29–006 

113TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 1st Session 113–5 

VETERAN EMERGENCY MEDICAL TECHNICIAN SUPPORT 

ACT OF 2013 

FEBRUARY 4, 2013.—Committed to the Committee of the Whole House on the State 

of the Union and ordered to be printed 

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

submitted the following 

R E P O R T 

[To accompany H.R. 235] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 235) to amend the Public Health Service Act to provide grants to States to streamline State requirements and procedures for veterans with military emergency medical training to become civilian emergency medical technicians, having considered the 

same, report favorably thereon without amendment and recommend that the bill do pass. 

CONTENTS 

Page 

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

Background and Need for the Legislation ............................................................. 2 

Hearings ................................................................................................................... 2 

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

Committee Votes ...................................................................................................... 3 

Committee Oversight Findings ............................................................................... 3 

Statement of General Performance Goals and Objectives .................................... 3 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 3 

Earmark, Limited Tax Benefits, and Limited Tariff Benefits ............................. 3 

Committee Cost Estimate ....................................................................................... 3 

Congressional Budget Office Estimate ................................................................... 3 

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

Duplication of Federal Programs ............................................................................ 5 

Disclosure of Directed Rule Makings ..................................................................... 5 

Advisory Committee Statement .............................................................................. 5 

Applicability to Legislative Branch ........................................................................ 5 

Section-by-Section Analysis of the Legislation ...................................................... 5 

Changes in Existing Law Made by the Bill, as Reported ..................................... 6 


sroberts on DSK5SPTVN1PROD with REPORTS
2 

1http://vets.syr.edu/wp-content/uploads/2012/09/Employment-Situation-July-20121.pdf 

PURPOSE AND SUMMARY

H.R. 235, the ‘‘Veteran Emergency Medical Technician Support 

Act of 2013,’’ was introduced on January 14, 2013, by Rep. Adam 

Kinzinger (R–IL) and referred to the Committee on Energy and 

Commerce. 

The legislation would amend the Public Health Service Act 

(PHSA) to provide demonstration grants to states with emergency 

medical technician (EMT) shortages to streamline state requirements for returning veterans with military EMT training to enter 

the EMT workforce without unnecessary duplication of their training. 

BACKGROUND AND NEED FOR THE LEGISLATION

Members of the U.S. military who trained as combat medics face 

State licensing challenges when they try to find similar work after 

discharge. Many States do not recognize their qualifications as applicable to the licensing requirements of the civilian health care 

system for emergency medical services, such as EMTs or paramedics. State licensing laws vary, and while some States make exceptions for former military medics to allow for reciprocity and a 

chance to sit for the licensing exam without repeating their training, many States do not. With many EMT shortage areas, and a 

10% unemployment rate among post 9/11 veterans,1 the legislation 

addresses two important policy goals and will help veterans transition into the civilian workforce as quickly as possible. 

H.R. 235, the ‘‘Veteran Emergency Medical Technician Support 

Act of 2013,’’ would provide demonstration grants to States with 

emergency medical technician (EMT) shortages to help streamline 

State requirements for returning veterans to enter the EMT workforce without unnecessary duplication of their training. States 

could determine the extent to which the State requirements for 

education and training of EMTs are equivalent to that of the military and identify methods, such as waivers, for qualified military 

EMTs to forego duplicative requirements. The bill would provide 

for an annual report to Congress on the demonstration grants. 

H.R. 235 would make available a total of $1,000,000 over a fiveyear period (FY 2014–FY 2018) for the program. Funding would be 

offset by authorizing it within total amounts authorized for the 

Area Health Education Centers (Section 751 of the PHSA). Any 

cost associated with enacting the provisions of this Act should be 

paid for out of existing funds. 

This bill is essentially the same as H.R. 4124, the ‘‘Veteran 

Emergency Medical Technician Support Act of 2012’’ that was 

passed by the House in September 2012 and sent to the Senate. No 

further action was taken on H.R. 4124 in the 112th Congress. 

HEARINGS

The Committee on Energy and Commerce has not held hearings 

on H.R. 235 during the 113th Congress. However, the Subcommittee on Health held a hearing on H.R. 4124 during the 112th 

Congress. 


sroberts on DSK5SPTVN1PROD with REPORTS
3 

COMMITTEE CONSIDERATION

On January 22, 2012, the Committee on Energy and Commerce 

met in open markup session and approved H.R. 235, the ‘‘Veteran 

Emergency Medical Technician Support Act of 2013,’’ by unanimous consent. 

