[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2853 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 2853
To amend title XVIII of the Social Security Act to expand access to
clinical care in the home, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
April 25, 2023
Mr. Smith of Nebraska (for himself and Mrs. Dingell) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committee on Ways and Means, for a
period to be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to expand access to
clinical care in the home, 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 ``Expanding Care in
the Home Act''.
(b) Table of Contents.--the table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Enhancing primary care in the home.
Sec. 3. Improving coverage for Medicare home infusion.
Sec. 4. Establishing payment for staff-assisted home dialysis.
Sec. 5. Ensuring Medicare beneficiaries have access to in-home labs.
Sec. 6. Expanding advanced diagnostic imaging in the home.
Sec. 7. Delivering personal care services to Medicare beneficiaries.
Sec. 8. Building the future of the home-based care workforce.
SEC. 2. ENHANCING PRIMARY CARE IN THE HOME.
(a) In General.--The Secretary of Health and Human Services (HHS
Secretary) shall allow primary care providers (PCPs) enrolled in
Medicare Part B to elect to receive a monthly capitated payment for
Primary Care Qualified Evaluation and Management Services (PQEM) as an
alternative to fee-for-service reimbursement. Providers shall be
allowed to elect to receive a monthly capitated payment for a period of
time ranging from one to five years.
(b) Covered Services.--The HHS Secretary shall annually identify
PQEM services no later than October 1 each year. At a minimum, these
services shall include the following services when billed by a primary
care provider or a nonprimary care specialist (as outlined by the
Secretary):
(1) Office or Other Outpatient Services (99201-99205,
99211-99215).
(2) Domiciliary, Rest Home or Custodial Care Services
(99324-99328, 99334-99337).
(3) Domiciliary, Rest Home or Home Care Plan Oversight
Services 99339-99340).
(4) Home Services (99341-99345, 99347-99350).
(5) Transitional Care Management Services (99495-99496).
(6) Care Coordination Management Services (99490).
(7) Wellness Visits (G0402, G0438, G0439).
(c) Payment.--The capitated payment system designed by the HHS
Secretary shall have the following:
(1) Base capitated payments should reflect the previous 3
years excluding the period during which there was an active
public health emergency for COVID-19.
(2) There should be an increase in payments to reflect the
need for PCPs to invest in changing their office practice
workflow.
(3) Higher PCP payment could be possible through greater
bonuses related to improving value through total cost of care
and quality.
(4) PCPs electing capitated payments should be permitted to
offer incentives to engage patients to be assigned to their
patient care panels.
(d) Attribution.--The HHS Secretary shall ensure that PCPs electing
to receive a capitated payment have visibility and input into the
attribution model used to attribute patients to them. At a minimum, the
attribution methodology should--
(1) patient attribution to panels should be prospective;
(2) panels should be updated monthly or quarterly; and
(3) PCPs should have a mechanism and incentives to enroll
patients so they can influence who is attributed to their
panel.
SEC. 3. IMPROVING COVERAGE FOR MEDICARE HOME INFUSION.
(a) In General.--The HHS Secretary shall establish reimbursement
for home infusion services and associated equipment and items under
part B.
(b) Covered Services and Supplies.--Home Infusion Therapy (HIT) and
associated equipment are defined to include--
(1) equipment (e.g., mechanical pumps) for drug
administration of Eligible Infusion Drugs;
(2) items (other than drugs and equipment) used in
connection with the delivery of Eligible Infusion Drugs such as
disposable supplies for the drug administration (e.g., tubing,
elastomeric pumps) and for the routine maintenance of the
infusion access device;
(3) 24/7 availability of pharmacist professional services
such as assessments, drug preparation and compounding,
dispensing, clinical monitoring, administrative, and education;
and
(4) 24/7 availability of nursing services (when not
provided as part of a home health episode).
(c) Qualified Providers.--Provided by a qualified home infusion
therapy services supplier as defined in section 1861(iii)(3)(C) of this
Act.
(d) Eligible Infusion Drugs.--Eligible part B and part D Infusion
Drugs are defined as parenteral drugs or biologics administered through
intravenous, intrathecal, intra-arterial, or subcutaneous access
device, except--
(1) drugs and biologics on the self-administered drug list;
and
(2) drugs and biologics covered under Part B Durable
Medical Equipment, Prosthetics, Orthotics and Supplies
(DMEPOS).
