,i  #aah? ,,congress  #b;d ,session  ,h4
 ,r4 #ajjjg  ,,9 ,,! ,,h\se ,,(         
,,repres5tatives  ,octob] #ah1 #bjbd,mr4
 ,higg9s ( ,l\isiana introduc$ ! foll[+ 
bill2 :i* 0 ref]r$ to ! ,committee on ! 
,judici>y  ,a ,,bill  ,to am5d !        
,immigration & ,nationality ,act to     
au?orize ! admission ( nonimmigrant     
em]g5cy m$ical te*nicians & p>am$ics4   
#a4 ,%ort title ,?is ,act may be cit$ z 
! ,p>am$ic & ,em]g5cy ,m$ical ,te*nician
 ,relief ,act ( #bjbd4  #b4 ,e/abli%m5t 
( ,h-#a;,d visas = ,e,m,ts & p>am$ics   
7a7 ,nonimmigrant category ,section     
#aja7;a77#ae77;,h77i7 ( ! ,immigration &
 ,nationality ,act 7#h ,u4,s4,c4        
#aaja7;a77#ae77;,h77i77 is am5d$ by     
/rik+ 2 or at ! end & ins]t+ 1 or 7d7 :o
 is com+ tempor>ily to ! ,unit$ ,/ates  
to p]=m s]vices z an em]g5cy m$ical     
te*nician or p>am$ic1 :o meets !        
qualifications describ$ 9 section       
#bab7u7 1 & ) respect to :om ! ,secret>y
 ( ,labor det]m9es & c]tifies to !      
,secret>y ( ,homel& ,security t an      

unexpir$ atte/ation is on file & 9      
effect "u section #bab7u77#b7 = !       
employ]2 or4  7b7 ,requirem5ts ,section 
#bab ( ! ,immigration & ,nationality    
,act 7#h ,u4,s4,c4 #aahb7 is am5d$ by   
add+ at ! end ! foll[+3  7u7            
,requirem5ts = admission ( nonimmigrant 
,e,m,ts & p>am$ics  7#a7 ,qualifications
 ,! qualifications ref]r$ to 9 section  
#aja7;a77#ae77;,h77i77d71 ) respect to  
an ali5 :o is com+ to ! ,unit$ ,/ates to
 p]=m s]vices z an em]g5cy m$ical       
te*nician or p>am$ic1 are t ! ali5--    
7,a7 has1 at a m9imum1 obta9$ em]g5cy   
m$ical te*nician1 p>am$ic1 or equival5t 
pre-hospital c>e1 education or tra9+ 9 a
 =eign c\ntry or 9 ! ,unit$ ,/ates2     
7,b7 n lat] ?an #ab weeks be=e ! ali5's 
int5d$ fir/ date ( employm5t 9 ! ,unit$ 
,/ates1 has pass$ an appropriate        
exam9ation 7recogniz$ 9 regulations     
promulgat$ 9 consultation ) ! ,secret>y 
( ,heal? & ,human ,s]vices7 or has      
obta9$ ! appropriate c]tificate or      
lic5se "u ,/ate law to practice z an    

em]g5cy m$ical te*nician or p>am$ic 9 ! 
,/ate ( int5d$ employm5t2  7,c7 n lat]  
?an #ab weeks be=e ! ali5's int5d$ fir/ 
date ( employm5t 9 ! ,unit$ ,/ates1 is  
fully qualifi$ & eligible "u ! laws     
7includ+ su* tempor>y or int]im lic5s+  
requirem5ts :i* au?orize ! em]g5cy      
m$ical te*nician or p>am$ic to be       
employ$7 gov]n+ ! place ( int5d$        
employm5t to engage 9 practice z an     
em]g5cy m$ical te*nician or a p>am$ic   
imm$iately ^u admission to ! ,unit$     
,/ates2 &  7,d7 n lat] ?an #ab weeks    
be=e ! ali5's int5d$ fir/ date (        
employm5t 9 ! ,unit$ ,/ates1 has pass$  
appropriate crim9al record *ecks & o!r  
backgr\nd & database *ecks1 z det]m9$ by
 ! ,secret>y ( ,homel& ,security 9      
coord9ation ) ! ,attorney ,g5]al1       
includ+ biometric data collection1 a    
review ( ! applicant's crim9al &        
immigration records1 v]ification ( !    
applicant's id5tity & travel hi/ory1 &  
an assessm5t ( any pot5tial risk !      
applicant poses to public safety or     

