Field EMS Innovation Act - Amends the Public Health Service Act to designate the Department of Health and Human Services (HHS) as the primary federal agency for emergency medical services (EMS) and trauma care.
Establishes the Office of Emergency Medical Services and Trauma (or Office of EMS and Trauma) within HHS. Gives the Office responsibilities related to emergency medical services and authorizes the Secretary of HHS to delegate additional responsibilities related to EMS.
Requires the Director of the Office to: (1) implement a national EMS strategy; (2) establish the EQUIP grant program to promote excellence, quality, universal access, innovation, and preparedness in field EMS; and (3) establish the SPIA grant program to improve EMS system performance, integration, and accountability, to ensure preparedness, to enhance oversight and data collection, and to promote standardization of certifications.
Defines "field EMS" to mean emergency medical services provided to patients (including transport by ground, air, or otherwise) prior to or outside a medical facility or other clinical setting.
Requires the Director to improve medical oversight of field EMS, including by: (1) promoting the development and adoption of national guidelines for medical oversight, and (2) convening a Field EMS Medical Oversight Advisory Committee.
Directs the Comptroller General (GAO) to study issues related to emergency medical care in field EMS.
Authorizes the Administrator of the National Highway Traffic Safety Administration (NHTSA) to maintain, improve, and expand the National EMS Information System.
Sets forth reporting requirements relating to data collection and electronic health records.
Declares that the Health Insurance Portability and Accountability Act of 1996 (HIPAA) shall not be construed to prohibit certain exchanges of information between field EMS practitioners, hospital personnel, state EMS offices, and the National EMS Database. Requires the Secretary to establish guidelines for the exchange of information between field EMS practitioners and hospital personnel.
Authorizes the Director of the Office to make grants for the development, availability, and dissemination of field EMS education programs and courses that improve the quality and capability of field EMS personnel.
Requires the Director to conduct or support demonstrations projects relating to alternative dispositions of field EMS patients.
Amends title XI (General Provisions, Peer Review, and Administrative Simplification) of the Social Security Act to include field EMS as a model for testing by the Center for Medicare and Medicaid Innovation.
Amends the Public Health Service Act to require the Secretary to conduct research and evaluation relating to field EMS through the Agency for Healthcare Research and Quality (AHRQ) and the Center for Medicare and Medicaid Innovation.
Requires the Director of AHRQ to establish a Field EMS Evidence-Based Practice Center.
Amends the Internal Revenue Code to: (1) establish the Emergency Medical Services Trust Fund, and (2) allow taxpayers to designate a portion of any income tax overpayment and make additional contributions to finance such Fund.
[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[S. 2400 Introduced in Senate (IS)]
113th CONGRESS
2d Session
S. 2400
To provide for improvement of field emergency medical services, and for
other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
May 22, 2014
Mr. Bennet (for himself, Mr. Crapo, and Mr. Johnson of South Dakota)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To provide for improvement of field emergency medical services, and for
other purposes.
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 ``Field EMS
Innovation Act''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Recognition of HHS as primary Federal agency for emergency
medical services and trauma care.
Sec. 4. Emergency medical services.
Sec. 5. Enhancing research in field EMS.
Sec. 6. Emergency Medical Services Trust Fund.
Sec. 7. Authorization of appropriations.
Sec. 8. Statutory construction.
SEC. 2. FINDINGS.
Congress finds the following:
(1) All persons throughout the United States should have
access to and receive high-quality emergency medical care as
part of a coordinated emergency medical services system.
(2) Properly functioning emergency medical services
(referred to in this section as ``EMS'') systems, 24 hours per
day, 7 days per week, are essential to ensure access to
emergency medical care and transport for all patients with
emergency medical conditions. Such coordinated EMS systems are
also necessary for response to catastrophic incidents.
(3) Ensuring high-quality and cost-effective EMS systems
requires readiness, preparedness, medical direction, oversight,
and innovation throughout the continuum of emergency medical
care through Federal, State, and local multijurisdictional
collaboration and sufficient resources for EMS agencies and
providers.
(4) At the Federal level, EMS responsibilities and
resources of several Federal agencies consistent with their
expertise and authority must emphasize the critical importance
of Federal agency collaboration and coordination for all
emergency medical services.
(5) At the State and local level, EMS systems and agencies
require the coordination and improved capabilities of multiple
and diverse stakeholders.
(6) Emergency medical services encompass the provision of
care provided to patients with emergency medical conditions
throughout the continuum, including emergency medical care and
trauma care provided in the field, hospital, and rehabilitation
settings.
(7) Field EMS comprises essential emergency medical
services, including medical care or medical transport provided
to patients prior to or outside medical facilities and other
clinical settings. The primary purpose of field emergency
medical services is to ensure that emergency medical patients
receive the right care at the right place in the right amount
of time.
(8) Coordinated and high-quality field EMS is essential to
the Nation's security. Field EMS is an essential public service
provided by governmental and nongovernmental agencies and
practitioners 24 hours a day, 7 days a week, and during
catastrophic incidents. To ensure disaster and all-hazards
preparedness for EMS operations as part of the Nation's
comprehensive disaster preparedness, Federal funding for
preparedness activities, including catastrophic training and
drills, must be provided to governmental and nongovernmental
EMS agencies to ensure a greater capability within each of
these areas.
(9) Numerous recommendations from several significant
national reports and documents have demonstrated the need in
multiple areas for substantial improvement of emergency medical
services provided in the field, including recommendations in
the ``EMS Agenda for the Future'' of the National Highway
Traffic Safety Administration and the Health Resources and
Services Administration, the Institute of Medicine report ``The
Future of Emergency Care in the United States Health System'',
and the ``EMS Education Agenda for the Future: A Systems
Approach'', and recommendations of the National EMS Workforce
Injury and Illness Surveillance Program, the National EMS
Advisory Council of the Department of Transportation, and the
Federal Interagency Committee on Emergency Medical Services.
(10) To substantially improve field EMS, advancements must
be made in several essential areas including readiness,
innovation, preparedness, education and workforce development,
safety, financing, quality, standards, and research.
(11) The recognition of a primary programmatic Federal
agency for emergency medical services within the Department of
Health and Human Services was recommended by the Institute of
Medicine and is necessary to provide a more streamlined, cost-
efficient, and comprehensive approach for field EMS and a focal
point for practitioners and agencies to interface with the
Federal Government.