(e) Current or Future Infusion Drugs.--Provided, nothing in this
section shall be construed to change the coverage status of any current
or future infusion drugs that meet the definition of a covered part D
drug as defined at section 1860D-2(e) and which are paid under Medicare
part D.
(f) Referring Providers.--Patients must be under the care of a
physician, nurse practitioner, or physician assistant.
(g) Safety and Quality.--Consistent with standards of care found
within commercial, Medicare Advantage, and State Medicaid programs with
regard to sterile preparation of the drug to a final, useable form;
timeliness of initiation of care; billing of drugs, items, and pharmacy
services by a single entity; performing periodic assessments of patient
satisfaction and collection and evaluation of quality outcome data; and
maintaining a consolidated patient record of services provided in
accordance with the plan of care.
(h)(1) Reimbursement.--A per infusion day payment is established
and defined as ``a payment for the date on which a drug was
administered to the individual at home (regardless of whether a skilled
professional was physically present in the home of such individual on
such date)''.
(2) Market Rates.--Such payment may be based on a market analysis
of rates paid for home infusion supplies and services by the commercial
sector and Medicare Advantage programs.
(3) Payment Eligibility.--Nothing shall prevent a home infusion
supplier from being paid a per infusion day payment when a qualified
home health agency provides the nursing services for the infusion
therapy under the part A home health benefit.
SEC. 4. ESTABLISHING PAYMENT FOR STAFF-ASSISTED HOME DIALYSIS.
(a) In General.--Section 1881(b)(14) of the Social Security Act (42
U.S.C. 1395rr(b)(14)) is amended by adding at the end the following new
subparagraph:
``(J)(i) For services furnished on or after the
date which is 1 year after the date of the enactment of
this subparagraph which are staff-assisted home
dialysis (as defined in clause (iv)(III)), the
Secretary shall increase the single payment that would
otherwise apply under this paragraph for renal dialysis
services furnished to new and respite individuals in
accordance with the payment system established under
clause (iii) by qualified providers.
``(ii)(I) Subject to subclause (II), staff-assisted
home dialysis may only be furnished during--
``(aa) with respect to an individual
described in subclause (iv)(I)(aa), one 90-day
period which may be renewed up to two 30-day
periods; and
``(bb) with respect to an individual
described in subclause (iv)(I)(bb) and
notwithstanding whether such an individual
receives any respite care under part A, any 30-
day period.
``(II) Notwithstanding the limits described in
subclause (I), staff-assisted home dialysis may be
furnished for as long as the Secretary determines
appropriate to an individual who--
``(aa) is blind;
``(bb) has a cognitive or neurological
impairment (including a stroke, Alzheimer's,
dementia amyotrophic lateral sclerosis, or any
other impairment determined by the Secretary);
or
``(cc) has any other illness or injury that
reduces mobility (including cerebral palsy,
spinal cord injuries, or any other illness or
injury determined by the Secretary).
``(iii) The Secretary shall establish a prospective
payment system through regulations to determine the
amounts payable to qualified providers for staff-
assisted home dialysis. In establishing such system,
the Secretary may consider--
``(I) the costs of furnishing staff-
assisted home dialysis;
``(II) consultations with dialysis
providers, dialysis patients, private payers,
and MA plans;
``(III) payment amounts for similar items
and services under parts A and B; and
``(IV) payment amounts established by MA
plans under part C, group health plans, and
health insurance coverage offered by health
insurance issuers.
``(iv) In this subparagraph:
``(I) The term `new and respite individual'
means an individual described in subsection (a)
who is either--
``(aa) initiating either peritoneal
or home hemodialysis; or
``(bb) receiving home dialysis and
is unable to self-dialyze due to
illness, injury, caregiver issues, or
other temporary circumstances.
``(II) The term `qualified provider' means
a trained professional (as determined by the
Secretary, including nurses and certified
patient technicians) who furnishes renal
dialysis services and--
``(aa) meets requirements (as
determined by the Secretary) that
ensures competency in patient care and
modality usage; and
``(bb) provides in-person
assistance to a patient for at least 75
percent of staff-assisted home dialysis
sessions during a period described in
clause (ii)(i).
``(III)(aa) The term `staff-assisted home
dialysis' means home dialysis using trained
professionals to assist individuals who have
been determined to have end stage renal
disease, and the frequency of such home
dialysis is determined by such professionals in
coordination with the patient and his or her
care partner, and outlined in a patient plan of
care.