national security4  7#b7 ,atte/ation    
7,a7 ,! atte/ation ref]r$ to 9 section  
#aja7;a77#ae77;,h77i77d71 ) respect to  
an employ] = :i* an ali5 w p]=m s]vices1
 is an atte/ation z to ! foll[+3 7i7 ,! 
employm5t ( ! ali5 w n adv]sely affect !
 wages & work+ conditions ( em]g5cy     
m$ical te*nicians or p>am$ics1 z        
applicable1 simil>ly employ$4  7ii7 ,!  
ali5 employ$ by ! employ] w be paid !   
wage rate = em]g5cy m$ical te*nicians or
 p>am$ics1 z applicable1 simil>ly       
employ$ by ! employ]4  7iii7 ,! employ] 
has tak5 & is tak+ timely & significant 
/eps design$ to recruit & reta9         
suffici5t em]g5cy m$ical te*nicians or  
p>am$ics1 z applicable1 :o are ,unit$   
,/ates citiz5s or immigrants :o are     
au?oriz$ to p]=m su* s]vices4  7iv7 ,!re
 is n a /rike or lock\t 9 ! c\rse ( a   
labor dispute1 ! employ] did n lay (f & 
w n lay (f an em]g5cy m$ical te*nician  
or a p>am$ic1 z applicable1 employ$ by !
 employ] )9 ! p]iod beg9n+ #ij days be=e
 & end+ #ij days aft] ! date ( fil+ (   

any visa petition1 & ! employm5t ( su*  
an ali5 is n int5d$ or design$ to       
influ5ce an election = a b>ga9+         
repres5tative = em]g5cy m$ical          
te*nicians or p>am$ics ( ! employ]4  7v7
 ,at ! "t ( ! fil+ ( ! petition =       
em]g5cy m$ical te*nicians or p>am$ics1 z
 applicable1 "u section                 
#aja7;a77#ae77;,h77i77d71 notice ( !    
fil+ has be5 provid$ by ! employ] to !  
b>ga9+ repres5tative ( ! em]g5cy m$ical 
te*nicians or p>am$ics employ$ by !     
employ] or1 :]e !re is no su* b>ga9+    
repres5tative1 notice ( ! fil+ has be5  
provid$ to ! em]g5cy m$ical te*nicians  
or p>am$ics employ$ by ! employ] ?r\gh  
po/+ 9 conspicu\s locations or          
electronic notification to su*          
employees4  7vi7 ,! employ] w n1 at any 
"t1 employ a numb] ( ali5s issu$ visas  
or o!rwise provid$ nonimmigrant /atus "u
 section #aaja7;a77#ae77;,h77i77d7 ( ?is
 title z em]g5cy m$ical te*nicians or   
p>am$ics t exce$s #ae p]c5t ( ! total   
numb] ( em]g5cy m$ical te*nicians or    

