EMS Staffing and Support Act
Bill: S.3910 | Sponsor: Sen. Sanders, Bernard (I-VT)
Policy area: Health

Summary:
EMS Staffing and Support Act
This bill provides funding for FY2023 and each fiscal year thereafter to support organizations that provide medical transport and emergency medical services (i.e., EMS organizations). It also requires the Department of Health and Human Services to report on reimbursement and other challenges faced by EMS organizations, including in rural areas.
Specifically, the Health Resources and Services Administration (HRSA) must establish a competitive grant program for state, territorial, tribal, and local governments; nonprofit EMS organizations; and nonprofits that represent the interests of EMS organizations. Grant funds may be used for training and other personnel costs, purchasing necessary equipment and supplies, and related purposes. The bill further requires HRSA to allocate funding through compacts or contracts to Indian tribes for such purposes.

To amend the Public Health Service Act to establish a funding program 
       for supporting EMS organizations, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``EMS Staffing and Support Act''.

SEC. 2. EMS ORGANIZATION FUNDING.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et seq.) is amended by adding at the end the following:

``SEC. 399V-7. EMS ORGANIZATION FUNDING.

    ``(a) Definitions.--In this section:
            ``(1) Indian tribe; tribal organization.--The terms `Indian 
        Tribe' and `Tribal organization' have the meanings given such 
        terms in section 4 of the Indian Self-Determination and 
        Education Assistance Act.
            ``(2) EMS organization.--The term `EMS organization' means 
        a public or private entity that provides medical transport and 
        emergency medical services.
            ``(3) Emergency medical services.--The term `emergency 
        medical services' has the meaning given such term in section 
        330J(e).
            ``(4) Qualified applicant.--The term `qualified applicant' 
        means--
                    ``(A) an EMS organization, other than an EMS 
                organization that operates for profit;
                    ``(B) a State, Indian Tribe, Tribal organization, 
                county, or municipality; or
                    ``(C) any other nonprofit organization that 
                represents the interests of EMS organizations.
            ``(5) State.--The term `State' means any State of the 
        United States, the District of Columbia, the Commonwealth of 
        Puerto Rico, American Samoa, Guam, the United States Virgin 
        Islands, the Commonwealth of the Northern Mariana Islands, and 
        any other territory or possession of the United States.
    ``(b) Competitive Grants.--
            ``(1) In general.--Beginning in fiscal year 2023, the 
        Secretary, acting through the Administrator of the Health 
        Resources and Services Administration, shall award grants on a 
        competitive basis to qualified applicants to carry out 
        activities described in subsection (d) in order to support EMS 
        organizations in the United States.
            ``(2) Applications.--
                    ``(A) In general.--A qualified applicant seeking a 
                grant under this subsection shall submit an application 
                to the Secretary at such time, in such manner, and 
                containing such information as the Secretary may 
                reasonably require, including--
                            ``(i) a description of the financial need 
                        of the qualified applicant (or each qualified 
                        applicant in the case of a joint application 
                        described in subparagraph (B)); and
                            ``(ii) an analysis of the costs and 
                        benefits, with respect to improving medical 
                        transport and emergency medical services, of 
                        the activities to be carried out through the 
                        grant.
                    ``(B) Joint applications.--A qualified applicant 
                may submit a joint application with 1 or more other 
                qualified applicants under this subsection.
                    ``(C) Peer review of grant applications.--
                            ``(i) In general.--The Secretary, after 
                        consultation with national emergency medical 
                        services organizations, shall appoint emergency 
                        medical service personnel to conduct peer 
                        reviews of applications received under this 
                        subsection.
                            ``(ii) Applicability of federal advisory 
                        committee act.--The Federal Advisory Committee 
                        Act (5 U.S.C. App.) shall not apply to 
                        activities carried out under this subparagraph.
                    ``(D) Prioritization of grant awards.--In awarding 
                grants under this subsection, the Secretary shall 
                consider each of the following:
                            ``(i) The findings and recommendations of 
                        the peer reviews carried out under subparagraph 
                        (C).
                            ``(ii) The degree to which an award will 
                        improve the coverage, response times, and 
                        ability of EMS organizations to provide medical 
                        transport and emergency medical services.
                            ``(iii) The extent of the need of an 
                        applicant for a grant under this subsection and 
                        the need to protect the United States as a 
                        whole.
    ``(c) Contracts or Compacts With Indian Tribes and Tribal 
Organizations.--
            ``(1) In general.--Beginning in fiscal year 2023, the 
        Secretary, acting through the Administrator of the Health 
