SIREN Reauthorization Act

Fund and Reauthorize the Supporting and Improving Rural EMS Needs (SIREN) Law. Support S.265/H.R. 4646, to reauthorize the SIREN Act grants for another five years (2024-2028); Urge Congress to fund the SIREN program at $32 million in FY25; Support legislation to reimburse EMS for Treatment in Place (TIP) and Transport to Alternate Destination (TAD). Support H.R. 8977, Improving Access to Emergency Medical Services Act of 2024; Support S.3236/H.R.6257, the Emergency Medical Services Reimbursement for On-Scene and Support Act; Support H.R. 8042, the Community Paramedicine Act of 2024; Support S. 1115/H.R. 2574, EMS Counts; S. 2757/H.R. 5530, VA Emergency Transportation Access Act; Educate and support for the creations of Critical Access Ambulance designation; S. 3765/H.R.6960 - Emergency Medical Services for Children (EMSC); Support S. 2757/H.R. 5530, Protect Access to Vital Ground Ambulance Services for Veterans and Communities; Support the inclusion of language in the House/Senate Labor HHS Appropriations for EMS workforce shortage. Insufficient reimbursement for EMS care and lack of federal investment in EMS are long-term problems that have been building for decades. The additional burdens placed on EMS systems and personnel during the pandemic made a serious problem even worse, pushing many EMS systems in our country to the breaking point. Most communities are facing crisis-level shortages of EMS personnel, and many have seen EMS agencies close altogether, removing a critical lifeline from these communities. The shortage of EMS personnel threatens to undermine our emergency 9-1-1 response infrastructure; Support Congress to hold congressional hearings on the EMS workforce crisis and the causes for the exodus of the EMS workforce from the profession; Support the inclusion of language in the House/Senate Labor HHS Appropriations bill on EMS education on rare diseases; Support H.R. 1666/S.1673, Protecting Access to Ground Ambulance Medical Services Act of 2023; Support language included in the NDAA on transitioning military medics; Support participation of EMS Caucus.

Client expense: Not reported · Firm income: $31,000

Government targets: Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Issues related to H.R. 8977, the Improving Access to Emergency Medical Services Act of 2024. Issues related to S. 3236/ H.R. 6257, the Emergency Medical Services Reimbursement for On-Scene Care and Support Act. Issues related to H.R. 8042, the Community Paramedicine Act of 2024. Issues related to H.R. 1737, Supporting Our First Responders Act. Issues related to H.R. 4646/ S. 265, the SIREN Reauthorization Act. Issues related to S. 1115, the EMS Counts Act of 2023. Issues related to H.R. 6140, the FAST PASS Act. Issues related to H.R. 6433, the PARA-EMT Act of 2023. Issues related to H.R. 1666/ S. 1673, Protecting Access to Ground Ambulance Medical Services Act of 2023.

Client expense: Not reported · Firm income: $30,000

Government targets: HOUSE OF REPRESENTATIVES, SENATE

S. 265/H.R. 4646, the SIREN Reauthorization Act to reauthorize the Rural Emergency Medical Services Training Grant program Issues related to the cost accounting of EMS services for Medicare patients 2025 Labor, Health and Human Services, and Education Appropriations relating to the National Firefighter Registry and the Supporting and Improving Rural EMS Needs (SIREN) grant, and NIOSH Firefighter Fatality Investigation and Prevention Program (FFFIPP). H.R. 3821/S. 2119, Firefighter Cancer Registry Reauthorization Act Provisions of H.R.8070/S.4638, the National Defense Authorization Act for Fiscal Year 2025, relating to firefighter cancer. H.R. 3671/H.R. 4274/S. 1925, HERO Act H.R. 1666/S. 1673, Protecting Access to Ground Ambulance Medical Services Act Issues relating to the Advisory Committee on Ground Ambulance and Patient Billing (GAPB) H.R. 2574/S. 1115, the EMS Counts Act Issues relating to volunteer firfighter status being added to the U.S. Standard Certificate of Death

