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42 U.S.C. § 300d–11 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–11. Establishment of program
(a) Requirement of allotments for States
The Secretary shall for each fiscal year make an allotment for each State in an amount determined in accordance with section 300d–18 of this title. The Secretary shall make payments, as grants, each fiscal year to each State from the allotment for the State if the Secretary approves for the fiscal year involved an application submitted by the State pursuant to section 300d–17 of this title.
(b) Purpose
Except as provided in section 300d–33 1 of this title, the Secretary may not make payments under this part for a fiscal year unless the State involved agrees that, with respect to the trauma care component of the State plan for the provision of emergency medical services, the payments will be expended only for the purpose of developing, implementing, and monitoring the modifications to such component described in section 300d–13 of this title.
(July 1, 1944, ch. 373, title XII, § 1211, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2919.)
heading: Editorial Notes
heading: References in Text
text: Section 300d–33 of this title, referred to in subsec. (b), was repealed by Pub. L. 103–183, title VI, § 601(e), Dec. 14, 1993, 107 Stat. 2239.
42 U.S.C. § 300d–12 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–12. Requirement of matching funds for fiscal years subsequent to first fiscal year of payments
(a) Non-Federal contributions
(1) In general
The Secretary may not make payments under section 300d–11(a) of this title unless the State involved agrees, with respect to the costs described in paragraph (2), to make available non-Federal contributions (in cash or in kind under subsection (b)(1)) toward such costs in an amount that—
(A) for the second and third fiscal years of such payments 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 300d–11(b) of this title; 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 condition of receiving payments under section 300d–11(a) of this title for the first fiscal year of such payments to the State.
(b) Determination of amount of non-Federal contribution
With respect to compliance with subsection (a) as a condition of receiving payments under section 300d–11(a) of this title—
(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 Government.
(July 1, 1944, ch. 373, title XII, § 1212, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2919; amended Pub. L. 103–183, title VI, § 601(f)(2), Dec. 14, 1993, 107 Stat. 2239; Pub. L. 110–23, § 6, May 3, 2007, 121 Stat. 92.)
heading: Editorial Notes
heading: Amendments
text: 2007—Pub. L. 110–23 amended section generally. Prior to amendment, section related to requirement of matching funds for fiscal years subsequent to first fiscal year of payments.
1993—Subsec. (a)(2)(A). Pub. L. 103–183 substituted “section 300d–11(b)” for “section 300d–11(c)”.
42 U.S.C. § 300d–14 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–14. 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 300d–11(a) of this title 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 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 component.
(c) Information received by State reporting and analysis system
The Secretary may not make payments to a State under section 300d–11(a) of this title 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 300d–13(a)(7) of this title.
(d) Availability of emergency medical services in rural areas
The Secretary may not make payments to a State under section 300d–11(a) of this title 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
(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.
(July 1, 1944, ch. 373, title XII, § 1214, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2922; amended Pub. L. 110–23, § 8, May 3, 2007, 121 Stat. 96.)
heading: Editorial Notes
heading: Amendments
text: 2007—Pub. L. 110–23 amended section generally. Prior to amendment, section related to requirement of submission to Secretary of trauma plan and certain information for fiscal year 1991 and subsequent fiscal years.
42 U.S.C. § 300d–15 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–15. Restrictions on use of payments
(a) In general
The Secretary may not, except as provided in subsection (b), make payments under section 300d–11(a) of this title for a fiscal year unless the State involved agrees that the payments will not be expended—
(1) for any purpose other than developing, implementing, and monitoring the modifications required by section 300d–11(b) of this title to be made to the State plan for the provision of emergency medical services;
(2) to make cash payments to intended recipients 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 expenditure of non-Federal funds as a condition for the receipt 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 300d–14(a) of this title by the State involved cannot otherwise be carried out.
(July 1, 1944, ch. 373, title XII, § 1215, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2923; amended Pub. L. 110–23, § 9, May 3, 2007, 121 Stat. 97.)
heading: Editorial Notes
heading: Amendments
text: 2007—Pub. L. 110–23 amended section generally. Prior to amendment, section related to restrictions on use of payments.
42 U.S.C. § 300d–21 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–21. Technical assistance and provision by Secretary of supplies and services in lieu of grant funds
(a) Technical assistance
The Secretary shall, without charge to a State receiving payments under section 300d–11(a) of this title, provide to the State (or to any public or nonprofit private entity designated by the State) technical assistance with respect to the planning, development, and operation of any program carried out pursuant to section 300d–11(b) of this title. The Secretary may provide such technical assistance directly, through contract, or through grants.
(b) Provision by Secretary of supplies and services in lieu of grant funds
(1) In general
Upon the request of a State receiving payments under section 300d–11(a) of this title, the Secretary may, subject to paragraph (2), provide supplies, equipment, and services for the purpose of aiding the State in carrying out section 300d–11(b) of this title and, for such purpose, may detail to the State any officer or employee of the Department of Health and Human Services.
