National Fire Protection Administration or 
coordinated by NHTSA; 
(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 con-
ditions; and 
(ii) strategies to implement the rec-
ommendations provided by the National 
Health Care Workforce Commission, pur-
suant 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 con-
siders appropriate; 
(4) incorporate into such strategy the prepared-
ness and response objectives identified by the Sec-
retary of Homeland Security and the Assistant Sec-
retary for Preparedness and Response in order— 
(A) to ensure the capability and capacity 
of the full spectrum of EMS to respond to ter-
rorist attacks, disasters, catastrophic events, 
and mass casualty events; and 
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(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 enact-
ment of this Act; 
(6) communicate such strategy to the relevant 
congressional committees of jurisdiction; 
(7) implement such strategy to the extent prac-
tical not later than 3 years after the date of enact-
ment of this Act; and 
(8) update such strategy not less than every 3 
years. 
(d) STATUTORY CONSTRUCTION.—Nothing in this 
Act shall be construed to supercede any statutory author-
ity of any Federal agency that is not within the Depart-
ment of Health and Human Services. 
SEC. 5. FIELD EMS EXCELLENCE, QUALITY, UNIVERSAL AC-
CESS, INNOVATION, AND PREPAREDNESS. 
(a) IN GENERAL.—The Director of the Office of 
EMS and Trauma (in this section referred to as the ‘‘Di-
rector’’), shall establish 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 
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through evidence-based, medically directed field 
emergency care; 
(3) to promote universal access to and avail-
ability of high-quality field EMS in all geographic lo-
cations of the Nation; 
(4) to spur innovation in the delivery of field 
EMS; and 
(5) to improve EMS agency readiness and pre-
paredness for day-to-day emergency medical re-
sponse. 
(b) APPLICATION.— 
(1) IN GENERAL.—To be eligible to receive a 
grant under this section, an eligible entity shall sub-
mit an application to the Director in such form and 
manner, that contains such agreements, assurances, 
and information as the Director determines to be 
reasonably 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 appli-
cations are consistent with national and relevant 
State preparedness plans and goals. 
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(c) USE OF FUNDS.—Grants may be used by eligible 
entities to— 
(1) sustain field EMS practitioners to ensure 
24 hours a day, 7 days a week readiness and pre-
paredness at the local level; 
(2) develop and implement initiatives related to 
delivery of medical services, including— 
(A) innovative clinical practices to improve 
the cost effectiveness and quality of care deliv-
ered to emergency patients in the field that re-
sults 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 evi-
dence-based protocols, interventions, systems, 
and technologies to reduce clinically meaningful 
response times; 
(3) purchase and implement— 
(A) medical equipment and training for 
using such equipment; 
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(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) participate in federally sponsored field EMS 
research; 
(5) establish or enhance comprehensive medical 
oversight and quality assurance programs that in-
clude the active participation by medical directors in 
field EMS medical direction and educational pro-
grams; and 
(6) such other uses as the Director may estab-
lish. 
(d) ADMINISTRATION OF GRANTS.—In establishing 
and administering the EQUIP grant program, the Direc-
tor— 
(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— 
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(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 ge-
ographic 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 effec-
tiveness; and 
(viii) such other factors as the Direc-
tor considers necessary; 
(B) a peer-reviewed process to recommend 
grant allocations in accordance with the 
prioritization established by the Director except 
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that final award determinations shall be made 
by the Director; and 
(C) the provision of grant awards to eligi-
ble 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 consider-
ation the recommendations of the Assistant Sec-
retary 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-inter-
est requirements as part of any such contractual re-
lationship. 
(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 
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(2) have medical oversight and quality improve-
ment programs as defined by the Director. 
(f) ANNUAL REPORT.—The Director shall submit an 
annual report on the EQUIP grant program under this 
section to the Congress. 
SEC. 6. FIELD EMS SYSTEM PERFORMANCE, INTEGRATION, 
AND ACCOUNTABILITY. 
(a) IN GENERAL.—The Director of the Office of 
EMS and Trauma (in this section referred to as the ‘‘Di-
rector’’) shall establish 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 sys-
tem; 
(5) to enhance data collection and analysis to 
improve, on a continuing basis, the field EMS sys-
tem; and 
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(6) to promote standardization of national EMS 
certification of emergency medical technicians and 
paramedics. 
