```

[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 2400 Introduced in Senate (IS)]

113th CONGRESS
  2d Session
                                S. 2400

To provide for improvement of field emergency medical services, and for 
                            other purposes.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                              May 22, 2014

 Mr. Bennet (for himself, Mr. Crapo, and Mr. Johnson of South Dakota) 
introduced the following bill; which was read twice and referred to the 
          Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
To provide for improvement of field emergency medical services, and for 
                            other purposes.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Field EMS 
Innovation Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Recognition of HHS as primary Federal agency for emergency 
                            medical services and trauma care.
Sec. 4. Emergency medical services.
Sec. 5. Enhancing research in field EMS.
Sec. 6. Emergency Medical Services Trust Fund.
Sec. 7. Authorization of appropriations.
Sec. 8. Statutory construction.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) All persons throughout the United States should have 
        access to and receive high-quality emergency medical care as 
        part of a coordinated emergency medical services system.
            (2) Properly functioning emergency medical services 
        (referred to in this section as ``EMS'') systems, 24 hours per 
        day, 7 days per week, are essential to ensure access to 
        emergency medical care and transport for all patients with 
        emergency medical conditions. Such coordinated EMS systems are 
        also necessary for response to catastrophic incidents.
            (3) Ensuring high-quality and cost-effective EMS systems 
        requires readiness, preparedness, medical direction, oversight, 
        and innovation throughout the continuum of emergency medical 
        care through Federal, State, and local multijurisdictional 
        collaboration and sufficient resources for EMS agencies and 
        providers.
            (4) At the Federal level, EMS responsibilities and 
        resources of several Federal agencies consistent with their 
        expertise and authority must emphasize the critical importance 
        of Federal agency collaboration and coordination for all 
        emergency medical services.
            (5) At the State and local level, EMS systems and agencies 
        require the coordination and improved capabilities of multiple 
        and diverse stakeholders.
            (6) Emergency medical services encompass the provision of 
        care provided to patients with emergency medical conditions 
        throughout the continuum, including emergency medical care and 
        trauma care provided in the field, hospital, and rehabilitation 
        settings.
            (7) Field EMS comprises essential emergency medical 
        services, including medical care or medical transport provided 
        to patients prior to or outside medical facilities and other 
        clinical settings. The primary purpose of field emergency 
        medical services is to ensure that emergency medical patients 
        receive the right care at the right place in the right amount 
        of time.
            (8) Coordinated and high-quality field EMS is essential to 
        the Nation's security. Field EMS is an essential public service 
        provided by governmental and nongovernmental agencies and 
        practitioners 24 hours a day, 7 days a week, and during 
        catastrophic incidents. To ensure disaster and all-hazards 
        preparedness for EMS operations as part of the Nation's 
        comprehensive disaster preparedness, Federal funding for 
        preparedness activities, including catastrophic training and 
        drills, must be provided to governmental and nongovernmental 
        EMS agencies to ensure a greater capability within each of 
        these areas.
            (9) Numerous recommendations from several significant 
        national reports and documents have demonstrated the need in 
        multiple areas for substantial improvement of emergency medical 
        services provided in the field, including recommendations in 
        the ``EMS Agenda for the Future'' of the National Highway 
        Traffic Safety Administration and the Health Resources and 
        Services Administration, the Institute of Medicine report ``The 
        Future of Emergency Care in the United States Health System'', 
        and the ``EMS Education Agenda for the Future: A Systems 
        Approach'', and recommendations of the National EMS Workforce 
        Injury and Illness Surveillance Program, the National EMS 
        Advisory Council of the Department of Transportation, and the 
        Federal Interagency Committee on Emergency Medical Services.
            (10) To substantially improve field EMS, advancements must 
        be made in several essential areas including readiness, 
        innovation, preparedness, education and workforce development, 
        safety, financing, quality, standards, and research.
            (11) The recognition of a primary programmatic Federal 
        agency for emergency medical services within the Department of 
        Health and Human Services was recommended by the Institute of 
        Medicine and is necessary to provide a more streamlined, cost-
        efficient, and comprehensive approach for field EMS and a focal 
        point for practitioners and agencies to interface with the 
        Federal Government.
            (12) The essential role of field EMS in disaster 
        preparedness and response must be incorporated into the 
        national preparedness and response strategy and implementation 
        as provided and overseen by the Department of Homeland Security 
        and the Department of Health and Human Services pursuant to 
        their respective jurisdictions.
            (13) The essential role of the National Highway Traffic 
        Safety Administration in the continued development of the 
        National EMS Information System and in overseeing 
        transportation issues related to field EMS such as EMS and 
        ambulance vehicle safety standards should be maintained.
            (14) The Federal Interagency Committee on Emergency Medical 
        Services must continue in its essential role in coordinating 
        the Federal activities related to the full spectrum of EMS.

SEC. 3. RECOGNITION OF HHS AS PRIMARY FEDERAL AGENCY FOR EMERGENCY 
              MEDICAL SERVICES AND TRAUMA CARE.

    Title XXVIII of the Public Health Service Act (42 U.S.C. 300hh et 
seq.) is amended by adding at the end the following:

                 ``Subtitle D--Office of EMS and Trauma

``SEC. 2831. RECOGNITION OF HHS AS PRIMARY FEDERAL AGENCY FOR EMERGENCY 
              MEDICAL SERVICES AND TRAUMA CARE; ESTABLISHMENT OF OFFICE 
              OF EMS AND TRAUMA.

    ``(a) Primary Federal Agency.--The Department of Health and Human 
Services shall serve as the primary Federal agency with responsibility 
for programs and activities relating to emergency medical services and 
trauma care.
    ``(b) Office of EMS and Trauma.--
            ``(1) Establishment.--There is established within the 
        Department of Health and Human Services an Office of Emergency 
        Medical Services and Trauma, also to be known as the `Office of 
        EMS and Trauma'. The Office of EMS and Trauma shall be headed 
        by a director appointed by the Secretary (referred to in this 
        section as the `Director').
            ``(2) Role of office within hhs.--
                    ``(A) In general.--The Office of EMS and Trauma 
                shall have--
                            ``(i) the responsibilities delegated to the 
                        Office of EMS and Trauma pursuant to paragraph 
                        (3); and
                            ``(ii) such responsibilities and 
                        authorities as may be delegated or transferred 
                        to the Office of EMS and Trauma pursuant to 
                        subparagraph (B).
                    ``(B) Additional responsibilities and 
                authorities.--In addition to the responsibilities and 
                authorities specified in subparagraph (A), the 
                Secretary may delegate or transfer to the Office of EMS 
                and Trauma any other responsibility or authority of the 
                Department of Health and Human Services relating to 
                emergency medical services and trauma care (except that 
                the Secretary may not delegate or transfer such 
                responsibilities or authorities that are otherwise 
                granted to a specific agency within the Department in 
                statute), including such services and care relating 
                to--
                            ``(i) the full continuum of emergency 
                        medical services, including field EMS and 
                        trauma and hospital emergency medical care; and
                            ``(ii) improving the quality, innovation, 
                        or cost effectiveness of emergency medical 
                        services.
