89–006 

111TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 111–608 

EMT ACT OF 2010 

SEPTEMBER 16, 2010.—Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 

Mr. WAXMAN, from the Committee on Energy and Commerce, 

submitted the following 

R E P O R T 

[To accompany H.R. 3199] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 3199) to amend the Public Health Service Act to provide grants to State emergency medical service departments to provide for the expedited training and licensing of veterans with prior 

medical training, and for other purposes, having considered the 

same, report favorably thereon with an amendment and recommend that the bill as amended do pass. 

CONTENTS 

Page 

Amendment .............................................................................................................. 2 

Purpose and Summary ............................................................................................ 2 

Background and Need for Legislation .................................................................... 3 

Committee Consideration ........................................................................................ 3 

Committee Votes ...................................................................................................... 4 

Committee Oversight Findings and Recommendations ........................................ 4 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 4 

Statement of General Performance Goals and Objectives .................................... 4 

Constitutional Authority Statement ...................................................................... 4 

Earmarks and Tax and Tariff Benefits .................................................................. 4 

Federal Advisory Committee Statement ................................................................ 4 

Applicability of Law to Legislative Branch ........................................................... 5 

Federal Mandates Statement ................................................................................. 5 

Committee Cost Estimate ....................................................................................... 5 

Congressional Budget Office Cost Estimate .......................................................... 5 

Section-by-Section Analysis of the Legislation ...................................................... 6 

Changes in Existing Law Made by the Bill, as Reported ..................................... 7 


jbell on DSKDVH8Z91PROD with REPORTS
2 

AMENDMENT

The amendment is as follows: 

Strike all after the enacting clause and insert the following: 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Emergency Medic Transition Act of 2010’’ or the ‘‘EMT Act of 2010’’. 

SEC. 2. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING TO BECOME 

STATE-LICENSED OR CERTIFIED EMERGENCY MEDICAL TECHNICIANS (EMTS). 

(a) IN GENERAL.—Part B of title III of the Public Health Service Act (42 U.S.C. 

243 et seq.) is amended by inserting after section 314 the following: 

‘‘SEC. 315. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING TO BECOME STATE-LICENSED OR CERTIFIED EMERGENCY MEDICAL TECHNICIANS 

(EMTS). 

‘‘(a) PROGRAM.—The Secretary shall establish a program consisting of awarding grants to States to assist veterans who received and completed military emergency 

medical training while serving in the Armed Forces of the United States to become, 

upon their discharge or release from active duty service, State-licensed or certified 

emergency medical technicians. ‘‘(b) USE OF FUNDS.—Amounts received as a grant under this section may be used to assist veterans described in subsection (a) to become State-licensed or certified 

emergency medical technicians as follows: 

‘‘(1) Providing to such veterans required course work and training that take 

into account, and are not duplicative of, medical course work and training received when such veterans were active members of the Armed Forces of the 

United States, to enable such veterans to satisfy emergency medical services 

personnel certification requirements in the civilian sector, as determined by the 

appropriate State regulatory entity. 

‘‘(2) Providing reimbursement for costs associated with— 

‘‘(A) such course work and training; or 

‘‘(B) applying for licensure or certification. 

‘‘(3) Expediting the licensing or certification process. 

‘‘(4) Entering into an agreement with any institution of higher education, or 

other educational institution certified to provide course work and training to 

emergency medical personnel, for purposes of providing course work and training under this section if such institution has developed a suitable curriculum 

that meets the requirements of paragraph (1). 

‘‘(c) ELIGIBILITY.—To be eligible for a grant under this section, a State shall demonstrate to the Secretary’s satisfaction that the State has a shortage of emergency 

medical technicians. 

‘‘(d) REPORT.—The Secretary shall submit to the Congress an annual report on the 

program under this section. 

‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there are authorized to be appropriated $5,000,000 for each of fiscal years 2011 through 2015.’’. 

(b) GAO STUDY AND REPORT.—The Comptroller General of the United States 

shall— 

(1) conduct a study on the barriers experienced by veterans who received 

training as medical personnel while serving in the Armed Forces of the United 

States and, upon their discharge or release from active duty service, seek to become licensed or certified in a State as civilian health professionals; and 

(2) not later than 2 years after the date of the enactment of this Act, submit 

to the Congress a report on the results of such study, including recommendations on whether the program established under section 315 of the Public 

Health Service Act, as added by subsection (a), should be expanded to assist 

veterans seeking to become licensed or certified in a State as health providers 

other than emergency medical technicians. 

