,,ii #aagth ,,congress #b;d ,session ,s4 #ciaj ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #bc1 #bjbb,mr4 ,sanders 7for himself and ,ms4 ,smith7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend the ,public ,health ,service ,act to establish a funding program for supporting ,,ems organizations1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,,ems ,staffing and ,support ,act4 #b4 ,,ems organization funding ,part ,p of title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bhj;g et seq47 is amended by adding at the end the following3 #cii,v-#g4 ,,ems organization funding 7a7 ,definitions ,in this section3 7#a7 ,indian ,tribe2 ,tribal organization ,the terms ,indian ,tribe and ,tribal organization have the meanings given such terms in section #d of the ,indian ,self-,determination and ,education ,assistance ,act4 7#b7 ,,ems organization ,the term ,,ems organization means a public or private entity that provides medical transport and emergency medical services4 7#c7 ,emergency medical services ,the term emergency medical services has the meaning given such term in section #ccj;,j7e74 7#d7 ,qualified applicant ,the term qualified applicant means-- 7,a7 an ,,ems organization1 other than an ,,ems organization that operates for profit2 7,b7 a ,state1 ,indian ,tribe1 ,tribal organization1 county1 or municipality2 or 7,c7 any other nonprofit organization that represents the interests of ,,ems organizations4 7#e7 ,state ,the term ,state means any ,state of the ,united ,states1 the ,district of ,columbia1 the ,commonwealth of ,puerto ,rico1 ,american ,samoa1 ,guam1 the ,united ,states ,virgin ,islands1 the ,commonwealth of the ,northern ,mariana ,islands1 and any other territory or possession of the ,united ,states4 7b7 ,competitive grants 7#a7 ,in general ,beginning in fiscal year #bjbc1 the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall award grants on a competitive basis to qualified applicants to carry out activities described in subsection 7d7 in order to support ,,ems organizations in the ,united ,states4 7#b7 ,applications 7,a7 ,in general ,a qualified applicant seeking a grant under this subsection shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary may reasonably require1 including-- 7i7 a description of the financial need of the qualified applicant 7or each qualified applicant in the case of a joint application described in subparagraph 7,b772 and 7ii7 an analysis of the costs and benefits1 with respect to improving medical transport and emergency medical services1 of the activities to be carried out through the grant4 7,b7 ,joint applications ,a qualified applicant may submit a joint application with #a or more other qualified applicants under this subsection4 7,c7 ,peer review of grant applications 7i7 ,in general ,the ,secretary1 after consultation with national emergency medical services organizations1 shall appoint emergency medical service personnel to conduct peer reviews of applications received under this subsection4 7ii7 ,applicability of ,federal ,advisory ,committee ,act ,the ,federal ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app47 shall not apply to activities carried out under this subparagraph4 7,d7 ,prioritization of grant awards ,in awarding grants under this subsection1 the ,secretary shall consider each of the following3 7i7 ,the findings and recommendations of the peer reviews carried out under subparagraph 7,c74 7ii7 ,the degree to which an award will improve the coverage1 response times1 and ability of ,,ems organizations to provide medical transport and emergency medical services4 7iii7 ,the extent of the need of an applicant for a grant under this subsection and the need to protect the ,united ,states as a whole4 7c7 ,contracts or compacts with ,indian ,tribes and ,tribal organizations 7#a7 ,in general ,beginning in fiscal year #bjbc1 the ,secretary1 acting through the ,administrator of the ,health ,resources and ,services ,administration1 shall award funding through contracts or compacts pursuant to the ,indian ,self-,determination and ,education ,assistance ,act1 distributed on a fair and equitable formula as developed through consultation with ,indian ,tribes and ,tribal organizations1 to ,indian ,tribes and ,tribal organizations to carry out activities described in subsection 7d7 in order to support ,,ems organizations in ,tribal communities4 7#b7 ,applications ,an ,indian ,tribe or ,tribal organization seeking funding under this subsection shall submit an application to the ,secretary at such time1 in such manner1 and containing such information as the ,secretary requires through consultation with ,indian ,tribes and ,tribal organizations4 7d7 ,activities 7#a7 ,in general ,grants or other funding awarded under this section may be used to support ,,ems organizations through any of the following3 7,a7 ,hiring ,,ems organization personnel4 7,b7 ,recruiting and retaining volunteer ,,ems organization personnel4 7,c7 ,providing training or reimbursing personnel for training4 7,d7 ,conducting courses and implementing apprenticeship programs that qualify graduates to serve in an ,,ems organization in accordance with ,state and local requirements4 7,e7 ,purchasing necessary equipment4 7,f7 ,purchasing medicine and medical supplies4 7,g7 ,purchasing ,,ems vehicles4 7,h7 ,wellness and fitness programs for ,,ems organization personnel4 7,i7 ,modifying facilities4 7,j7 ,improving regional coordination among ,,ems organizations4 7,k7 ,establishing or supporting community paramedicine or mobile integrated health care initiatives4 7,l7 ,any other activity the ,secretary determines appropriate4 7#b7 ,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 services1 or medical transport1 for profit4 7e7 ,amount ,each grant awarded under subsection 7b71 or funding through a contract or compact under subsection 7c71 shall be in an amount not to exceed #a1jjj1jjj4 7f7 ,appropriations 7#a7 ,awards 7,a7 ,in general ,there is authorized to be appropriated1 and there is appropriated1 to the ,secretary to award grants1 and funding through contracts or compacts1 under this section-- 7i7 for fiscal year #bjbc1 #ejj1jjj1jjj2 and 7ii7 for each fiscal year thereafter1 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 7all items2 ,united ,states city average7 for the most recent #ab-month period for which applicable data is available4 7,b7 ,contracts and compacts ,of the amount appropriated under subparagraph 7,a7 for each fiscal year1 not less than #e percent shall be set aside to carry out subsection 7c74 7#b7 ,technical assistance ,there is authorized to be appropriated1 and there is appropriated1 to the ,secretary to provide technical assistance to entities completing and submitting applications under this section-- 7,a7 for fiscal year #bjbc1 #aj1jjj1jjj2 and 7,b7 for each fiscal year thereafter1 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 7all items2 ,united ,states city average7 for the most recent #ab-month period for which applicable data is available4 4 #c4 ,reports 7a7 ,in general ,not later than #ij days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 in consultation with the ,administrator of the ,centers for ,medicare ,medicaid ,services1 the ,administrator of the ,health ,resources and ,services ,administration1 the ,assistant ,secretary for ,preparedness and ,response1 and ,,ems stakeholders1 shall submit to ,congress a report detailing the challenges1 disparities1 and inadequacies in providing ,federal1 ,state1 and private 7including commercial insurers7 reimbursement for medical transport and emergency medical services and providing recommendations for improvement with respect to providing such reimbursement4 7b7 ,rural ,,ems organizations ,not later than #ij days after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 in consultation with the ,administrator of the ,centers for ,medicare ,medicaid ,services1 the ,administrator of the ,health ,resources and ,services ,administration1 the ,assistant ,secretary for ,preparedness and ,response1 and ,,ems stakeholders1 shall submit to ,congress a report on the challenges specific to rural ,,ems organizations1 including with respect to ,federal1 ,state1 and private 7including private insurers7 reimbursement rates and policies1 and develop an action plan to address those challenges through grants and other administrative action4