---
kind: "section"
citation: "42 U.S.C. § 300d–42"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300d–42"
heading: "Preferences in making grants"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300d-42"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter X — Trauma Care"
  - "Part D — Trauma Centers Operating in Areas Severely Affected by Drug-Related Violence"
---

# §300d–42. Preferences in making grants

- (a) **Substantial uncompensated care awards—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) shall establish an award basis for each eligible [trauma](/usc/42/300d–31.md?p=4) center for grants under [section 300d–41(a)(1) of this title](/usc/42/300d–41.md?p=a-1) according to the percentage described in [paragraph (2)](#a-2), subject to the requirements of [section 300d–41(b)(3) of this title](/usc/42/300d–41.md?p=b-3).
  - (2) **Percentages—** The applicable percentages are as follows:
    - (A) With respect to a category A [trauma](/usc/42/300d–31.md?p=4) center, 100 percent of the uncompensated care costs.
    - (B) With respect to a category B [trauma](/usc/42/300d–31.md?p=4) center, not more than 75 percent of the uncompensated care costs.
    - (C) With respect to a category C [trauma](/usc/42/300d–31.md?p=4) center, not more than 50 percent of the uncompensated care costs.
- (b) **Core mission awards—**
  - (1) **1 In general—** In awarding grants under [section 300d–41(a)(2) of this title](/usc/42/300d–41.md?p=a-2), the [Secretary](/usc/42/201.md?p=c) shall—
    - (A) reserve 25 percent of the amount allocated for core mission awards for Level III and Level IV [trauma](/usc/42/300d–31.md?p=4) centers; and
    - (B) reserve 25 percent of the amount allocated for core mission awards for large urban Level I and II [trauma](/usc/42/300d–31.md?p=4) centers—
      - (i) that have at least 1 graduate medical education fellowship in [trauma](/usc/42/300d–31.md?p=4) or [trauma](/usc/42/300d–31.md?p=4) related specialties for which demand is exceeding supply;
      - (ii) for which—
        - (I) annual uncompensated care costs exceed $10,000,000; or
        - (II) at least 20 percent of emergency department visits are charity or self-pay or Medicaid patients; and
      - (iii) that are not eligible for substantial uncompensated care awards under [section 300d–41(a)(1) of this title](/usc/42/300d–41.md?p=a-1).
- (c) **Emergency awards—** In awarding grants under [section 300d–41(a)(3) of this title](/usc/42/300d–41.md?p=a-3), the [Secretary](/usc/42/201.md?p=c) shall—
  - (1) give preference to any application submitted by a [trauma](/usc/42/300d–31.md?p=4) center that provides [trauma](/usc/42/300d–31.md?p=4) care in a geographic area in which the availability of [trauma](/usc/42/300d–31.md?p=4) care has significantly decreased or will significantly decrease if the center is forced to close or downgrade [service](/usc/42/201.md?p=a) or growth in demand for [trauma](/usc/42/300d–31.md?p=4) [services](/usc/42/201.md?p=a) exceeds capacity; and
  - (2) reallocate any emergency awards funds not obligated due to insufficient, or a lack of qualified, applications to the significant uncompensated care award [program](/usc/42/274l–1.md?p=4).

## Footnotes

[^1]: So in original. No par. (2) has been enacted.

## Source credit

(July 1, 1944, ch. 373, title XII, § 1242, as added Pub. L. 102–321, title VI, § 601, July 10, 1992, 106 Stat. 434; amended Pub. L. 111–148, title III, § 3505(a)(2), Mar. 23, 2010, 124 Stat. 523.)

## Notes

### Editorial Notes

### Amendments

2010—Pub. L. 111–148 added subsecs. (a) to (c) and struck out former subsecs. (a) and (b) which related to preferences in making grants and preferences for certain applications.

### Statutory Notes and Related Subsidiaries

### Effective Date

Section effective July 10, 1992, with programs making awards providing financial assistance in fiscal year 1993 and subsequent years effective for awards made on or after Oct. 1, 1992, see section 801(b), (d)(1) of Pub. L. 102–321, set out as an Effective Date of 1992 Amendment note under section 236 of this title.