Part A—General Authority and Duties of Secretary
§300d. 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, analyze, 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 and medically underserved 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; and
(5) promote the collection and categorization of trauma data in a consistent and standardized manner.
(b) Trauma care readiness and coordination
The Secretary, acting through the Assistant Secretary for Preparedness and Response, shall support the efforts of States and consortia of States to coordinate and improve emergency medical services and trauma care during a public health emergency declared by the Secretary pursuant to
(1) developing, issuing, and updating guidance, as appropriate, to support the coordinated medical triage and evacuation to appropriate medical institutions based on patient medical need, taking into account regionalized systems of care;
(2) disseminating, as appropriate, information on evidence-based or evidence-informed trauma care practices, taking into consideration emergency medical services and trauma care systems, including such practices identified through activities conducted under subsection (a) and which may include the identification and dissemination of performance metrics, as applicable and appropriate; and
(3) other activities, as appropriate, to optimize a coordinated and flexible approach to the emergency response and medical surge capacity of hospitals, other health care facilities, critical care, and emergency medical systems.
(c) 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).
(July 1, 1944, ch. 373, title XII, §1201, as added
Editorial Notes
Prior Provisions
A prior section 300d, act July 1, 1944, ch. 373, title XII, §1201, as added Nov. 16, 1973,
A prior section 1201 of act July 1, 1944, ch. 373, title XII, formerly §1205, as added Nov. 16, 1973,
Amendments
2022—Subsec. (a)(3).
Subsec. (a)(5), (6).
Subsecs. (b), (c).
2007—
1996—Subsec. (a).
1993—Subsec. (a).
Subsec. (c).
Statutory Notes and Related Subsidiaries
Effective Date of 1996 Amendment
Amendment by
Congressional Statement of Findings
"(1) the Federal Government and the governments of the States have established a history of cooperation in the development, implementation, and monitoring of integrated, comprehensive systems for the provision of emergency medical services throughout the United States;
"(2) physical trauma is the leading cause of death of Americans between the ages of 1 and 44 and is the third leading cause of death in the general population of the United States;
"(3) physical trauma in the United States results in an aggregate annual cost of $180,000,000,000 in medical expenses, insurance, lost wages, and property damage;
"(4) barriers to the provision of prompt and appropriate emergency medical services exist in many areas of the United States;
"(5) few States and communities have developed and implemented trauma care systems;
"(6) many trauma centers have incurred substantial uncompensated costs in providing trauma care, and such costs have caused many such centers to cease participation in trauma care systems; and
"(7) the number of incidents of physical trauma in the United States is a serious medical and social problem, and the number of deaths resulting from such incidents can be substantially reduced by improving the trauma-care components of the systems for the provision of emergency medical services in the United States."
§300d–1. Repealed. Pub. L. 103–183, title VI, §601(b)(1), Dec. 14, 1993, 107 Stat. 2238 ; Pub. L. 105–392, title IV, §401(a)(1)(A), Nov. 13, 1998, 112 Stat. 3587
Section, act July 1, 1944, ch. 373, title XII, §1202, as added Nov. 16, 1990,
A prior section 300d–1, act July 1, 1944, ch. 373, title XII, §1202, as added Nov. 16, 1973,
§300d–2. Repealed. Pub. L. 110–23, §3(1), May 3, 2007, 121 Stat. 90
Section, act July 1, 1944, ch. 373, title XII, §1202, formerly §1203, as added
A prior section 300d–2, act July 1, 1944, ch. 373, title XII, §1203, as added Nov. 16, 1973,
§300d–3. Grants to improve trauma care in rural areas
(a) In general
The Secretary shall award grants to eligible entities for the purpose of carrying out research and demonstration projects to support the improvement of emergency medical services and trauma care in rural areas through the development of innovative uses of technology, training and education, transportation of seriously injured patients for the purposes of receiving such emergency medical services, access to prehospital care, evaluation of protocols for the purposes of improvement of outcomes and dissemination of any related best practices, activities to facilitate clinical research, as applicable and appropriate, and increasing communication and coordination with applicable State or Tribal trauma systems.
(b) Eligible entities
(1) In general
To be eligible to receive a grant under this section, an entity shall be a public or private entity that provides trauma care in a rural area.
(2) Priority
In awarding grants under this section, the Secretary shall give priority to eligible entities that will provide services under the grant in any rural area identified by a State under
(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.
(d) Reports
An entity that receives a grant under this section shall submit to the Secretary such reports as the Secretary may require to inform administration of the program under this section.
