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H.R. 3999 (rfs) To designate the United States Postal Service building located at 5209 Greene Street, Philadelphia, Pennsylvania, as the ``David P. Richardson, Jr., Post Office Building''. ...


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108th CONGRESS
  2d Session
                                H. R. 3999

To amend the Public Health Service Act with respect to trauma care, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 18, 2004

Mr. Greenwood (for himself, Mr. Green of Texas, Mr. Bilirakis, and Mr. 
Brown of Ohio) introduced the following bill; which was referred to the 
                    Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
To amend the Public Health Service Act with respect to 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 Research and Access to Urgent 
Medical Attention Act of 2004'' or the ``TRAUMA Act of 2004''.

SEC. 2. AMENDMENT TO 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) by striking part D; and
            (2) by amending parts A, B, and C to read as follows:

                      ``PART A--GENERAL AUTHORITY

``SEC. 1201. GENERAL AUTHORITY AND DUTIES OF THE SECRETARY.

    ``(a) In General.--The Secretary may, with respect to trauma care--
            ``(1) conduct and support research, training, evaluations, 
        and demonstration projects;
            ``(2) foster the development of appropriate, modern systems 
        of trauma care through the sharing of information among 
        agencies and individuals involved in the study and provision of 
        such care;
            ``(3) provide to State and local agencies technical 
        assistance, including the development of a model plan for the 
        designation of trauma centers and for triage, transfer, and 
        transportation policies; and
            ``(4) sponsor workshops and conferences.
    ``(b) Consultation.--In carrying out this section, the Secretary 
shall consult with appropriate State and professional organizations.

``SEC. 1202. DATA COLLECTION.

    ``(a) In General.--The Director of the Centers for Disease Control 
and Prevention, directly or through grants or contracts, may establish 
and provide for the operation of information systems and provide for 
the collection, coordination, and exchange of information related to 
trauma system development or operation.
    ``(b) Consultation.--In carrying out this section, the Director of 
the Centers for Disease Control and Prevention shall consult with the 
Administrator of the Health Resources and Services Administration and 
such other persons outside of the Centers as the Director deems 
appropriate.

``SEC. 1203. GRANTS TO STATES TO IMPROVE TRAUMA CARE SYSTEMS.

    ``(a) In General.--The Secretary, acting through the Administrator 
of the Health Resources and Services Administration, shall make a 
grant, in the amount referred to in section 1208(c), to each State that 
submits an application and agrees to comply with the requirements of 
this section, for the purpose of improving access to and enhancing the 
development of trauma care systems.
    ``(b) Requirements.--The Secretary may make a grant to a State 
under this section only if the State has developed a plan that--
            ``(1) specifies a public or private entity that will 
        designate trauma care regions and trauma centers in the State;
            ``(2) contains, for the designation of level I, level II, 
        and level III trauma centers, standards and requirements 
        developed by--
                    ``(A) taking into account standards developed by 
                professional organizations and any guidelines or model 
                plans developed by the Secretary with the goal of 
                ensuring the greatest possible access to trauma care 
                and providing the highest quality of trauma care;
                    ``(B) consulting with medical, surgical, and 
                nursing speciality groups, hospital associations, 
                emergency medical services State and local directors, 
                concerned advocates, and other interested parties; and
                    ``(C) conducting public hearings on the proposed 
                standards after providing adequate notice to the public 
                concerning such hearings;
            ``(3) 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;
            ``(4) contains standards and requirements 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;
            ``(5) utilizes a program with procedures for the evaluation 
        of designated trauma centers (including trauma centers 
        described in paragraph (4)) and trauma care systems;
            ``(6) provides for the establishment and collection of data 
        from each designated trauma center in the State of a central 
        data reporting and analysis system (to be transmitted to the 
        Secretary in accordance with section 1202)--
                    ``(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;
            ``(7) provides for the use of procedures by paramedics and 
        emergency medical technicians to assess the severity of the 
        injuries incurred by trauma patients;
            ``(8) 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;
            ``(9) conducts public education activities concerning 
        injury prevention and obtaining access to trauma care;
            ``(10) 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; and
            ``(11) coordinates planning for trauma systems with State 
        disaster emergency planning and bioterrorism 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 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.
            ``(2) 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 paragraph (1), 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.
            ``(3) Information received by state reporting and analysis 
        system.--The Secretary may not make payments to a State under 
        this section 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 unless--
                    ``(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 
                        system; 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 subparagraph (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 available 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 Urgent 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 compliance with paragraph (1)--
                    ``(A) a State may make the non-Federal 
                contributions in cash or in kind, fairly evaluated, 
                including plant, equipment, or staff services; 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 subsidized 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 expended--
                    ``(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 improvements to real 
                property); or
                    ``(C) to satisfy any requirement for the 
                expenditure of non-Federal funds as a condition for the 
                receipt of Federal funds.
            ``(2) Waiver.--The Secretary may waive a restriction 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 section, a State 
shall submit to the Secretary an application in such form, in such 
manner, and containing such information 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 subdivisions, consortia of States or political 
subdivisions, and accredited schools of medicine 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--
            ``(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 innovative 
                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 treatment for trauma or 
                critical care;
                    ``(D) to expand communications between the trauma 
                care system and emergency medical services through 
                improved equipment or a telemedicine system;
                    ``(E) to improve data collection and retention; or
                    ``(F) 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; or
            ``(2) in the case of an application by an accredited 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, political 
subdivisions, and consortia of States or political subdivisions (but 
not accredited schools of medicine) for purposes of making grants under 
this section, the Secretary shall give preference to applicants that--

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