I 118th CONGRESS 1st Session H. R. 1737 IN THE HOUSE OF REPRESENTATIVES March 23, 2023 Mr. Kim of New Jersey (for himself, Mr. Carey , Mr. Fitzpatrick , Mr. Molinaro , and Ms. Perez ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To direct the Secretary of Health and Human Services to establish the Emergency Medical Services (EMS) Grant Program through which the Secretary may make grants to qualified applicants, and for other purposes.

1. Short title This Act may be cited as the Supporting Our First Responders Act . 2. Emergency Medical Services Grant Program (a) Emergency Medical Services Grant Program (1) In general The Secretary of Health and Human Services (referred to in this Act as the Secretary ) shall establish a program, to be known as the Emergency Medical Services (EMS) Grant Program (in this section referred to as the Program ), through which the Secretary shall award grants on a competitive basis to qualified applicants. (2) Eligibility To be eligible for a grant under the Program, a qualified applicant shall submit to the Secretary an application at such a time, in such manner, and containing such information as the Secretary may require, including the following: (A) A description of the financial need of the qualified applicant. (B) An analysis of the costs and benefits, with respect to improving medical transport and emergency medical services (referred to in this section as EMS ), of the activities to be carried out through the grant. (3) Joint applications A qualified applicant may submit a joint application with one or more other qualified applicants under this subsection. (4) Peer review of grant applications The Secretary, after consultation with national qualified applicants, shall appoint representatives of volunteer, governmental, Tribal, for-profit, and nonprofit qualified applicants and entities to conduct peer review of applications. (5) Selection considerations In awarding grants under the Program the Secretary shall consider each of the following: (A) The findings and recommendations of the peer reviews carried out under paragraph (4). (B) The degree to which an award will improve the coverage, response times, and ability of qualified applicants to provide medical transport and emergency medical services. (C) 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. (D) Whether a qualified applicant has previously received Federal funding. (6) Prioritization among for-profit qualified applicants In awarding grants under the Program, the Secretary shall, in selecting among qualified applicants that operate for profit, give priority to such applicants that are smaller for profit entities, determined on an annual basis based on the net profits of the entity and the number of employees hired during the preceding year. (b) Purposes Grants made under the Program may be used by recipient qualified applicants for the following purposes: (1) Maintaining, or, if appropriate, increasing, the number of trained front-line EMS responders, whether paid or volunteer, including providing salaries and stipends. (2) Providing mental health programs for qualified applicant personnel. (3) Covering or reimbursing costs associated with certification and recertification courses. (4) Obtaining resources, including purchasing personal protective equipment, uniforms, medicine, and medical supplies. (5) Constructing or modifying facilities in such a way so as to improve coverage, response time, and ability of qualified applicants to provide medical transport and emergency medical services. (6) Upgrading or purchasing EMS vehicles, communications equipment, and mapping equipment. (7) Establishing or supporting community paramedicine or mobile integrated healthcare initiatives. (c) Allocation of grant awards (1) Limitation (A) For profit (i) In general Not more than two percent of grants awarded under the Program may be made available to qualified applicants that operate for profit or to otherwise support efforts to establish or provide emergency medical services, or medical transport, for profit. (ii) Maximum amount A grant under the Program to such a for-profit qualified applicant (if singly) or to such qualified applicants (if a result of a joint application) or to otherwise so support such efforts shall be in an amount not to exceed $100,000. (iii) Purposes A qualified applicant that operates for profit may use funds awarded through a grant under the Program only for the purposes specified in paragraphs (1), (2), and (3) of subsection (b). (B) Time-based A for-profit qualified applicant (if singly) or qualified applicants (if a result of a joint application) awarded a grant under the Program may not apply for another such award for a period of three years. (2) Further limitation A grant under the Program to a not-for-profit qualified applicant or a joint application shall be in an amount not to exceed $300,000. (3) Reservation Not less than 20 percent of grants awarded under the Program shall be made available to qualified applicants in rural areas. (d) Metrics The Secretary of Health and Human Services shall develop metrics to assess the effectiveness of the Program in improving the coverage, response times, and ability of qualified applicants to provide medical transport and emergency medical services. (e) Claw backs The Secretary of Health and Human Services shall make every available effort to recover grant funds in case of noncompliance. To carry out this subsection, the Secretary shall establish a process through which notification is conveyed to qualified applicants determined to be in noncompliance, and such organizations are provided an opportunity to respond to such notification prior to the recovery of such funds. (f) Assessments; reports Not later than two years after the date of the enactment of this Act and not less frequently than biennially after, the Secretary of Health and Human Services shall— (1) conduct an assessment of the Program based on the metrics developed pursuant to subsection (d); and (2) submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report summarizing the findings of the assessment and recommendations to strengthen the overall program. (g) Authorization of appropriations There is authorized to be appropriated to the Secretary of Health and Human Services— (1) for each of the first 5 fiscal years following the date of the enactment of this Act, $50,000,000 to carry out the Program; and (2) for each of such fiscal years, $5,000,000 to provide technical assistance to qualified applicants completing and submitting applications. (h) Reports (1) In general Not later than 90 days after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with the Administrator of the Centers for Medicare and 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 that— (A) details the challenges, disparities, and inadequacies in providing Federal, State, and private (including commercial insurers) reimbursement for medical transport and emergency medical services; and (B) provides recommendations for improvement with respect to providing such reimbursement. (2) Qualified applicants Not later than 90 days after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with the Administrator of the Centers for Medicare and 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 that— (A) describes the challenges specific to qualified applicants, including with respect to Federal, State, and private (including private insurers) reimbursement rates and policies; and (B) contains an action plan to address such challenges through grants and other administrative action. (3) Establishing a Federal EMS Office Not later than 90 days after the date of the enactment of this Act, the Secretary of Health and Human Services, in consultation with the Administrator of the Centers for Medicare and 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 that assesses the feasibility of establishing a Federal office to— (A) better advocate for EMS personnel, collect data, promote EMS education, research, and training; and (B) implement recommendations and action plans based on the findings in the reports under paragraphs (1) and (2). (i) Definitions In this section: (1) EMS organization The term EMS organization means a nongovernmental or governmental entity that provides emergency medical services. (2) Emergency medical services The term emergency medical services — (A) means resources used by a licensed entity to deliver medical care outside of a medical facility under emergency conditions that occur as a result of the condition of the patient; and (B) includes services provided (either on a compensated or volunteer basis) at the location of the emergency or en route to, or at, a health care facility by an emergency medical services provider or other provider that is licensed or certified by the State involved as an emergency medical technician, a paramedic, or an equivalent professional (as determined by the State). (3) Medical transport The term medical transport means the transportation, by ambulance, of sick, injured, or otherwise incapacitated persons who require emergency medical care to a health care facility, including a hospital, clinic, or alternative destination. (4) Qualified applicant The term qualified applicant means— (A) an EMS organization; or (B) a State (or a political subdivision thereof), Indian Tribe, Tribal organization (as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act ( 25 U.S.C. 5304 )), territory, or municipality. (5) Rural area The term rural area means— (A) a nonmetropolitan statistical area; (B) an area designated as a rural area by any law or regulation of a State; or (C) a rural census tract of a metropolitan statistical area (as determined under the most recent rural urban commuting area code as set forth by the Office of Management and Budget). (6) State The term State means a State of the United States, the District of Columbia, Puerto Rico, the Virgin Islands, American Samoa, the Northern Mariana Islands, and Guam.