p>am$ics1 respectively1 employ$ by !    
employ]4  7vii7 ,! employ] is affiliat$ 
) an em]g5cy m$ical s]vices education   
program approv$ by ! applicable lic5s+  
body ( ! ,/ate 9 :i* ! ali5 w "w4 ,no?+ 
9 clause 7iii7 %all be con/ru$ z requir+
 an employ] to h tak5 significant /eps  
describ$ 9 su* clause be=e ! effective  
date ( ! ,p>am$ic & ,em]g5cy ,m$ical    
,te*nician ,relief ,act ( #bjbc4 ,a copy
 ( ! atte/ation ref]r$ to 9 section     
#aja7a77ae77;,h77i77d7 %all be provid$1 
)9 #cj days ( ! date ( fil+1 to em]g5cy 
m$ical te*nicians or p>am$ics1 z        
applicable1 employ$ by ! employ] on !   
date ( fil+4  7,b7 ,= purposes (        
subp>agraph 7,a77iii71 ea* ( ! foll[+   
%all be consid]$ a significant /ep      
reasonably design$ to recruit & reta9   
em]g5cy m$ical te*nicians or p>am$ics3  
7i7 ,op]at+ a tra9+ program = em]g5cy   
m$ical te*nicians or p>am$ics or f9anc+ 
7or provid+ p>ticipation 97 a tra9+     
program = em]g5cy m$ical te*nicians or  
p>am$ics4  7ii7 ,provid+ c>e] developm5t

 programs & o!r me?ods ( facilitat+     
nationals ( ! ,unit$ ,/ates to become   
em]g5cy m$ical te*nicians or p>am$ics4  
7iii7 ,pay+ em]g5cy m$ical te*nicians or
 p>am$ics wages at a rate equal to or   
high] ?an curr5tly be+ paid to em]g5cy  
m$ical te*nicians or p>am$ics simil>ly  
employ$ 9 ! geographic area4  7iv7      
,provid+ reasonable opportunities =     
mean+ful sal>y advancem5t by em]g5cy    
m$ical te*nicians or p>am$ics4  ,! /eps 
describ$ 9 ?is subp>agraph %all n be    
consid]$ to be an exclusive li/ ( !     
significant /eps t may be tak5 to meet !
 conditions ( subp>agraph 7,a77iii74    
,no?+ 9 ?is subp>agraph %all require an 
employ] to take m ?an "o /ep if !       
employ] c demon/rate t tak+ a second /ep
 is n reasonable4  7,c7 ,subject to     
subp>agraph 7,e71 an atte/ation "u      
subp>agraph 7,a7-- 7i7 %all expire on ! 
date t is ! lat] (-- 7,i7 ! end ( !     
"o-ye> p]iod beg9n+ on ! date ( its fil+
 ) ! ,secret>y ( ,labor2 or  7,,ii7 !   
end ( ! p]iod ( admission "u section    

#aja7;a77#ae77;,h77i77d7 ( ! la/ ali5 ) 
respect to ^: admission x 0 appli$ 79   
accordance ) clause 7ii772 &  7ii7 %all 
apply to petitions fil$ dur+ ! "o-ye>   
p]iod beg9n+ on ! date ( its fil+ ) !   
,secret>y ( ,labor if ! employ] /ates 9 
ea* su* petition t x cont9ues to comply 
) ! conditions 9 ! atte/ation4  7,d7 ,an
 employ] may meet ! requirem5ts "u ?is  
p>agraph ) respect to m ?an "o em]g5cy  
m$ical te*nician or p>am$ic 9 a s+le    
petition4  7,e7 7i7 ,! ,secret>y (      
,labor %all compile & make publicly     
available onl9e a li/ id5tify+ employ]s 
:i* h fil$ petitions = nonimmigrants "u 
section #aja7;a77#ae77;,h77i77d7 &1 =   
ea* su* employ]1 a copy ( ! employ]'s   
atte/ation "u subp>agraph 7,a7 7&       
accompany+ docum5tation7 & ea* su*      
petition fil$ by ! employ]4  7ii7 ,!    
,secret>y ( ,labor %all e/abli% a       
process1 includ+ reasonable "t limits1 =
 ! receipt1 inve/igation1 & disposition 
( compla9ts respect+ an employ]'s       
failure to meet conditions atte/$ to or 