(12) The essential role of field EMS in disaster
preparedness and response must be incorporated into the
national preparedness and response strategy and implementation
as provided and overseen by the Department of Homeland Security
and the Department of Health and Human Services pursuant to
their respective jurisdictions.
(13) The essential role of the National Highway Traffic
Safety Administration in the continued development of the
National EMS Information System and in overseeing
transportation issues related to field EMS such as EMS and
ambulance vehicle safety standards should be maintained.
(14) The Federal Interagency Committee on Emergency Medical
Services must continue in its essential role in coordinating
the Federal activities related to the full spectrum of EMS.
SEC. 3. RECOGNITION OF HHS AS PRIMARY FEDERAL AGENCY FOR EMERGENCY
MEDICAL SERVICES AND TRAUMA CARE.
Title XXVIII of the Public Health Service Act (42 U.S.C. 300hh et
seq.) is amended by adding at the end the following:
``Subtitle D--Office of EMS and Trauma
``SEC. 2831. RECOGNITION OF HHS AS PRIMARY FEDERAL AGENCY FOR EMERGENCY
MEDICAL SERVICES AND TRAUMA CARE; ESTABLISHMENT OF OFFICE
OF EMS AND TRAUMA.
``(a) Primary Federal Agency.--The Department of Health and Human
Services shall serve as the primary Federal agency with responsibility
for programs and activities relating to emergency medical services and
trauma care.
``(b) Office of EMS and Trauma.--
``(1) Establishment.--There is established within the
Department of Health and Human Services an Office of Emergency
Medical Services and Trauma, also to be known as the `Office of
EMS and Trauma'. The Office of EMS and Trauma shall be headed
by a director appointed by the Secretary (referred to in this
section as the `Director').
``(2) Role of office within hhs.--
``(A) In general.--The Office of EMS and Trauma
shall have--
``(i) the responsibilities delegated to the
Office of EMS and Trauma pursuant to paragraph
(3); and
``(ii) such responsibilities and
authorities as may be delegated or transferred
to the Office of EMS and Trauma pursuant to
subparagraph (B).
``(B) Additional responsibilities and
authorities.--In addition to the responsibilities and
authorities specified in subparagraph (A), the
Secretary may delegate or transfer to the Office of EMS
and Trauma any other responsibility or authority of the
Department of Health and Human Services relating to
emergency medical services and trauma care (except that
the Secretary may not delegate or transfer such
responsibilities or authorities that are otherwise
granted to a specific agency within the Department in
statute), including such services and care relating
to--
``(i) the full continuum of emergency
medical services, including field EMS and
trauma and hospital emergency medical care; and
``(ii) improving the quality, innovation,
or cost effectiveness of emergency medical
services.
``(C) Location of office in hhs.--The Secretary
shall locate the Office of EMS and Trauma within the
organizational structure of the Department of Health
and Human Services in a manner that achieves each of
the following:
``(i) Recognition of the importance and
unique life-saving services associated with
field EMS, trauma care, and hospital emergency
care as a significant Federal priority.
``(ii) Integration of the essential
services described in clause (i) with the
larger health care system and within the
disaster preparedness system, including through
regionalization of such services and by
enhancing daily readiness capabilities to
ensure adequate disaster readiness
capabilities, consistent with the National
Health Security Strategy.
``(iii) Consolidation, co-location, and
cost efficiencies in administering programs and
activities related to field EMS, trauma care,
and hospital emergency medical care.
``(iv) Establishment of a Federal focal
point for leadership and improved coordination,
support, and oversight of field EMS, trauma
care, and hospital emergency medical care.
``(v) Sufficient level and stature such
that--
``(I) such Office is able to
fulfill its role, responsibilities, and
authorities; and
``(II) the Director of such Office
reports directly to the Secretary or an
official within the Department who
reports directly to the Secretary.
``(vi) Establishment of a visible and
identifiable point of contact with which the
public; EMS agencies and practitioners; State
and local government agencies; EMS educational
institutions; EMS, trauma, and hospital
emergency care professional associations; and
all other parties may interact.
``(3) Responsibilities.--The Secretary shall, at a minimum,
delegate responsibility to the Office of EMS and Trauma to
carry out section 330J and parts A, B, C, D, H, and I (except
subsection (c)(1) of section 1294) of title XII.
``(c) National EMS Strategy.--The Secretary, acting through the
Director, and in consultation with the Assistant Secretary for
Preparedness and Response and the Administrator of the Health Resources
and Services Administration, shall develop and implement a cohesive
national EMS strategy to strengthen the development of the full
continuum of EMS at the Federal, State, and local levels. In
establishing such a strategy, the Secretary shall--
``(1) solicit and consider the recommendations of the
National Emergency Medical Services Advisory Council as well as
relevant stakeholders;
``(2) consult and collaborate with the Federal Interagency
Committee on Emergency Medical Services to ensure consistency
of such national EMS strategy within the larger Federal
strategy regarding all of emergency medical services and
national preparedness and response;
``(3) address issues related to EMS patient and
practitioner safety, standardization of EMS practitioner
licensing and credentialing, field EMS quality and medical
oversight, regionalization of field EMS and trauma and
emergency care services, availability of field EMS and trauma
care and emergency medical services throughout the Nation, and
integration of field EMS practitioners into the broader health
care system, including--
``(A) promotion of the adoption by States of the
education standards identified in the `Emergency
Medical Services Education Agenda for the Future: A
Systems Approach' and any revisions thereto, including
the standardization of licensing and credentialing of
field EMS practitioners and standards of care, based on
best practices and evidence-based medicine, including
by--
``(i) the identification of differences in
the levels of care, scope of practice, and
licensure and credentialing requirements among
the States; and
``(ii) the adoption by the States of
national standards for such levels of care,
scope of practice and licensure and
credentialing requirements;
``(B) promotion of a culture of safety, including--
``(i) the adoption of an anonymous error
reporting system designed to identify systemic
problems in field EMS patient and practitioner
safety and ensure a single means of collecting
and reporting relevant error data by field EMS
agencies and States;
``(ii) the establishment of field EMS
patient and practitioner safety goals and the
specific means to improve field EMS
practitioner and patient safety to achieve such
goals; and
``(iii) the adoption of more uniform
national ambulance vehicle safety and
manufacturing standards as developed by the
National Fire Protection Administration or
coordinated by the National Highway Traffic
Safety Administration;
``(C) the integration and utilization of field EMS
practitioners as part of the larger health care system,
including--
``(i) the potential utilization of field
EMS practitioners for the provision of care to
patients with nonemergent medical conditions,
such as through mobile integrated health care
services or community paramedicine; and
``(ii) strategies to implement the
recommendations provided by the National Health
Care Workforce Commission, pursuant to section
5101(d)(2) of the Patient Protection and
Affordable Care Act (42 U.S.C. 294q(d)(2)); and
``(D) such other issues as the Secretary considers
appropriate;
``(4) incorporate into such strategy the preparedness and
response objectives identified by the Secretary of Homeland
Security and the Assistant Secretary for Preparedness and
Response in order--
``(A) to ensure the capability and capacity of the
full spectrum of EMS to respond to terrorist attacks,
disasters, catastrophic events, and mass casualty
events; and
``(B) to coordinate with the Secretary of Homeland
Security accordingly;
``(5) complete the development of such strategy not later
than 18 months after the date of enactment of this Act;
``(6) communicate such strategy to the relevant
congressional committees of jurisdiction;
``(7) implement such strategy, to the extent practicable,
not later than 3 years after the date of enactment of the Field
EMS Innovation Act; and
``(8) update such strategy not less than every 3 years.