COMMITTEE VOTES

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

to report legislation and amendments thereto. There were no 

record votes taken in connection with ordering H.R. 235 reported. 

A motion by Mr. Upton to order H.R. 235 reported to the House, 

without amendment, was agreed to by unanimous consent. 

COMMITTEE OVERSIGHT FINDINGS

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

of Representatives, the Committee has not held oversight hearings 

on this legislation. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

The goal of the legislation is to help Veteran EMTs to enter the 

civilian EMT workforce without unnecessary duplication of their 

training. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

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

House of Representatives, the Committee finds that H.R. 235, the 

‘‘Veteran Emergency Medical Technician Support Act of 2013,’’ 

would result in no new or increased budget authority, entitlement 

authority, or tax expenditures or revenues. 

EARMARK, LIMITED TAX BENEFITS, AND LIMITED TARIFF BENEFITS

In compliance with clause 9(e), 9(f), and 9(g) of rule XXI of the 

Rules of the House of Representatives, the Committee finds that 

H.R. 235, the ‘‘Veteran Emergency Medical Technician Support Act 

of 2013,’’ contains no earmarks, limited tax benefits, or limited tariff benefits. 

COMMITTEE COST ESTIMATE

The Committee adopts as its own the cost estimate prepared by 

the Director of the Congressional Budget Office pursuant to section 

402 of the Congressional Budget Act of 1974. 

CONGRESSIONAL BUDGET OFFICE ESTIMATE

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

of Representatives, the following is the cost estimate provided by 

the Congressional Budget Office pursuant to section 402 of the 

Congressional Budget Act of 1974: 


sroberts on DSK5SPTVN1PROD with REPORTS
4 

U.S. CONGRESS, CONGRESSIONAL BUDGET OFFICE, Washington, DC, January 31, 2013. 

Hon. FRED UPTON, 

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. 235, the Veteran Emergency Medical Technician Support Act of 2013. 

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. 235—Veteran Emergency Medical Technician Support Act of 

2013 

Summary: H.R. 235 would authorize grants to states for streamlining state certification and licensing requirements for veterans to 

become licensed or certified emergency medical technicians (EMT). 

The bill would authorize the appropriation of $1 million and CBO 

estimates that implementing the bill would cost $1 million over the 

2014–2018 period, assuming the appropriation of the authorized 

amount. Pay-as-you-go procedures do not apply to this legislation 

because it would not affect direct spending or revenues. 

The bill 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. 235 is shown in the following table. The costs 

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

By fiscal year, in millions of dollars— 

2013 2014 2015 2016 2017 2018 2013– 

2018 

CHANGES IN SPENDING SUBJECT TO APPROPRIATION 

Estimated Authorization Level ..................................... 0 1 0 0 0 0 1 

Estimated Outlays ....................................................... 0 * * * * 0 1 

Note: * = less than $500,000. 

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

and Human Services to award demonstration grants to states to 

streamline state licensing and certification standards to assist veterans to meet state requirements applicable to becoming a certified 

or licensed EMT in the state if they have completed military EMT 

training while serving in the Armed Forces. The bill would authorize the appropriation of $1 million for the period of 2014 through 

2018 and direct that the authorized amount come from funds appropriated in fiscal year 2014 to provide grants to area health education centers. 

For this estimate, CBO assumes that H.R. 225 will be enacted 

near the end of fiscal year 2013 and that the full amount authorized will be appropriated. Based on historical patterns of spending 

for the similar demonstration programs, CBO estimates that implementing the bill would cost less than $1 million in 2014 and a total 


sroberts on DSK5SPTVN1PROD with REPORTS
5 

of $1 million over the 2014–2018 period, assuming appropriation of 

the specified amounts. 

Intergovernmental and private-sector impact: H.R. 235 contains 

no intergovernmental or private-sector mandates as defined in 

UMRA. Funds authorized in the bill would benefit states that restructure state procedures to certify or license eligible veterans as 

emergency medical technicians. 

Estimate prepared by: Federal costs: Lisa Ramirez-Branum, Impact on state, local, and tribal governments: Lisa Ramirez-Branum, 

Impact on the private sector: Michael Levine. 

Estimate approved by: Holly Harvey, Deputy Assistant Director 

for Budget Analysis. 

