II

106TH CONGRESS

2D SESSION S. 3125

To amend the Public Health Service Act, the Internal Revenue Code of

1986, and title XVIII of the Social Security Act to sustain access

to vital emergency medical services in rural areas.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 27 (legislative day, SEPTEMBER 22), 2000

Mr. CONRAD introduced the following bill; which was read twice and referred

to the Committee on Finance

A BILL

To amend the Public Health Service Act, the Internal Revenue Code of 1986, and title XVIII of the Social Security

Act to sustain access to vital emergency medical services

in rural areas.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

4 (a) SHORT TITLE.—This Act may be cited as the

5 ‘‘Sustaining Access to Vital Emergency Medical Services

6 Act of 2000’’.

7 (b) TABLE OF CONTENTS.—The table of contents of

8 this Act is as follows:
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Sec. 1. Short title; table of contents.

Sec. 2. Rural emergency medical service training and equipment assistance program.

Sec. 3. Tax credit for volunteer emergency medical service providers.

Sec. 4. Study and report on the costs of rural ambulance services.

Sec. 5. Elimination of reduction in inflation adjustments for ambulance services.

1 SEC. 2. RURAL EMERGENCY MEDICAL SERVICE TRAINING

2 AND EQUIPMENT ASSISTANCE PROGRAM.

3 Part E of title XII of the Public Health Service Act

4 (42 U.S.C. 300d–51 et seq.) is amended by adding at the

5 end the following new section:

6 ‘‘SEC. 1253. RURAL EMERGENCY MEDICAL SERVICE TRAIN7 ING AND EQUIPMENT ASSISTANCE PROGRAM.

8 ‘‘(a) GRANTS.—The Secretary, acting through the

9 Administrator of the Health Resources and Services Ad10 ministration (referred to in this section as the ‘Secretary’)

11 shall award grants to eligible entities to enable such enti12 ties to provide for improved emergency medical services

13 in rural areas.

14 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant

15 under this section, an entity shall—

16 ‘‘(1) be—

17 ‘‘(A) a State emergency medical services

18 office;

19 ‘‘(B) a State department of Transpor20 tation;

21 ‘‘(C) a State emergency medical services

22 association;
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1 ‘‘(D) a State office of rural health; or

2 ‘‘(E) any other entity determined appro3 priate by the Secretary; and

4 ‘‘(2) prepare and submit to the Secretary an

5 application at such time, in such manner, and con6 taining such information as the Secretary may re7 quire, that includes—

8 ‘‘(A) a description of the activities to be

9 carried out under the grant; and

10 ‘‘(B) an assurance that the applicant will

11 comply with the matching requirement of sub12 section (d).

13 ‘‘(c) USE OF FUNDS.—

14 ‘‘(1) IN GENERAL.—An entity shall use

15 amounts received under a grant made under sub16 section (a), either directly or through grants to

17 emergency medical service squads that are located

18 in, or that serve residents of, non-metropolitan sta19 tistical areas, to—

20 ‘‘(A) hire or recruit emergency medical

21 service personnel;

22 ‘‘(B) recruit or retain volunteer emergency

23 medical service personnel;

24 ‘‘(C) train emergency medical service per25 sonnel in emergency response, injury preven-
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1 tion, safety awareness, and other topics relevant

2 to the delivery of emergency medical services;

3 ‘‘(D) fund specific training to meet State

4 certification requirements;

5 ‘‘(E) develop new ways to educate emer6 gency health care providers through the use of

7 technology-enhanced educational methods (such

8 as distance learning);

9 ‘‘(F) acquire emergency medical services

10 vehicles, including ambulances;

11 ‘‘(G) acquire emergency medical services

12 equipment, including cardiac defibrillators;

13 ‘‘(H) acquire personal protective equip14 ment for emergency medical services personnel

15 as required by the Occupational Safety and

16 Health Administration; and

17 ‘‘(I) educate the public concerning

18 cardiopulmonary resuscitation (CPR), first aid,

19 injury prevention, safety awareness, illness pre20 vention, and other related emergency prepared21 ness topics.

22 ‘‘(2) PREFERENCE.—In awarding grants under

23 this section the Secretary shall give preference to en24 tities that intend to use amounts provided under the
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1 grant to fund activities described in any of subpara2 graphs (A) through (E) of paragraph (1).

3 ‘‘(d) MATCHING REQUIREMENT.—The Director may

4 not make a grant under this section to an entity unless

5 the entity agrees that the entity will make available (di6 rectly or through contributions from other public or pri7 vate entities) non-Federal contributions toward the activi8 ties to be carried out under the grant in an amount equal

9 to 5 percent of the amount received under the grant.

10 ‘‘(e) EMERGENCY MEDICAL SERVICES.—In this sec11 tion, the term ‘emergency medical services’—

12 ‘‘(1) means resources used by a qualified public

13 or private nonprofit entity, or by any other entity

14 recognized as qualified by the State involved, to de15 liver medical care outside of a medical facility under

16 emergency conditions that occur—

17 ‘‘(A) as a result of the condition of the pa18 tient; or

19 ‘‘(B) as a result of a natural disaster or

20 similar situation; and

21 ‘‘(2) includes services delivered by an emer22 gency medical services provider (either compensated

23 or volunteer) or other provider recognized by the

24 State involved that is licensed or certified by the

25 State as an emergency medical technician, a para-
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1 medic, a registered nurse, a physician assistant, or

2 a physician that provides services similar to services

3 provided by such an emergency medical services pro4 vider.

