‘‘(E) to improve data collection and reten-
tion; or 
‘‘(F) to increase education, training, and 
technical assistance opportunities, such as 
training and continuing education in the man-
agement of emergency medical services acces-
sible to emergency medical personnel in rural 
areas through telehealth, home studies, and 
other methods; or 
‘‘(2) in the case of an application by an accred-
ited school of medicine, the applicant agrees to use 
the grant to expand and improve emergency medical 
services for children who need treatment for trauma 
or critical care. 
‘‘(c) PREFERENCE.—In selecting among States, po-
litical subdivisions, and consortia of States or political 
subdivisions (but not accredited schools of medicine) for 
purposes of making grants under this section, the Sec-
retary shall give preference to applicants that—
‘‘(A) have developed a process and adopted 
standards for designating trauma centers; 
‘‘(B) recognize protocols for the delivery of seri-
ously injured patients to trauma centers; 
‘‘(C) implement a process for evaluating the 
performance of the trauma system; and
‘‘(D) agree to participate in information sys-
tems described in section 1202 by collecting, pro-
viding, 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. 
‘‘(e) DEFINITIONS.—For purposes of this section, the 
terms ‘accredited’ and ‘school of medicine’ have the mean-
ings given to those terms in section 799B. 
‘‘SEC. 1205. REPORTS. 
‘‘(a) REPORT BY SECRETARY.—Not later than the 
end of fiscal year 2006, the Secretary shall submit a re-
port to the appropriate committees of the Congress on the 
activities of the States carried out with assistance under 
this part. Such report—
‘‘(1) shall include an assessment of the extent 
to which Federal and State efforts to develop sys-
tems of trauma care and to designate trauma cen-
ters have reduced the incidence of mortality, and the 
incidence of permanent disability, resulting from 
trauma; 
‘‘(2) shall include an assessment of the grants 
awarded under section 1204; and
‘‘(3) may include any recommendations of the 
Secretary to improve trauma care. 
‘‘(b) EVALUATIONS BY COMPTROLLER GENERAL.—
The Comptroller General of the United States—
‘‘(1) shall evaluate the expenditures by grantees 
of payments under section 1203 and section 1204 to 
assure that such expenditures are consistent with 
the provisions of such sections; and 
‘‘(2) not later than December 1, 2006, shall 
submit to the Committee on Energy and Commerce 
of the House of Representatives and the Committee 
on Health, Education, Labor, and Pensions of the 
Senate a report concerning such evaluation. 
‘‘SEC. 1206. RULE OF CONSTRUCTION. 
‘‘Nothing in this title authorizes the Secretary to es-
tablish Federal standards for the treatment of patients or 
the licensure of health care professionals. 
‘‘SEC. 1207. DEFINITIONS. 
‘‘For purposes of this part: 
‘‘(1) DESIGNATED TRAUMA CENTER.—The term 
‘designated trauma center’ means a trauma center 
designated in accordance with the provisions of the 
State plan described in section 1203(b). 
‘‘(2) STATE
PLAN
REGARDING
EMERGENCY 
MEDICAL SERVICES.—The term ‘State plan’, with re-
spect to the provision of emergency medical services, 
means a plan for a comprehensive, organized system 
to provide for the access, response, triage, field sta-
bilization, transport, hospital stabilization, definitive 
care, and rehabilitation of patients of all ages with 
respect to emergency medical services. 
‘‘(3) STATE.—The term ‘State’ means each of 
the several States, the District of Columbia, the 
Commonwealth of Puerto Rico, the Virgin Islands, 
Guam, American Samoa, and the Commonwealth of 
the Northern Mariana Islands. 
‘‘(4) TRAUMA.—The term ‘trauma’ means an 
injury resulting from exposure to a mechanical force. 
‘‘(5) TRAUMA
CARE
COMPONENT
OF
STATE 
PLAN.—The term ‘trauma care component’, with re-
spect to components of the State plan for the provi-
sion of emergency medical services, means a plan for 
a comprehensive health care system, within rural 
and urban areas of the State, for the prompt rec-
ognition, prehospital care, emergency medical care, 
acute surgical and medical care, rehabilitation, and 
outcome evaluation of seriously injured patients. 
‘‘SEC. 1208. AUTHORIZATION OF APPROPRIATIONS. 
‘‘(a) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out sections 1201, 1202, 1203, and
1204, there is authorized to be appropriated $31,000,000 
for each of fiscal years 2005 through 2009. 
‘‘(b) ALLOCATION OF FUNDS.—Of the amount appro-
priated for each of fiscal years 2005 through 2009 under 
subsection (a)—
‘‘(1) if such amount is $12,000,000 or less, the 
Secretary shall make available 100 percent of such 
amount for the purpose of carrying out sections 
1201, 1202, and 1204; or 
‘‘(2) 
if 
such 
amount 
is 
greater 
than 
$12,000,000, the Secretary shall make available 50 
percent of such amount for the purpose of carrying 
out sections 1201, 1202, and 1204 and 50 percent 
of such amount for the purpose of carrying out sec-
tion 1203. 