PURPOSE AND SUMMARY

H.R. 3199, the ‘‘Emergency Medic Transition (EMT) Act of 2009’’, 

was introduced by Rep. Jane Harman (D–CA) and referred to the 

Committee on Energy and Commerce on July 14, 2009. The goal 

of H.R. 3199 is to help states with a shortage of emergency medical 

technicians (EMTs) qualify veterans with military medical training 

to become state-certified EMTs. 


jbell on DSKDVH8Z91PROD with REPORTS
3 

H.R. 3199 amends the Public Health Service Act to direct the 

Secretary of Health and Human Services (HHS) to establish a program consisting of grants to state entities with jurisdiction over 

emergency medical personnel to help defray the costs to veterans 

with military medical training to become a state-qualified or licensed EMT. The legislation authorizes such grants to be used to: 

• Provide EMT training. 

• Provide reimbursement for costs associated with EMT training and the application process for EMT licensure or certification. 

• Expedite the EMT licensing or certification process. 

The legislation also authorizes $5 million in each of fiscal years 

2011 through 2015 to support these activities. 

During consideration of H.R. 3199, the Subcommittee on Health 

adopted a substitute amendment (manager’s amendment) offered 

by Rep. Harman that made several changes to the bill. The substitute amendment includes the following provisions: 

• Clarifies that grant money can be used for training veterans 

to become EMTs. 

• Requires states to demonstrate that they have a shortage of 

EMTs in the state in order to be eligible for grant funds. 

• Requires the Government Accountability Office (GAO) to (1) 

conduct a study to examine existing barriers that restrict the 

ability of returning veterans with medical training to become 

civilian health professionals; and (2) make recommendations 

on whether the program established under the legislation 

should be expanded to help returning veterans with medical 

training become other kinds of state-qualified health professionals. 

BACKGROUND AND NEED FOR LEGISLATION

Veterans with military medical training often encounter significant certification fees and burdensome requirements to study 

entry-level curricula when they seek to qualify as civilian EMTs, 

making their entry into this field more difficult and time-consuming. These barriers come at a time when states with EMT 

shortages are seeking additional personnel to help build their 

emergency response capability. H.R. 3199 is designed to address 

both of these concerns. 

COMMITTEE CONSIDERATION

H.R. 3199, the ‘‘Emergency Medic Transition (EMT) Act of 2009’’, 

was introduced by Rep. Harman (D–CA) and referred to the Committee on Energy and Commerce on July 14, 2009. The bill was 

subsequently referred to the Subcommittee on Health on July 15, 

2009. On July 22, 2010, the Subcommittee on Health met in open 

markup session to consider H.R. 3199. An amendment in the nature of a substitute (manager’s amendment) by Rep. Harman was 

adopted by a voice vote. Subsequently, H.R. 3199 was favorably forwarded to the full Committee, amended, by a voice vote. 

On July 28, 2010, the Committee on Energy and Commerce met 

in open markup session and considered H.R. 3199 as approved by 

the Subcommittee. Subsequently, the Committee ordered H.R. 3199 


jbell on DSKDVH8Z91PROD with REPORTS
4 

favorably reported to the House, as amended by the Subcommittee 

on Health, by a voice vote. 

COMMITTEE VOTES

Clause 3(b) of rule XIII of the Rules of the House of Representatives requires the Committee to list each record vote on the motion 

to report legislation and amendments thereto. A motion by Mr. 

Waxman ordering H.R. 3199 reported to the House, as amended by 

the Subcommittee on Health on July 22, 2010, was approved by a 

voice vote. There were no record votes taken during consideration 

of this bill. 

COMMITTEE OVERSIGHT FINDINGS AND RECOMMENDATIONS

In compliance with clause 3(c)(1) of rule XIII and clause (2)(b)(1) 

of rule X of the Rules of the House of Representatives, the oversight findings and recommendations of the Committee are reflected 

in the descriptive portions of this report, including the finding that 

veterans with military medical training often encounter significant 

obstacles when seeking to qualify as civilian EMTs. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

Regarding compliance with clause 3(c)(2) of rule XIII of the Rules 

of the House of Representatives, the Committee finds that H.R. 

