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106th CONGRESS
  2d Session
                                 S. 3125

 To amend the Public Health Service Act, the Internal Revenue Code of 
 1986, and title XVIII of the Social Security Act to sustain access to 
            vital emergency medical services in rural areas.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

           September 27 (legislative day, September 22), 2000

  Mr. Conrad introduced the following bill; which was read twice and 
                  referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


 
 To amend the Public Health Service Act, the Internal Revenue Code of 
 1986, and title XVIII of the Social Security Act to sustain access to 
            vital emergency medical services in rural areas.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Sustaining Access 
to Vital Emergency Medical Services Act of 2000''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Rural emergency medical service training and equipment 
                            assistance program.
Sec. 3. Tax credit for volunteer emergency medical service providers.
Sec. 4. Study and report on the costs of rural ambulance services.
Sec. 5. Elimination of reduction in inflation adjustments for ambulance 
                            services.

SEC. 2. RURAL EMERGENCY MEDICAL SERVICE TRAINING AND EQUIPMENT 
              ASSISTANCE PROGRAM.

    Part E of title XII of the Public Health Service Act (42 U.S.C. 
300d-51 et seq.) is amended by adding at the end the following new 
section:

``SEC. 1253. RURAL EMERGENCY MEDICAL SERVICE TRAINING AND EQUIPMENT 
              ASSISTANCE PROGRAM.

    ``(a) Grants.--The Secretary, acting through the Administrator of 
the Health Resources and Services Administration (referred to in this 
section as the `Secretary') shall award grants to eligible entities to 
enable such entities to provide for improved emergency medical services 
in rural areas.
    ``(b) Eligibility.--To be eligible to receive a grant under this 
section, an entity shall--
            ``(1) be--
                    ``(A) a State emergency medical services office;
                    ``(B) a State department of Transportation;
                    ``(C) a State emergency medical services 
                association;
                    ``(D) a State office of rural health; or
                    ``(E) any other entity determined appropriate by 
                the Secretary; and
            ``(2) prepare and submit to the Secretary an application at 
        such time, in such manner, and containing such information as 
        the Secretary may require, that includes--
                    ``(A) a description of the activities to be carried 
                out under the grant; and
                    ``(B) an assurance that the applicant will comply 
                with the matching requirement of subsection (d).
    ``(c) Use of Funds.--
            ``(1) In general.--An entity shall use amounts received 
        under a grant made under subsection (a), either directly or 
        through grants to emergency medical service squads that are 
        located in, or that serve residents of, non-metropolitan 
        statistical areas, to--
                    ``(A) hire or recruit emergency medical service 
                personnel;
                    ``(B) recruit or retain volunteer emergency medical 
                service personnel;
                    ``(C) train emergency medical service personnel in 
                emergency response, injury prevention, safety 
                awareness, and other topics relevant to the delivery of 
                emergency medical services;
                    ``(D) fund specific training to meet State 
                certification requirements;
                    ``(E) develop new ways to educate emergency health 
                care providers through the use of technology-enhanced 
                educational methods (such as distance learning);
                    ``(F) acquire emergency medical services vehicles, 
                including ambulances;
                    ``(G) acquire emergency medical services equipment, 
                including cardiac defibrillators;
                    ``(H) acquire personal protective equipment for 
                emergency medical services personnel as required by the 
                Occupational Safety and Health Administration; and
                    ``(I) educate the public concerning cardiopulmonary 
                resuscitation (CPR), first aid, injury prevention, 
                safety awareness, illness prevention, and other related 
                emergency preparedness topics.
            ``(2) Preference.--In awarding grants under this section 
        the Secretary shall give preference to entities that intend to 
        use amounts provided under the grant to fund activities 
        described in any of subparagraphs (A) through (E) of paragraph 
        (1).
    ``(d) Matching Requirement.--The Director may not make a grant 
under this section to an entity unless the entity agrees that the 
entity will make available (directly or through contributions from 
other public or private entities) non-Federal contributions toward the 
activities to be carried out under the grant in an amount equal to 5 
percent of the amount received under the grant.
    ``(e) Emergency Medical Services.--In this section, the term 
`emergency medical services'--
            ``(1) means resources used by a qualified public or private 
        nonprofit entity, or by any other entity recognized as 
        qualified by the State involved, to deliver medical care 
        outside of a medical facility under emergency conditions that 
        occur--
                    ``(A) as a result of the condition of the patient; 
                or
                    ``(B) as a result of a natural disaster or similar 
                situation; and
            ``(2) includes services delivered by an emergency medical 
        services provider (either compensated or volunteer) or other 
        provider recognized by the State involved that is licensed or 
        certified by the State as an emergency medical technician, a 
        para- medic, a registered nurse, a physician assistant, or a 
physician that provides services similar to services provided by such 
an emergency medical services provider.
    ``(f) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $50,000,000 for each of fiscal years 
        2001 through 2006.
            ``(2) Administrative costs.--The Director may use not more 
        than 10 percent of the amount appropriated under paragraph (1) 
        for a fiscal year for the administrative expenses of carrying 
        out this section.''.

