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114th Congress    }                                    {        Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                    {       114-552

======================================================================



 
        VETERAN EMERGENCY MEDICAL TECHNICIAN SUPPORT ACT OF 2016

                                _______
                                

  May 10, 2016.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

  Mr. Upton, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 1818]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 1818) to amend the Public Health Service Act to 
provide grants to States to streamline State requirements and 
procedures for veterans with military emergency medical 
training to become civilian emergency medical technicians, 
having considered the same, report favorably thereon with an 
amendment and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     2
Background and Need for Legislation..............................     2
Hearings.........................................................     3
Committee Consideration..........................................     3
Committee Votes..................................................     3
Committee Oversight Findings.....................................     3
Statement of General Performance Goals and Objectives............     3
New Budget Authority, Entitlement Authority, and Tax Expenditures     3
Earmark, Limited Tax Benefits, and Limited Tariff Benefits.......     3
Committee Cost Estimate..........................................     3
Congressional Budget Office Estimate.............................     4
Federal Mandates Statement.......................................     5
Duplication of Federal Programs..................................     5
Disclosure of Directed Rule Makings..............................     5
Advisory Committee Statement.....................................     5
Applicability to Legislative Branch..............................     5
Section-by-Section Analysis of the Legislation...................     6
Changes in Existing Law Made by the Bill, as Reported............     6

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Veteran Emergency Medical Technician 
Support Act of 2016''.

SEC. 2. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING TO 
                    MEET REQUIREMENTS FOR BECOMING CIVILIAN EMERGENCY 
                    MEDICAL TECHNICIANS.

  Part B of title III of the Public Health Service Act (42 U.S.C. 243 
et seq.) is amended by inserting after section 314 the following:

``SEC. 315. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING 
                    TO MEET REQUIREMENTS FOR BECOMING CIVILIAN 
                    EMERGENCY MEDICAL TECHNICIANS.

  ``(a) Program.--The Secretary shall establish a program consisting of 
awarding demonstration grants to States to streamline State 
requirements and procedures in order to assist veterans who completed 
military emergency medical technician training while serving in the 
Armed Forces of the United States to meet certification, licensure, and 
other requirements applicable to becoming an emergency medical 
technician in the State.
  ``(b) Use of Funds.--Amounts received as a demonstration grant under 
this section shall be used to prepare and implement a plan to 
streamline State requirements and procedures as described in subsection 
(a), including by--
          ``(1) determining the extent to which the requirements for 
        the education, training, and skill level of emergency medical 
        technicians in the State are equivalent to requirements for the 
        education, training, and skill level of military emergency 
        medical technicians; and
          ``(2) identifying methods, such as waivers, for military 
        emergency medical technicians to forgo or meet any such 
        equivalent State requirements.
  ``(c) Eligibility.--To be eligible for a grant under this section, a 
State shall demonstrate that the State has a shortage of emergency 
medical technicians.
  ``(d) Report.--The Secretary shall submit to the Congress an annual 
report on the program under this section.
  ``(e) Funding.--No additional funds are authorized to be appropriated 
for the purpose of carrying out this section. This section shall be 
carried out using amounts otherwise available for such purpose.''.

                          Purpose and Summary

    H.R. 1818, the ``Veteran Emergency Medical Technician 
Support Act of 2016,'' was introduced by Rep. Adam Kinzinger 
(R-IL) on April 15, 2015.
    The legislation amends the Public Health Service Act to 
provide grants to states to streamline state requirements and 
procedures for veterans with military emergency medical 
training to become civilian emergency medical technicians 
(EMT).

                  Background and Need for Legislation

    Members of the U.S. military who trained as combat medics 
face state licensing challenges when they try to find similar 
work after discharge. Many states do not recognize their 
qualifications as applicable to the licensing requirements of 
the civilian health care system for emergency medical services, 
such as EMTs or paramedics. State licensing laws vary, and 
while some states make exceptions for former military medics to 
allow for reciprocity and a chance to sit for the licensing 
exam without repeating their training, many states do not.
    H.R. 1818 would provide demonstration grants to states with 
EMT shortages to help streamline State requirements for 
veterans to enter the EMT workforce without unnecessary 
duplication of their training. No additional funds are 
authorized to be appropriated for this legislation.

