State legislatures regularly address issues related to the provision of trauma care and injury pre- vention. The U.S. Congress has also historically
played a role in trauma system development and funding, but federal lawmakers recently have experienced
difficulty passing system development legislation and
appropriating money for trauma, leaving it to state
legislatures to identify funding sources and to design
and implement their own trauma systems.
The American College of Surgeons (ACS) actively
monitors state legislative activity. In 2015, for example,
ACS State Affairs staff has reviewed approximately 200
pieces of trauma-related legislation. Most of these bills
pertained to injury prevention efforts, but some were
related to trauma system development and funding. In
addition, the American Medical Association’s (AMA)
House of Delegates (HOD), which includes an ACS delegation, took a close look at trauma prevention during
its annual meeting in June. A number of resolutions
were put forth calling for the AMA to weigh in on
injury prevention policy.
This article examines the trauma-related issues considered in state legislatures and by the AMA HOD over
the last year.
State legislatures debated a significant amount of legislation aimed at injury prevention in 2015, including laws
pertaining to distracted driving, motorcycle helmet
use, gun control, and vulnerable users of roadways.
The most ubiquitous type of injury prevention legislation recently considered in the state legislatures seeks
to discourage distracted driving. Most states restrict
the use of cell phones and other handheld devices
while driving. In all, 14 states (California, Connecticut,
Delaware, Hawaii, Illinois, Maryland, Nevada, New
Hampshire, New Jersey, New York, Oregon, Vermont,
Washington, and West Virginia), and the District of
Columbia and Puerto Rico, have prohibited drivers
from using handheld devices; however, most states
have specifically banned texting while driving with
either a primary or secondary enforcement mechanism.
A primary enforcement mechanism means that an officer can ticket the driver for the offense without any
other traffic violation taking place, whereas a secondary enforcement mechanism means an officer can only
issue a ticket if a driver has been pulled over for another
violation, such as driving erratically. Only two states,
Montana and Arizona, allow texting while driving.
This year, the lawmakers at the state level considered
legislation that would update current distracted driving
statutes to address advances in technology. Utah is one
of the few states that attempted to weaken its law by
altering its ban on texting while driving to allow one-button dialing on cell phones with voice commands and
similar one-button commands for music or other apps.
However, that legislation failed to advance.
Motorcycle helmet mandates
In a number of states, legislators attempted but ultimately failed to change current laws related to
mandatory helmet use. In Iowa, H.F. 267 would have
mandated that motorcycle operators and passengers
wear a safety helmet. In New Mexico, two bills were
introduced that would have placed new requirements
on motorcycle operators. One bill, S.B. 327, would
have implemented a universal helmet requirement.
The other bill, S.B. 308, would have instituted a helmet
requirement, although under the proposed law operators would have been permitted to ride helmetless if
they were older than 18 years of age and if they had purchased a validating sticker for $692. The fees collected
• Describes state-level legislative activity
regarding injury prevention and
trauma system development
• Updates on distracted driving and motorcycle
helmet safety mandates are summarized
• Discusses the AMA HOD annual meeting, which
focused on resolutions related to gun safety and
protective headgear for female lacrosse players
V100 No 9 BULLETIN American College of Surgeons