``(d) Definitions.--In this section, the terms `field EMS',
`emergency medical services', and `medical oversight' have the meaning
given such terms in section 1291.''.
SEC. 4. EMERGENCY MEDICAL SERVICES.
Title XII of the Public Health Service Act (42 U.S.C. 300d et seq.)
is amended by adding at the end the following:
``PART I--EMERGENCY MEDICAL SERVICES
``SEC. 1291. DEFINITIONS.
``In this part:
``(1) The term `ambulance diversion' means the practice of
hospitals of denying access to an incoming ambulance and
requesting that the ambulance proceed to another facility due
to a stated lack of capacity at the initial facility, resulting
in delayed access to definitive care.
``(2) The term `Director' means the Director of the Office
of EMS and Trauma established under section 2831.
``(3) The term `EMS' means emergency medical services.
``(4) The term `FICEMS' means the Federal Interagency
Committee on Emergency Medical Services.
``(5) The term `field EMS' means emergency medical services
provided to patients (including transport by ground, air, or
otherwise) prior to or outside a medical facility or other
clinical setting.
``(6) The term `field EMS agency' means an organization
providing field EMS, including--
``(A) governmental (including fire-based agencies),
nongovernmental (including hospital-based or private
agencies), and volunteer organizations; and
``(B) organizations that provide field EMS by
ground, air, or otherwise.
``(7) The term `emergency medical services' or `EMS' means
emergency medical care, trauma care, and related services
provided to patients at any point in the continuum of health
care services, including emergency medical dispatch and
emergency medical care, trauma care, and related services
provided in the field, during transport, or in a medical
facility or other clinical setting.
``(8) The term `field EMS patient care reports' means the
information that a field EMS agency typically creates regarding
a patient's medical condition and treatment in the course of
providing emergency medical services to that patient.
``(9) The term `medical oversight' means the supervision by
a physician of the medical aspects of an EMS system or agency
and its providers, including prospective, concurrent, and
respective components of field EMS and the education of EMS
providers.
``(10) The term `NEMSAC' means the National Emergency
Medical Services Advisory Council.
``(11) The term `NEMSIS' means the National EMS Information
System.
``(12) The term `NHTSA' means the National Highway Traffic
Safety Administration.
``(13) The term `patient parking' means the practice by
hospitals of refusing to accept transfer of a patient's care
from an ambulance crew until a regular emergency department bed
is available, requiring the crew to continue to provide patient
care on the ambulance stretcher rather than in a patient bed in
the hospital, until hospital staff will accept the transfer of
care, resulting in delayed access to definitive care.
``(14) The term `State EMS Office' means an office
designated by the State with primary responsibility for
oversight of the State's EMS system, such as responsibility for
oversight of EMS coordination, licensing or certifying EMS
practitioners, and EMS system improvement.
``(15) The term `STEMI' means ST-Segment Elevation
Myocardial Infarction.
``SEC. 1292. FIELD EMS EXCELLENCE, QUALITY, UNIVERSAL ACCESS,
INNOVATION, AND PREPAREDNESS.
``(a) In General.--The Director shall establish the an EMS
Excellence, Quality, Universal Access, Innovation, and Preparedness
grant program, to be referred to as the `EQUIP grant program'--
``(1) to promote excellence in all aspects of the provision
of field EMS by field EMS agencies;
``(2) to enhance the quality of emergency medical care
provided to patients by field EMS practitioners through
evidence-based, medically directed field emergency care;
``(3) to promote universal access to and availability of
high-quality field EMS in all geographic locations of the
Nation;
``(4) to spur innovation in the delivery of field EMS; and
``(5) to improve EMS agency readiness and preparedness for
day-to-day emergency medical response.
``(b) Application.--
``(1) In general.--To be eligible to receive a grant under
this section, an eligible entity shall submit an application to
the Director in such form and manner, and containing such
agreements, assurances, and information as the Director
determines to be necessary to carry out this section.
``(2) Simple form.--The Director shall ensure that grant
application requirements are not unduly burdensome to smaller
and volunteer field EMS agencies or other agencies with limited
resources.
``(3) Consistency with preparation goals.--The Director
shall ensure that grant applications are consistent with
national and relevant State preparedness plans and goals.
``(c) Use of Funds.--Grants may be used by eligible entities--
``(1) to sustain field EMS practitioners to ensure 24 hours
a day, 7 days a week readiness and preparedness at the local
level;
``(2) to develop and implement initiatives related to
delivery of medical services, including--
``(A) innovative clinical practices to improve the
cost effectiveness and quality of care delivered to
emergency patients in the field that results in
improved patient outcomes and cost savings to the
health system, including for high prevalence emergency
medical conditions such as sudden cardiac arrest,
STEMI, stroke, and trauma; and
``(B) delivery systems to improve patient outcomes,
which may include implementing evidence-based
protocols, interventions, systems, and technologies to
reduce clinically meaningful response times;
``(3) to purchase and implement--
``(A) medical equipment and training for using such
equipment;
``(B) communication systems to ensure seamless and
interoperable communications with other first
responders; and
``(C) information systems to comply with NEMSIS
data collection and integrate field emergency care with
electronic medical records;
``(4) to participate in federally sponsored field EMS
research;
``(5) to establish or enhance comprehensive medical
oversight and quality assurance programs that include the
active participation by medical directors in field EMS medical
direction and educational programs; and
``(6) for such other uses as the Director determines
appropriate.