(July 1, 1944, ch. 373, title XII, §1202, formerly §1204, as added
Editorial Notes
Prior Provisions
A prior section 300d–3, act July 1, 1944, ch. 373, title XII, §1204, as added Nov. 16, 1973,
A prior section 1202 of act July 1, 1944, was classified to
Another prior section 1202 of act July 1, 1944, was classified to
Another prior section 1202 of act July 1, 1944, was classified to
Amendments
2022—
Subsecs. (a), (b).
Subsec. (d).
2007—
1998—
1993—Subsec. (c).
Statutory Notes and Related Subsidiaries
Effective Date of 1998 Amendment
Amendment by
§300d–4. Emergency medical services
(a) Federal Interagency Committee on Emergency Medical Services
(1) Establishment
The Secretary of Transportation, the Secretary of Health and Human Services, and the Secretary of Homeland Security, acting through the Under Secretary for Emergency Preparedness and Response, shall establish a Federal Interagency Committee on Emergency Medical Services.
(2) Membership
The Interagency Committee shall consist of the following officials, or their designees:
(A) The Administrator, National Highway Traffic Safety Administration.
(B) The Director, Preparedness Division, Directorate of Emergency Preparedness and Response of the Department of Homeland Security.
(C) The Administrator, Health Resources and Services Administration, Department of Health and Human Services.
(D) The Director, Centers for Disease Control and Prevention, Department of Health and Human Services.
(E) The Administrator, United States Fire Administration, Directorate of Emergency Preparedness and Response of the Department of Homeland Security.
(F) The Administrator, Centers for Medicare and Medicaid Services, Department of Health and Human Services.
(G) The Under Secretary of Defense for Personnel and Readiness.
(H) The Director, Indian Health Service, Department of Health and Human Services.
(I) The Chief, Wireless Telecommunications Bureau, Federal Communications Commission.
(J) A representative of any other Federal agency appointed by the Secretary of Transportation or the Secretary of Homeland Security through the Under Secretary for Emergency Preparedness and Response, in consultation with the Secretary of Health and Human Services, as having a significant role in relation to the purposes of the Interagency Committee.
(K) A State emergency medical services director appointed by the Secretary.
(3) Purposes
The purposes of the Interagency Committee are as follows:
(A) To ensure coordination among the Federal agencies involved with State, local, tribal, or regional emergency medical services and 9–1–1 systems.
(B) To identify State, local, tribal, or regional emergency medical services and 9–1–1 needs.
(C) To recommend new or expanded programs, including grant programs, for improving State, local, tribal, or regional emergency medical services and implementing improved emergency medical services communications technologies, including wireless 9–1–1.
(D) To identify ways to streamline the process through which Federal agencies support State, local, tribal or regional emergency medical services.
(E) To assist State, local, tribal or regional emergency medical services in setting priorities based on identified needs.
(F) To advise, consult, and make recommendations on matters relating to the implementation of the coordinated State emergency medical services programs.
(4) Administration
The Administrator of the National Highway Traffic Safety Administration, in cooperation with the Administrator of the Health Resources and Services Administration of the Department of Health and Human Services and the Director of the Preparedness Division, Directorate of Emergency Preparedness and Response of the Department of Homeland Security, shall provide administrative support to the Interagency Committee, including scheduling meetings, setting agendas, keeping minutes and records, and producing reports.
(5) Leadership
The members of the Interagency Committee shall select a chairperson of the Committee each year.
(6) Meetings
The Interagency Committee shall meet as frequently as is determined necessary by the chairperson of the Committee.
(7) Annual reports
The Interagency Committee shall prepare an annual report to Congress regarding the Committee's activities, actions, and recommendations.
(b) National Emergency Medical Services Advisory Council
(1) Establishment
The Secretary of Transportation, in coordination with the Secretary of Health and Human Services and the Secretary of Homeland Security, shall establish a National Emergency Medical Services Advisory Council (referred to in this subsection as the "Advisory Council").
(2) Membership
The Advisory Council shall be composed of 25 members, who—
(A) shall be appointed by the Secretary of Transportation; and
(B) shall collectively be representative of all sectors of the emergency medical services community.
(3) Purposes
The purposes of the Advisory Council are to advise and consult with—
(A) the Federal Interagency Committee on Emergency Medical Services on matters relating to emergency medical services issues; and
(B) the Secretary of Transportation on matters relating to emergency medical services issues affecting the Department of Transportation.
