I 
112TH CONGRESS 
1ST SESSION H. R. 3144 
To provide for improvement of field emergency medical services, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
OCTOBER 7, 2011 
Mr. WALZ of Minnesota (for himself and Mrs. MYRICK) introduced the fol-
lowing bill; which was referred to the Committee on Energy and Com-
merce, and in addition to the Committee on Ways and Means, for a pe-
riod to be subsequently determined by the Speaker, in each case for con-
sideration of such provisions as fall within the jurisdiction of the com-
mittee concerned 
A BILL 
To provide for improvement of field emergency medical 
services, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives 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 Quality, Innovation, and Cost Effectiveness 
Improvements Act of 2011’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
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Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
Sec. 3. Definitions. 
Sec. 4. Recognition of HHS as primary Federal agency for emergency medical 
services and trauma care. 
Sec. 5. Field EMS Excellence, Quality, Universal Access, Innovation, and Pre-
paredness. 
Sec. 6. Field EMS System Performance, Integration, and Accountability. 
Sec. 7. Field EMS quality. 
Sec. 8. Field EMS education grants. 
Sec. 9. Evaluating innovative models for access and delivery of field EMS for 
patients. 
Sec. 10. Enhancing research in field EMS. 
Sec. 11. Emergency Medical Services Trust Fund. 
Sec. 12. Authorization of appropriations. 
SEC. 2. FINDINGS. 
The Congress finds the following: 
(1) All persons throughout the country 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 (EMS) systems, 24 hours per day, 7 days 
per week, are essential to ensure access to emer-
gency medical care and transport for all patients 
with emergency medical conditions. Such coordi-
nated EMS systems are also necessary for response 
to catastrophic incidents. 
(3) Ensuring high-quality and cost-effective 
EMS systems requires readiness, preparedness, med-
ical direction, oversight, and innovation throughout 
the continuum of emergency medical care through 
Federal, State, and local multijurisdictional collabo-
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ration 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 collabora-
tion and coordination for all emergency medical serv-
ices. 
(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 emer-
gency medical conditions throughout the continuum, 
including emergency medical care and trauma care 
provided in the field, hospital, and rehabilitation set-
tings. 
(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 pri-
mary 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. 
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(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 pre-
paredness for EMS operations as part of the Na-
tion’s comprehensive disaster preparedness, Federal 
funding for preparedness activities, including cata-
strophic training and drills, must be provided to gov-
ernmental and nongovernmental EMS agencies so as 
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 substan-
tial improvement of emergency medical services pro-
vided in the field, including recommendations in the 
EMS Agenda for the Future, the Institute of Medi-
cine report ‘‘The Future of Emergency Care in the 
United Health System’’, and the National EMS 
Education Agenda for the Future: A Systems Ap-
proach and recommendations by the National EMS 
Workforce Injury and Illness Surveillance Program, 
the Department of Transportation’s National EMS 
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Advisory Council (NEMSAC), and the Federal 
Interagency Committee on Emergency Medical Serv-
ices (FICEMS). 
(10) To substantially improve field EMS, ad-
vancements must be made in several essential areas 
including readiness, innovation, preparedness, edu-
cation and workforce development, safety, financing, 
quality, standards, and research. 
(11) The recognition of a primary pro-
grammatic 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 ap-
proach for field EMS and a focal point for practi-
tioners 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 Depart-
ment of Health and Human Services pursuant to 
their respective jurisdictions. 
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(13) The essential role of NHTSA in the con-
tinued development of NEMSIS and in overseeing 
transportation issues related to field EMS such as 
EMS and ambulance vehicle safety standards should 
be maintained. 
(14) FICEMS must continue in its essential 
role in coordinating the Federal activities related to 
the full spectrum of EMS. 
SEC. 3. DEFINITIONS. 
In this Act: 
(1) The term ‘‘ambulance diversion’’ means the 
practice by hospitals of denying access to an incom-
ing ambulance by requesting it to 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 ‘‘EMS’’ means emergency medical 
services. 
(3) The term ‘‘FICEMS’’ means the Federal 
Interagency Committee on Emergency Medical Serv-
ices. 
(4) 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. 
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(5) The term ‘‘field EMS agency’’ means an or-
ganization providing field EMS, regardless of— 
(A) whether such organization is govern-
mental, nongovernmental, or volunteer; and 
(B) whether such organization provides 
field EMS by ground, air, or otherwise. 
(6) 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, in-
cluding emergency medical dispatch and emergency 
medical care, trauma care, and related services pro-
vided in the field, during transport, or in a medical 
facility or other clinical setting. 