``(bb) In this subclause, the term `care
partner' means anyone who is designated by the
patient who assists the individual with the
furnishing of home dialysis.
``(cc) In this subclause, the term `patient
plan of care' has the meaning given such term
in section 494.90 of title 42, Code of Federal
Regulations.''.
(b) Patient Education and Training Relating to Staff-Assisted Home
Dialysis.--Section 1881(b)(5) of the Social Security Act (42 U.S.C.
1395rr(b)(5)) is amended--
(1) in subparagraph (C), by striking at the end ``and'';
(2) in subparagraph (D), by striking the period at the end
and inserting a semicolon; and
(3) by adding at the end the following new subparagraphs:
``(D) educate patients of the opportunity to
receive staff-assisted home dialysis (as defined in
paragraph (14)(J)(iv)(III)) during the period beginning
30 days after the first day such facility furnishes
renal dialysis services to an individual and ending 60
days after such day; and
``(E) provide for nurses, certified patient
technicians, or other professionals to train patients
and their care partners in skills and procedures needed
to perform home dialysis (as defined in paragraph
(14)(J)(iv)(III)) treatment--
``(i) regularly and independently;
``(ii) through telehealth services or
through group training (as described in the
interpretive guidance relating to tag number
V590 of `Advance Copy--End Stage Renal Disease
(ESRD) Program Interpretive Guidance Version
1.1' (published on October 3, 2008)) in
accordance with the Federal regulations
(concerning the privacy of individually
identifiable health information) promulgated
under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996; and
``(iii) in the home or resident of a
patient, in a dialysis facility, or the place
in which the patient intends to receive staff-
assisted home dialysis.''.
(c) Other Provisions.--
(1) Anti-kickback statute.--Section 1128B(b)(3) of the
Social Security Act (42 U.S.C. 1320a-7b(b)(3)) is amended--
(A) in subparagraph (J), by striking at the end
``and'';
(B) in subparagraph (K), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following new
subparagraph:
``(L) any remuneration relating to
the furnishing of staff-assisted home
dialysis (as defined in section
1881(b)(14)(J)(iv)(III)).''.
(2) CMI model.--Section 1115A(b)(2)(B) of the Social
Security Act (42 U.S.C. 1320b-(b)(2)(B)) is amended by adding
at the end the following new clause:
``(xxviii) Making payment to anyone who is
designated by a patient who receives staff-
assisted home dialysis (as defined in section
1881(b)(14)(J)(iv)(III)) and otherwise meets
the requirements (as determined by the
Secretary), notwithstanding whether an
individual is a qualified provider (as defined
in section 1881(b)(14)(J)(iv)(II)) or otherwise
eligible for reimbursement under title
XVIII.''.
(3) Study.--Not later than 2 years after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall submit to the Committee on Energy and Commerce
of the House of Representatives and the Committee on Finance of
the Senate a report that examines racial disparities in the
utilization of the home dialysis defined in section
1881(b)(14)(J)(iv)(III) of the Social Security Act (42 U.S.C.
1395rr(b)(14)(J)(iv)(III)) and make recommendations on how to
improve access to such dialysis for communities of color.
(4) Patient decision tool.--Not later than December 31,
2023, for the purpose of section 1881(b)(14)(J) of the Social
Security Act (42 U.S.C. 1395rr(b)(14)(J)), the Secretary of
Health and Human Services shall convene a patient panel to
create a patient-centered decision tool for dialysis patients
to evaluate their lifestyle and goals and be assisted in
choosing the dialysis modality that best suits them. This tool
should include an acknowledgment that they are capable of home
dialysis and want home dialysis, if that is the modality they
choose.
(5) Patient quality of life metric.--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 new subparagraph:
``(i) A patient quality of life metric for
all patients utilizing dialysis regardless of
modality with the intent of measuring and
improving patient quality of life on
dialysis.''.
SEC. 5. ENSURING MEDICARE BENEFICIARIES HAVE ACCESS TO IN-HOME LABS.
(a) In General.--The Secretary shall establish reimbursements for
an add-on payment to cover travel costs and mailing costs associated
with specimen collection of at-home clinical laboratory tests for
eligible Medicare beneficiaries.
(b) Coverage.--The add-on payment shall apply to all at-home
clinical laboratory tests currently reimbursed under Part B as ordered
by an eligible Medicare provider.
