I 118th CONGRESS 2d Session H. R. 10007 IN THE HOUSE OF REPRESENTATIVES October 18, 2024 Mr. Higgins of Louisiana introduced the following bill; which was referred to the Committee on the Judiciary A BILL To amend the Immigration and Nationality Act to authorize the admission of nonimmigrant emergency medical technicians and paramedics.

1. Short title This Act may be cited as the Paramedic and Emergency Medical Technician Relief Act of 2024 . 2. Establishment of H–1D visas for EMTs and paramedics (a) Nonimmigrant category Section 101(a)(15)(H)(i) of the Immigration and Nationality Act ( 8 U.S.C. 1101(a)(15)(H)(i) ) is amended by striking ; or at the end and inserting , or (d) who is coming temporarily to the United States to perform services as an emergency medical technician or paramedic, who meets the qualifications described in section 212(u) , and with respect to whom the Secretary of Labor determines and certifies to the Secretary of Homeland Security that an unexpired attestation is on file and in effect under section 212(u)(2) for the employer; or . (b) Requirements Section 212 of the Immigration and Nationality Act ( 8 U.S.C. 1182 ) is amended by adding at the end the following: (u) Requirements for admission of nonimmigrant EMTs and paramedics (1) Qualifications The qualifications referred to in section 101(a)(15)(H)(i)(d), with respect to an alien who is coming to the United States to perform services as an emergency medical technician or paramedic, are that the alien— (A) has, at a minimum, obtained emergency medical technician, paramedic, or equivalent pre-hospital care, education or training in a foreign country or in the United States; (B) not later than 12 weeks before the alien’s intended first date of employment in the United States, has passed an appropriate examination (recognized in regulations promulgated in consultation with the Secretary of Health and Human Services) or has obtained the appropriate certificate or license under State law to practice as an emergency medical technician or paramedic in the State of intended employment; (C) not later than 12 weeks before the alien’s intended first date of employment in the United States, is fully qualified and eligible under the laws (including such temporary or interim licensing requirements which authorize the emergency medical technician or paramedic to be employed) governing the place of intended employment to engage in practice as an emergency medical technician or a paramedic immediately upon admission to the United States; and (D) not later than 12 weeks before the alien’s intended first date of employment in the United States, has passed appropriate criminal record checks and other background and database checks, as determined by the Secretary of Homeland Security in coordination with the Attorney General, including biometric data collection, a review of the applicant's criminal and immigration records, verification of the applicant's identity and travel history, and an assessment of any potential risk the applicant poses to public safety or national security. (2) Attestation (A) The attestation referred to in section 101(a)(15)(H)(i)(d), with respect to an employer for which an alien will perform services, is an attestation as to the following: (i) The employment of the alien will not adversely affect the wages and working conditions of emergency medical technicians or paramedics, as applicable, similarly employed. (ii) The alien employed by the employer will be paid the wage rate for emergency medical technicians or paramedics, as applicable, similarly employed by the employer. (iii) The employer has taken and is taking timely and significant steps designed to recruit and retain sufficient emergency medical technicians or paramedics, as applicable, who are United States citizens or immigrants who are authorized to perform such services. (iv) There is not a strike or lockout in the course of a labor dispute, the employer did not lay off and will not lay off an emergency medical technician or a paramedic, as applicable, employed by the employer within the period beginning 90 days before and ending 90 days after the date of filing of any visa petition, and the employment of such an alien is not intended or designed to influence an election for a bargaining representative for emergency medical technicians or paramedics of the employer. (v) At the time of the filing of the petition for emergency medical technicians or paramedics, as applicable, under section 101(a)(15)(H)(i)(d), notice of the filing has been provided by the employer to the bargaining representative of the emergency medical technicians or paramedics employed by the employer or, where there is no such bargaining representative, notice of the filing has been provided to the emergency medical technicians or paramedics employed by the employer through posting in conspicuous locations or electronic notification to such employees. (vi) The employer will not, at any time, employ a number of aliens issued visas or otherwise provided nonimmigrant status under section 1101(a)(15)(H)(i)(d) of this title as emergency medical technicians or paramedics that exceeds 15 percent of the total number of emergency medical technicians or paramedics, respectively, employed by the employer. (vii) The employer is affiliated with an emergency medical services education program approved by the applicable licensing body of the State in which the alien will work. Nothing in clause (iii) shall be construed as requiring an employer to have taken significant steps described in such clause before the effective date of the Paramedic and Emergency Medical Technician Relief Act of 2023. A copy of the attestation referred to in section 