3199 would result in no new budget authority, entitlement authority, or tax expenditures or revenues. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c)(4) of rule XIII of the Rules of the 

House of Representatives, the performance goals and objectives of 

the Committee are reflected in the descriptive portions of this report, including the goal of helping states with a shortage of emergency medical technicians qualify veterans with military medical 

training to become state-certified EMTs. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that the constitutional authority for H.R. 3199 is provided under Article I, section 8, clauses 

3 and 18 of the Constitution of the United States. 

EARMARKS AND TAX AND TARIFF BENEFITS

H.R. 3199 does not contain any congressional earmarks, limited 

tax benefits, or limited tariff benefits as defined in clause 9(d), 9(e), 

or 9(f) of rule XXI of the Rules of the House of Representatives. 

FEDERAL ADVISORY COMMITTEE STATEMENT

The Committee finds that the legislation does not establish or 

authorize the establishment of an advisory committee within the 

definition of 5 U.S.C. App., section 5(b) of the Federal Advisory 

Committee Act. 


jbell on DSKDVH8Z91PROD with REPORTS
5 

APPLICABILITY OF LAW TO THE LEGISLATIVE BRANCH

Section 102(b)(3) of Public Law 104–1 requires a description of 

the application of this bill to the legislative branch where the bill 

relates to terms and conditions of employment or access to public 

services and accommodations. H.R. 3199 contains no such provisions. 

FEDERAL MANDATES STATEMENT

Section 423 of the Congressional Budget and Impoundment Con- trol Act of 1974 (as amended by section 101(a)(2) of the Unfunded 

Mandates Reform Act, P.L. 104–4) requires a statement on whether 

the provisions of the report include unfunded mandates. In compliance with this requirement the Committee adopts as its own the 

estimates of federal mandates prepared by the Director of the Congressional Budget Office. 

COMMITTEE COST ESTIMATE

Pursuant to clause 3(d)(2) of rule XIII of the Rules of the House 

of Representatives, the Committee adopts as its own the cost estimate of H.R. 3199 prepared by the Director of the Congressional 

Budget Office pursuant to section 402 of the Congressional Budget 

Act of 1974. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

With respect to the requirements of clause (3)(c)(3) of rule XIII 

of the Rules of the House of Representatives and section 402 of the 

Congressional Budget Act of 1974, the Committee has received the 

following cost estimate for H.R. 3199 from the Director of the Congressional Budget Office: 

SEPTEMBER 7, 2010. 

Hon. HENRY A. WAXMAN, 

Chairman, Committee on Energy and Commerce, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 3199, the Emergency 

Medic Transition Act of 2010. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Lisa Ramirez-Branum. 

Sincerely, 

DOUGLAS W. ELMENDORF. 

Enclosure. 

H.R. 3199—Emergency Medic Transition Act of 2010 

Summary: H.R. 3199 would authorize a grant program to provide 

funds to states to assist veterans who received and completed military emergency medical training while serving in the Armed Forces 

to become licensed or certified emergency medical technicians. 

The bill would authorize the appropriation of $5 million for fiscal 

year 2011 and $25 million over the 2011–2015 period. Assuming 

the appropriation of those amounts, CBO estimates that implementing the act would cost $3 million in 2011 and $23 million over 

the 2011–2015 period. Enacting H.R. 3199 would not affect direct 


jbell on DSKDVH8Z91PROD with REPORTS
6 

spending or revenues; therefore, pay-as-you-go procedures do not 

apply. 

H.R. 3199 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act (UMRA). 

Estimated cost to the Federal Government: The estimated budgetary impact of H.R. 3199 is shown in the following table. The costs 

of this legislation fall within budget function 550 (health). 

By fiscal year, in millions of dollars— 

2011 2012 2013 2014 2015 2011– 

2015 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Authorization Level ................................................................................... 5 5 5 5 5 25 

Estimated Outlays .................................................................................... 3 5 5 5 5 23 

Basis of estimate: The bill would direct the Secretary of Health 

and Human Services to award grants to states to assist veterans 

to become licensed or certified to work in states as a certified emergency medical technician (EMT). The bill would authorize $5 million in fiscal year 2011 and for each fiscal year through 2015. For 

this estimate, CBO assumes that H.R. 3199 will be enacted near 

the beginning of fiscal year 2011 and that the full amounts authorized will be appropriated. The outlays are estimated based on the 

projected number of military personnel discharged or released from 

active duty service who would be eligible to receive grant assistance, the average costs to train and license an EMT, and the assumption that the authorized amounts would be appropriated near 

the beginning of each fiscal year. 

