or services assisted or subsidized to any significant 
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 provision 
of emergency medical services, the modifications referred 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 possible 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; 
‘‘(2) specifies a public or private entity that will 
designate trauma care regions and trauma centers in 
the State; 
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‘‘(3) subject to subsection (b), contains national 
standards and requirements of the American College 
of Surgeons or another appropriate entity for the des-
ignation of level I and level II trauma centers, and 
in the case of rural areas level III trauma centers (in-
cluding trauma centers with specified capabilities 
and expertise in the care of pediatric trauma pa-
tients), 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, in-
cluding 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; 
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‘‘(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 trau-
ma care systems; 
‘‘(7) provides for the establishment and collection 
of data in accordance with data collection require-
ments developed in consultation with surgical, med-
ical, 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 in-
jured trauma patients and the number of deaths 
from trauma within trauma care systems in the 
State; 
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‘‘(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 emergency- 
department discharges and rehabilitation infor-
mation) for the purpose of evaluating the diag-
nosis, treatment, and treatment outcome of such 
trauma patients; 
‘‘(E) to identify the total amount of uncom-
pensated trauma care expenditures for each fis-
cal 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 patients; 
‘‘(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 patients to 
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designated trauma centers and other facilities within 
and outside of the jurisdiction of such system, includ-
ing policies to ensure that only individuals appro-
priately 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 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 established 
in this subsection, provides for coordination and co-
operation 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 CENTERS AND SYSTEMS.— 
‘‘(1) IN GENERAL.—The Secretary may not make 
payments under section 1211(a) for a fiscal year un-
less the State involved agrees that, in carrying out 
paragraphs (3) through (5) of subsection (a), the 
State will adopt standards for the designation of 
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trauma centers, and for triage, transfer, and trans-
portation policies, and that the State will, in adopt-
ing such standards— 
‘‘(A) take into account national standards 
that outline resources for optimal care of injured 
patients; 
‘‘(B) consult with medical, surgical, and 
nursing speciality groups, hospital associations, 
emergency medical services State and local direc-
tors, 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 sub-
section (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 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 
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hospital associations, emergency medical services 
State directors and associations, and other inter-
ested 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 trau-
ma center, and for triage, transfer, and trans-
portation 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 re-
spect 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: 
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‘‘SEC. 1214. REQUIREMENT OF SUBMISSION TO SECRETARY 
OF TRAUMA PLAN AND CERTAIN INFORMA-
TION. 
‘‘(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 component 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 trau-
ma care component of the State plan described in subsection 
(a), the State may provide, in lieu of such completed compo-
nent, an interim component or a description of efforts made 
toward the completion of the component. 
‘‘(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, pro-
vide 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 pay-
ments to a State under section 1211(a) unless— 
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‘‘(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 
‘‘(2) the State submits to the Secretary a list of 
rural areas identified pursuant to paragraph (1) 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 section 
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; 
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‘‘(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 improvements 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 
‘‘(5) to provide financial assistance to any entity 
other than a public or nonprofit private entity. 
‘‘(b) WAIVER.—The Secretary may waive a restriction 
under subsection (a) only if the Secretary determines that 
the activities outlined by the State plan submitted under 
section 1214(a) by the State involved cannot otherwise 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 ac-
tivities of the States carried out pursuant to section 1211. 
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Such report shall include an assessment of the extent to 
which Federal and State efforts to develop systems of trau-
ma care and to designate trauma centers have reduced the 
incidence of mortality, and the incidence of permanent dis-
ability, resulting from trauma. Such report may include 
any recommendations of the Secretary for appropriate ad-
ministrative and legislative initiatives with respect to trau-
ma care.’’. 
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, subject to sub-
sections (b) and (c), there are authorized 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 appro-
priated under subsection (a) for a fiscal year is equal to 
or less than $1,000,000, such appropriation is available 
only for the purpose of carrying out part A. If the amount 
so appropriated is greater than $1,000,000, 50 percent of 
such appropriation shall be made available for the purpose 
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