                    ``(C) Location of office in hhs.--The Secretary 
                shall locate the Office of EMS and Trauma within the 
                organizational structure of the Department of Health 
                and Human Services in a manner that achieves each of 
                the following:
                            ``(i) Recognition of the importance and 
                        unique life-saving services associated with 
                        field EMS, trauma care, and hospital emergency 
                        care as a significant Federal priority.
                            ``(ii) Integration of the essential 
                        services described in clause (i) with the 
                        larger health care system and within the 
                        disaster preparedness system, including through 
                        regionalization of such services and by 
                        enhancing daily readiness capabilities to 
                        ensure adequate disaster readiness 
                        capabilities, consistent with the National 
                        Health Security Strategy.
                            ``(iii) Consolidation, co-location, and 
                        cost efficiencies in administering programs and 
                        activities related to field EMS, trauma care, 
                        and hospital emergency medical care.
                            ``(iv) Establishment of a Federal focal 
                        point for leadership and improved coordination, 
                        support, and oversight of field EMS, trauma 
                        care, and hospital emergency medical care.
                            ``(v) Sufficient level and stature such 
                        that--
                                    ``(I) such Office is able to 
                                fulfill its role, responsibilities, and 
                                authorities; and
                                    ``(II) the Director of such Office 
                                reports directly to the Secretary or an 
                                official within the Department who 
                                reports directly to the Secretary.
                            ``(vi) Establishment of a visible and 
                        identifiable point of contact with which the 
                        public; EMS agencies and practitioners; State 
                        and local government agencies; EMS educational 
                        institutions; EMS, trauma, and hospital 
                        emergency care professional associations; and 
                        all other parties may interact.
            ``(3) Responsibilities.--The Secretary shall, at a minimum, 
        delegate responsibility to the Office of EMS and Trauma to 
        carry out section 330J and parts A, B, C, D, H, and I (except 
        subsection (c)(1) of section 1294) of title XII.
    ``(c) National EMS Strategy.--The Secretary, acting through the 
Director, and in consultation with the Assistant Secretary for 
Preparedness and Response and the Administrator of the Health Resources 
and Services Administration, shall develop and implement a cohesive 
national EMS strategy to strengthen the development of the full 
continuum of EMS at the Federal, State, and local levels. In 
establishing such a strategy, the Secretary shall--
            ``(1) solicit and consider the recommendations of the 
        National Emergency Medical Services Advisory Council as well as 
        relevant stakeholders;
            ``(2) consult and collaborate with the Federal Interagency 
        Committee on Emergency Medical Services to ensure consistency 
        of such national EMS strategy within the larger Federal 
        strategy regarding all of emergency medical services and 
        national preparedness and response;
            ``(3) address issues related to EMS patient and 
        practitioner safety, standardization of EMS practitioner 
        licensing and credentialing, field EMS quality and medical 
        oversight, regionalization of field EMS and trauma and 
        emergency care services, availability of field EMS and trauma 
        care and emergency medical services throughout the Nation, and 
        integration of field EMS practitioners into the broader health 
        care system, including--
                    ``(A) promotion of the adoption by States of the 
                education standards identified in the `Emergency 
                Medical Services Education Agenda for the Future: A 
                Systems Approach' and any revisions thereto, including 
                the standardization of licensing and credentialing of 
                field EMS practitioners and standards of care, based on 
                best practices and evidence-based medicine, including 
                by--
                            ``(i) the identification of differences in 
                        the levels of care, scope of practice, and 
                        licensure and credentialing requirements among 
                        the States; and
                            ``(ii) the adoption by the States of 
                        national standards for such levels of care, 
                        scope of practice and licensure and 
                        credentialing requirements;
                    ``(B) promotion of a culture of safety, including--
                            ``(i) the adoption of an anonymous error 
                        reporting system designed to identify systemic 
                        problems in field EMS patient and practitioner 
                        safety and ensure a single means of collecting 
                        and reporting relevant error data by field EMS 
                        agencies and States;
                            ``(ii) the establishment of field EMS 
                        patient and practitioner safety goals and the 
                        specific means to improve field EMS 
                        practitioner and patient safety to achieve such 
                        goals; and
                            ``(iii) the adoption of more uniform 
                        national ambulance vehicle safety and 
                        manufacturing standards as developed by the 
                        National Fire Protection Administration or 
                        coordinated by the National Highway Traffic 
                        Safety Administration;
                    ``(C) the integration and utilization of field EMS 
                practitioners as part of the larger health care system, 
                including--
                            ``(i) the potential utilization of field 
                        EMS practitioners for the provision of care to 
                        patients with nonemergent medical conditions, 
                        such as through mobile integrated health care 
                        services or community paramedicine; and
                            ``(ii) strategies to implement the 
                        recommendations provided by the National Health 
                        Care Workforce Commission, pursuant to section 
                        5101(d)(2) of the Patient Protection and 
                        Affordable Care Act (42 U.S.C. 294q(d)(2)); and
                    ``(D) such other issues as the Secretary considers 
                appropriate;
            ``(4) incorporate into such strategy the preparedness and 
        response objectives identified by the Secretary of Homeland 
        Security and the Assistant Secretary for Preparedness and 
        Response in order--
                    ``(A) to ensure the capability and capacity of the 
                full spectrum of EMS to respond to terrorist attacks, 
                disasters, catastrophic events, and mass casualty 
                events; and
                    ``(B) to coordinate with the Secretary of Homeland 
                Security accordingly;
            ``(5) complete the development of such strategy not later 
        than 18 months after the date of enactment of this Act;
            ``(6) communicate such strategy to the relevant 
        congressional committees of jurisdiction;
            ``(7) implement such strategy, to the extent practicable, 
        not later than 3 years after the date of enactment of the Field 
        EMS Innovation Act; and
            ``(8) update such strategy not less than every 3 years.
    ``(d) Definitions.--In this section, the terms `field EMS', 
`emergency medical services', and `medical oversight' have the meaning 
given such terms in section 1291.''.

SEC. 4. EMERGENCY MEDICAL SERVICES.

    Title XII of the Public Health Service Act (42 U.S.C. 300d et seq.) 
is amended by adding at the end the following:

                  ``PART I--EMERGENCY MEDICAL SERVICES

``SEC. 1291. DEFINITIONS.

    ``In this part:
            ``(1) The term `ambulance diversion' means the practice of 
        hospitals of denying access to an incoming ambulance and 
        requesting that the ambulance proceed to another facility due 
        to a stated lack of capacity at the initial facility, resulting 
        in delayed access to definitive care.
            ``(2) The term `Director' means the Director of the Office 
        of EMS and Trauma established under section 2831.