``(d) Administration of Grants.--In establishing and administering
the EQUIP grant program, the Director--
``(1) shall establish a grantmaking process that includes--
``(A) prioritization for the awarding of grants to
eligible entities and consideration of the factors in
reviewing grant applications by eligible entities,
including--
``(i) demonstrated financial need for
funding;
``(ii) utilization of public and private
partnerships;
``(iii) enhanced access to high-quality
field EMS in under served geographic areas;
``(iv) unique needs of volunteer and rural
field EMS agencies;
``(v) distribution among a variety of
geographic areas, including urban, suburban,
and rural;
``(vi) distribution of funds among types of
EMS agencies, including governmental,
nongovernmental and volunteer;
``(vii) implementation of evidence-based
interventions that improve quality of care,
patient outcomes, efficiency, or cost
effectiveness; and
``(viii) such other factors as the Director
determines necessary;
``(B) a peer-reviewed process to recommend grant
allocations in accordance with the prioritization
established by the Director, except that final award
determinations shall be made by the Director; and
``(C) the provision of grant awards to eligible
entities on an annual basis, except that the Director
may reserve not more than 25 percent of the available
appropriations for multiyear grants and no grant award
may exceed a 2-year period;
``(2) shall consult with and take into consideration the
recommendations of the Assistant Secretary for Preparedness and
Response, FICEMS, NEMSAC, and relevant stakeholders;
``(3) shall ensure that funds used for day-to-day
preparedness activities are consistent and aligned with Federal
preparedness priorities; and
``(4) may contract with an independent, third-party,
nonprofit organization to administer the grant program if the
Director establishes conflict-of-interest requirements as part
of any such contractual relationship.
``(e) Eligibility.--Eligible grant recipients are field EMS
agencies that--
``(1) are licensed by or otherwise authorized in the State
in which they operate; and
``(2) have medical oversight and quality improvement
programs as defined by the Director.
``(f) Required Use of Guidelines.--As a condition on receipt of a
grant under this section, the Director shall require the grant
recipient to adopt and implement (to the extent applicable) the
guidelines promoted, developed, and disseminated under subparagraphs
(B) and (C) of section 1294(a)(1).
``(g) Annual Report.--The Director shall submit an annual report on
the EQUIP grant program under this section to Congress.
``SEC. 1293. FIELD EMS SYSTEM PERFORMANCE, INTEGRATION, AND
ACCOUNTABILITY.
``(a) In General.--The Director shall establish a Field EMS System
Performance, Integration, and Accountability grant program, to be
referred to as the `SPIA grant program'--
``(1) to improve field EMS system performance, integration,
and accountability;
``(2) to ensure preparedness for field EMS at the State and
local levels;
``(3) to enhance physician medical oversight of field EMS
systems;
``(4) to improve coordination between regional field EMS
systems and integration of such regional field EMS systems into
the larger health care system;
``(5) to enhance data collection and analysis to improve,
on a continuing basis, the field EMS system; and
``(6) to promote standardization of national EMS
certification of emergency medical technicians and paramedics.
``(b) Use of Funds.--Entities receiving grants under this section
may use such grant funds--
``(1) to enhance EMS system readiness and preparedness for
day-to-day emergency medical response;
``(2) to improve cross-border collaboration and planning
among States; and
``(3) to collect data with regard to--
``(A) NEMSIS;
``(B) field EMS education;
``(C) field EMS workforce;
``(D) cardiac events, including STEMI and sudden
cardiac arrest;
``(E) stroke;
``(F) disasters, including injuries and illnesses;
``(G) ambulance diversion and patient parking;
``(H) trauma (in a manner that is complementary and
not duplicative of other trauma data collection, such
as the National Trauma Data Bank);
``(I) data determined necessary by the State office
of EMS for oversight and coordination of the State
field EMS system; and
``(J) any other such data that the Director
specifies;
``(4) to implement and evaluate system-wide quality
improvement initiatives, including medical direction at the
State, local, and regional levels;
``(5) to integrate field EMS with other health care
services as part of a coordinated system of care provided to
patients with emergency medical conditions to help ensure the
right patient receives the right care by the right crew in the
right vehicle and at the right medical facility in the right
amount of time, including by enhancing regional emergency
medical dispatch;
``(6) to incorporate national EMS certification for all
levels of emergency medical technicians and paramedics;
``(7) to improve the State's planning for ensuring a
consistent, available EMS workforce;
``(8) to fund EMS regional and local oversight and planning
organizations or develop regional systems of emergency medical
care within the State to further enhance coordination and
systemic development throughout the State; and
``(9) for such other uses as the Director determines
appropriate.
``(c) Administration of Grants.--In establishing and administering
the SPIA grant program, the Director shall--
``(1) establish State EMS system performance standards to
serve as guidance to States in improving EMS systems and in
applying for grants under this section, taking into
consideration--
``(A) the recommendations of the Assistant
Secretary for Preparedness and Response, FICEMS,
NEMSAC, and relevant stakeholders;
``(B) national, evidence-based guidelines; and
``(C) the needs and resource limitations of
volunteer, smaller agencies, and agencies in rural
areas;
``(2) provide technical assistance to State EMS offices in
conducting comprehensive EMS planning with regard to evidence-
based workforce and development competencies for field EMS
management;
``(3) allocate, within the available funds, SPIA grants to
a maximum of one grant per applicant according to a formula
based on population and geographic area, as determined by the
Director, for a period not to exceed 2 years; and
``(4) require that States allocate a portion of funds
awarded under this section to regional and local oversight and
planning EMS organizations within the State for the purpose of
field EMS system development, maintenance, and improvement of
coordination among regional organizations.
``(d) Application.--To be eligible to receive a grant under this
section, an eligible entity shall submit an application to the Director
in such form and manner, containing such agreements, assurances, and
information as the Director determines to be necessary to carry out
this section.
``(e) Eligibility.--The entities eligible for a grant under this
section are the State EMS office in each of the several States, Indian
tribes, and territories.
``(f) Required Use of Guidelines.--As a condition on receipt of a
grant under this section, the Director shall require the grant
recipient to adopt and implement (to the extent applicable) the
guidelines promoted, developed, and disseminated under subparagraphs
(B) and (C) of section 1294(a)(1).
``(g) Annual Report.--The Director shall submit an annual report on
the SPIA grant program under this section to Congress.
``SEC. 1294. FIELD EMS QUALITY.
