[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 727 Enrolled Bill (ENR)]

        H.R.727

                       One Hundred Tenth Congress

                                 of the

                        United States of America




          Begun and held at the City of Washington on Thursday,
            the fourth day of January, two thousand and seven


                                 An Act


 
  To amend the Public Health Service Act to add requirements regarding 
                  trauma care, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
    This Act may be cited as the ``Trauma Care Systems Planning and 
Development Act of 2007''.
SEC. 2. ESTABLISHMENT.
    Section 1201 of the Public Health Service Act (42 U.S.C. 300d) is 
amended to read as follows:
``SEC. 1201. ESTABLISHMENT.
    ``(a) In General.--The Secretary shall, with respect to trauma 
care--
        ``(1) conduct and support research, training, evaluations, and 
    demonstration projects;
        ``(2) foster the development of appropriate, modern systems of 
    such care through the sharing of information among agencies and 
    individuals involved in the study and provision of such care;
        ``(3) collect, compile, and disseminate information on the 
    achievements of, and problems experienced by, State and local 
    agencies and private entities in providing trauma care and 
    emergency medical services and, in so doing, give special 
    consideration to the unique needs of rural areas;
        ``(4) provide to State and local agencies technical assistance 
    to enhance each State's capability to develop, implement, and 
    sustain the trauma care component of each State's plan for the 
    provision of emergency medical services;
        ``(5) sponsor workshops and conferences; and
        ``(6) promote the collection and categorization of trauma data 
    in a consistent and standardized manner.
    ``(b) Grants, Cooperative Agreements, and Contracts.--The Secretary 
may make grants, and enter into cooperative agreements and contracts, 
for the purpose of carrying out subsection (a).''.
SEC. 3. CLEARINGHOUSE ON TRAUMA CARE AND EMERGENCY MEDICAL SERVICES.
    The Public Health Service Act (42 U.S.C. 201 et seq.) is amended--
        (1) by striking section 1202; and
        (2) by redesignating section 1203 as section 1202.
SEC. 4. ESTABLISHMENT OF PROGRAMS FOR IMPROVING TRAUMA CARE IN RURAL 
AREAS.
    Section 1202 of the Public Health Service Act, as redesignated by 
section 3(2), is amended to read as follows:
``SEC. 1202. ESTABLISHMENT OF PROGRAMS FOR IMPROVING TRAUMA CARE IN 
RURAL AREAS.
    ``(a) In General.--The Secretary may make grants to public and 
nonprofit private entities for the purpose of carrying out research and 
demonstration projects with respect to improving the availability and 
quality of emergency medical services in rural areas--
        ``(1) by developing innovative uses of communications 
    technologies and the use of new communications technology;
        ``(2) by developing model curricula, such as advanced trauma 
    life support, for training emergency medical services personnel, 
    including first responders, emergency medical technicians, 
    emergency nurses and physicians, and paramedics--
            ``(A) in the assessment, stabilization, treatment, 
        preparation for transport, and resuscitation of seriously 
        injured patients, with special attention to problems that arise 
        during long transports and to methods of minimizing delays in 
        transport to the appropriate facility; and
            ``(B) in the management of the operation of the emergency 
        medical services system;
        ``(3) by making training for original certification, and 
    continuing education, in the provision and management of emergency 
    medical services more accessible to emergency medical personnel in 
    rural areas through telecommunications, home studies, providing 
    teachers and training at locations accessible to such personnel, 
    and other methods;
        ``(4) by developing innovative protocols and agreements to 
    increase access to prehospital care and equipment necessary for the 
    transportation of seriously injured patients to the appropriate 
    facilities;
        ``(5) by evaluating the effectiveness of protocols with respect 
    to emergency medical services and systems; and
        ``(6) by increasing communication and coordination with State 
    trauma systems.
    ``(b) Special Consideration for Certain Rural Areas.--In making 
grants under subsection (a), the Secretary shall give special 
consideration to any applicant for the grant that will provide services 
under the grant in any rural area identified by a State under section 
1214(d)(1).
    ``(c) Requirement of Application.--The Secretary may not make a 
grant under subsection (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 Secretary determines to be necessary to carry out 
this section.''.
SEC. 5. COMPETITIVE GRANTS.
    Part A of title XII of the Public Health Service Act, as amended by 
section 3, is amended by adding at the end the following:
