I 

118TH CONGRESS 

1ST SESSION H. R. 6433 

To preserve access to emergency medical services. 

IN THE HOUSE OF REPRESENTATIVES 

NOVEMBER 15, 2023 

Ms. PEREZ (for herself and Mr. FINSTAD) introduced the following bill; which 

was referred to the Committee on Energy and Commerce, and in addition 

to the Committee on Education and the Workforce, for a period to be 

subsequently determined by the Speaker, in each case for consideration 

of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To preserve access to emergency medical services. 

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. 

4 This Act may be cited as the ‘‘Preserve Access to 

5 Rapid Ambulance Emergency Medical Treatment Act of 

6 2023’’ or the ‘‘PARA–EMT Act of 2023’’. 

7 SEC. 2. FINDINGS. 

8 Congress finds the following: 

9 (1) Paramedics and emergency medical techni10 cians (in this section referred to as ‘‘EMTs’’) proVerDate Sep 11 2014 22:05 Nov 27, 2023 Jkt 049200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6433.IH H6433

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1 vide care to ill or injured people in emergency med2 ical settings and are a vital component of the Na3 tion’s Emergency Medical Services (in this section 

4 referred to as ‘‘EMS’’) system. 

5 (2) EMTs provide basic emergency medical care 

6 and transportation for patients while paramedics 

7 provide advanced emergency medical care such as 

8 intubation, oral and intravenous drug administra9 tion, and other procedures. 

10 (3) The United States EMS system is facing a 

11 crippling workforce shortage, a long-term problem 

12 that has been building for more than a decade. 

13 (4) In 2019, the Health Resources and Services 

14 Administration reported that by 2030, there would 

15 be a need for an additional 42,000 EMTs and Para16 medics to meet the nation’s demand for healthcare 

17 services. 

18 (5) The COVID–19 pandemic has further exac19 erbated this workforce shortage, with ambulance 

20 crews suffering the effects of surging demand, burn21 out, fear of illness and stress on their families. 

22 (6) A 2021 survey of nearly 20,000 employees 

23 working at 258 EMS organizations found that over24 all turnover among paramedics and EMTs ranges 

25 from 20 to 30 percent annually. 


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1 (7) With COVID–19 halting clinical and in-per2 son trainings for a significant period of time, the 

3 pipeline of new EMS staff has been stretched even 

4 thinner. 

5 SEC. 3. EMS PREPAREDNESS AND RESPONSE WORKFORCE 

6 SHORTAGE PILOT PROGRAM. 

7 Title XII of the Public Health Service Act (42 U.S.C. 

8 300d et seq.) is amended by inserting after section 1204 

9 the following: 

10 ‘‘SEC. 1205. EMS PREPAREDNESS AND RESPONSE WORK11 FORCE SHORTAGE PILOT PROGRAM. 

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

13 Assistant Secretary for Preparedness and Response, shall 

14 establish a pilot program to award grants to eligible emer15 gency medical services agencies to support the recruitment 

16 and training of emergency medical technicians and para17 medics to improve access to, and enhance the quality of, 

18 emergency medical services. 

19 ‘‘(b) APPLICATION.—An eligible emergency medical 

20 services agency seeking a grant under this section shall 

21 submit to the Secretary an application at such time, in 

22 such manner, and containing such information as the Sec23 retary may require. 

24 ‘‘(c) USE OF FUNDS.—An eligible emergency medical 

25 services agency receiving a grant under this section shall 


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1 use funds received through the grant to implement a new 

2 program or enhance an existing program to— 

3 ‘‘(1) recruit and retain emergency medical serv4 ices personnel, which may include volunteer per5 sonnel; 

6 ‘‘(2) train emergency medical services personnel 

7 to obtain and maintain licenses and certifications 

8 relevant to service in an emergency medical services 

9 agency; 

10 ‘‘(3) conduct courses and implement apprentice11 ship programs that qualify graduates to serve in an 

12 emergency medical services agency in accordance 

13 with State and local requirements; 

