II 

117TH CONGRESS 

2D SESSION S. 3910 

To amend the Public Health Service Act to establish a funding program 

for supporting EMS organizations, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

MARCH 23, 2022 

Mr. SANDERS (for himself and Ms. SMITH) introduced the following bill; which 

was read twice and referred to the Committee on Health, Education, 

Labor, and Pensions 

A BILL 

To amend the Public Health Service Act to establish a funding program for supporting EMS organizations, and for 

other purposes. 

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 ‘‘EMS Staffing and 

5 Support Act’’. 

6 SEC. 2. EMS ORGANIZATION FUNDING. 

7 Part P of title III of the Public Health Service Act 

8 (42 U.S.C. 280g et seq.) is amended by adding at the end 

9 the following: 


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1 ‘‘SEC. 399V–7. EMS ORGANIZATION FUNDING. 

2 ‘‘(a) DEFINITIONS.—In this section: 

3 ‘‘(1) INDIAN TRIBE; TRIBAL ORGANIZATION.— 

4 The terms ‘Indian Tribe’ and ‘Tribal organization’ 

5 have the meanings given such terms in section 4 of 

6 the Indian Self-Determination and Education Assist7 ance Act. 

8 ‘‘(2) EMS ORGANIZATION.—The term ‘EMS or9 ganization’ means a public or private entity that 

10 provides medical transport and emergency medical 

11 services. 

12 ‘‘(3) EMERGENCY MEDICAL SERVICES.—The 

13 term ‘emergency medical services’ has the meaning 

14 given such term in section 330J(e). 

15 ‘‘(4) QUALIFIED APPLICANT.—The term ‘quali16 fied applicant’ means— 

17 ‘‘(A) an EMS organization, other than an 

18 EMS organization that operates for profit; 

19 ‘‘(B) a State, Indian Tribe, Tribal organi20 zation, county, or municipality; or 

21 ‘‘(C) any other nonprofit organization that 

22 represents the interests of EMS organizations. 

23 ‘‘(5) STATE.—The term ‘State’ means any 

24 State of the United States, the District of Columbia, 

25 the Commonwealth of Puerto Rico, American 

26 Samoa, Guam, the United States Virgin Islands, the 


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1 Commonwealth of the Northern Mariana Islands, 

2 and any other territory or possession of the United 

3 States. 

4 ‘‘(b) COMPETITIVE GRANTS.— 

5 ‘‘(1) IN GENERAL.—Beginning in fiscal year 

6 2023, the Secretary, acting through the Adminis7 trator of the Health Resources and Services Admin8 istration, shall award grants on a competitive basis 

9 to qualified applicants to carry out activities de10 scribed in subsection (d) in order to support EMS 

11 organizations in the United States. 

12 ‘‘(2) APPLICATIONS.— 

13 ‘‘(A) IN GENERAL.—A qualified applicant 

14 seeking a grant under this subsection shall sub15 mit an application to the Secretary at such 

16 time, in such manner, and containing such in17 formation as the Secretary may reasonably re18 quire, including— 

19 ‘‘(i) a description of the financial need 

20 of the qualified applicant (or each qualified 

21 applicant in the case of a joint application 

22 described in subparagraph (B)); and 

23 ‘‘(ii) an analysis of the costs and ben24 efits, with respect to improving medical 

25 transport and emergency medical services, 


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1 of the activities to be carried out through 

2 the grant. 

3 ‘‘(B) JOINT APPLICATIONS.—A qualified 

4 applicant may submit a joint application with 1 

5 or more other qualified applicants under this 

6 subsection. 

7 ‘‘(C) PEER REVIEW OF GRANT APPLICA8 TIONS.— 

9 ‘‘(i) IN GENERAL.—The Secretary, 

10 after consultation with national emergency 

11 medical services organizations, shall ap12 point emergency medical service personnel 

13 to conduct peer reviews of applications re14 ceived under this subsection. 

15 ‘‘(ii) APPLICABILITY OF FEDERAL AD16 VISORY COMMITTEE ACT.—The Federal 

17 Advisory Committee Act (5 U.S.C. App.) 

18 shall not apply to activities carried out 

19 under this subparagraph. 

20 ‘‘(D) PRIORITIZATION OF GRANT

21 AWARDS.—In awarding grants under this sub22 section, the Secretary shall consider each of the 

23 following: 


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1 ‘‘(i) The findings and recommenda2 tions of the peer reviews carried out under 

3 subparagraph (C). 

4 ‘‘(ii) The degree to which an award 

5 will improve the coverage, response times, 

6 and ability of EMS organizations to pro7 vide medical transport and emergency 

8 medical services. 

9 ‘‘(iii) The extent of the need of an ap10 plicant for a grant under this subsection 

11 and the need to protect the United States 

12 as a whole. 

13 ‘‘(c) CONTRACTS OR COMPACTS WITH INDIAN

14 TRIBES AND TRIBAL ORGANIZATIONS.— 

15 ‘‘(1) IN GENERAL.—Beginning in fiscal year 

16 2023, the Secretary, acting through the Adminis17 trator of the Health Resources and Services Admin18 istration, shall award funding through contracts or 

19 compacts pursuant to the Indian Self-Determination 

20 and Education Assistance Act, distributed on a fair 

21 and equitable formula as developed through con22 sultation with Indian Tribes and Tribal organiza23 tions, to Indian Tribes and Tribal organizations to 

24 carry out activities described in subsection (d) in 


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1 order to support EMS organizations in Tribal com2 munities. 