(7) The term ‘‘field EMS patient care reports’’ 
means the information that a field EMS agency 
typically creates regarding a patient’s medical condi-
tion and treatment in the course of providing emer-
gency medical services to that patient. 
(8) The term ‘‘medical oversight’’ means the 
supervision by a physician of the medical aspects of 
an EMS system or agency and its providers includ-
ing prospective, concurrent, and respective compo-
nents of field EMS and the education of EMS pro-
viders. 
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(9) The term ‘‘NEMSAC’’ means the National 
Emergency Medical Services Advisory Council. 
(10) The term ‘‘NEMSIS’’ means the National 
EMS Information System. 
(11) The term ‘‘NHTSA’’ means the National 
Highway Traffic Safety Administration. 
(12) 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, re-
quiring the crew to continue to provide patient care 
on the ambulance stretcher other than a patient bed 
in the hospital until hospital staff will accept the 
transfer of care, resulting in delayed access to defin-
itive care. 
(13) The term ‘‘State EMS Office’’ means an 
office designated by the State with primary responsi-
bility 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. 
(14) The term ‘‘STEMI’’ means ST–Segment 
Elevation Myocardial Infarction. 
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SEC. 4. RECOGNITION OF HHS AS PRIMARY FEDERAL 
AGENCY FOR EMERGENCY MEDICAL SERV-
ICES AND TRAUMA CARE. 
(a) PRIMARY FEDERAL AGENCY.—The Department 
of Health and Human Services shall serve as the primary 
Federal agency with responsibility for programs and ac-
tivities relating to emergency medical services and trauma 
care. 
(b) OFFICE OF EMS AND TRAUMA.— 
(1) ESTABLISHMENT.—There is established an 
Office of Emergency Medical Services and Trauma, 
to be known as the Office of EMS and Trauma, 
within the Department of Health and Human Serv-
ices. The Office of EMS and Trauma shall be head-
ed by a director appointed by the Secretary of 
Health and Human Services. 
(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); 
(ii) the responsibilities and authorities 
vested in the Office of EMS and Trauma 
by other provisions of this Act; and 
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(iii) such responsibilities and authori-
ties 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 responsibil-
ities and authorities specified in clauses (i) and 
(ii) of subparagraph (A), the Secretary of 
Health and Human Services may delegate or 
transfer to the Office of EMS and Trauma any 
other responsibility or authority of the Depart-
ment of Health and Human Services relating to 
emergency medical services and trauma care, 
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; or 
(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 
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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 these essential serv-
ices 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 coordi-
nation, support, and oversight of field 
EMS, trauma care and hospital emergency 
medical care. 
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(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 re-
ports 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 
of 
Health and Human Services shall, at a minimum, 
delegate responsibility to the Office of EMS and 
Trauma to carry out— 
(A) sections 5 and 6 (relating to the 
EQUIP and SPIA grant programs, respec-
tively); and 
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(B) section 330J of the Public Health 
Service Act (42 U.S.C. 254c–15; relating to 
rural emergency service training and equipment 
assistance program); 
(C) part A (42 U.S.C. 300d et seq.), part 
B (42 U.S.C. 300d–11 et seq.), part C (42 
U.S.C. 300d–31 et seq.), part D (42 U.S.C. 
300d–41 et seq.), and part H (42 U.S.C. 300d– 
81 et seq.) of title XII of the Public Health 
Service Act (relating to trauma care); 
(D) section 8 (relating to the field EMS 
education grant program); and 
(E) section 9 (relating to evaluating inno-
vative models for access and delivery of field 
EMS for patients). 
(c) NATIONAL EMS STRATEGY.—The Secretary of 
Health and Human Services, acting through the Director 
of the Office of EMS and Trauma, and in consultation 
with the Assistant Secretary for Preparedness and Re-
sponse and the Administrator of the Health Resources and 
Services Administration, shall develop and implement a 
cohesive national EMS strategy to strengthen the develop-
ment of the full continuum of EMS at the Federal, State, 
and local levels. In establishing such a strategy, the Sec-
retary shall— 
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(1) solicit and consider the recommendations of 
the NEMSAC as well as relevant stakeholders; 
(2) consult and collaborate with FICEMS to 
ensure consistency of such national EMS strategy 
within the larger Federal strategy regarding all of 
emergency medical services and national prepared-
ness and response; 
(3) address issues related to EMS patient and 
practitioner safety, standardization of EMS practi-
tioner 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 med-
ical 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 Agen-
da for the Future: A Systems Approach’’ and 
any revisions thereto, including the standardiza-
tion of licensing and credentialing of field EMS 
practitioners and standards of care, based on 
best practices and evidence-based medicine, in-
cluding by— 
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