[Congressional Record Volume 150, Number 55 (Tuesday, April 27, 2004)]
[Senate]
[Pages S4431-S4432]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself and Mr. Feingold):
  S. 2351. A bill to establish a Federal Interagency Committee on 
Emergency Medical Services and a Federal Interagency Committee on 
Emergency Medical Services Advisory Council, and for other purposes; to 
the Committee on Governmental Affairs.
  Ms. COLLINS. Mr. President, I rise today to introduce the Emergency 
Medical Services Support Act of 2004 with my colleague, Senator Russ 
Feingold. This legislation will strengthen Federal efforts to support 
community-based emergency medical services across America.

[[Page S4432]]

  A comprehensive, coordinated emergency medical services system is 
essential to assure quality care and prompt response in incidents 
ranging from automobile crashes to catastrophic weather to terrorist 
attacks. The emergency medical services system is a crucial part of our 
health care safety net.
  Unfortunately, for the past twenty years, Federal support for EMS has 
been both inefficient and uncoordinated. No fewer than seven Federal 
agencies are involved in various aspects of emergency medical services. 
Most, however, focus on only one segment of the EMS system and don't 
effectively coordinate with other agencies.
  In 2001, at the request of Senator Feingold and myself, the General 
Accounting Office researched the status of this vital system. The GAO 
report, titled, ``Emergency Medical Services: Reported needs are Wide-
Ranging with a Growing Focus on Lack of Data,'' exposed the need to 
increase coordination among Federal agencies as they address the needs 
of regional, State, or local emergency medical services systems.
  This legislation would formally establish a Federal Interagency 
Committee on Emergency Medical Services (FICEMS), which is currently an 
ad-hoc committee with little formal direction. It would require the 
National Highway Traffic Safety Administration, in coordination with 
the Department of Homeland Security, to provide organizational and 
staff support.
  This legislation would enhance coordination among the Federal 
agencies involved with the State, local, tribal and regional emergency 
medical services and 9-1-1 systems. It also would help Federal agencies 
coordinate their EMS-related activities and maximize the best use of 
established funding.
  The President has recognized the need for this coordination. He 
included a similar proposal in his reauthorization proposal for the 
``Safe, Accountable, Flexible, and Efficient Transportation Equity act 
of 2003'' (SAFETEA) that was transmitted by Secretary Mineta to 
Congress on May 12, 2003. The Senate-passed highway bill also included 
a similar proposal.
  The legislation we introduce today builds upon the Administration's 
proposal by creating a more effective structure and enhancing the role 
of local EMS providers into Federal EMS programs. While I support the 
provisions in the Senate-passed bill, they fail to create a mechanism 
for individuals at the state and local levels to provide input into how 
Federal EMS programs should be coordinated.
  Local, State and Federal level emergency medical services systems are 
extremely diverse and involve numerous different agencies and 
organizations. To assure a viable, responsive emergency medical 
services system, Federal agencies need the input and advice of their 
non-Federal partners and from persons regulating or providing emergency 
medical services systems at the state and local level.
  According to Tom Judge, the Executive Director of Lifeflight of 
Maine, an air ambulance provider, and Jay Bradshaw, the State of 
Maine's EMS Director, improved coordination can help strengthen support 
for a wide range of emergency medical services, from rural EMS 
providers, to communications between EMS systems, to improving 
coordination between local EMS providers and their Federal partners.
  Another recent GAO report made it clear that the Center for Medicare 
and Medicaid Services needs to better coordinate its reimbursement with 
the Department of Transportation's matching grants for equipment and 
vehicles. Many of Maine's rural communities, such as Rumford, are at 
risk of seeing their first ambulance service closures due to low-
reimbursement rates. If DOT targeted assistance to the low 
reimbursement areas that are at risk of shutting down, we might be able 
to maintain service in these areas.
  Decisions at the Federal Communications Commission regarding spectrum 
management could make most of the existing EMS and Fire radios obsolete 
over the next few years. In St. George, Maine, the volunteer Fire 
Rescue has 30 mobile and portable radios, 40 pagers, and a base station 
that could become obsolete. In making future decisions regarding 
spectrum management, the FCC must work with Department of Homeland 
Security and the Department of Justice to help communities purchase 
interoperable radios if their old ones become obsolete.
  I am pleased to have the support of Maine EMS, LifeFlight of Maine, 
the American Ambulance Association, the National Association of EMS 
Directors, and others for this legislation.
  We must ensure that Federal agencies coordinate their efforts to 
support the dedicated men and women who provide EMS services across our 
Nation. I urge my colleagues to join me in supporting their efforts by 
cosponsoring this legislation.
  Mr. FEINGOLD. Mr. President, I am pleased to join my colleague from 
Maine, Senator Collins, today to introduce legislation that will help 
improve and streamline Federal support for community-based emergency 
medical services. Our proposal will also provide an avenue for local 
officials and EMS providers to help Federal agencies improve existing 
programs and future initiatives.
  Congress has long recognized the important role played by EMS 
providers. However, Federal support for EMS has been unfocused and 
uncoordinated, with responsibility scattered among a number of 
different agencies. In 2001, the General Accounting Office cited the 
need to increase coordination between the federal agencies involved 
with EMS issues but not much progress has been made since that report 
was issued. The Federal Government doesn't even have a good handle on 
how much it is spending on EMS or what the needs are for EMS. The bill 
we introduce today is a good first step towards addressing the 
deficiencies in our current EMS policies.
  This legislation establishes a federal interagency committee whose 
purpose will be to coordinate federal EMS activities, identify EMS 
needs, assure proper integration of EMS in homeland security planning, 
and make recommendations on improving and streamlining EMS support. 
Although Federal law, PL 107-188, called for the establishment of a 
working group on EMS, this legislation goes further in detailing the 
role and function of the interagency committee. The Senate Governmental 
Affairs Committee will certainly iron out any overlap that may exist.
  This legislation also establishes an advisory council for the 
interagency committee that includes representatives from throughout the 
EMS community. The advisory committee, made up of non-Federal 
representatives from all EMS sectors and from both urban and rural 
areas, will provide guidance and input to the interagency committee on 
a variety of issues including the development of standards and national 
plans, expanding or creating grant programs, and improving and 
streamlining Federal EMS efforts. The advisory council is a critical 
component of this legislation because it is the channel through which 
local EMS practitioners can directly impact and help reform national 
EMS policy.
  I want to thank the American Ambulance Association, the Association 
of Air Medical Services, the Emergency Nurses Association, the National 
Association of EMS Physicians, the National Association of State EMS 
Directors, and the National Registry of EMTs for their support of this 
bill. I also want to thank all of those Wisconsinites who provided so 
much helpful input in coming up with this legislation. In particular, I 
would like to thank Dr. Marvin Birnbaum of the University of Wisconsin, 
Fire Chief Dave Bloom of the Town of Madison, and Dan Williams, chair 
of Wisconsin's EMS advisory board for their advice and guidance.
  EMS providers are a critical component of our Nation's first 
responder network. We must act now to streamline and coordinate federal 
EMS support and work to better understand the needs of the EMS 
community. I therefore ask my colleagues to join me in supporting this 
legislation.
                                 ______