‘‘(c) DETERMINATION
OF
AMOUNT
OF
ALLOT-
MENT.—
‘‘(1) IN
GENERAL.—For purposes of section 
1203(a), the amount referred to in this subsection 
for a State for a fiscal year is the sum of—
‘‘(A) an amount determined under para-
graph (2); 
‘‘(B) an amount determined under para-
graph (3); and
‘‘(C) any amount allotted to the State 
under paragraph (4). 
‘‘(2) AMOUNT RELATING TO POPULATION.—The 
amount referred to in subparagraph (A) of para-
graph (1) for a State for a fiscal year is the product 
of—
‘‘(A) an amount equal to 80 percent of the 
amounts appropriated under this section to 
carry out section 1203 for the fiscal year; and 
‘‘(B) a percentage equal to the quotient 
of—
‘‘(i) an amount equal to the popu-
lation of the State; divided by 
‘‘(ii) an amount equal to the popu-
lation of all States. 
‘‘(3) AMOUNT
RELATING
TO
SQUARE
MILE-
AGE.—The amount referred to in subparagraph (B) 
of paragraph (1) for a State for a fiscal year is the 
product of—
‘‘(A) an amount equal to 20 percent of the 
amounts appropriated under this section to 
carry out section 1203 for the fiscal year; and 
‘‘(B) a percentage equal to the quotient 
of—
‘‘(i) an amount equal to the lesser of 
266,807 or the amount of the square mile-
age of the State; divided by 
‘‘(ii) an amount equal to the sum of 
the respective amounts determined for the 
States under clause (i). 
‘‘(4) DISPOSITION OF CERTAIN FUNDS APPRO-
PRIATED FOR ALLOTMENTS.—
‘‘(A) IN GENERAL.—Amounts described in 
subparagraph (B) shall, in accordance with sub-
paragraph (C), be allotted by the Secretary to 
States receiving payments under section 1203 
for the fiscal year (other than any State re-
ferred to in subparagraph (B)(iii)). 
‘‘(B) TYPE OF AMOUNTS.—The amounts 
referred to in subparagraph (A) are any 
amounts that are made available pursuant to 
this section to carry out section 1203, but are 
not paid to a State as a result of—
‘‘(i) the failure of the State to submit 
an application under section 1203; 
‘‘(ii) the failure, in the determination 
of the Secretary, of the State to prepare 
within a reasonable period of time such ap-
plication in compliance with such section; 
or 
‘‘(iii) the State informing the Sec-
retary that the State does not intend to ex-
pend the full amount of the allotment 
made for the State. 
‘‘(C) AMOUNT.—The amount of an allot-
ment under subparagraph (A) for a State for a 
fiscal year shall be an amount equal to the 
product of—
‘‘(i) an amount equal to the amounts 
described in subparagraph (B) for the fis-
cal year involved; and 
‘‘(ii) the percentage equal to the 
quotient of an amount equal to the popu-
lation of the State, divided by an amount 
equal to the population of all States (other 
than any State referred to in subparagraph 
(B)(iii)). 
‘‘(d) FAILURE TO COMPLY WITH AGREEMENTS.—
‘‘(1) REPAYMENT OF PAYMENTS.—
‘‘(A) REQUIREMENT.—The Secretary may, 
in accordance with paragraph (2), require a 
State to repay any payments received by the 
State under section 1203 that the Secretary de-
termines were not expended by the State in ac-
cordance with the agreements required to be 
made by the State as a condition of the receipt 
of payments under such section. 
‘‘(B) OFFSET OF AMOUNTS.—If a State 
fails to make a repayment required in subpara-
graph (A), the Secretary may offset the amount 
of the repayment against any amount due to be 
paid to the State under section 1203. 
‘‘(2) OPPORTUNITY FOR A HEARING.—Before 
requiring repayment of payments under paragraph 
(1)(A), the Secretary shall provide to the State an 
opportunity for a hearing.’’. 
SEC. 3. INTERAGENCY PROGRAM FOR TRAUMA RESEARCH. 
Title IV of the Public Health Service Act (42 U.S.C. 
281 et seq.) is amended by inserting after section 494A 
the following: 
‘‘INTERAGENCY PROGRAM FOR TRAUMA RESEARCH 
‘‘SEC. 494B. (a) IN GENERAL.—The Secretary, act-
ing through the Director of NIH, shall establish a com-
prehensive program of basic and clinical research on trau-
ma (in this section referred to as the ‘Program’), including 
the prevention, diagnosis, treatment, and rehabilitation of 
trauma-related injuries. 