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

Fund and Reauthorize the Supporting and Improving Rural EMS Needs (SIREN) Law. Support S.265/H.R. 4646, to reauthorize the SIREN Act grants for another five years (2024-2028); Urge Congress to fund the SIREN program at $32 million in FY25; Support legislation to reimburse EMS for Treatment in Place (TIP) and Transport to Alternate Destination (TAD). Support S.3236/H.R.6257, the Emergency Medical Services Reimbursement for On-Scene and Support Act. Support introduction of legislation on a TIP/TAD pilot; Support H.R. 8042, the Community Paramedicine Act of 2024; Support S. 1115/H.R. 2574, EMS Counts; S. 2757/H.R. H.R.5530, VA Emergency Transportation Access Act; Educate and support for the creations of Critical Access Ambulance designation; S. 3765/H.R.6960 - Emergency Medical Services for Children (EMSC); Support S. 2757/H.R. 5530, Protect Access to Vital Ground Ambulance Services for Veterans and Communities; Support the inclusion of language in the House/Senate Labor HHS Appropriations for EMS workforce shortage. Insufficient reimbursement for EMS care and lack of federal investment in EMS are long-term problems that have been building for decades. The additional burdens placed on EMS systems and personnel during the pandemic made a serious problem even worse, pushing many EMS systems in our country to the breaking point. Most communities are facing crisis-level shortages of EMS personnel, and many have seen EMS agencies close altogether, removing a critical lifeline from these communities. The shortage of EMS personnel threatens to undermine our emergency 9-1-1 response infrastructure; Support Congress to hold congressional hearings on the EMS workforce crisis and the causes for the exodus of the EMS workforce from the profession; Support the inclusion of language in the House/Senate Labor HHS Appropriations bill on EMS education on rare diseases; Support H.R. 1666/S.1673, Protecting Access to Ground Ambulance Medical Services Act of 2023; Express concern and urge Congress to amend language on military medics included in H.R.6433, to preserve access to emergency medical services; Support language included in the NDAA on transitioning military medics; Support participation of EMS Caucus.

H.R. 9029, the FY 2025 Labor, Health and Human Services, and Education Appropriations Act, provisions re: - Funding at the National Institute of Occupational Safety and Health for a national firefighter cancer registry. - Funding at the U.S. Department of Health and Human Services' Substance Abuse & Mental Health Services Administration for the Rural Emergency Medical Services Training Grant program. S. 265/H.R. 4646, the SIREN Reauthorization Act, provisions to reauthorize the Rural Emergency Medical Services Training Grant program. H.R. 8977, legislation to reimburse fire and EMS departments for treating patients on scene. H.R. 3821/S. 2119, the Firefighter Cancer Registry Reauthorization Act of 2023, provisions to reauthorize the National Firefighter Cancer Registry. Issues relating to supply chain issues and the effects on the cost and delivery of fire apparatus and equipment. Issues relating to the Ground Emergency Medical Transportation program. H.R. 8042, the Community Paramedicine Act, provisions to create a grant program for mobile integrated health programs. H.R. 3671/H.R. 4274/S.1925, the Helping Emergency Responders Overcome Act, provisions to create behavioral health resources for fire and EMS personnel. S. 645/H.R. 472, The Fighting Post-Traumatic Stress Disorder Act, provisions to provide behavioral health resources to first responders at the Department of Justice. Issues relating to the National EMS Advisory Council. Issues relating to the Advisory Committee on Ground Ambulance and Patient Billing (GAPB). Issues related to fire safety in home oxygen systems and reimbursement for the installation of thermal fuses. H.R. 5530/S. 2757, the VA Emergency Transportation Access Act, provisions to set requirements before the Department of Veterans Affairs can change reimbursement rates for ambulance transport. H.R. 2574/S. 1115, the EMS Counts Act, provisions to better account for the national EMS workforce. H.R. 1666/S. 1673, the Protecting Access to Ground Ambulance Medical Services Act, provisions to extend the add-on payments for ambulance transport of patients.

