I 
111TH CONGRESS 
2D SESSION 
H. R. 6528 
To provide for improvement of field emergency medical services, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
DECEMBER 16, 2010 
Mr. WALZ (for himself and Mrs. MYRICK) introduced the following bill; which 
was referred to the Committee on Energy and Commerce, and in addition 
to the Committee on Ways and Means, for a period to be subsequently 
determined by the Speaker, in each case for consideration of such provi-
sions as fall within the jurisdiction of the committee 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 2010’’. 
(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Findings. 
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Sec. 3. Definitions. 
Sec. 4. Recognition of NHTSA as primary Federal agency for field EMS. 
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. National Emergency Medical Services Advisory Council. 
Sec. 12. Emergency care coordination. 
Sec. 13. Emergency Medical Services Trust Fund. 
Sec. 14. 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 care provided in the field, hospital, and re-
habilitation 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 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 for 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 in readiness, innovation, preparedness, 
education and workforce development, safety, financ-
ing, quality, standards, and research. 
(11) The recognition of a primary Federal 
agency specifically for field EMS is necessary to pro-
vide a more streamlined, cost-efficient, and com-
prehensive approach for field EMS as well as pro-
vide a focal point for practitioners and agencies to 
interface with the Federal Government. 
(12) The long-standing role and capability of 
the National Highway Traffic Safety Administration 
(NHTSA) to promote the development of field EMS 
should be enhanced to serve in a federally recognized 
leadership role for field EMS, and enable NHTSA to 
serve as a full and equal partner with other Federal 
agencies that oversee other aspects of the EMS sys-
tem and national preparedness and response. 
(13) The Emergency Care Coordinating Center 
(ECCC) should be statutorily created to ensure its 
continued and essential leadership role in supporting 
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the Federal Government’s coordination of in-hospital 
emergency medical care activities, including by pro-
moting the regionalization of emergency medical 
care and promoting other programs and resources 
that improve the seamless delivery of the Nation’s 
daily emergency medical care and emergency behav-
ioral care. 
(14) 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. 
(15) The discretionary National EMS Advisory 
Council (NEMSAC) created by the Department of 
Transportation under the Federal Advisory Com-
mittee Act should be a statutorily established council 
that ensures non-Federal input and recommenda-
tions to NHTSA, FICEMS, and all Federal agencies 
involved with EMS. 
(16) FICEMS must continue in its essential 
role in coordinating the Federal activities related to 
the full spectrum of EMS. 
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SEC. 3. DEFINITIONS. 
In this Act: 
(1) The term ‘‘EMS’’ means emergency medical 
services. 
(2) The term ‘‘FICEMS’’ means the Federal 
Interagency Committee on Emergency Medical Serv-
ices. 
(3) The term ‘‘field EMS’’ means emergency 
medical services provided to patients (pursuant to 
transport by ground, air, or otherwise) prior to or 
outside a medical facility or other clinical setting. 
(4) 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. 
(5) The term ‘‘emergency medical services’’ or 
‘‘EMS’’ means emergency medical care and related 
services provided to patients at any point in the con-
tinuum of health care services, including emergency 
medical dispatch and medical care and related serv-
ices provided in the field, during transport, or in a 
medical facility or other clinical setting. 
(6) The term ‘‘field EMS patient care reports’’ 
means the information that a field EMS agency 
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typically creates regarding a patient’s medical condi-
tion and treatment in the course of providing emer-
gency medical services to that patient. 
(7) The term ‘‘NEMSAC’’ means the National 
Emergency Medical Services Advisory Council estab-
lished by section 12. 
(8) The term ‘‘NEMSIS’’ means the National 
EMS Information System. 
(9) The term ‘‘NHTSA’’ means the National 
Highway Traffic Safety Administration. 
(10) 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. 
(11) The term ‘‘STEMI’’ means ST–Segment 
Elevation Myocardial Infarction. 
SEC. 4. RECOGNITION OF NHTSA AS PRIMARY FEDERAL 
AGENCY FOR FIELD EMS. 