‘‘(b) PLAN FOR PROGRAM.—The Director of NIH 
shall establish and implement a plan for carrying out the
activities of the Program, taking into consideration the 
recommendations contained in the report of the NIH 
Trauma Research Taskforce. The plan shall be periodi-
cally reviewed, and revised as appropriate. 
‘‘(c) PARTICIPATING AGENCIES; COORDINATION AND 
COLLABORATION.—The Director of NIH—
‘‘(1) shall provide for the conduct of activities 
under the Program by the directors of the agencies 
of the National Institutes of Health involved in re-
search with respect to trauma; 
‘‘(2) shall ensure that the activities of the Pro-
gram are coordinated among such agencies; and 
‘‘(3) shall, as appropriate, provide for collabora-
tion among such agencies in carrying out such ac-
tivities. 
‘‘(d) CERTAIN ACTIVITIES OF PROGRAM.—The Pro-
gram shall include—
‘‘(1) studies with respect to all phases of trau-
ma care, including prehospital, resuscitation, sur-
gical intervention, critical care, infection control, 
wound healing, nutritional care and support, and 
medical rehabilitation care; 
‘‘(2) basic and clinical research regarding the 
response of the body to trauma and the acute treat-
ment and medical rehabilitation of individuals who 
are the victims of trauma; 
‘‘(3) basic and clinical research regarding trau-
ma care for pediatric and geriatric patients; and 
‘‘(4) the authority to make awards of grants or 
contracts to public or nonprofit private entities for 
the conduct of basic and applied research regarding 
traumatic brain injury, which research may in-
clude—
‘‘(A) the development of new methods and 
modalities for the more effective diagnosis, 
measurement of degree of brain injury, post-in-
jury monitoring, and prognostic assessment of 
head injury for acute, subacute, and later 
phases of care; 
‘‘(B) the development, modification, and 
evaluation of therapies that retard, prevent, or 
reverse brain damage after traumatic brain in-
jury, that arrest further deterioration following 
injury, and that provide the restitution of func-
tion for individuals with long-term injuries; 
‘‘(C) the development of research on a con-
tinuum of care from acute care through reha-
bilitation, designed, to the extent practicable, to
integrate rehabilitation and long-term outcome 
evaluation with acute care research; 
‘‘(D) the development of programs that in-
crease the participation of academic centers of 
excellence in traumatic brain injury treatment 
and rehabilitation research and training; and 
‘‘(E) carrying out subparagraphs (A) 
through (D) with respect to cognitive disorders 
and neurobehavioral consequences arising from 
traumatic brain injury, including the develop-
ment, modification, and evaluation of therapies 
and programs of rehabilitation toward reaching 
or restoring normal capabilities in areas such as 
reading, comprehension, speech, reasoning, and 
deduction. 
‘‘(e) MECHANISMS OF SUPPORT.—In carrying out the 
Program, the Director of NIH, acting through the direc-
tors of the agencies referred to in subsection (c)(1), may 
make grants to public and nonprofit entities, including 
designated trauma centers. 
‘‘(f) RESOURCES.—The Director of NIH shall assure 
the availability of appropriate resources to carry out the 
Program, including the plan established under subsection 
(b) and the activities described in subsection (d). 
‘‘(g) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘designated trauma center’ has 
the meaning given such term in section 1207. 
‘‘(2) The term ‘trauma’ means any serious in-
jury that could result in loss of life or in significant 
disability and that would meet prehospital triage cri-
teria for transport to a designated trauma center. 
‘‘(3) The term ‘traumatic brain injury’ means 
an acquired injury to the brain. Such term does not 
include brain dysfunction caused by congenital or 
degenerative disorders, nor birth trauma, but may 
include brain injuries caused by anoxia due to trau-
ma. The Secretary may revise the definition of such 
term as the Secretary determines necessary, after 
consultation with States and other appropriate pub-
lic or nonprofit private entities. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2005 through 2009.’’. 
SEC. 4. CONFORMING AMENDMENTS. 
(a) 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) in part E, by resdesignating sections 1251 
through 1253 as sections 1221 through 1223, re-
spectively; 
(2) by redesignating part E as part B; 
(3) by striking part F; 
(4) in part G, by redesignating sections 1271 
through 1274 as sections 1231 through 1234, re-
spectively; and 
(5) by redesignating part G as part C. 
(b) TITLE XIX OF PUBLIC HEALTH SERVICE ACT.—
Title XIX of the Public Health Service Act (42 U.S.C. 
300w et seq.) is amended—
(1) in subparagraph (C) of section 1904(a)(1), 
by striking ‘‘section 1213(a)’’ and inserting ‘‘section 
1203’’; and 
(2) by striking section 1910.
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