FEDERAL MANDATES STATEMENT

The Committee adopts as its own the estimate of Federal mandates prepared by the Director of the Congressional Budget Office 

pursuant to section 423 of the Unfunded Mandates Reform Act. 

DUPLICATION OF FEDERAL PROGRAMS

No provision of H.R. 235, the ‘‘Veteran Emergency Medical Technician Support Act of 2013,’’ establishes or reauthorizes a program 

of the Federal Government known to be duplicative of another Federal program, a program that was included in any report from the 

Government Accountability Office to Congress pursuant to section 

21 of Public Law 111–139, or a program related to a program identified in the most recent Catalog of Federal Domestic Assistance. 

DISCLOSURE OF DIRECTED RULE MAKINGS

The Committee estimates that enacting H.R. 235, the ‘‘Veteran 

Emergency Medical Technician Support Act of 2013,’’ specifically 

directs to be completed no specific rule makings within the meaning of 5 U.S.C. 551. 

ADVISORY COMMITTEE STATEMENT

No advisory committees within the meaning of section 5(b) of the 

Federal Advisory Committee Act were created by this legislation. 

APPLICABILITY TO LEGISLATIVE BRANCH

The Committee finds that the legislation does not relate to the 

terms and conditions of employment or access to public services or 

accommodations within the meaning of section 102(b)(3) of the Congressional Accountability Act. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title 

Section 1 states that the legislation may be cited as the ‘‘Veteran 

Emergency Medical Technician Support Act of 2013.’’ 


sroberts on DSK5SPTVN1PROD with REPORTS
6 

Section 2. Assisting Veterans with military emergency medical 

training to meet requirements for becoming civilian emergency 

medical technicians 

Section 2 amends the PHSA by adding a new Section 315. The 

new section would allow the Secretary of Health and Human Services (HHS) to establish a program for awarding demonstration 

grants to states to streamline state requirements and procedures 

and assist veterans who have completed military emergency medical training in meeting state certification and licensing requirements. In addition, the HHS Secretary would be required to submit 

an annual report on the demonstration projects to Congress. Funding would be authorized within total amounts authorized for the 

Area Health Education Centers program (PHSA Section 751(j)(1)) 

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 (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, 

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 MEET REQUIREMENTS FOR BECOMING CIVILIAN EMERGENCY MEDICAL TECHNICIANS. 

(a) PROGRAM.—The Secretary shall establish a program consisting of awarding demonstration grants to States to streamline 

State requirements and procedures in order to assist veterans who 

completed military emergency medical technician training while 

serving in the Armed Forces of the United States to meet certification, licensure, and other requirements applicable to becoming an 

emergency medical technician in the State. 

(b) USE OF FUNDS.—Amounts received as a demonstration grant 

under this section shall be used to prepare and implement a plan 

to streamline State requirements and procedures as described in 

subsection (a), including by— 

(1) determining the extent to which the requirements for the 

education, training, and skill level of emergency medical technicians in the State are equivalent to requirements for the education, training, and skill level of military emergency medical 

technicians; and 

(2) identifying methods, such as waivers, for military emergency medical technicians to forego or meet any such equivalent 

State requirements. 


sroberts on DSK5SPTVN1PROD with REPORTS
7 

(c) ELIGIBILITY.—To be eligible for a grant under this section, a 

State shall demonstrate 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) FUNDING.—Of the amount authorized by section 751(j)(1) to be 

appropriated to carry out section 751 for fiscal year 2014, there is 

authorized to be appropriated to carry out this section $1,000,000 

for the period of fiscal years 2014 through 2018. 

* * * * * * * 

TITLE VII—HEALTH PROFESSIONS 

EDUCATION 

* * * * * * * 

PART D—INTERDISCIPLINARY, COMMUNITYBASED LINKAGES 

* * * * * * * 

SEC. 751. AREA HEALTH EDUCATION CENTERS. 

(a) * * * 

* * * * * * * 

(j) AUTHORIZATION OF APPROPRIATIONS.— (1) IN GENERAL.—øThere is authorized to be appropriated¿ 

Subject to section 315(e), there is authorized to be appropriated 

to carry out this section $125,000,000 for each of the fiscal 

years 2010 through 2014. 

* * * * * * * 

Æ 


sroberts on DSK5SPTVN1PROD with REPORTS