PUBLIC LAW 101-590 —NOV. 16, 1990 104 STAT. 2921 "(D) to monitor trauma patient care (including prehospital care) in each designated trauma center within regional trauma care systems in the State (including relevant emergency-department discharges and rehabilitation information) for the purpose of evaluating the diagnosis, treatment and treatment 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 in the State; and "(F) to identify patients transferred within a regional trauma system, including reasons for such transfer; "(8) to provide for the use of procedures by paramedics and emergency medical technicians to assess the severity of the injuries incurred by trauma patients; "(9) to provide appropriate transportation and transfer policies to ensure the delivery of patients to designated trauma centers and other facilities 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, and to provide periodic reviews of the transfers and the auditing of such transfers that are determined to be appropriate; "(10) to conduct public education activities concerning injury prevention and obtaining access to trauma care; and "(11) with respect to the requirements established in this subsection, provides for coordination and cooperation between the State and any other State with which the State shares any standard metropolitan statistical area. "(b) CERTAIN STANDARDS WITH RESPECT TO TRAUMA CARE CENTERS AND SYSTEMS. — "(1) IN GENERAL.—The Secretary may not make payments under section 1211(a) for a fiscal year unless the State involved agrees that, in carrying out paragraphs (3) through (5) of subsection (a), the State will adopt standards for the designation of trauma centers, and for triage, transfer, and transportation policies, and that the State wSl, in adopting such standards— "(A) take into account national standards concerning such; "(B) consult with medical, surgical, and nursing speciality groups, hospital associations, emergency medical services State and local directors, concerned advocates and other interested parties; "(C) conduct hearings on the proposed standards after providing adequate notice to the public concerning such hearing; and "(D) beginning in fiscal year 1992, take into account the model plan described in subsection (c). "(2) QUALITY OF TRAUMA CARE.— The highest quality of trauma care shall be the primary goal of State standards adopted under this subsection. "(3) APPROVAL BY SECRETARY. — The Secretary may not make payments under section 1211(a) to a State if the Secretary determines that— "(A) in the case of payments for fiscal year 1991 and subsequent fiscal years, the State has not taken into account national standards, including those of the American College of Surgeons, the American College of Emer-
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