an employ]'s misrepres5tation ( a       
mat]ial fact 9 an atte/ation4 ,compla9ts
 may be fil$ by any aggriev$ p]son or   
organization 7includ+ b>ga9+            
repres5tatives1 associations deem$      
appropriate by ! ,secret>y1 & o!r       
aggriev$ p>ties z det]m9$ "u regulations
 ( ! ,secret>y74 ,! ,secret>y %all      
conduct an inve/igation "u ?is clause if
 !re is reasonable cause to believe t an
 employ] fails to meet conditions atte/$
 to4 ,subject to ! "t limits e/abli%$ "u
 ?is clause1 ?is subp>agraph %all apply 
reg>dless ( :e!r an atte/ation is expir$
 or unexpir$ at ! "t a compla9t is fil$4
  7iii7 ,"u su* process1 ! ,secret>y    
%all provide1 )9 #ahj days aft] ! date  
su* a compla9t is fil$1 = a det]m9ation 
z to :e!r or n a basis exi/s to make a  
f9d+ describ$ 9 clause 7iv74 ,if !      
,secret>y det]m9es t su* a basis exi/s1 
! ,secret>y %all provide = notice ( su* 
det]m9ation to ! int]e/$ p>ties & an    
opportunity = a he>+ on ! compla9t )9   
#fj days ( ! date ( ! det]m9ation4  7iv7

 ,if ! ,secret>y ( ,labor f9ds1 aft]    
notice & opportunity = a he>+1 t an     
employ] 7= :i* an atte/ation is made7   
has fail$ to meet a condition atte/$ to 
or t !re 0 a misrepres5tation ( mat]ial 
fact 9 ! atte/ation1 ! ,secret>y (      
,labor %all notify ! ,secret>y ( ,homel&
 ,security ( su* f9d+ & may1 9 addition1
 impose su* o!r adm9i/rative rem$ies    
7includ+ civil monet>y p5alties 9 an    
am\nt n to exce$ #a1jjj p] em]g5cy      
m$ical te*nician or p>am$ic p]          
violation1 ) ! total p5alty n to exce$  
#aj1jjj p] violation7 z ! ,secret>y (   
,labor det]m9es to be appropriate4 ,^u  
receipt ( su* notice1 ! ,secret>y (     
,homel& ,security %all n approve        
petitions fil$ ) respect to an employ]  
dur+ a p]iod ( at lea/ "o ye> = em]g5cy 
m$ical te*nicians or p>am$ics1 z        
applicable to be employ$ by ! employ]4  
7v7 ,9 addition to ! sanctions provid$ =
 "u clause 7iv71 if ! ,secret>y ( ,labor
 f9ds1 aft] notice & an opportunity = a 
he>+1 t an employ] has violat$ !        

condition atte/$ to "u subp>agraph      
7,a77ii7 7relat+ to paym5t ( em]g5cy    
m$ical te*nicians or p>am$ics at !      
prevail+ wage rate71 ! ,secret>y %all   
ord] ! employ] to provide = paym5t ( su*
 am\nts ( back pay z may be requir$ to  
comply ) su* condition4  7,f7 7i7 ,!    
,secret>y ( ,labor %all impose on an    
employ] fil+ an atte/ation "u           
subp>agraph 7,a7 a fil+ fee1 9 an am\nt 
prescrib$ by ! ,secret>y bas$ on ! co/s 
( c>ry+ out ! ,secret>y's duties "u ?is 
subsection1 b n exce$+ #bej4  7ii7 ,fees
 collect$ "u ?is subp>agraph %all be    
deposit$ 9 a fund e/abli%$ = ?is purpose
 9 ! ,treasury ( ! ,unit$ ,/ates4  7iii7
 ,! collect$ fees 9 ! fund %all be      
available to ! ,secret>y ( ,labor1 to ! 
ext5t & 9 su* am\nts z may be provid$ 9 
appropriations ,acts1 to cov] ! co/s    
describ$ 9 clause 7i71 9 addition to any
 o!r funds t are available to !         
,secret>y to cov] su* co/s4  7#c7 ,p]iod
 ( admission ,! p]iod ( admission ( an  
ali5 "u section #aja7;a77#ae77;,h77i77d7

