[Congressional Record Volume 151, Number 70 (Tuesday, May 24, 2005)]
[Senate]
[Pages S5852-S5853]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. CONRAD (for himself, Mr. Roberts, Mr. Harkin, and Mr. 
        Nelson of Nebraska):
  S. 1108. A bill to amend title XVIII of the Social Security Act to 
make improvements to payments to ambulance providers in rural areas, 
and for other purposes; to the Committee on Finance.
  Mr. Conrad. Mr. President, today I am introducing the Rural Access to 
Emergency Services (RAES) Act, which will improve access to emergency 
medical services (EMS) in rural communities. This bill will take the 
critical steps to help sustain rural emergency care in the future.
  EMS is a vital component of the health care system, particularly in 
rural areas. Ambulance personnel are not only the first responders to 
an emergency, but also play a key role in the provision of life-saving 
medical care. It is said that time is one of the most important factors 
relating to patient outcomes in emergency situations. Rural EMS 
providers often have the enormous strain of responding to emergencies 
many miles away--sometimes nearly 50 minutes. However, current 
reimbursement levels are insufficient for the squads to bear the costs 
of responding to calls over these long distances. As rural EMS squads 
are forced

[[Page S5853]]

to close, rural residents--and others traveling through rural areas--
are left without access to emergency services. Due to the inadequacy of 
Medicare reimbursement, rural ambulance providers are also finding it 
difficult to maintain the heightened ``readiness requirement,'' 
exposing communities to the threat of being ill-prepared to respond to 
a major public health emergency.
  My legislation will take steps to improve the EMS system by 
eliminating the 35-mile rule for ambulance services that provide care 
in communities served by Critical Access Hospitals. In addition, it 
will establish an ambulance-specific definition of ``urban'' and 
``rural'' for Medicare reimbursement. Moreover, my legislation will 
provide $15 million in funds to be used for a variety of activities 
aimed at improving the rural EMS system. Finally, it will expand the 
Universal Service Fund's definition of ``health care provider'' to 
include ``ambulance services.''
  It is important to assure that rural Americans receive the best 
emergency medical services possible. This is especially important to me 
because 54 percent of North Dakotans live in rural communities, served 
largely by unpaid volunteer emergency personnel. In fact, only 10 
percent receive compensation for their services. In recent years, rural 
ambulance services have found it difficult to recruit and retain EMS 
personnel. Congress must take steps to ensure that every American has 
access to quality emergency care. The RAES Act would do just that by 
improving reimbursement, increasing collaboration among healthcare 
entities, and allowing EMS providers to collect quality data.
  The EMS bill will provide improved healthcare and better access to 
EMS for the 49 million Americans living in rural areas, and I urge my 
colleagues to support this essential legislation.
                                 ______