---
kind: "section"
citation: "42 U.S.C. § 300d–6"
title: "42"
title_heading: "The Public Health and Welfare"
number: "300d–6"
heading: "Competitive grants for trauma centers"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/300d-6"
units:
  - "Chapter 6A — Public Health Service"
  - "Subchapter X — Trauma Care"
  - "Part A — General Authority and Duties of Secretary"
---

# §300d–6. Competitive grants for trauma centers

- (a) **In general—** The [Secretary](/usc/42/201.md?p=c), acting through the Assistant [Secretary](/usc/42/201.md?p=c) for Preparedness and Response, shall award not fewer than 4 multiyear contracts or competitive grants to eligible entities to support pilot [projects](/usc/42/13641.md?p=2) to design, implement, and evaluate new or existing innovative models of regionalized, comprehensive, and accountable emergency medical and [trauma](/usc/42/300d–31.md?p=4) systems, and improve access to [trauma](/usc/42/300d–31.md?p=4) care within such systems.
- (b) **Eligible entity; region—** In this section:
  - (1) **Eligible entity—** The term “eligible entity” means—
    - (A) a [State](/usc/42/201.md?p=f) or consortia of [States](/usc/42/201.md?p=f);
    - (B) an Indian Tribe or Tribal organization (as defined in [section 5304 of title 25](/usc/25/5304.md));
    - (C) a [consortium](/usc/42/17061.md?p=4) of level I, II, or III [trauma](/usc/42/300d–31.md?p=4) centers designated by applicable [State](/usc/42/201.md?p=f) or local [agencies](/usc/42/8262.md?p=1) within an applicable [State](/usc/42/201.md?p=f) or region, and, as applicable, other emergency [services](/usc/42/201.md?p=a) [providers](/usc/42/299b–21.md?p=8); or
    - (D) a [consortium](/usc/42/17061.md?p=4) or partnership of [nonprofit](/usc/42/300s–3.md?p=3) Indian Health [Service](/usc/42/201.md?p=a), Indian Tribal, and urban Indian [trauma](/usc/42/300d–31.md?p=4) centers.
  - (2) **Region—** The term “region” means an area within a [State](/usc/42/201.md?p=f), an area that lies within multiple [States](/usc/42/201.md?p=f), or a similar area (such as a multicounty area), as determined by the [Secretary](/usc/42/201.md?p=c).
  - (3) **Emergency services—** The term “emergency [services](/usc/42/201.md?p=a)” includes acute, prehospital, and [trauma](/usc/42/300d–31.md?p=4) care.
- (c) **Pilot projects—** The [Secretary](/usc/42/201.md?p=c) shall award a contract or grant under [subsection (a)](#a) to an eligible entity to design, implement, and evaluate a new or existing emergency medical and [trauma](/usc/42/300d–31.md?p=4) 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](/usc/42/201.md?p=a), emergency medical [services](/usc/42/201.md?p=a), [medical facilities](/usc/42/300s–3.md?p=11), [trauma](/usc/42/300d–31.md?p=4) centers, and other entities in a region to develop approaches to improve situational awareness and emergency medical and [trauma](/usc/42/300d–31.md?p=4) 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](/usc/42/300s–3.md?p=1) resources, including inpatient bed capacity, emergency department capacity, [trauma](/usc/42/300d–31.md?p=4) center capacity, on-call specialist coverage, ambulance diversion status, and the coordination of such tracking with regional communications and [hospital](/usc/42/300s–3.md?p=1) destination decisions.
  - (4) Supporting a consistent region-wide prehospital, [hospital](/usc/42/300s–3.md?p=1), and interfacility data management system that—
    - (A) submits data to the National EMS Information System, the National [Trauma](/usc/42/300d–31.md?p=4) Data Bank, and others;
    - (B) reports data to appropriate Federal and [State](/usc/42/201.md?p=f) databanks and registries; and
    - (C) contains information sufficient to evaluate key elements of prehospital care, [hospital](/usc/42/300s–3.md?p=1) destination decisions, including initial [hospital](/usc/42/300s–3.md?p=1) and interfacility decisions, and relevant health outcomes of [hospital](/usc/42/300s–3.md?p=1) care.
  - (5) Establishing, implementing, and disseminating, or utilizing existing, as applicable, evidence-based or evidence-informed [practices](/usc/42/17061.md?p=19) across facilities within such emergency medical and [trauma](/usc/42/300d–31.md?p=4) system to improve health outcomes, including such [practices](/usc/42/17061.md?p=19) related to management of injuries, and the ability of such facilities to surge.
  - (6) Conducting activities to facilitate [clinical research](/usc/42/284d.md?p=b), as applicable and appropriate.
- (d) **Application—**
