[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10007 Introduced in House (IH)]

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118th CONGRESS
  2d Session
                               H. R. 10007

To amend the Immigration and Nationality Act to authorize the admission 
     of nonimmigrant emergency medical technicians and paramedics.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            October 18, 2024

   Mr. Higgins of Louisiana introduced the following bill; which was 
               referred to the Committee on the Judiciary

_______________________________________________________________________

                                 A BILL


 
To amend the Immigration and Nationality Act to authorize the admission 
     of nonimmigrant emergency medical technicians and paramedics.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Paramedic and Emergency Medical 
Technician Relief Act of 2024''.

SEC. 2. ESTABLISHMENT OF H-1D VISAS FOR EMTS AND PARAMEDICS.

    (a) Nonimmigrant Category.--Section 101(a)(15)(H)(i) of the 
Immigration and Nationality Act (8 U.S.C. 1101(a)(15)(H)(i)) is amended 
by striking ``; or'' at the end and inserting ``, or (d) who is coming 
temporarily to the United States to perform services as an emergency 
medical technician or paramedic, who meets the qualifications described 
in section 212(u) , and with respect to whom the Secretary of Labor 
determines and certifies to the Secretary of Homeland Security that an 
unexpired attestation is on file and in effect under section 212(u)(2) 
for the employer; or''.
    (b) Requirements.--Section 212 of the Immigration and Nationality 
Act (8 U.S.C. 1182) is amended by adding at the end the following:
    ``(u) Requirements for Admission of Nonimmigrant EMTs and 
Paramedics.--
            ``(1) Qualifications.--The qualifications referred to in 
        section 101(a)(15)(H)(i)(d), with respect to an alien who is 
        coming to the United States to perform services as an emergency 
        medical technician or paramedic, are that the alien--
                    ``(A) has, at a minimum, obtained emergency medical 
                technician, paramedic, or equivalent pre-hospital care, 
                education or training in a foreign country or in the 
                United States;
                    ``(B) not later than 12 weeks before the alien's 
                intended first date of employment in the United States, 
                has passed an appropriate examination (recognized in 
                regulations promulgated in consultation with the 
                Secretary of Health and Human Services) or has obtained 
                the appropriate certificate or license under State law 
                to practice as an emergency medical technician or 
                paramedic in the State of intended employment;
                    ``(C) not later than 12 weeks before the alien's 
                intended first date of employment in the United States, 
                is fully qualified and eligible under the laws 
                (including such temporary or interim licensing 
                requirements which authorize the emergency medical 
                technician or paramedic to be employed) governing the 
                place of intended employment to engage in practice as 
                an emergency medical technician or a paramedic 
                immediately upon admission to the United States; and
                    ``(D) not later than 12 weeks before the alien's 
                intended first date of employment in the United States, 
                has passed appropriate criminal record checks and other 
                background and database checks, as determined by the 
                Secretary of Homeland Security in coordination with the 
                Attorney General, including biometric data collection, 
                a review of the applicant's criminal and immigration 
                records, verification of the applicant's identity and 
                travel history, and an assessment of any potential risk 
                the applicant poses to public safety or national 
                security.
            ``(2) Attestation.--
                    ``(A) The attestation referred to in section 
                101(a)(15)(H)(i)(d), with respect to an employer for 
                which an alien will perform services, is an attestation 
                as to the following:
                            ``(i) The employment of the alien will not 
                        adversely affect the wages and working 
                        conditions of emergency medical technicians or 
                        paramedics, as applicable, similarly employed.
                            ``(ii) The alien employed by the employer 
                        will be paid the wage rate for emergency 
                        medical technicians or paramedics, as 
                        applicable, similarly employed by the employer.
                            ``(iii) The employer has taken and is 
                        taking timely and significant steps designed to 
                        recruit and retain sufficient emergency medical 
                        technicians or paramedics, as applicable, who 
                        are United States citizens or immigrants who 
                        are authorized to perform such services.
                            ``(iv) There is not a strike or lockout in 
                        the course of a labor dispute, the employer did 
                        not lay off and will not lay off an emergency 
                        medical technician or a paramedic, as 
                        applicable, employed by the employer within the 
                        period beginning 90 days before and ending 90 
                        days after the date of filing of any visa 
                        petition, and the employment of such an alien 
                        is not intended or designed to influence an 