14 ‘‘(4) fund specific training to meet Federal or 

15 State licensing or certification requirements; 

16 ‘‘(5) develop new ways to educate emergency 

17 medical services personnel through the use of tech18 nology-enhanced educational methods; 

19 ‘‘(6) establish wellness and fitness programs for 

20 emergency medical services personnel to ensure that 

21 such personnel are able to carry out their duties, in22 cluding programs dedicated to raising awareness of, 

23 and prevention of, job-related mental health issues; 

24 or 


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1 ‘‘(7) train emergency medical services personnel 

2 to care for people with mental and substance use 

3 disorders in emergency situations. 

4 ‘‘(d) PRIORITIZATION.—In awarding grants under 

5 this section, the Secretary shall prioritize eligible emer6 gency medical services agencies that— 

7 ‘‘(1) seek to promote diversity and ensure equal 

8 opportunity for participation in the emergency med9 ical services workforce; 

10 ‘‘(2) emphasize the recruitment and training of 

11 youth, particularly high school students, rural youth, 

12 and youth from low-income or disadvantaged back13 grounds; 

14 ‘‘(3) develop and implement programs to assist 

15 veterans who completed military emergency medical 

16 technician training while serving in the Armed 

17 Forces of the United States to meet certification, li18 censure, and other requirements applicable to be19 coming an emergency medical technician or para20 medic; 

21 ‘‘(4) are small or are located in rural areas and 

22 serve rural populations; or 

23 ‘‘(5) address such other priorities as the Sec24 retary considers appropriate. 


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1 ‘‘(e) ALLOCATION OF GRANTS TO RURAL EMER2 GENCY MEDICAL SERVICES AGENCIES.—The Secretary 

3 shall ensure that not less than 20 percent of the total 

4 number of grants under this section are made to emer5 gency medical services agencies located in rural areas. 

6 ‘‘(f) MAXIMUM GRANT AMOUNT.—The amount of a 

7 grant made under this section to a single grant recipient 

8 shall not exceed $1,000,000. 

9 ‘‘(g) REPORTS.— 

10 ‘‘(1) REPORT TO SECRETARY.—An eligible 

11 emergency medical services agency receiving a grant 

12 under subsection (a) shall periodically submit to the 

13 Secretary a report evaluating the activities sup14 ported by the grant. 

15 ‘‘(2) REPORT TO PUBLIC.—The Secretary shall 

16 submit to the Committee on Energy and Commerce 

17 of the House of Representatives and the Committee 

18 on Health, Education, Labor, and Pensions of the 

19 Senate, and make publicly available, a report on the 

20 Secretary’s findings with respect to the success of 

21 the program under this section in improving access 

22 to, and enhancing the quality of, emergency medical 

23 services. 


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1 ‘‘(h) DEFINITION.—In this section, the term ‘eligible 

2 emergency medical services agency’ means an entity that 

3 is— 

4 ‘‘(1) licensed to deliver medical care outside of 

5 a medical facility under emergency conditions that 

6 occur as a result of the condition of the patient; and 

7 ‘‘(2) delivers services (either on a compensated 

8 or volunteer basis) by an emergency medical services 

9 provider or other provider that is licensed or cer10 tified by the State involved as an emergency medical 

11 technician, a paramedic, or an equivalent profes12 sional (as determined by the State). 

13 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 

14 ‘‘(1) IN GENERAL.—To carry out this section, 

15 there are authorized to be appropriated $50,000,000 

16 for each of fiscal years 2024 through 2028. 

17 ‘‘(2) ADMINISTRATIVE COSTS.—The Secretary 

18 may use not more than 10 percent of the amount 

19 appropriated pursuant to paragraph (1) for a fiscal 

20 year for the administrative expenses of carrying out 

21 this section.’’. 