``(a) Medical Oversight.--
``(1) In general.--To improve medical oversight of field
EMS and ensure continuity and quality for such medical
oversight, the Director shall--
``(A) promote high-quality and comprehensive
medical oversight of--
``(i) all medical care provided by field
EMS practitioners; and
``(ii) the education and training of field
EMS practitioners;
``(B) promote the development, adoption, and
utilization of national guidelines for the roles of
physicians who provide medical oversight for field EMS
and other health care providers who support physicians
in this role;
``(C) support efforts of relevant physician
stakeholders in developing and disseminating guidelines
for use by EMS medical directors and field EMS
practitioners on a national basis; and
``(D) convene a Field EMS Medical Oversight
Advisory Committee, comprised of representatives of
relevant physician stakeholders, to advise the Director
on ways and means to advance and support development
and maintenance of quality medical oversight throughout
the Nation's systems for field EMS.
``(2) Additional considerations.--In carrying out
subparagraphs (B) and (C) of paragraph (1), the Director shall
take into consideration--
``(A) existing guidelines developed by national
professional physician associations, States, and other
relevant governmental or nongovernmental entities;
``(B) the input of other relevant stakeholders,
including health care providers who support physicians
who provide medical oversight for field EMS; and
``(C) the unique needs associated with medical
oversight of provision of field EMS in rural areas or
by volunteers.
``(3) Flexibility.--The guidelines promoted, developed, and
disseminated under subparagraphs (B) and (C) of paragraph (1)
shall ensure high-quality training, credentialing, and
direction in connection with medical oversight of field EMS at
the State, regional, and local levels while providing
sufficient flexibility to account for historical and legitimate
differences in field EMS among States, regions, and localities.
``(b) GAO Study and Report.--
``(1) In general.--The Comptroller General of the United
States shall complete a study on--
``(A) medical and administrative liability issues
that may impede--
``(i) medical direction provided by
physicians directly regarding specific patients
or medical oversight provided by physicians in
establishing medical protocols, procedures, and
other activities related to the provision of
emergency medical care in field EMS; or
``(ii) the highest quality emergency
medical care in field EMS provided by personnel
other than physicians such as emergency medical
technicians and paramedics;
``(B) reimbursement for any component of medical
oversight; and
``(C) such other issues as the Comptroller General
determines appropriate relating to improving the
quality and medical oversight of emergency medical care
in field EMS.
``(2) Report to congress.--Not later than 18 months after
the date of the enactment of the Field EMS Innovation Act, the
Comptroller General shall complete the study under paragraph
(1) and submit a report to Congress on the results of such
study, including any recommendations.
``(c) Data Collection and Exchange.--
``(1) National ems information system.--
``(A) In general.--The Administrator of NHTSA may
maintain, improve, and expand the National EMS
Information System, including the National EMS
Database.
``(B) Consultation.--The Administrator of NHTSA
shall carry out this paragraph in consultation with the
Director.
``(C) Standardization.--In carrying out
subparagraph (A), the Administrator of NHTSA shall
promote the collection and reporting of data on field
EMS in a standardized manner.
``(D) Availability of data.--The Administrator of
NHTSA shall ensure that information in the National EMS
Database (other than individually identifiable
information) is available to Federal and State
policymakers, EMS stakeholders, and researchers.
``(E) Technical assistance.--In carrying out
subparagraph (A), the Administrator of NHTSA may
provide technical assistance to State and local
agencies, field EMS agencies, and other entities, as
the Administrator determines appropriate, to assist in
the collection, analysis, and reporting of data.
``(2) Report on data gaps.--
``(A) In general.--Not later than 1 year after the
date of the enactment of the Field EMS Innovation Act,
the Secretary of Health and Human Services, acting
through the Director, in consultation with the
Administrator of NHTSA, shall submit to Congress a
report that--
``(i) identifies gaps in the collection of
data related to the provision of field EMS; and
``(ii) includes recommendations for
improving the collection, reporting, and
analysis of such data.
``(B) Recommendations.--The recommendations
required by subparagraph (A)(ii) shall--
``(i) take into consideration the
recommendations of FICEMS and NEMSAC and
relevant stakeholders;
``(ii) recommend methods for improving data
collection and reporting and analysis without
unduly burdening reporting entities and without
duplicating existing data sources (such as data
collected by the National Trauma Data Bank);
``(iii) address the quality and
availability of data, and linkages with
existing patient registries, related to the
provision of field EMS and utilization of field
EMS with respect to a variety of illnesses and
injuries (in both the everyday provision of
field EMS and catastrophic or disaster
response), including--
``(I) cardiac events such as chest
pain, sudden cardiac arrest, and STEMI;
``(II) stroke;
``(III) trauma;
``(IV) disaster and catastrophic
incidents, such as incidents related to
terrorism or natural or manmade
disasters; and
``(V) ambulance diversion and
patient parking; and
``(iv) include an analysis of the variety
of services provided by field EMS agencies.
``(3) Report on data integration to promote quality of
care.--Not later than 18 months after the date of enactment of
the Field EMS Innovation Act, the Secretary, acting through the
head of the Office of the National Coordinator for Health
Information Technology and the Director, in collaboration with
FICEMS and the Administrator of NHTSA as appropriate, and
taking into consideration input from relevant stakeholders,
shall submit a report (including recommendations) on issues,
impediments, and potential solutions pertaining to the
following objectives:
``(A) Incorporation of field EMS patient care
reports into patient electronic health records, taking
into consideration--
``(i) the extent to which field EMS patient
care reports are created in electronic format
and the potential for elements of such reports
to be incorporated into patient electronic
health records;
``(ii) the data elements of field EMS
patient care reports that would promote quality
and efficiency of care if incorporated into
patient electronic health records;
``(iii) potential modifications to the
Medicare and Medicaid programs under titles
XVIII and XIX, respectively, of the Social
Security Act (42 U.S.C. 1395 et seq., 1396 et
seq.) or other Federal health programs
(including potential modifications to the
HITECH Act (title XIII of division A and title
IV of Division B of Public Law 111-5),
including modifications to the entities
included as eligible for incentive payments
under section 1848(o), 1853(l) (to the extent
that such section 1848(o) is applied), or
1903(t) of the Social Security Act (42 U.S.C.
