59–006 

114TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 114–552 

VETERAN EMERGENCY MEDICAL TECHNICIAN SUPPORT 

ACT OF 2016 

MAY 10, 2016.—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. 1818] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 1818) 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 with an amendment and recommend that the bill as amended do pass. 

CONTENTS 

Page 

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

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

Hearings ................................................................................................................... 3 

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 ................................................................... 4 

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 ...................................................... 6 

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

The amendment is as follows: 


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Strike all after the enacting clause and insert the following: 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Veteran Emergency Medical Technician Support Act 

of 2016’’. 

SEC. 2. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING TO MEET REQUIREMENTS FOR BECOMING CIVILIAN EMERGENCY MEDICAL TECHNICIANS. 

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 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 forgo or meet any such equivalent State requirements. 

‘‘(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.—No additional funds are authorized to be appropriated for the purpose of carrying out this section. This section shall be carried out using amounts 

otherwise available for such purpose.’’. 

PURPOSE AND SUMMARY

H.R. 1818, the ‘‘Veteran Emergency Medical Technician Support 

Act of 2016,’’ was introduced by Rep. Adam Kinzinger (R–IL) on 

April 15, 2015. 

The legislation amends 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 (EMT). 

BACKGROUND AND NEED FOR 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. 

H.R. 1818 would provide demonstration grants to states with 

EMT shortages to help streamline State requirements for veterans 

to enter the EMT workforce without unnecessary duplication of 

their training. No additional funds are authorized to be appropriated for this legislation. 


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HEARINGS

On January 27, 2015, the Subcommittee on Health held a hearing on a discussion draft of H.R. 1818. The Subcommittee received 

testimony from: 

• LTC (Ret.) Ben Chlapek, the National Association of Emergency Medical Technicians. 

COMMITTEE CONSIDERATION

On April 20, 2016 the Subcommittee on Health met in open 

markup session and forwarded H.R. 1818 to the full Committee, 

without amendment, by a voice vote. On April 26, 27, and 28, 2016, 

the full Committee on Energy and Commerce met in open markup 

session and ordered H.R. 1818 reported to the House, as amended, 

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 the record votes on the motion 

to report legislation and amendments thereto. There were no 

record votes taken in connection with ordering H.R. 1818 reported. 

COMMITTEE OVERSIGHT FINDINGS

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

of Representatives, the Committee held a hearing and made findings that are reflected in this report. 

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. 1818 

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. 1818 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. 


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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: 

U.S. CONGRESS, 

CONGRESSIONAL BUDGET OFFICE, 

Washington, DC, May 6, 2016. 

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. 1818, the Veteran Emergency Medical Technician Support Act of 2016. 

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

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

Sincerely, 

KEITH HALL. 

Enclosure. 

H.R. 1818—Veteran Emergency Medical Technician Support Act of 

2016 

Summary: H.R. 1818 would direct the Secretary of Health and 

Human Services (HHS) to award demonstration grants to states to 

streamline procedures for licensing and certifying emergency medical technicians (EMT) who received similar certifications while 

serving in the armed forces. 

CBO estimates that implementing H.R. 1818 would cost $30 million over the 2017–2021 period; any such spending would be subject to the availability of appropriated funds. Pay-as-you-go procedures do not apply to this legislation because it would not affect 

direct spending or revenues. CBO estimates that enacting H.R. 

1818 would not increase net direct spending or on-budget deficits 

in any of the four consecutive 10-year periods beginning in 2027. 

H.R. 1818 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 effect of H.R. 1818 is shown in the following table. The costs 

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

By fiscal year, in millions of dollars— 

2017 2018 2019 2020 2021 2017–2021 

INCREASES IN SPENDING SUBJECT TO APPROPRIATION 

Estimated Authorization Level .............................. 3 5 8 11 12 39 

Estimated Outlays ................................................ 1 3 6 9 11 30 

Basis of estimate: The bill would authorize a demonstration program of grants to states to help them streamline requirements and 

procedures necessary for licensing emergency medical technicians 

who have backgrounds and experience as military medical technicians. 

Based on information from the Department of Labor’s interim report on the Veterans’ Licensing and Certification Demonstration, 


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CBO expects most states would use grant funds provided by HHS 

to provide training and education assistance to veterans who would 

like to become a certified or licensed EMT. Based on data from the 

Department of Defense and information from training providers, 

CBO estimates that approximately 5,000 veterans per year would 

participate in the training program once it is fully implemented 

and that training costs would average about $2,000 per participant. 

In total, CBO estimates that implementing H.R. 1818 would cost 

$30 million over the 2017–2021 period; such spending would be 

subject to the availability of appropriated funds. 

Pay-As-You-Go considerations: None. 

Increase in long-term direct spending and deficits: CBO estimates that enacting H.R. 1818 would not increase net direct spending or on-budget deficits in any of the four consecutive 10-year periods beginning in 2027. 

Intergovernmental and private-sector impact: H.R. 1818 contains 

no intergovernmental or private-sector mandates as defined in 

UMRA and would impose no costs on state, local, or tribal governments. 

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

private sector: Amy Petz. 

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. 1818 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. 1818 specifically directs to be completed 0 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. 


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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 2016.’’ 

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. 

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 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 


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

State requirements. 

(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.—No additional funds are authorized to be appropriated for the purpose of carrying out this section. This section 

shall be carried out using amounts otherwise available for such 

purpose. 

* * * * * * * 

Æ 


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