(2) Reduction in payments
With respect to a request described in paragraph (1), the Secretary shall reduce the amount of payments to the State under section 300d–11(a) of this title by an amount equal to the costs of detailing personnel and the fair market value of any supplies, equipment, or services provided by the Secretary. The Secretary shall, for the payment of expenses incurred in complying with such request, expend the amounts withheld.
(July 1, 1944, ch. 373, title XII, § 1221, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2926.)
heading: Editorial Notes
heading: Prior Provisions
text: A prior section 300d–21, act July 1, 1944, ch. 373, title XII, § 1221, as added Oct. 21, 1976, Pub. L. 94–573, § 14(3), 90 Stat. 2718; amended Dec. 12, 1979, Pub. L. 96–142, title I, § 107(a)–(c), 93 Stat. 1069, related to programs for burn, trauma, and poison injuries, prior to repeal by Pub. L. 97–35, title IX, § 902(d)(1), (h), Aug. 13, 1981, 95 Stat. 560, 561, effective Oct. 1, 1981.
42 U.S.C. § 300d–22 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–22. Report by Secretary
Not later than October 1, 2008, the Secretary shall report to the appropriate committees of Congress on the activities of the States carried out pursuant to section 300d–11 of this title. Such report shall include an assessment of the extent to which Federal and State efforts to develop systems of trauma care and to designate trauma centers have reduced the incidence of mortality, and the incidence of permanent disability, resulting from trauma. Such report may include any recommendations of the Secretary for appropriate administrative and legislative initiatives with respect to trauma care.
(July 1, 1944, ch. 373, title XII, § 1222, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2926; amended Pub. L. 103–183, title VI, § 601(d), Dec. 14, 1993, 107 Stat. 2238; Pub. L. 110–23, § 11, May 3, 2007, 121 Stat. 97.)
heading: Editorial Notes
heading: Amendments
text: 2007—Pub. L. 110–23 amended section generally. Prior to amendment, section required Secretary to submit report no later than Oct. 1, 1995.
1993—Pub. L. 103–183 substituted “1995” for “1992” and inserted after first sentence “Such report shall include an assessment of the extent to which Federal and State efforts to develop systems of trauma care and to designate trauma centers have reduced the incidence of mortality, and the incidence of permanent disability, resulting from trauma.”
42 U.S.C. § 300d–31 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–31. Definitions
For purposes of this part and parts A and B:
(1) Designated trauma center
The term “designated trauma center” means a trauma center designated in accordance with the modifications to the State plan described in section 300d–13 of this title.
(2) State plan regarding emergency medical services
The term “State plan”, with respect to the provision of emergency medical services, means a plan for a comprehensive, organized system to provide for the access, response, triage, field stabilization, 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) a mechanical force; or
(B) another extrinsic agent, including an extrinsic agent that is thermal, electrical, chemical, or radioactive.
(5) Trauma care component of State plan
The term “trauma care component”, with respect to components of the State plan for the provision of emergency medical services, means a plan for a comprehensive health care system, within rural and urban areas of the State, for the prompt recognition, prehospital care, emergency medical care, acute surgical and medical care, rehabilitation, and outcome evaluation of seriously injured patients.
(July 1, 1944, ch. 373, title XII, § 1231, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2926; amended Pub. L. 102–321, title VI, § 602(2), July 10, 1992, 106 Stat. 436; Pub. L. 103–183, title VI, § 601(f)(4), Dec. 14, 1993, 107 Stat. 2239; Pub. L. 113–152, § 2(a), Aug. 8, 2014, 128 Stat. 1825.)
heading: Editorial Notes
heading: Amendments
text: 2014—Par. (4). Pub. L. 113–152 amended par. (4) generally. Prior to amendment, text read as follows: “The term ‘trauma’ means an injury resulting from exposure to a mechanical force.”
1993—Par. (3). Pub. L. 103–183 substituted “Puerto Rico,” for “Puerto Rico;”.
1992—Pub. L. 102–321 substituted “this part and parts A and B” for “this subchapter” in introductory provisions.
heading: Statutory Notes and Related Subsidiaries
heading: Effective Date of 1992 Amendment
text: Amendment by Pub. L. 102–321 effective July 10, 1992, with provision for programs providing financial assistance, see section 801(b), (d) of Pub. L. 102–321, set out as a note under section 236 of this title.
42 U.S.C. § 300d–42 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–42. Preferences in making grants
(a) Substantial uncompensated care awards
(1) In general
The Secretary shall establish an award basis for each eligible trauma center for grants under section 300d–41(a)(1) of this title according to the percentage described in paragraph (2), subject to the requirements of section 300d–41(b)(3) of this title.