Fund and Reauthorize the Supporting and Improving Rural EMS Needs (SIREN) Law. Support S.265/H.R. 4646, to reauthorize the SIREN Act grants for another five years (2024-2028); Urge Congress to fund the SIREN program at $32 million in FY25; Support legislation to reimburse EMS for Treatment in Place (TIP) and Transport to Alternate Destination (TAD). Support S.3236/H.R.6257, the Emergency Medical Services Reimbursement for On-Scene and Support Act. Support introduction of legislation on a TIP/TAD pilot; Support efforts to create a bill to promote MIH-CP legislation; Support S. 1115/H.R. 2574, EMS Counts; S. 2757/H.R. H.R.5530, VA Emergency Transportation Access Act; S. 3765/H.R.6960 - Emergency Medical Services for Children (EMSC); Support S. 2757/H.R. 5530, Protect Access to Vital Ground Ambulance Services for Veterans and Communities; Support EMS Workforce: Insufficient reimbursement for EMS care and lack of federal investment in EMS are long-term problems that have been building for decades. The additional burdens placed on EMS systems and personnel during the pandemic made a serious problem even worse, pushing many EMS systems in our country to the breaking point. Most communities are facing crisis-level shortages of EMS personnel, and many have seen EMS agencies close altogether, removing a critical lifeline from these communities. The shortage of EMS personnel threatens to undermine our emergency 9-1-1 response infrastructure; Support Congress to hold congressional hearings on the EMS workforce crisis and the causes for the exodus of the EMS workforce from the profession; Support H.R. 1666/S.1673, Protecting Access to Ground Ambulance Medical Services Act of 2023; Support H.Res. 1042, Congressional Gold Medal for the Freedom House Ambulance Service; Express concern and urge Congress to amend language on military medics included in H.R.6433, to preserve access to emergency medical services; Support participation of EMS Caucus.

S. 265/H.R. 4646, the SIREN Reauthorization Act to reauthorize the Rural Emergency Medical Services Training Grant program Issues related to the cost accounting of EMS services for Medicare patients Provisions of H.R. 5894/S. 2624, the FY 2024 Labor, Health and Human Services, and Education Appropriations Act relating to the National Firefighter Registry and the Supporting and Improving Rural EMS Needs (SIREN) grant. H.R. 3821/S. 2119, Firefighter Cancer Registry Reauthorization Act Provisions of S.2226, the National Defense Authorization Act for Fiscal Year 2024, relating to reauthorizing the National Firefighter Cancer Registry. H.R. 3671/H.R. 4274/S. 1925, HERO Act H.R. 1666/S. 1673, Protecting Access to Ground Ambulance Medical Services Act Issues relating to the Advisory Committee on Ground Ambulance and Patient Billing (GAPB) H.R. 2574/S. 1115, the EMS Counts Act Issues relating to volunteer firfighter status being added to the U.S. Standard Certificate of Death

Client expense: $10,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

P.L. 118-47, the Fiscal Year (FY) 2024 Further Consolidated Appropriations Act, provisions re: - Funding at the National Institute of Occupational Safety and Health for a national firefighter cancer registry. - Funding at the U.S. Department of Health and Human Services' Substance Abuse & Mental Health Services Administration for the Rural Emergency Medical Services Training Grant program. S. 265/H.R. 4646, the SIREN Reauthorization Act, provisions to reauthorize the Rural Emergency Medical Services Training Grant program. Issues relating to reimbursement for ambulance transport and the treatment of patients in place or their transportation to an alternate destination of care. H.R. 3821/S. 2119, the Firefighter Cancer Registry Reauthorization Act of 2023, provisions to reauthorize the National Firefighter Cancer Registry. Issues relating to supply chain issues and the effects on the cost and delivery of fire apparatus and equipment. Issues relating to the Ground Emergency Medical Transportation program. Issues relating to reimbursement of fire and EMS departments for mobile integrated health programs, treatment of patients in place, and transportation of patients to alternate destinations of care. H.R. 3671/H.R. 4274/S.1925, the Helping Emergency Responders Overcome Act, provisions to create behavioral health resources for fire and EMS personnel. S. 645/H.R. 472, The Fighting Post-Traumatic Stress Disorder Act, provisions to provide behavioral health resources to first responders at the Department of Justice. Issues relating to the National EMS Advisory Council. Issues relating to the Advisory Committee on Ground Ambulance and Patient Billing (GAPB). Issues related to fire safety in home oxygen systems and reimbursement for the installation of thermal fuses. H.R. 5530/S. 2757, the VA Emergency Transportation Access Act, provisions to set requirements before the Department of Veterans Affairs can change reimbursement rates for ambulance transport. H.R. 2574/S. 1115, the EMS Counts Act, provisions to better account for the national EMS workforce.

