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HELPING VETERANS WITH EMERGENCY MEDICAL 

TRAINING TRANSITION TO CIVILIAN SERVICE 

HEARING 

BEFORE THE

SUBCOMMITTEE ON HEALTH 

OF THE

COMMITTEE ON ENERGY AND 

COMMERCE 

HOUSE OF REPRESENTATIVES 

ONE HUNDRED TWELFTH CONGRESS 

SECOND SESSION 

JULY 11, 2012 

Serial No. 112–162 

( 

Printed for the use of the Committee on Energy and Commerce 

energycommerce.house.gov 

COMMITTEE ON ENERGY AND COMMERCE 

FRED UPTON, Michigan 

Chairman 

JOE BARTON, Texas 

Chairman Emeritus 

CLIFF STEARNS, Florida 

ED WHITFIELD, Kentucky 

JOHN SHIMKUS, Illinois 

JOSEPH R. PITTS, Pennsylvania 

MARY BONO MACK, California 

GREG WALDEN, Oregon 

LEE TERRY, Nebraska 

MIKE ROGERS, Michigan 

SUE WILKINS MYRICK, North Carolina 

Vice Chairman 

JOHN SULLIVAN, Oklahoma 

TIM MURPHY, Pennsylvania 

MICHAEL C. BURGESS, Texas 

MARSHA BLACKBURN, Tennessee 

BRIAN P. BILBRAY, California 

CHARLES F. BASS, New Hampshire 

PHIL GINGREY, Georgia 

STEVE SCALISE, Louisiana 

ROBERT E. LATTA, Ohio 

CATHY MCMORRIS RODGERS, Washington 

GREGG HARPER, Mississippi 

LEONARD LANCE, New Jersey 

BILL CASSIDY, Louisiana 

BRETT GUTHRIE, Kentucky 

PETE OLSON, Texas 

DAVID B. MCKINLEY, West Virginia 

CORY GARDNER, Colorado 

MIKE POMPEO, Kansas 

ADAM KINZINGER, Illinois 

H. MORGAN GRIFFITH, Virginia 

HENRY A. WAXMAN, California 

Ranking Member 

JOHN D. DINGELL, Michigan 

Chairman Emeritus 

EDWARD J. MARKEY, Massachusetts 

EDOLPHUS TOWNS, New York 

FRANK PALLONE, JR., New Jersey 

BOBBY L. RUSH, Illinois 

ANNA G. ESHOO, California 

ELIOT L. ENGEL, New York 

GENE GREEN, Texas 

DIANA DEGETTE, Colorado 

LOIS CAPPS, California 

MICHAEL F. DOYLE, Pennsylvania 

JANICE D. SCHAKOWSKY, Illinois 

CHARLES A. GONZALEZ, Texas 

TAMMY BALDWIN, Wisconsin 

MIKE ROSS, Arkansas 

JIM MATHESON, Utah 

G.K. BUTTERFIELD, North Carolina 

JOHN BARROW, Georgia 

DORIS O. MATSUI, California 

DONNA M. CHRISTENSEN, Virgin Islands 

KATHY CASTOR, Florida 

JOHN P. SARBANES, Maryland 

SUBCOMMITTEE ON HEALTH

JOSEPH R. PITTS, Pennsylvania 

Chairman 

MICHAEL C. BURGESS, Texas 

Vice Chairman 

ED WHITFIELD, Kentucky 

JOHN SHIMKUS, Illinois 

MIKE ROGERS, Michigan 

SUE WILKINS MYRICK, North Carolina 

TIM MURPHY, Pennsylvania 

MARSHA BLACKBURN, Tennessee 

PHIL GINGREY, Georgia 

ROBERT E. LATTA, Ohio 

CATHY MCMORRIS RODGERS, Washington 

LEONARD LANCE, New Jersey 

BILL CASSIDY, Louisiana 

BRETT GUTHRIE, Kentucky 

JOE BARTON, Texas 

FRED UPTON, Michigan (ex officio) 

FRANK PALLONE, JR., New Jersey 

Ranking Member 

JOHN D. DINGELL, Michigan 

EDOLPHUS TOWNS, New York 

ELIOT L. ENGEL, New York 

LOIS CAPPS, California 

JANICE D. SCHAKOWSKY, Illinois 

CHARLES A. GONZALEZ, Texas 

TAMMY BALDWIN, Wisconsin 

MIKE ROSS, Arkansas 

ANTHONY D. WEINER, New York 

JIM MATHESON, Utah 

HENRY A. WAXMAN, California (ex officio) 

(II) 

(III) 

C O N T E N T S 

Page 

Hon. Joseph R. Pitts, a Representative in Congress from the Commonwealth 

of Pennsylvania, opening statement ................................................................... 1 

Prepared statement .......................................................................................... 3 

Hon. Joe Barton, a Representative in Congress from the State of Texas, 

opening statement ................................................................................................ 4 

Hon. Adam Kinzinger, a Representative in Congress from the State of Illinois, 

opening statement ................................................................................................ 4 

Hon. Frank Pallone, Jr., a Representative in Congress from the State of 

New Jersey, opening statement .......................................................................... 5 

Hon. Lois Capps, a Representative in Congress from the State of California, 

opening statement ................................................................................................ 6 

Hon. John D. Dingell, a Representative in Congress from the State of Michigan, prepared statement ...................................................................................... 37 

Hon. Henry A. Waxman, a Representative in Congress from the State of 

California, prepared statement ........................................................................... 42 

WITNESSES

Ben D. Chlapek, Deputy Chief, Central Jackson County Fire Protection District, Blue Springs, Missouri, and Chair, Military Relations Committee, 

National Association of Emergency Medical Technicians ................................. 8 

Prepared statement .......................................................................................... 10 

Daniel M. Nichols, Senior Vice President, Victory Media, and Chief Executive 

Officer, Victory Tech ............................................................................................ 18 

Prepared statement .......................................................................................... 20 

(1) 

HELPING VETERANS WITH EMERGENCY MEDICAL TRAINING TRANSITION TO CIVILIAN 

SERVICE 

WEDNESDAY, JULY 11, 2012 

HOUSE OF REPRESENTATIVES, 

SUBCOMMITTEE ON HEALTH, 

COMMITTEE ON ENERGY AND COMMERCE, 

Washington, DC. 

The subcommittee met, pursuant to call, at 10:16 a.m., in room 

2123, Rayburn House Office Building, Hon. Joseph R. Pitts (chairman of the subcommittee) presiding. 

Members present: Representatives Pitts, Shimkus, Murphy, 

Gingrey, Latta, Lance, Cassidy, Guthrie, Barton, Kinzinger, 

Pallone, Dingell, Capps, and Schakowsky. 

Staff present: Anita Bradley, Senior Policy, Advisor to Chairman 

Emeritus; Brenda Destro, Professional Staff Member, Health; Ryan 

Long, Chief Counsel, Health; Katie Novaria, Legislative Clerk; 

Monica Popp, Professional Staff Member, Health; Andrew 

Powaleny, Deputy Press Secretary; Heidi Stirrup, Health Policy Coordinator; Alli Corr, Democratic Policy Analyst; Ruth Katz, Democratic Chief Public Health Counsel; and Anne Morris Reid, Democratic Professional Staff Member. 

Mr. PITTS. The subcommittee will come to order. The Chair will 

recognize himself for 5 minutes for an opening statement. 

OPENING STATEMENT OF HON. JOSEPH R. PITTS, A REPRESENTATIVE IN CONGRESS FROM THE COMMONWEALTH 

OF PENNSYLVANIA 

We are here today to discuss H.R. 4124, the Veteran Emergency 

Medical Technician Support Act of 2012, which would give States 

demonstration grants to study how to better integrate military 

medics into civilian EMT jobs. 

Emergency response is a crucial component of our health care 

system, as EMTs are often the first point of contact in a crisis situation, and their care can make the difference between life and 

death. Emergency response is even more crucial on the battlefield, 

where military medics respond to emergencies and provide care for 

the soldiers until a physician or other health professional can take 

over. These soldiers, trained as combat medics, become very experienced dealing with massive trauma injuries and other complex 

health problems. 

It seems that utilizing those with combat medic experience in our 

EMT workforce here at home would be good for the returning solVerDate Aug 31 2005 09:48 Nov 26, 2013 Jkt 037690 PO 00000 Frm 00005 Fmt 6633 Sfmt 6633 F:\112-16~3\112-16~1 WAYNE
2 

diers, good for the health care system, and good for patients. Many 

areas throughout the U.S. are experiencing a shortage of EMTs, 

both paid and volunteers, and military medics could potentially fill 

those workforce gaps. However, there are a number of issues keeping military medics from EMT employment. Most importantly are 

State licensing requirements, which can require duplicative training and education that is likely to be unnecessary for someone with 

significant experience. There is a need to better understand the differences in military medic training versus traditional EMT training 

and bridge the gap between the two to make it easier for our returning soldiers to find jobs. It is our hope that this bill would 

allow States to study this and streamline their EMT requirements 

for those returning from the military who have the experience so 

desperately needed in many communities. 

I look forward to hearing from our witnesses today, and I would 

like to thank our witnesses for being here. I look forward to your 

testimony, and I now yield to chair emeritus of the committee, Representative Barton. 

[The prepared statement of Mr. Pitts follows:] 

3 


82106.001

Rep. Joseph R. Pitts 

Opening Statement 

Energy and Commerce Subcommittee on Health 

Hearing on "Helping Veterans with Emergency Medical Training Transition 

to Civilian Service" 

July 11, 2012 

(As Preparedfor Delivery) 

We are here today to discuss H.R. 4124, the Veteran Emergency Medical Technician Support 

Act of2012, which would give states demonstration grants to study how to better integrate 

military medics into civilian EMT jobs. 

Emergency response is a crucial component of our health care system, as EMTs are often the first 

point of contact in a crisis situation and their care can make the difference between life and 

death. 

Emergency response is even more crucial on the battlefield, where military medics respond to 

emergencies and provide care for the soldiers until a physician or other health professional can 

take over. 

These soldiers trained as combat medics become very experienced dealing with massive trauma 

injuries and other complex health problems. 

It seems that utilizing those with combat medic experience in our EMT workforce here at home 

would be good for the returning soldiers, good for the healthcare system, and good for patients. 

Many areas throughout the U.S. are experiencing a shortage ofEMTs, both paid and volunteers, 

and military medics could potentially fill those workforce gaps. 

However, there are a number of issues keeping military medics from EMT employment. Most 

importantly are state licensing requirements, which can require duplicative training and 

education that is likely to be unnecessary for someone with significant experience. 

There is a need to better understand the differences in military medic training versus traditional 

EMT training and bridge the gap between the two to make it easier for our returning soldiers to 

find jobs. 

It is our hope that this bill would allow states to study this and streamline their EMT 

requirements for those returning from the military who have the experience so desperately 

needed in many communities. 
4 

OPENING STATEMENT OF HON. JOE BARTON, A 

REPRESENTATIVE IN CONGRESS FROM THE STATE OF TEXAS 

Mr. BARTON. Thank you, Chairman Pitts, and thank you and Mr. 

Pallone for holding this hearing today. Helping veterans with emergency medical training transition to civilian service, this is a discussion that is long overdue. 

As we all know, our United States military forces have tens of 

thousands of veterans who have been trained as medics and who 

can make a contribution immediately in most cases in the private 

sector if they choose to continue that vocation. Once their service 

is concluded, sometimes, though, it is very difficult for them to find 

civilian jobs due to a variety of different State occupational license 

requirements. It is a fact that military emergency medical technicians are highly trained and offer the civilian market a heightened 

skill set, particularly when it is related to a trauma situation. 

