,,ii #aagth ,,congress #b;d ,session ,s4 #ceff ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,february #b1 #bjbb,mr4 ,reed 7for himself and ,mr4 ,moran7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act with respect to trauma care4 #a4 ,short title ,this ,act may be cited as the ,improving ,trauma ,systems and ,emergency ,care ,act4 #b4 ,trauma care reauthorization 7a7 ,in general ,section #abja of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;d7 is amended-- 7#a7 in subsection 7a7-- 7,a7 in paragraph 7#c7-- 7i7 by inserting analyze1 after compile12 and 7ii7 by inserting and medically underserved areas before the semicolon2 7,b7 in paragraph 7#d71 by adding and after the semicolon2 7,c7 by striking paragraph 7#e72 and 7,d7 by redesignating paragraph 7#f7 as paragraph 7#e72 7#b7 by redesignating subsection 7b7 as subsection 7c72 and 7#c7 by inserting after subsection 7a7 the following3 7b7 ,trauma care readiness and coordination ,the ,secretary1 acting through the ,assistant ,secretary for ,preparedness and ,response1 shall support the efforts of ,states and consortia of ,states to coordinate and improve emergency medical services and trauma care during a public health emergency declared by the ,secretary pursuant to section #cai or a major disaster or emergency declared by the ,president under section #dja or #eja1 respectively1 of the ,robert ,t4 ,stafford ,disaster ,relief and ,emergency ,assistance ,act4 ,such support may include-- 7#a7 developing1 issuing1 and updating guidance1 as appropriate1 to support the coordinated medical triage and evacuation to appropriate medical institutions based on patient medical need1 taking into account regionalized systems of care2 7#b7 disseminating1 as appropriate1 information on evidence-based or evidence-informed trauma care practices1 taking into consideration emergency medical services and trauma care systems1 including such practices identified through activities conducted under subsection 7a7 and which may include the identification and dissemination of performance metrics1 as applicable and appropriate2 and 7#c7 other activities1 as appropriate1 to optimize a coordinated and flexible approach to the emergency response and medical surge capacity of hospitals1 other health care facilities1 critical care1 and emergency medical systems4 4 7b7 ,grants ,to improve trauma care in rural areas ,section #abjb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;d-#c7 is amended-- 7#a7 by amending the section heading to read as follows3 ,grants to improve trauma care in rural areas2 7#b7 by amending subsections 7a7 and 7b7 to read as follows3 7a7 ,in general ,the ,secretary shall award grants to eligible entities for the purpose of carrying out research and demonstration projects to support the improvement of emergency medical services and trauma care in rural areas through the development of innovative uses of technology1 training and education1 transportation of seriously injured patients for the purposes of receiving such emergency medical services1 access to prehospital care1 evaluation of protocols for the purposes of improvement of outcomes and dissemination of any related best practices1 activities to facilitate clinical research1 as applicable and appropriate1 and increasing communication and coordination with applicable ,state or ,tribal trauma systems4 7b7 ,eligible entities 7#a7 ,in general ,to be eligible to receive a grant under this section1 an entity shall be a public or private entity that provides trauma care in a rural area4 7#b7 ,priority ,in awarding grants under this section1 the ,secretary shall give priority to eligible entities that will provide services under the grant in any rural area identified by a ,state under section #abad7;d77#a74 2 and 7#c7 by adding at the end the following3 7d7 ,reports ,an entity that receives a grant under this section shall submit to the ,secretary such reports as the ,secretary may require to inform administration of the program under this section4 4 7c7 ,pilot grants for trauma centers ,section #abjd of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;d-#f7 is amended-- 7#a7 by amending the section heading to read as follows3 ,pilot grants for trauma centers2 7#b7 in subsection 7a7-- 7,a7 by striking not fewer than #d and inserting #aj2 7,b7 by striking that design1 implement1 and evaluate and inserting to design1 implement1 and evaluate new or existing2 7,c7 by striking emergency care and inserting emergency medical2 and 7,d7 by inserting 1 and improve access to trauma care within such systems before the period2 7#c7 in subsection 7b77#a71 by striking subparagraphs 7,a7 and 7,b7 and inserting the following3 7,a7 a ,state or consortia of ,states2 7,b7 an ,indian ,tribe or ,tribal organization 7as defined in section #d of the ,indian ,self-,determination and ,education ,assistance ,act72 7,c7 a consortium of level ,i1 ,,ii1 or ,,iii trauma centers designated by applicable ,state or local agencies within an applicable ,state or region1 and1 as applicable1 other emergency services providers2 or 7,d7 a consortium or partnership of nonprofit ,indian ,health ,service1 ,indian ,tribal1 and urban ,indian trauma centers4 2 7#d7 in subsection 7c7-- 7,a7 in the matter preceding paragraph 7#a7-- 7i7 by striking that proposes a pilot project2 and 7ii7 by striking an emergency medical and trauma system that-- and inserting a new or existing emergency medical and trauma system4 ,such eligible entity shall use amounts awarded under this subsection to carry out #b or more of the following activities32 7,b7 in paragraph 7#a7-- 7i7 by striking coordinates and inserting ,strengthening coordination and communication2 and 7ii7 by striking an approach to emergency medical and trauma system access throughout the region1 including #i-a-a ,public ,safety ,answering ,points and emergency medical dispatch2 and inserting approaches to improve situational awareness and emergency medical and trauma system access1 including distribution of patients during a mass casualty incident1 throughout the region42 7,c7 in paragraph 7#b7-- 7i7 by striking includes and inserting ,providing2 7ii7 by inserting support patient movement to after region to2 and 7iii7 by striking the semicolon and inserting a period2 7,d7 in paragraph 7#c7-- 7i7 by striking allows for and inserting ,improving2 and 7ii7 by striking 2 and and inserting a period2 7,e7 in paragraph 7#d71 by striking includes a consistent and inserting ,supporting a consistent2 and 7,f7 by adding at the end the following3 7#e7 ,establishing1 implementing1 and disseminating1 or utilizing existing1 as applicable1 evidence-based or evidence-informed practices across facilities within such emergency medical and trauma system to improve health outcomes1 including such practices related to management of injuries1 and the ability of such facilities to surge4 7#f7 ,conducting activities to facilitate clinical research1 as applicable and appropriate4 2 7#e7 in subsection 7d77#b7-- 7,a7 in subparagraph 7,a7-- 7i7 in the matter preceding clause 7i71 by striking the proposed and inserting the applicable emergency medical and trauma system2 7ii7 in clause 7i71 by inserting or ,tribal entity after equivalent ,state office2 and 7iii7 in clause 7vi71 by striking 2 and and inserting a semicolon2 7,b7 by redesignating subparagraph 7,b7 as subparagraph 7,c72 and 7,c7 by inserting after subparagraph 7,a7 the following3 7,b7 for eligible entities described in subparagraph 7,c7 or 7,d7 of subsection 7b77#a71 a description of1 and evidence of1 coordination with the applicable ,state ,office of ,emergency ,medical ,services 7or equivalent ,state ,office7 or applicable such office for a ,tribe or ,tribal organization2 and 2 7#f7 in subsection 7e7-- 7,a7 in paragraph 7#a71 by striking #a for each #c and inserting #a for each #e2 and 7,b7 by adding at the end the following3 7#c7 ,waiver ,the ,secretary may waive all or part of the matching requirement described in paragraph 7#a7 for any fiscal year for a ,state1 consortia of ,states1 ,indian ,tribe or ,tribal organization1 or trauma center1 if the ,secretary determines that applying such matching requirement would result in serious hardship or an inability to carry out the purposes of the pilot program4 2 7#g7 in subsection 7f71 by striking population in a medically underserved area and inserting medically underserved population2 7#h7 in subsection 7g7-- 7,a7 in the matter preceding paragraph 7#a71 by striking described in2 7,b7 in paragraph 7#b71 by striking the system characteristics that contribute to and inserting opportunities for improvement1 including recommendations for how to improve2 7,c7 by striking paragraph 7#d72 7,d7 by redesignating paragraphs 7#e7 and 7#f7 as paragraphs 7#d7 and 7#e71 respectively2 7,e7 in paragraph 7#d71 as so redesignated1 by striking 2 and and inserting a semicolon2 7,f7 in paragraph 7#e71 as so redesignated1 by striking the period and inserting 2 and2 and 7,g7 by adding at the end the following3 7#f7 any evidence-based or evidence-informed strategies developed or utilized pursuant to subsection 7c77#e74 2 and 7#i7 by amending subsection 7h7 to read as follows3 7h7 ,dissemination of findings ,not later than #a year after the completion of the final project under subsection 7a71 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 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 7g7 and any additional actions planned by the ,secretary related to regionalized emergency care and trauma systems4 4 7d7 ,program funding ,section #abcb7;a7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;d-#cb7;a77 is amended by striking #bjaj through #bjad and inserting #bjbc through #bjbg4