‘‘(D) the Secretary determines warrants fi-
nancial assistance if the trauma center is in a 
geographic location substantially affected by a 
natural disaster or other catastrophic event 
such as a terrorist attack; and 
‘‘(2) shall reallocate any funds available for 
grants under section 1241(a)(3), but not awarded 
due to insufficient or a lack of qualified applications, 
to grants under section 1241(a)(1). 
‘‘(d) 
INFORMATION
TECHNOLOGY.—In 
making 
grants under section 1241(a)(4), the Secretary shall— 
‘‘(1) make grants only to applicants who are eli-
gible to receive a grant under section 1241(a)(1); 
‘‘(2) give preference to qualified applicants 
who— 
‘‘(A) demonstrate the greatest financial 
need; and 
‘‘(B) are level I or level II centers; and 
‘‘(3) not make an award less than $1,000,000 
for a fiscal year unless such award would cover the 
full cost of an applicant’s proposed project. 
‘‘(e) DESIGNATIONS OF LEVELS OF TRAUMA CEN-
TERS IN CERTAIN STATES.—In the case of a State which 
has not designated 4 levels of trauma centers in the man-
VerDate Aug 31 2005 
05:25 May 02, 2008
Jkt 069200
PO 00000
Frm 00013
Fmt 6652
Sfmt 6201
E:\BILLS\H5942.IH
H5942
erowe on PRODPC61 with BILLS
ner described in this section, any reference in this section 
to— 
‘‘(1) a level I or level II trauma center is 
deemed to be a reference to a trauma center within 
the highest two levels of trauma centers designated 
under State guidelines; and 
‘‘(2) a level III or IV trauma center is deemed 
to be a reference to a trauma center not within such 
highest two levels.’’. 
(c) CERTAIN AGREEMENTS.—Section 1243 of the 
Public Health Service Act (42 U.S.C. 300d–43) is amend-
ed to read as follows: 
‘‘SEC. 1243. CERTAIN AGREEMENTS. 
‘‘(a) COMMITMENT REGARDING CONTINUED PAR-
TICIPATION IN TRAUMA CARE SYSTEM.—The Secretary 
may not make a grant under section 1241(a)(1) (relating 
to uncompensated care costs) unless the trauma center in-
volved agrees that— 
‘‘(1) the center will continue participation in 
the system described in section 1241(b)(1), expect 
as provided in section 1241(b)(2), throughout the 
grant period; and 
‘‘(2) if the center violates the agreement made 
pursuant to paragraph (1), the center will be liable 
VerDate Aug 31 2005 
05:25 May 02, 2008
Jkt 069200
PO 00000
Frm 00014
Fmt 6652
Sfmt 6201
E:\BILLS\H5942.IH
H5942
erowe on PRODPC61 with BILLS
to the United States for an amount equal to the sum 
of— 
‘‘(A) the amount of assistance provided to 
the center under section 1241(a) for the fiscal 
year involved; and 
‘‘(B) an amount representing interest on 
the amount specified in subparagraph (A). 
‘‘(b) PERIOD OF CERTAIN GRANTS.—The period of 
a grant under section 1241(a)(3) (relating to emergency 
relief) shall be 3 fiscal years, except that the Secretary 
may waive the application of this subsection to a trauma 
center and authorize the center to receive payments under 
such section for 1 additional fiscal year. 
‘‘(c) MAINTENANCE OF FINANCIAL SUPPORT.—With 
respect to activities for which a grant under section 1241 
is authorized to be expended, the Secretary may not make 
such a grant unless the trauma center involved agrees 
that, during the grant period, the center will maintain ac-
cess to trauma services at levels not less than the prior 
year, taking into account reasonable volume fluctuation 
not caused by— 
‘‘(1) intentional trauma boundary reduction or 
downgrading of level; or 
‘‘(2) diversion of services in excess of 5 percent. 
VerDate Aug 31 2005 
05:25 May 02, 2008
Jkt 069200
PO 00000
Frm 00015
Fmt 6652
Sfmt 6201
E:\BILLS\H5942.IH
H5942
erowe on PRODPC61 with BILLS
‘‘(d) SUPPLEMENT, NOT SUPPLANT.—The Secretary 
may not make a grant under section 1241 unless the trau-
ma center involved agrees that funds received through the 
grant will be used to supplement and not supplant funding 
otherwise available for the activities and costs described 
in such section. 
‘‘(e) TRAUMA CARE REGISTRY.—The Secretary may 
not make a grant under section 1241(a) unless the trauma 
center involved agrees that— 
‘‘(1) the center will— 
‘‘(A) operate a registry of trauma cases in 
accordance with guidelines developed by the 
American College of Surgeons or similar guide-
lines applicable to the center in the State in-
volved; and 
‘‘(B) begin operation of the registry not 
later than 6 months after the date on which the 
center submits to the Secretary the application 
for the grant; and 
‘‘(2) in carrying out paragraph (1), the center 
will maintain information on the number of trauma 
cases treated by the center and, for each such case, 
the extent to which the center incurs uncompensated 
care costs in providing trauma care.’’. 
VerDate Aug 31 2005 
05:25 May 02, 2008
Jkt 069200
PO 00000
Frm 00016
Fmt 6652
Sfmt 6201
E:\BILLS\H5942.IH
H5942
erowe on PRODPC61 with BILLS
(d) GENERAL PROVISIONS.—Section 1244 of the 
Public Health Service Act (42 U.S.C. 300d–44) is amend-
ed to read as follows: 
‘‘SEC. 1244. GENERAL PROVISIONS. 
‘‘(a) APPLICATION.—The Secretary may not make a 
grant under section 1241(a) unless an application for the 
grant is submitted to the Secretary and the application 
is in such form, is made in such manner, and contains 
such agreements, assurances, and information as the Sec-
retary determines to be necessary to carry out this part. 
‘‘(b) LIMITATION
ON AMOUNT
OF GRANT.—The 
amount of a grant under section 1241 for a fiscal year 
may not exceed $2,000,000. 
‘‘(c) ELIGIBILITY.—Receipt of or eligibility for a 
grant under any 1 of the 4 grant programs described in 
section 1241(a) shall not preclude a trauma center from 
receipt of or eligibility for a grant under any of the other 
programs described in such section. 
‘‘(d) NOTICE OF ELIGIBILITY.—The Secretary shall 
annually determine and notify trauma centers of their eli-
gibility to receive a grant under section 1241. 
‘‘(e) REPORT.—Beginning 2 years after the date of 
enactment of the National Trauma Center Stabilization 
Act of 2008, and every 2 years thereafter, the Secretary 
shall— 
VerDate Aug 31 2005 
05:25 May 02, 2008
Jkt 069200
PO 00000
Frm 00017
Fmt 6652
Sfmt 6201
E:\BILLS\H5942.IH
H5942
erowe on PRODPC61 with BILLS