            ``(3) The term `EMS' means emergency medical services.
            ``(4) The term `FICEMS' means the Federal Interagency 
        Committee on Emergency Medical Services.
            ``(5) The term `field EMS' means emergency medical services 
        provided to patients (including transport by ground, air, or 
        otherwise) prior to or outside a medical facility or other 
        clinical setting.
            ``(6) The term `field EMS agency' means an organization 
        providing field EMS, including--
                    ``(A) governmental (including fire-based agencies), 
                nongovernmental (including hospital-based or private 
                agencies), and volunteer organizations; and
                    ``(B) organizations that provide field EMS by 
                ground, air, or otherwise.
            ``(7) The term `emergency medical services' or `EMS' means 
        emergency medical care, trauma care, and related services 
        provided to patients at any point in the continuum of health 
        care services, including emergency medical dispatch and 
        emergency medical care, trauma care, and related services 
        provided in the field, during transport, or in a medical 
        facility or other clinical setting.
            ``(8) The term `field EMS patient care reports' means the 
        information that a field EMS agency typically creates regarding 
        a patient's medical condition and treatment in the course of 
        providing emergency medical services to that patient.
            ``(9) The term `medical oversight' means the supervision by 
        a physician of the medical aspects of an EMS system or agency 
        and its providers, including prospective, concurrent, and 
        respective components of field EMS and the education of EMS 
        providers.
            ``(10) The term `NEMSAC' means the National Emergency 
        Medical Services Advisory Council.
            ``(11) The term `NEMSIS' means the National EMS Information 
        System.
            ``(12) The term `NHTSA' means the National Highway Traffic 
        Safety Administration.
            ``(13) The term `patient parking' means the practice by 
        hospitals of refusing to accept transfer of a patient's care 
        from an ambulance crew until a regular emergency department bed 
        is available, requiring the crew to continue to provide patient 
        care on the ambulance stretcher rather than in a patient bed in 
        the hospital, until hospital staff will accept the transfer of 
        care, resulting in delayed access to definitive care.
            ``(14) The term `State EMS Office' means an office 
        designated by the State with primary responsibility for 
        oversight of the State's EMS system, such as responsibility for 
        oversight of EMS coordination, licensing or certifying EMS 
        practitioners, and EMS system improvement.
            ``(15) The term `STEMI' means ST-Segment Elevation 
        Myocardial Infarction.

``SEC. 1292. FIELD EMS EXCELLENCE, QUALITY, UNIVERSAL ACCESS, 
              INNOVATION, AND PREPAREDNESS.

    ``(a) In General.--The Director shall establish the an EMS 
Excellence, Quality, Universal Access, Innovation, and Preparedness 
grant program, to be referred to as the `EQUIP grant program'--
            ``(1) to promote excellence in all aspects of the provision 
        of field EMS by field EMS agencies;
            ``(2) to enhance the quality of emergency medical care 
        provided to patients by field EMS practitioners through 
        evidence-based, medically directed field emergency care;
            ``(3) to promote universal access to and availability of 
        high-quality field EMS in all geographic locations of the 
        Nation;
            ``(4) to spur innovation in the delivery of field EMS; and
            ``(5) to improve EMS agency readiness and preparedness for 
        day-to-day emergency medical response.
    ``(b) Application.--
            ``(1) In general.--To be eligible to receive a grant under 
        this section, an eligible entity shall submit an application to 
        the Director in such form and manner, and containing such 
        agreements, assurances, and information as the Director 
        determines to be necessary to carry out this section.
            ``(2) Simple form.--The Director shall ensure that grant 
        application requirements are not unduly burdensome to smaller 
        and volunteer field EMS agencies or other agencies with limited 
        resources.
            ``(3) Consistency with preparation goals.--The Director 
        shall ensure that grant applications are consistent with 
        national and relevant State preparedness plans and goals.
    ``(c) Use of Funds.--Grants may be used by eligible entities--
            ``(1) to sustain field EMS practitioners to ensure 24 hours 
        a day, 7 days a week readiness and preparedness at the local 
        level;
            ``(2) to develop and implement initiatives related to 
        delivery of medical services, including--
                    ``(A) innovative clinical practices to improve the 
                cost effectiveness and quality of care delivered to 
                emergency patients in the field that results in 
                improved patient outcomes and cost savings to the 
                health system, including for high prevalence emergency 
                medical conditions such as sudden cardiac arrest, 
                STEMI, stroke, and trauma; and
                    ``(B) delivery systems to improve patient outcomes, 
                which may include implementing evidence-based 
                protocols, interventions, systems, and technologies to 
                reduce clinically meaningful response times;
            ``(3) to purchase and implement--
                    ``(A) medical equipment and training for using such 
                equipment;
                    ``(B) communication systems to ensure seamless and 
                interoperable communications with other first 
                responders; and
                    ``(C) information systems to comply with NEMSIS 
                data collection and integrate field emergency care with 
                electronic medical records;
            ``(4) to participate in federally sponsored field EMS 
        research;
            ``(5) to establish or enhance comprehensive medical 
        oversight and quality assurance programs that include the 
        active participation by medical directors in field EMS medical 
        direction and educational programs; and
            ``(6) for such other uses as the Director determines 
        appropriate.
    ``(d) Administration of Grants.--In establishing and administering 
the EQUIP grant program, the Director--
            ``(1) shall establish a grantmaking process that includes--
                    ``(A) prioritization for the awarding of grants to 
                eligible entities and consideration of the factors in 
                reviewing grant applications by eligible entities, 
                including--
                            ``(i) demonstrated financial need for 
                        funding;
                            ``(ii) utilization of public and private 
                        partnerships;
                            ``(iii) enhanced access to high-quality 
                        field EMS in under served geographic areas;
                            ``(iv) unique needs of volunteer and rural 
                        field EMS agencies;
                            ``(v) distribution among a variety of 
                        geographic areas, including urban, suburban, 
                        and rural;
                            ``(vi) distribution of funds among types of 
                        EMS agencies, including governmental, 
                        nongovernmental and volunteer;
                            ``(vii) implementation of evidence-based 
                        interventions that improve quality of care, 
                        patient outcomes, efficiency, or cost 
                        effectiveness; and
                            ``(viii) such other factors as the Director 
                        determines necessary;
                    ``(B) a peer-reviewed process to recommend grant 
                allocations in accordance with the prioritization 
                established by the Director, except that final award 
                determinations shall be made by the Director; and
                    ``(C) the provision of grant awards to eligible 
                entities on an annual basis, except that the Director 
                may reserve not more than 25 percent of the available 
                appropriations for multiyear grants and no grant award 
                may exceed a 2-year period;
            ``(2) shall consult with and take into consideration the 
        recommendations of the Assistant Secretary for Preparedness and 
        Response, FICEMS, NEMSAC, and relevant stakeholders;
            ``(3) shall ensure that funds used for day-to-day 
        preparedness activities are consistent and aligned with Federal 
        preparedness priorities; and
            ``(4) may contract with an independent, third-party, 
        nonprofit organization to administer the grant program if the 
        Director establishes conflict-of-interest requirements as part 
        of any such contractual relationship.
