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[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 10933 Introduced in House (IH)]
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119th CONGRESS
2d Session
H. R. 10933
To amend the Public Health Service Act to direct the Secretary of
Health and Human Services to make grants to eligible entities for
activities related to emergency medical services, and for other
purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
October 29, 2026
Mr. Kean introduced the following bill; which was referred to the
Committee on Energy and Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to direct the Secretary of
Health and Human Services to make grants to eligible entities for
activities related to 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.
This Act may be cited as the ``EMS Supporting Personnel,
Operations, Upgrades, Resources, and Training Act of 2026'' or the
``EMS SUPPORT Act of 2026''.
SEC. 2. STAFFING FOR ADEQUATE EMERGENCY MEDICAL SERVICES.
Part P of title III of the Public Health Service Act (42 U.S.C.
280g et seq.) is amended by adding at the end the following:
``SEC. 399V-8. STAFFING FOR ADEQUATE EMERGENCY MEDICAL SERVICES.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration, (in this section
referred to as the `Administrator') and in consultation with the chief
executives of the States, shall make grants to eligible entities to
carry out any of the following activities:
``(1) Maintaining or increasing the number of emergency
medical services personnel in a career fire department,
combination fire departments, volunteer fire department, or
nonaffiliated EMS organization to conform with industry minimum
standards and attain 24-hour staffing for adequate emergency
medical services.
``(2) Providing mental health services to such personnel.
``(3) Covering or reimbursing any cost related to any
required certification for such personnel.
``(4) Acquiring equipment and supplies used in connection
with emergency medical services, including the following:
``(A) Personal protective equipment.
``(B) Medication.
``(C) Uniforms for such personnel.
``(5) Upgrading or improving, with respect to such
department or organization, any of the following:
``(A) Communications equipment.
``(B) Facilities.
``(C) Mapping equipment.
``(D) Vehicles.
``(6) Any such other activity the Administrator determines
appropriate.
``(b) Applications.--
``(1) In general.--An eligible entity that seeks a grant
under this section shall submit to the Administrator an
application at such time, in such manner, and containing such
information as the Administrator may require.
``(2) Contents.--An application under paragraph (1) shall
include information relating to the following:
``(A) The inability of the applicant to carry out
an activity under subsection (a) unless such applicant
receives such grant to fund such activity.
``(B) The long-term plans of such applicant to
retain emergency medical services personnel after such
grant ends.
``(C) If such applicant proposes to carry out an
activity described in subsection (a)(1), how such
applicant plans to satisfy the requirements under
subsection (e).
``(c) Competitive Grants; Preference.--A grant under this section
shall be made on a competitive basis through a neutral peer review
process, but the Administrator may give preferential consideration to a
grant application that involves a non-Federal contribution for an
activity described in subsection (a)(1).
``(d) Grant Period.--A grant under this section shall be for a
period of 3 years.
``(e) Limitation for Hiring EMS Personnel.--Of the amount of any
funding received through a grant under this section, an eligible entity
that receives such a grant may use to hire emergency medical services
personnel--
``(1) with respect to each of the first and second years of
the grant period described in paragraph (3), not more than 75
percent of such funding; and
``(2) with respect to the third year of such grant period,
not more than 35 percent of such funding.
``(f) Off-Duty Services.--An eligible entity that hires emergency
medical services personnel with funds from a grant under this section
may not discriminate against such personnel on the basis of, or
prohibit such personnel from, engaging in volunteer emergency medical
services during the off-duty hours of such personnel.
``(g) Limitations on Funds.--
``(1) Supplement not supplant.--Funds received under this
section shall be used to supplement and not supplant State
funds, local funds, or funds supplied by the Bureau of Indian
Affairs described under subsection (h).
``(2) Maintenance of effort.--With respect to any activity
for which a grant under this section is to be expended, an
eligible entity shall agree to maintain expenditures of amounts
from State sources, local sources, or the Bureau of Indian
Affairs for such an activity at a level that is not less than
the level of such expenditure maintained by such eligible
entity for the fiscal year preceding the fiscal year for which
such entity receives such a grant.
``(3) Budgets.--The Administrator may not make a grant to a
municipality under this section with an annual budget for
emergency medical services that has been reduced below 80
percent of the average funding level in the 3 years immediately
preceding the date on which such municipality or other entity
applies for such grant.