We spend billions of dollars every year in the military to provide 

this medical training. We have over 21 million men and women 

who have served in the military. Of this number, over 2 million 

have served since September of 2001. We have a bipartisan bill 

that is introduced by Congressman Kinzinger, Congresswoman 

Capps, and other members that would help in this transition between the military and the civilian EMT market. The bill would 

incentivize States to initiate under demonstration programs a 

method to streamline the requirements and procedures so that the 

training and skill set that the military, the veterans already have 

can be immediately recognized. Our veterans should not have to 

completely redo the medical training that they have already received in the military to receive civilian certification. I support the 

bipartisan bill, and I support this hearing. 

With that, Mr. Chairman, I yield back to you or to any other 

member the remaining time that I have. 

Mr. PITTS. Mr. Kinzinger. 

OPENING STATEMENT OF HON. ADAM KINZINGER, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF ILLINOIS 

Mr. KINZINGER. Thank you, Mr. Chairman, and Ranking Member 

Pallone, members of the Health subcommittee, and I want to express my appreciation to you for holding this important hearing on 

this, the Veterans Emergency Medical Technician Support Act of 

2012. 

I also want to express my gratitude to Ms. Capps for working 

with me on this very important piece of legislation. Our corpsmen, 

medics, and soldiers receive some of the best emergency medicine 

training in the world, and they prove it every day on the battlefield, both in Iraq and Afghanistan. Unfortunately, many veteran 

EMTs are required to take classes they have already completed in 

the military to satisfy the civilian licensure system, needlessly delaying their entry into the civilian workforce. 

This legislation would streamline the process by providing grants 

to States so they can make the requirements easier and streamline 

it with military EMT training to become certified civilian EMTs. In 

doing so, returning veterans will not have to start over at square 

one in their training and they can enter the civilian workforce 

much sooner. 

5 

And just to wrap up, I will say last week’s job numbers highlighted the incredible difficulty that returning veterans are having 

in the civilian workforce, so I think this is a very important first 

step. Again, I thank the subcommittee for having the hearing, and 

I yield back. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize the ranking member, Mr. Pallone, for 5 minutes 

for an opening statement. 

OPENING STATEMENT OF HON. FRANK PALLONE, JR., A REPRESENTATIVE IN CONGRESS FROM THE STATE OF NEW JERSEY 

Mr. PALLONE. Thank you, Mr. Chairman. 

I welcome today’s hearing on the Helping Veterans With Emergency Medical Training to Civilian Service Act. 

As we continue working to improve the health quality and coverage of our Nation, we have a unique opportunity and responsibility to address two very important issues that are critical to 

achieving that goal. First, ensuring that our Nation’s veterans have 

career opportunities when they come home, and, second, addressing 

shortages in a vital sector of health care service and delivery. I believe this bill is good health policy. It was good policy when it 

passed the committee as part of the America’s Affordable Health 

Choices Act of 2009, and it is good policy now. 

By assisting veterans with military medical training to meet the 

requirements for becoming civilian medical technicians, we help ensure that the brave men and women who protect our freedom have 

an opportunity to support themselves while helping attenuate the 

shortage of emergency medical services upon which Americans depend. 

Last week we celebrated our Nation’s 236th anniversary, and we 

remembered the sacrifices of those who served in Iraq and Afghanistan and elsewhere around the world. Although we celebrate our 

independence once a year, it is important to always remember the 

remarkable sacrifice and service of our men and women in uniform 

to provide the opportunity to make the U.S. stronger around the 

world and at home, building an American future worthy of our veterans’ sacrifice, and as part of keeping our promises to our veterans, the President and Congress have to focus on taking major 

steps to help our men and women in uniform obtain good jobs when 

they come home. 

As we honor their nobility and patriotism, we must also speak 

to the stark realities they face. In September, the unemployment 

rate for returning Iraq and Afghanistan veterans was a staggering 

11.7 percent, leaving 235,000 veterans struggling to find jobs after 

the most severe economic recession since the depression, and 

younger returning veterans ages 18 to 24 are facing an even more 

difficult challenge, with more than one in five out of work and looking for a job last year. So we have an obligation to make sure our 

veterans have the necessary tools to navigate this difficult labor 

market. 

At the same time, emergency medical services are a vital part of 

the American health care system, and they are critical to both 

emergency and nonemergency situations. However, studies over the 

6 

past decade have shown that poor recruitment and retention of 

qualified professionals may have a detrimental effect on the health 

of our communities—this is especially true in rural areas where access to health care is often limited or unavailable—and that there 

is a high turnover and shortages of qualified emergency medical 

technicians or EMTs and paramedics and emergency medical service, both during normal conditions and following disasters or similar events. 

In these fiscally strained times, we must find ways to adequately 

address the needs of our communities and our veterans. We must 

be efficient, creative, and innovative in our approaches, and this 

bill gives us a way to help with their transition to civilian life. The 

bill allows the streamlining of training and certification so that our 

veterans who have received military emergency medical training 

can apply their skills and talents to communities at home where 

they are needed and where they can become an integral part of 

their community and economy. 

On the battlefield, the military pledges to leave no soldier behind, and, Mr. Chairman, as a Nation, let it be our pledge that 

when they return home, we leave no veteran behind. 

I yield back. 

Mr. PITTS. Do you want to yield to Ms. Capps? 

Mr. PALLONE. I think she is going to use Mr. Waxman’s time. 

Is that OK? 

Mr. PITTS. Yes, that is fine. We recognize Ms. Capps for 5 minutes for an opening statement. 

OPENING STATEMENT OF HON. LOIS CAPPS, A REPRESENTATIVE IN CONGRESS FROM THE STATE OF CALIFORNIA 

Mrs. CAPPS. Thank you, Mr. Chairman, and thank you and 

Ranking Member Pallone for holding this important hearing today. 

I am really excited by the prospect. 

The individuals who serve our Nation in uniform do so with distinction. Our military men and women are trained to perform at 

the highest level in a host of jobs. However, there is so much more 

to be done to help these men and women and their families when 

they return home to translate those skills and experience into civilian service. The service we need, by the way. And that disconnect 

is why we are here today. 

Our men and women receive some of the best technical training 

in emergency medicine, and they prove their skills on the battlefield every day. However, when they return home, experienced 

military medics are often required to begin at entry level curricula, 

as though they were just graduating from high school, to receive 

certification for civilian jobs. Similarly, military medics with civilian credentials often must let their civilian certifications lapse— 

this is another problem—while they are defending our country. Either way, this keeps our veterans out of the civilian workforce, and 

it also withholds valuable medical personnel from our communities. 

As a nurse, I know the importance of having qualified and capable first responders available in our community, and as our Nation 

climbs out of this recession, it is so important to realize that the 

health care sector has continued to grow with good-paying jobs 

often left unfilled and waiting for qualified providers. That is why 

7 

we must do all we can to break down the artificial barriers, and 

they are very artificial, both in licensure and resources, that obstruct our military medics from civilian opportunities. 

I am so pleased to be working with my colleagues from both sides 

of the aisle to make that happen. I am proud to have introduced 

H.R. 3884, the Emergency Medic Transition Act, with Congressman Todd Young from Indiana to help support our military medics 

reach civilian licensure and help the colleges and technical schools 

develop appropriate fast track military-to-community programs. 

Similar legislation, as my colleague has said, passed the House in 

a near unanimous vote in the 111th Congress. 

And I am also pleased to have joined Congressman Adam 

Kinzinger to introduce H.R. 4124, the Veteran Emergency Medical 

Technician Support Act. Again, this is a straightforward bipartisan 

bill which will help States streamline their certification processes 

to take military medic training into account for civilian licensure. 

Finally, I wanted to take a second to recognize a former member, 

Congresswoman Jane Harman, who spearheaded this issue in the 

last Congress. So now I am hopeful we continue to work together 

in a bipartisan way and move this important legislation out of the 

committee so that we can begin to actually help these talented professionals join our health care workforce, improve the health care 

options in our communities, actually make our communities and 

Nation a safer place. 

And I yield back. 

Mr. PITTS. The Chair thanks the gentlelady. 

I would like now to introduce today’s witnesses. 

Mr. Ben Chlapek is the deputy chief of Central Jackson County 

Fire Protection District in Blue Springs, Missouri, and he represents the National Association of Emergency Medical Technicians. 

Mr. Chlapek, I understand you recently retired from the U.S. 

Army after 36 years of service. I think I can speak for all members 

in thanking you for your many years of service and offering our 

congratulations. We are glad to have you with us today. 

And Mr. Daniel Nichols is senior vice president of Victory Media, 

Inc., a disabled veteran-owned business, and CEO of Victory Tech, 

a vocational and workforce training institute. Mr. Nichols is also a 

Navy Reserve officer and a veteran of Operation Iraqi Freedom. 

Thank you for your service, Mr. Nichols. And we are happy to 

have you here with us today as well. 

STATEMENTS OF BEN D. CHLAPEK, DEPUTY CHIEF, CENTRAL 

JACKSON COUNTY FIRE PROTECTION DISTRICT, BLUE 

SPRINGS, MISSOURI, AND CHAIR, MILITARY RELATIONS 

COMMITTEE, NATIONAL ASSOCIATION OF EMERGENCY MEDICAL TECHNICIANS; AND DANIEL M. NICHOLS, SENIOR VICE 

PRESIDENT, VICTORY MEDIA, AND CHIEF EXECUTIVE OFFICER, VICTORY TECH 

Mr. PITTS. At this time, Mr. Chlapek, your written testimony will 

be entered into the record. You are recognized for 5 minutes to 

summarize. 

8 

STATEMENT OF BEN D. CHLAPEK 

Mr. CHLAPEK. Thank you, Chairman Pitts, Ranking Member 

Pallone, and members of the committee. We appreciate this opportunity to discuss this issue with you to assess veterans who are 

getting out of the military and trying to transition into the civilian 

EMS world. 

Today I represent the National Association of Emergency Medical Technicians, formed in 1975. The association represents over 

32,000 EMS professionals, first responders, fire department EMTs 

and medics, private, industrial, and other forms of even some of the 

military EMTs and paramedics. 

A smooth transition of our veterans into civilian life underscores 

the importance of the hearings and the responsibilities today in developing policies that honor the training of our military medics and 

seamlessly transitioning our veterans into the workforce and providing valuable military medical personnel to our communities. 

As has been previously stated, our military members and specifically medics receive some of the best training in the world and are 

some of the best there are at trauma care and other facets of medical care. Currently when military medics leave the service, many 

are required, most are required to redo their medical training, to 

either renew their license or obtain a license to practice in a civilian EMS capacity. 

A Navy independent duty corpsman, a Navy SEAL medic, an 

Army special forces medic, or 18 Delta, and Air Force pararescue 

medics receive advanced medical training. Most of these medics can 

put external fixation devices on mangled limbs to restore an anatomical structure so innervation and circulation is reestablished to 

save a limb. They can put in chest tubes. They routinely perform 

surgical procedures, and they can even tie—some are even trained 

in vascular surgery, so we can tie vessels back together and restore 

circulation in the field in austere environments when we have to 

maintain a patient for more than 72 hours. These are procedures 

that are normally reserved for emergency rooms, operating rooms, 

and trauma suites. 

Unfortunately, these folks are having to complete an entire paramedic program over the course of a year-plus to obtain a civilian 

paramedic license. These folks should be able to take a week, at 

the most, refresher training, maybe brush up on some geriatric 

training, and then be able to challenge the practical and written 

test, whether it is State or nationally. 

Basic medics in the services leave the service and could easily 

challenge the EMT test, the basic emergency medical technician 

test, both practical and written. The Army and the Air Force medics in their advanced individual training courses obtain those licenses, but many aren’t renewed or they are still required if they 

don’t have a current license to go back through a course, depending 

on how long they have been expired. 

Some States have made adjustments. Texas, Arkansas, Missouri, 

Alabama, and Tennessee are just a few who have State EMS agencies that are willing to take these on an individual basis or allow 

medics with a little bit of refresher to challenge a test and become 

licensed. 