    ``(e) Eligibility.--Eligible grant recipients are field EMS 
agencies that--
            ``(1) are licensed by or otherwise authorized in the State 
        in which they operate; and
            ``(2) have medical oversight and quality improvement 
        programs as defined by the Director.
    ``(f) Required Use of Guidelines.--As a condition on receipt of a 
grant under this section, the Director shall require the grant 
recipient to adopt and implement (to the extent applicable) the 
guidelines promoted, developed, and disseminated under subparagraphs 
(B) and (C) of section 1294(a)(1).
    ``(g) Annual Report.--The Director shall submit an annual report on 
the EQUIP grant program under this section to Congress.

``SEC. 1293. FIELD EMS SYSTEM PERFORMANCE, INTEGRATION, AND 
              ACCOUNTABILITY.

    ``(a) In General.--The Director shall establish a Field EMS System 
Performance, Integration, and Accountability grant program, to be 
referred to as the `SPIA grant program'--
            ``(1) to improve field EMS system performance, integration, 
        and accountability;
            ``(2) to ensure preparedness for field EMS at the State and 
        local levels;
            ``(3) to enhance physician medical oversight of field EMS 
        systems;
            ``(4) to improve coordination between regional field EMS 
        systems and integration of such regional field EMS systems into 
        the larger health care system;
            ``(5) to enhance data collection and analysis to improve, 
        on a continuing basis, the field EMS system; and
            ``(6) to promote standardization of national EMS 
        certification of emergency medical technicians and paramedics.
    ``(b) Use of Funds.--Entities receiving grants under this section 
may use such grant funds--
            ``(1) to enhance EMS system readiness and preparedness for 
        day-to-day emergency medical response;
            ``(2) to improve cross-border collaboration and planning 
        among States; and
            ``(3) to collect data with regard to--
                    ``(A) NEMSIS;
                    ``(B) field EMS education;
                    ``(C) field EMS workforce;
                    ``(D) cardiac events, including STEMI and sudden 
                cardiac arrest;
                    ``(E) stroke;
                    ``(F) disasters, including injuries and illnesses;
                    ``(G) ambulance diversion and patient parking;
                    ``(H) trauma (in a manner that is complementary and 
                not duplicative of other trauma data collection, such 
                as the National Trauma Data Bank);
                    ``(I) data determined necessary by the State office 
                of EMS for oversight and coordination of the State 
                field EMS system; and
                    ``(J) any other such data that the Director 
                specifies;
            ``(4) to implement and evaluate system-wide quality 
        improvement initiatives, including medical direction at the 
        State, local, and regional levels;
            ``(5) to integrate field EMS with other health care 
        services as part of a coordinated system of care provided to 
        patients with emergency medical conditions to help ensure the 
        right patient receives the right care by the right crew in the 
        right vehicle and at the right medical facility in the right 
        amount of time, including by enhancing regional emergency 
        medical dispatch;
            ``(6) to incorporate national EMS certification for all 
        levels of emergency medical technicians and paramedics;
            ``(7) to improve the State's planning for ensuring a 
        consistent, available EMS workforce;
            ``(8) to fund EMS regional and local oversight and planning 
        organizations or develop regional systems of emergency medical 
        care within the State to further enhance coordination and 
        systemic development throughout the State; and
            ``(9) for such other uses as the Director determines 
        appropriate.
    ``(c) Administration of Grants.--In establishing and administering 
the SPIA grant program, the Director shall--
            ``(1) establish State EMS system performance standards to 
        serve as guidance to States in improving EMS systems and in 
        applying for grants under this section, taking into 
        consideration--
                    ``(A) the recommendations of the Assistant 
                Secretary for Preparedness and Response, FICEMS, 
                NEMSAC, and relevant stakeholders;
                    ``(B) national, evidence-based guidelines; and
                    ``(C) the needs and resource limitations of 
                volunteer, smaller agencies, and agencies in rural 
                areas;
            ``(2) provide technical assistance to State EMS offices in 
        conducting comprehensive EMS planning with regard to evidence-
        based workforce and development competencies for field EMS 
        management;
            ``(3) allocate, within the available funds, SPIA grants to 
        a maximum of one grant per applicant according to a formula 
        based on population and geographic area, as determined by the 
        Director, for a period not to exceed 2 years; and
            ``(4) require that States allocate a portion of funds 
        awarded under this section to regional and local oversight and 
        planning EMS organizations within the State for the purpose of 
        field EMS system development, maintenance, and improvement of 
        coordination among regional organizations.
    ``(d) Application.--To be eligible to receive a grant under this 
section, an eligible entity shall submit an application to the Director 
in such form and manner, containing such agreements, assurances, and 
information as the Director determines to be necessary to carry out 
this section.
    ``(e) Eligibility.--The entities eligible for a grant under this 
section are the State EMS office in each of the several States, Indian 
tribes, and territories.
    ``(f) Required Use of Guidelines.--As a condition on receipt of a 
grant under this section, the Director shall require the grant 
recipient to adopt and implement (to the extent applicable) the 
guidelines promoted, developed, and disseminated under subparagraphs 
(B) and (C) of section 1294(a)(1).
    ``(g) Annual Report.--The Director shall submit an annual report on 
the SPIA grant program under this section to Congress.

``SEC. 1294. FIELD EMS QUALITY.

    ``(a) Medical Oversight.--
            ``(1) In general.--To improve medical oversight of field 
        EMS and ensure continuity and quality for such medical 
        oversight, the Director shall--
                    ``(A) promote high-quality and comprehensive 
                medical oversight of--
                            ``(i) all medical care provided by field 
                        EMS practitioners; and
                            ``(ii) the education and training of field 
                        EMS practitioners;
                    ``(B) promote the development, adoption, and 
                utilization of national guidelines for the roles of 
                physicians who provide medical oversight for field EMS 
                and other health care providers who support physicians 
                in this role;
                    ``(C) support efforts of relevant physician 
                stakeholders in developing and disseminating guidelines 
                for use by EMS medical directors and field EMS 
                practitioners on a national basis; and
                    ``(D) convene a Field EMS Medical Oversight 
                Advisory Committee, comprised of representatives of 
                relevant physician stakeholders, to advise the Director 
                on ways and means to advance and support development 
                and maintenance of quality medical oversight throughout 
                the Nation's systems for field EMS.
            ``(2) Additional considerations.--In carrying out 
        subparagraphs (B) and (C) of paragraph (1), the Director shall 
        take into consideration--
                    ``(A) existing guidelines developed by national 
                professional physician associations, States, and other 
                relevant governmental or nongovernmental entities;
                    ``(B) the input of other relevant stakeholders, 
                including health care providers who support physicians 
                who provide medical oversight for field EMS; and
                    ``(C) the unique needs associated with medical 
                oversight of provision of field EMS in rural areas or 
                by volunteers.