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1 SEC. 4. ASSISTING VETERANS WITH MILITARY EMERGENCY 

2 MEDICAL TRAINING TO MEET REQUIRE3 MENTS FOR BECOMING CIVILIAN EMER4 GENCY MEDICAL TECHNICIANS AND PARA5 MEDICS. 

6 Part B of title III of the Public Health Service Act 

7 (42 U.S.C. 243 et seq.) is amended by inserting after sec8 tion 320B the following: 

9 ‘‘SEC. 320C. ASSISTING VETERANS WITH MILITARY EMER10 GENCY MEDICAL TRAINING TO MEET RE11 QUIREMENTS FOR BECOMING CIVILIAN 

12 EMERGENCY MEDICAL TECHNICIANS AND 

13 PARAMEDICS. 

14 ‘‘(a) PROGRAM.—The Secretary shall establish a 

15 demonstration program under which the Secretary will 

16 award grants to States to streamline State requirements 

17 and procedures in order to assist veterans who have com18 pleted military emergency medical technician training 

19 while serving in the Armed Forces of the United States 

20 meet the certification, licensure, and other requirements 

21 applicable to becoming an emergency medical technician 

22 or paramedic in the State. 

23 ‘‘(b) USES OF FUNDS.—A State receiving a grant 

24 under this section shall use amounts received through the 

25 grant to prepare and implement a plan to streamline State 


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1 requirements and procedures as described in subsection 

2 (a), including by— 

3 ‘‘(1) determining the extent to which the re4 quirements for the education, training, and skill level 

5 of emergency medical technicians in the State are 

6 equivalent to requirements for the education, train7 ing, and skill level of military emergency medical 

8 technicians; and 

9 ‘‘(2) identifying methods, such as waivers, for 

10 military emergency medical technicians to forego or 

11 meet any such equivalent State requirements. 

12 ‘‘(c) ELIGIBILITY.—To be eligible for a grant under 

13 this section, a State shall demonstrate to the satisfaction 

14 of the Secretary that the State has a shortage of emer15 gency medical technicians. 

16 ‘‘(d) REPORT.—Beginning on the date that is one 

17 year after the date on which the first grant is awarded 

18 under this section, and annually thereafter, the Secretary 

19 shall submit to the Congress an report on the success of 

20 the program under this section in assisting military emer21 gency medical technicians to receive certification or licen22 sure as an emergency medical technician or paramedic in 

23 a State. 

24 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

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1 priated $20,000,000 for each of fiscal years 2024 through 

2 2028.’’. 

3 SEC. 5. STUDY AND REPORT ON EMERGENCY MEDICAL 

4 TECHNICIAN AND PARAMEDIC WORKFORCE 

5 SHORTAGE. 

6 (a) STUDY.—The Secretary of Labor, in coordination 

7 with the Secretary of Health and Human Services, shall 

8 conduct a study on— 

9 (1) the number of currently available emergency 

10 medical technician and paramedic jobs, categorized 

11 by type of employer (such as ambulance services, 

12 local governments other than hospitals, and hos13 pitals); 

14 (2) the projected increase in available emer15 gency medical technician and paramedic jobs from 

16 2023 through 2032, categorized by type of employer; 

17 (3) the percentage of available emergency med18 ical technician and paramedic jobs from 2023 

19 through 2032 that are expected to result from the 

20 need to replace workers who transfer to different oc21 cupations or exit the labor force; 

22 (4) the availability of appropriate training and 

23 education programs in the United States sufficient 

24 to meet the projected demand for emergency medical 


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1 technician and paramedic jobs from 2023 through 

2 2032; and 

3 (5) the projected shortage of emergency medical 

4 technicians and paramedics from 2023 through 

5 2032. 

6 (b) REPORT TO CONGRESS.—Not later than one year 

7 after the date of the enactment of this Act, the Secretary 

8 of Labor, in coordination with the Secretary of Health and 

9 Human Services, shall submit to Congress a report on the 

10 study conducted under subsection (a) together with such 

11 recommendations that the Secretaries determine are ap12 propriate to address the projected shortage of emergency 

13 medical technicians and paramedics, including whether 

14 Schedule A should be expanded to include these occupa15 tions. 

Æ 


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