5 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—

6 ‘‘(1) IN GENERAL.—There is authorized to be

7 appropriated to carry out this section, $50,000,000

8 for each of fiscal years 2001 through 2006.

9 ‘‘(2) ADMINISTRATIVE COSTS.—The Director

10 may use not more than 10 percent of the amount

11 appropriated under paragraph (1) for a fiscal year

12 for the administrative expenses of carrying out this

13 section.’’.

14 SEC. 3. TAX CREDIT FOR VOLUNTEER EMERGENCY MED15 ICAL SERVICE PROVIDERS.

16 (a) IN GENERAL.—Subpart A of part IV of sub17 chapter A of chapter 1 of the Internal Revenue Code of

18 1986 (relating to nonrefundable personal credits) is

19 amended by adding at the end the following:

20 ‘‘SEC. 25B. VOLUNTEER EMERGENCY MEDICAL SERVICE

21 PROVIDER CREDIT.

22 ‘‘(a) ALLOWANCE OF CREDIT.—In the case of an eli23 gible volunteer emergency medical service provider, there

24 shall be allowed as a credit against the tax imposed by

25 this chapter for the taxable year an amount equal to $500.
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1 ‘‘(b) ELIGIBLE VOLUNTEER EMERGENCY MEDICAL

2 SERVICE PROVIDER.—For purposes of this section—

3 ‘‘(1) IN GENERAL.—The term ‘eligible volunteer

4 emergency medical service provider’ means an indi5 vidual who—

6 ‘‘(A) is an emergency medical service pro7 vider or other provider (within the meaning of

8 section 1253(e)(2) of the Public Health Service

9 Act) providing emergency medical services in

10 connection with an emergency medical service

11 squad,

12 ‘‘(B) volunteers with respect to such serv13 ices, and

14 ‘‘(C) is listed as active on the official staff

15 roster of such squad for the taxable year.

16 ‘‘(2) EMERGENCY MEDICAL SERVICES.—For

17 purposes of paragraph (1), the term ‘emergency

18 medical services’ means—

19 ‘‘(A) emergency medical services (as de20 fined in section 1253(e)(1) of such Act), and

21 ‘‘(B) any other services provided in rela22 tion to such emergency medical services, such

23 as administrative and operational duties and

24 community education and training programs.
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1 ‘‘(3) VOLUNTEER.—For purposes of paragraph

2 (1), the term ‘volunteer’ means to provide services

3 without compensation, other than reimbursement or

4 payment of reasonable and necessary expenses in5 curred in the performance of the emergency medical

6 service provider’s duty.’’.

7 ‘‘(c) VERIFICATION.—The Secretary may require ad8 ditional information to be provided, in such form and such

9 manner as the Secretary deems necessary, to verify the

10 eligibility for the credit under this section.’’.

11 (b) CONFORMING AMENDMENT.—The table of sec12 tions for subpart A of part IV of subchapter A of chapter

13 1 of the Internal Revenue Code of 1986 is amended by

14 inserting after the item relating to section 25A the fol15 lowing new item:

‘‘Sec. 25B. Volunteer emergency services provider credit.’’.

16 (c) EFFECTIVE DATE.—The amendments made by

17 this section shall apply to taxable years beginning after

18 December 31, 2000.

19 SEC. 4. STUDY AND REPORT ON THE COSTS OF RURAL AM20 BULANCE SERVICES.

21 (a) STUDY.—The Secretary of Health and Human

22 Services, in consultation with the Director of the Office

23 of Rural Health Policy and with the assistance of the Ad24 ministrator of the Health Care Financing Administration,

25 shall conduct a study of the means by which rural areas
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1 with low population densities can be identified for the pur2 pose of designating areas in which the cost of providing

3 ambulance services would be expected to be higher than

4 similar services provided in more heavily populated areas

5 because of low usage. Such study shall also include—

6 (1) an examination of the cost differences be7 tween independent volunteer ambulance providers

8 and hospital-based ambulance providers serving

9 rural areas; and

10 (2) an identification and analysis of the factors

11 that contribute to the additional costs of providing

12 ambulance services in areas designated under the

13 previous sentence.

14 (b) REPORT.—Not later than June 30, 2001, the

15 Secretary shall submit to Congress a report on the results

16 of the study conducted under this section, together with

17 a proposed regulation based on that study which adjusts

18 the fee schedule under section 1834(l) of the Social Secu19 rity Act (42 U.S.C. 1395m(l)) with respect to payment

20 rates for ambulance services provided in low density rural

21 areas to take into account the increased cost of providing

22 such services in such areas.

23 (c) IMPLEMENTATION OF REGULATION.—The regula24 tion submitted under clause (ii) shall take effect not later

25 than January 1, 2002.
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1 SEC. 5. ELIMINATION OF REDUCTION IN INFLATION AD2 JUSTMENTS FOR AMBULANCE SERVICES.

3 Subparagraphs (A) and (B) of section 1834(l)(3) (42

4 U.S.C. 1395m(l)(3)(A)) are each amended by striking ‘‘re5 duced in the case of 2001 and 2002 by 1.0 percentage

6 points’’ and inserting ‘‘increased in the case of 2001 by

7 1.0 percentage point’’.

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