1395w-4(o), 1395w-23(l), 1396b(t)), criteria
for certified EHR technology for purposes of
such sections, and objectives and measures for
determining meaningful use of such technology
for purposes of such sections) to provide
appropriate reimbursement and financial
incentives for EMS agencies--
``(I) to maintain field EMS patient
care reports in a structured electronic
format; and
``(II) to otherwise adopt and use
electronic health records; and
``(iv) potential modifications to the
HITECH Act to provide incentives to eligible
hospitals under section 1886(n), 1853(m) (to
the extent that such section 1886(n) is
applied), or section 1814(l)(3) of the Social
Security Act to incorporate appropriate data
elements of field EMS patient care reports into
patient electronic health records.
``(B) Incorporation of patient health information
created subsequent to the receipt of field EMS
emergency care into NEMSIS, taking into consideration--
``(i) the types of medical information
created subsequent to the receipt of field EMS
emergency care (such as outcomes information or
information regarding subsequent care and
treatment) that would, if included in NEMSIS,
be potentially useful in evaluating and
improving the quality of EMS care;
``(ii) how best to integrate such
information into NEMSIS;
``(iii) potential modifications to the
HITECH Act to require eligible hospitals, as
defined in section 1886(n)(6)(B) of the Social
Security Act (42 U.S.C. 1395ww(n)(6)(B)), for
purposes of incentive payments under
1886(b)(3)(B)(ix) and 1886(n) of such Act, to
develop or report relevant data to NEMSIS or
other appropriate State or private registries;
and
``(iv) potential modifications to the
Medicare and Medicaid programs under titles
XVIII and XIX, respectively, of the Social
Security Act or other Federal health programs
to provide appropriate reimbursement and
financial incentives for field EMS agencies to
develop or report relevant data to NEMSIS or
other appropriate State or private registries.
``(d) Clarification of HIPAA.--
``(1) Exchange of information related to the treatment of
patients.--
``(A) In general.--Nothing in HIPAA privacy and
security law (as defined in section 3009(a)(2)) shall
be construed as prohibiting the exchange of information
between field EMS practitioners treating an individual
and personnel of a hospital to which the individual is
transported for the purposes of relating information on
the medical history, treatment, care, and outcome of
such individual (including any health care personnel
safety issues such as infectious disease).
``(B) Guidelines.--The Secretary shall establish
guidelines for exchanges of information between field
EMS practitioners treating an individual and personnel
of a hospital to which the individual is transported to
protect the privacy of the individual while ensuring
the ability of such EMS practitioners and hospital
personnel to communicate effectively to further the
continuity and quality of emergency medical care
provided to such individual.
``(2) NEMSIS data.--Nothing in HIPAA privacy and security
law (as defined in section 3009(a)(2)) shall be construed as
prohibiting--
``(A) a field EMS agency from submitting EMS data
to the State EMS Office for the purpose of quality
improvement and data collection by the State for
submission to NEMSIS; or
``(B) the State EMS Office from submitting
aggregated nonindividually identifiable EMS data to the
National EMS Database maintained by NHTSA.
``SEC. 1295. FIELD EMS EDUCATION GRANTS.
``(a) In General.--For the purpose of promoting field EMS as a
health profession and ensuring the availability, quality, and
capability of field EMS educators, practitioners, and medical
directors, the Director may make grants to eligible entities for the
development, availability, and dissemination of field EMS education
programs and courses that improve the quality and capability of field
EMS personnel. In carrying out this section, the Director shall take
into consideration recommendations of the Administrators of each of
NHTSA, FICEMS, and NEMSAC, the National Health Care Workforce
Commission established under section 5101 of the Patient Protection and
Affordable Care Act (42 U.S.C. 294q), and relevant stakeholders.
``(b) Eligibility.--In this section, the term `eligible entity'
means an educational organization, an educational institution, a
professional association, and any other entity involved with the
education of field EMS practitioners.
``(c) Use of Funds.--The Director may award a grant to an eligible
entity under paragraph (1) only if the entity agrees to use the grant
to--
``(1) develop and implement education programs that--
``(A) train field EMS trainers and promote the
adoption and implementation of the education standards
identified in the `Emergency Medical Services Education
Agenda for the Future: A Systems Approach' including
any revisions thereto;
``(B) bridge the gap in knowledge and skills in
field EMS and among field EMS and other allied health
professions to develop a larger cadre of educational
instructors and build a stronger and more flexible
field EMS practitioner corps; or
``(C) provide training and retraining programs to
provide displaced workers the opportunity to enter a
field EMS profession;
``(2) develop and implement educational courses pertaining
to--
``(A) instructor courses;
``(B) provision of medical direction of field EMS;
``(C) field EMS practitioners, including
physicians, emergency medical technicians, paramedics,
nurses, and other relevant clinicians providing
emergency medical care in the field;
``(D) field EMS educational and clinical research;
``(E) bridge programs among field EMS, nursing, and
other allied health professions;
``(F) field EMS management;
``(G) national, evidence-based guidelines; and
``(H) translation of the lessons learned in
military medicine to field EMS;
``(3) evaluate education and training courses and
methodologies to identify optimal educational modalities for
field EMS practitioners;
``(4) improve the field EMS education infrastructure by
increasing the number of field EMS instructors and the quality
of their preparation by improving, enhancing, and modernizing
the dissemination of EMS education, including distance
learning, and by establishing quality improvement for EMS
education programs;
``(5) enhance the opportunity for medical direction
training and for promoting appropriate medical oversight of
field emergency medical care;
``(6) improve systems to design, implement, and evaluate
education for prospective and current field EMS providers; or
``(7) carrying out such other activities as the Director
determines appropriate.
``(d) Priority.--The Director, in consultation with NHTSA and
relevant stakeholders, and taking into consideration the
recommendations of FICEMS and NEMSAC, shall establish a system of
prioritization in awarding grants under this section to eligible
entities.
``(e) Duration of Grants.--Grants under this section shall be for a
period of 1 to 3 years.
``(f) Application.--The Director may not award a grant to an
eligible entity under this section unless the entity submits an
application to the Director in such form, in such manner, and
containing such agreements, assurances, and information as the Director
may require. The Director shall ensure that the requirements for
submitting an application under this section are not unduly burdensome.
``SEC. 1296. EVALUATING INNOVATIVE MODELS FOR ACCESS AND DELIVERY OF
FIELD EMS FOR PATIENTS.
``(a) Evaluation.--
``(1) In general.--Not later than 1 year after the date of
the enactment of the Field EMS Innovation Act, the Director, in
consultation with the Administrator of the Centers for Medicare
& Medicaid Services, and taking into consideration the
recommendations of NEMSAC and FICEMS, shall complete an
evaluation of--
``(A) the provision of and reimbursement for
alternative delivery models for medical care through
field EMS; and
``(B) the integration of field EMS patients with
other medical providers and facilities as medically
appropriate.