(a) PRIMARY FEDERAL AGENCY FOR FIELD EMS.— 
NHTSA shall serve as the primary Federal agency for 
field EMS to provide enhanced Federal support for the 
development of patient-centered, medically directed, evi-
dence-based, cost-effective, and safe field emergency med-
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ical services that are accessible to patients throughout the 
United States and which ensure 24 hours a day, 7 days 
a week readiness, catastrophic preparedness, and con-
tinual innovation in quality and capability for the better-
ment of patients. In this capacity, the Administrator of 
NHTSA shall— 
(1) provide enhanced leadership for emergency 
medical services provided in the field; 
(2) work in partnership with the other Federal 
agencies involved with EMS in their respective lead-
ership roles in overseeing other aspects of the full 
spectrum of emergency medical services and pre-
paredness and response; and 
(3) work in collaboration with FICEMS, which 
coordinates all Federal EMS efforts, to ensure a 
seamless Federal approach to a coordinated emer-
gency medical services system across the continuum 
of emergency medical care. 
(b) COHESIVE NATIONAL FIELD EMS STRATEGY.— 
The Administrator of NHTSA shall, pursuant to this Act, 
develop and implement a cohesive national strategy to 
strengthen the development of field emergency medical 
services (EMS) at the Federal, State, and local levels. In 
establishing such a strategy, the Administrator 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 a field 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 oper-
ational improvements and integration of field EMS 
practitioners into the broader health care system in-
cluding— 
(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— 
(i) the identification of differences in 
the levels of care, scope of practice, and li-
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censure and credentialing requirements 
among the States; and 
(ii) the adoption by the States of na-
tional standards for such levels of care, 
scope of practice and licensure and 
credentialing requirements; 
(B) promotion of a culture of safety, in-
cluding— 
(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 na-
tional ambulance vehicle safety and manu-
facturing standards; 
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(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 non-emergent medical con-
ditions; and 
(ii) such other strategies to implement 
the recommendations provided by the Na-
tional Health Care Workforce Commission, 
pursuant to section 5101(d)(2) of the Pa-
tient Protection and Affordable Care Act 
(42 U.S.C. 294q(d)(2)); and 
(D) such other issues that the Adminis-
trator considers appropriate; 
(4) complete the development of such strategy 
not later than 18 months after the date of enact-
ment of this Act; 
(5) communicate such strategy to the relevant 
congressional committees of jurisdiction; 
(6) implement such strategy to the extent prac-
tical not later than 3 years after the date of enact-
ment of this Act; and 
(7) update such strategy not less than every 3 
years. 
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(c) STATUTORY CONSTRUCTION.—Nothing in this 
Act shall be construed to preempt any statutory authority 
otherwise provided for any other Federal agency. 
SEC. 5. FIELD EMS EXCELLENCE, QUALITY, UNIVERSAL AC-
CESS, INNOVATION AND PREPAREDNESS. 
(a) IN GENERAL.—The Administrator 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 
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 preparedness for 
everyday and catastrophic 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 Administrator in such form 
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and manner, that contains such agreements, assur-
ances, and information as the Administrator deter-
mines to be reasonably necessary to carry out this 
section. 
(2) SIMPLE
FORM.—The Administrator shall 
ensure that grant application requirements are not 
unduly burdensome to smaller and volunteer field 
EMS agencies or other agencies with limited re-
sources. 
(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 
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(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; 
(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 Administrator may 
establish. 
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(d) ADMINISTRATION OF GRANTS.—In establishing 
and administering the EQUIP grant program, the Admin-
istrator— 
(1) shall establish a grant making 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 ge-
ographic areas, including urban, suburban, 
and rural; 
(vi) distribution of funds among types 
of EMS agencies, including governmental, 
non-governmental and volunteer; 
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(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 Admin-
istrator considers necessary; 
(B) a peer reviewed process to recommend 
grant allocations in accordance with the 
prioritization established by the Administrator 
except that final award determinations shall be 
made by the Administrator; and 
(C) the provision of grant awards to eligi-
ble entities on an annual basis, except that the 
Administrator may reserve not more than 25 
percent of the available appropriations for 
multi-year grants and no grant award may ex-
ceed a 2-year period; 
(2) shall consult with and take into consider-
ation the recommendations of FICEMS, NEMSAC 
and relevant stakeholders; 
(3) shall ensure that funds used for cata-
strophic 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 
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program if the Administrator establishes conflict-of- 
interest requirements as part of any such contrac-
tual 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 improve-
ment programs as defined by the Administrator. 
(f) ANNUAL REPORT.—The Administrator shall sub-
mit 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 Administrator 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 
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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 
(6) to enhance 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 pandemic influenza and all haz-
ards EMS preparedness and coordination of medical 
first response; 
(2) to improve cross-border collaboration and 
planning among States; 
(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; 
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(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); 
(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 Adminis-
trator 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; 
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(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 
further enhance coordination and systemic develop-
ment throughout the State; and 
(9) for such other uses as the Administrator 
may establish. 