9 

However, right now, for example, Kansas City, Missouri, fire has 

26 paramedic options, and they don’t have people applying for the 

jobs because there is a shortage. Olathe fire in Kansas, a southern 

suburb of Kansas City, has six openings and as most of the suburban departments require an EMT or paramedic license to come to 

work, and streamlining this would really help our veterans. 

National Registry of Emergency Medical Technicians offers 90 

days of leeway upon return to work with this, and Bill Brown, a 

retired pararescue jumper, was a former executive director and 

really helped us with that. 

This subcommittee has the potential to help veterans return to 

work upon their completion of military duty and reduce unemployment among veterans. NAMT wholly supports any process and legislation that helps military medics transition into the civilian world 

and use their skills and expertise to make our communities safer 

and better. Thank you. 

[The prepared statement of Mr. Chlapek follows:] 

10 


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Statement of Ben Chlapek 

Deputy Chief of Central Jackson County Fire Protection District, 

Blue Springs, Missouri 

and representing 

The National Association of Emergency Medical Technicians (NAEMT) 

on the topic of 

Veteran Emergency Medical Training Transition to Civilian Service 

before 

Health Subcommittee, 

Committee on House Energy and Commerce 

U.S. House of Representatives 

July 11,2012 
11 


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Introduction 

Chainnan Pitts, Vice Chainnan Burgess, Mr. Pallone and members of the Subcommittee, thank 

you for giving me this opportunity to discuss the issue of assisting veterans with emergency 

medical training transition to civilian service. I am Ben Chlapek, Deputy Chief of Central 

Jackson County Fire Protection District, Blue Springs, Missouri, and here representing the 

National Association of Emergency Medical Technicians (NAEMT). I recently retired as a 

Lieutenant Colonel from the United States Anny after 36 years of service with tours in 

Afghanistan, Kosovo, Central America, and multiple other countries. I have served as faculty at 

Louisiana State University and hold undergraduate degrees in Chemistry and Fire Science, a 

Masters Degree in Public Administration and a second Masters Degree in Homeland Defense 

and Security from the Naval Postgraduate School. I serve on numerous national, state, and local 

committees including the Missouri Governor's Advisory Council for EMS and as the Chair of 

the Military Relations Committee for the National Association of Emergency Medical 

Technicians. Fonned in 1975, the National Association of Emergency Medical Technicians 

(NAEMT) is the nation's only organization solely dedicated to representing the professional 

interests of all EMS practitioners, including paramedics, emergency medical technicians, 

emergency medical responders and other professionals working in prehospital emergency 

medicine. NAEMT's 32,000+ members work in all sectors of EMS, including government 

service agencies, fire departments, hospital-based ambulance services, private companies, 

industrial and special operations settings, and in the military. 

NAEMT works to increase understanding and appreciation by government agencies at the local, 

state and national levels of the role that EMS plays in our nation's health care, public safety, and 
12 


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disaster response systems; and works with these agencies and Members of Congress to develop 

public policy that supports EMS systems and the patients they serve. 

Background 

The smooth transition of our veterans into civilian life underscores the importance of these 

hearings and the responsibilities of the subcommittee in developing policies that honor the 

training of our military medics to seamlessly transition our veterans into the workforce to 

provide valuable medical personnel for our communities. Military veterans receive some of the 

best medical training and experience available when serving our country. Their sacrifices, 

commitment to duty, and ability to get the job done in austere environments make them 

exceptionally well suited for working as EMTs and paramedics in our communities upon their 

release from the armed services. 

Currently, experienced military medics are often required to re-do their medical training 

completely over at the most basic level to receive certification to be hired for a civilian EMS job. 

Depending on the state, the returning veteran will obtain or renew his or her EMS license, the 

requirements can vary significantly. Furthermore, the requirements that exist at certified EMS 

education facilities that allow candidates to test for the EMS licenses have vast differences, too. 

A Navy Independent Duty Corpsman, a Navy SEAL medic, an Army Special Forces medic 

(180), and an Air Force Special Operations Pararescue medic receive extensive medical training 

and are trained to operate in austere environments. They learn skills and perform procedures in 

the field that are many times reserved for physicians and specialists in operating rooms or trauma 
13 


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rooms. External fixation of multiple fractures shunts to restore circulation to a mangled limb, 

and insertion of chest tubes to expand a collapsed lung are just a few of the procedures they learn 

and perform in the most severe conditions. Depending on current leadership framework in the 

respective school houses, these Special Operations medics mayor may not hold a paramedic 

license with a licensing entity. When they get out of the service and try to enter the EMS 

profession, they are required to go through a year-long paramedic class and several hundred 

clinical hours; testing upon completion to get a license to work. In reality, all they may need is a 

two-day Advanced Cardiac Life Support class, a module on geriatric medicine, a refresher on 

obstetrics, and a chance to challenge the written and practical tests. In a matter of weeks or a 

month at the most, they should be able to work as paramedics for any service in the world. 

However, that is rarely the case. 

Currently, it appears that Army medics and Air Force medics graduate from their military 

training eligible to test for EMT licenses or registry cards from the National Registry of 

Emergency Medical Technicians; Navy Corpsmen do not. By the time they leave the service, 

many do not have current licenses so they are not eligible to go to work at civilian EMS 

agencies. Making matters worse, many have licenses that have been expired long enough that 

they cannot even challenge a state test or take a refresher to challenge the test; they have to take 

a complete provider course to work as an Emergency Medical Technician. This requires a 

semester of classroom work, a weekend of clinical work, and waiting for a test date to take the 

licensing test. It can take half of a year to get an Emergency Medical Technician license waiting 

for test dates and results. Basic combat medics, Navy Corpsmen, and Air Force medics have all 
14 


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of the training they need to challenge the test and should be allowed to do so. If they are rusty or 

need a review in a specific area, a weekend of refresher is plenty to prepare them for the test. 

Some states and training entities have made adjustments and are starting to streamline the 

education process for service members. Veterans in positions of authority like Greg Natsch, the 

Director of the Missouri Bureau of EMS, talk with veterans on a case by case basis. If the 

veterans can document the training experience they had in the military, at their mobilization 

stations, or on a forward operating base, he adjusts their requirements to allow them to 

streamline the licensing and testing process. Finding an EMS education facility to streamline 

this process can be a challenge. A bill with bipartisan support and sponsors was introduced in 

the Missouri House last session to streamline EMS licensure for honorably discharged veterans. 

Tennessee, Alabama, Arkansas, Texas, and Missouri have training entities and educational 

institutions that take veterans and their training records through individualized processes to 

streamline the process for the veterans and get them into the workforce. This helps veterans get 

licensed and get to work as soon as possible while alleviating Paramedic shortages in some 

portions of the country. Almost all suburban fire departments require that applicants are 

Emergency Medical Technicians or Paramedics. Paramedics are not as plentiful and streamlining 

the process would help staff open Paramedic positions; the Kansas City Missouri Fire 

Department currently has twenty-six (26) Paramedic openings and is struggling to find 

candidates with Paramedic licenses who want to work in their extremely busy environment. The 

Olathe Fire Department is hiring six firefighters and a Paramedic or Emergency Medical 

Technician license is required to apply. Streamlining the licensing process for veterans will help 

them be employed quicker. 
15 


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Another issue facing veterans pertains to those who are working in EMS in the civilian sector 

and get mobilized in the National Guard or Reserves. There were over forty (40) Emergency 

Medical Technicians at the Basic, Intermediate, and Paramedic levels in the U.S. Army portion 

of Task Force Falcon in Kosovo in 2004. The soldiers who were EMS personnel were licensed 

in at least eight (8) different states and some were nationally registered through the National 

Registry of Emergency Medical Technicians, holding state and national certifications and 

licenses. Many of these soldiers held cards in Advanced Cardiac Life Support, Advanced 

Pediatric Life Support, PreHospital Trauma Life Support, Advanced Medical Life Support, 

Advanced Trauma Life Support, and other certifications required or offered by their civilian 

employers. Those stationed at Camp Bondsteel had the opportunity to rotate through the 

hospital, take courses at the local universities and colleges with classrooms on the base, and get 

enough continuing medical education credits to relicense. My training entity at the Central 

Jackson County Fire Protection District allowed me to offer an Advanced Cardiac Life Support 

Class and a PreHospital Trauma Life Support class to medics because we had enough instructors 

between the flight medics, the ambulance platoon leader, and me. The training entity provided 

the texts, slides, and certification authority and the flight surgeon, Colonel (Dr.) Todd Fredricks, 

the Command Flight Surgeon for the West Virginia National Guard, served as the Medical 

Director for the courses. This worked well for the medics on Camp Bondsteel. The medics at 

Camp Monteith and with the maneuver units were not able to participate and did not receive 

enough continuing medical education credits to relicense in most cases. Some deployed with 

enough credits but others had to go through several weeks of continuing medical education 

before they could retest and relicense due to their operational tempo during the mission keeping 
16 


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them from class participation. At least one did not return to work in EMS due to licensing 

difficulties and two were employed by their fire departments on administrative duties until they 

could relicense. Streamlining the renewal process for National Guard and Reserves returning to 

civilian EMS positions should be addressed. A weekend refresher and license renewal or 

extension to relicense would help. The National Registry of Emergency Medical Technicians 

will issue a ninety (90) day extension upon return if a provider needs to renew an expired license 

due to a deployment. However, it has not been needed according to their Executive Director, 

retired Air Force Pararescue Jumper William Brown, because the majority of providers are 

getting the required continuing medical education and experience to renew prior to or upon 

return from deployment. 

Gentlemen like Navy Captain (Dr.) Frank Butler, retired, Army Lieutenant Colonel (Dr.) Robert 

Mabry, Army Colonel (Dr.) Todd Fredricks, Army Colonel (Dr.) Patricia Hastings, and other 

Special Operations and Emergency Medicine physicians have taken EMS education and training 

to a new level in educating special operations medical personnel, Emergency Medical 

Technicians, Paramedics, Physician Assistants, and others allied health personnel. Their 

guidance and tutelage in the military and the civilian sectors have helped medics keep soldiers 

alive on the battlefield and civilians alive in our communities. They continue to work tirelessly 

to make sure the front line medics are the best in the world and work to keep them educated, 

licensed, and employed. Lessons from the battlefield and adjuncts such as QuikClot zeolite 

granules, Combat Gauze, and the Combat Action Tourniquet have helped us transition efficacy 

in trauma care into our communities to increase civilian levels of care and survivability. The 

military experience is too rich and too costly to throwaway and deny in our civilian 
17 


82106.009

communities. Congressional assistance in streamlining the licensing process to get these 

experienced combat medics and corpsmen into the civilian EMS community will help our 

communities and the level of care provided to our citizens. 

Conclusion 

The subcommittee has the potential to help veterans return to work upon their completion of 

military duty and reduce unemployment among veterans. I wholeheartedly support any process 

and legislation that helps military medics transition into the civilian world and use their skills 

and expertise to make our communities safer and better. I firmly believe your attention to this 

issue is a step in the right direction and an excellent investment to help our military veterans, our 

emergency response agencies, and our country. 

Thank you for your time and attention. I sincerely appreciate the opportunity to come before you 

to present a perspective from the emergency medical response community on this important 

subject. God bless. 

I would welcome any feedback or questions. 
18 

Mr. PITTS. The Chair thanks the gentleman. 

Mr. Nichols, you are recognized for 5 minutes for an opening 

statement. 

STATEMENT OF DANIEL M. NICHOLS 

Mr. NICHOLS. Chairman Pitts, Congressman Pallone, members of 

the committee, I appreciate the opportunity to testify before you 

today. I am Daniel Nichols, and I offer my testimony to you as an 

OIF veteran, a member of the Navy Reserve, and one of the growing number of veteran entrepreneurs who has dedicated their time 

and creative efforts to creating jobs and successful business enterprises that are capable of returning value and resource back to my 

military family and to our local community. 

