,i  #aag? ,,congress  #b;d ,session  ,h4
 ,r4 #hiid  ,,9 ,,! ,,h\se ,,(          
,,repres5tatives  ,septemb] #bh1 #bjbb  
,mr4 ,kim ( ,new ,j]sey 7= himself1 ,mr4
 ,mull91 ,mrs4 ,axne1 ,mr4 ,veasey1 ,mr4
 ,lawson ( ,florida1 ,mr4 ,we/]man1 &   
,mr4 ,c>ey7 introduc$ ! foll[+ bill2 :i*
 0 ref]r$ to ! ,committee on ,en]gy &   
,comm]ce  ,a ,,bill  ,to direct !       
,secret>y ( ,heal? & ,human ,s]vices to 
e/abli% ! ,em]g5cy ,m$ical ,s]vices     
7,,ems7 ,grant ,program ?r\gh :i* !     
,secret>y may make grants to ,,ems      
organizations1 & = o!r purposes4  #a4   
,%ort title ,?is ,act may be cit$ z !   
,support+ ,our ,fir/ ,respond]s ,act4   
#b4 ,em]g5cy ,m$ical ,s]vices ,grant    
,program  7a7 ,em]g5cy ,m$ical ,s]vices 
,grant ,program  7#a7 ,9 g5]al ,!       
,secret>y ( ,heal? & ,human ,s]vices    
%all e/abli% a program1 to be kn[n z !  
,em]g5cy ,m$ical ,s]vices 7,,ems7 ,grant
 ,program 79 ?is section ref]r$ to z !  
,program71 ?r\gh :i* ! ,secret>y %all   
aw>d grants on a competitive basis to   

,,ems organizations4  7#b7 ,eligibility 
,to be eligible = a grant "u ! ,program1
 an ,,ems organization %all submit to ! 
,secret>y ( ,heal? & ,human ,s]vices an 
application at su* a "t1 9 su* mann]1 & 
conta9+ su* in=mation z ! ,secret>y may 
require1 includ+ ! foll[+3 7,a7 ,a      
description ( ! f9ancial ne$ ( ! ,,ems  
organization4  7,b7 ,an analysis ( !    
co/s & b5efits1 ) respect to improv+    
m$ical transport & em]g5cy m$ical       
s]vices1 ( ! activities to be c>ri$ out 
?r\gh ! grant4  7#c7 ,jo9t applications 
,an ,,ems organization may submit a jo9t
 application ) "o or m o!r ,,ems        
organizations "u ?is subsection4  7#d7  
,pe] review ( grant applications ,!     
,secret>y ( ,heal? & ,human ,s]vices1   
aft] consultation ) national ,,ems      
organizations1 %all appo9t              
repres5tatives ( volunte]1 municipal1   
=-pr(it1 & nonpr(it ,,ems organizations 
& entities to conduct pe] review (      
applications4  7#e7 ,prioritization (   
grant aw>ds ,9 aw>d+ grants "u !        

,program ! ,secret>y ( ,heal? & ,human  
,s]vices %all consid] ea* ( ! foll[+3   
7,a7 ,! f9d+s & recomm5dations ( ! pe]  
reviews c>ri$ out "u p>agraph 7#d74     
7,b7 ,! degree to :i* an aw>d w improve 
! cov]age1 response times1 & ability (  
,,ems organizations to provide m$ical   
transport & em]g5cy m$ical s]vices4     
7,c7 ,! ext5t ( ! ne$ ( an applicant = a
 grant "u ?is subsection & ! ne$ to     
protect ! ,unit$ ,/ates z a :ole4  7,d7 
,:e!r an ,,ems organization has         
previ\sly receiv$ ,f$]al fund+4  7b7    
,purposes ,grants made "u ! ,program may
 be us$ by recipi5t ,,ems organizations 
= ! foll[+ purposes3 7#a7 ,ma9ta9+1 or1 
if appropriate1 increas+1 ! numb] (     
tra9$ front-l9e ,,ems respond]s1 includ+
 provid+ sal>ies & /ip5ds1 provid+      
wellness & fitness programs = ,,ems     
organization p]sonnel1 & cov]+ or       
reimburs+ co/s associat$ ) c]tification 
& rec]tification c\rses4  7#b7 ,obta9+  
res\rces1 includ+ pur*as+ ,,ems         
vehicles1 p]sonal protective equipm5t1  

uni=ms1 m$ic9e1 & m$ical supplies4  7#c7
 ,modify+ facilities4  7#d7 ,any o!r    
activity ! ,secret>y det]m9es           
appropriate4  7c7 ,allocation ( grant   
aw>ds  7#a7 ,limitation ,n m ?an two    
p]c5t ( grants aw>d$ "u ! ,program may  
be made available to ,,ems organizations
 t op]ate = pr(it or to o!rwise support 
ef=ts to e/abli% or provide em]g5cy     
m$ical s]vices1 or m$ical transport1 =  
pr(it4 ,a grant "u ! ,program to su* a  
=-pr(it ,,ems organization 7if s+ly7 or 
to su* ,,ems organizations 7if a result 
( a jo9t application7 or to o!rwise s   
support su* ef=ts %all be 9 an am\nt n  
to exce$ #ajj1jjj4  7#b7 ,fur!r         
limitation ,a grant "u ! ,program to a  
n-=-pr(it ,,ems organization or a jo9t  
application %all be 9 an am\nt n to     
exce$ #cjj1jjj4  7#c7 ,res]vation ,n    
less ?an #bj p]c5t ( grants aw>d$ "u !  
,program %all be made available to ,,ems
 organizations 9 rural areas4  7d7      
,metrics ,! ,secret>y ( ,heal? & ,human 
,s]vices %all develop metrics to assess 

