I

107TH CONGRESS

1ST SESSION H. R. 1353

To amend the Public Health Service Act and titles XVIII and XIX of

the Social Security Act to sustain access to vital emergency medical

services in rural areas.

IN THE HOUSE OF REPRESENTATIVES

APRIL 3, 2001

Mr. KENNEDY of Minnesota introduced the following bill; which was referred

to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, 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 amend the Public Health Service Act and titles XVIII

and XIX 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.

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

5 Vital Emergency Medical Services Act of 2001’’.
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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.), as amended by section 1305

5 of the Children’s Health Act of 2000 (Public Law 106–

6 310; 114 Stat. 1141) is amended by adding at the end

7 the following new section:

8 ‘‘SEC. 1254. RURAL EMERGENCY MEDICAL SERVICE TRAIN9 ING AND EQUIPMENT ASSISTANCE PROGRAM.

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

11 Administrator of the Health Resources and Services Ad12 ministration (referred to in this section as the ‘Secretary’)

13 shall award grants to eligible entities to enable such enti14 ties to provide for improved emergency medical services

15 in rural areas.

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

17 under this section, an entity shall—

18 ‘‘(1) be—

19 ‘‘(A) a State emergency medical services

20 office;

21 ‘‘(B) a State emergency medical services

22 association;

23 ‘‘(C) a State office of rural health;

24 ‘‘(D) a local government entity;

25 ‘‘(E) a State or local ambulance provider;

26 or
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1 ‘‘(F) any other entity determined appro2 priate by the Secretary; and

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

4 application at such time, in such manner, and con5 taining such information as the Secretary may re6 quire, that includes—

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

8 carried out under the grant; and

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

10 comply with the matching requirement of sub11 section (e).

12 ‘‘(c) USE OF FUNDS.—An entity shall use amounts

13 received under a grant made under subsection (a), either

14 directly or through grants to emergency medical service

15 squads that are located in, or that serve residents of, a

16 non-metropolitan statistical area, an area designated as

17 rural area by any law or regulation of the State, or a rural

18 census tract of a metropolitan statistical area (as deter19 mined under the most recent Goldsmith Modification,

20 originally published in the Federal Register on February

21 27, 1992 (57 Fed. Reg. 6725)), to—

22 ‘‘(1) hire or recruit emergency medical service

23 personnel;

24 ‘‘(2) recruit or retain volunteer emergency med25 ical service personnel;
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1 ‘‘(3) train emergency medical service personnel

2 in emergency response, injury prevention, safety

3 awareness, and other topics relevant to the delivery

4 of emergency medical services;

5 ‘‘(4) fund specific training to meet State or

6 Federal certification requirements;

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

8 health care providers through the use of technology9 enhanced educational methods (such as distance

10 learning);

11 ‘‘(6) acquire emergency medical services vehi12 cles, including ambulances;

13 ‘‘(7) acquire emergency medical services equip14 ment, including cardiac defibrillators;

15 ‘‘(8) acquire personal protective equipment for

16 emergency medical services personnel as required by

17 the Occupational Safety and Health Administration;

18 and

19 ‘‘(9) educate the public concerning

20 cardiopulmonary resuscitation (CPR), first aid, in21 jury prevention, safety awareness, illness prevention,

22 and other related emergency preparedness topics.

23 ‘‘(d) PREFERENCE.—In awarding grants under this

24 section the Secretary shall give preference to—
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1 ‘‘(1) applications that reflect a collaborative ef2 fort by 2 or more of the entities described in sub3 paragraphs (A) through (F) of subsection (b)(1);

4 and

5 ‘‘(2) applications submitted by entities that in6 tend to use amounts provided under the grant to

7 fund activities described in any of paragraphs (1)

8 through (5) of subsection (c).

9 ‘‘(e) MATCHING REQUIREMENT.—The Secretary may

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

11 the entity agrees that the entity will make available (di12 rectly or through contributions from other public or pri13 vate entities) non-Federal contributions toward the activi14 ties to be carried out under the grant in an amount equal

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

16 ‘‘(f) EMERGENCY MEDICAL SERVICES.—In this sec17 tion, the term ‘emergency medical services’—

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

19 or private nonprofit entity, or by any other entity

20 recognized as qualified by the State involved, to de21 liver medical care outside of a medical facility under

22 emergency conditions that occur—

23 ‘‘(A) as a result of the condition of the pa24 tient; or
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1 ‘‘(B) as a result of a natural disaster or

2 similar situation; and

3 ‘‘(2) includes services delivered by an emer4 gency medical services provider (either compensated

5 or volunteer) or other provider recognized by the

6 State involved that is licensed or certified by the

7 State as an emergency medical technician or its

8 equivalent (as determined by the State), a registered

9 nurse, a physician assistant, or a physician that pro10 vides services similar to services provided by such an

11 emergency medical services provider.

12 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—

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

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

15 for each of fiscal years 2002 through 2007.

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

17 may use not more than 10 percent of the amount

18 appropriated under paragraph (1) for a fiscal year

19 for the administrative expenses of carrying out this

20 section.’’.

21 SEC. 3. PRUDENT LAYPERSON STANDARD FOR EMERGENCY

22 AMBULANCE SERVICES UNDER MEDICARE

23 AND MEDICAID.

24 (a) AMBULANCE SERVICES FOR MEDICARE FEE25 FOR-SERVICE BENEFICIARIES.—Section 1861(s)(7) of
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1 the Social Security Act (42 U.S.C. 1395x(s)(7)) is amend2 ed by inserting before the semicolon at the end the fol3 lowing: ‘‘, except that such regulations shall not fail to

4 treat ambulance services as medical and other health serv5 ices solely because the ultimate diagnosis of the individual

6 receiving the ambulance services results in the conclusion

7 that ambulance services were not necessary, as long as the

8 request for ambulance services is made after the sudden

9 onset of a medical condition that would be classified as

10 an emergency medical condition (as defined in section

11 1852(d)(3)(B))’’.

12 (b) AMBULANCE SERVICES FOR MEDICARE+CHOICE

13 ENROLLEES.—Section 1852(d)(3)(A) of the Social Secu14 rity Act (42 U.S.C. 1395w–22(d)(3)(A)) is amended by

15 inserting ‘‘(including the services described in section

16 1861(s)(7))’’ after ‘‘outpatient services’’ in the matter

17 preceding clause (i).

18 (c) AMBULANCE SERVICES IN MEDICAID MANAGED

19 CARE PLANS.—Section 1932(b)(2)(B) of the Social Secu20 rity Act (42 U.S.C. 1396u–2(b)(2)(B)) is amended by in21 serting ‘‘(including the services described in section

22 1861(s)(7) (if covered by the State plan))’’ after ‘‘out23 patient services’’ in the matter preceding clause (i).
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1 (d) EFFECTIVE DATE.—The amendments made by

2 this section shall apply with respect to services provided

3 on and after the date of enactment of the Act.

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