                        election for a bargaining representative for 
                        emergency medical technicians or paramedics of 
                        the employer.
                            ``(v) At the time of the filing of the 
                        petition for emergency medical technicians or 
                        paramedics, as applicable, under section 
                        101(a)(15)(H)(i)(d), notice of the filing has 
                        been provided by the employer to the bargaining 
                        representative of the emergency medical 
                        technicians or paramedics employed by the 
                        employer or, where there is no such bargaining 
                        representative, notice of the filing has been 
                        provided to the emergency medical technicians 
                        or paramedics employed by the employer through 
                        posting in conspicuous locations or electronic 
                        notification to such employees.
                            ``(vi) The employer will not, at any time, 
                        employ a number of aliens issued visas or 
                        otherwise provided nonimmigrant status under 
                        section 1101(a)(15)(H)(i)(d) of this title as 
                        emergency medical technicians or paramedics 
                        that exceeds 15 percent of the total number of 
                        emergency medical technicians or paramedics, 
                        respectively, employed by the employer.
                            ``(vii) The employer is affiliated with an 
                        emergency medical services education program 
                        approved by the applicable licensing body of 
                        the State in which the alien will work.
                        Nothing in clause (iii) shall be construed as 
                        requiring an employer to have taken significant 
                        steps described in such clause before the 
                        effective date of the Paramedic and Emergency 
                        Medical Technician Relief Act of 2023. A copy 
                        of the attestation referred to in section 
                        101(1)(15)(H)(i)(d) shall be provided, within 
                        30 days of the date of filing, to emergency 
                        medical technicians or paramedics, as 
                        applicable, employed by the employer on the 
                        date of filing.
                    ``(B) For purposes of subparagraph (A)(iii), each 
                of the following shall be considered a significant step 
                reasonably designed to recruit and retain emergency 
                medical technicians or paramedics:
                            ``(i) Operating a training program for 
                        emergency medical technicians or paramedics or 
                        financing (or providing participation in) a 
                        training program for emergency medical 
                        technicians or paramedics.
                            ``(ii) Providing career development 
                        programs and other methods of facilitating 
                        nationals of the United States to become 
                        emergency medical technicians or paramedics.
                            ``(iii) Paying emergency medical 
                        technicians or paramedics wages at a rate equal 
                        to or higher than currently being paid to 
                        emergency medical technicians or paramedics 
                        similarly employed in the geographic area.
                            ``(iv) Providing reasonable opportunities 
                        for meaningful salary advancement by emergency 
                        medical technicians or paramedics.
                The steps described in this subparagraph shall not be 
                considered to be an exclusive list of the significant 
                steps that may be taken to meet the conditions of 
                subparagraph (A)(iii). Nothing in this subparagraph 
                shall require an employer to take more than one step if 
                the employer can demonstrate that taking a second step 
                is not reasonable.
                    ``(C) Subject to subparagraph (E), an attestation 
                under subparagraph (A)--
                            ``(i) shall expire on the date that is the 
                        later of--
                                    ``(I) the end of the one-year 
                                period beginning on the date of its 
                                filing with the Secretary of Labor; or
                                    ``(II) the end of the period of 
                                admission under section 
                                101(a)(15)(H)(i)(d) of the last alien 
                                with respect to whose admission it was 
                                applied (in accordance with clause 
                                (ii)); and
                            ``(ii) shall apply to petitions filed 
                        during the one-year period beginning on the 
                        date of its filing with the Secretary of Labor 
                        if the employer states in each such petition 
                        that it continues to comply with the conditions 
                        in the attestation.
                    ``(D) An employer may meet the requirements under 
                this paragraph with respect to more than one emergency 
                medical technician or paramedic in a single petition.
                    ``(E)(i) The Secretary of Labor shall compile and 
                make publicly available online a list identifying 
                employers which have filed petitions for nonimmigrants 
                under section 101(a)(15)(H)(i)(d) and, for each such 
