HR2220-119

1. Short title This Act may be cited as the Preserve Access to Rapid Ambulance Emergency Medical Treatment Act of 2025 or the PARA–EMT Act of 2025.

2. Findings Congress finds the following: Paramedics and emergency medical technicians (in this section referred to as EMTs) provide care to ill or injured people in emergency medical settings and are a vital component of the Nation’s Emergency Medical Services (in this section referred to as EMS) system. EMTs provide basic emergency medical care and transportation for patients while paramedics provide advanced emergency medical care such as intubation, oral and intravenous drug administration, and other procedures. The United States EMS system is facing a crippling workforce shortage, a long-term problem that has been building for more than a decade. In 2019, the Health Resources and Services Administration reported that by 2030, there would be a need for an additional 42,000 EMTs and Paramedics to meet the nation’s demand for healthcare services. The COVID–19 pandemic has further exacerbated this workforce shortage, with ambulance crews suffering the effects of surging demand, burnout, fear of illness and stress on their families. A 2021 survey of nearly 20,000 employees working at 258 EMS organizations found that overall turnover among paramedics and EMTs ranges from 20 to 30 percent annually. With COVID–19 halting clinical and in-person trainings for a significant period of time, the pipeline of new EMS staff has been stretched even thinner.

3. EMS preparedness and response workforce shortage pilot program Title XII of the Public Health Service Act (42 U.S.C. 300d et seq.) is amended by inserting after section 1204 the following: The Secretary, acting through the Assistant Secretary for Preparedness and Response, shall establish a pilot program to award grants to eligible emergency medical services agencies to support the recruitment and training of emergency medical technicians and paramedics to improve access to, and enhance the quality of, emergency medical services. An eligible emergency medical services agency seeking a grant under this section shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. An eligible emergency medical services agency receiving a grant under this section shall use funds received through the grant to implement a new program or enhance an existing program to— recruit and retain emergency medical services personnel, which may include volunteer personnel; train emergency medical services personnel to obtain and maintain licenses and certifications relevant to service in an emergency medical services agency; conduct courses and implement apprenticeship programs that qualify graduates to serve in an emergency medical services agency in accordance with State and local requirements; fund specific training to meet Federal or State licensing or certification requirements; develop new ways to educate emergency medical services personnel through the use of technology-enhanced educational methods; establish wellness and fitness programs for emergency medical services personnel to ensure that such personnel are able to carry out their duties, including programs dedicated to raising awareness of, and prevention of, job-related mental health issues; or train emergency medical services personnel to care for people with mental and substance use disorders in emergency situations. In awarding grants under this section, the Secretary shall prioritize eligible emergency medical services agencies that— emphasize the recruitment and training of youth, particularly high school students, rural youth, and youth from low-income or disadvantaged backgrounds; develop and implement programs 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 or paramedic; are small or are located in rural areas and serve rural populations; or address such other priorities as the Secretary considers appropriate. The Secretary shall ensure that not less than 20 percent of the total number of grants under this section are made to emergency medical services agencies located in rural areas. The amount of a grant made under this section to a single grant recipient shall not exceed $1,000,000. An eligible emergency medical services agency receiving a grant under subsection (a) shall periodically submit to the Secretary a report evaluating the activities supported by the grant. The Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report on the Secretary’s findings with respect to the success of the program under this section in improving access to, and enhancing the quality of, emergency medical services. In this section, the term eligible emergency medical services agency means an entity that is— licensed to deliver medical care outside of a medical facility under emergency conditions that occur as a result of the condition of the patient; and delivers services (either on a compensated or volunteer basis) by an emergency medical services provider or other provider that is licensed or certified by the State involved as an emergency medical technician, a paramedic, or an equivalent professional (as determined by the State). To carry out this section, there are authorized to be appropriated $50,000,000 for each of fiscal years 2026 through 2030. The Secretary may use not more than 10 percent of the amount appropriated pursuant to paragraph (1) for a fiscal year for the administrative expenses of carrying out this section. 1205.EMS preparedness and response workforce shortage pilot program (a)GrantsThe Secretary, acting through the Assistant Secretary for Preparedness and Response, shall establish a pilot program to award grants to eligible emergency medical services agencies to support the recruitment and training of emergency medical technicians and paramedics to improve access to, and enhance the quality of, emergency medical services. (b)ApplicationAn eligible emergency medical services agency seeking a grant under this section shall submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require. (c)Use of fundsAn eligible emergency medical services agency receiving a grant under this section shall use funds received through the grant to implement a new program or enhance an existing program to— (1)recruit and retain emergency medical services personnel, which may include volunteer personnel; (2)train emergency medical services personnel to obtain and maintain licenses and certifications relevant to service in an emergency medical services agency; (3)conduct courses and implement apprenticeship programs that qualify graduates to serve in an emergency medical services agency in accordance with State and local requirements; (4)fund specific training to meet Federal or State licensing or certification requirements; (5)develop new ways to educate emergency medical services personnel through the use of technology-enhanced educational methods; (6)establish wellness and fitness programs for emergency medical services personnel to ensure that such personnel are able to carry out their duties, including programs dedicated to raising awareness of, and prevention of, job-related mental health issues; or (7)train emergency medical services personnel to care for people with mental and substance use disorders in emergency situations. (d)PrioritizationIn awarding grants under this section, the Secretary shall prioritize eligible emergency medical services agencies that— (1)emphasize the recruitment and training of youth, particularly high school students, rural youth, and youth from low-income or disadvantaged backgrounds; (2)develop and implement programs 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 or paramedic; (3)are small or are located in rural areas and serve rural populations; or (4)address such other priorities as the Secretary considers appropriate. (e)Allocation of grants to rural emergency medical services agenciesThe Secretary shall ensure that not less than 20 percent of the total number of grants under this section are made to emergency medical services agencies located in rural areas. (f)Maximum grant amountThe amount of a grant made under this section to a single grant recipient shall not exceed $1,000,000. (g)Reports (1)Report to SecretaryAn eligible emergency medical services agency receiving a grant under subsection (a) shall periodically submit to the Secretary a report evaluating the activities supported by the grant. (2)Report to publicThe Secretary shall submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, and make publicly available, a report on the Secretary’s findings with respect to the success of the program under this section in improving access to, and enhancing the quality of, emergency medical services. (h)DefinitionIn this section, the term eligible emergency medical services agency means an entity that is— (1)licensed to deliver medical care outside of a medical facility under emergency conditions that occur as a result of the condition of the patient; and (2)delivers services (either on a compensated or volunteer basis) by an emergency medical services provider or other provider that is licensed or certified by the State involved as an emergency medical technician, a paramedic, or an equivalent professional (as determined by the State). (i)Authorization of appropriations (1)In generalTo carry out this section, there are authorized to be appropriated $50,000,000 for each of fiscal years 2026 through 2030. (2)Administrative costsThe Secretary may use not more than 10 percent of the amount appropriated pursuant to paragraph (1) for a fiscal year for the administrative expenses of carrying out this section..