  - (1) **In general—** An eligible entity that seeks a contract or grant described in [subsection (a)](#a) shall submit to the [Secretary](/usc/42/201.md?p=c) an application at such time and in such manner as the [Secretary](/usc/42/201.md?p=c) may require.
  - (2) **Application information—** Each application shall include—
    - (A) an assurance from the eligible entity that the applicable emergency medical and [trauma](/usc/42/300d–31.md?p=4) system system—[^1]
      - (i) has been coordinated with the applicable [State](/usc/42/201.md?p=f) Office of Emergency Medical [Services](/usc/42/201.md?p=a) (or equivalent [State](/usc/42/201.md?p=f) office or Tribal entity);
      - (ii) includes consistent indirect and direct medical oversight of prehospital, [hospital](/usc/42/300s–3.md?p=1), and interfacility transport throughout the region;
      - (iii) coordinates prehospital [treatment](/usc/42/11851.md?p=11) and triage, [hospital](/usc/42/300s–3.md?p=1) destination, and interfacility transport throughout the region;
      - (iv) includes a categorization or designation system for special [medical facilities](/usc/42/300s–3.md?p=11) throughout the region that is integrated with transport and destination protocols;
      - (v) includes a regional medical direction, patient tracking, and resource [allocation](/usc/42/2021b.md?p=2) system that supports day-to-day emergency care and surge capacity and is integrated with other components of the national and [State](/usc/42/201.md?p=f) emergency preparedness system; and
      - (vi) addresses pediatric concerns related to integration, planning, preparedness, and coordination of emergency medical [services](/usc/42/201.md?p=a) for infants, children and [adolescents](/usc/42/300z–1.md?p=a-9);
    - (B) for eligible entities described in subparagraph [(C)](#b-1-C) or [(D)](#b-1-D) of subsection (b)(1), a description of, and evidence of, coordination with the applicable [State](/usc/42/201.md?p=f) Office of Emergency Medical [Services](/usc/42/201.md?p=a) (or equivalent [State](/usc/42/201.md?p=f) Office) or applicable such office for a Tribe or Tribal organization; and
    - (C) such other information as the [Secretary](/usc/42/201.md?p=c) may require.
- (e) **Requirement of matching funds—**
  - (1) **In general—** The [Secretary](/usc/42/201.md?p=c) may not make a grant under this section unless the [State](/usc/42/201.md?p=f) (or consortia of [States](/usc/42/201.md?p=f)) involved agrees, with respect to the costs to be incurred by the [State](/usc/42/201.md?p=f) (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)](#e-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)](#e-1) may be in cash or in kind, fairly evaluated, including equipment or [services](/usc/42/201.md?p=a) (and excluding indirect or overhead costs). Amounts provided by the Federal Government, or [services](/usc/42/201.md?p=a) 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)](#e-1) shall take effect on October 1, 2025.
- (f) **Priority—** The [Secretary](/usc/42/201.md?p=c) shall give priority for the award of the contracts or grants described in [subsection (a)](#a) to any eligible entity that serves a [medically underserved population](/usc/42/300s–3.md?p=14) (as defined in [section 254b(b)(3) of this title](/usc/42/254b.md?p=b-3)).
- (g) **Report—** Not later than 90 days after the completion of a pilot [project](/usc/42/13641.md?p=2) under [subsection (a)](#a), the recipient of such contract or grant shall submit to the [Secretary](/usc/42/201.md?p=c) a report containing the results of an evaluation of the [program](/usc/42/274l–1.md?p=4), including an identification of—
  - (1) the impact of the regional, accountable emergency care and [trauma](/usc/42/300d–31.md?p=4) system on patient health outcomes for various critical care categories, such as [trauma](/usc/42/300d–31.md?p=4), 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](/usc/42/274l–1.md?p=4) (or lack thereof);
  - (3) methods of assuring the long-term financial sustainability of the emergency care and [trauma](/usc/42/300d–31.md?p=4) system;
  - (4) the barriers to developing regionalized, accountable emergency care and [trauma](/usc/42/300d–31.md?p=4) 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)](#c-5).
- (h) **Dissemination of findings—** Not later than 1 year after the completion of the final [project](/usc/42/13641.md?p=2) under [subsection (a)](#a), the [Secretary](/usc/42/201.md?p=c) 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)](#g) and any additional actions planned by the [Secretary](/usc/42/201.md?p=c) related to regionalized emergency care and [trauma](/usc/42/300d–31.md?p=4) systems.