For far too long we have known precisely what the challenges are 

in military transition, and as a Nation, we have been unable to 

adequately address the perceived gap between military training 

outcomes and civilian workplace skills, and that includes the 

health care sector. Our military members have skills, and they 

have no problem being put to the test to prove their competence. 

As recruitment director for a prominent health system, I led the 

development and implementation of a new competency-based selection process for emergency medical technicians and clinical technicians across our hospital system where we are facing significant 

turnover and shortage. At the time, my team of recruiters handled 

about 85,000 resums for these positions. The vast majority of the 

applicants were unqualified. The workload for them was grueling; 

the conditions, which persist due to high unemployment, resulted 

in costly turnover. Military re ́sume ́s were typically flushed straight 

out of the process by our electronic applicant tracking system. 

Our methodology was straightforward. We performed a comprehensive competency review of the position requirements, we developed assessments and tests for the most relevant and predictive 

foundational competencies. We determined appropriate passing levels and provided the assessments to each applicant to determine 

their eligibility for the positions. Military talent rose to the top 

time and again. Yet the problems for veteran talent continued. We 

found that we either could not hire them because they lacked the 

State required credentials, or we had to first employ them in lesser 

positions because the credentials they did have were well below the 

position for which they were found sufficiently qualified. 

Success on the job is about competency or sufficiency of qualification. The hire, however, is a business transaction that is highly 

regulated and controlled. The hire is an artificial process that discriminates inherently against our military service members. I believe the ultimate solution would be to create a means by which 

training provided by the Department of Defense could be accredited 

by civilian standards and therefore allow military training and 

skills to easily transition into existing safeguards and competency 

standards established by civilian and State institutions. 

H.R. 4124 on the surface appears to be small change. These 

changes, however, would positively affect the livelihood of our veterans and improve health care delivery. H.R. 4124 provides for two 

specific possibilities that have not yet been considered by other legislation. First, it allows for military training to be mapped to 

19 

equivalencies and credentials above the basic entry level qualifications. The emergency medical technician credentialing letter has 

basic, intermediate, and advanced specialty certifications. To date, 

military training has only been mapped to the EMT basic, which 

falls well below the pay rate and functional capability of service 

members who have honed their skills on the front lines. 

The second, H.R. 4124, calls for the development of methods to 

establish equivalency. Solutions to date have forced skilled medics 

into lengthy and costly training programs, a redundancy that is ineffective, inefficient, and detrimental to the economic success of our 

military members. Using GI bill benefits to sit in classes that they 

could teach is not a good use of their hard-earned benefits. According to UCX data that was released from the Army in fiscal year 

2011, there were 190,000 DD–214s; 100,000 of those applied for unemployment insurance, and nearly 3,000 of those that were applying were Army medics. They were the third largest military occupational specialty to do so. There is a problem, and we have not 

yet solved it. 

We founded Victory Tech for the express purpose of creating an 

alternative for our military families, a means of achieving the required academic validation of competency to qualify for the appropriate level of credential without unnecessary use of time, benefits 

or personal income. 

I wish to commend this legislation to the committee, and I and 

my colleagues stand ready to assist in any way possible. Thank you 

for the opportunity to provide this testimony to you, and I would 

like to submit the remainder of the testimony for the record. 

[The prepared statement of Mr. Nichols follows:] 

20 


82106.010

Written Statement 

of 

Daniel M. Nichols 

Senior Vice President, Victory Media Inc. 

Chief Execntive Officer, Victory Tech 

Before the 

Committee on Energy and Commerce 

Subcommittee on Health 

United States House of Representatives 

July 11, 2012 2123 Rayburn House Office Building 

"Helping Veterans with Emergency Medical Training Transition to Civilian Service" 

Chairman Pitts, Congressman Pallone, and Members of the Committee, I appreciate the 

opportunity to testify before you. I am Daniel Nichols, Senior Vice President of Victory Media Inc. 

a small disabled veteran owned business, and Chief Executive Officer of Victory Tech, our vocational 

and workforce training institute. I offer my testimony to you today on July I I, 2012 as an OIF 

veteran, a member of the Navy Reserve, and one of a growing number of veteran entrepreneurs 

dedicated to creating jobs, and successful business enterprises capable of returning value and 

resource back to my military family and local community. 

Unlike other entities which tout a sense of entitlement,Victory Media brings long-term and 

sustainable economic opportunity to the military community by showing corporate America the 

business value of military service. We are by no means alone in this: Iraq and Afghanistan Veteran 

leadership and entrepreneurship is on the rise and we are supported, mentored and surrounded 

by savvy Veteran business leaders from Vietnam, the Cold War Era, the Gulf War and beyond. 

We hold to a new framework of belief about our service: We believe that military service is a 

privilege, an honor. We believe that it makes good business sense to hire veterans and to invest in 

veteran businesses; and we firmly believe that we are better-off for having served. 

The barriers to success of this next generation mirror that of our beloved country. and we 

have not returned to our homes and communities from global service to witness the fall of the 

American dream. 

For far too long we have known precisely what the challenges are in military transition. and as a 

nation we have been unable to adequately address the perceived gap between military training 

outcomes and civilian workplace skills. and that includes the healthcare sector. 

We are told that adequate solutions are too complex, too costly. too time consuming and too 

difficult to tackle. Across the United States, more than 40 million hiring transactions take place per 

month, and our accepted means of managing this transactional nightmare is a currency called the 

resume. Ultimately the resume is an indecipherable. inefficient. and outdated mess. Worse. the 

reliance on narrative over validated competency is a significant impediment to transitioning military 
21 


82106.011

members whose language of work is wholly different from the civilian world. There are many 

organizations and consultants providing services to address the challenges individuals and 

corporations face along with countless government programs: but the vast majority offer only 

limited "soft-skill" solutions, which are inadequate measures of satisfaction and workplace 

preference coupled with meager skill assessment. 

It is not enough, and it misses the point entirely. 

Our military members have skills, and have no problem being put to the test to prove their 

competence. As recruitment director for a prominent health system, I lead the development and 

implementation of a new competency-based selection process for Emergency Medical and Clinical 

technicians across the hospital as we were facing significant turnover. 

At the time my team of recruiters handled more than 85,000 resumes for these positions; the 

vast majority of applicants were unqualified, the workload was grueling, and the conditions which 

persist due to high unemployment resulted in costly turnover. Military resumes were typically 

flushed straight out of the process by our electronic applicant system. 

Our methodology was straightforward; we performed a comprehensive competency review of 

the position requirements, we developed assessments and tests for the most relevant and 

predictive foundational competencies, we determined appropriate passing levels and provided the 

assessments to each applicant to determine their eligibility for the position. Military talent rose to 

the top. Yet the problems for veteran talent continued: we found that we either could not hire 

them because they lacked the state required credentials, or we had to first employ them in lesser 

positions because the credentials they did have were well below the position for which they were 

found sufficiently qualified. 

Success on the job is about competency, or "sufficiency of qualification." The "Hire", however, is 

a business transaction that is highly regulated and controlled:The Hire is an artificial process that 

discriminates inherently against our military service members. 

I believe the ultimate solution would create a means by which training provided by the 

Department of Defense could be accredited by civilian standards, and therefore allow military 

training and skills to easily transition into existing safeguards and competency standards established 

by civilian and state institutions. 

HR 4124 on the surface appears to be small change. These changes, however. would positively 

affect the livelihood of our veterans and improve healthcare delivery. HR 4124 provides for two 

specific possibilities that have not yet been considered: 

I) HR 4124 allows for military training to be mapped to equivalencies in credentials above the 

basic entry level qualifications. The Emergency Medical Technician credentialing ladder has basic, 

intermediate and advanced specialty certifications. To date, military training has only be mapped 

to the EMT Basic; which falls well below the pay rate and functional capability of service 

members who have honed their skills on the front-lines. 

2 
22 


82106.012

2) HR 4124 calls for the development of methods to establish equivalency. Solutions to date 

have forced skilled medics into lengthy and costly training programs ... a redundancy that is 

ineffective, inefficient and detrimental to the economic success of our military members. Using 

GI Bill benefits to sit in class that they could teach is not a good use their hard-earned benefits. 

According to UCX data released from the Army in Fiscal Year 20 I I, 190,000 DD-214's were 

generated by the US Army, and 100,000 applied for unemployment. Nearly 3,000 of those 

applying for unemployment last year were Army medics ... they were the third largest military 

occupational specialty to do so. There is a problem, and we have not yet solved it. 

We founded Victory Tech for the express purpose of creating an alternative for our military 

families. A means of achieving the required academic validation of competency to quality for the 

appropriate level of credential without unnecessary use of time, benefits or personal income. 

I wish to commend this legislation to the Committee and I and my colleagues stand ready to 

assist in any way possible. Again, thank you for the opportunity to provide this testimony to you, I 

would like to submit the remainder of my testimony for the record. 

"Sufficiency of Qualification" and a competency model 

The greatest challenges in selection and management of human capital lie at the transactional 

level. Decision-making surrounding a hire, termination, promotion, tasking, reporting, team 

construction, project assignment, etc. rests on a manager's or organization's ability to observe, infer, 

trust and ultimately make the correct choice. A myriad of options, products, and tools exist to 

assist in a decision process that often comes down to intuition in the face of what is essentially 

unknowable complexity. 

Demystifying "The Hire" 

Using the "hire" as an example, we will consider the various decision points the typical 

organization navigates to arrive at a selection. The process generally begins with the recognition of 

a need for additional staff to perform a variety of functions, some of which are obvious tasks, some 

of which are not. Let's sayan organization decides to hire additional emergency medical 

technicians (EMT). Assuming that the organization has hired EMT professionals in the past, they 

may have a "template" to work from, generally in the form of a "job description". If not, they will 

likely task a manager to develop a job description or profile based on what that hiring manager 

perceives to be the ideal candidate. 

Regardless of how an employer derives their job requirements, the job transaction is based 

upon a job description to which a number of additional screening "questions" may be added to 

narrow the pool of applicants. Interested applicants submit a narrative document known as the 

"resume," as evidence of their qualifications. Resumes, being narrative in nature, have few 

standards, but can be "parsed" into discrete data fields (generally aligned to those basic 

requirements identified in the job description). Additional measures may be added to further filter 

the pool including electronic and paper forms that require the applicant to rewrite the content of 

the resume in a format determined by the employer to more easily baseline and compare 
23 


82106.013

information presented by the applicant. Once all the applicant data has been normalized into a 

similar format, the process typically takes a dramatic turn into the realm of the subjective. 

From the perspective of the job seeker, the entire process is not only intimidating and 

confusing, but devaluing of their own perspective of their capabilities, motivations and capacity to 

perform the requirements of the job. Worse, a candidate generally has no idea whether they 

qualify or not for a position. For transitioning military. this process rapidly becomes a nightmare 

that results in underemployment when the need for income exceeds confidence in capability. 

Undoubtedly. all parties involved would be better served by a cleaner, clearer system that 

allows candidates to know if they qualify for a position, and managers to have confidence that their 

final slate of candidates can perform the required functions. To begin to address the inefficiencies 

and high costs associated with worker selection, promotion and development, Victory Media, Inc. 

through its educational arm Victory Tech, developed a more cohesive means of classifying work 

requirements at the fundamental unit of work, the competency. 

A Competency Based Model 

In our model framework, time becomes only one means by which mastery can be 

demonstrated, but coequal with more definitive and relevant measures such as proof by 

examination, demonstration, and certification. Employers may still select "time utilizing a given skill" 

as a measure of maturity or sufficiency. but would be wise to consider more relevant testing 

mechanisms as supplemental proof of sufficiency of qualification (and skill relevance). 

