---
kind: "section"
citation: "42 U.S.C. § 300d–13"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300d–13"
heading: "Requirements with respect to carrying out purpose of allotments"
release: "119-102"
url: "https://uscodex.org/usc/42/300d-13"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter X — Trauma Care"
  - "Part B — Formula Grants With Respect to Modifications of State Plans"
---

# §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](/usc/42/300gg–91.md?p=d-14) plan for the provision of emergency medical [services](/usc/42/201.md?p=a), the [modifications](/usc/42/7501.md?p=4) referred to in [section 300d–11(b) of this title](/usc/42/300d–11.md?p=b) are such [modifications](/usc/42/7501.md?p=4) to the [State](/usc/42/300gg–91.md?p=d-14) plan as may be necessary for the [State](/usc/42/300gg–91.md?p=d-14) 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](/usc/42/7501.md?p=4) required pursuant to paragraphs [(2)](#a-2) through [(11)](#a-11) will be implemented by the principal [State agency](/usc/42/1396r–8.md?p=k-9) with respect to emergency medical [services](/usc/42/201.md?p=a) or by the designee of such agency;
  - (2) specifies a public or [private entity](/usc/42/12181.md?p=6) that will designate trauma care regions and trauma centers in the [State](/usc/42/300gg–91.md?p=d-14);
  - (3) subject to [subsection (b)](#b), contains national [standards](/usc/42/1320d.md?p=7) 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 patients), by such entity, including [standards](/usc/42/1320d.md?p=7) 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](/usc/42/201.md?p=a) for trauma patients;
  - (4) contains [standards](/usc/42/1320d.md?p=7) and requirements for the implementation of regional trauma care systems, including [standards](/usc/42/1320d.md?p=7) and guidelines (consistent with the provisions of [section 1395dd of this title](/usc/42/1395dd.md)) for medically directed triage and transportation of trauma patients (including patients injured in rural areas) prior to care in [designated trauma centers](/usc/42/300d–31.md?p=1);
  - (5) subject to [subsection (b)](#b), contains national [standards](/usc/42/1320d.md?p=7) and requirements, including those of the American Academy of Pediatrics and the American College of Emergency [Physicians](/usc/42/1395cc–4.md?p=a-2-E), for medically directed triage and transport of severely injured [children](/usc/42/256e.md?p=g-2) to [designated trauma centers](/usc/42/300d–31.md?p=1) with specified capabilities and expertise in the care of pediatric trauma patients;
  - (6) utilizes a [program](/usc/42/274l–1.md?p=4) with procedures for the evaluation of [designated trauma centers](/usc/42/300d–31.md?p=1) (including trauma centers described in [paragraph (5)](#a-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](/usc/42/300gg–91.md?p=d-14) and local emergency medical [services](/usc/42/201.md?p=a) [directors](/usc/42/5061.md?p=1), and other trained professionals in trauma care, from each [designated trauma center](/usc/42/300d–31.md?p=1) in the [State](/usc/42/300gg–91.md?p=d-14) 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](/usc/42/300gg–91.md?p=d-14);
    - (B) to identify the [cause](/usc/42/9908.md?p=c-2) 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](/usc/42/300d–31.md?p=1) within regional trauma care systems in the [State](/usc/42/300gg–91.md?p=d-14) (including relevant emergency-department discharges and rehabilitation information) for the purpose of evaluating the diagnosis, [treatment](/usc/42/11851.md?p=11), and [treatment](/usc/42/11851.md?p=11) 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](/usc/42/300d–31.md?p=1) in the [State](/usc/42/300gg–91.md?p=d-14); 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](/usc/42/300d–31.md?p=1) and other [facilities](/usc/42/11049.md?p=4) 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](/usc/42/300d–31.md?p=1), 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](/usc/42/300gg–91.md?p=d-14) [disaster](/usc/42/5204.md?p=2) emergency planning and bioterrorism [hospital](/usc/42/1395dd.md?p=e-5) preparedness planning; and
  - (12) with respect to the requirements established in this subsection, provides for coordination and cooperation between the [State](/usc/42/300gg–91.md?p=d-14) and any other [State](/usc/42/300gg–91.md?p=d-14) with which the [State](/usc/42/300gg–91.md?p=d-14) shares any [standard](/usc/42/1320d.md?p=7) metropolitan statistical area.
- (b) **Certain standards with respect to trauma care centers and systems—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) may not make payments under [section 300d–11(a) of this title](/usc/42/300d–11.md?p=a) for a fiscal year unless the [State](/usc/42/300gg–91.md?p=d-14) involved agrees that, in carrying out paragraphs [(3)](#a-3) through [(5)](#a-5) of subsection (a), the [State](/usc/42/300gg–91.md?p=d-14) will adopt [standards](/usc/42/1320d.md?p=7) for the designation of trauma centers, and for triage, transfer, and transportation policies, and that the [State](/usc/42/300gg–91.md?p=d-14) will, in adopting such [standards](/usc/42/1320d.md?p=7)—
