[Congressional Record Volume 153, Number 30 (Friday, February 16, 2007)]
[Senate]
[Pages S2168-S2171]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REED (for himself, Mr. Roberts, Mr. Kennedy, Mr. Burr, 
        Mrs. Murray, Mr. Hatch, Mr. Brown, Mrs. Clinton, Mr. Isakson, 
        Mr. Bingaman, Ms. Collins, and Mr. Biden):
  S. 657. A bill to amend the Public Health Service Act to add 
requirements regarding trauma care, and for other purposes; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. REED. Mr. President, I am pleased to join my colleague, Senator 
Roberts, along with Senators Kennedy, Burr, Murray, Clinton, Brown, 
Bingaman, Collins, Isakson, and Biden in introducing the Trauma Care 
Systems Planning and Development Act.

[[Page S2169]]

  Our Nation's emergency medical system is a system on the brink. We 
need to support and strengthen this essential component of our health 
care system. The Trauma Care Systems Planning and Development Act is an 
important building block to achieving an improved national network of 
care across the country.
  Unintentional injury is the leading cause of death among people 
between the ages of 1 to 44 and in 2002, injuries were responsible for 
161,000 deaths. In 2004, about 29.6 million people were treated for an 
injury in U.S. hospital emergency departments, of which nearly 2 
million injuries were severe enough to require hospitalization. Yet, 
between 20,000 and 25,000 trauma deaths are preventable each year.
  A trauma system is an organized, coordinated effort in a specific 
area that delivers the full range of care to all injured patients. It 
provides resources, supporting equipment, and personnel along a 
continuum of care including pre-hospital, hospital, and rehabilitation 
services. Trauma systems have been proven to reduce mortality rates and 
provide efficient, cost-effective, and timely care. Since 1990, the 
Federal Government, through Title XII of the Public Health Service Act, 
has helped States and territories develop and implement regional and 
statewide trauma care systems.
  The legislation I am introducing today along with my colleagues will 
reauthorize and reaffirm the Federal Government's commitment to trauma 
care systems. It will also authorize additional resources for systems 
planning and development, as well as improved data collection and 
analysis and the inclusion of an Institute of Medicine study on the 
state of trauma care and trauma research.
  Trauma care is not only critical to providing timely access to 
lifesaving interventions for persons suffering from serious 
unintentional injuries, it is central to our national security and 
disaster preparedness. The tragic events of September 11, 2001 and 
Hurricanes Rita and Katrina serve as stark reminders of the potential 
intentional and natural disasters that threaten our Nation. Trauma care 
systems are an important element of our security and response efforts.
  I look forward to working with my colleagues toward expeditious 
passage of this legislation. I ask unanimous consent that the text of 
the Trauma Care Systems Planning and Development Act be printed in the 
Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 657

       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.''.

[[Page S2170]]

     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 patient), 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 the 
     pediatric trauma patient;
       ``(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 concerning that 
     outline resources for optimal care of the injured patient;
       ``(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

[[Page S2171]]

     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 subparagraph (A) 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)(1) 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, 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 
     making grants under part A. If the amount so appropriated is 
     greater than $1,000,000, 50 percent of such appropriation 
     shall be made available for grants under part A and 50 
     percent shall be made available for grants under part B.
       ``(c) Allocation of Funds by Secretary.--
       ``(1) General authority.--For the purpose of carrying out 
     part A, the Secretary shall make available 10 percent of the 
     amounts appropriated for a fiscal year under subsection (a).
       ``(2) Rural grants.--For the purpose of carrying out 
     section 1202, the Secretary shall make available 10 percent 
     of the amounts appropriated for a fiscal year under 
     subsection (a).''.

     SEC. 13. INSTITUTE OF MEDICINE STUDY.

       Part E of title XII of the Public Health Service Act (20 
     U.S.C. 300d-51 et seq.) is amended by adding at the end the 
     following:

     ``SEC. 1254. INSTITUTE OF MEDICINE STUDY.

       ``(a) In General.--The Secretary shall enter into a 
     contract with the Institute of Medicine of the National 
     Academy of Sciences, or another appropriate entity, to 
     conduct a study on the state of trauma care and trauma 
     research.
       ``(b) Content.--The study conducted under subsection (a) 
     shall--
       ``(1) examine and evaluate the state of trauma care and 
     trauma systems research (including the role of Federal 
     entities in trauma research) on the date of enactment of this 
     section, and identify trauma research priorities;
       ``(2) examine and evaluate the clinical effectiveness of 
     trauma care and the impact of trauma care on patient 
     outcomes, with special attention to high-risk groups, such as 
     children, the elderly, and individuals in rural areas;
       ``(3) examine and evaluate trauma systems development and 
     identify obstacles that prevent or hinder the effectiveness 
     of trauma systems and trauma systems development;
       ``(4) examine and evaluate alternative strategies for the 
     organization, financing, and delivery of trauma care within 
     an overall systems approach; and
       ``(5) examine and evaluate the role of trauma systems and 
     trauma centers in preparedness for mass casualties.
       ``(c) Report.--Not later than 2 years after the date of 
     enactment of this section, the Secretary shall submit to the 
     appropriate committees of Congress a report containing the 
     results of the study conducted under this section.
       ``(d) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section $750,000 for 
     fiscal year 2008.''.

     SEC. 14. 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 in 
     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. 15. 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'' .
                                 ______