42 USC 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
Terms Used In 42 USC 300d-6
- Contract: A legal written agreement that becomes binding when signed.
- Evidence: Information presented in testimony or in documents that is used to persuade the fact finder (judge or jury) to decide the case for one side or the other.
- Oversight: Committee review of the activities of a Federal agency or program.
- Partnership: A voluntary contract between two or more persons to pool some or all of their assets into a business, with the agreement that there will be a proportional sharing of profits and losses.
- Secretary: means the Secretary of Health and Human Services. See 42 USC 201
- Service: means the Public Health Service. See 42 USC 201
- State: includes , in addition to the several States, only the District of Columbia, Guam, the Commonwealth of Puerto Rico, the Northern Mariana Islands, the Virgin Islands, American Samoa, and the Trust Territory of the Pacific Islands. See 42 USC 201
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 section 5304 of title 25);
(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 section 254b(b)(3) of this title).
(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.