(c) Eligible Beneficiaries.--The Secretary shall determine the
screening tool or utilization management that would trigger beneficiary
eligibility for at-home clinical laboratory tests. Eligibility shall be
more comprehensive than the homebound status as defined in sections
1835(a) and 1814(a) of the Social Security Act. The screening tool
shall consider other criteria such as chronic conditions, social needs,
barriers to accessing care, income level, or dual eligible status.
(d) Eligible Suppliers.--The Secretary shall determine eligible
suppliers for specimen collection of at-home clinical lab tests.
(e) Payment for Travel Allowance.--The Secretary shall establish
payment methodology for the travel allowance reimbursement. The
methodology shall account for geographic variation in costs of
transportation.
(f) Payment for Mailing Costs.--The Secretary shall establish
payment methodology for reimbursement of the cost for mailing completed
at-home clinical lab tests. The reimbursement structure shall be tiered
on shipping based upon the nature of the collection and processing
needs, for example cold chain requirements, time sensitively, and other
infectious disease protocols.
(g) Beneficiary Costs.--No provision in this section shall impact
the coinsurance applied to beneficiaries as currently reimbursed for
clinical laboratory tests.
SEC. 6. EXPANDING ADVANCED DIAGNOSTIC IMAGING IN THE HOME.
(a) General.--The Secretary shall conduct an evaluation of Medicare
reimbursable advanced diagnostic imaging as defined in subsection
(e)(1)(B) of section 1834 of the Social Security Act. The purpose of
the evaluation shall be to consider expansions to reimbursable at-home
advanced diagnostic imaging services, including costs of
transportation.
(b) Minimum Action.--At a minimum, the Secretary shall permit the
delivery and reimbursement of ultrasound imaging in the home, including
the cost of transportation.
(c) Eligibility.--The Secretary shall determine the screening tool
or utilization management that would trigger beneficiary eligibility
for at-home advanced diagnostic services. Eligibility shall be more
comprehensive than the homebound status as defined in sections 1835(a)
and 1814(a) of the Social Security Act. The screening tool shall
consider other criteria such as chronic conditions, social needs,
barriers to accessing care, income level, or dual eligible status.
(d) Authority.--The Secretary shall have the authority to expand
the types of at-home advanced diagnostic imaging services reimbursable
under Medicare, if medically appropriate and safe.
(e) Payment.--No provision in this section shall impact the payment
rates set annually through the physician fee schedule.
(f) Report to Congress.--The Secretary shall submit the findings
from the evaluation in section (a) in a report to Congress not later
than 90 days after enacted. The report should provide justification for
the Secretary's decision not to expand particular diagnostic services
in the home and recommendations to further expand advanced diagnostic
imaging in the home.
SEC. 7. DELIVERING PERSONAL CARE SERVICES TO MEDICARE BENEFICIARIES.
(a) General.--The Social Security Act is amended to establish
coverage for personal care assistance services as defined in subsection
(k) to eligible Medicare beneficiaries (``Benefit'' hereafter).
(b) Services.--Up to 12 hours per week of personal care assistance
services in increments of no less than four hours.
(c) Time Limited Benefit.--If prescribed by a qualified Medicare
provider, the eligible beneficiary is entitled to 30 days of personal
care services and eligible for two additional 30-day periods if the
provider deems it is appropriate. The Benefit shall be capped at 90
days per calendar year.
(d) Eligibility.--To be considered eligible for the Benefit, the
beneficiary--
(1) must be Medicare eligible;
(2) must not be Medicaid-eligible;
(3) must have an income at or below 400 percent of the
Federal Poverty Level (FPL);
(4) must be functionally disabled as defined in subsection
(l); and
(5) must have four or more chronic conditions as defined by
the Secretary or had a qualified hospitalization stay, as
defined by the Secretary, in the last 30 days.
(e) Other Eligibility Requirements.--The Secretary may consider
other eligibility requirements that are known to, based on evaluation
and research, improve value of care and coordination of care. For
example, the beneficiary could be required to attend an annual wellness
visit or be aligned with a primary care provider or specialist who
functions as a primary care provider.
(f) Benefit Determination Process.--The Secretary shall establish a
process to validate beneficiary eligibility for the Benefit through a
determination process. Additionally, the Secretary shall put in place
an appeals process to review possible wrongful determinations.
(g) Coinsurance.--After 30 days of personal care services, a 20
percent coinsurance shall apply for the remaining Benefit period.