101(1)(15)(H)(i)(d) shall be provided, within 30 days of the date of filing, to emergency medical technicians or paramedics, as applicable, employed by the employer on the date of filing. (B) For purposes of subparagraph (A)(iii), each of the following shall be considered a significant step reasonably designed to recruit and retain emergency medical technicians or paramedics: (i) Operating a training program for emergency medical technicians or paramedics or financing (or providing participation in) a training program for emergency medical technicians or paramedics. (ii) Providing career development programs and other methods of facilitating nationals of the United States to become emergency medical technicians or paramedics. (iii) Paying emergency medical technicians or paramedics wages at a rate equal to or higher than currently being paid to emergency medical technicians or paramedics similarly employed in the geographic area. (iv) Providing reasonable opportunities for meaningful salary advancement by emergency medical technicians or paramedics. The steps described in this subparagraph shall not be considered to be an exclusive list of the significant steps that may be taken to meet the conditions of subparagraph (A)(iii). Nothing in this subparagraph shall require an employer to take more than one step if the employer can demonstrate that taking a second step is not reasonable. (C) Subject to subparagraph (E), an attestation under subparagraph (A)— (i) shall expire on the date that is the later of— (I) the end of the one-year period beginning on the date of its filing with the Secretary of Labor; or (II) the end of the period of admission under section 101(a)(15)(H)(i)(d) of the last alien with respect to whose admission it was applied (in accordance with clause (ii)); and (ii) shall apply to petitions filed during the one-year period beginning on the date of its filing with the Secretary of Labor if the employer states in each such petition that it continues to comply with the conditions in the attestation. (D) An employer may meet the requirements under this paragraph with respect to more than one emergency medical technician or paramedic in a single petition. (E) (i) The Secretary of Labor shall compile and make publicly available online a list identifying employers which have filed petitions for nonimmigrants under section 101(a)(15)(H)(i)(d) and, for each such employer, a copy of the employer's attestation under subparagraph (A) (and accompanying documentation) and each such petition filed by the employer. (ii) The Secretary of Labor shall establish a process, including reasonable time limits, for the receipt, investigation, and disposition of complaints respecting an employer’s failure to meet conditions attested to or an employer's misrepresentation of a material fact in an attestation. Complaints may be filed by any aggrieved person or organization (including bargaining representatives, associations deemed appropriate by the Secretary, and other aggrieved parties as determined under regulations of the Secretary). The Secretary shall conduct an investigation under this clause if there is reasonable cause to believe that an employer fails to meet conditions attested to. Subject to the time limits established under this clause, this subparagraph shall apply regardless of whether an attestation is expired or unexpired at the time a complaint is filed. (iii) Under such process, the Secretary shall provide, within 180 days after the date such a complaint is filed, for a determination as to whether or not a basis exists to make a finding described in clause (iv). If the Secretary determines that such a basis exists, the Secretary shall provide for notice of such determination to the interested parties and an opportunity for a hearing on the complaint within 60 days of the date of the determination. (iv) If the Secretary of Labor finds, after notice and opportunity for a hearing, that an employer (for which an attestation is made) has failed to meet a condition attested to or that there was a misrepresentation of material fact in the attestation, the Secretary of Labor shall notify the Secretary of Homeland Security of such finding and may, in addition, impose such other administrative remedies (including civil monetary penalties in an amount not to exceed $1,000 per emergency medical technician or paramedic per violation, with the total penalty not to exceed $10,000 per violation) as the Secretary of Labor determines to be appropriate. Upon receipt of such notice, the Secretary of Homeland Security shall not approve petitions filed with respect to an employer during a period of at least one year for emergency medical technicians or paramedics, as applicable to be employed by the employer. (v) In addition to the sanctions provided for under clause (iv), if the Secretary of Labor finds, after notice and an opportunity for a hearing, that an employer has violated the condition attested to under subparagraph (A)(ii) (relating to payment of emergency medical technicians or paramedics at the prevailing wage rate), the Secretary shall order the employer to provide for payment of such amounts of back pay as may be required to comply with such condition. (F) (i) The Secretary of Labor shall impose on an employer filing an attestation under subparagraph (A) a filing fee, in an amount prescribed by the Secretary based on the costs of carrying out the Secretary's duties under this subsection, but not exceeding $250. (ii) Fees collected under this subparagraph shall be deposited in a fund established for this purpose in the Treasury of the United States. (iii) The collected fees in the fund shall be available to the Secretary of Labor, to the extent and in such