3 ‘‘(2) APPLICATIONS.—An Indian Tribe or Trib4 al organization seeking funding under this sub5 section shall submit an application to the Secretary 

6 at such time, in such manner, and containing such 

7 information as the Secretary requires through con8 sultation with Indian Tribes and Tribal organiza9 tions. 

10 ‘‘(d) ACTIVITIES.— 

11 ‘‘(1) IN GENERAL.—Grants or other funding 

12 awarded under this section may be used to support 

13 EMS organizations through any of the following: 

14 ‘‘(A) Hiring EMS organization personnel. 

15 ‘‘(B) Recruiting and retaining volunteer 

16 EMS organization personnel. 

17 ‘‘(C) Providing training or reimbursing 

18 personnel for training. 

19 ‘‘(D) Conducting courses and imple20 menting apprenticeship programs that qualify 

21 graduates to serve in an EMS organization in 

22 accordance with State and local requirements. 

23 ‘‘(E) Purchasing necessary equipment. 

24 ‘‘(F) Purchasing medicine and medical 

25 supplies. 


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1 ‘‘(G) Purchasing EMS vehicles. 

2 ‘‘(H) Wellness and fitness programs for 

3 EMS organization personnel. 

4 ‘‘(I) Modifying facilities. 

5 ‘‘(J) Improving regional coordination 

6 among EMS organizations. 

7 ‘‘(K) Establishing or supporting commu8 nity paramedicine or mobile integrated health 

9 care initiatives. 

10 ‘‘(L) Any other activity the Secretary de11 termines appropriate. 

12 ‘‘(2) LIMITATION.—No funds awarded under 

13 this section may be made available to an EMS orga14 nization that operates for profit or to otherwise sup15 port efforts to establish or provide emergency med16 ical services, or medical transport, for profit. 

17 ‘‘(e) AMOUNT.—Each grant awarded under sub18 section (b), or funding through a contract or compact 

19 under subsection (c), shall be in an amount not to exceed 

20 $1,000,000. 

21 ‘‘(f) APPROPRIATIONS.— 

22 ‘‘(1) AWARDS.— 

23 ‘‘(A) IN GENERAL.—There is authorized to 

24 be appropriated, and there is appropriated, to 

25 the Secretary to award grants, and funding 


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1 through contracts or compacts, under this sec2 tion— 

3 ‘‘(i) for fiscal year 2023, 

4 $500,000,000; and 

5 ‘‘(ii) for each fiscal year thereafter, 

6 the amount authorized under this subpara7 graph for the preceding fiscal year in8 creased by the percentage increase in the 

9 consumer price index for all urban con10 sumers (all items; United States city aver11 age) for the most recent 12-month period 

12 for which applicable data is available. 

13 ‘‘(B) CONTRACTS AND COMPACTS.—Of the 

14 amount appropriated under subparagraph (A) 

15 for each fiscal year, not less than 5 percent 

16 shall be set aside to carry out subsection (c). 

17 ‘‘(2) TECHNICAL ASSISTANCE.—There is au18 thorized to be appropriated, and there is appro19 priated, to the Secretary to provide technical assist20 ance to entities completing and submitting applica21 tions under this section— 

22 ‘‘(A) for fiscal year 2023, $10,000,000; 

23 and 

24 ‘‘(B) for each fiscal year thereafter, the 

25 amount authorized under this paragraph for the 


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1 preceding fiscal year increased by the percent2 age increase in the consumer price index for all 

3 urban consumers (all items; United States city 

4 average) for the most recent 12-month period 

5 for which applicable data is available.’’. 

6 SEC. 3. REPORTS. 

7 (a) IN GENERAL.—Not later than 90 days after the 

8 date of enactment of this Act, the Secretary of Health and 

9 Human Services, in consultation with the Administrator 

10 of the Centers for Medicare & Medicaid Services, the Ad11 ministrator of the Health Resources and Services Admin12 istration, the Assistant Secretary for Preparedness and 

13 Response, and EMS stakeholders, shall submit to Con14 gress a report detailing the challenges, disparities, and in15 adequacies in providing Federal, State, and private (in16 cluding commercial insurers) reimbursement for medical 

17 transport and emergency medical services and providing 

18 recommendations for improvement with respect to pro19 viding such reimbursement. 

20 (b) RURAL EMS ORGANIZATIONS.—Not later than 

21 90 days after the date of enactment of this Act, the Sec22 retary of Health and Human Services, in consultation with 

23 the Administrator of the Centers for Medicare & Medicaid 

24 Services, the Administrator of the Health Resources and 

25 Services Administration, the Assistant Secretary for PreVerDate Sep 11 2014 03:36 Mar 24, 2022 Jkt 029200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\S3910.IS S3910

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1 paredness and Response, and EMS stakeholders, shall 

2 submit to Congress a report on the challenges specific to 

3 rural EMS organizations, including with respect to Fed4 eral, State, and private (including private insurers) reim5 bursement rates and policies, and develop an action plan 

6 to address those challenges through grants and other ad7 ministrative action. 

Æ 


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