        Resources and Services Administration, shall award funding 
        through contracts or compacts pursuant to the Indian Self-
        Determination and Education Assistance Act, distributed on a 
        fair and equitable formula as developed through consultation 
        with Indian Tribes and Tribal organizations, to Indian Tribes 
        and Tribal organizations to carry out activities described in 
        subsection (d) in order to support EMS organizations in Tribal 
        communities.
            ``(2) Applications.--An Indian Tribe or Tribal organization 
        seeking funding under this subsection shall submit an 
        application to the Secretary at such time, in such manner, and 
        containing such information as the Secretary requires through 
        consultation with Indian Tribes and Tribal organizations.
    ``(d) Activities.--
            ``(1) In general.--Grants or other funding awarded under 
        this section may be used to support EMS organizations through 
        any of the following:
                    ``(A) Hiring EMS organization personnel.
                    ``(B) Recruiting and retaining volunteer EMS 
                organization personnel.
                    ``(C) Providing training or reimbursing personnel 
                for training.
                    ``(D) Conducting courses and implementing 
                apprenticeship programs that qualify graduates to serve 
                in an EMS organization in accordance with State and 
                local requirements.
                    ``(E) Purchasing necessary equipment.
                    ``(F) Purchasing medicine and medical supplies.
                    ``(G) Purchasing EMS vehicles.
                    ``(H) Wellness and fitness programs for EMS 
                organization personnel.
                    ``(I) Modifying facilities.
                    ``(J) Improving regional coordination among EMS 
                organizations.
                    ``(K) Establishing or supporting community 
                paramedicine or mobile integrated health care 
                initiatives.
                    ``(L) Any other activity the Secretary determines 
                appropriate.
            ``(2) Limitation.--No funds awarded under this section may 
        be made available to an EMS organization that operates for 
        profit or to otherwise support efforts to establish or provide 
        emergency medical services, or medical transport, for profit.
    ``(e) Amount.--Each grant awarded under subsection (b), or funding 
through a contract or compact under subsection (c), shall be in an 
amount not to exceed $1,000,000.
    ``(f) Appropriations.--
            ``(1) Awards.--
                    ``(A) In general.--There is authorized to be 
                appropriated, and there is appropriated, to the 
                Secretary to award grants, and funding through 
                contracts or compacts, under this section--
                            ``(i) for fiscal year 2023, $500,000,000; 
                        and
                            ``(ii) for each fiscal year thereafter, the 
                        amount authorized under this subparagraph for 
                        the preceding fiscal year increased by the 
                        percentage increase in the consumer price index 
                        for all urban consumers (all items; United 
                        States city average) for the most recent 12-
                        month period for which applicable data is 
                        available.
                    ``(B) Contracts and compacts.--Of the amount 
                appropriated under subparagraph (A) for each fiscal 
                year, not less than 5 percent shall be set aside to 
                carry out subsection (c).
            ``(2) Technical assistance.--There is authorized to be 
        appropriated, and there is appropriated, to the Secretary to 
        provide technical assistance to entities completing and 
        submitting applications under this section--
                    ``(A) for fiscal year 2023, $10,000,000; and
                    ``(B) for each fiscal year thereafter, the amount 
                authorized under this paragraph for the preceding 
                fiscal year increased by the percentage increase in the 
                consumer price index for all urban consumers (all 
                items; United States city average) for the most recent 
                12-month period for which applicable data is 
                available.''.

SEC. 3. REPORTS.

    (a) In General.--Not later than 90 days after the date of enactment 
of this Act, the Secretary of Health and Human Services, in 
consultation with the Administrator of the Centers for Medicare & 
Medicaid Services, the Administrator of the Health Resources and 
Services Administration, the Assistant Secretary for Preparedness and 
Response, and EMS stakeholders, shall submit to Congress a report 
detailing the challenges, disparities, and inadequacies in providing 
Federal, State, and private (including commercial insurers) 
reimbursement for medical transport and emergency medical services and 
providing recommendations for improvement with respect to providing 
such reimbursement.
    (b) Rural EMS Organizations.--Not later than 90 days after the date 
of enactment of this Act, the Secretary of Health and Human Services, 
in consultation with the Administrator of the Centers for Medicare & 
Medicaid Services, the Administrator of the Health Resources and 
Services Administration, the Assistant Secretary for Preparedness and 
Response, and EMS stakeholders, shall submit to Congress a report on 
the challenges specific to rural EMS organizations, including with 
respect to Federal, State, and private (including private insurers) 
reimbursement rates and policies, and develop an action plan to address 
those challenges through grants and other administrative action.
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