘‘(8) 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-