
From the U.S. Code Online via GPO Access
[wais.access.gpo.gov]
[Laws in effect as of January 23, 2000]
[Document not affected by Public Laws enacted between
  January 23, 2000 and December 4, 2001]
[CITE: 42USC300d-13]

 
                 TITLE 42--THE PUBLIC HEALTH AND WELFARE
 
                    CHAPTER 6A--PUBLIC HEALTH SERVICE
 
                        SUBCHAPTER X--TRAUMA CARE
 
   Part B--Formula Grants With Respect to Modifications of State Plans
 
Sec. 300d-13. 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 300d-11(b) of this title 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 (10) will be implemented by the principal 
    State agency with respect to emergency medical services or by the 
    designee of such agency;
        (2) specifies any public or private entity that will designate 
    trauma care regions and trauma centers in the State;
        (3) subject to subsection (b) of this section, contains 
    standards and requirements 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 the 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) subject to subsection (b) of this section, contains 
    standards and requirements for the implementation of regional trauma 
    care systems, including standards and guidelines (consistent with 
    the provisions of section 1395dd of this title) 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) of this section, 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;
        (6) specifies 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 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 within regional 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;

        (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 provides for 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; and
        (11) 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 300d-11(a) of 
    this title for a fiscal year unless the State involved agrees that, 
    in carrying out paragraphs (3) through (5) of subsection (a) of this 
    section, 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 such;
            (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 1992, take into account the 
        model plan described in subsection (c) of this section.

                     (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 Secretary

        The Secretary may not make payments under section 300d-11(a) of 
    this title to a State if the Secretary determines that--
            (A) in the case of payments for fiscal year 1991 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 1992 and 
        subsequent fiscal years, the State has not, in adopting such 
        standards, taken into account the model plan developed under 
        subsection (c) of this section.

(c) Model trauma care plan

    Not later than 1 year after November 16, 1990, the Secretary shall 
develop a 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--
        (1) take into account national standards, including those of the 
    American College of Surgeons, American College of Emergency 
    Physicians and the American Academy of Pediatrics;
        (2) take into account existing State plans;
        (3) 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
        (4) 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.

Standards described in paragraph (4) 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) of this section as a 
condition of the receipt of a grant under section 300d-11(a) of this 
title, such subsection may not be construed to specify the number of 
trauma care centers designated pursuant to such subsection.

(July 1, 1944, ch. 373, title XII, Sec. 1213, as added Pub. L. 101-590, 
Sec. 3, Nov. 16, 1990, 104 Stat. 2920; amended Pub. L. 103-183, title 
VI, Sec. 601(f)(3), Dec. 14, 1993, 107 Stat. 2239; Pub. L. 105-392, 
title IV, Sec. 401(b)(4), Nov. 13, 1998, 112 Stat. 3587.)


                               Amendments

    1998--Subsec. (a)(8). Pub. L. 105-392 substituted ``provides for'' 
for ``provides for for''.
    1993--Subsec. (a)(4). Pub. L. 103-183, Sec. 601(f)(3)(A), 
substituted ``section 1395dd of this title)'' for ``section 1395dd of 
this title''.
    Subsec. (a)(8), (9). Pub. L. 103-183, Sec. 601(f)(3)(B), substituted 
``provides for'' for ``to provide'' wherever appearing.
    Subsec. (a)(10). Pub. L. 103-183, Sec. 601(f)(3)(C), substituted 
``conducts'' for ``to conduct''.


                    Effective Date of 1998 Amendment

    Amendment by Pub. L. 105-392 deemed to have taken effect immediately 
after enactment of Pub. L. 103-183, see section 401(e) of Pub. L. 105-
392, set out as a note under section 242m of this title.

                  Section Referred to in Other Sections

    This section is referred to in sections 300d-11, 300d-14, 300d-31, 
300d-41, 300w-3 of this title.
