,i  #aah? ,,congress  #a/ ,session  ,h4 
,r4 #agcg  ,,9 ,,! ,,h\se ,,(           
,,repres5tatives  ,m>* #bc1 #bjbc,mr4   
,kim ( ,new ,j]sey 7= himself1 ,mr4     
,c>ey1 ,mr4 ,fitzpatrick1 ,mr4 ,mol9>o1 
& ,ms4 ,p]ez7 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$ical ,s]vices     
7,,ems7 ,grant ,program ?r\gh :i* !     
,secret>y may make grants to qualifi$   
applicants1 & = 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    
7ref]r$ to 9 ?is ,act z ! ,secret>y7    
%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   

qualifi$ applicants4  7#b7 ,eligibility 
,to be eligible = a grant "u ! ,program1
 a qualifi$ applicant %all submit to !  
,secret>y 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$ ( 
! qualifi$ applicant4  7,b7 ,an analysis
 ( ! co/s & b5efits1 ) respect to       
improv+ m$ical transport & em]g5cy      
m$ical s]vices 7ref]r$ to 9 ?is section 
z ,,ems71 ( ! activities to be c>ri$ out
 ?r\gh ! grant4  7#c7 ,jo9t applications
 ,a qualifi$ applicant may submit a jo9t
 application ) "o or m o!r qualifi$     
applicants "u ?is subsection4  7#d7 ,pe]
 review ( grant applications ,!         
,secret>y1 aft] consultation ) national 
qualifi$ applicants1 %all appo9t        
repres5tatives ( volunte]1 gov]nm5tal1  
,tribal1 =-pr(it1 & nonpr(it qualifi$   
applicants & entities to conduct pe]    
review ( applications4  7#e7 ,selection 
consid]ations ,9 aw>d+ grants "u !      
,program ! ,secret>y %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 ( qualifi$ applicants 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 a qualifi$ applicant  
has previ\sly receiv$ ,f$]al fund+4     
7#f7 ,prioritization among =-pr(it      
qualifi$ applicants ,9 aw>d+ grants "u !
 ,program1 ! ,secret>y %all1 9 select+  
among qualifi$ applicants t op]ate =    
pr(it1 give priority to su* applicants t
 are small] = pr(it entities1 det]m9$ on
 an annual basis bas$ on ! net pr(its ( 
! entity & ! numb] ( employees hir$ dur+
 ! prec$+ ye>4  7b7 ,purposes ,grants   
made "u ! ,program may be us$ by        
recipi5t qualifi$ applicants = ! foll[+ 
purposes3 7#a7 ,ma9ta9+1 or1 if         
appropriate1 increas+1 ! numb] ( tra9$  
front-l9e ,,ems respond]s1 :e!r paid or 