``SEC. 1203. COMPETITIVE 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 subdivisions, or consortia of States or political 
subdivisions for the purpose of improving 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 the applicant agrees to use the grant--
        ``(1) to integrate and broaden the reach of a trauma care 
    system, such as by developing innovative protocols to increase 
    access to prehospital care;
        ``(2) to strengthen, develop, and improve an existing trauma 
    care system;
        ``(3) to expand communications between the trauma care system 
    and emergency medical services through improved equipment or a 
    telemedicine system;
        ``(4) to improve data collection and retention; or
        ``(5) to increase education, training, and technical assistance 
    opportunities, such as training and continuing education in the 
    management of emergency medical services accessible to emergency 
    medical personnel in rural areas through telehealth, home studies, 
    and other methods.
    ``(c) Preference.--In selecting among States, political 
subdivisions, and consortia of States or political subdivisions for 
purposes of making grants under this section, the Secretary shall give 
preference to applicants that--
        ``(1) have developed a process, using national standards, for 
    designating trauma centers;
        ``(2) recognize protocols for the delivery of seriously injured 
    patients to trauma centers;
        ``(3) implement a process for evaluating the performance of the 
    trauma system; and
        ``(4) agree to participate in information systems described in 
    section 1202 by collecting, providing, and sharing information.
    ``(d) Priority.--In making grants under this section, the Secretary 
shall give priority to applicants that will use the grants to focus on 
improving access to trauma care systems.
    ``(e) Special Consideration.--In awarding grants under this 
section, the Secretary shall give special consideration to projects 
that demonstrate strong State or local support, including availability 
of non-Federal contributions.''.
SEC. 6. REQUIREMENT OF MATCHING FUNDS FOR FISCAL YEARS SUBSEQUENT TO 
FIRST FISCAL YEAR OF PAYMENTS.
    Section 1212 of the Public Health Service Act (42 U.S.C. 300d-12) 
is amended to read as follows:
``SEC. 1212. 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 1211(a) 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 1211(b); 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 1211(a) 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 1211(a)--
        ``(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.''.
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 implemented 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;
        ``(3) subject to subsection (b), contains national standards 
    and requirements of the American College of Surgeons or another 
    appropriate entity for the designation of level I and level II 
    trauma centers, and in the case of rural areas level III trauma 
    centers (including trauma centers with specified capabilities and 
    expertise in the care of pediatric trauma patients), by such 
    entity, including standards and requirements for--
            ``(A) the number and types of trauma patients 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 services for 
        trauma patients;
        ``(4) contains standards and requirements for the 
    implementation of regional trauma care systems, including 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;
        ``(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 directed triage and transport of severely injured 
    children to designated trauma centers with specified capabilities 
    and expertise in the care of pediatric trauma patients;
        ``(6) utilizes a program with procedures for the evaluation of 
    designated trauma centers (including trauma centers described in 
    paragraph (5)) and trauma care systems;
        ``(7) provides for the establishment and collection of data in 
    accordance with data collection requirements developed in 
    consultation with surgical, medical, and nursing specialty groups, 
    State and local emergency medical services directors, and other 
    trained professionals in trauma care, from each designated trauma 
    center in the State of a central data reporting and analysis 
    system--
            ``(A) to identify the number of severely injured trauma 
        patients and the number of deaths from trauma within trauma 
        care systems in the State;
            ``(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 (including prehospital 
        care) in each designated trauma center within regional trauma 
        care systems in the State (including relevant emergency-
        department discharges and rehabilitation information) for the 
        purpose of evaluating the diagnosis, treatment, and treatment 
        outcome of such trauma patients;
            ``(E) to identify the total amount of uncompensated trauma 
        care expenditures for each fiscal 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 paramedics and 
    emergency medical technicians to assess the severity of the 