4. Assisting veterans with military emergency medical training to meet requirements for becoming emergency medical technicians and civilian paramedics Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 320B (42 U.S.C. 247d–11) the following: The Secretary shall— establish a program consisting of awarding demonstration grants to States to cover transition costs in order to assist veterans who completed robust military emergency medical technician or paramedic training while serving in the Armed Forces of the United States to meet certification, licensure, and other requirements applicable to becoming a civilian emergency medical technician or paramedic in the State; and in implementing such program, assist States in honoring the service of such veterans who have completed training through such service in the Armed Forces of the United States and passed the respective National Registry of Emergency Medical Technicians exam to ease the transition to the civilian Nation’s Emergency Medical Services workforce. A State receiving a grant under this section shall use amounts of such grants to prepare and implement a plan to assist with the transition of a veteran to becoming a civilian emergency medical technician or paramedic as described in subsection (a), including by establishing a grant program within the applicable State agency responsible for emergency medical services to cover— the costs of training, education, certification, and credentialing by an accredited institution; and fees for national testing for official certification and State fees to acquire State licensure. The Secretary shall submit to the Congress an annual report on the program under this section. To carry out this section, there are authorized to be appropriated $20,000,000 for each of fiscal years 2026 through 2030. 320C.Assisting veterans with military emergency medical training to meet requirements for becoming emergency medical technicians and civilian paramedics (a)ProgramThe Secretary shall— (1)establish a program consisting of awarding demonstration grants to States to cover transition costs in order to assist veterans who completed robust military emergency medical technician or paramedic training while serving in the Armed Forces of the United States to meet certification, licensure, and other requirements applicable to becoming a civilian emergency medical technician or paramedic in the State; and (2)in implementing such program, assist States in honoring the service of such veterans who have completed training through such service in the Armed Forces of the United States and passed the respective National Registry of Emergency Medical Technicians exam to ease the transition to the civilian Nation’s Emergency Medical Services workforce. (b)Use of fundsA State receiving a grant under this section shall use amounts of such grants to prepare and implement a plan to assist with the transition of a veteran to becoming a civilian emergency medical technician or paramedic as described in subsection (a), including by establishing a grant program within the applicable State agency responsible for emergency medical services to cover— (1)the costs of training, education, certification, and credentialing by an accredited institution; and (2)fees for national testing for official certification and State fees to acquire State licensure. (c)ReportThe Secretary shall submit to the Congress an annual report on the program under this section. (d)Authorization of appropriationsTo carry out this section, there are authorized to be appropriated $20,000,000 for each of fiscal years 2026 through 2030..

5. Study and report on emergency medical technician and paramedic workforce shortage The Secretary of Labor, in coordination with the Secretary of Health and Human Services, shall conduct a study on— the number of currently available emergency medical technician and paramedic jobs, categorized by type of employer (such as ambulance services, local governments other than hospitals, and hospitals); the projected increase in available emergency medical technician and paramedic jobs from 2025 through 2034, categorized by type of employer; the percentage of available emergency medical technician and paramedic jobs from 2025 through 2034 that are expected to result from the need to replace workers who transfer to different occupations or exit the labor force; the availability of appropriate training and education programs in the United States sufficient to meet the projected demand for emergency medical technician and paramedic jobs from 2025 through 2034; and the projected shortage of emergency medical technicians and paramedics from 2025 through 2034. Not later than one year after the date of the enactment of this Act, the Secretary of Labor, in coordination with the Secretary of Health and Human Services, shall submit to Congress a report on the study conducted under subsection (a) together with such recommendations that the Secretaries determine are appropriate to address the projected shortage of emergency medical technicians and paramedics, including whether Schedule A should be expanded to include these occupations.