(b) USE OF FUNDS.—Grants may be used by eligible 
entities— 
(1) to enhance EMS system readiness and pre-
paredness for day-to-day emergency medical re-
sponse; 
(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 ill-
nesses; 
(G) ambulance diversion and patient park-
ing; 
(H) trauma (in a manner that is com-
plementary and not duplicative of other trauma 
data collection such as the National Trauma 
Data Bank); 
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(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 di-
rection 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 condi-
tions 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 sys-
tems of emergency medical care within the State to 
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further enhance coordination and systemic develop-
ment throughout the State; and 
(9) for such other uses as the Director may es-
tablish. 
(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 improv-
ing their EMS systems and in applying for grants 
under this subsection. In establishing such stand-
ards, the Director shall— 
(A) take into the consideration the rec-
ommendations of the Assistant Secretary for 
Preparedness 
and 
Response, 
FICEMS, 
NEMSAC, and relevant stakeholders; 
(B) include national, evidence-based guide-
lines; and 
(C) take into account the needs and re-
source limitations of volunteer, smaller agen-
cies, 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 devel-
opment competencies for field EMS management; 
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(3) allocate, within the available funds, SPIA 
grants to a maximum of one grant per applicant ac-
cording to a formula based on population and geo-
graphic area, as determined by the Director, for a 
period not to exceed 2 years; and 
(4) require that States allocate a portion of 
their grant funds to regional and local oversight and 
planning EMS organizations within the State for the 
purpose of field EMS system development, mainte-
nance, and improvement of coordination among re-
gional organizations. 
(d) APPLICATION.—To be eligible to receive a grant 
under this section, an eligible entity shall submit an appli-
cation to the Director in such form and manner, that con-
tains such agreements, assurances, and information as the 
Director determines to be reasonably necessary to carry 
out this section. 
(e) ELIGIBILITY.—The eligible entities for a grant 
under this section are the State EMS office in each of 
the several States, tribes, and territories. 
(f) ANNUAL REPORT.—The Director shall submit an 
annual report on the SPIA grant program under this sec-
tion to the Congress. 
SEC. 7. FIELD EMS QUALITY. 
(a) MEDICAL OVERSIGHT.— 
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(1) IN
GENERAL.—To improve medical over-
sight of field EMS and ensure continuity and quality 
for such medical oversight, the Director of the Office 
of EMS and Trauma (in this section referred to as 
the ‘‘Director’’) shall— 
(A) promote high-quality and comprehen-
sive 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 over-
sight for field EMS and other health care pro-
viders 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 Over-
sight Advisory Committee, comprised of rep-
resentatives of relevant physician stakeholders, 
to advise the Director on ways and means to 
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advance and support development and mainte-
nance of quality medical oversight throughout 
the Nation’s systems for field EMS. 
(2) ADDITIONAL
CONSIDERATIONS.—In car-
rying out subparagraphs (B) and (C) of paragraph 
(1) (relating to supporting guidelines), the Director 
shall take into consideration— 
(A) existing guidelines developed by na-
tional 
professional 
physician 
associations, 
States, and other relevant governmental or non-
governmental entities; 
(B) the input of other relevant stake-
holders, including health care providers who 
support physicians who provide medical over-
sight for field EMS; and 
(C) the unique needs associated with med-
ical oversight of provision of field EMS in rural 
areas or by volunteers. 
(3) FLEXIBILITY.—The guidelines promoted 
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 
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historical and legitimate differences in field EMS 
among States, regions, and localities. 
(4) REQUIRED USE OF GUIDELINES.—As a con-
dition on receipt of a grant under section 5 or 6, the 
Director shall require the grant recipient to adopt 
and implement (to the extent applicable) the guide-
lines promoted under subparagraphs (B) and (C) of 
paragraph (1). 
(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 phy-
sicians directly regarding specific patients 
or medical oversight provided by physicians 
in establishing medical protocols, proce-
dures, 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 per-
sonnel other than physicians such as emer-
gency medical technicians and paramedics; 
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(B) reimbursement for any component of 
medical oversight; and 
(C) such other issues as the Comptroller 
General deems appropriate relating to improv-
ing the quality and medical oversight of emer-
gency medical care in field EMS. 