(h) Reimbursement.--The Secretary will establish an hourly rate for
personal care services through the annual physician fee schedule. The
hourly rate should be based on a blend of the Department of Veterans
Affairs fee schedule for the homemaker/home health aide service (G0156)
and averages for private sector home care.
(i) Value-Based Care Reimbursement.--The Secretary should establish
a value-based component to the reimbursement of the Benefit that
focuses on reducing medical needs. For example, a portion of the fee-
for-service reimbursement could be withheld and if certain quality
measures (e.g., avoiding unnecessary hospitalizations) are achieved,
the remaining portion of the reimbursement would be paid.
(j) Oversight.--The Secretary shall establish a process to certify
personal care agencies, for example requirements for Federal background
checks, and other appropriate oversight. Personal care aides shall be
employed by an agency. To ensure sufficient number of providers,
Agencies providing solely personal care services as defined in this
section shall not be required to comply with Conditions of
Participation (CoPs).
(k) Overlap.--The Secretary shall develop criteria describing how
model overlap will be addressed when patients are eligible for the
Benefit and are otherwise participating in a payment and delivery
reform model under section 1899 or through the Center for Medicare and
Medicaid Innovation. The Secretary shall exclude costs of the Benefit
from reconciliation in these payment and delivery reform models as
appropriate to limit unintended consequences.
(l) Definitions.--
(1) Functionally disabled.--An individual is ``functionally
disabled'' if the individual--
(A) is unable to perform without substantial
assistance from another individual at least 2 of the
following 3 activities of daily living: toileting,
transferring, and eating; or
(B) has a primary or secondary diagnosis of
Alzheimer's disease and is--
(i) unable to perform without substantial
human assistance (including verbal reminding or
physical cueing) or supervision at least 2 of
the following 5 activities of daily living:
bathing, dressing, toileting, transferring, and
eating; or
(ii) cognitively impaired so as to require
substantial supervision from another individual
because he or she engages in inappropriate
behaviors that pose serious health or safety
hazards to himself or herself or others.
(2) Personal care assistance services.--Assistance with
activities of daily living, as defined at subsection III of
this section, which do not require the skills of qualified
technical or professional personnel.
(3) Activities of daily living.--As defined in 42 CFR Sec.
441.505, activities of daily living (ADLs) means basic personal
everyday activities including, but not limited to, tasks such
as eating, toileting, grooming, dressing, bathing, and
transferring.
SEC. 8. BUILDING THE FUTURE OF THE HOME-BASED CARE WORKFORCE.
(a) Creation of Grants to Communities To Foster Home-Based Care
Professionals.--
(1) General.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, may award grants to entities to invest in
developing the home-based care workforce.
(2) Eligible grantees.--The Secretary may award grants to
nonprofit hospital or health systems, community-based
organizations, non-profit home health agencies or personal care
organizations, State and local health agencies, and other
entities identified by the Secretary.
(3) Use of funds.--The grantee may use funds for the
following:
(A) Invest in transitioning facility-based medical
personnel to care models that are focused on delivering
care in the home.
(B) Establish career advancement training to
improve the unique needs of medical personnel entering
the home, for example training for cultural
sensitivity, use of digital technologies, and best
practices.
(C) Recruit new medical personnel that will be
responsible for delivering care or support services for
care models in the home.
(4) Application.--To be eligible to receive a grant, an
entity shall submit an application to the Secretary at such
time, in such manner, and containing such information as the
Secretary may require.
(5) Priority.--In selecting grant recipients, the Secretary
shall prioritize entities that are able to provide evidence
that they primarily serve minority populations, operate in a
medically underserved community or a health professional
shortage area, or are heavily community-focused.
(6) Grantee reporting requirements.--Each entity awarded a
grant shall submit an annual report to the Secretary on the
activities conducted under such grant, and other information as
the Secretary may require.
(7) Report to congress.--Not later than 5 years after the
date of enactment of this section and every 5 years thereafter,
the Secretary shall submit a report to Congress that provides a
summary of the activities and outcomes associated with grants
made under this section.
(8) Appropriation.--To carry out this section, there is
authorized to be appropriated $50,000,000 to remain available
until expended.
(b) Establishment of Home-Based Nursing Task Force.--
(1) General.--Not later than 90 days after the date of
enactment of this Act, the Secretary shall establish a task
force on developing standards for a home-based nursing board
certification (in this section referred to as the ``Task
Force'').