In concert with this notion, the Victory Tech model was born from more than a decade of 

expertise in military job transition, and is structured to open the doors of possibility with a 

functional solution that addresses the inherent complexities and inefficiencies of human resource 

transactions, most notably the "Hire." Better still, Victory Media is building a framework to improve 

the translation of job skills from military occupational categories, and a means by which the 

"unmeasurable" competencies developed during military service may gain recognition for the 

purpose of employment in the civilian world. So too will be a new ability to establish competency 

as a measure of job fit. 

The difficulty of achieving the goal of "sufficiency of qualification" is evidenced in the inherent 

separation of job requirements and worker characteristics. Relating these attributes is the central 

purpose of any hiring system, and has been the express purpose of federal and state workforce 

systems. "More education;' has been the clarion call, but the solution for America's transitioning 

military is not to throw hard-earned benefits after "training" that only repeats skills already trained 

once, tested, and proven on the job. Rather, our system should acknowledge the high quality of 

training delivered in the military and establish processes to rapidly verify, fill in the gaps and employ 

atthe highest appropriate professional level. This appears to be the intent of HR 4124. 

If for no other reason, HR 4124 is a first mover in a new direction that provides some hope of 

a solution not rooted entirely in re-hashed education - which places the entire weight of 

responsibility for skill development on the shoulders and bank-accounts of students who probably 

exceed the knowledge and experience of the faculty instructing them. HR 4124 may not take 

large steps, but it takes important steps in re-shaping the way we think about transitional workers 
24 


82106.014

and skill translation, and it provides a needed source of relief for our military service members and 

their families. 

About Victory Media 

A veteran-owned business anchored by experienced managers, a strong performance history and 

aggressive growth plans, Victory Media is a global military niche media firm headquartered in Pittsburgh 

with field offices coast to coast. The company has been honored as one of the 30 fastest growing 

companies in Pittsburgh three years straight by Pittsburgh Business Times. Victory Media's brands have 

been the source of countless media coverage and its employees, as experts in their field, are called upon 

to speak on military and veteran related issues. 

Victory Tech as the education arm of Victory Media partners with businesses to produce sldlled 

workers for the jobs of today and far into the future. Building a workforce is not a simple matter of 

setting up a learning management system, it takes planning, assessment and applied knowhow at the 

individual and aggregate level. The Victory Tech process helps organizations better understand their 

human capital to reduce risk, improve productivity, and enter new markets with confidence. Learn more 

online at wwwvictorvtechinstitute.com 

Victory Media owns and operates five global brands: GI.jobs, Victory Tech, NaVOBA, Vetrepreneur, 

and Military Spouse. Victory Media, Inc. is a GSA-scheduled SDVOB: GSA Contract GS 02F-00 17T. 

5 
25 

Mr. PITTS. The Chair thanks the gentleman. 

And now we will begin questioning, and I will recognize myself 

5 minutes for that purpose. 

We will start with you, Mr. Nichols. 

Do some States have certification and some have licensure? It 

sounds like there is significant variation between State requirements that would help EMTs if the States had more reciprocity or 

at least consistent requirements. Are there any good reasons that 

States would differ with regard to their training requirements? 

Walk us through, if you will, the traditional State credentialing 

and licensing process. 

Mr. NICHOLS. There are a number of, from State to State, there 

are reciprocity allowances, largely because the emergency medical 

technician is not covered under the medical or the same branch of 

State legislature, you run into issues there. Some it is under the 

Department of Transportation, other areas it is medical. It may be 

just a State board all by itself. So you do have issues on the reciprocity side of things. 

The key challenge, though, is that there is no reciprocity granted 

between the military training and between the State, so while an 

individual may have training and then go through a shorter reciprocity period to, say, move from California into Pennsylvania, the 

military is not afforded that because their training is not accredited 

basically. So the key challenge that you do find from that reciprocity side is, yes, there are differences; there are different areas 

of State government. It is a State license typically, which means 

that it is personal property, so it is controlled on the State level, 

and that is why I think your legislation is a good approach because 

it has to be a State solution to figure those things out. 

I think national certifying agencies have made the greatest effort 

in our stand there in place to try to create the reciprocity and an 

equalization of credentials and requirements. That is extremely important, but not all States actually recognize or embrace that or 

they add on to what has been established by the national agencies, 

like my colleague represents today. 

Mr. PITTS. Mr. Chlapek, you mentioned the gaps that military 

medics have in their knowledge, such as geriatrics. Would there be 

a way to implement a shortened curriculum to train former medics 

on anything they may have missed in their military training without duplicating the entire EMT training? Who do you recommend 

create and implement this supplemental curriculum, and are there 

enough returning medics that the schools could run profitable supplemental programs? 

Mr. CHLAPEK. Absolutely, Chairman Pitts. 

There is a process with each training entity where refresher 

courses are taught one weekend—they can be taught in one weekend for basic emergency medical technicians and over two weekends for the advanced level paramedics. This is something that is 

commonly done to help people recertify or re-license, recertify with 

the National Registry of Emergency Medical Technicians or re-license with the State. You are right in that some States have certifications, and some have licensure. There are some discrepancies 

there. Most, with the exception of one or two, offer reciprocity, as 

Mr. Nichols said, but there is no reason that those gaps could not 

26 

be covered over a week at the most to get these people ready, the 

military medics, to challenge the written and practical test that the 

State or national registry offer. 

Mr. PITTS. All right. If you would like to continue or both of you, 

if you were making recommendations to the States to streamline 

the process for veterans to become EMTs, what would you focus 

on? 

Mr. NICHOLS. I will be glad to field that. 

Mr. PITTS. Mr. Nichols? 

Mr. NICHOLS. Yes, sir. In fact, I had written some legislation that 

was passed in several States last year. There are three different 

approaches you can take, which one is direct reciprocity, I believe 

the State of North Carolina looked at that as an issue where they 

are doing what this bill is suggesting; they are allowing for direct 

reciprocity. Others have backed off from that direct approach and 

taken the approach of streamlining the education process, allowing 

for some shorter times. 

From my standpoint, you do want to protect the public for certain to make sure the individuals have the right skill sets and they 

meet the standards that are set, so I think some kind of a testing 

mechanism to just validate the skills would probably be the best 

approach on the State level. 

Mr. PITTS. Now, someone with training as a military medic, 

would they be qualified as an EMT basic, an EMT intermediate or 

an EMT paramedic? 

Mr. CHLAPEK. The common combat medical training for medics 

that staff the majority of the Army and Air Force as well as the 

Navy corpsman is a basic EMT level training. Currently the 

schools with the Air Force and the Army graduate their medics, 

specifically in the Army the 68-whiskey program, with the qualifications to test, and they test and get a national registry card as 

a basic EMT. 

Now, the Special Forces or Special Operations medical personnel 

throughout all the services through U.S. SOCOM and then through 

Fort Sam Houston and Fort Bragg qualify at the paramedic level, 

obviously, but they don’t have the license most of the time. It has 

become a political and who-is-in-charge issue as to whether or not 

they get licenses or not. 

Mr. PITTS. Mr. Nichols. 

Mr. NICHOLS. Navy corpsmen are often recruited with an existing EMT–B, and some of the Army service members that come in 

already have that EMT–B. The Corps and the Army and the Air 

Force as well, they are having a joint school that is now established 

down in San Antonio; there are significant differences in those 

training. When a corpsman completes their training, they are very 

much closer to an RN or to at least a licensed practical nurse in 

terms of what is allowed. The EMT basic is the very, very basic 

level they complete with. The minute they step on and start really 

practicing this hands on, they receive that. 

Mr. PITTS. The Chair thanks the gentlemen, and now recognize 

the ranking member, Mr. Pallone, for 5 minutes for questions. 

Mr. PALLONE. Thank you, Mr. Chairman. 

I wanted to start with Chief Chlapek. I want to thank you for 

your service and your testimony, and you have explained to us the 

27 

challenges that many veterans face when entering the EMS workforce; classes, clinical work, waiting for a test date once they have 

completed all the course work, and all these issues can delay the 

licensure of qualified veterans sometimes for many months. 

So I had two questions. First, if you could address the costs associated with achieving the training and education required, and 

what are the costs? And then what about the opportunity costs for 

veterans by investing in that training? That may be redundant. In 

other words, you know, they can’t get another job. They are out of 

work. While doing that training, they could be doing something 

else. So I wanted you to address those two things, you know, actual 

costs and then, you know, what it might mean for the individual 

because, you know, they are doing this redundant training when 

they could be doing something else, and they are not making any 

money. 

Mr. CHLAPEK. Yes, sir. 

Mr. Pallone, it varies across the board as far as EMT training 

and paramedic training. An EMT course may be anywhere from 

$500 at a local small fire department to $1,500 at a larger department to the cost of a semester of schooling at a community college 

to obtain that as well as the $150 or whatever is paid to test depending on the testing entity. So that is the real cost. The paramedic school can routinely run $5,000 or a year’s worth of community college tuition, plus testing costs that are similar to the EMT. 

In reality, if a service member has to spend a year in college 

going 2 or 3 days a week throughout the day or evenings, they are 

limited to part-time work to meet the schedule of that. So it essentially costs a year’s worth of salary minus whatever they might 

make on a part-time job. 

Mr. PALLONE. All right. I wanted to ask Mr. Nichols again—it is 

Commander Nichols, correct? 

Mr. NICHOLS. Yes, sir. 

Mr. PALLONE. Again, thanks for your remarks and your service, 

and I couldn’t agree with you more that members of the military 

have skills and competencies that would provide critical services in 

the communities. 

However—and the latest reports from the Institute of Medicine 

and RTI International suggest that EMT shortages are due at least 

in part to high turnover rates and other retention difficulties. 

But I think that you already addressed the streamlining of the 

licensure and the credentialing renewal process. So I wanted to ask 

in these IOM and RTI reports, they identified additional retention 

issues that contribute to EMT shortages, such as career advancement. Could you comment on other ways in which this bill may 

help address retention issues? You know, you answered—in response to the chairman, I think you talked about the whole issue 

of streamlining the licensure and how you would do that, but talk 

a little bit about the retention issues and to what extent, you know, 

we need to address career advancement and how this bill would get 

into that. 

Mr. NICHOLS. Many of the individuals that we would hire into 

these positions, the EMT basic was not sufficient as a qualification, 

but for those positions that were very, very entry level who did hire 

EMT basic, the pay rate is anywhere from $10 to $15 an hour, so 

28 

a service member coming out, that is well below typically what 

they have expected and what they have received in the military, 

and that becomes a key challenge for them, is sustaining their lifestyle on that. 

EMT intermediate level, which many of them could likely qualify 

for or the paramedic level, which is a much higher level certification, pay at much higher rates, closer to the $20 to $25, sometimes above that, and these are DC-area numbers, so they may differ across the States. That one piece alone is a significant issue. It 

is what work you are allowed to do. 

My colleague talked about what some of the higher level skilled 

individuals were able to do from tracheotomies in the field to a lot 

of fairly highly technical things that only physicians or practical 

nurses may be here able to do. So coming out and transitioning to 

the EMT basic, they are doing very, very little work, and a lot of 

that is more to do with cleaning and repair and maintenance of 

equipment as opposed to really the hands-on stuff that they have 

been skilled at doing. So it is a big step down. It oftentimes is a 

blow to their psyche, their sense of personal pride. 

Mr. PALLONE. But how can we correct that? Does the bill help 

in that respect? 

Mr. NICHOLS. I believe it does in that if it is handled properly 

on the State level, it allows for an individual not to find equivalency at the basic level but to find equivalency upward in that ladder, equivalency to their skill experience. And that is a huge piece 

that I haven’t seen in other legislation before. It allows for that. I 

don’t know if it is quite as specifically directed toward that, but it 

certainly allows for States to be able to do that. 

Mr. PALLONE. All right. Thank you very much. 

Mr. PITTS. The Chair thanks the gentleman. 