``(h) Tribal Governments.--Any funding supplied by the Bureau of
Indian Affairs for the following activities may be considered a non-
Federal contribution under this section:
``(1) An agency of a Tribal government performing emergency
medical services on Tribal lands.
``(2) The Bureau of Indian Affairs performing such services
on Tribal lands.
``(i) Revocation or Suspension of Funding.--If the Administrator
determines that an eligible entity that receives a grant under this
section is not in substantial compliance with the terms or requirements
of such grant, the Administrator may revoke or suspend funding with
respect to such grant, in whole or in part.
``(j) Majority Volunteer and All Volunteer Departments and
Organizations.--At the beginning of each fiscal year in which the
Administrator makes a grant under this section, the Administrator shall
set aside 10 percent of any funds made available under subsection (n)
for eligible entities with majority volunteer, or all volunteer,
personnel.
``(k) Economic Hardship Waivers.--
``(1) In general.--In a case of economic hardship, the
Administrator may carry out any of the following:
``(A) Waive the application of subsection (g)(1).
``(B) Waive or reduce the application of subsection
(e) or (g)(2).
``(2) Guidelines.--
``(A) In general.--The Administrator shall publish
guidelines for determining economic hardship under
paragraph (1).
``(B) Consultation and consideration.--In
developing guidelines for publication under
subparagraph (A), the Administrator shall carry out the
following:
``(i) Consult with individuals who satisfy
the following requirements:
``(I) Have been recognized for
expertise in any of the following:
``(aa) Emergency medical
services.
``(bb) The economic affairs
of State or local governments.
``(II) Are members of any of the
following:
``(aa) Eligible entities.
``(bb) National
organizations that represent
the interests of such
governments.
``(ii) Consider, with respect to relevant
communities, the following factors:
``(I) Changes in rates of
unemployment from previous years.
``(II) Whether the rates of
unemployment of such communities are
currently and have consistently
exceeded the annual national average
rates of unemployment.
``(III) Changes from previous years
in percentages of individuals who live
in a household eligible to receive
benefits through the supplemental
nutrition assistance program
established under the Food and
Nutrition Act of 2008 (7 U.S.C. 2011 et
seq.).
``(IV) Such other factors as the
Administrator determines appropriate.
``(l) Technical Assistance.--In carrying out this section, the
Administrator may provide technical assistnce to an eligible entity
operated by a State that receives a grant under this section.
``(m) Performance Assessment System.--
``(1) In general.--The Administrator shall establish a
performance assessment system, including quantifiable
performance metrics, to evaluate the extent to which grants
made under this section are effective.
``(2) Submission.--The Administrator may require an
eligible entity that receives a grant under this section to
submit to the Administrator information the Administrator
considers necessary for the system established under paragraph
(1).
``(n) Access to Documents.--The Administrator and the Comptroller
General of the United States shall, for audit and examination purposes
relating to carrying out this section, have access to--
``(1) any pertinent books, documents, papers, or records of
an eligible entity that receives a grant under this section;
and
``(2) any pertinent books, documents, papers, or records of
State or local governments, persons, private sector entities,
or other entities involved in an activity carried out through
such grant.
``(o) Report.--Not later than September 30, 2030, the Administrator
shall submit to the Secretary a report on the effectiveness of grants
made under this section, including any recommendation for legislation
regarding such grants.
``(p) Definitions.--In this section:
``(1) EMS terms.--The terms `career fire department',
`combination fire department', `nonaffiliated EMS
organization', and `volunteer fire department' have the meaning
given such terms in section 33 of the Federal Fire Prevention
and Control Act of 1974 (15 U.S.C. 2229).
``(2) Eligible entity.--The term `eligible entity'--
``(A) means a career fire department, combination
fire department, volunteer fire department,
nonaffiliated EMS organization, or the municipality in
which such a department or organization operates; and
``(B) does not include such a department,
organization, or municipality that has received a grant
under section 553 with respect to rural emergency
medical services training and equipment assistance.
``(3) Emergency medical services personnel.--The term
`emergency medical services personnel' includes an individual
who is employed by or volunteers at a station for deploying
emergency medical services.
``(q) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section $750,000,000 for each of fiscal years
2027 through 2031.
``(2) Administrative expenses.--Of the amounts authorized
to be appropriated under paragraph (1) for a fiscal year, the
Administrator may not use more than 5 percent of such amounts
to cover salaries, expenses, and other administrative costs
incurred by the Administrator with respect to carrying out this
section.
``(r) Termination.--This section shall terminate on September 30,
2031.''.
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