## Footnotes

[^1]: So in original.

## Source credit

(July 1, 1944, ch. 373, title XII, § 1204, as added Pub. L. 111–148, title III, § 3504(a)(2), Mar. 23, 2010, 124 Stat. 518; amended Pub. L. 117–328, div. FF, title II, § 2113(c), Dec. 29, 2022, 136 Stat. 5724.)

## Notes

### 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, Pub. L. 93–154, § 2(a), 87 Stat. 602; amended Oct. 21, 1976, Pub. L. 94–573, § 8, 90 Stat. 2714; Nov. 10, 1978, Pub. L. 95–626, title II, § 210(d), 92 Stat. 3588; Dec. 12, 1979, Pub. L. 96–142, title I, § 105, 93 Stat. 1068; renumbered § 1202 and amended Aug. 13, 1981, Pub. L. 97–35, title IX, § 902(d)(1), (4), 95 Stat. 560, authorized appropriations for purposes of this subchapter, prior to repeal by Pub. L. 99–117, § 12(e), Oct. 7, 1985, 99 Stat. 495.

A prior section 1204 of act July 1, 1944, was classified to section 300d–3 of this title prior to repeal by Pub. L. 97–35.

Prior sections 300d–7 to 300d–9 were repealed by Pub. L. 97–35, title IX, § 902(d)(1), (h), Aug. 13, 1981, 95 Stat. 560, 561, effective Oct. 1, 1981.

Section 300d–7, act July 1, 1944, ch. 373, title XII, § 1208, as added Nov. 16, 1973, Pub. L. 93–154, § 2(a), 87 Stat. 602; amended Oct. 12, 1976, Pub. L. 94–484, title VIII, § 801(b), 90 Stat. 2322; Oct. 21, 1976, Pub. L. 94–573, § 9, 90 Stat. 2715, set forth provisions relating to administration of emergency medical services administrative unit.

Section 300d–8, act July 1, 1944, ch. 373, title XII, § 1209, as added Nov. 16, 1973, Pub. L. 93–154, § 2(a), 87 Stat. 602; amended Oct. 21, 1976, Pub. L. 94–573, § 10, 90 Stat. 2716; Oct. 17, 1979, Pub. L. 96–88, title V, § 509(b), 93 Stat. 695; Dec. 12, 1979, Pub. L. 96–142, title I, § 106, 93 Stat. 1069, related to Interagency Committee on Emergency Medical Services.