Fund and Reauthorize the Supporting and Improving Rural EMS Needs (SIREN) Law. Support S.265/H.R. 4646, to reauthorize the SIREN Act grants for another five years (2024-2028); Support legislation to reimburse EMS for Treatment in Place (TIP) and Transport to Alternate Destination (TAD). Support S.3236/H.R.6257, the Emergency Medical Services Reimbursement for On-Scene and Support Act. Support efforts to create TIP/TAD pilot; Support efforts to create a bill to promote MIH-CP legislation; Support S. 1115/H.R. 2574, EMS Counts; S.2757/H.R. H.R.5530, VA Emergency Transportation Access Act. Supported a letter to the Secretary of Veterans Affairs to request a delay in implementation of the final rule on changes in the rates that the VA pays for ambulance services, and a meeting with the Secretary and his staff to discuss how the VA and EMS can work together during the delay to help ensure that veterans can continue to receive ambulance services. NAEMT supported the VA delaying the final rule for one year until 2025 on ground and air ambulance reimbursement to allow for further VA review. In addition, NAEMT supported a Senate amendment that was adopted to prohibit the VA from reducing air/ground ambulance reimbursement; H.R.6960 - Emergency Medical Services for Children (EMSC). Joined a Congressional letter to House and Senate Appropriations Committee in support of funding for this program; Support S. 2757/H.R. 5530, Protect Access to Vital Ground Ambulance Services for Veterans and Communities; Support EMS Workforce: Insufficient reimbursement for EMS care and lack of federal investment in EMS are long-term problems that have been building for decades. The additional burdens placed on EMS systems and personnel during the pandemic made a serious problem even worse, pushing many EMS systems in our country to the breaking point. Most communities are facing crisis-level shortages of EMS personnel, and many have seen EMS agencies close altogether, removing a critical lifeline from these communities. The shortage of EMS personnel threatens to undermine our emergency 9-1-1 response infrastructure; Support Congress to hold congressional hearings on the EMS workforce crisis and the causes for the exodus of the EMS workforce from the profession; Support H.R. 1666/S.1673, Protecting Access to Ground Ambulance Medical Services Act of 2023; Supported a letter to Congressional opposing any legislation that would increase the legal size or weight limits of trucks because of the serious safety risks inherent in allowing bigger trucks on our nations roads and bridges; S. 1176/H.R.2663, Workplace Violence; S.3449/4783, Pathways to Health Careers Act H.R.1784, Next Generation 9-1-1 Act of 2023; H.R.1423 - 911 Community Crisis Responders Act; H.R.1477 - The Freedom to Invest in Tomorrow's Workforce Act; S.1653 - BLEEDing Act; Support participation of EMS Caucus.

S. 265/H.R. 4646, the SIREN Reauthorization Act to reauthorize the Rural Emergency Medical Services Training Grant program Issues related to the cost accounting of EMS services for Medicare patients Provisions of H.R. 5894/S. 2624, the FY 2024 Labor, Health and Human Services, and Education Appropriations Act relating to the National Firefighter Registry and the Supporting and Improving Rural EMS Needs (SIREN) grant. H.R. 3821/S. 2119, Firefighter Cancer Registry Reauthorization Act Provisions of S.2226, the National Defense Authorization Act for Fiscal Year 2024, relating to reauthorizing the National Firefighter Cancer Registry. H.R. 3671/H.R. 4274/S. 1925, HERO Act H.R. 1666/S. 1673, Protecting Access to Ground Ambulance Medical Services Act Issues relating to the Advisory Committee on Ground Ambulance and Patient Billing (GAPB) H.R. 2574/S. 1115, the EMS Counts Act

Client expense: $20,000 · Firm income: Not reported

Government targets: Centers For Disease Control & Prevention (CDC), Centers For Medicare and Medicaid Services (CMS), HOUSE OF REPRESENTATIVES, Health & Human Services, Dept of (HHS), Natl Highway Traffic Safety Administration (NHTSA), SENATE, Substance Abuse & Mental Health Services Administration (SAMHSA)