(2) REPORT TO CONGRESS.—Not later than 18 
months after the date of the enactment of this Act, 
the Comptroller General shall complete the study 
under paragraph (1) and submit a report to the 
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, includ-
ing 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 re-
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porting of data on field EMS in a standardized 
manner. 
(D) AVAILABILITY OF DATA.—The Admin-
istrator of NHTSA shall ensure that informa-
tion in the National EMS Database (other than 
individually identifiable information) is available 
to Federal and State policymakers, EMS stake-
holders, 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 deemed appropriate by the 
Administrator to assist in the collection, anal-
ysis, and reporting of data. 
(2) REPORT ON DATA GAPS.— 
(A) IN
GENERAL.—Not later than 12 
months after the date of the enactment of this 
Act, the Secretary of Health and Human Serv-
ices, acting through the Director, in consulta-
tion with the Administrator of NHTSA, shall 
submit to the Congress a report that— 
(i) identifies gaps in the collection of 
data related to the provision of field EMS; 
and 
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(ii) includes recommendations for im-
proving the collection, reporting, and anal-
ysis of such data. 
(B) 
RECOMMENDATIONS.—The 
rec-
ommendations required by subparagraph (A)(ii) 
shall— 
(i) take into consideration the rec-
ommendations of FICEMS and NEMSAC 
and relevant stakeholders; 
(ii) recommend methods for improving 
data collection and reporting and analysis 
without unduly burdening reporting enti-
ties and without duplicating existing data 
sources (such as data collected by the Na-
tional Trauma Data Bank); 
(iii) address the quality and avail-
ability 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 re-
sponse) including— 
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(I) cardiac events such as chest 
pain, sudden cardiac arrest, and 
STEMI; 
(II) stroke; 
(III) trauma; 
(IV) disaster and catastrophic in-
cidents, such as incidents related to 
terrorism or natural or manmade dis-
asters; and 
(V) ambulance diversion and pa-
tient parking; and 
(iv) include an analysis of the variety 
of services provided by field EMS agencies. 
(3) REPORT ON DATA INTEGRATION TO PRO-
MOTE
QUALITY
OF
CARE.—Not later than 18 
months after the date of the enactment of this Act, 
the Secretary of Health and Human Services, acting 
through the head of the Office of the National Coor-
dinator for Health Information Technology, in col-
laboration with the Director of the Office of EMS 
and Trauma, FICEMS, and the Administrator of 
NHTSA as appropriate, and taking into consider-
ation input from relevant stakeholders, shall submit 
a report (including recommendations) on issues, im-
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pediments, 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 pa-
tient care reports are presently created in 
electronic format and the potential for ele-
ments 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 incor-
porated into patient electronic health 
records; 
(iii) potential modifications to the 
Medicare and Medicaid programs under ti-
tles XVIII and XIX, respectively, of the 
Social Security Act or other Federal health 
programs (including potential modifica-
tions to the HITECH Act (title XIII of di-
vision A of Public Law 111–5) including 
modifications to the entities included as el-
igible for incentive payments under section 
1848(o), 1853(l) (to the extent that such 
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section 1848(o) is applied), or 1903(t) of 
the Social Security Act, criteria for cer-
tified 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 eligi-
ble 
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 infor-
mation created subsequent to the receipt of 
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field EMS emergency care into NEMSIS, tak-
ing into consideration— 
(i) what types of medical information 
created subsequent to the receipt of field 
EMS emergency care (such as outcomes 
information or information regarding sub-
sequent care and treatment) would, if in-
cluded in NEMSIS, be potentially useful in 
evaluating and improving the quality of 
EMS care; 
(ii) how best to integrate such infor-
mation 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, for purposes of incen-
tive payments under 1886(b)(3)(B)(ix) and 
1886(n) of such Act, to develop or report 
relevant data to NEMSIS or other appro-
priate State or private registries; and 
(iv) potential modifications to the 
Medicare and Medicaid programs under ti-
tles XVIII and XIX, respectively, of the 
Social Security Act or other Federal health 
programs to provide appropriate reim-
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bursement 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 pri-
vacy and security law (as defined in section 
3009(a)(2) of the Public Health Service Act (42 
U.S.C. 300jj–19(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 indi-
vidual is transported for the purposes of relat-
ing information on the medical history, treat-
ment, care, and outcome of such individual (in-
cluding any health care personnel safety issues 
such as infectious disease). 
