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; 
‘‘(9) conducts public education activities con-
cerning injury prevention and obtaining access to 
trauma care; 
‘‘(10) 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; and 
‘‘(11) coordinates planning for trauma systems 
with State disaster emergency planning and bioter-
rorism hospital preparedness planning. 
‘‘(c) TRAUMA PLAN.—
‘‘(1) IN GENERAL.—For each fiscal year, the 
Secretary may not make payments to a State under 
this section unless, subject to paragraph (2), the 
State submits to the Secretary the trauma care com-
ponent of the State plan for the provision of emer-
gency medical services, including any changes to the 
trauma care component and any plans to address 
deficiencies in the trauma care component.
‘‘(2) INTERIM PLAN OR DESCRIPTION OF EF-
FORTS.—For each fiscal year, if a State has not 
completed the trauma care component of the State 
plan described in paragraph (1), the State may pro-
vide, in lieu of such completed component, an in-
terim component or a description of efforts made to-
ward the completion of the component. 
‘‘(3) INFORMATION
RECEIVED
BY
STATE
RE-
PORTING
AND
ANALYSIS
SYSTEM.—The Secretary 
may not make payments to a State under this sec-
tion 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 
subsection (b)(6). 
‘‘(4) AVAILABILITY
OF
EMERGENCY
MEDICAL 
SERVICES IN RURAL AREAS.—The Secretary may not 
make payments to a State under this section un-
less—
‘‘(A) the State identifies any rural area in 
the State for which—
‘‘(i) there is no system of access to 
emergency medical services through the 
telephone number 911; 
‘‘(ii) there is no basic life-support sys-
tem; or
‘‘(iii) there is no advanced life-support 
system; and 
‘‘(B) the State submits to the Secretary a 
list of rural areas identified pursuant to sub-
paragraph (A) or, if there are no such areas, a 
statement that there are no such areas. 
‘‘(d) REQUIREMENT OF MATCHING FUNDS.—
‘‘(1) NON-FEDERAL CONTRIBUTIONS.—
‘‘(A) IN
GENERAL.—The Secretary may 
not make a grant to a State under this section 
unless the State agrees, with respect to the 
costs of carrying out the grant, to make avail-
able non-Federal contributions (in cash or in 
kind under paragraph (2)(A)) toward such 
costs in an amount equal to—
‘‘(i) for the first and second fiscal 
year of payments under this section to the 
State after the date of the enactment of 
the Trauma Research and Access to Ur-
gent Medical Attention Act of 2004, not 
less than $1 for each $1 of Federal funds 
provided in such payments for such fiscal 
year; and 
‘‘(ii) for any subsequent fiscal year of 
such payments to the State, not less than
$2 for each $1 of Federal funds provided 
in such payments for such fiscal year. 
‘‘(2) DETERMINATION
OF
AMOUNT
OF
NON-
FEDERAL CONTRIBUTION.—With respect to compli-
ance with paragraph (1)—
‘‘(A) a State may make the non-Federal 
contributions in cash or in kind, fairly evalu-
ated, including plant, equipment, or staff serv-
ices; and 
‘‘(B) 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 sub-
sidized to any significant extent by the Federal 
Government. 
‘‘(e) RESTRICTIONS.—
‘‘(1) IN
GENERAL.—The Secretary may not 
make payments to a State under this section unless 
the State agrees that the payments will not be ex-
pended—
‘‘(A) to make cash payments to intended 
recipients of services provided pursuant to this 
section;
‘‘(B) to purchase or improve real property 
(other than minor remodeling of existing im-
provements to real property); or 
‘‘(C) to satisfy any requirement for the ex-
penditure of non-Federal funds as a condition 
for the receipt of Federal funds. 
‘‘(2) WAIVER.—The Secretary may waive a re-
striction under paragraph (1) only if the Secretary 
determines that the activities outlined by the State 
plan submitted under subsection (c)(1) by the State 
involved cannot otherwise be carried out. 
‘‘(f) APPLICATION.—To seek a grant under this sec-
tion, a State shall submit to the Secretary an application 
in such form, in such manner, and containing such infor-
mation and assurances as the Secretary may require. 
‘‘(g) REPORTS BY STATES.—A grant may be made 
to a State under this section only if the State agrees that, 
promptly after the end of the fiscal year for which the 
grant is made, the State will submit to the Secretary a 
report that describes the activities of the State under the 
grant. 
‘‘SEC. 1204. 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, consortia of States or political subdivisions, and 
accredited schools of medicine for the purpose of improv-
ing 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—
‘‘(1) in the case of an application by a State, 
political subdivision, or consortium, the applicant 
agrees to use the grant—
‘‘(A) to integrate and broaden the reach of 
a trauma care system, such as by developing in-
novative 
protocols 
to 
increase 
access 
to 
prehospital care and equipment necessary for 
the transportation of seriously injured patients 
to the appropriate facilities; 
‘‘(B) to strengthen, develop, and improve 
an existing trauma care system; 
‘‘(C) to expand and improve emergency 
medical services for children who need treat-
ment for trauma or critical care; 
‘‘(D) to expand communications between 
the trauma care system and emergency medical 
services through improved equipment or a tele-
medicine system;