The most controversial provision of the proposed Field EMS Bill—the one establishing the National Highway Traffic Safety Administration (NHTSA) as the lead agency for EMS issues— was reversed at a March summit of the broad coalition of EMS organizations and stakeholders hammering out consensus on the bill. After considerable discussion, the group voted to change the lead agency from NHTSA to the Department of Health and Human Services (HHS). NHTSA was the lead agency in the original bill introduced in the fall of 2010; the revised bill language creates a Bureau of Emergency Medical Services within the HHS Health Resources and Services Administration (HRSA).
Kurt Krumperman, president of Advocates for EMS, the organization spearheading the process, called the discussion leading to the change very productive. “We started by laying out what it was we wanted, not where [EMS] would be but what the programs, the functions were that we wanted,” he says. “What people could agree to was a separate entity, a bureau, whatever it would be called, and where it ended up being was within HHS.” He believes that what drove the decision was the fact that EMS is a component of, and needs to be integrated into, health care.
EMS programs currently dispersed throughout numerous federal offices would be consolidated into this new EMS agency. Representatives participating in the discussion still have to report back to their organizations for approval of the revised bill language, which bill sponsors could change.
“While EMS organizations are drafting the legislation, the bill sponsors have the final say over its provisions,” Krumperman adds. “They make determinations about what is feasible and what the chances are of it moving in Congress ... and that has a lot of implications as to what the final language looks like.” Represen- tatives Tim Walz (D-Minn.) and Sue Myrick (R-N.C.) co-sponsored the bill in the 111th Congress and are expected to reintro- duce it this year. Senate sponsors have not yet been identified.
Bill supporters would like to have the legislation introduced prior to May 3, EMS Day on the Hill. “It would be fantastic to have a specific piece of legislation so that the folks who come to EMS Day on the Hill can meet with their members of Congress and staff and say, ‘Please support this bill,’” Krumperman says.
Ambulance Transport Rate Increase Proposed
Ambulance service providers would see much-needed relief through the reimbursement increases proposed in the Medicare Ambulance Access Preservation Act (MAAPA), reintroduced in both houses of Congress in March 2011. MAAPA would increase the Medicare ambulance fee 6 percent over the base rate in urban and rural areas and provide a 22.6 percent bonus payment over the base rate for transports originating in super-rural areas. The legislation would begin Jan. 1, 2012, and expire in five years. Base rates for transport fees are based on formulas developed by the Centers for Medicare and Medicaid Services.
The House bill was referred to the Ways and Means and Energy and Commerce committees. The Senate bill was referred to the Finance Committee. Both bills are identical, so if passed, they could go directly to the president to be signed into law.
AFG and SAFER Reauthorization
Funding for two crucial fire grants, Assistance to Firefighters (AFG) and Staffing for Adequate Fire and Emergency Response (SAFER), has been uncertain in the current atmosphere of fiscal belt-tightening in Washington. Congress’ original fiscal year 2011 budget bill allocated only $300 million for AFG funding and eliminated SAFER grants altogether. In response, the House approved an amendment in February to save these much-needed programs.
The amendment restores funding for AFG and SAFER to 2010 levels of $390 million and $420 million, respectively. Career, volunteer and combination fire departments would each receive a minimum of 25 percent of the AFG grant funds, with the remaining money allocated to departments on the basis of risk and other factors. Additionally, the maximum AFG grant award would increase and departments would find relief in reduced matching requirements or avoid the match altogether under hardship circumstances. These changes would enable a greater number of departments to seek funding.
The budget bill was sent to the Senate, whose members introduced amendments to the House version.
Mixed Reaction to D Block Bill
A number of legislators introduced bills that would reserve the D Block, 758–763 MHz and 788–793 MHz bands, for public safety use and allocate funding for the build-out of the network.
Of the two bills viewed as most likely to succeed, one in the House and one in the Senate, the House bill has caused the most consternation among emergency responders. While they support the D Block allocation for public safety use contained in the bill, there is a troublesome provision: To reduce the cost of the network build-out, public safety organizations must abandon their use of the 420–512 MHz spectrum bands and move to the D Block within eight years of the bill’s passage. That section of the spectrum would then be sold to commercial interests.
Most responders on this UHF band have already spent significant funds to upgrade their communications systems to meet the Federal Communications Commission’s unfunded narrowbanding mandate by the January 2013 deadline. (Narrowbanding al- lows licensees to operate on narrower channel bandwidths, creating additional channels in the same spectrum and allowing more users.) Several organizations drafted form letters to bill sponsors supporting the legislation’s D Block provisions and asking legisla- tors to reconsider their UHF band position.
The House bill, Broadband for First Responders Act, was referred to the Subcommittee on Communications and Technolo- gy. The Public Safety Spectrum and Wireless Innovation Act was referred to the Senate Committee on Commerce, Science and Transportation. A narrowbanding FAQ is at fcc.gov/pshs/public- safety-spectrum/narrowbanding-faq.html.