    injuries incurred by trauma patients;
        ``(9) provides for appropriate transportation and transfer 
    policies to ensure the delivery of patients to designated trauma 
    centers and other facilities within and outside of the jurisdiction 
    of such system, including policies to ensure that only individuals 
    appropriately 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 concerning injury 
    prevention and obtaining access to trauma care;
        ``(11) coordinates planning for trauma systems with State 
    disaster emergency planning and bioterrorism hospital preparedness 
    planning; and
        ``(12) with respect to the requirements established in this 
    subsection, provides for coordination and cooperation 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 unless the State involved agrees 
    that, in carrying out paragraphs (3) through (5) of subsection (a), 
    the State will adopt standards for the designation of trauma 
    centers, and for triage, transfer, and transportation policies, and 
    that the State will, in adopting 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 directors, 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 subsection (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 Secretary 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 not taken into account 
        national standards, including those of the American College of 
        Surgeons, the American College of Emergency Physicians, and the 
        American Academy of Pediatrics, in adopting standards under 
        this subsection; or
            ``(B) in the case of payments for fiscal year 2008 and 
        subsequent fiscal years, the State has not, in adopting such 
        standards, taken into account the model plan developed under 
        subsection (c).
    ``(c) Model Trauma Care Plan.--
        ``(1) In general.--Not later than 1 year after the date of the 
    enactment of the Trauma Care Systems Planning and Development Act 
    of 2007, the Secretary shall update the model plan for the 
    designation of trauma centers and for triage, transfer, and 
    transportation policies that may be adopted for guidance by the 
    State. Such plan shall--
            ``(A) take into account national standards, including those 
        of the American College of Surgeons, American College of 
        Emergency Physicians, and the American Academy of Pediatrics;
            ``(B) take into account existing State plans;
            ``(C) be developed in consultation with medical, surgical, 
        and nursing speciality groups, hospital associations, emergency 
        medical services State directors and associations, and other 
        interested parties; and
            ``(D) include standards for the designation of rural health 
        facilities and hospitals best able to receive, stabilize, and 
        transfer trauma patients to the nearest appropriate designated 
        trauma center, and for triage, transfer, and transportation 
        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 respect 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:
``SEC. 1214. 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 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 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 
1211(a) 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 1213(a)(7).
    ``(d) Availability of Emergency Medical Services in Rural Areas.--
The Secretary may not make payments to a State under section 1211(a) 
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.''.
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, implementing, and 
    monitoring the modifications required by section 1211(b) 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 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 activities of the States 
carried out pursuant to section 1211. 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.''.
  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 subsections (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 appropriated 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 
of carrying out part A and 50 percent shall be made available for the 
purpose of carrying out part B.
    ``(c) Allocation of Part A Funds.--Of the amounts appropriated 
under subsection (a) for a fiscal year to carry out part A--
        ``(1) 10 percent of such amounts for such year shall be 
    allocated for administrative purposes; and
        ``(2) 10 percent of such amounts for such year shall be 
    allocated for the purpose of carrying out section 1202.''.
  SEC. 13. RESIDENCY TRAINING PROGRAMS IN EMERGENCY MEDICINE.
    Section 1251 of the Public Health Service Act (42 U.S.C. 300d-51) 
is amended to read as follows:
``SEC. 1251. 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.''.
  SEC. 14. STATE GRANTS FOR CERTAIN PROJECTS.
    Section 1252 of the Public Health Service Act (42 U.S.C. 300d-52) 
is amended in the section heading by striking ``demonstration''.

                               Speaker of the House of Representatives.

                            Vice President of the United States and    
                                               President of the Senate.