            ``(3) Flexibility.--The guidelines promoted, developed, and 
        disseminated under subparagraphs (B) and (C) of paragraph (1) 
        shall ensure high-quality training, credentialing, and 
        direction in connection with medical oversight of field EMS at 
        the State, regional, and local levels while providing 
        sufficient flexibility to account for historical and legitimate 
        differences in field EMS among States, regions, and localities.
    ``(b) GAO Study and Report.--
            ``(1) In general.--The Comptroller General of the United 
        States shall complete a study on--
                    ``(A) medical and administrative liability issues 
                that may impede--
                            ``(i) medical direction provided by 
                        physicians directly regarding specific patients 
                        or medical oversight provided by physicians in 
                        establishing medical protocols, procedures, and 
                        other activities related to the provision of 
                        emergency medical care in field EMS; or
                            ``(ii) the highest quality emergency 
                        medical care in field EMS provided by personnel 
                        other than physicians such as emergency medical 
                        technicians and paramedics;
                    ``(B) reimbursement for any component of medical 
                oversight; and
                    ``(C) such other issues as the Comptroller General 
                determines appropriate relating to improving the 
                quality and medical oversight of emergency medical care 
                in field EMS.
            ``(2) Report to congress.--Not later than 18 months after 
        the date of the enactment of the Field EMS Innovation Act, the 
        Comptroller General shall complete the study under paragraph 
        (1) and submit a report to Congress on the results of such 
        study, including any recommendations.
    ``(c) Data Collection and Exchange.--
            ``(1) National ems information system.--
                    ``(A) In general.--The Administrator of NHTSA may 
                maintain, improve, and expand the National EMS 
                Information System, including the National EMS 
                Database.
                    ``(B) Consultation.--The Administrator of NHTSA 
                shall carry out this paragraph in consultation with the 
                Director.
                    ``(C) Standardization.--In carrying out 
                subparagraph (A), the Administrator of NHTSA shall 
                promote the collection and reporting of data on field 
                EMS in a standardized manner.
                    ``(D) Availability of data.--The Administrator of 
                NHTSA shall ensure that information in the National EMS 
                Database (other than individually identifiable 
                information) is available to Federal and State 
                policymakers, EMS stakeholders, and researchers.
                    ``(E) Technical assistance.--In carrying out 
                subparagraph (A), the Administrator of NHTSA may 
                provide technical assistance to State and local 
                agencies, field EMS agencies, and other entities, as 
                the Administrator determines appropriate, to assist in 
                the collection, analysis, and reporting of data.
            ``(2) Report on data gaps.--
                    ``(A) In general.--Not later than 1 year after the 
                date of the enactment of the Field EMS Innovation Act, 
                the Secretary of Health and Human Services, acting 
                through the Director, in consultation with the 
                Administrator of NHTSA, shall submit to Congress a 
                report that--
                            ``(i) identifies gaps in the collection of 
                        data related to the provision of field EMS; and
                            ``(ii) includes recommendations for 
                        improving the collection, reporting, and 
                        analysis of such data.
                    ``(B) Recommendations.--The recommendations 
                required by subparagraph (A)(ii) shall--
                            ``(i) take into consideration the 
                        recommendations of FICEMS and NEMSAC and 
                        relevant stakeholders;
                            ``(ii) recommend methods for improving data 
                        collection and reporting and analysis without 
                        unduly burdening reporting entities and without 
                        duplicating existing data sources (such as data 
                        collected by the National Trauma Data Bank);
                            ``(iii) address the quality and 
                        availability of data, and linkages with 
                        existing patient registries, related to the 
                        provision of field EMS and utilization of field 
                        EMS with respect to a variety of illnesses and 
                        injuries (in both the everyday provision of 
                        field EMS and catastrophic or disaster 
                        response), including--
                                    ``(I) cardiac events such as chest 
                                pain, sudden cardiac arrest, and STEMI;
                                    ``(II) stroke;
                                    ``(III) trauma;
                                    ``(IV) disaster and catastrophic 
                                incidents, such as incidents related to 
                                terrorism or natural or manmade 
                                disasters; and
                                    ``(V) ambulance diversion and 
                                patient parking; and
                            ``(iv) include an analysis of the variety 
                        of services provided by field EMS agencies.
            ``(3) Report on data integration to promote quality of 
        care.--Not later than 18 months after the date of enactment of 
        the Field EMS Innovation Act, the Secretary, acting through the 
        head of the Office of the National Coordinator for Health 
        Information Technology and the Director, in collaboration with 
        FICEMS and the Administrator of NHTSA as appropriate, and 
        taking into consideration input from relevant stakeholders, 
        shall submit a report (including recommendations) on issues, 
        impediments, and potential solutions pertaining to the 
        following objectives:
                    ``(A) Incorporation of field EMS patient care 
                reports into patient electronic health records, taking 
                into consideration--
                            ``(i) the extent to which field EMS patient 
                        care reports are created in electronic format 
                        and the potential for elements of such reports 
                        to be incorporated into patient electronic 
                        health records;
                            ``(ii) the data elements of field EMS 
                        patient care reports that would promote quality 
                        and efficiency of care if incorporated into 
                        patient electronic health records;
                            ``(iii) potential modifications to the 
                        Medicare and Medicaid programs under titles 
                        XVIII and XIX, respectively, of the Social 
                        Security Act (42 U.S.C. 1395 et seq., 1396 et 
                        seq.) or other Federal health programs 
                        (including potential modifications to the 
                        HITECH Act (title XIII of division A and title 
                        IV of Division B of Public Law 111-5), 
                        including modifications to the entities 
                        included as eligible for incentive payments 
                        under section 1848(o), 1853(l) (to the extent 
                        that such section 1848(o) is applied), or 
                        1903(t) of the Social Security Act (42 U.S.C. 
                        1395w-4(o), 1395w-23(l), 1396b(t)), criteria 
                        for certified EHR technology for purposes of 
                        such sections, and objectives and measures for 
                        determining meaningful use of such technology 
                        for purposes of such sections) to provide 
                        appropriate reimbursement and financial 
                        incentives for EMS agencies--
                                    ``(I) to maintain field EMS patient 
                                care reports in a structured electronic 
                                format; and
                                    ``(II) to otherwise adopt and use 
                                electronic health records; and
                            ``(iv) potential modifications to the 
                        HITECH Act to provide incentives to eligible 
                        hospitals under section 1886(n), 1853(m) (to 
                        the extent that such section 1886(n) is 
                        applied), or section 1814(l)(3) of the Social 
                        Security Act to incorporate appropriate data 
                        elements of field EMS patient care reports into 
                        patient electronic health records.