(2) Percentages
The applicable percentages are as follows:
(A) With respect to a category A trauma center, 100 percent of the uncompensated care costs.
(B) With respect to a category B trauma center, not more than 75 percent of the uncompensated care costs.
(C) With respect to a category C trauma center, not more than 50 percent of the uncompensated care costs.
(b) Core mission awards
(1) 1 In general
In awarding grants under section 300d–41(a)(2) of this title, the Secretary shall—
(A) reserve 25 percent of the amount allocated for core mission awards for Level III and Level IV trauma centers; and
(B) reserve 25 percent of the amount allocated for core mission awards for large urban Level I and II trauma centers—
(i) that have at least 1 graduate medical education fellowship in trauma or trauma related specialties for which demand is exceeding supply;
(ii) for which—
(I) annual uncompensated care costs exceed $10,000,000; or
(II) at least 20 percent of emergency department visits are charity or self-pay or Medicaid patients; and
(iii) that are not eligible for substantial uncompensated care awards under section 300d–41(a)(1) of this title.
(c) Emergency awards
In awarding grants under section 300d–41(a)(3) of this title, the Secretary shall—
(1) give preference to any application submitted by a trauma center that provides trauma care in a geographic area in which the availability of trauma care has significantly decreased or will significantly decrease if the center is forced to close or downgrade service or growth in demand for trauma services exceeds capacity; and
(2) reallocate any emergency awards funds not obligated due to insufficient, or a lack of qualified, applications to the significant uncompensated care award program.
(July 1, 1944, ch. 373, title XII, § 1242, as added Pub. L. 102–321, title VI, § 601, July 10, 1992, 106 Stat. 434; amended Pub. L. 111–148, title III, § 3505(a)(2), Mar. 23, 2010, 124 Stat. 523.)
heading: Editorial Notes
heading: Amendments
text: 2010—Pub. L. 111–148 added subsecs. (a) to (c) and struck out former subsecs. (a) and (b) which related to preferences in making grants and preferences for certain applications.
heading: Statutory Notes and Related Subsidiaries
heading: Effective Date
text: Section effective July 10, 1992, with programs making awards providing financial assistance in fiscal year 1993 and subsequent years effective for awards made on or after Oct. 1, 1992, see section 801(b), (d)(1) of Pub. L. 102–321, set out as an Effective Date of 1992 Amendment note under section 236 of this title.
42 U.S.C. § 300d–43 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–43. Certain agreements
(a) Maintenance of financial support
The Secretary may require a trauma center receiving a grant under section 300d–41(a) of this title to maintain access to trauma services at comparable levels to the prior year during the grant period.
(b) Trauma care registry
The Secretary may require the trauma center receiving a grant under section 300d–41(a) of this title to provide data to a national and centralized registry of trauma cases, in accordance with guidelines developed by the American College of Surgeons, and as the Secretary may otherwise require.
(July 1, 1944, ch. 373, title XII, § 1243, as added Pub. L. 102–321, title VI, § 601, July 10, 1992, 106 Stat. 434; amended Pub. L. 111–148, title III, § 3505(a)(3), Mar. 23, 2010, 124 Stat. 524.)
heading: Editorial Notes
heading: Amendments
text: 2010—Pub. L. 111–148 added subsecs. (a) and (b) and struck out former subsecs. (a) to (c) which related to commitment regarding continued participation in trauma care system, maintenance of financial support, and trauma care registry.
heading: Statutory Notes and Related Subsidiaries
heading: Effective Date
text: Section effective July 10, 1992, with programs making awards providing financial assistance in fiscal year 1993 and subsequent years effective for awards made on or after Oct. 1, 1992, see section 801(b), (d)(1) of Pub. L. 102–321, set out as an Effective Date of 1992 Amendment note under section 236 of this title.
42 U.S.C. § 300d–45 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–45. Authorization of appropriations
For the purpose of carrying out this part, there are authorized to be appropriated $100,000,000 for fiscal year 2009, and such sums as may be necessary for each of fiscal years 2010 through 2015. Such authorization of appropriations is in addition to any other authorization of appropriations or amounts that are available for such purpose.
(July 1, 1944, ch. 373, title XII, § 1245, as added Pub. L. 102–321, title VI, § 601, July 10, 1992, 106 Stat. 435; amended Pub. L. 111–148, title III, § 3505(a)(5), Mar. 23, 2010, 124 Stat. 525.)
heading: Editorial Notes
heading: Amendments
text: 2010—Pub. L. 111–148 amended section generally. Prior to amendment, text read as follows: “For the purpose of carrying out this part, there are authorized to be appropriated $100,000,000 for fiscal year 1993, and such sums as may be necessary for fiscal year 1994. Such authorization of appropriations is in addition to any other authorization of appropriations or amounts that are available for such purpose.”
heading: Statutory Notes and Related Subsidiaries
heading: Effective Date
text: Section effective July 10, 1992, with programs making awards providing financial assistance in fiscal year 1993 and subsequent years effective for awards made on or after Oct. 1, 1992, see section 801(b), (d)(1) of Pub. L. 102–321, set out as an Effective Date of 1992 Amendment note under section 236 of this title.