                employer, a copy of the employer's attestation under 
                subparagraph (A) (and accompanying documentation) and 
                each such petition filed by the employer.
                    ``(ii) The Secretary of Labor shall establish a 
                process, including reasonable time limits, for the 
                receipt, investigation, and disposition of complaints 
                respecting an employer's failure to meet conditions 
                attested to or an employer's misrepresentation of a 
                material fact in an attestation. Complaints may be 
                filed by any aggrieved person or organization 
                (including bargaining representatives, associations 
                deemed appropriate by the Secretary, and other 
                aggrieved parties as determined under regulations of 
                the Secretary). The Secretary shall conduct an 
                investigation under this clause if there is reasonable 
                cause to believe that an employer fails to meet 
                conditions attested to. Subject to the time limits 
                established under this clause, this subparagraph shall 
                apply regardless of whether an attestation is expired 
                or unexpired at the time a complaint is filed.
                    ``(iii) Under such process, the Secretary shall 
                provide, within 180 days after the date such a 
                complaint is filed, for a determination as to whether 
                or not a basis exists to make a finding described in 
                clause (iv). If the Secretary determines that such a 
                basis exists, the Secretary shall provide for notice of 
                such determination to the interested parties and an 
                opportunity for a hearing on the complaint within 60 
                days of the date of the determination.
                    ``(iv) If the Secretary of Labor finds, after 
                notice and opportunity for a hearing, that an employer 
                (for which an attestation is made) has failed to meet a 
                condition attested to or that there was a 
                misrepresentation of material fact in the attestation, 
                the Secretary of Labor shall notify the Secretary of 
                Homeland Security of such finding and may, in addition, 
                impose such other administrative remedies (including 
                civil monetary penalties in an amount not to exceed 
                $1,000 per emergency medical technician or paramedic 
                per violation, with the total penalty not to exceed 
                $10,000 per violation) as the Secretary of Labor 
                determines to be appropriate. Upon receipt of such 
                notice, the Secretary of Homeland Security shall not 
                approve petitions filed with respect to an employer 
                during a period of at least one year for emergency 
                medical technicians or paramedics, as applicable to be 
                employed by the employer.
                    ``(v) In addition to the sanctions provided for 
                under clause (iv), if the Secretary of Labor finds, 
                after notice and an opportunity for a hearing, that an 
                employer has violated the condition attested to under 
                subparagraph (A)(ii) (relating to payment of emergency 
                medical technicians or paramedics at the prevailing 
                wage rate), the Secretary shall order the employer to 
                provide for payment of such amounts of back pay as may 
                be required to comply with such condition.
                    ``(F)(i) The Secretary of Labor shall impose on an 
                employer filing an attestation under subparagraph (A) a 
                filing fee, in an amount prescribed by the Secretary 
                based on the costs of carrying out the Secretary's 
                duties under this subsection, but not exceeding $250.
                    ``(ii) Fees collected under this subparagraph shall 
                be deposited in a fund established for this purpose in 
                the Treasury of the United States.
                    ``(iii) The collected fees in the fund shall be 
                available to the Secretary of Labor, to the extent and 
                in such amounts as may be provided in appropriations 
                Acts, to cover the costs described in clause (i), in 
                addition to any other funds that are available to the 
                Secretary to cover such costs.
            ``(3) Period of admission.--The period of admission of an 
        alien under section 101(a)(15)(H)(i)(d) shall be 3 years, and 
        may be extended for an additional 3-year period.
            ``(4) Numerical limitation.--
                    ``(A) In general.--The total number of aliens who 
                may be issued visas or otherwise provided nonimmigrant 
                status during any fiscal year under section 
                101(a)(15)(H)(i)(d) may not exceed 2,500. The numerical 
                limitation under this subparagraph shall be allocated 
                for a fiscal year so that the total number of aliens 
                subject to such numerical limit who enter the United 
                States pursuant to a visa or are accorded nonimmigrant 
                status under section 101(a)(15)(H)(i)(d) during the 
                first 6 months of such fiscal year is not more than 
                1,250.
                    ``(B) Adjustment by secretary.--Beginning in the 
                fourth fiscal year that begins after the date of 
                enactment of this paragraph, the Secretary of Homeland 
                Security, in consultation with the Secretary of Labor 
                and other relevant stakeholders, may adjust the 
                numerical limitation under subparagraph (A), as the 
