II 
110TH CONGRESS 
1ST SESSION 
H. R. 727 
IN THE SENATE OF THE UNITED STATES 
MARCH 28, 2007 
Received 
AN ACT 
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, 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
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: 
‘‘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; 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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 
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-
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
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 
medical services personnel, including first respond-
ers, emergency medical technicians, emergency 
nurses and physicians, and paramedics— 
‘‘(A) in the assessment, stabilization, treat-
ment, preparation for transport, and resuscita-
tion of seriously injured patients, with special 
attention to problems that arise during long 
transports and to methods of minimizing delays 
in transport to the appropriate facility; and 
‘‘(B) in the management of the operation 
of the emergency medical services system; 
‘‘(3) by making training for original certifi-
cation, and continuing education, in the provision 
and management of emergency medical services 
more accessible to emergency medical personnel in 
rural areas through telecommunications, home stud-
ies, providing teachers and training at locations ac-
cessible to such personnel, and other methods; 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(4) by developing innovative protocols and 
agreements to increase access to prehospital care 
and equipment necessary for the transportation of 
seriously injured patients to the appropriate facili-
ties; 
‘‘(5) by evaluating the effectiveness of protocols 
with respect to emergency medical services and sys-
tems; and 
‘‘(6) by increasing communication and coordi-
nation with State trauma systems. 
‘‘(b) SPECIAL CONSIDERATION FOR CERTAIN RURAL 
AREAS.—In making grants under subsection (a), the Sec-
retary shall give special consideration to any applicant for 
the grant that will provide services under the grant in any 
rural area identified by a State under section 1214(d)(1). 
‘‘(c) REQUIREMENT
OF APPLICATION.—The Sec-
retary may not make a grant under subsection (a) unless 
an application for the grant is submitted to the Secretary 
and the application is in such form, is made in such man-
ner, and contains such agreements, assurances, and infor-
mation as the Secretary determines to be necessary to 
carry out this section.’’. 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
SEC. 5. COMPETITIVE GRANTS. 
Part A of title XII of the Public Health Service Act, 
as amended by section 3, is amended by adding at the 
end the following: 
‘‘SEC. 1203. COMPETITIVE GRANTS FOR THE IMPROVEMENT 
OF TRAUMA CARE. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Administrator of the Health Resources and Services 
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 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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. 
‘‘(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. 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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.’’. 
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 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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. 
‘‘(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 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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; 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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 
patients), by such entity, including standards and 
requirements 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 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
Act) for medically directed triage and transportation 
of trauma patients (including patients injured in 
rural areas) prior to care in designated trauma cen-
ters; 
‘‘(5) subject to subsection (b), contains national 
standards and requirements, including those of the 
American Academy of Pediatrics and the American 
College of Emergency Physicians, for medically di-
rected triage and transport of severely injured chil-
dren to designated trauma centers with specified ca-
pabilities and expertise in the care of pediatric trau-
ma patients; 
‘‘(6) utilizes a program with procedures for the 
evaluation of designated trauma centers (including 
trauma centers described in paragraph (5)) and 
trauma care systems; 
‘‘(7) provides for the establishment and collec-
tion of data in accordance with data collection re-
quirements developed in consultation with surgical, 
medical, and nursing specialty groups, State and 
local emergency medical services directors, and other 
trained professionals in trauma care, from each des-
ignated trauma center in the State of a central data 
reporting and analysis system— 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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; 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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. 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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 
that outline resources for optimal care of in-
jured patients; 
‘‘(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 2008, take 
into account the model plan described in sub-
section (c). 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
‘‘(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-
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS
HR 727 RDS
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 
VerDate Aug 31 2005 
03:51 Mar 31, 2007
Jkt 059200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H727.RDS
H727
bajohnson on PROD1PC77 with BILLS