volunte]1 includ+ provid+ sal>ies &     
/ip5ds4  7#b7 ,provid+ m5tal heal?      
programs = qualifi$ applicant p]sonnel4 
7#c7 ,cov]+ or reimburs+ co/s associat$ 
) c]tification & rec]tification c\rses4 
7#d7 ,obta9+ res\rces1 includ+ pur*as+  
p]sonal protective equipm5t1 uni=ms1    
m$ic9e1 & m$ical supplies4  7#e7        
,con/ruct+ or modify+ facilities 9 su* a
 way s z to improve cov]age1 response   
"t1 & ability ( qualifi$ applicants to  
provide m$ical transport & em]g5cy      
m$ical s]vices4  7#f7 ,upgrad+ or       
pur*as+ ,,ems vehicles1 communications  
equipm5t1 & mapp+ equipm5t4  7#g7       
,e/abli%+ or support+ community         
p>am$ic9e or mobile integrat$ heal?c>e  
initiatives4  7c7 ,allocation ( grant   
aw>ds  7#a7 ,limitation  7,a7 ,= pr(it  
7i7 ,9 g5]al ,n m ?an two p]c5t ( grants
 aw>d$ "u ! ,program may be made        
available to qualifi$ applicants 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  7ii7 ,maximum am\nt ,a grant "u 
! ,program to su* a =-pr(it qualifi$    
applicant 7if s+ly7 or to su* qualifi$  
applicants 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  7iii7 ,purposes ,a qualifi$  
applicant t op]ates = pr(it may use     
funds aw>d$ ?r\gh a grant "u ! ,program 
only = ! purposes specifi$ 9 p>agraphs  
7#a71 7#b71 & 7#c7 ( subsection 7b74    
7,b7 ,"t-bas$ ,a =-pr(it qualifi$       
applicant 7if s+ly7 or qualifi$         
applicants 7if a result ( a jo9t        
application7 aw>d$ a grant "u ! ,program
 may n apply = ano!r su* aw>d = a p]iod 
( ?ree ye>s4  7#b7 ,fur!r limitation ,a 
grant "u ! ,program to a n-=-pr(it      
qualifi$ applicant 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 qualifi$ applicants 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 ( qualifi$ applicants  
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 qualifi$     
applicants 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 = ea* ( ! fir/ #e
 fiscal ye>s foll[+ ! date ( ! enactm5t 
( ?is ,act1 #ej1jjj1jjj to c>ry out !   
,program2 &  7#b7 = ea* ( su* fiscal    
ye>s1 #e1jjj1jjj to provide te*nical    
assi/ance to qualifi$ applicants        
complet+ & submitt+ applications4  7h7  
,reports  7#a7 ,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$ical s]vices2 &  
7,b7 provides recomm5dations =          
improvem5t ) respect to provid+ su*     
reimbursem5t4  7#b7 ,qualifi$ applicants
 ,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>$ness & ,response1 & ,,ems        
/akehold]s1 %all submit to ,congress a  
report t-- 7,a7 describes ! *all5ges    
specific to qualifi$ applicants1 includ+
 ) respect to ,f$]al1 ,/ate1 & private  
7includ+ private insur]s7 reimbursem5t  
rates & policies2 &  7,b7 conta9s an    
action plan to address su* *all5ges     
?r\gh grants & o!r adm9i/rative action4 
7#c7 ,e/abli%+ a ,f$]al ,,ems ,(fice ,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>$ness & ,response1 & ,,ems        
/akehold]s1 %all submit to ,congress a  
report t assesses ! feasibility (       
e/abli%+ a ,f$]al (fice to-- 7,a7 bett] 
advocate = ,,ems p]sonnel1 collect data1
 promote ,,ems education1 rese>*1 &     
tra9+2 &  7,b7 implem5t recomm5dations &
 action plans bas$ on ! f9d+s 9 !       
reports "u p>agraphs 7#a7 & 7#b74  7i7  
,def9itions ,9 ?is section3 7#a7 ,,ems  
organization ,! t]m ,,ems organization  
means a nongov]nm5tal or gov]nm5tal     
entity t provides 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 provid$ 7ei!r on a

 comp5sat$ or volunte] basis7 at !      
location ( ! em]g5cy or en r\te to1 or  
at1 a heal? c>e facility 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 ,m$ical      
transport ,! t]m m$ical transport means 
! transportation1 by ambulance1 ( sick1 
injur$1 or o!rwise incapacitat$ p]sons  
:o require em]g5cy m$ical c>e to a heal?
 c>e facility1 includ+ a hospital1      
cl9ic1 or alt]native de/9ation4  7#d7   
,qualifi$ applicant ,! t]m qualifi$     
applicant means-- 7,a7 an ,,ems         
organization2 or  7,b7 a ,/ate 7or a    
political subdivision !re(71 ,indian    
,tribe1 ,tribal organization 7z ^? t]ms 
are def9$ 9 section #d ( ! ,indian      
,self-,det]m9ation & ,education         
,assi/ance ,act 7#be ,u4,s4,c4 #ecjd771 
t]ritory1 or municipality4  7#e7 ,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    
7#f7 ,/ate ,! t]m ,/ate means a ,/ate ( 
! ,unit$ ,/ates1 ! ,di/rict ( ,columbia1
 ,pu]to ,rico1 ! ,virg9 ,isl&s1 ,am]ican
 ,samoa1 ! ,nor!rn ,m>iana ,isl&s1 &    
,guam4