SEC. 3. TAX CREDIT FOR VOLUNTEER EMERGENCY MEDICAL SERVICE PROVIDERS.

    (a) In General.--Subpart A of part IV of subchapter A of chapter 1 
of the Internal Revenue Code of 1986 (relating to nonrefundable 
personal credits) is amended by adding at the end the following:

``SEC. 25B. VOLUNTEER EMERGENCY MEDICAL SERVICE PROVIDER CREDIT.

    ``(a) Allowance of Credit.--In the case of an eligible volunteer 
emergency medical service provider, there shall be allowed as a credit 
against the tax imposed by this chapter for the taxable year an amount 
equal to $500.
    ``(b) Eligible Volunteer Emergency Medical Service Provider.--For 
purposes of this section--
            ``(1) In general.--The term `eligible volunteer emergency 
        medical service provider' means an individual who--
                    ``(A) is an emergency medical service provider or 
                other provider (within the meaning of section 
                1253(e)(2) of the Public Health Service Act) providing 
                emergency medical services in connection with an 
                emergency medical service squad,
                    ``(B) volunteers with respect to such services, and
                    ``(C) is listed as active on the official staff 
                roster of such squad for the taxable year.
            ``(2) Emergency medical services.--For purposes of 
        paragraph (1), the term `emergency medical services' means--
                    ``(A) emergency medical services (as defined in 
                section 1253(e)(1) of such Act), and
                    ``(B) any other services provided in relation to 
                such emergency medical services, such as administrative 
                and operational duties and community education and 
                training programs.
            ``(3) Volunteer.--For purposes of paragraph (1), the term 
        `volunteer' means to provide services without compensation, 
        other than reimbursement or payment of reasonable and necessary 
        expenses incurred in the performance of the emergency medical 
        service provider's duty.''.
    ``(c) Verification.--The Secretary may require additional 
information to be provided, in such form and such manner as the 
Secretary deems necessary, to verify the eligibility for the credit 
under this section.''.
    (b) Conforming Amendment.--The table of sections for subpart A of 
part IV of subchapter A of chapter 1 of the Internal Revenue Code of 
1986 is amended by inserting after the item relating to section 25A the 
following new item:

                              ``Sec. 25B. Volunteer emergency services 
                                        provider credit.''.
    (c) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2000.

SEC. 4. STUDY AND REPORT ON THE COSTS OF RURAL AMBULANCE SERVICES.

    (a) Study.--The Secretary of Health and Human Services, in 
consultation with the Director of the Office of Rural Health Policy and 
with the assistance of the Administrator of the Health Care Financing 
Administration, shall conduct a study of the means by which rural areas 
with low population densities can be identified for the purpose of 
designating areas in which the cost of providing ambulance services 
would be expected to be higher than similar services provided in more 
heavily populated areas because of low usage. Such study shall also 
include--
            (1) an examination of the cost differences between 
        independent volunteer ambulance providers and hospital-based 
        ambulance providers serving rural areas; and
            (2) an identification and analysis of the factors that 
        contribute to the additional costs of providing ambulance 
        services in areas designated under the previous sentence.
    (b) Report.--Not later than June 30, 2001, the Secretary shall 
submit to Congress a report on the results of the study conducted under 
this section, together with a proposed regulation based on that study 
which adjusts the fee schedule under section 1834(l) of the Social 
Security Act (42 U.S.C. 1395m(l)) with respect to payment rates for 
ambulance services provided in low density rural areas to take into 
account the increased cost of providing such services in such areas.
    (c) Implementation of Regulation.--The regulation submitted under 
clause (ii) shall take effect not later than January 1, 2002.

SEC. 5. ELIMINATION OF REDUCTION IN INFLATION ADJUSTMENTS FOR AMBULANCE 
              SERVICES.

    Subparagraphs (A) and (B) of section 1834(l)(3) (42 U.S.C. 
1395m(l)(3)(A)) are each amended by striking ``reduced in the case of 
2001 and 2002 by 1.0 percentage points'' and inserting ``increased in 
the case of 2001 by 1.0 percentage point''.

                                 <all>

Pages: 1

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