                    ``(B) Incorporation of patient health information 
                created subsequent to the receipt of field EMS 
                emergency care into NEMSIS, taking into consideration--
                            ``(i) the types of medical information 
                        created subsequent to the receipt of field EMS 
                        emergency care (such as outcomes information or 
                        information regarding subsequent care and 
                        treatment) that would, if included in NEMSIS, 
                        be potentially useful in evaluating and 
                        improving the quality of EMS care;
                            ``(ii) how best to integrate such 
                        information into NEMSIS;
                            ``(iii) potential modifications to the 
                        HITECH Act to require eligible hospitals, as 
                        defined in section 1886(n)(6)(B) of the Social 
                        Security Act (42 U.S.C. 1395ww(n)(6)(B)), for 
                        purposes of incentive payments under 
                        1886(b)(3)(B)(ix) and 1886(n) of such Act, to 
                        develop or report relevant data to NEMSIS or 
                        other appropriate State or private registries; 
                        and
                            ``(iv) potential modifications to the 
                        Medicare and Medicaid programs under titles 
                        XVIII and XIX, respectively, of the Social 
                        Security Act or other Federal health programs 
                        to provide appropriate reimbursement and 
                        financial incentives for field EMS agencies to 
                        develop or report relevant data to NEMSIS or 
                        other appropriate State or private registries.
    ``(d) Clarification of HIPAA.--
            ``(1) Exchange of information related to the treatment of 
        patients.--
                    ``(A) In general.--Nothing in HIPAA privacy and 
                security law (as defined in section 3009(a)(2)) shall 
                be construed as prohibiting the exchange of information 
                between field EMS practitioners treating an individual 
                and personnel of a hospital to which the individual is 
                transported for the purposes of relating information on 
                the medical history, treatment, care, and outcome of 
                such individual (including any health care personnel 
                safety issues such as infectious disease).
                    ``(B) Guidelines.--The Secretary shall establish 
                guidelines for exchanges of information between field 
                EMS practitioners treating an individual and personnel 
                of a hospital to which the individual is transported to 
                protect the privacy of the individual while ensuring 
                the ability of such EMS practitioners and hospital 
                personnel to communicate effectively to further the 
                continuity and quality of emergency medical care 
                provided to such individual.
            ``(2) NEMSIS data.--Nothing in HIPAA privacy and security 
        law (as defined in section 3009(a)(2)) shall be construed as 
        prohibiting--
                    ``(A) a field EMS agency from submitting EMS data 
                to the State EMS Office for the purpose of quality 
                improvement and data collection by the State for 
                submission to NEMSIS; or
                    ``(B) the State EMS Office from submitting 
                aggregated nonindividually identifiable EMS data to the 
                National EMS Database maintained by NHTSA.

``SEC. 1295. FIELD EMS EDUCATION GRANTS.

    ``(a) In General.--For the purpose of promoting field EMS as a 
health profession and ensuring the availability, quality, and 
capability of field EMS educators, practitioners, and medical 
directors, the Director may make grants to eligible entities for the 
development, availability, and dissemination of field EMS education 
programs and courses that improve the quality and capability of field 
EMS personnel. In carrying out this section, the Director shall take 
into consideration recommendations of the Administrators of each of 
NHTSA, FICEMS, and NEMSAC, the National Health Care Workforce 
Commission established under section 5101 of the Patient Protection and 
Affordable Care Act (42 U.S.C. 294q), and relevant stakeholders.
    ``(b) Eligibility.--In this section, the term `eligible entity' 
means an educational organization, an educational institution, a 
professional association, and any other entity involved with the 
education of field EMS practitioners.
    ``(c) Use of Funds.--The Director may award a grant to an eligible 
entity under paragraph (1) only if the entity agrees to use the grant 
to--
            ``(1) develop and implement education programs that--
                    ``(A) train field EMS trainers and promote the 
                adoption and implementation of the education standards 
                identified in the `Emergency Medical Services Education 
                Agenda for the Future: A Systems Approach' including 
                any revisions thereto;
                    ``(B) bridge the gap in knowledge and skills in 
                field EMS and among field EMS and other allied health 
                professions to develop a larger cadre of educational 
                instructors and build a stronger and more flexible 
                field EMS practitioner corps; or
                    ``(C) provide training and retraining programs to 
                provide displaced workers the opportunity to enter a 
                field EMS profession;
            ``(2) develop and implement educational courses pertaining 
        to--
                    ``(A) instructor courses;
                    ``(B) provision of medical direction of field EMS;
                    ``(C) field EMS practitioners, including 
                physicians, emergency medical technicians, paramedics, 
                nurses, and other relevant clinicians providing 
                emergency medical care in the field;
                    ``(D) field EMS educational and clinical research;
                    ``(E) bridge programs among field EMS, nursing, and 
                other allied health professions;
                    ``(F) field EMS management;
                    ``(G) national, evidence-based guidelines; and
                    ``(H) translation of the lessons learned in 
                military medicine to field EMS;
            ``(3) evaluate education and training courses and 
        methodologies to identify optimal educational modalities for 
        field EMS practitioners;
            ``(4) improve the field EMS education infrastructure by 
        increasing the number of field EMS instructors and the quality 
        of their preparation by improving, enhancing, and modernizing 
        the dissemination of EMS education, including distance 
        learning, and by establishing quality improvement for EMS 
        education programs;
            ``(5) enhance the opportunity for medical direction 
        training and for promoting appropriate medical oversight of 
        field emergency medical care;
            ``(6) improve systems to design, implement, and evaluate 
        education for prospective and current field EMS providers; or
            ``(7) carrying out such other activities as the Director 
        determines appropriate.
    ``(d) Priority.--The Director, in consultation with NHTSA and 
relevant stakeholders, and taking into consideration the 
recommendations of FICEMS and NEMSAC, shall establish a system of 
prioritization in awarding grants under this section to eligible 
entities.
    ``(e) Duration of Grants.--Grants under this section shall be for a 
period of 1 to 3 years.
    ``(f) Application.--The Director may not award a grant to an 
eligible entity under this section unless the entity submits an 
application to the Director in such form, in such manner, and 
containing such agreements, assurances, and information as the Director 
may require. The Director shall ensure that the requirements for 
submitting an application under this section are not unduly burdensome.

``SEC. 1296. EVALUATING INNOVATIVE MODELS FOR ACCESS AND DELIVERY OF 
              FIELD EMS FOR PATIENTS.

    ``(a) Evaluation.--
            ``(1) In general.--Not later than 1 year after the date of 
        the enactment of the Field EMS Innovation Act, the Director, in 
        consultation with the Administrator of the Centers for Medicare 
        & Medicaid Services, and taking into consideration the 
        recommendations of NEMSAC and FICEMS, shall complete an 
        evaluation of--
                    ``(A) the provision of and reimbursement for 
                alternative delivery models for medical care through 
                field EMS; and
                    ``(B) the integration of field EMS patients with 
                other medical providers and facilities as medically 
                appropriate.
