H. R. 727—4
‘‘(A) for the second and third fiscal years of such pay-
ments 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. 
‘‘(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 Secretary may not 
require a State to make non-Federal contributions as a condi-
tion of receiving payments under section 1211(a) for the first 
fiscal year of such payments to the State. 
‘‘(b) DETERMINATION OF AMOUNT OF NON-FEDERAL CONTRIBU-
TION.—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 contributions 
required in such subsection in cash or in kind, fairly evaluated, 
including plant, equipment, or services; and 
‘‘(2) the Secretary may not, in making a determination 
of the amount of non-Federal contributions, include amounts 
provided by the Federal Government or services assisted or 
subsidized to any significant extent by the Federal Govern-
ment.’’. 
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 PUR-
POSE OF ALLOTMENTS. 
‘‘(a) TRAUMA CARE MODIFICATIONS TO STATE PLAN FOR EMER-
GENCY MEDICAL SERVICES.—With respect to the trauma care compo-
nent of a State plan for the provision of emergency medical services, 
the modifications referred to in section 1211(b) are such modifica-
tions to the State plan as may be necessary for the State involved 
to ensure that the plan provides for access to the highest possible 
quality of trauma care, and that the plan—
‘‘(1) specifies that the modifications required pursuant to 
paragraphs (2) through (11) will be implemented by the prin-
cipal State agency with respect to emergency medical services 
or by the designee of such agency; 
‘‘(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 centers (including trauma centers with specified 
capabilities and expertise in the care of pediatric trauma 
patients), by such entity, including standards and requirements 
for—
H. R. 727—5
‘‘(A) the number and types of trauma patients 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 cen-
ters; and 
‘‘(C) the availability of rehabilitation services 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 Act) for medically directed 
triage and transportation of trauma patients (including patients 
injured in rural areas) prior to care in designated trauma 
centers; 
‘‘(5) subject to subsection (b), contains national standards 
and requirements, including those of the American Academy 
of Pediatrics and the American College of Emergency Physi-
cians, for medically directed triage and transport of severely 
injured children to designated trauma centers with specified 
capabilities and expertise in the care of pediatric trauma 
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 collection of data 
in accordance with data collection requirements 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—
‘‘(A) to identify the number of severely injured trauma 
patients and the number of deaths from trauma within 
trauma care systems 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 (including 
prehospital care) in each designated trauma center within 
regional trauma care systems in the State (including rel-
evant emergency-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 uncompensated 
trauma care expenditures for each fiscal year by each des-
ignated 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 patients; 
‘‘(8) provides for the use of procedures by paramedics and 
emergency medical technicians to assess the severity of the 
injuries incurred by trauma patients; 
‘‘(9) provides for appropriate transportation and transfer 
policies to ensure the delivery of patients to designated trauma 
centers and other facilities within and outside of the jurisdiction
H. R. 727—6
of such system, including policies to ensure that only individ-
uals appropriately identified as trauma patients are transferred 
to designated trauma centers, and to provide periodic reviews 
of the transfers and the auditing of such transfers that are 
determined to be appropriate; 
‘‘(10) conducts public education activities concerning injury 
prevention and obtaining access to trauma care; 
‘‘(11) coordinates planning for trauma systems with State 
disaster 
emergency 
planning 
and 
bioterrorism 
hospital 
preparedness planning; and 
‘‘(12) with respect to the requirements established in this 
subsection, provides for coordination and cooperation between 
the State and any other State with which the State shares 
any standard metropolitan statistical area. 
‘‘(b) CERTAIN STANDARDS WITH RESPECT TO TRAUMA CARE CEN-
TERS 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 carrying out paragraphs (3) through (5) of sub-
section (a), the State will adopt standards for the designation 
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 injured patients; 
‘‘(B) consult with medical, surgical, and nursing spe-
ciality groups, hospital associations, emergency medical 
services State and local directors, concerned advocates, and 
other interested 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 subsection (c). 
‘‘(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 Secretary 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 Amer-
ican College of Surgeons, the American College of Emer-
gency Physicians, and the American Academy 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 devel-
oped 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 Systems Planning and 
Development Act of 2007, the Secretary shall update the model 
plan for the designation of trauma centers and for triage, 
transfer, and transportation policies that may be adopted for 
guidance by the State. Such plan shall—
H. R. 727—7
‘‘(A) take into account national standards, including 
those of the American College of Surgeons, American Col-
lege of Emergency Physicians, and the American Academy 
of Pediatrics; 
‘‘(B) take into account existing State plans; 
‘‘(C) be developed in consultation with medical, sur-
gical, and nursing speciality groups, hospital associations, 
emergency medical services State directors and associa-
tions, 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 patients 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 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 respect to compliance with 
subsection (a) as a condition of the receipt of a grant under section 
1211(a), such subsection may not be construed to specify the number 
of trauma care centers designated pursuant to such subsection.’’. 
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 INFORMATION. 
‘‘(a) IN GENERAL.—For each fiscal year, the Secretary may 
not make payments to a State under section 1211(a) unless, subject 
to subsection (b), the State submits 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 compo-
nent and any plans to address deficiencies in the trauma care 
component. 
‘‘(b) INTERIM PLAN
OR DESCRIPTION
OF EFFORTS.—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 description 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 SERVICES 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 emergency medical 
services through the telephone number 911; 
‘‘(B) there is no basic life-support system; or 
‘‘(C) there is no advanced life-support system; and