(4) Administration
The Administrator of the National Highway Traffic Safety Administration shall provide administrative support to the Advisory Council, including scheduling meetings, setting agendas, keeping minutes and records, and producing reports.
(5) Leadership
The members of the Advisory Council shall annually select a chairperson of the Advisory Council.
(6) Meetings
The Advisory Council shall meet as frequently as is determined necessary by the chairperson of the Advisory Council.
(7) Annual reports
The Advisory Council shall prepare an annual report to the Secretary of Transportation regarding the Advisory Council's actions and recommendations.
(
Editorial Notes
Codification
Section was enacted as part of the Safe, Accountable, Flexible, Efficient Transportation Equity Act: A Legacy for Users or SAFETEA–LU, and not as part of the Public Health Service Act which comprises this chapter.
Prior Provisions
A prior section 300d–4, act July 1, 1944, ch. 373, title XII, §1201, formerly §1205, as added Nov. 16, 1973,
Amendments
2012—Subsec. (b).
Statutory Notes and Related Subsidiaries
Effective Date of 2012 Amendment
Amendment by
§300d–5. Competitive grants for trauma systems for the improvement of trauma care
(a) In general
The Secretary, acting through the Assistant Secretary for Preparedness and Response, 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
(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.
(July 1, 1944, ch. 373, title XII, §1203, as added
Editorial Notes
Prior Provisions
A prior section 300d–5, act July 1, 1944, ch. 373, title XII, §1206, as added Nov. 16, 1973,
A prior section 1203 of act July 1, 1994, was renumbered section 1202 and is classified to
Another prior section 1203 of act July 1, 1994, was renumbered section 1202 and was classified to
Amendments
2010—
§300d–6. Competitive grants for trauma centers
(a) In general
The Secretary, acting through the Assistant Secretary for Preparedness and Response, shall award not fewer than 4 multiyear contracts or competitive grants to eligible entities to support pilot projects to design, implement, and evaluate new or existing innovative models of regionalized, comprehensive, and accountable emergency medical and trauma systems, and improve access to trauma care within such systems.
(b) Eligible entity; region
In this section:
(1) Eligible entity
The term "eligible entity" means—
(A) a State or consortia of States;
(B) an Indian Tribe or Tribal organization (as defined in
(C) a consortium of level I, II, or III trauma centers designated by applicable State or local agencies within an applicable State or region, and, as applicable, other emergency services providers; or
(D) a consortium or partnership of nonprofit Indian Health Service, Indian Tribal, and urban Indian trauma centers.
(2) Region
The term "region" means an area within a State, an area that lies within multiple States, or a similar area (such as a multicounty area), as determined by the Secretary.
(3) Emergency services
The term "emergency services" includes acute, prehospital, and trauma care.
(c) Pilot projects
The Secretary shall award a contract or grant under subsection (a) to an eligible entity to design, implement, and evaluate a new or existing emergency medical and trauma system. Such eligible entity shall use amounts awarded under this subsection to carry out 2 or more of the following activities:
(1) Strengthening coordination and communication with public health and safety services, emergency medical services, medical facilities, trauma centers, and other entities in a region to develop approaches to improve situational awareness and emergency medical and trauma system access.
(2) Providing a mechanism, such as a regional medical direction or transport communications system, that operates throughout the region to support patient movement to ensure that the patient is taken to the medically appropriate facility (whether an initial facility or a higher-level facility) in a timely fashion.
(3) Improving the tracking of prehospital and hospital resources, including inpatient bed capacity, emergency department capacity, trauma center capacity, on-call specialist coverage, ambulance diversion status, and the coordination of such tracking with regional communications and hospital destination decisions.
(4) Supporting a consistent region-wide prehospital, hospital, and interfacility data management system that—
(A) submits data to the National EMS Information System, the National Trauma Data Bank, and others;
(B) reports data to appropriate Federal and State databanks and registries; and
(C) contains information sufficient to evaluate key elements of prehospital care, hospital destination decisions, including initial hospital and interfacility decisions, and relevant health outcomes of hospital care.
(5) Establishing, implementing, and disseminating, or utilizing existing, as applicable, evidence-based or evidence-informed practices across facilities within such emergency medical and trauma system to improve health outcomes, including such practices related to management of injuries, and the ability of such facilities to surge.
(6) Conducting activities to facilitate clinical research, as applicable and appropriate.
(d) Application
(1) In general
An eligible entity that seeks a contract or grant described in subsection (a) shall submit to the Secretary an application at such time and in such manner as the Secretary may require.