(B) 
GUIDELINES.—The 
Secretary 
of 
Health and Human Services shall establish 
guidelines for exchanges of information between 
field EMS practitioners treating an individual 
and personnel of a hospital to which the indi-
vidual is transported to protect the privacy of 
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the individual while ensuring the ability of such 
EMS practitioners and hospital personnel to 
communicate effectively to further the con-
tinuity and quality of emergency medical care 
provided to such individual. 
(2) NEMSIS DATA.—Nothing in HIPAA pri-
vacy and security law (as defined in section 
3009(a)(2) of the Public Health Service Act (42 
U.S.C. 300jj–19(a)(2)) shall be construed as prohib-
iting— 
(A) a field EMS agency from submitting 
EMS data to the State EMS Office for the pur-
pose 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. 8. FIELD EMS EDUCATION GRANTS. 
(a) IN GENERAL.—For the purpose of promoting 
field EMS as a health profession and ensuring the avail-
ability, quality, and capability of field EMS educators, 
practitioners, and medical directors, the Director of the 
Office of EMS and Trauma (in this section referred to 
as the ‘‘Director’’) may make grants to eligible entities 
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for the development, availability, and dissemination of 
field EMS education programs and courses that improve 
the quality and capability of field EMS personnel. In car-
rying out this section, the Director shall take into consid-
eration input from the Administrator of NHTSA, 
FICEMS, 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 edu-
cation standards identified in the ‘‘Emergency 
Medical Services Education Agenda for the Fu-
ture: A Systems Approach’’ including any revi-
sions thereto; 
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(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 practi-
tioner corps; or 
(C) provide training and retraining pro-
grams to provide displaced workers the oppor-
tunity 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 phy-
sicians, emergency medical technicians, para-
medics, nurses, and other relevant clinicians 
providing emergency medical care in the field; 
(D) field EMS educational and clinical re-
search; 
(E) bridge programs among field EMS, 
nursing, and other allied health professions; 
(F) field EMS management; 
(G) national, evidence-based guidelines; 
and 
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(H) translation of the lessons learned in 
military medicine to field EMS; 
(3) evaluate education and training courses and 
methodologies to identify optimal educational modal-
ities for field EMS practitioners; 
(4) improve the field EMS education infrastruc-
ture by increasing the number of field EMS instruc-
tors and the quality of their preparation by improv-
ing, enhancing, and modernizing the dissemination 
of EMS education, including distance learning, and 
by establishing quality improvement for EMS edu-
cation programs; 
(5) enhance the opportunity for medical direc-
tion 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 Di-
rector may identify. 
(d) PRIORITY.—The Director, in consultation with 
NHTSA and relevant stakeholders, and taking into con-
sideration 
the 
recommendations 
of 
FICEMS 
and 
NEMSAC, shall establish a system of prioritization in 
awarding grants under this section to eligible entities. 
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(e) DURATION OF GRANTS.—Grants under this sec-
tion 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, assur-
ances, and information as the Director may require. The 
Director shall ensure that the requirements for submitting 
an application under this section are not unduly burden-
some. 
SEC. 9. 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 this Act, the Director 
of the Office of EMS and Trauma, in consultation 
with the Administrator of the Centers for Medicare 
& Medicaid Services (in this section referred to as 
the ‘‘Director’’), 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 
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(B) the integration of field EMS patients 
with other medical providers and facilities as 
medically appropriate. 
(2) SPECIFIC
ISSUES.—The evaluation under 
paragraph (1) shall consider each of the following: 
(A) Alternative dispositions of patients, in-
cluding— 
(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 an-
other health care provider; 
(ii) when medically necessary, the 
evaluation, treatment, or referral of pa-
tients to other medically appropriate health 
care providers; and 
(iii) the funding of the provision of 
medical care regardless of the decision to 
transport such as reimbursement models 
based on readiness rather than transport 
and shared savings. 
(B) Issues related to medical liability and 
the requirements of section 1867 of the Social 
Security Act (42 U.S.C. 1395dd; commonly re-
ferred to as ‘‘EMTALA’’) associated with 
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