 %all be #c ye>s1 & may be ext5d$ = an  
additional #c-ye> p]iod4  7#d7 ,num]ical
 limitation  7,a7 ,9 g5]al ,! total     
numb] ( ali5s :o may be issu$ visas or  
o!rwise provid$ nonimmigrant /atus dur+ 
any fiscal ye> "u section               
#aja7;a77#ae77;,h77i77d7 may n exce$    
#b1ejj4 ,! num]ical limitation "u ?is   
subp>agraph %all be allocat$ = a fiscal 
ye> s t ! total numb] ( ali5s subject to
 su* num]ical limit :o ent] ! ,unit$    
,/ates pursuant to a visa or are accord$
 nonimmigrant /atus "u section          
#aja7;a77#ae77;,h77i77d7 dur+ ! fir/ #f 
mon?s ( su* fiscal ye> is n m ?an       
#a1bej4  7,b7 ,adju/m5t by ,secret>y    
,beg9n+ 9 ! f\r? fiscal ye> t beg9s aft]
 ! date ( enactm5t ( ?is p>agraph1 !    
,secret>y ( ,homel& ,security1 9        
consultation ) ! ,secret>y ( ,labor &   
o!r relevant /akehold]s1 may adju/ !    
num]ical limitation "u subp>agraph 7,a71
 z ! ,secret>y f9ds appropriate4 ,9 mak+
 su* det]m9ation1 ! ,secret>y %all      
consid] ! foll[+3 7i7 ,! curr5t &       

project$ dem& = em]g5cy m$ical          
te*nicians & p>am$ics 9 ! ,unit$ ,/ates4
  7ii7 ,! capacity ( ,unit$ ,/ates      
educational & tra9+ in/itutions to      
produce em]g5cy m$ical te*nicians &     
p>am$ics4  7iii7 ,! pot5tial impact ( ! 
admission ( nonimmigrants "u section    
#aja7;a77#ae77;,h77i77d7 on ! dome/ic   
labor m>ket1 includ+ wages1 work+       
conditions1 & employm5t opportunities = 
,unit$ ,/ates work]s4  7iv7 ,! ne$ to   
balance ! admission ( =eign em]g5cy     
m$ical te*nicians & p>am$ics ) !        
protection ( ,unit$ ,/ates work]s & !   
promotion ( dome/ic work=ce developm5t  
initiatives4  ,! ,secret>y ( ,homel&    
,security is au?oriz$ to grant          
exemptions f ! num]ical limitation "u   
?is p>agraph 9 cases ( extreme h>d%ip1  
national int]e/1 or o!r compell+        
circum/ances1 z det]m9$ on a            
case-by-case basis4  7#e7 ,wage rates2  
unions ,an employ] t has fil$ a petition
 "u section #aja7;a77#ae77;,h77i77d7 to 
employ a nonimmigrant to p]=m em]g5cy   

m$ical te*nician or p>am$ic s]vices = ! 
employ]-- 7,a7 %all provide !           
nonimmigrant a wage rate & work+        
conditions comm5surate ) ^? ( em]g5cy   
m$ical te*nicians or p>am$ics1 z        
applicable1 simil>ly employ$ by !       
employ]2  7,b7 %all require !           
nonimmigrant to "w h\rs comm5surate ) ^?
 ( em]g5cy m$ical te*nicians or         
p>am$ics1 z applicable1 simil>ly employ$
 by ! employ]2 &  7,c7 may n engage 9   
any unfair labor practice li/$ 9 section
 #h ( ! ,national ,labor ,relations ,act
 7#bi ,u4,s4,c4 #aeh7 ) respect to any  
su* employee1 or o!rwise int]f]e ) !    
employee's rights "u section #g ( su*   
,act 7#bi ,u4,s4,c4 #aeg74  7#f7 ,report
 to ,congress ,! ,secret>y ( ,homel&    
,security & ! ,secret>y ( ,labor %all   
submit to ,congress an annual report on 
admission ( nonimmigrants "u section    
#aja7;a77#ae77;,h77i77d71 :i* report    
%all include ! foll[+3 7,a7 ,! impact ( 
! admission ( su* nonimmigrants on !    
em]g5cy m$ical te*nician & p>am$ic      