amounts as may be provided in appropriations Acts, to cover the costs described in clause (i), in addition to any other funds that are available to the Secretary to cover such costs. (3) Period of admission The period of admission of an alien under section 101(a)(15)(H)(i)(d) shall be 3 years, and may be extended for an additional 3-year period. (4) Numerical limitation (A) In general The total number of aliens who may be issued visas or otherwise provided nonimmigrant status during any fiscal year under section 101(a)(15)(H)(i)(d) may not exceed 2,500. The numerical limitation under this subparagraph shall be allocated for a fiscal year so that the total number of aliens subject to such numerical limit who enter the United States pursuant to a visa or are accorded nonimmigrant status under section 101(a)(15)(H)(i)(d) during the first 6 months of such fiscal year is not more than 1,250. (B) Adjustment by Secretary Beginning in the fourth fiscal year that begins after the date of enactment of this paragraph, the Secretary of Homeland Security, in consultation with the Secretary of Labor and other relevant stakeholders, may adjust the numerical limitation under subparagraph (A), as the Secretary finds appropriate. In making such determination, the Secretary shall consider the following: (i) The current and projected demand for emergency medical technicians and paramedics in the United States. (ii) The capacity of United States educational and training institutions to produce emergency medical technicians and paramedics. (iii) The potential impact of the admission of nonimmigrants under section 101(a)(15)(H)(i)(d) on the domestic labor market, including wages, working conditions, and employment opportunities for United States workers. (iv) The need to balance the admission of foreign emergency medical technicians and paramedics with the protection of United States workers and the promotion of domestic workforce development initiatives. The Secretary of Homeland Security is authorized to grant exemptions from the numerical limitation under this paragraph in cases of extreme hardship, national interest, or other compelling circumstances, as determined on a case-by-case basis. (5) Wage rates; unions An employer that has filed a petition under section 101(a)(15)(H)(i)(d) to employ a nonimmigrant to perform emergency medical technician or paramedic services for the employer— (A) shall provide the nonimmigrant a wage rate and working conditions commensurate with those of emergency medical technicians or paramedics, as applicable, similarly employed by the employer; (B) shall require the nonimmigrant to work hours commensurate with those of emergency medical technicians or paramedics, as applicable, similarly employed by the employer; and (C) may not engage in any unfair labor practice listed in section 8 of the National Labor Relations Act ( 29 U.S.C. 158 ) with respect to any such employee, or otherwise interfere with the employee's rights under section 7 of such Act ( 29 U.S.C. 157 ). (6) Report to Congress The Secretary of Homeland Security and the Secretary of Labor shall submit to Congress an annual report on admission of nonimmigrants under section 101(a)(15)(H)(i)(d), which report shall include the following: (A) The impact of the admission of such nonimmigrants on the emergency medical technician and paramedic workforce, as well as any instances of fraud, abuse, or non-compliance with the requirements under this subsection. (B) The number of visas issued under such section and the number of applications received during the previous fiscal year. (C) The distribution of such nonimmigrants by geographic region, State, and type of employer. (D) The prevailing wages paid to such nonimmigrants and any wage disparities with similarly employed United States workers. (E) Any violations of labor conditions or program requirements identified by the Secretary of Labor, including any action taken to address such a violation. (F) Recommendations for improving the admission of such nonimmigrants or addressing any identified barriers to admission. (7) Monitoring The Secretary of Homeland Security and the Secretary of Labor shall develop and implement procedures to monitor employer compliance with the requirements under this subsection, including periodic site visits, audits, and investigations based on complaints or other credible information. (8) Definition For purposes of paragraph (2)(A)(iv), the term lay off , with respect to a worker has the meaning given such term in subsection (m). . 3. Effective date (a) In general This Act and the amendments made by this Act shall take effect 180 days after the date of enactment of this Act. (b) Regulations The Secretary of Homeland Security and the Secretary of Labor shall issue regulations and guidance as necessary to implement the amendments made by this Act, including the following: (1) Developing and publishing application forms and instructions for employers and aliens seeking admission under section 101(a)(15)(H)(i)(d) of the Immigration and Nationality Act ( 8 U.S.C. 1101(a)(15)(H) ). (2) Establishing procedures for conducting background checks and security screenings, and enforcing labor protections. (3) Coordinating with other relevant government agencies, such as the Federal Bureau of Investigation and State licensing boards, to ensure effective implementation and compliance with the requirements under section 212(u) of the Immigration and Nationality Act ( 8 U.S.C. 1182 ). (4) Providing training and resources to Department of Homeland Security and Department of Labor staff responsible for administering the admission of aliens under such section 101(a)(15)(H)(i)(d), as well as any other relevant stakeholders.