``(2) Specific issues.--In completing the evaluation under
paragraph (1), the Director shall consider each of the
following:
``(A) Alternative dispositions of patients,
including--
``(i) transporting patients by ambulance to
destinations other than a hospital such as the
office of the patient's physician, an urgent
care center, or the facilities of another
health care provider;
``(ii) when medically necessary, the
evaluation, treatment, or referral of patients
to other medically appropriate health care
providers;
``(iii) the provision of medical care
regardless of the decision to transport, such
as reimbursement models based on readiness
rather than transport and shared savings; and
``(iv) the provision of health care using
patient centered mobile resources in the out-
of-hospital environment, such as mobile
integrated health care services and community
paramedicine.
``(B) Issues related to medical liability and the
requirements of section 1867 of the Social Security Act
(42 U.S.C. 1395dd; commonly referred to as `EMTALA')
associated with transport to destinations other than a
hospital emergency department.
``(C) Necessary protections to ensure that patients
receive timely and appropriate care in the appropriate
setting.
``(D) Whether there are any barriers to providing
alternate dispositions to patients who are not in need
of care in hospital emergency departments.
``(E) Other issues determined by the Director,
including, when practicable, issues recommended by
FICEMS or NEMSAC for evaluation under this subsection.
``(b) Demonstration Projects.--
``(1) In general.--Beginning not later than 1 year after
the date of the enactment of the Field EMS Innovation Act, the
Director shall conduct or support at least 10 demonstration
projects to--
``(A) evaluate the implementation and reimbursement
of alternative dispositions of field EMS patients,
including--
``(i) transporting patients by ambulance to
alternate destinations when medically
appropriate and in the patients' best
interests;
``(ii) when medically necessary,
evaluating, treating, or referring patients to
other medically appropriate providers; and
``(iii) when medically appropriate,
treating patients through mobile integrated
health care services or community paramedicine.
``(B) evaluate the implementation of reimbursement
models based on readiness rather than transport or
shared savings; and
``(C) determine whether such alternative
dispositions and reimbursement models--
``(i) improve the safety, effectiveness,
timeliness, and efficiency of EMS; and
``(ii) reduce overall utilization and
expenditures under the Medicare program under
title XVIII of the Social Security Act.
``(2) Evidence-based protocols.--The Director shall ensure
that at least one demonstration project under paragraph (1)
evaluates evidence-based protocols that give guidance on
selection of the destination to which patients are transported.
``(3) Duration.--The period of a demonstration project
under paragraph (1) shall not exceed 3 years.
``(4) Research.--The Director shall conduct or support
further research that the Director determines to be necessary
prior to or in conjunction with the demonstration projects
under this subsection in order to evaluation the implementation
of alternative dispositions of field EMS patients.
``(5) Funding.--Of the amount made available to carry out
section 1115A of the Social Security Act (42 U.S.C. 1315a) for
a fiscal year, the Secretary may transfer such sums as may be
necessary to carry out this subsection.
``(c) Report to Congress.--Not later than 1 year after the
completion of all demonstration projects under subsection (b), the
Director shall submit to Congress a report on the results of activities
under this section, including recommendations on the efficacy of
alternative dispositions of field EMS patients.''.
SEC. 5. ENHANCING RESEARCH IN FIELD EMS.
(a) Models To Be Tested by Center for Medicare and Medicaid
Innovation.--Section 1115A(b)(2)(B) of the Social Security Act (42
U.S.C. 1315a(b)(2)(B)) is amended by adding at the end the following:
``(xxi) Enhancing health outcomes for
patients receiving field emergency medical
services and improving timely and efficient
delivery of high-quality field emergency
medical services, such as through--
``(I) regionalization of emergency
care;
``(II) medical transport to
alternate destinations; or
``(III) when medically necessary,
the evaluation, treatment, or referral
of patients to other medically
appropriate health providers.''.
(b) Emergency Medical Research.--Section 498D of the Public Health
Service Act (42 U.S.C. 289g-4) is amended--
(1) by redesignating subsections (c) and (d) as subsections
(d) and (e), respectively; and
(2) by inserting after subsection (b) the following:
``(c) Field EMS Emergency Medical Research.--
``(1) In general.--The Secretary shall conduct research and
evaluation relating to field EMS through the Agency for
Healthcare Research and Quality and the Center for Medicare and
Medicaid Innovation.
``(2) Definition.--In this subsection, the term `field EMS'
has the meaning given such term in section 1291.''.
(c) Field EMS Practice Center.--Subpart II of part D of title IX of
the Public Health Service Act (42 U.S.C. 299b-33 et seq.) is amended by
adding at the end the following:
``SEC. 938. FIELD EMS PRACTICE CENTER.
``(a) Establishment.--The Director shall establish within the
Office of Research and Evaluation a Field EMS Evidence-Based Practice
Center (referred to in this section as the `Center').
``(b) Purpose.--The purpose of the Center is to conduct or support
research to promote the highest quality of emergency medical care in
field EMS and the most effective delivery system for the provision of
such care, including--
``(1) comparative safety and effectiveness research;
``(2) other appropriate clinical or systems research; and
``(3) research addressing--
``(A) critical care transport;
``(B) off-shore operations;
``(C) tactical emergency medical services;
``(D) air medical services; and
``(E) the application of lessons learned in
military field medicine in the delivery of emergency
medical care in field EMS.
``(c) Definition.--In this section, the term `field EMS' has the
meaning given such term in section 1291.''.
(d) Limitations on Certain Uses of Research.--Section 1182 of the
Social Security Act (42 U.S.C. 1320e-1) is amended by striking
``section 1181'' each place it appears and inserting ``section 1181 of
this Act or section 498D(c) or 938 of the Public Health Service Act''.
(e) Regulatory Barriers.--For the purposes of research conducted
pursuant to clause (xxi) of section 1115A(b)(2)(B) of the Social
Security Act (as added by subsection (a)), subsection (c) of section
498D of the Public Health Service Act (as added by subsection (b)),
section 938 of the Public Health Service Act (as added by subsection
(c)), or any other research funded by the Department of Health and
Human Services related to emergency medical services in the field in
which informed consent is required but may not be attainable, the
Secretary of Health and Human Services shall--
(1) evaluate and consider the patient and research issues
involved; and
(2) address regulatory barriers to such research related to
the need for informed consent in a manner that ensures adequate
patient safety and notification, and submit recommendations to
Congress for any changes to Federal statutes necessary to
address such barriers.