! effectiv5ess ( ! ,program 9 improv+ ! 
cov]age1 response times1 & ability (    
,,ems organizations to provide m$ical   
transport & em]g5cy m$ical s]vices4  7e7
 ,claw backs ,! ,secret>y ( ,heal? &    
,human ,s]vices %all make e available   
ef=t to recov] grant funds 9 case (     
noncompliance4 ,to c>ry out ?is         
subsection1 ! ,secret>y %all e/abli% a  
process ?r\gh :i* notification is       
convey$ to ,,ems organizations det]m9$  
to be 9 noncompliance1 & su*            
organizations are provid$ an opportunity
 to respond to su* notification prior to
 ! recov]y ( su* funds4  7f7            
,assessm5ts2 reports ,n lat] ?an two    
ye>s aft] ! date ( ! enactm5t ( ?is ,act
 & n less frequ5tly ?an bi5nially aft]1 
! ,secret>y ( ,heal? & ,human ,s]vices  
%all-- 7#a7 conduct an assessm5t ( !    
,program bas$ on ! metrics develop$     
pursuant to subsection 7d72 &  7#b7     
submit to ! ,committee on ,en]gy &      
,comm]ce ( ! ,h\se ( ,repres5tatives & !
 ,committee on ,heal?1 ,education1      

,labor1 & ,p5sions ( ! ,s5ate a report  
summ>iz+ ! f9d+s ( ! assessm5t &        
recomm5dations to /r5g!n ! ov]all       
program4  7g7 ,au?orization (           
appropriations ,!re is au?oriz$ to be   
appropriat$ to ! ,secret>y ( ,heal? &   
,human ,s]vices--  7#a7 #ej1jjj1jjj =   
ea* ( fiscal ye>s #bjbc ?r\gh #bjbg to  
c>ry out ! ,program2 &  7#b7 #e1jjj1jjj 
= ea* ( su* fiscal ye>s to provide      
te*nical assi/ance to ,,ems             
organizations complet+ & submitt+       
applications4  7h7 ,def9itions ,9 ?is   
section3 7#a7 ,,ems organization ,! t]m 
,,ems organization means a nongov]nm5tal
 or gov]nm5tal entity t provides m$ical 
transport & em]g5cy m$ical s]vices4     
7#b7 ,em]g5cy m$ical s]vices ,! t]m     
em]g5cy m$ical s]vices-- 7,a7 means     
res\rces us$ by a lic5s$ entity to      
deliv] m$ical c>e outside ( a m$ical    
facility "u em]g5cy conditions t occur z
 a result ( ! condition ( ! pati5t2 &   
7,b7 includes s]vices deliv]$ 7ei!r on a
 comp5sat$ or volunte] basis7 by an     

em]g5cy m$ical s]vices provid] or o!r   
provid] t is lic5s$ or c]tifi$ by !     
,/ate involv$ z an em]g5cy m$ical       
te*nician1 a p>am$ic1 or an equival5t   
pr(essional 7z det]m9$ by ! ,/ate74     
7#c7 ,rural area ,! t]m rural area      
means--  7,a7 a nonmetropolitan         
/ati/ical area2  7,b7 an area designat$ 
z a rural area by any law or regulation 
( a ,/ate2 or  7,c7 a rural c5sus tract 
( a metropolitan /ati/ical area 7z      
det]m9$ "u ! mo/ rec5t rural urban      
commut+ area code z set =? by ! ,(fice (
 ,managem5t & ,budget74  #c4 ,reports   
7a7 ,9 g5]al ,n lat] ?an #ij days aft] !
 date ( ! enactm5t ( ?is ,act1 !        
,secret>y ( ,heal? & ,human ,s]vices1 9 
consultation ) ! ,adm9i/rator ( ! ,c5t]s
 = ,m$ic>e & ,m$icaid ,s]vices1 !       
,adm9i/rator ( ! ,heal? ,res\rces &     
,s]vices ,adm9i/ration1 ! ,assi/ant     
,secret>y = ,prep>$ness & ,response1 &  
,,ems /akehold]s1 %all submit to        
,congress a report t--  7#a7 details !  
*all5ges1 disp>ities1 & inadequacies 9  

provid+ ,f$]al1 ,/ate1 & private        
7includ+ comm]cial insur]s7 reimbursem5t
 = m$ical transport & em]g5cy m$ical    
s]vices2 &  7#b7 provides recomm5dations
 = improvem5t ) respect to provid+ su*  
reimbursem5t4  7b7 ,,ems organizations  
,n lat] ?an #ij days aft] ! date ( !    
enactm5t ( ?is ,act1 ! ,secret>y (      
,heal? & ,human ,s]vices1 9 consultation
 ) ! ,adm9i/rator ( ! ,c5t]s = ,m$ic>e &
 ,m$icaid ,s]vices1 ! ,adm9i/rator ( !  
,heal? ,res\rces & ,s]vices             
,adm9i/ration1 ! ,assi/ant ,secret>y =  
,prep>$ness & ,response1 & ,,ems        
/akehold]s1 %all submit to ,congress a  
report t-- 7#a7 describes ! *all5ges    
specific to ,,ems organizations1 includ+
 ) respect to ,f$]al1 ,/ate1 & private  
7includ+ private insur]s7 reimbursem5t  
rates & policies2 &  7#b7 conta9s an    
action plan to address su* *all5ges     
?r\gh grants & o!r adm9i/rative action4