Grant funds would be available to support the costs of classes, 

other training, and licensing fees. H.R. 3199 also would require the 

Government Accountability Office to conduct a study on the barriers experienced by veterans who receive training as medical personnel while serving in the Armed Forces of the United States and, 

upon their discharge or release from active duty service, seek to become licensed or certified in a state as a civilian health professional. 

Intergovernmental and private-sector impact: H.R. 3199 contains 

no intergovernmental or private-sector mandates as defined in 

UMRA. Funds authorized in the bill would benefit states that provide training and education assistance to veterans. 

Estimate prepared by: Federal Costs and Impact on State, Local, 

and Tribal Governments: Lisa Ramirez-Branum, Impact on the Private Sector: Sarah Axeen. 

Estimate approved by: Peter H. Fontaine, Assistant Director for 

Budget Analysis. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title; Table of contents 

Section 1 designates that the short title may be cited as the 

‘‘Emergency Medic Transition Act of 2010’’ or ‘‘EMT Act of 2010’’. 


jbell on DSKDVH8Z91PROD with REPORTS
7 

Section 2. Assisting veterans with military emergency medical training to become State-licensed or certified emergency medical 

technicians (EMTs) 

Section 2(a) establishes a program at HHS to award grants to 

states to assist veterans with military emergency medical training 

to become state-licensed or certified EMTs. It sets forth grant eligibility criteria and specifies the requirements for use of grant funds. 

It also requires that the HHS Secretary submit an annual report 

to Congress on the program. 

Section 2(b) requires the Government Accountability Office to 

conduct a study on the barriers experienced by veterans with military medical training to become civilian EMTs. It also requires 

GAO to make recommendations as to whether the program established under the legislation should be expanded to assist veterans 

seeking to become licensed or certified in a State as a health provider other than an EMT. 

CHANGES IN EXISTING LAW MADE BY THE BILL, AS REPORTED

In compliance with clause 3(e) of rule XIII of the Rules of the 

House of Representatives, changes in existing law made by the bill, 

as reported, are shown as follows (new matter is printed in italic 

and existing law in which no change is proposed is shown in 

roman): 

PUBLIC HEALTH SERVICE ACT 

* * * * * * * 

TITLE III—GENERAL POWERS AND DUTIES OF PUBLIC 

HEALTH SERVICE 

* * * * * * * 

PART B—FEDERAL-STATE COOPERATION 

* * * * * * * 

SEC. 315. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL 

TRAINING TO BECOME STATE-LICENSED OR CERTIFIED 

EMERGENCY MEDICAL TECHNICIANS (EMTS). 

(a) PROGRAM.—The Secretary shall establish a program consisting of awarding grants to States to assist veterans who received 

and completed military emergency medical training while serving in 

the Armed Forces of the United States to become, upon their discharge or release from active duty service, State-licensed or certified 

emergency medical technicians. 

(b) USE OF FUNDS.—Amounts received as a grant under this section may be used to assist veterans described in subsection (a) to become State-licensed or certified emergency medical technicians as 

follows: 

(1) Providing to such veterans required course work and 

training that take into account, and are not duplicative of, medical course work and training received when such veterans were 

active members of the Armed Forces of the United States, to enable such veterans to satisfy emergency medical services personnel certification requirements in the civilian sector, as determined by the appropriate State regulatory entity. 


jbell on DSKDVH8Z91PROD with REPORTS
8 

(2) Providing reimbursement for costs associated with— (A) such course work and training; or 

(B) applying for licensure or certification. (3) Expediting the licensing or certification process. 

(4) Entering into an agreement with any institution of higher 

education, or other educational institution certified to provide 

course work and training to emergency medical personnel, for 

purposes of providing course work and training under this section if such institution has developed a suitable curriculum that 

meets the requirements of paragraph (1). (c) ELIGIBILITY.—To be eligible for a grant under this section, a 

State shall demonstrate to the Secretary’s satisfaction that the State 

has a shortage of emergency medical technicians. (d) REPORT.—The Secretary shall submit to the Congress an annual report on the program under this section. (e) AUTHORIZATION OF APPROPRIATIONS.—To carry out this section, there are authorized to be appropriated $5,000,000 for each of 

fiscal years 2011 through 2015. 

* * * * * * * 

fi 


jbell on DSKDVH8Z91PROD with REPORTS