IB 
Union Calendar No. 443 
118TH CONGRESS 
2D SESSION 
H. R. 4646 
[Report No. 118–532] 
To reauthorize the rural emergency medical service training and equipment 
assistance program, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 14, 2023 
Mr. JOYCE of Ohio (for himself, Mrs. DINGELL, Mr. ARMSTRONG, Mr. CAREY, 
Mr. FITZPATRICK, Mr. PHILLIPS, and Mrs. MILLER of West Virginia) in-
troduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
MAY 31, 2024 
Additional sponsors: Mr. PAPPAS, Ms. LEE of Nevada, Mrs. MILLER-MEEKS, 
Mrs. CAMMACK, Mr. THOMPSON of Pennsylvania, Ms. PEREZ, Ms. PIN-
GREE, Mr. TRONE, Ms. TOKUDA, Mr. RUIZ, Mr. RYAN, Mr. 
GOTTHEIMER, Mr. LAWLER, Mr. VASQUEZ, Ms. NORTON, and Ms. LEE 
of Pennsylvania 
MAY 31, 2024 
Reported with an amendment; committed to the Committee of the Whole 
House on the State of the Union and ordered to be printed 
[Strike out all after the enacting clause and insert the part printed in italic] 
[For text of introduced bill, see copy of bill as introduced on July 14, 2023] 
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A BILL 
To reauthorize the rural emergency medical service training 
and equipment assistance program, and for other purposes. 
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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 ‘‘Supporting and Improv-
ing Rural EMS Needs Reauthorization Act’’ or the ‘‘SIREN 
Reauthorization Act’’. 
SEC. 2. RURAL EMERGENCY MEDICAL SERVICE TRAINING 
AND EQUIPMENT ASSISTANCE PROGRAM. 
Section 330J of the Public Health Service Act (42 
U.S.C. 254c–15) is amended— 
(1) in subsection (a), by striking ‘‘the Adminis-
trator of the Health Resources and Services Adminis-
tration (referred to in this section as the ‘Secretary’)’’ 
and inserting ‘‘the Assistant Secretary,’’; 
(2) in subsection (c)— 
(A) in paragraph (1)— 
(i) in subparagraph (C), by striking ‘‘; 
and’’ and inserting a semicolon; and 
(ii) by adding at the end the following: 
‘‘(E) ensure emergency medical services per-
sonnel are trained on mental health and sub-
stance use disorders and care for individuals 
with such disorders in emergency situations; 
and’’; and 
(B) in paragraph (2)— 
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(i) in subparagraph (B), by striking ‘‘; 
or’’ and inserting a semicolon; 
(ii) in subparagraph (C), by striking 
the period and inserting ‘‘; or’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(D) acquire drugs or devices approved, 
cleared, or otherwise legally marketed under the 
Federal Food, Drug, and Cosmetic Act for emer-
gency treatment of known or suspected over-
dose.’’; 
(3) by striking subsection (f); 
(4) by redesignating subsection (g) as subsection 
(f); 
(5) in subsection (f)(1), as so redesignated, by 
striking ‘‘2019 through 2023’’ and inserting ‘‘2025 
through 2029’’; 
(6) by redesignating such section 330J as section 
553 of the Public Health Service Act; and 
(7) by transferring such section 553, as so redes-
ignated, to appear at the end of part D of title V of 
the Public Health Service Act (42 U.S.C. 290dd et 
seq.). 
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Union Calendar No. 443 
118TH CONGRESS 
2D SESSION 
H. R. 4646 
[Report No. 118–532] 
A BILL 
To reauthorize the rural emergency medical service 
training and equipment assistance program, and 
for other purposes. 
MAY 31, 2024 
Reported with an amendment, committed to the Com-
mittee of the Whole House on the State of the Union, 
and ordered to be printed 
VerDate Sep 11 2014 
21:30 May 31, 2024
Jkt 049200
PO 00000
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