            ``(2) Specific issues.--In completing the evaluation under 
        paragraph (1), the Director shall consider each of the 
        following:
                    ``(A) Alternative dispositions of patients, 
                including--
                            ``(i) transporting patients by ambulance to 
                        destinations other than a hospital such as the 
                        office of the patient's physician, an urgent 
                        care center, or the facilities of another 
                        health care provider;
                            ``(ii) when medically necessary, the 
                        evaluation, treatment, or referral of patients 
                        to other medically appropriate health care 
                        providers;
                            ``(iii) the provision of medical care 
                        regardless of the decision to transport, such 
                        as reimbursement models based on readiness 
                        rather than transport and shared savings; and
                            ``(iv) the provision of health care using 
                        patient centered mobile resources in the out-
                        of-hospital environment, such as mobile 
                        integrated health care services and community 
                        paramedicine.
                    ``(B) Issues related to medical liability and the 
                requirements of section 1867 of the Social Security Act 
                (42 U.S.C. 1395dd; commonly referred to as `EMTALA') 
                associated with transport to destinations other than a 
                hospital emergency department.
                    ``(C) Necessary protections to ensure that patients 
                receive timely and appropriate care in the appropriate 
                setting.
                    ``(D) Whether there are any barriers to providing 
                alternate dispositions to patients who are not in need 
                of care in hospital emergency departments.
                    ``(E) Other issues determined by the Director, 
                including, when practicable, issues recommended by 
                FICEMS or NEMSAC for evaluation under this subsection.
    ``(b) Demonstration Projects.--
            ``(1) In general.--Beginning not later than 1 year after 
        the date of the enactment of the Field EMS Innovation Act, the 
        Director shall conduct or support at least 10 demonstration 
        projects to--
                    ``(A) evaluate the implementation and reimbursement 
                of alternative dispositions of field EMS patients, 
                including--
                            ``(i) transporting patients by ambulance to 
                        alternate destinations when medically 
                        appropriate and in the patients' best 
                        interests;
                            ``(ii) when medically necessary, 
                        evaluating, treating, or referring patients to 
                        other medically appropriate providers; and
                            ``(iii) when medically appropriate, 
                        treating patients through mobile integrated 
                        health care services or community paramedicine.
                    ``(B) evaluate the implementation of reimbursement 
                models based on readiness rather than transport or 
                shared savings; and
                    ``(C) determine whether such alternative 
                dispositions and reimbursement models--
                            ``(i) improve the safety, effectiveness, 
                        timeliness, and efficiency of EMS; and
                            ``(ii) reduce overall utilization and 
                        expenditures under the Medicare program under 
                        title XVIII of the Social Security Act.
            ``(2) Evidence-based protocols.--The Director shall ensure 
        that at least one demonstration project under paragraph (1) 
        evaluates evidence-based protocols that give guidance on 
        selection of the destination to which patients are transported.
            ``(3) Duration.--The period of a demonstration project 
        under paragraph (1) shall not exceed 3 years.
            ``(4) Research.--The Director shall conduct or support 
        further research that the Director determines to be necessary 
        prior to or in conjunction with the demonstration projects 
        under this subsection in order to evaluation the implementation 
        of alternative dispositions of field EMS patients.
            ``(5) Funding.--Of the amount made available to carry out 
        section 1115A of the Social Security Act (42 U.S.C. 1315a) for 
        a fiscal year, the Secretary may transfer such sums as may be 
        necessary to carry out this subsection.
    ``(c) Report to Congress.--Not later than 1 year after the 
completion of all demonstration projects under subsection (b), the 
Director shall submit to Congress a report on the results of activities 
under this section, including recommendations on the efficacy of 
alternative dispositions of field EMS patients.''.

SEC. 5. ENHANCING RESEARCH IN FIELD EMS.

    (a) Models To Be Tested by Center for Medicare and Medicaid 
Innovation.--Section 1115A(b)(2)(B) of the Social Security Act (42 
U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the following:
                            ``(xxi) Enhancing health outcomes for 
                        patients receiving field emergency medical 
                        services and improving timely and efficient 
                        delivery of high-quality field emergency 
                        medical services, such as through--
                                    ``(I) regionalization of emergency 
                                care;
                                    ``(II) medical transport to 
                                alternate destinations; or
                                    ``(III) when medically necessary, 
                                the evaluation, treatment, or referral 
                                of patients to other medically 
                                appropriate health providers.''.
    (b) Emergency Medical Research.--Section 498D of the Public Health 
Service Act (42 U.S.C. 289g-4) is amended--
            (1) by redesignating subsections (c) and (d) as subsections 
        (d) and (e), respectively; and
            (2) by inserting after subsection (b) the following:
    ``(c) Field EMS Emergency Medical Research.--
            ``(1) In general.--The Secretary shall conduct research and 
        evaluation relating to field EMS through the Agency for 
        Healthcare Research and Quality and the Center for Medicare and 
        Medicaid Innovation.
            ``(2) Definition.--In this subsection, the term `field EMS' 
        has the meaning given such term in section 1291.''.
    (c) Field EMS Practice Center.--Subpart II of part D of title IX of 
the Public Health Service Act (42 U.S.C. 299b-33 et seq.) is amended by 
adding at the end the following:

``SEC. 938. FIELD EMS PRACTICE CENTER.

    ``(a) Establishment.--The Director shall establish within the 
Office of Research and Evaluation a Field EMS Evidence-Based Practice 
Center (referred to in this section as the `Center').
    ``(b) Purpose.--The purpose of the Center is to conduct or support 
research to promote the highest quality of emergency medical care in 
field EMS and the most effective delivery system for the provision of 
such care, including--
            ``(1) comparative safety and effectiveness research;
            ``(2) other appropriate clinical or systems research; and
            ``(3) research addressing--
                    ``(A) critical care transport;
                    ``(B) off-shore operations;
                    ``(C) tactical emergency medical services;
                    ``(D) air medical services; and
                    ``(E) the application of lessons learned in 
                military field medicine in the delivery of emergency 
                medical care in field EMS.
    ``(c) Definition.--In this section, the term `field EMS' has the 
meaning given such term in section 1291.''.
    (d) Limitations on Certain Uses of Research.--Section 1182 of the 
Social Security Act (42 U.S.C. 1320e-1) is amended by striking 
``section 1181'' each place it appears and inserting ``section 1181 of 
this Act or section 498D(c) or 938 of the Public Health Service Act''.
    (e) Regulatory Barriers.--For the purposes of research conducted 
pursuant to clause (xxi) of section 1115A(b)(2)(B) of the Social 
Security Act (as added by subsection (a)), subsection (c) of section 
498D of the Public Health Service Act (as added by subsection (b)), 
section 938 of the Public Health Service Act (as added by subsection 
(c)), or any other research funded by the Department of Health and 
Human Services related to emergency medical services in the field in 
which informed consent is required but may not be attainable, the 
Secretary of Health and Human Services shall--
            (1) evaluate and consider the patient and research issues 
        involved; and
            (2) address regulatory barriers to such research related to 
        the need for informed consent in a manner that ensures adequate 
        patient safety and notification, and submit recommendations to 
        Congress for any changes to Federal statutes necessary to 
        address such barriers.