(2) Application information
Each application shall include—
(A) an assurance from the eligible entity that the applicable emergency medical and trauma system system— 1
(i) has been coordinated with the applicable State Office of Emergency Medical Services (or equivalent State office or Tribal entity);
(ii) includes consistent indirect and direct medical oversight of prehospital, hospital, and interfacility transport throughout the region;
(iii) coordinates prehospital treatment and triage, hospital destination, and interfacility transport throughout the region;
(iv) includes a categorization or designation system for special medical facilities throughout the region that is integrated with transport and destination protocols;
(v) includes a regional medical direction, patient tracking, and resource allocation system that supports day-to-day emergency care and surge capacity and is integrated with other components of the national and State emergency preparedness system; and
(vi) addresses pediatric concerns related to integration, planning, preparedness, and coordination of emergency medical services for infants, children and adolescents;
(B) for eligible entities described in subparagraph (C) or (D) of subsection (b)(1), a description of, and evidence of, coordination with the applicable State Office of Emergency Medical Services (or equivalent State Office) or applicable such office for a Tribe or Tribal organization; and
(C) such other information as the Secretary may require.
(e) Requirement of matching funds
(1) In general
The Secretary may not make a grant under this section unless the State (or consortia of States) involved agrees, with respect to the costs to be incurred by the State (or consortia) in carrying out the purpose for which such grant was made, to make available non-Federal contributions (in cash or in kind under paragraph (2)) toward such costs in an amount equal to not less than $1 for each $3 of Federal funds provided in the grant. Such contributions may be made directly or through donations from public or private entities.
(2) Non-Federal contributions
Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including equipment or services (and excluding indirect or overhead costs). Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.
(3) Effective date
The matching requirement described in paragraph (1) shall take effect on October 1, 2025.
(f) Priority
The Secretary shall give priority for the award of the contracts or grants described in subsection (a) to any eligible entity that serves a medically underserved population (as defined in
(g) Report
Not later than 90 days after the completion of a pilot project under subsection (a), the recipient of such contract or grant shall submit to the Secretary a report containing the results of an evaluation of the program, including an identification of—
(1) the impact of the regional, accountable emergency care and trauma system on patient health outcomes for various critical care categories, such as trauma, stroke, cardiac emergencies, neurological emergencies, and pediatric emergencies;
(2) opportunities for improvement, including recommendations for how to improve the effectiveness and efficiency of the program (or lack thereof);
(3) methods of assuring the long-term financial sustainability of the emergency care and trauma system;
(4) the barriers to developing regionalized, accountable emergency care and trauma systems, as well as the methods to overcome such barriers;
(5) recommendations on the utilization of available funding for future regionalization efforts; and
(6) any evidence-based or evidence-informed strategies developed or utilized pursuant to subsection (c)(5).
(h) Dissemination of findings
Not later than 1 year after the completion of the final project under subsection (a), the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives a report describing the information contained in each report submitted pursuant to subsection (g) and any additional actions planned by the Secretary related to regionalized emergency care and trauma systems.
(July 1, 1944, ch. 373, title XII, §1204, as added
Editorial Notes
Prior Provisions
A prior section 300d–6, act July 1, 1944, ch. 373, title XII, §1202, formerly §1207, as added Nov. 16, 1973,
A prior section 1204 of act July 1, 1944, was classified to
Prior sections 300d–7 to 300d–9 were repealed by
Section 300d–7, act July 1, 1944, ch. 373, title XII, §1208, as added Nov. 16, 1973,
Section 300d–8, act July 1, 1944, ch. 373, title XII, §1209, as added Nov. 16, 1973,
Section 300d–9, act July 1, 1944, ch. 373, title XII, §1210, as added Nov. 16, 1973,
Amendments
2022—
Subsec. (a).
Subsec. (b)(1).
"(A) a State or a partnership of 1 or more States and 1 or more local governments; or
"(B) an Indian tribe (as defined in
Subsec. (c).
Subsec. (c)(1).
Subsec. (c)(2).
Subsec. (c)(3).
Subsec. (c)(4).
Subsec. (c)(5), (6).
Subsec. (d)(2)(A).
Subsec. (d)(2)(A)(i).
Subsec. (d)(2)(B), (C).
Subsec. (e)(3).
Subsec. (f).
Subsec. (g).
Subsec. (g)(2).
Subsec. (g)(4) to (6).
Subsec. (h).