Section 300d–9, act July 1, 1944, ch. 373, title XII, § 1210, as added Nov. 16, 1973, Pub. L. 93–154, § 2(a), 87 Stat. 603; amended Oct. 21, 1976, Pub. L. 94–573, § 11, 90 Stat. 2717, related to annual report to Congress.

### Amendments

2022—Pub. L. 117–328, § 2113(c)(1), amended section catchline generally. Prior to amendment, section catchline read as follows: “Competitive grants for regionalized systems for emergency care response”.

Subsec. (a). Pub. L. 117–328, § 2113(c)(2), substituted “to design, implement, and evaluate new or existing” for “that design, implement, and evaluate” and “emergency medical” for “emergency care” and inserted “, and improve access to trauma care within such systems” before period at end.

Subsec. (b)(1). Pub. L. 117–328, § 2113(c)(3), added subpars. (A) to (D) and struck out former subpars. (A) and (B) which read as follows:

“(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 section 1603 of title 25) or a partnership of 1 or more Indian tribes.”

Subsec. (c). Pub. L. 117–328, § 2113(c)(4)(A), struck out “that proposes a pilot project” after “an eligible entity” and substituted “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:” for “an emergency medical and trauma system that—” in introductory provisions.

Subsec. (c)(1). Pub. L. 117–328, § 2113(c)(4)(B), substituted “Strengthening coordination and communication” for “coordinates” and “approaches to improve situational awareness and emergency medical and trauma system access.” for “an approach to emergency medical and trauma system access throughout the region, including 9–1–1 Public Safety Answering Points and emergency medical dispatch;”.

Subsec. (c)(2). Pub. L. 117–328, § 2113(c)(4)(C), substituted “Providing” for “includes” and “fashion.” for “fashion;” and inserted “support patient movement to” after “region to”.

Subsec. (c)(3). Pub. L. 117–328, § 2113(c)(4)(D), substituted “Improving” for “allows for” and “decisions.” for “decisions; and”.

Subsec. (c)(4). Pub. L. 117–328, § 2113(c)(4)(E), substituted “Supporting a consistent” for “includes a consistent” in introductory provisions.

Subsec. (c)(5), (6). Pub. L. 117–328, § 2113(c)(4)(F), added pars. (5) and (6).

Subsec. (d)(2)(A). Pub. L. 117–328, § 2113(c)(5)(A)(i), substituted “the applicable emergency medical and trauma system” for “the proposed” in introductory provisions.

Subsec. (d)(2)(A)(i). Pub. L. 117–328, § 2113(c)(5)(A)(ii), inserted “or Tribal entity” after “equivalent State office”.

Subsec. (d)(2)(B), (C). Pub. L. 117–328, § 2113(c)(5)(A)(iii)–(C), added subpar. (B) and redesignated former subpar. (B) as (C).

Subsec. (e)(3). Pub. L. 117–328, § 2113(c)(6), added par. (3).

Subsec. (f). Pub. L. 117–328, § 2113(c)(7), substituted “medically underserved population” for “population in a medically underserved area”.

Subsec. (g). Pub. L. 117–328, § 2113(c)(8)(A), struck out “described in” after “grant” in introductory provisions.

Subsec. (g)(2). Pub. L. 117–328, § 2113(c)(8)(B), substituted “opportunities for improvement, including recommendations for how to improve” for “the system characteristics that contribute to”.

Subsec. (g)(4) to (6). Pub. L. 117–328, § 2113(c)(8)(C)–(G), added par. (6), redesignated former pars. (5) and (6) as (4) and (5), respectively, and struck out former par. (4) which read as follows: “the State and local legislation necessary to implement and to maintain the system;”.

Subsec. (h). Pub. L. 117–328, § 2113(c)(9), amended subsec. (h) generally. Prior to amendment, text read as follows: “The Secretary shall, as appropriate, disseminate to the public and to the appropriate Committees of the Congress, the information contained in a report made under subsection (g).”