                                Hearings

    On January 27, 2015, the Subcommittee on Health held a 
hearing on a discussion draft of H.R. 1818. The Subcommittee 
received testimony from:
     LTC (Ret.) Ben Chlapek, the National Association 
of Emergency Medical Technicians.

                        Committee Consideration

    On April 20, 2016 the Subcommittee on Health met in open 
markup session and forwarded H.R. 1818 to the full Committee, 
without amendment, by a voice vote. On April 26, 27, and 28, 
2016, the full Committee on Energy and Commerce met in open 
markup session and ordered H.R. 1818 reported to the House, as 
amended, by a voice vote.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no record votes taken in connection with ordering 
H.R. 1818 reported.

                      Committee Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee held a hearing and made 
findings that are reflected in this report.

         Statement of General Performance Goals and Objectives

    The goal of the legislation is to help veteran EMTs to 
enter the civilian EMT workforce without unnecessary 
duplication of their training.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
1818 would result in no new or increased budget authority, 
entitlement authority, or tax expenditures or revenues.

       Earmark, Limited Tax Benefits, and Limited Tariff Benefits

    In compliance with clause 9(e), 9(f), and 9(g) of rule XXI 
of the Rules of the House of Representatives, the Committee 
finds that H.R. 1818 contains no earmarks, limited tax 
benefits, or limited tariff benefits.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate prepared 
by the Director of the Congressional Budget Office pursuant to 
section 402 of the Congressional Budget Act of 1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate 
provided by the Congressional Budget Office pursuant to section 
402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                       Washington, DC, May 6, 2016.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 1818, the Veteran 
Emergency Medical Technician Support Act of 2016.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
            Sincerely,
                                                        Keith Hall.
    Enclosure.

H.R. 1818--Veteran Emergency Medical Technician Support Act of 2016

    Summary: H.R. 1818 would direct the Secretary of Health and 
Human Services (HHS) to award demonstration grants to states to 
streamline procedures for licensing and certifying emergency 
medical technicians (EMT) who received similar certifications 
while serving in the armed forces.
    CBO estimates that implementing H.R. 1818 would cost $30 
million over the 2017-2021 period; any such spending would be 
subject to the availability of appropriated funds. Pay-as-you-
go procedures do not apply to this legislation because it would 
not affect direct spending or revenues. CBO estimates that 
enacting H.R. 1818 would not increase net direct spending or 
on-budget deficits in any of the four consecutive 10-year 
periods beginning in 2027.
    H.R. 1818 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
    Estimated cost to the Federal Government: The estimated 
budgetary effect of H.R. 1818 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                            By fiscal year, in millions of dollars--
                                               -----------------------------------------------------------------
                                                                                                          2017-
                                                   2017       2018       2019       2020       2021       2021
----------------------------------------------------------------------------------------------------------------
                                 INCREASES IN SPENDING SUBJECT TO APPROPRIATION
 
Estimated Authorization Level.................          3          5          8         11         12         39
Estimated Outlays.............................          1          3          6          9         11         30
----------------------------------------------------------------------------------------------------------------