(2) Duties.--Not later than 12 months after the
establishment of the Task Force, the Task Force shall develop
and submit to the Secretary recommendations and strategies for
the Department of Health and Human Services for the following:
(A) Identify key considerations and opportunities
for a potential registered nurse board certification in
home-based care.
(B) Develop the specifications and eligibility
requirements that would need to be met for a nursing
board certification in home-based care.
(C) Outline the benefits and potential issues that
would be associated with establishing a nursing board
certification in home-based care.
(3) Considerations.--In developing recommendations and
strategies, the Task Force shall consider the following:
(A) Current and future state of the in-home
registered nursing workforce, including projected job
needs.
(B) Factors influencing individuals to pursue
careers in home-based care nursing.
(C) Access and barriers to in-home nursing career
opportunities for vulnerable or underrepresented
populations into nursing.
(D) Unique role the in-home registered nursing
workforce plays in engaging with caregivers.
(E) Differences in facility-based care verses home-
based care from the perspective of the nurse, such as
clinical competency, burnout, level of experience
required, cultural sensitivities required, stressors,
and more.
(4) Public report.--Not later than 60 days after the
submission of the recommendations and strategies, the Secretary
shall submit to the Congress a report containing such
recommendations and strategies.
(5) Period of appointment.--Members shall be appointed to
the Task Force the duration of the existence of the Task Force.
(6) Compensation.--Task Force members shall serve without
compensation.
(7) Sunset.--The Task Force shall terminate upon the
submission of the report required.
(c) Expanding Emergency Medical Services Workforce Study.--
(1) General.--Not later than 90 days after the date of
enactment of Expanding Emergency Medical Services (EMS)
Workforce Program, the Secretary shall establish a council to
study the impacts of expanding the role of emergency medical
service (EMS) providers in the triage, treatment, and transfer
of patients in both emergency and non-emergency encounters and
associated impacts on the EMS workforce (in this section
referred to as the ``Council'').
(2) Duties.--Not later than 12 months after the
establishment of the Council, the Council shall develop and
submit a study to the Secretary of the Department of Health and
Human Services that--
(A) details barriers to EMS providers to treating
in-place;
(B) outlines the benefits and other considerations
associated with expanding the scope of services
delivered by EMS providers;
(C) examines the current EMS provider workforce's
ability to expand their role in healthcare encounters;
(D) evaluates best practices for nurse navigation
programs that assist in triage and dispatch of
appropriate level of EMS providers;
(E) evaluates best practices for community
paramedicine programs; and
(F) assesses the impacts of the Expanding Emergency
Medical Services (EMS) Workforce Program on medically
and socially underserved communities' access to care
and emergency department utilization.
(3) Considerations.--In developing the study, the Council
shall consider the following:
(A) Previous and existing community paramedicine
programs.
(B) Previous and existing nurse navigation
programs.
(C) Access to EMS services in rural communities.
(D) Current and future state of the EMS provider
workforce, including projected job needs.
(E) Unique role the EMS workforce plays in engaging
with the community.
(F) Training of EMS providers.
(G) Varying roles and capabilities of different
levels of EMS professionals, including Emergency
Medical Responder, Emergency Medical Technician,
Advanced--EMT, Paramedic, Community Paramedic.
(4) Public report.--Not later than 60 days after the
submission of the study, the Secretary shall submit to the
Congress a report containing recommendations and strategies for
utilizing the EMS workforce beyond the scope of their current
role in healthcare encounters.
(5) Period of appointment.--Members shall be appointed to
the Council the duration of the existence of the Council.
(6) Compensation.--Council members shall serve without
compensation.
(7) Sunset.--The Council shall terminate upon the
submission of the report required.
(8) FACA applicability.--The Federal Advisory Committee Act
(5 U.S.C. App.) shall not apply to the Council.
(9) Council procedures.--The Secretary, in consultation
with the Comptroller General of the United States and the
Director of the Office of Management and Budget, shall
establish procedures for the Council to--
(A) ensure that adequate resources are available to
effectively execute the responsibilities of the
Council;
(B) effectively coordinate with other relevant
advisory bodies and working groups to avoid unnecessary
duplication;
(C) create transparency to the public and Congress
with regard to Council membership, costs, and
activities, including through use of modern technology
and social media to disseminate information; and
(D) avoid conflicts of interest that would
jeopardize the ability of the Council to make decisions
and provide recommendations.
<all>