SEC. 6. EMERGENCY MEDICAL SERVICES TRUST FUND.
(a) Designation of Income Tax Overpayments and Additional
Contributions for Emergency Medical Services.--Subchapter A of chapter
61 of the Internal Revenue Code of 1986 is amended by adding at the end
the following new part:
``PART IX--DESIGNATION OF INCOME TAX OVERPAYMENTS AND ADDITIONAL
CONTRIBUTIONS FOR EMERGENCY MEDICAL SERVICES
``SEC. 6097. DESIGNATION BY INDIVIDUALS.
``(a) In General.--Every individual (other than a nonresident
alien) may designate that--
``(1) a specified portion of any overpayment of tax for a
taxable year, and
``(2) any amount contributed in addition to any payment of
tax for such taxable year and any designation under paragraph
(1),
shall be used to fund the Emergency Medical Services Trust Fund.
Designations under the preceding sentence shall be in an amount not
less than $1, and the Secretary shall provide for elections in amounts
of $1, $5, $10, or such other amount as the taxpayer designates.
``(b) Overpayments Treated as Refunded.--For purposes of this
title, any portion of an overpayment of tax designated under subsection
(a) shall be treated as--
``(1) being refunded to the taxpayer as of the last date
prescribed for filing the return of tax imposed by chapter 1
(determined without regard to extensions) or, if later, the
date the return is filed, and
``(2) a contribution made by such taxpayer on such date to
the United States.
``(c) Manner and Time of Designation.--A designation under
subsection (a) may be made with respect to any taxable year--
``(1) at the time of filing the return of the tax imposed
by chapter 1 for such taxable year, or
``(2) at any other time (after the time of filing the
return of the tax imposed by chapter 1 for such taxable year)
specified in regulations prescribed by the Secretary.
Such designation shall be made in such manner as the Secretary
prescribes by regulations except that, if such designation is made at
the time of filing the return of the tax imposed by chapter 1 for such
taxable year, such designation shall be made either on the first page
of the return or on the page bearing the signature of the taxpayer.''.
(b) Emergency Medical Services Trust Fund.--Subchapter A of chapter
98 of the Internal Revenue Code of 1986 is amended by adding at the end
the following new section:
``SEC. 9512. EMERGENCY MEDICAL SERVICES TRUST FUND.
``(a) Creation of Trust Fund.--There is established in the Treasury
of the United States a trust fund to be known as the `Emergency Medical
Services Trust Fund', consisting of such amounts as may be credited or
paid to such trust fund as provided in subsection (b).
``(b) Transfers to Trust Fund.--There are hereby appropriated to
the Emergency Medical Services Trust Fund amounts equivalent to the
amounts of the overpayments of tax to which designations under section
6097 apply.
``(c) Expenditures From Trust Fund.--Amounts in the Emergency
Medical Services Trust Fund shall be available, as provided in
appropriation Acts, only for carrying out the provisions for which
amounts are authorized to be appropriated under subsections (a) and (b)
of section 7 of the Field EMS Innovation Act.''.
(c) Clerical Amendments.--
(1) Clerical amendment.--The table of parts for subchapter
A of chapter 61 of the Internal Revenue Code of 1986 is amended
by adding at the end the following new item:
``Part IX. Designation of Income Tax Overpayments and Additional
Contributions for Emergency Medical Services.''.
(2) The table of sections for subchapter A of chapter 98 of
such Code is amended by adding at the end the following new
item:
``Sec. 9512. Emergency Medical Services Trust Fund.''.
(d) Effective Date.--The amendments made by this section shall
apply to taxable years beginning after December 31, 2015.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--Out of amounts in the Emergency Medical Services
Trust Fund, there are authorized to be transferred--
(1) to the Secretary of Health and Human Services--
(A) $12,000,000, for the purpose of carrying out
section 2831 of the Public Health Service Act (except
for subsection (b)(3) of such section), section 1294 of
such Act, and section 1296 of such Act (except for
subsection (b) of such section) for each of fiscal
years 2015 through 2019;
(B) $200,000,000 for each of fiscal years 2015
through 2019, for the purpose of carrying out section
1292 of the Public Health Service Act;
(C) $50,000,000 for each of fiscal years 2015
through 2019, for the purpose of carrying out section
1293 of the Public Health Service Act;
(D) $15,000,000 for each of fiscal years 2015
through 2019, for the purpose of carrying out section
1295 of the Public Health Service Act; and
(E) $40,000,000 for each of fiscal years 2015
through 2019, for the purpose of carrying out sections
498D(c) and 938 of the Public Health Service Act, as
added by section 5; and
(2) to the Secretary of Transportation, $4,000,000 for each
of fiscal years 2015 through 2019, for the purpose of carrying
out section 1292(c)(1) of the Public Health Service Act.
(b) Excess Amounts.--If, for any fiscal year, amounts in the
Emergency Medical Services Trust Fund exceed the maximum amount
authorized to be transferred under subsection (a), the Secretary of
Health and Human Services may transfer such excess amounts for the
purpose of carrying out section 330J, section 498D, and parts A, B, C,
D, and H of title XII of the Public Health Service Act (42 U.S.C. 254c-
15, 289g-4, 300d et seq., 300d-11 et seq., 300d-31 et seq., and 300d-81
et seq.).
(c) Start-Up Funding.--
(1) In general.--Out of the discretionary funds available
to the Secretary of Health and Human Services for each of
fiscal years 2015 and 2016, $40,000,000 shall be used for
carrying out the amendments made by subsections (a), (b), and
(c) of section 5.
(2) Relation to other funds.--The amount of discretionary
funds allocated under paragraph (1) for the purpose of carrying
out subsections (a), (b), and (c) of section 5 shall be in
addition to, not in lieu of, the amount of discretionary funds
that would otherwise be available for such purpose.
(d) Administrative Expenses.--Of the amounts made available under
subsection (a), (b), or (c) to carry out each of the provisions listed
in subsection (a), not more than 5 percent of each such amount may be
used for Federal administrative expenses.
SEC. 8. STATUTORY CONSTRUCTION.
Nothing in this Act, including the amendments made by this Act
shall be construed to supercede any statutory authority of any Federal
agency that is not within the Department of Health and Human Services.
<all>
Introduced in Senate
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.
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