    Basis of estimate: The bill would authorize a demonstration 
program of grants to states to help them streamline 
requirements and procedures necessary for licensing emergency 
medical technicians who have backgrounds and experience as 
military medical technicians.
    Based on information from the Department of Labor's interim 
report on the Veterans' Licensing and Certification 
Demonstration, CBO expects most states would use grant funds 
provided by HHS to provide training and education assistance to 
veterans who would like to become a certified or licensed EMT. 
Based on data from the Department of Defense and information 
from training providers, CBO estimates that approximately 5,000 
veterans per year would participate in the training program 
once it is fully implemented and that training costs would 
average about $2,000 per participant. In total, CBO estimates 
that implementing H.R. 1818 would cost $30 million over the 
2017-2021 period; such spending would be subject to the 
availability of appropriated funds.
    Pay-As-You-Go considerations: None.
    Increase in long-term direct spending and deficits: CBO 
estimates that enacting H.R. 1818 would not increase net direct 
spending or on-budget deficits in any of the four consecutive 
10-year periods beginning in 2027.
    Intergovernmental and private-sector impact: H.R. 1818 
contains no intergovernmental or private-sector mandates as 
defined in UMRA and would impose no costs on state, local, or 
tribal governments.
    Estimate prepared by: Federal costs: Lisa Ramirez-Branum; 
Impact on state, local, and tribal governments: Leo Lex; Impact 
on the private sector: Amy Petz.
    Estimate approved by: Holly Harvey, Deputy Assistant 
Director for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

                    Duplication of Federal Programs

    No provision of H.R. 1818 establishes or reauthorizes a 
program of the Federal Government known to be duplicative of 
another Federal program, a program that was included in any 
report from the Government Accountability Office to Congress 
pursuant to section 21 of Public Law 111-139, or a program 
related to a program identified in the most recent Catalog of 
Federal Domestic Assistance.

                  Disclosure of Directed Rule Makings

    The Committee estimates that enacting H.R. 1818 
specifically directs to be completed 0 rule makings within the 
meaning of 5 U.S.C. 551.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by this 
legislation.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 states that the legislation may be cited as the 
``Veteran Emergency Medical Technician Support Act of 2016.''

Section 2. Assisting veterans with military emergency medical training 
        to meet requirements for becoming civilian emergency medical 
        technicians

    Section 2 amends the PHSA by adding a new Section 315. The 
new section would allow the Secretary of Health and Human 
Services (HHS) to establish a program for awarding 
demonstration grants to states to streamline state requirements 
and procedures and assist veterans who have completed military 
emergency medical training in meeting state certification and 
licensing requirements. In addition, the HHS Secretary would be 
required to submit an annual report on the demonstration 
projects to Congress.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

PUBLIC HEALTH SERVICE ACT

           *       *       *       *       *       *       *



TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



Part B--Federal-State Cooperation

           *       *       *       *       *       *       *



SEC. 315. ASSISTING VETERANS WITH MILITARY EMERGENCY MEDICAL TRAINING 
                    TO MEET REQUIREMENTS FOR BECOMING CIVILIAN 
                    EMERGENCY MEDICAL TECHNICIANS.

  (a) Program.--The Secretary shall establish a program 
consisting of awarding demonstration grants to States to 
streamline State requirements and procedures in order to assist 
veterans who completed military emergency medical technician 
training while serving in the Armed Forces of the United States 
to meet certification, licensure, and other requirements 
applicable to becoming an emergency medical technician in the 
State.
  (b) Use of Funds.--Amounts received as a demonstration grant 
under this section shall be used to prepare and implement a 
plan to streamline State requirements and procedures as 
described in subsection (a), including by--
          (1) determining the extent to which the requirements 
        for the education, training, and skill level of 
        emergency medical technicians in the State are 
        equivalent to requirements for the education, training, 
        and skill level of military emergency medical 
        technicians; and
          (2) identifying methods, such as waivers, for 
        military emergency medical technicians to forgo or meet 
        any such equivalent State requirements.
  (c) Eligibility.--To be eligible for a grant under this 
section, a State shall demonstrate that the State has a 
shortage of emergency medical technicians.
  (d) Report.--The Secretary shall submit to the Congress an 
annual report on the program under this section.
  (e) Funding.--No additional funds are authorized to be 
appropriated for the purpose of carrying out this section. This 
section shall be carried out using amounts otherwise available 
for such purpose.

           *       *       *       *       *       *       *


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