SEC. 6. EMERGENCY MEDICAL SERVICES TRUST FUND.

    (a) Designation of Income Tax Overpayments and Additional 
Contributions for Emergency Medical Services.--Subchapter A of chapter 
61 of the Internal Revenue Code of 1986 is amended by adding at the end 
the following new part:

   ``PART IX--DESIGNATION OF INCOME TAX OVERPAYMENTS AND ADDITIONAL 
              CONTRIBUTIONS FOR EMERGENCY MEDICAL SERVICES

``SEC. 6097. DESIGNATION BY INDIVIDUALS.

    ``(a) In General.--Every individual (other than a nonresident 
alien) may designate that--
            ``(1) a specified portion of any overpayment of tax for a 
        taxable year, and
            ``(2) any amount contributed in addition to any payment of 
        tax for such taxable year and any designation under paragraph 
        (1),
shall be used to fund the Emergency Medical Services Trust Fund. 
Designations under the preceding sentence shall be in an amount not 
less than $1, and the Secretary shall provide for elections in amounts 
of $1, $5, $10, or such other amount as the taxpayer designates.
    ``(b) Overpayments Treated as Refunded.--For purposes of this 
title, any portion of an overpayment of tax designated under subsection 
(a) shall be treated as--
            ``(1) being refunded to the taxpayer as of the last date 
        prescribed for filing the return of tax imposed by chapter 1 
        (determined without regard to extensions) or, if later, the 
        date the return is filed, and
            ``(2) a contribution made by such taxpayer on such date to 
        the United States.
    ``(c) Manner and Time of Designation.--A designation under 
subsection (a) may be made with respect to any taxable year--
            ``(1) at the time of filing the return of the tax imposed 
        by chapter 1 for such taxable year, or
            ``(2) at any other time (after the time of filing the 
        return of the tax imposed by chapter 1 for such taxable year) 
        specified in regulations prescribed by the Secretary.
Such designation shall be made in such manner as the Secretary 
prescribes by regulations except that, if such designation is made at 
the time of filing the return of the tax imposed by chapter 1 for such 
taxable year, such designation shall be made either on the first page 
of the return or on the page bearing the signature of the taxpayer.''.
    (b) Emergency Medical Services Trust Fund.--Subchapter A of chapter 
98 of the Internal Revenue Code of 1986 is amended by adding at the end 
the following new section:

``SEC. 9512. EMERGENCY MEDICAL SERVICES TRUST FUND.

    ``(a) Creation of Trust Fund.--There is established in the Treasury 
of the United States a trust fund to be known as the `Emergency Medical 
Services Trust Fund', consisting of such amounts as may be credited or 
paid to such trust fund as provided in subsection (b).
    ``(b) Transfers to Trust Fund.--There are hereby appropriated to 
the Emergency Medical Services Trust Fund amounts equivalent to the 
amounts of the overpayments of tax to which designations under section 
6097 apply.
    ``(c) Expenditures From Trust Fund.--Amounts in the Emergency 
Medical Services Trust Fund shall be available, as provided in 
appropriation Acts, only for carrying out the provisions for which 
amounts are authorized to be appropriated under subsections (a) and (b) 
of section 7 of the Field EMS Innovation Act.''.
    (c) Clerical Amendments.--
            (1) Clerical amendment.--The table of parts for subchapter 
        A of chapter 61 of the Internal Revenue Code of 1986 is amended 
        by adding at the end the following new item:

   ``Part IX. Designation of Income Tax Overpayments and Additional 
            Contributions for Emergency Medical Services.''.

            (2) The table of sections for subchapter A of chapter 98 of 
        such Code is amended by adding at the end the following new 
        item:

``Sec. 9512. Emergency Medical Services Trust Fund.''.
    (d) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2015.

SEC. 7. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--Out of amounts in the Emergency Medical Services 
Trust Fund, there are authorized to be transferred--
            (1) to the Secretary of Health and Human Services--
                    (A) $12,000,000, for the purpose of carrying out 
                section 2831 of the Public Health Service Act (except 
                for subsection (b)(3) of such section), section 1294 of 
                such Act, and section 1296 of such Act (except for 
                subsection (b) of such section) for each of fiscal 
                years 2015 through 2019;
                    (B) $200,000,000 for each of fiscal years 2015 
                through 2019, for the purpose of carrying out section 
                1292 of the Public Health Service Act;
                    (C) $50,000,000 for each of fiscal years 2015 
                through 2019, for the purpose of carrying out section 
                1293 of the Public Health Service Act;
                    (D) $15,000,000 for each of fiscal years 2015 
                through 2019, for the purpose of carrying out section 
                1295 of the Public Health Service Act; and
                    (E) $40,000,000 for each of fiscal years 2015 
                through 2019, for the purpose of carrying out sections 
                498D(c) and 938 of the Public Health Service Act, as 
                added by section 5; and
            (2) to the Secretary of Transportation, $4,000,000 for each 
        of fiscal years 2015 through 2019, for the purpose of carrying 
        out section 1292(c)(1) of the Public Health Service Act.
    (b) Excess Amounts.--If, for any fiscal year, amounts in the 
Emergency Medical Services Trust Fund exceed the maximum amount 
authorized to be transferred under subsection (a), the Secretary of 
Health and Human Services may transfer such excess amounts for the 
purpose of carrying out section 330J, section 498D, and parts A, B, C, 
D, and H of title XII of the Public Health Service Act (42 U.S.C. 254c-
15, 289g-4, 300d et seq., 300d-11 et seq., 300d-31 et seq., and 300d-81 
et seq.).
    (c) Start-Up Funding.--
            (1) In general.--Out of the discretionary funds available 
        to the Secretary of Health and Human Services for each of 
        fiscal years 2015 and 2016, $40,000,000 shall be used for 
        carrying out the amendments made by subsections (a), (b), and 
        (c) of section 5.
            (2) Relation to other funds.--The amount of discretionary 
        funds allocated under paragraph (1) for the purpose of carrying 
        out subsections (a), (b), and (c) of section 5 shall be in 
        addition to, not in lieu of, the amount of discretionary funds 
        that would otherwise be available for such purpose.
    (d) Administrative Expenses.--Of the amounts made available under 
subsection (a), (b), or (c) to carry out each of the provisions listed 
in subsection (a), not more than 5 percent of each such amount may be 
used for Federal administrative expenses.

SEC. 8. STATUTORY CONSTRUCTION.

    Nothing in this Act, including the amendments made by this Act 
shall be construed to supercede any statutory authority of any Federal 
agency that is not within the Department of Health and Human Services.
                                 <all>
```