I 
118TH CONGRESS 
1ST SESSION H. R. 6433 
To preserve access to emergency medical services. 
IN THE HOUSE OF REPRESENTATIVES 
NOVEMBER 15, 2023 
Ms. PEREZ (for herself and Mr. FINSTAD) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Education and the Workforce, for a period to be 
subsequently determined by the Speaker, in each case for consideration 
of such provisions as fall within the jurisdiction of the committee con-
cerned 
A BILL 
To preserve access to emergency medical services. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Preserve Access to 
Rapid Ambulance Emergency Medical Treatment Act of 
2023’’ or the ‘‘PARA–EMT Act of 2023’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Paramedics and emergency medical techni-
cians (in this section referred to as ‘‘EMTs’’) pro-
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vide care to ill or injured people in emergency med-
ical settings and are a vital component of the Na-
tion’s Emergency Medical Services (in this section 
referred to as ‘‘EMS’’) system. 
(2) EMTs provide basic emergency medical care 
and transportation for patients while paramedics 
provide advanced emergency medical care such as 
intubation, oral and intravenous drug administra-
tion, and other procedures. 
(3) The United States EMS system is facing a 
crippling workforce shortage, a long-term problem 
that has been building for more than a decade. 
(4) In 2019, the Health Resources and Services 
Administration reported that by 2030, there would 
be a need for an additional 42,000 EMTs and Para-
medics to meet the nation’s demand for healthcare 
services. 
(5) The COVID–19 pandemic has further exac-
erbated this workforce shortage, with ambulance 
crews suffering the effects of surging demand, burn-
out, fear of illness and stress on their families. 
(6) A 2021 survey of nearly 20,000 employees 
working at 258 EMS organizations found that over-
all turnover among paramedics and EMTs ranges 
from 20 to 30 percent annually. 
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(7) With COVID–19 halting clinical and in-per-
son trainings for a significant period of time, the 
pipeline of new EMS staff has been stretched even 
thinner. 
SEC. 3. EMS PREPAREDNESS AND RESPONSE WORKFORCE 
SHORTAGE PILOT PROGRAM. 
Title XII of the Public Health Service Act (42 U.S.C. 
300d et seq.) is amended by inserting after section 1204 
the following: 
‘‘SEC. 1205. EMS PREPAREDNESS AND RESPONSE WORK-
FORCE SHORTAGE PILOT PROGRAM. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Assistant Secretary for Preparedness and Response, shall 
establish a pilot program to award grants to eligible emer-
gency medical services agencies to support the recruitment 
and training of emergency medical technicians and para-
medics to improve access to, and enhance the quality of, 
emergency medical services. 
‘‘(b) APPLICATION.—An eligible emergency medical 
services agency seeking a grant under this section shall 
submit to the Secretary an application at such time, in 
such manner, and containing such information as the Sec-
retary may require. 
‘‘(c) USE OF FUNDS.—An eligible emergency medical 
services agency receiving a grant under this section shall 
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use funds received through the grant to implement a new 
program or enhance an existing program to— 
‘‘(1) recruit and retain emergency medical serv-
ices personnel, which may include volunteer per-
sonnel; 
‘‘(2) train emergency medical services personnel 
to obtain and maintain licenses and certifications 
relevant to service in an emergency medical services 
agency; 
‘‘(3) conduct courses and implement apprentice-
ship programs that qualify graduates to serve in an 
emergency medical services agency in accordance 
with State and local requirements; 
‘‘(4) fund specific training to meet Federal or 
State licensing or certification requirements; 
‘‘(5) develop new ways to educate emergency 
medical services personnel through the use of tech-
nology-enhanced educational methods; 
‘‘(6) establish wellness and fitness programs for 
emergency medical services personnel to ensure that 
such personnel are able to carry out their duties, in-
cluding programs dedicated to raising awareness of, 
and prevention of, job-related mental health issues; 
or 
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‘‘(7) train emergency medical services personnel 
to care for people with mental and substance use 
disorders in emergency situations. 
‘‘(d) PRIORITIZATION.—In awarding grants under 
this section, the Secretary shall prioritize eligible emer-
gency medical services agencies that— 
‘‘(1) seek to promote diversity and ensure equal 
opportunity for participation in the emergency med-
ical services workforce; 
‘‘(2) emphasize the recruitment and training of 
youth, particularly high school students, rural youth, 
and youth from low-income or disadvantaged back-
grounds; 
‘‘(3) develop and implement programs to assist 
veterans who completed military emergency medical 
technician training while serving in the Armed 
Forces of the United States to meet certification, li-
censure, and other requirements applicable to be-
coming an emergency medical technician or para-
medic; 
‘‘(4) are small or are located in rural areas and 
serve rural populations; or 
‘‘(5) address such other priorities as the Sec-
retary considers appropriate. 
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‘‘(e) ALLOCATION
OF GRANTS
TO RURAL EMER-
GENCY MEDICAL SERVICES AGENCIES.—The Secretary 
shall ensure that not less than 20 percent of the total 
number of grants under this section are made to emer-
gency medical services agencies located in rural areas. 
‘‘(f) MAXIMUM GRANT AMOUNT.—The amount of a 
grant made under this section to a single grant recipient 
shall not exceed $1,000,000. 