42 U.S.C. § 300d–51 (THE PUBLIC HEALTH AND WELFARE)
§ 300d–51. Residency training programs in emergency medicine
(a) In general
The Secretary may make grants to public and nonprofit private entities for the purpose of planning and developing approved residency training programs in emergency medicine.
(b) Identification and referral of domestic violence
The Secretary may make a grant under subsection (a) only if the applicant involved agrees that the training programs under subsection (a) will provide education and training in identifying and referring cases of domestic violence.
(c) Authorization of appropriations
For the purpose of carrying out this section, there is authorized to be appropriated $400,000 for each of the fiscal years 2008 though 2012.
(July 1, 1944, ch. 373, title XII, § 1251, as added Pub. L. 102–408, title III, § 304, Oct. 13, 1992, 106 Stat. 2084; amended Pub. L. 110–23, § 13, May 3, 2007, 121 Stat. 98.)
heading: Editorial Notes
heading: Amendments
text: 2007—Pub. L. 110–23 amended section generally. Prior to amendment, section related to residency training programs in emergency medicine and authorized appropriations for fiscal years 1993 through 1995.
(THE PUBLIC HEALTH AND WELFARE)
§§ 300e–2, 300e–3. Repealed. Pub. L. 99–660, title VIII, § 803(a), Nov. 14, 1986, 100 Stat. 3799
text: Section 300e–2, act July 1, 1944, ch. 373, title XIII, § 1303, as added Dec. 29, 1973, Pub. L. 93–222, § 2, 87 Stat. 920; amended Oct. 8, 1976, Pub. L. 94–460, title I, §§ 107(a), 109(d)(1), 117(b)(3), 90 Stat. 1948, 1950, 1955; Aug. 13, 1981, Pub. L. 97–35, title IX, § 947(a), 95 Stat. 577, provided for grants and contracts for feasibility surveys.
text: Section 300e–3, act July 1, 1944, ch. 373, title XIII, § 1304, as added Dec. 29, 1973, Pub. L. 93–222, § 2, 87 Stat. 921; amended Apr. 21, 1976, Pub. L. 94–273, § 40, 90 Stat. 381; Oct. 8, 1976, Pub. L. 94–460, title I, §§ 107(b), 108(a), (b), (d)(1), 109(d)(2), (3), (e), 113(a), 117(b)(4), 90 Stat. 1948–1950, 1953, 1955; Nov. 1, 1978, Pub. L. 95–559, §§ 2(a), 3(a)–(c), 6, 92 Stat. 2131, 2134; July 10, 1979, Pub. L. 96–32, § 2(a), 93 Stat. 82; Aug. 13, 1981, Pub. L. 97–35, title IX, §§ 941(c), 947(b), 95 Stat. 573, 577, provided for grants, contracts, and loan guarantees for planning and for initial development costs.
heading: Statutory Notes and Related Subsidiaries
heading: Effective Date of Repeal
text: Repeal not applicable to any grant made or contract entered into under this subchapter before Oct. 1, 1985, see section 803(c) of Pub. L. 99–660, set out as an Effective Date of 1986 Amendment note under section 300e–5 of this title.
Repeal effective Oct. 1, 1985, see section 815(a) of Pub. L. 99–660, set out as an Effective and Termination Dates of 1986 Amendment note under section 300e–1 of this title.
42 U.S.C. § 300e–4a (THE PUBLIC HEALTH AND WELFARE)
§ 300e–4a. Repealed. Pub. L. 99–660, title VIII, § 805(a), Nov. 14, 1986, 100 Stat. 3800
text: Section, act July 1, 1944, ch. 373, title XIII, § 1305A, as added Nov. 1, 1978, Pub. L. 95–559, § 5(a), 92 Stat. 2133; amended July 10, 1979, Pub. L. 96–32, § 2(e), 93 Stat. 82; Aug. 13, 1981, Pub. L. 97–35, title IX, § 944, 95 Stat. 576, related to loans and loan guarantees for acquisition and construction of ambulatory health care facilities.
heading: Statutory Notes and Related Subsidiaries
heading: Effective Date of Repeal
text: Repeal not applicable to any loan or loan guarantee made under this section before Oct. 1, 1985, see section 805(c) of Pub. L. 99–660, set out as an Effective Date of 1986 Amendment note under section 300e–5 of this title.
Repeal effective Oct. 1, 1985, see section 815(a) of Pub. L. 99–660, set out as an Effective and Termination Dates of 1986 Amendment note under section 300e–1 of this title.