work=ce1 z well z any in/ances ( fraud1 
abuse1 or non-compliance ) ! requirem5ts
 "u ?is subsection4  7,b7 ,! numb] (    
visas issu$ "u su* section & ! numb] (  
applications receiv$ dur+ ! previ\s     
fiscal ye>4  7,c7 ,! di/ribution ( su*  
nonimmigrants by geographic region1     
,/ate1 & type ( employ]4  7,d7 ,!       
prevail+ wages paid to su* nonimmigrants
 & any wage disp>ities ) simil>ly       
employ$ ,unit$ ,/ates work]s4  7,e7 ,any
 violations ( labor conditions or       
program requirem5ts id5tifi$ by !       
,secret>y ( ,labor1 includ+ any action  
tak5 to address su* a violation4  7,f7  
,recomm5dations = improv+ ! admission ( 
su* nonimmigrants or address+ any       
id5tifi$ b>ri]s to admission4  7#g7     
,monitor+ ,! ,secret>y ( ,homel&        
,security & ! ,secret>y ( ,labor %all   
develop & implem5t proc$ures to monitor 
employ] compliance ) ! requirem5ts "u   
?is subsection1 includ+ p]iodic site    
visits1 audits1 & inve/igations bas$ on 
compla9ts or o!r cr$ible in=mation4     

7#h7 ,def9ition ,= purposes ( p>agraph  
7#b77;,a77iv71 ! t]m lay (f1 ) respect  
to a work] has ! mean+ giv5 su* t]m 9   
subsection 7m74  4  #c4 ,effective date 
7a7 ,9 g5]al ,?is ,act & ! am5dm5ts made
 by ?is ,act %all take effect #ahj days 
aft] ! date ( enactm5t ( ?is ,act4  7b7 
,regulations ,! ,secret>y ( ,homel&     
,security & ! ,secret>y ( ,labor %all   
issue regulations & guidance z necess>y 
to implem5t ! am5dm5ts made by ?is ,act1
 includ+ ! foll[+3 7#a7 ,develop+ &     
publi%+ application =ms & in/ructions = 
employ]s & ali5s seek+ admission "u     
section #aja7;a77#ae77;,h77i77d7 ( !    
,immigration & ,nationality ,act 7#h    
,u4,s4,c4 #aaja7;a77#ae77;,h774  7#b7   
,e/abli%+ proc$ures = conduct+ backgr\nd
 *ecks & security scre5+s1 & en=c+ labor
 protections4  7#c7 ,coord9at+ ) o!r    
relevant gov]nm5t ag5cies1 su* z !      
,f$]al ,bureau ( ,inve/igation & ,/ate  
lic5s+ bo>ds1 to ensure effective       
implem5tation & compliance ) !          
requirem5ts "u section #bab7u7 ( !      

,immigration & ,nationality ,act 7#h    
,u4,s4,c4 #aahb74  7#d7 ,provid+ tra9+ &
 res\rces to ,dep>tm5t ( ,homel&        
,security & ,dep>tm5t ( ,labor /aff     
responsible = adm9i/]+ ! admission (    
ali5s "u su* section                    
#aja7;a77#ae77;,h77i77d71 z well z any  
o!r relevant /akehold]s4