(c) ADMINISTRATION OF GRANTS.—In establishing 
and administering the SPIA grant program, the Adminis-
trator 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 Administrator shall— 
(A) take into the consideration the rec-
ommendations of FICEMS, NEMSAC, and rel-
evant 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; 
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(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; 
(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 Administrator, 
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 Administrators in such form and manner, 
that contains such agreements, assurances and informa-
tion as the Administrator determines to be reasonably nec-
essary 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. 
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(f) ANNUAL REPORT.—The Administrator shall sub-
mit an annual report on the SPIA grant program under 
this section to the Congress. 
SEC. 7. FIELD EMS QUALITY. 
(a) MEDICAL OVERSIGHT.— 
(1) IN
GENERAL.—To improve medical over-
sight of field EMS and ensure continuity and ac-
countability for such medical oversight, the Adminis-
trator of NHTSA shall— 
(A) establish national guidelines for train-
ing, credentialing, and direction in connection 
with medical oversight; and 
(B) promote high-quality medical direction 
and maximization of participation and training 
by physicians in medical direction. 
(2) CONSIDERATIONS.—In establishing guide-
lines under paragraph (1)(A), the Administrator of 
NHTSA shall take into consideration— 
(A) nationally recognized guidelines; 
(B) relevant stakeholder input; and 
(C) the unique needs associated with the 
provision of field EMS in rural areas or by vol-
unteers. 
(3) FLEXIBILITY.—The guidelines established 
under paragraph (1)(A) shall ensure high-quality 
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training, credentialing, and direction in connection 
with medical oversight of field EMS at the State, re-
gional, and local levels while providing sufficient 
flexibility to account for historical and legitimate dif-
ferences in field EMS among States, regions, and lo-
calities. 
(4) REQUIRED USE OF GUIDELINES.—As a con-
dition on receipt of a grant under section 5 or 6, the 
Administrator of NHTSA shall require the grant re-
cipient to adopt and implement (to the extent appli-
cable) the guidelines established under paragraph 
(1)(A). 
(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 medial 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 
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(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; 
(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) 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. 
(C) 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. 
(D) 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 Administrator of NHTSA, in consulta-
tion with the Secretary of Health and Human 
Services, 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 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— 
(I) cardiac events such as chest 
pain, sudden cardiac arrest, and 
STEMI; 
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(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 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-
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— 
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(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 
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 
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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 
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-
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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-
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.— 
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(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 
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. 
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(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 pro-
hibiting— 
(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 non-individually 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 Secretary of 
Health and Human Services, acting through the Adminis-
trator of the Health Resources and Services Administra-
tion, may make grants to eligible entities for the develop-
ment, availability, and dissemination of field EMS edu-
cation programs and courses that improve the quality and 
capability of field EMS personnel. In carrying out this sec-
tion, the Secretary shall take into consideration input from 
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the Administrator of NHTSA, FICEMS, NEMSAC, the 
National Health Care Workforce Commission established 
under section 5101 of the Patient Protection and Afford-
able Care Act (42 U.S.C. 294q), and relevant stake-
holders. 
(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 Secretary of Health and 
Human Services 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; 
(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 
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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 
(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; 
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(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 
Secretary may identify. 
(d) PRIORITY.—The Secretary of Health and Human 
Services, in consultation with NHTSA and relevant stake-
holders, and taking into consideration the recommenda-
tions 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 sec-
tion shall be for a period of 1 to 3 years. 
(f) APPLICATION.—The Secretary of Health and 
Human Services may not award a grant to an eligible enti-
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(xxi) emergency management; 
(xxii) State homeland security direc-
tors; 
(xxiii) State or local legislative bodies; 
and 
(xxiv) consumers not directly affiliated 
with an emergency medical system or 
health care organization; and 
(D) appoint at least 2 members without re-
gard to the categories listed in subparagraph 
(C). 
(5) VACANCIES.—A vacancy in the membership 
of NEMSAC shall— 
(A) not affect the powers of NEMSAC; 
and 
(B) be filled in the manner in which the 
original appointment was made. 
(6) NO PAY; TRAVEL EXPENSES.—Each mem-
ber of NEMSAC shall serve without pay, but shall 
be reimbursed for travel and per diem in lieu of sub-
sistence expenses during the performance of duties 
of NEMSAC while away from home or his or her 
regular place of business, in accordance with appli-
cable provisions under subchapter I of chapter 57 of 
title 5, United States Code. 
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