                Secretary finds appropriate. In making such 
                determination, the Secretary shall consider the 
                following:
                            ``(i) The current and projected demand for 
                        emergency medical technicians and paramedics in 
                        the United States.
                            ``(ii) The capacity of United States 
                        educational and training institutions to 
                        produce emergency medical technicians and 
                        paramedics.
                            ``(iii) The potential impact of the 
                        admission of nonimmigrants under section 
                        101(a)(15)(H)(i)(d) on the domestic labor 
                        market, including wages, working conditions, 
                        and employment opportunities for United States 
                        workers.
                            ``(iv) The need to balance the admission of 
                        foreign emergency medical technicians and 
                        paramedics with the protection of United States 
                        workers and the promotion of domestic workforce 
                        development initiatives.
        The Secretary of Homeland Security is authorized to grant 
        exemptions from the numerical limitation under this paragraph 
        in cases of extreme hardship, national interest, or other 
        compelling circumstances, as determined on a case-by-case 
        basis.
            ``(5) Wage rates; unions.--An employer that has filed a 
        petition under section 101(a)(15)(H)(i)(d) to employ a 
        nonimmigrant to perform emergency medical technician or 
        paramedic services for the employer--
                    ``(A) shall provide the nonimmigrant a wage rate 
                and working conditions commensurate with those of 
                emergency medical technicians or paramedics, as 
                applicable, similarly employed by the employer;
                    ``(B) shall require the nonimmigrant to work hours 
                commensurate with those of emergency medical 
                technicians or paramedics, as applicable, similarly 
                employed by the employer; and
                    ``(C) may not engage in any unfair labor practice 
                listed in section 8 of the National Labor Relations Act 
                (29 U.S.C. 158) with respect to any such employee, or 
                otherwise interfere with the employee's rights under 
                section 7 of such Act (29 U.S.C. 157).
            ``(6) Report to congress.--The Secretary of Homeland 
        Security and the Secretary of Labor shall submit to Congress an 
        annual report on admission of nonimmigrants under section 
        101(a)(15)(H)(i)(d), which report shall include the following:
                    ``(A) The impact of the admission of such 
                nonimmigrants on the emergency medical technician and 
                paramedic workforce, as well as any instances of fraud, 
                abuse, or non-compliance with the requirements under 
                this subsection.
                    ``(B) The number of visas issued under such section 
                and the number of applications received during the 
                previous fiscal year.
                    ``(C) The distribution of such nonimmigrants by 
                geographic region, State, and type of employer.
                    ``(D) The prevailing wages paid to such 
                nonimmigrants and any wage disparities with similarly 
                employed United States workers.
                    ``(E) Any violations of labor conditions or program 
                requirements identified by the Secretary of Labor, 
                including any action taken to address such a violation.
                    ``(F) Recommendations for improving the admission 
                of such nonimmigrants or addressing any identified 
                barriers to admission.
            ``(7) Monitoring.--The Secretary of Homeland Security and 
        the Secretary of Labor shall develop and implement procedures 
        to monitor employer compliance with the requirements under this 
        subsection, including periodic site visits, audits, and 
        investigations based on complaints or other credible 
        information.
            ``(8) Definition.--For purposes of paragraph (2)(A)(iv), 
        the term `lay off', with respect to a worker has the meaning 
        given such term in subsection (m).''.

SEC. 3. EFFECTIVE DATE.

    (a) In General.--This Act and the amendments made by this Act shall 
take effect 180 days after the date of enactment of this Act.
    (b) Regulations.--The Secretary of Homeland Security and the 
Secretary of Labor shall issue regulations and guidance as necessary to 
implement the amendments made by this Act, including the following:
            (1) Developing and publishing application forms and 
        instructions for employers and aliens seeking admission under 
        section 101(a)(15)(H)(i)(d) of the Immigration and Nationality 
        Act (8 U.S.C. 1101(a)(15)(H)).
            (2) Establishing procedures for conducting background 
        checks and security screenings, and enforcing labor 
        protections.
            (3) Coordinating with other relevant government agencies, 
        such as the Federal Bureau of Investigation and State licensing 
        boards, to ensure effective implementation and compliance with 
        the requirements under section 212(u) of the Immigration and 
        Nationality Act (8 U.S.C. 1182).
            (4) Providing training and resources to Department of 
        Homeland Security and Department of Labor staff responsible for 
        administering the admission of aliens under such section 
        101(a)(15)(H)(i)(d), as well as any other relevant 
        stakeholders.
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