I recognize the gentleman from Pennsylvania, Dr. Murphy, for 5 

minutes for questions. 

Mr. MURPHY. Thank you, Mr. Chairman. 

I want to also state, too, that I have the distinct pleasure and 

honor of serving in the Navy Reserve with many of these corpsmen, 

and they are pretty remarkable what they have gone through in 

training. I would like to ask our witnesses here to comment, too, 

that when it comes to doing EMT work, in addition to the training, 

there is also what one does on the job. Can you give me a little 

rundown of the typical kind of crisis or situation a paramedic or 

EMT might be facing in a day’s work? 

Mr. CHLAPEK. Yes, sir. Congressman, Doctor, it can be—a day’s 

work can be anything from multiple post changes without running 

a call on a patient to call after call after call, responding from one 

call, clearing the hospital quickly to run another one, and it may 

be anything from whether a large system or a small system, anything from holding the hand of a 96-year-old patient and making 

them as comfortable as you can on the way to the emergency room, 

back to their residential care facility or anything like that, to treating gunshot victims or explosion victims and being in hazardous 

environments while we do that. The day varies greatly, and that 

EMT and paramedic have to work as a team, regardless of how 

many are there and within their scope of practice. 

29 

Mr. MURPHY. Given that, I imagine a lot of people go through the 

training, the book training, the course training, the lector training, 

and yet when they actually get on site and they are dealing with 

someone who is a gunshot victim or who is in a horrendous auto 

accident or pulling someone with third degree burns out of a fire, 

I imagine that the horrors of the situation itself also weed some 

people out, some people say this I can’t do. Am I correct in that? 

Mr. CHLAPEK. That is correct, sir. 

Mr. MURPHY. That is not something you can necessarily test for 

or question for when someone is applying for the job. 

Mr. CHLAPEK. That is correct. We do background checks. In my 

educational facility, we do further testing to try to weed some of 

those folks out, but they are few and far between. In reality, once 

you go through the training and the clinical work, you know whether or not you will make it on the street, and once you get out on 

the street or whatever environment you are working in, you do 

what you are trained to do, and you let the emotional part come 

later, and running a SIDS baby is a prime example. You do what 

you are trained to do and try to resuscitate the baby if they are 

viable at all, but afterwards, you get to the emergency room and 

transfer care or back to your station, once like a pediatrician told 

me, and we go home at night and cry like anybody else or call our 

spouses and say, give the kids an extra hug. So you can weed those 

people out, and of course, with PTSD, it adds up over time, just 

like it does with soldiers and sailors. 

Mr. MURPHY. You may guess where I am going with this, and 

that is this is part of the training that you just can’t deal with in 

a classroom. You can’t talk to someone about this, and this is an 

incredible skill that many of those who have gone through corpsman training experiences in Afghanistan and Iraq bring to the situation where they can probably be a source of strength and teaching to their colleagues. How do we make sure that we account for 

this, I ask both of you this, in terms of it is not just a matter of 

giving them credit for what they have already learned, but those 

things that happen in the classroom and the battlefield in putting 

someone back together, dealing with some of the atrocities of war, 

some of the things that we know that the al Qaeda and Taliban 

do to children in torturing them and damaging them. I am thinking 

here of a book called ‘‘Outlaw Platoon’’ by Sean Parnell, a best seller where he spent some 400 days in Afghanistan and particularly 

outlines the story of a corpsman there who probably ought to be 

nominated for the congressional medal of honor who was running 

from wounded soldier to soldier in his platoon, they were shot up, 

while he was getting shot himself, with incredible courage under 

fire. And I want to make sure that such people are getting credit, 

an opportunity to have jobs. 

It almost seems silly to me that we have to have an act of Congress to say to do this. So perhaps if each of you could comment 

on why we need to move forward on a bill like this quickly. Go 

ahead. 

Mr. NICHOLS. Thank you, Congressman, thank you for representing our district at home very well in the Pittsburgh area. I 

had the privilege as well to serve. As a Navy chaplain, we serve 

right alongside the medical corpsmen and did so throughout Iraq, 

30 

and to watch them work as a team to see leadership develop and 

leadership expressed, that is absolutely something you cannot 

train. The challenge they find in coming home is too many barriers, 

too many people saying no, too many regulations and long processes of filling out paperwork and following this step and that step 

and talking to the right person. We learned that as Navy personnel, how to kind of work through the system that is fairly difficult, but it is a challenge for them when you try to start feeding 

your family and to do that at the same time. 

The other challenge they bump into is the issue of liability. So 

there are a lot of strictures that our civilian hospitals who really 

make sure you don’t step over and do more, and that becomes, you 

know, that additional challenge. I think to take that leadership 

piece that has been honed, you can’t grow it, but we could sure use 

that on the front lines of our communities. 

Mr. PITTS. The Chair thanks the gentleman and now recognizes 

the gentlelady from California, Mrs. Capps, for 5 minutes for questions. 

Mrs. CAPPS. Thank you, Mr. Chairman. 

Thank you, each of you, for your excellent testimony today from 

your perspectives. Both your testimonies express very clearly that 

there are a host of contributing barriers to a smooth transition 

from military to civilian service. I agree with you that H.R. 4124 

is an important step toward breaking down some of these barriers, 

but there are other roadblocks noted in your testimony that would 

also have to be addressed, and I would like to get to maybe a few 

of those in my time with you. 

Mr. Chlapek or Chief Chlapek, excuse me, I want to use your 

title, can you speak a bit more about the potential issues around 

medics finding and facilities developing refresher or booster EMT 

courses to satisfy any gaps in military training? Geriatrics, someone mentioned that, I think that can be sort of filled in quite quickly. But I will start with that question to you. 

Mr. CHLAPEK. Thank you, Congresswoman Capps. It can be done 

at the training entities, and it has been done in some States at the 

training entities as far as what does this person need. You know 

what, they can spend a weekend with us, and our training entity 

specifically has done that and they will spend a weekend with us, 

and then we get them signed up for a test to challenge the test. 

That is where the refinement lies. 

The National Highway Traffic Safety Agency has gone so far as 

to help rewrite and reclassify some of the curriculum so that it is 

more malleable to put people through the streamlined process, it 

makes it a little easier to do. Agencies like ours, NAMT, puts in 

their employer guides how to help make this happen, and we embrace veterans. Veterans get credit at our institution or my place 

of employment as well as many others, and we bring them, we give 

preferential treatment to hiring veterans because we know they 

have seen what Congressman Murphy addressed. We know what 

their leadership skills are, as Commander Nichols talked about, 

but it all goes to the training entities and the States allowing them 

to do that, and that is what we do. You can absolutely get somebody prepared in a weekend or a week to challenge the test. 

31 

Mrs. CAPPS. So there is some good models out there for how to 

do this in States, and your agency, your group is prepared to give 

advice and sort of support this transition should States wish to go 

down this path? 

Mr. CHLAPEK. Yes, ma’am, and we do that now. We have developed a guide for deploying soldiers who have licenses who are 

members of NAMT, and we have also developed a guide for the employers to help these folks, keep them licensed if they have a license and if not help them get licensed when they get back. 

Mrs. CAPPS. All right. Thank you. 

Mr. CHLAPEK. Yes, there are some States, those I mentioned 

Texas, Missouri, Alabama, several of those, Tennessee. 

Mrs. CAPPS. Right. That is good to know. Thank you very much. 

Commander Nichols, your testimony noted the sheer costs of taking the certification. That is a barrier for some of our returning 

vets, isn’t it, returning soldiers? 

Mr. NICHOLS. Absolutely. And, again, typically when an individual chooses where they are going to take that certification or 

whatever else remaining skill level that they need, they will take 

the quickest path there, but oftentimes, they also want some of the 

more expensive options that may have a better name or better 

brand associated with it, and I think where we hope that this bill 

would help to address is that they don’t use their benefits to retrain on skills they already have. 

Mrs. CAPPS. Exactly. 

Mr. NICHOLS. Use the benefits to take the next step and the next 

level in their career. That is why I believe it was created after 

World War II to begin with. 

Mrs. CAPPS. Right. These are important considerations, and they 

kind of go beyond the scope of H.R. 4124’s focus on State certification changes. There are issues that I address in another bill, 

EMT bill, H.R. 3884. Mr. Chairman, I am hoping this committee 

will also look at this companion piece of legislation in some future 

hearings or markups on this matter. There is a lot here that can 

carry us a great deal. There is also some more that we could do 

to ensure that we are doing all we can to remove every barrier that 

we can to make this successful transition for our medics. It is such 

an important topic. 

There is another one, I just have 2 seconds, I will put it out on 

the table in case there is another way to explore the barriers that 

exist for current EMTs, civilian EMTs who want to join the National Guard, that is sort of the flip side of this, but it is also of 

very big importance to both of you and I think to our Congress as 

we are talking about getting out of this recession. Thank you, and 

I will yield back. 

Mr. PITTS. The Chair thanks the gentlelady and recognizes the 

gentleman from Ohio, Mr. Latta, for 5 minutes for questions. 

Mr. LATTA. Thank you, Mr. Chairman, and Colonel and Commander, thank you very much for being with us today. I really appreciated your testimony. 

Colonel, if I could just kind of back up to what you said a little 

bit earlier and the questions going to some of the difficulties that 

were at the State level, you said it becomes kind of a political 

32 

issue. Do you want to explain what you meant by becoming a political issue? 

Mr. CHLAPEK. Yes, sir. It deals with who is in charge of the bureau, if the bureau still exists. Some bureaus of EMS in certain 

States have been eliminated for budgetary reasons, and they fall 

under some other area of health or public safety. As far as the politics of it, it depends on who is in charge of the licensing agency at 

the time and, for example, in Missouri we have a veteran in 

charge, the director of the bureau of EMS, and he takes veterans 

issues on a one-by-one basis and helps these veterans get licensed 

in the most efficient and quickest way possible, but still making 

sure they have the qualifications. When he retires in January, we 

don’t know who will go in there, but it is possible someone without 

his knowledge or passion for veterans employment, and that gets 

to be an issue, much like in the military schools. Depending on who 

is in charge of that specific school, they may or may not like the 

national registry, certification or they may or may not like the 

Texas certification, in the case of Fort Sam Houston, and licensing 

process. If they don’t like it, then these medics start and EMTs 

start coming out of school without licenses, and if they do like it, 

then they are given the opportunity to test and all the training 

they need to test. 

Mr. LATTA. Let me follow up if I could. You said the gentleman 

that you said that is going to be retiring does it on a one-on-one 

basis, but wouldn’t it be easier if he would look at everybody and 

say that all these people that graduated or came out of the Army 

medic or the National Guard—pardon me, not National Guard, but 

the Air Force or if they are Navy corpsmen, that he could already 

categorize them so he could already say they are qualified to save 

that time? 

Mr. CHLAPEK. Absolutely, Congressman Latta, and last session, 

I believe Representative McCaffrey introduced a bill that should 

come up this time for passage this next session doing exactly what 

you said. 

Mr. LATTA. You know, and also just sitting here thinking about 

this, especially since every Governor in this country is the head of 

the National Guard units, you would think they would be able to 

say, you know what, we have got these people that are trained, and 

they know it because they are in such close contact with the adjutant generals in each of the States that they ought to be able to 

get something worked together that they could say at the State 

level, you know, that they would have, they would know right off 

the bat that, yes, these people are qualified to do X or X plus 1 or 

X plus 2, but we can get them categorized, they don’t need that 

extra training. So it seems to me that the Governors could be doing 

more just as the head of the National Guards in their respective 

States. 

Mr. CHLAPEK. Absolutely, sir. It works the other way, too. At 

Camp Atterbury, Indiana, I had a medic who had been a Navy 

independent duty corpsman and done two tours in Iraq as an independent duty corpsman, and the Army, even though he was designated as 68-whiskey by the Army Guard of his State, the Army 

folks at Fort Sam would not recognize that, and he had to go all 

the way through a basic EMT class while we were at MOB station 

33 

before he could join up with us 2 weeks into the deployment. So 

it works both ways. We need to get the military and the civilian 

sector on the same sheet of music. 