    - (A) take into account national [standards](/usc/42/1320d.md?p=7) that outline resources for optimal care of injured patients;
    - (B) consult with medical, surgical, and nursing speciality groups, [hospital](/usc/42/1395dd.md?p=e-5) associations, emergency medical [services](/usc/42/201.md?p=a) [State](/usc/42/300gg–91.md?p=d-14) and local [directors](/usc/42/5061.md?p=1), concerned advocates, and other interested parties;
    - (C) conduct hearings on the proposed [standards](/usc/42/1320d.md?p=7) 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)](#c).
  - (2) **Quality of trauma care—** The highest quality of trauma care shall be the primary goal of [State](/usc/42/300gg–91.md?p=d-14) [standards](/usc/42/1320d.md?p=7) adopted under this subsection.
  - (3) **Approval by the Secretary—** The [Secretary](/usc/42/201.md?p=c) may not make payments under [section 300d–11(a) of this title](/usc/42/300d–11.md?p=a) to a [State](/usc/42/300gg–91.md?p=d-14) if the [Secretary](/usc/42/201.md?p=c) determines that—
    - (A) in the case of payments for fiscal year 2008 and subsequent fiscal years, the [State](/usc/42/300gg–91.md?p=d-14) has not taken into account national [standards](/usc/42/1320d.md?p=7), including those of the American College of Surgeons, the American College of Emergency [Physicians](/usc/42/1395cc–4.md?p=a-2-E), and the American Academy of Pediatrics, in adopting [standards](/usc/42/1320d.md?p=7) under this subsection; or
    - (B) in the case of payments for fiscal year 2008 and subsequent fiscal years, the [State](/usc/42/300gg–91.md?p=d-14) has not, in adopting such [standards](/usc/42/1320d.md?p=7), taken into account the model plan developed under [subsection (c)](#c).
- (c) **Model trauma care plan—**
  - (1) **In general—** Not later than 1 year after May 3, 2007, the [Secretary](/usc/42/201.md?p=c) 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](/usc/42/300gg–91.md?p=d-14). Such plan shall—
    - (A) take into account national [standards](/usc/42/1320d.md?p=7), including those of the American College of Surgeons, American College of Emergency [Physicians](/usc/42/1395cc–4.md?p=a-2-E), and the American Academy of Pediatrics;
    - (B) take into account existing [State](/usc/42/300gg–91.md?p=d-14) plans;
    - (C) be developed in consultation with medical, surgical, and nursing speciality groups, [hospital](/usc/42/1395dd.md?p=e-5) associations, emergency medical [services](/usc/42/201.md?p=a) [State](/usc/42/300gg–91.md?p=d-14) [directors](/usc/42/5061.md?p=1) and associations, and other interested parties; and
    - (D) include [standards](/usc/42/1320d.md?p=7) for the designation of rural health [facilities](/usc/42/11049.md?p=4) and [hospitals](/usc/42/1395dd.md?p=e-5) best able to receive, stabilize, and transfer trauma patients to the nearest appropriate [designated trauma center](/usc/42/300d–31.md?p=1), and for triage, transfer, and transportation policies as they relate to rural areas.
  - (2) **Applicability—** [Standards](/usc/42/1320d.md?p=7) described in [paragraph (1)(D)](#c-1-D) shall be applicable to all rural areas in the [State](/usc/42/300gg–91.md?p=d-14), including both non-metropolitan areas and [frontier areas](/usc/42/254c–1b.md?p=c-2) 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)](#a) as a condition of the receipt of a grant under [section 300d–11(a) of this title](/usc/42/300d–11.md?p=a), such subsection may not be construed to specify the number of trauma care centers designated pursuant to such subsection.

## Source credit

(July 1, 1944, ch. 373, title XII, § 1213, as added Pub. L. 101–590, § 3, Nov. 16, 1990, 104 Stat. 2920; amended Pub. L. 103–183, title VI, § 601(f)(3), Dec. 14, 1993, 107 Stat. 2239; Pub. L. 105–392, title IV, § 401(b)(4), Nov. 13, 1998, 112 Stat. 3587; Pub. L. 110–23, § 7, May 3, 2007, 121 Stat. 93.)

## Notes

### Editorial Notes

### Amendments

2007—Pub. L. 110–23 amended section generally. Prior to amendment, section related to requirements with respect to carrying out purpose of allotments.

1998—Subsec. (a)(8). Pub. L. 105–392 substituted “provides for” for “provides for for”.

1993—Subsec. (a)(4). Pub. L. 103–183, § 601(f)(3)(A), substituted “section 1395dd of this title)” for “section 1395dd of this title”.

Subsec. (a)(8), (9). Pub. L. 103–183, § 601(f)(3)(B), substituted “provides for” for “to provide” wherever appearing.

Subsec. (a)(10). Pub. L. 103–183, § 601(f)(3)(C), substituted “conducts” for “to conduct”.

### Statutory Notes and Related Subsidiaries

### 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.