‘‘(g) REPORTS.— 
‘‘(1) REPORT
TO
SECRETARY.—An eligible 
emergency medical services agency receiving a grant 
under subsection (a) shall periodically submit to the 
Secretary a report evaluating the activities sup-
ported by the grant. 
‘‘(2) REPORT TO PUBLIC.—The Secretary shall 
submit to the Committee on Energy and Commerce 
of the House of Representatives and the Committee 
on Health, Education, Labor, and Pensions of the 
Senate, and make publicly available, a report on the 
Secretary’s findings with respect to the success of 
the program under this section in improving access 
to, and enhancing the quality of, emergency medical 
services. 
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‘‘(h) DEFINITION.—In this section, the term ‘eligible 
emergency medical services agency’ means an entity that 
is— 
‘‘(1) licensed to deliver medical care outside of 
a medical facility under emergency conditions that 
occur as a result of the condition of the patient; and 
‘‘(2) delivers services (either on a compensated 
or volunteer basis) by an emergency medical services 
provider or other provider that is licensed or cer-
tified by the State involved as an emergency medical 
technician, a paramedic, or an equivalent profes-
sional (as determined by the State). 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—To carry out this section, 
there are authorized to be appropriated $50,000,000 
for each of fiscal years 2024 through 2028. 
‘‘(2) ADMINISTRATIVE COSTS.—The Secretary 
may use not more than 10 percent of the amount 
appropriated pursuant to paragraph (1) for a fiscal 
year for the administrative expenses of carrying out 
this section.’’. 
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SEC. 4. ASSISTING VETERANS WITH MILITARY EMERGENCY 
MEDICAL 
TRAINING 
TO 
MEET 
REQUIRE-
MENTS 
FOR 
BECOMING 
CIVILIAN 
EMER-
GENCY MEDICAL TECHNICIANS AND PARA-
MEDICS. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 320B the following: 
‘‘SEC. 320C. ASSISTING VETERANS WITH MILITARY EMER-
GENCY MEDICAL TRAINING TO MEET RE-
QUIREMENTS 
FOR 
BECOMING 
CIVILIAN 
EMERGENCY MEDICAL TECHNICIANS AND 
PARAMEDICS. 
‘‘(a) PROGRAM.—The Secretary shall establish a 
demonstration program under which the Secretary will 
award grants to States to streamline State requirements 
and procedures in order to assist veterans who have com-
pleted military emergency medical technician training 
while serving in the Armed Forces of the United States 
meet the certification, licensure, and other requirements 
applicable to becoming an emergency medical technician 
or paramedic in the State. 
‘‘(b) USES OF FUNDS.—A State receiving a grant 
under this section shall use amounts received through the 
grant to prepare and implement a plan to streamline State 
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requirements and procedures as described in subsection 
(a), including by— 
‘‘(1) determining the extent to which the re-
quirements for the education, training, and skill level 
of emergency medical technicians in the State are 
equivalent to requirements for the education, train-
ing, and skill level of military emergency medical 
technicians; and 
‘‘(2) identifying methods, such as waivers, for 
military emergency medical technicians to forego or 
meet any such equivalent State requirements. 
‘‘(c) ELIGIBILITY.—To be eligible for a grant under 
this section, a State shall demonstrate to the satisfaction 
of the Secretary that the State has a shortage of emer-
gency medical technicians. 
‘‘(d) REPORT.—Beginning on the date that is one 
year after the date on which the first grant is awarded 
under this section, and annually thereafter, the Secretary 
shall submit to the Congress an report on the success of 
the program under this section in assisting military emer-
gency medical technicians to receive certification or licen-
sure as an emergency medical technician or paramedic in 
a State. 
‘‘(e) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
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priated $20,000,000 for each of fiscal years 2024 through 
2028.’’. 
SEC. 5. STUDY AND REPORT ON EMERGENCY MEDICAL 
TECHNICIAN AND PARAMEDIC WORKFORCE 
SHORTAGE. 
(a) STUDY.—The Secretary of Labor, in coordination 
with the Secretary of Health and Human Services, shall 
conduct a study on— 
(1) the number of currently available emergency 
medical technician and paramedic jobs, categorized 
by type of employer (such as ambulance services, 
local governments other than hospitals, and hos-
pitals); 
(2) the projected increase in available emer-
gency medical technician and paramedic jobs from 
2023 through 2032, categorized by type of employer; 
(3) the percentage of available emergency med-
ical technician and paramedic jobs from 2023 
through 2032 that are expected to result from the 
need to replace workers who transfer to different oc-
cupations or exit the labor force; 
(4) the availability of appropriate training and 
education programs in the United States sufficient 
to meet the projected demand for emergency medical 
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technician and paramedic jobs from 2023 through 
2032; and 
(5) the projected shortage of emergency medical 
technicians and paramedics from 2023 through 
2032. 
(b) REPORT TO CONGRESS.—Not later than one year 
after the date of the enactment of this Act, the Secretary 
of Labor, in coordination with the Secretary of Health and 
Human Services, shall submit to Congress a report on the 
study conducted under subsection (a) together with such 
recommendations that the Secretaries determine are ap-
propriate to address the projected shortage of emergency 
medical technicians and paramedics, including whether 
Schedule A should be expanded to include these occupa-
tions. 
Æ 
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