Mr. LATTA. Well, thank you very much, Mr. Chairman, and I 

yield back my time. 

Mr. PITTS. The Chair thanks the gentleman. 

Recognize the gentlelady from Illinois, Ms. Schakowsky, for 5 

minutes for questions. 

Ms. SCHAKOWSKY. Thank you, Mr. Chairman, and thank you, 

gentlemen. For a number of years now in Illinois I have been working with an organization mostly sponsored by the Teamsters, Helmets to Hardhats, and I think there is another organization or 

focus, Heroes to Healthcare, where we are trying to work on these 

kinds of smooth transitions. It makes so much sense. We are 

spending sometimes $100,000 training individuals in the military, 

and then they come home, and this skill, these skills are not recognized. 

In Illinois, we have made some progress on members of the military who have been driving trucks getting commercial driver’s licenses, so that is one area. But clearly, in this area of EMTs, when 

we have the most extreme conditions on the battlefield that would 

perfectly meld, and thank you for the progress that you have made. 

We have talked a lot about the States and the licensing processes 

and the barriers there, but I want to focus a little bit more on the 

military side and how that transition, how the military itself can 

be more helpful. Are certificates given? Are hours of training, some 

kind of piece of paper that a veteran can take when discharged 

from the military that says, I have had this kind of training, this 

number of hours—not necessarily that I am qualified in Texas or 

in Illinois for this job—but this is what I have learned, how many 

hours I have experienced? You talked about in your testimony dealing, talking with veterans on a case-by-case basis, this is Missouri. 

I mean, isn’t there some way of routinizing that in a better way 

so that the person doesn’t have to explain individual by individual 

but have a piece of paper? 

Commander, either one of you who really knows how to answer 

that or both, I would appreciate it. 

Mr. NICHOLS. I would love to jump in there, Congresswoman, 

and I am very familiar with the work the Teamsters are doing with 

Helmets to Hardhats and Heroes to Healthcare. They are doing excellent, outstanding work, have for many, many years now. 

The key challenge that you find is in order for that training to 

qualify against the credential or the license, it must be provided by 

a licensed or accredited school. The military is neither licensed nor 

accredited, and that is what I have really boiled it down to is the 

key issue. 

The Department of Education and these accreditation councils do 

not recognize the Department of Defense as an accredited training 

institution. Therefore, all the training that comes from them cannot 

be, unless some specific legislation says so, accepted. 

Ms. SCHAKOWSKY. Well, isn’t that sort of the bottleneck, then? 

Isn’t that something that we ought to directly deal with is acknowledging the military as a place that is qualified and certified? 

34 

Mr. NICHOLS. Ma’am, if there is one area where there is a national ability to take action, that to me is the one area where there 

is the national ability to take action and allow the military in some 

way or other to achieve and to be accredited according to those civilian standards or to set up some kind of a reciprocity piece there. 

Ms. SCHAKOWSKY. I heard the chairman talk about reciprocity. 

So—did you want to add to that, Colonel? 

Mr. CHLAPEK. Yes, ma’am. Our military relations committee with 

NAMT has recently done a gap analysis on the military medical 

training, and there is no consistency between the different schools. 

The Army doesn’t train exactly what the Air Force trains, and they 

don’t train what the Navy trains. So there is a lack of consistency 

with the training, and that leads to a problem with reciprocity. In 

addition—— 

Ms. SCHAKOWSKY. Let me just interrupt for a second. So then, 

maybe, we can work with the military to make sure that if it is 

a couple more hours of this or something instead of that, that it 

is with an eye toward discharge and what they are going to do 

afterwards. 

Mr. CHLAPEK. Yes, ma’am, and we have worked with this reciprocity issue within the military and in the civilian sector for several decades now, since the EMS came about. It has constantly 

been an issue, and one thing that we are doing with our checklist 

for employers and checklist for deploying civilian providers is saying, get all of your training records—it is up to the individual soldier, sailor, airman or Marine when they get out to get all their 

training records from mobilization station and what they may have 

received overseas. And then they can take that to the State and 

say here are my training hours. It might not be part of your curriculum, but I have 3 weeks of HAZMAT training, and that goes 

a long way toward satisfying some of the requirements. Right now 

reciprocity is hit and miss. 

Ms. SCHAKOWSKY. I just want to say, I want to work with whoever is taking the lead. I just think this is something that we can 

figure out together and with the expertise of people like our witnesses. 

Mr. PITTS. The Chair thanks the gentlelady. 

I recognize the gentleman from Georgia, Dr. Gingrey, for 5 minutes for questions. 

Mr. GINGREY. Mr. Chairman, thank you for the recognition. 

And Mrs. Capps, thank you for your comments. 

And Ms. Schakowsky, absolutely. I am one on this side ready, 

willing and able—I don’t know whether I am able so much as ready 

and willing, but I want to thank Lois and Adam and others that, 

you know, have put together this piece of legislation because clearly it seems to me, and Congresswoman Schakowsky just made this 

comment, why in the world wouldn’t there be consistency, at least 

some consistency across the services in regard to the 68-whiskey 

designation, the same that you would have in the Air Force and the 

Navy as well as in the Army. 

I mean, if you have got a soldier that is hit by a torpedo or run 

over by a tank or shot by a sniper, you know, you have got pretty 

much the same amount of damage and what you need to do to save 

their lives, and it seems to me that there should be consistency no 

35 

matter what branch they happen to be in, and the accreditation 

should be granted across all service lines, assuming that they have 

developed that consistency of training. 

When doctors who are fully trained and accredited and licensed 

in whatever subspecialty and from whatever State, when they go 

down range for a couple of years, do you think that they don’t continue to get accredited and have continuing education during some 

part of that deployment time? Of course, they do. They don’t just— 

they are not out there at the tip of the sphere with their hand in 

a wound stopping blood and holding a lacerated artery 24/7. They 

clean up, dust off, go back and take a course periodically during 

their military training. 

I am sure the same thing exists for these EMSs, and if it doesn’t 

exist, it is deplorable if they are working 24/7 and have no time to 

go in a classroom and keep their skills up and keep that accreditation, particularly those who come into the military who are already 

licensed as paramedics or EMTs. I mean, that should be a nobrainer. 

Now, I don’t know whether I put that in the form of a question, 

but I would love a response from our two witnesses. 

But, you know, one thing that is missing here from this hearing 

is you all are doing a great job, but obviously, you both have sort 

of a military background bent on this in regards to what you think 

needs to be done to streamline our military EMTs and paramedics 

to get them more quickly into civilian workforce. 

I couldn’t agree more, but I would love to hear from someone who 

maybe is kind of an expert, worked in an emergency room for years 

or run an ambulance service or whatever with very little, if any, 

military background who could bring to us some concerns that 

maybe some of these people from the military are bringing to the 

civilian side, whether it is post-traumatic stress syndrome or trying 

to resuscitate every single person before even giving them an opportunity to fog a mirror, you know. So maybe you all can comment 

on that a little bit as well. 

Mr. NICHOLS. Thank you, Congressman, I will grab one or two 

of them. 

The first time when I first became director of recruitment for 

Inova Health System in the area here, I did a survey of all the hiring managers across our facilities there, talking specifically about 

this issue of military, and it was 100 percent—it wasn’t even 90 

percent that—yes, they would take military hands down. Obviously, they want to make sure the skills are there to meet the requirements for the issue of liability sake, but absolutely would take 

military hands down. 

On the other, for the other question, the first portion of that, there has been about $1.2 billion or so invested in the new training 

facility down in San Antonio, which is a purple training facility for 

health care technicians from the E5 and below level, and from 

what I understand, all services will be transitioning through there, 

they can hold up to 8,000 students a day and will transition about, 

train about 24,000 students per year through that facility. Now, 

will the courses be the same? Probably not right immediately, even 

among the chaplain corps, and we made a purple training facility 

for all the chaplains going through, we still had separate buildings 

36 

for the Army, the Navy, and the Air Force and kind of did a little 

bit of our own thing. 

You know, as long as when you break it down to the competency 

level and you look across all the curriculum from a competency 

standpoint and find those similarities and then allow them to 

maybe add on what they might need for, say, sea service, I think 

you will find similarities. I think they are moving in that direction 

right now with the investment that you are seeing in the Department of Defense, but still it doesn’t address the issue that they are 

not an accredited training facility. From the States’ side that is still 

an issue. 

Mr. PITTS. The Chair thanks the gentleman. 

I recognize the ranking member emeritus, Mr. Dingell, 5 minutes 

for questions. 

Mr. DINGELL. Thank you, Mr. Chairman. I commend you for 

holding this important hearing today. As a veteran myself and as 

a student of military history, I find this piece of legislation to be 

a no-brainer. It is more than a two-fer. I ask unanimous consent 

that I can be permitted to insert into the record a rather excellent 

statement upon which I worked very hard. 

Mr. PITTS. Without objection, sir. 

[The prepared statement of Mr. Dingell follows:] 

37 


82106.015

Statement of the Honorable John D. Dingell 

House Committee on Energy and Commerce Subcommittee on Health 

"Helping Veterans with Emergency Medical Training Transition to Civilian 

Service" 

2012 

Thank you, Mr. Chairman, for holding this important hearing today. As a veteran myself, I 

am pleased to see this Subcommittee focusing on the problems facing our troops once they 

return home. Veterans continue to be unemployed at a higher rate than the rest of the 

population, and this is a serious national problem. With over one million veterans expected 

to leave the military in the next five years, we need outside-of-the-box solutions to help 

them successfully reintegrate into society. 

I was proud to be at the VA for Vets Hiring Fair in Detroit a few weeks ago, and I got to 

speak with many veterans and heard about their problems firsthand. One common theme 

that I continued to hear was that our veterans are returning home with great leadership 

skills and experiences that employers are looking for, but they are having trouble getting 

licensed to do the work. This problem is particularly acute in the emergency medicine field, 

where former military medics often times have to go through extensive re-training 

programs to be eligible to work as an emergency medical technician. Although these 

licensing requirements vary by state, it seems that a reciprocity program would help break 

down this barrier and help veterans find jobs which they are already qualified for. 

I applaud the gentleman from Illinois, Mr. Kinzinger, and the gentlewoman from California 

Ms. Capps, for taking the lead on this important issue by introducing H.R. 4124, the Veteran 

Emergency Medical Technician Support Act of 2012. This legislation would direct the 

Secretary of Veterans Affairs to create a grant program for states with emergency medical 

technician shortages. States would use this money to streamline their licensing 

requirements for veterans and offer waivers for licenses when necessary. This is a common 

sense solution to the licensing issue facing our veterans. 

I hope the Subcommittee will continue to use its time on practical, bipartisan solutions to 

problems facing working Americans. Thank you, Mr. Chairman, and I yield back the balance 

of my time. 
38 

Mr. DINGELL. I also want to make it very clear that when I came 

out of the Army back in 1946, I would observe that I was given by 

the school that I returned to, Georgetown, full credit for a lot of the 

things that I had learned and done in the military. That same 

thing is true about a lot of our veterans who are returning home, 

particularly in the area of medical care, because they are seeing 

things and doing things under the most appalling conditions, involving the most terrifying kinds of wounds and injuries and damages and diseases and all kinds of weird parasitic diseases that you 

get by serving in places like that, and they are having to learn 

things that people are desperately anxious to know about in the 

field of organized medicine, but they don’t ever get exposure to 

these kinds of situations. 

So here we have got a bunch of veterans who we want to put 

back to work. We have got a problem with unemployment, which 

is a very significant problem to the veterans, homelessness and all 

the other things that attend that, but we have also got another little problem that I think very frankly we should take a hard doggone look at, and that is we are going to have a growing and increasing shortage of people who are qualified to give health care. 

