I
107TH CONGRESS
1ST SESSION
H. R. 1353
To amend the Public Health Service Act and titles XVIII and XIX of
the Social Security Act to sustain access to vital emergency medical
services in rural areas.
IN THE HOUSE OF REPRESENTATIVES
APRIL 3, 2001
Mr. KENNEDY of Minnesota introduced the following bill; which was referred
to the Committee on Energy and Commerce, and in addition to the Com-
mittee on Ways and Means, 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 concerned
A BILL
To amend the Public Health Service Act and titles XVIII
and XIX of the Social Security Act to sustain access
to vital emergency medical services in rural areas.
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 ‘‘Sustaining Access to
Vital Emergency Medical Services Act of 2001’’.
SEC. 2. RURAL EMERGENCY MEDICAL SERVICE TRAINING
AND EQUIPMENT ASSISTANCE PROGRAM.
Part E of title XII of the Public Health Service Act
(42 U.S.C. 300d–51 et seq.), as amended by section 1305
of the Children’s Health Act of 2000 (Public Law 106–
310; 114 Stat. 1141) is amended by adding at the end
the following new section:
‘‘SEC. 1254. RURAL EMERGENCY MEDICAL SERVICE TRAIN-
ING AND EQUIPMENT ASSISTANCE PROGRAM.
‘‘(a) GRANTS.—The Secretary, acting through the
Administrator of the Health Resources and Services Ad-
ministration (referred to in this section as the ‘Secretary’)
shall award grants to eligible entities to enable such enti-
ties to provide for improved emergency medical services
in rural areas.
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant
under this section, an entity shall—
‘‘(1) be—
‘‘(A) a State emergency medical services
office;
‘‘(B) a State emergency medical services
association;
‘‘(C) a State office of rural health;
‘‘(D) a local government entity;
‘‘(E) a State or local ambulance provider;
or
‘‘(F) any other entity determined appro-
priate by the Secretary; and
‘‘(2) prepare and submit to the Secretary an
application at such time, in such manner, and con-
taining such information as the Secretary may re-
quire, that includes—
‘‘(A) a description of the activities to be
carried out under the grant; and
‘‘(B) an assurance that the applicant will
comply with the matching requirement of sub-
section (e).
‘‘(c) USE OF FUNDS.—An entity shall use amounts
received under a grant made under subsection (a), either
directly or through grants to emergency medical service
squads that are located in, or that serve residents of, a
non-metropolitan statistical area, an area designated as
rural area by any law or regulation of the State, or a rural
census tract of a metropolitan statistical area (as deter-
mined under the most recent Goldsmith Modification,
originally published in the Federal Register on February
27, 1992 (57 Fed. Reg. 6725)), to—
‘‘(1) hire or recruit emergency medical service
personnel;
‘‘(2) recruit or retain volunteer emergency med-
ical service personnel;
‘‘(3) train emergency medical service personnel
in emergency response, injury prevention, safety
awareness, and other topics relevant to the delivery
of emergency medical services;
‘‘(4) fund specific training to meet State or
Federal certification requirements;
‘‘(5) develop new ways to educate emergency
health care providers through the use of technology-
enhanced educational methods (such as distance
learning);
‘‘(6) acquire emergency medical services vehi-
cles, including ambulances;
‘‘(7) acquire emergency medical services equip-
ment, including cardiac defibrillators;
‘‘(8) acquire personal protective equipment for
emergency medical services personnel as required by
the Occupational Safety and Health Administration;
and
‘‘(9) 
educate 
the 
public 
concerning
cardiopulmonary resuscitation (CPR), first aid, in-
jury prevention, safety awareness, illness prevention,
and other related emergency preparedness topics.
‘‘(d) PREFERENCE.—In awarding grants under this
section the Secretary shall give preference to—
‘‘(1) applications that reflect a collaborative ef-
fort by 2 or more of the entities described in sub-
paragraphs (A) through (F) of subsection (b)(1);
and
‘‘(2) applications submitted by entities that in-
tend to use amounts provided under the grant to
fund activities described in any of paragraphs (1)
through (5) of subsection (c).
‘‘(e) MATCHING REQUIREMENT.—The Secretary may
not make a grant under this section to an entity unless
the entity agrees that the entity will make available (di-
rectly or through contributions from other public or pri-
vate entities) non-Federal contributions toward the activi-
ties to be carried out under the grant in an amount equal
to 5 percent of the amount received under the grant.
‘‘(f) EMERGENCY MEDICAL SERVICES.—In this sec-
tion, the term ‘emergency medical services’—
‘‘(1) means resources used by a qualified public
or private nonprofit entity, or by any other entity
recognized as qualified by the State involved, to de-
liver medical care outside of a medical facility under
emergency conditions that occur—
‘‘(A) as a result of the condition of the pa-
tient; or
‘‘(B) as a result of a natural disaster or
similar situation; and
‘‘(2) includes services delivered by an emer-
gency medical services provider (either compensated
or volunteer) or other provider recognized by the
State involved that is licensed or certified by the
State as an emergency medical technician or its
equivalent (as determined by the State), a registered
nurse, a physician assistant, or a physician that pro-
vides services similar to services provided by such an
emergency medical services provider.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—There is authorized to be
appropriated to carry out this section, $50,000,000
for each of fiscal years 2002 through 2007.
‘‘(2) ADMINISTRATIVE
COSTS.—The Director
may use not more than 10 percent of the amount
appropriated under paragraph (1) for a fiscal year
for the administrative expenses of carrying out this
section.’’.
SEC. 3. PRUDENT LAYPERSON STANDARD FOR EMERGENCY
AMBULANCE SERVICES UNDER MEDICARE
AND MEDICAID.
(a) AMBULANCE SERVICES
FOR MEDICARE FEE-
FOR-SERVICE BENEFICIARIES.—Section 1861(s)(7) of
the Social Security Act (42 U.S.C. 1395x(s)(7)) is amend-
ed by inserting before the semicolon at the end the fol-
lowing: ‘‘, except that such regulations shall not fail to
treat ambulance services as medical and other health serv-
ices solely because the ultimate diagnosis of the individual
receiving the ambulance services results in the conclusion
that ambulance services were not necessary, as long as the
request for ambulance services is made after the sudden
onset of a medical condition that would be classified as
an emergency medical condition (as defined in section
1852(d)(3)(B))’’.
(b) AMBULANCE SERVICES FOR MEDICARE+CHOICE
ENROLLEES.—Section 1852(d)(3)(A) of the Social Secu-
rity Act (42 U.S.C. 1395w–22(d)(3)(A)) is amended by
inserting ‘‘(including the services described in section
1861(s)(7))’’ after ‘‘outpatient services’’ in the matter
preceding clause (i).
(c) AMBULANCE SERVICES IN MEDICAID MANAGED
CARE PLANS.—Section 1932(b)(2)(B) of the Social Secu-
rity Act (42 U.S.C. 1396u–2(b)(2)(B)) is amended by in-
serting ‘‘(including the services described in section
1861(s)(7) (if covered by the State plan))’’ after ‘‘out-
patient services’’ in the matter preceding clause (i).
(d) EFFECTIVE DATE.—The amendments made by
this section shall apply with respect to services provided
on and after the date of enactment of the Act.
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