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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''.
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