Here we have people who are deserving of it by their service, 

who are skilled and have experience that is enormously valuable. 

I am satisfied that the schools and education and higher learning 

in this country are anxious to have these people come. I am equally 

satisfied that they are happy to have them contribute to the wellbeing of the schools by paying tuition and things of that kind. We 

are providing tuition for those people, but in addition to that, we 

have the opportunity to see to it that all of a sudden, we get an 

influx of valuable people who saw the need for this kind of service 

while they were in the military. 

So we are going to give them, we have already given them a lot 

of training, including ongoing training which they get in the service 

dealing with their particular specialties. Now I have talked to a lot 

of the people in the military who are doing this kind of work. It 

is very clear to me that they want to continue in this kind of area. 

They want to make a contribution. If you look, you will find a lot 

of the people who are corpsmen and other things have plans to become nurses or have plans to move on into being specialists in 

some kind of disease or to have a doctor’s degree or something of 

that kind, and these are a tremendous resource, and I don’t see 

how we could do other than to save the money that it takes to put 

those kind of people to work to see to it that they have the opportunity to benefit themselves and benefit the country by their skills 

that they have learned and why we can’t move about speedily to 

moving this legislation forward. 

So I congratulate you for the hearing, Mr. Chairman. I urge my 

colleagues to support this legislation. 

I congratulate the authors of the legislation because it is going 

to be something that is going to be useful. 

And to our witnesses in the committee well, I do have some comments, I would be delighted to hear, starting with you, in whichever order, Mr. Chlapek or Mr. Nichols, if you have some comments 

to make, you have the remainder of my time, which is a minute 

and 19 seconds. 

39 

Mr. CHLAPEK. Thank you, Congressman Dingell. 

The military can set the baseline here, much like Mr. Nichols 

talked about on the training at Fort Sam Houston in San Antonio, 

and they are going a long way toward standardizing the training. 

We just have to make sure these youngsters come out of the military with the license or the ability to test at that point. 

And you talked about the records you walked away with or the 

training and education in 1946, and I believe we could do the same 

here with that. 

Mr. DINGELL. If you can’t, you are wasting a lot of something. 

Mr. CHLAPEK. Say again, sir? 

Mr. DINGELL. If you can’t, you are going to be wasting a lot of 

talent, skills, and money. 

Mr. CHLAPEK. Yes, sir, agree. 

Mr. NICHOLS. Thank you, Congressman, thank you for your service to our Nation. 

Mr. DINGELL. Thank you. 

Mr. NICHOLS. And I am sure you know probably more than most 

of us that really the foundation for the community college system 

and the workforce system of the country was based on the return 

of soldiers from World War II, and we have come a long way and 

a lot of good work that has come from there, but in some respects, 

that transition from out of the military—— 

Mr. DINGELL. This is so much more beneficial today and so much 

better, and they are dealing with new things that we never had to 

deal with. World War II, most of it was shrapnel or rifle bullets or 

something like that or some guy get hit by a tank, you know, or 

all kinds of things including some weird diseases that we got in 

places like Africa. 

The hard fact of the matter is now we are having to contend with 

a whole new array of diseases, damages, injuries, including the effects of blast, which is beginning to show up as having effects we 

never understood or never were able to address, and these people 

have got skills that I think in many ways exceed those which are 

available through the training programs we now have or through 

the organized system that we have delivering medicine, hospitals 

and things of that type. A lot of this stuff is brand new to American 

medicine and the medicine of the world. But you go ahead. I interrupted you, and you have my apologies. 

Mr. NICHOLS. Sir, with that, I concur. 

Mr. PITTS. The Chair thanks the gentleman. 

I now recognize Mr. Kinzinger, one of the authors of the legislation, for 5 minutes for questions. 

Mr. KINZINGER. Thank you, Mr. Chairman, again, for holding the 

hearing and allowing me to ask some questions here. 

You know, actually as I was sitting here, this intended to be part 

of my questioning, but I am actually a major in the military. In the 

Air National Guard, I am a pilot. And the one thing that really hit 

me is when I finished pilot training in 2004, I went to an FAA examiner, and I took a test, and I actually had a master question file 

that you study. And I went and I took a very quick test, and immediately my training in the military transferred to an instrument 

rating; it transferred to a multi-engine rating and also a rating in 

the various aircraft I flew with the military, all by taking a test. 

40 

I didn’t have to go and get retrained and get my civilian equivalent 

of an instrument rating; I got it in the military. I didn’t have to 

go get my civilian equivalent of a multi-engine; I got it in the military. 

And so from the piloting perspective, they recognize that what 

you learn in the military should transition to the civilian force. In 

fact, we see that every day when you see military pilots that do 

their 20 years, and then they go get a job with United or American 

or one of the airlines and, if you are lucky, Fed Ex or UPS or something like that. So when you look at where the—and I don’t see 

being a pilot as being much different than an EMT. You are faced 

with situations. You learn how to control a situation, how to address it, and how to move on. Very recently, actually within the 

last few years, the FAA also began to recognize an instructor rating 

in the military as well. So if you are an instructor pilot in the military, you used to have to come out and actually go through the 

whole instructor rating process civilian wise. A few years ago, they 

said, you know what, that is stupid, you are an instructor on the 

civilian side. Guess what? We have not had major catastrophes as 

a result of it. In fact, we got a whole new breadth of talent I think 

into the civilian piloting world as a result of that recognition. 

And I see this as not very different from that. I see this as the 

same kind of idea and I think something that can be learned from 

what has happened in the piloting community. 

But here is a question for both of you. So we talk about somebody coming out of the military and being able to transition to having their civilian EMT equivalent. What do you think—and maybe 

not an exact but kind of a general, what would be a basic time 

frame? Obviously, somebody can come in and say, hey, I was a civilian—or I was a military EMT in 1991. They probably should not 

be granted immediately the ability to transition to a civilian EMT. 

So there has to be some kind of a time limit. Maybe it is a year; 

maybe it is 2 years. I just wanted to get your general thought, we 

will start with you, Mr. Nichols, on what you think would be a good 

time frame between I came out with this military experience, and 

now this can transition to the civilian side. 

Mr. NICHOLS. I believe since the transition out of the military is 

typically not a surprise for individuals that they should start that 

process and be allowed to start that process before they get out so 

they don’t have a gap in between the two. I think that really is 

where the issue is or at least at a minimum allow them to have 

a testing and a verification in the military so they know what the 

gap is and know what their requirements will be so they can properly economically plan. 

The chief difference, though, between what the FAA has and the 

health care side is the FAA has a national standard of skills that 

crosses all the States; whereas with the health care and the EMT, 

there is no national standard that is recognized by every State. 

Mr. DINGELL. Would the gentleman yield? 

Mr. KINZINGER. Sure, sir. 

Mr. DINGELL. He makes a very good point. We could overcomplicate what we are doing here today by drafting in all kinds of requirements and standards and things or we could just use the 

State and the professional accreditation agencies to do the work 

41 

that we are talking about. They have the full ability to define how 

long it would be, what the particular skills are, and if we need any 

help when we take the next look at this, I think we could address 

all these questions. 

I do want to commend the gentleman for what he has done on 

this. 

Mr. KINZINGER. Thank you. 

Mr. Chlapek, did you have any input on that? 

Mr. CHLAPEK. I don’t know, Congressman Kinzinger, if there is 

actually a magic number as far as 1 year, 2 years, something like 

that. A lot depends on the individual and their ability to retain 

things, but absolutely, it can’t be someone from the Vietnam War 

or World War II coming back and saying, I want to re-license. At 

some point you have to go back through the training. 

Mr. KINZINGER. Thank you. And then just quickly, so 10 seconds 

apiece basically, do most of these guys come back, men and women, 

come back with experience from their 16 weeks of training or is it 

experience that they have received on the job? I mean, which is the 

most beneficial, the formal training or the fact that they were in 

Iraq and Afghanistan fixing wounds et cetera? 

Mr. CHLAPEK. Without fail, I would say their real world experience when they are deployed. 

Mr. KINZINGER. Right. Which is something you can’t, not to 

downtrod on civilian EMTs at all, but it is something that can’t be 

replicated necessarily, you know, on the civilian side hopefully. 

Mr. NICHOLS. I absolutely agree. Employers want to hire experienced individuals. 

Mr. KINZINGER. With that, Mr. Chairman, I yield back, and I 

thank you for your courtesy. 

Mr. PITTS. The Chair thanks the gentleman, and that concludes 

the questioning, and the Chair looks forward to working with the 

members in a bipartisan way to address the issues that have been 

brought up today and moving legislation. 

Mr. Pallone, you have a unanimous consent request? 

Mr. PALLONE. Thank you, Mr. Chairman. 

I just wanted to ask unanimous consent to enter into the record 

the statement by our ranking member, Henry Waxman. 

Mr. PITTS. Without objection, so ordered. 

[The prepared statement of Mr. Waxman follows:] 

42 


82106.016

Rep. Henry A. Waxman 

Ranking Member 

Committee on Energy and Commerce 

Subcommittee on Health Hearing on "Helping 

Veterans with Emergency Medical Training 

Transition to Civilian Service" 

July 11,2012 

Thank you, Mr. Chairman, for holding today's 

hearing. 

Among the United States' finest citizens are the 

members of our military. And not just because they 

are prepared to put their lives on the line -- and often 

do -- to protect our homeland and national interests, 

and to stand up for the guiding principles upon 

which our great country has been built. This goes 

without saying. 
43 


82106.017

We also count them among our best and 

brightest because of the tremendous skills and 

significant work experience they bring back to 

civilian life once their military obligation is 

completed. In every regard, then, these 

extraordinary Americans truly are, all that they can 

be. 

Because they deserve it -- and because they have 

earned it -- we should do everything we can to 

ensure that armed services personnel can move from 

their military jobs to civilian jobs if and when they 

want to. And they should be able to do so with 

relative ease and timeliness. This is a moral 

obligation we bear as a nation. And, indeed, through 

the 01 Bill and other related initiatives, we have 

worked to fulfill that duty. 

2 
44 


82106.018

Efforts to further improve this transition make 

good business sense as well, especially for medical 

professionals who have served in the military. They 

have the training. They have the know-how. And 

they have the commitment - all to provide needed 

medical services and to help fill the gaps in areas 

where shortages in the health professions exist -

right here at home. 

But making the shift to the civilian workforce is 

not always as smooth or as quick as we would like 

or think it should be. 

3 
45 


82106.019

Today we will learn about the challenges facing 

one such group -- veterans with emergency medical 

training -- when they try to put that training to use as 

civilians after their discharge. Reports indicate that 

many road blocks -- such as state licensure laws and 

continuing education requirements -- stand in their 

way. 

Legislation was passed in the House during the 

last Congress to address these concerns. 

Congresswoman Capps has championed the cause in 

this Congress with the introduction of her bill, H.R. 

3884, the Emergency Medic Transition Act. More 

recently, Ms. Capps has joined forces with our 

Republican colleague, Congressman Kinzinger, to 

introduce H.R. 4124, the Veteran Emergency 

Medical Technician Support Act. 

4 
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82106.020

I am hopeful that working together, we can take 

a bill through the Congress that this time, goes all 

the way to the President's desk for his signature. 

But first things first. Today's hearing is the 

initial step in that process. I thank our witnesses for 

being here and look forward to a thoughtful and 

productive hearing. 

5 
47 

Mr. PITTS. Excellent testimony, excellent hearing. Thank you. We 

will be in touch with you. I remind members that they have 10 

business days to submit questions for the record. 

And I ask the witnesses to respond to the questions promptly. 

Members should submit their questions by close of business on 

Wednesday, July 25th. 

Without objection, the subcommittee is adjourned. 

[Whereupon, at 11:31 a.m., the subcommittee was adjourned.] 

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