FY 2024 Labor, Health and Human Services, and Education Appropriations Act, provisions re: - Funding at the National Institute of Occupational Safety and Health for a national firefighter cancer registry. - Funding at the U.S. Department of Health and Human Services' Substance Abuse & Mental Health Services Administration for the Rural Emergency Medical Services Training Grant program. S. 265/H.R. 4646, the SIREN Reauthorization Act, provisions to reauthorize the Rural Emergency Medical Services Training Grant program. Issues relating to billing for ambulance transport. H.R. 3821/S. 2119, the Firefighter Cancer Registry Reauthorization Act of 2023, provisions to reauthorize the National Firefighter Cancer Registry. S.2226, the National Defense Authorization Act for Fiscal Year 2024, provisions to reauthorize the National Firefighter Cancer Registry. Issues relating to supply chain issues and the effects on the cost and delivery of fire apparatus and equipment. Issues relating to the Ground Emergency Medical Transportation program. Issues relating to reimbursement of fire and EMS departments for mobile integrated health programs, treatment of patients in place, and transportation of patients to alternate destinations of care. H.R. 3671/H.R. 4274/S.1925, the Helping Emergency Responders Overcome Act, provisions to create behavioral health resources for fire and EMS personnel. S. 645/H.R. 472, The Fighting Post-Traumatic Stress Disorder Act, provisions to provide behavioral health resources to first responders at the Department of Justice. Issues relating to the National EMS Advisory Council. Issues relating to the Advisory Committee on Ground Ambulance and Patient Billing (GAPB). Issues related to fire safety in home oxygen systems. H.R. 5530/S. 2757, the VA Emergency Transportation Access Act, provisions to set requirements before the Department of Veterans Affairs can change reimbursement rates for ambulance transport. H.R. 2574/S. 1115, the EMS Counts Act, provisions to better account for the national EMS workforce.

Fund and Reauthorize the Supporting and Improving Rural EMS Needs (SIREN) Law; Support legislation to reimburse EMS for Treatment in Place (TIP) and Transport to Alternate Destination (TAD); Support EMS Workforce: Insufficient reimbursement for EMS care and lack of federal investment in EMS are long-term problems that have been building for decades. The additional burdens placed on EMS systems and personnel during the pandemic made a serious problem even worse, pushing many EMS systems in our country to the breaking point. Most communities are facing crisis-level shortages of EMS personnel, and many have seen EMS agencies close altogether, removing a critical lifeline from these communities. The shortage of EMS personnel threatens to undermine our emergency 9-1-1 response infrastructure; Support Congress to hold congressional hearings on the EMS workforce crisis and the causes for the exodus of the EMS workforce from the profession; Support participation of EMS Caucus; Support S.265/H.R. 4646, to reauthorize the SIREN Act grants for another five years (2024-2028); Support appropriate funding for Support S. 1115/H.R. 2574, EMS Counts; Support H.R. 1666/S.1673, Protecting Access to Ground Ambulance Medical Services Act of 2023;

Client expense: Not reported · Firm income: $31,500

Government targets: HOUSE OF REPRESENTATIVES, SENATE

FY 2024 Labor, Health and Human Services, and Education Appropriations Act, provisions re: - Funding at the National Institute of Occupational Safety and Health for a national firefighter cancer registry. - Funding at the U.S. Department of Health and Human Services' Substance Abuse & Mental Health Services Administration for the Rural Emergency Medical Services Training Grant program. S. 265/H.R. 4646, the SIREN Reauthorization Act, provisions to reauthorize the Rural Emergency Medical Services Training Grant program. Issues relating to billing for ambulance transport. H.R. 3821/S. 2119, the Firefighter Cancer Registry Reauthorization Act of 2023, provisions to reauthorize the National Firefighter Cancer Registry. S.2226, the National Defense Authorization Act for Fiscal Year 2024, provisions to reauthorize the National Firefighter Cancer Registry. Issues relating to supply chain issues and the effects on the cost and delivery of fire apparatus and equipment. H.R. 3671/H.R. 4274/S.1925, provisions to create behavioral health resources for fire and EMS personnel. S. 645/H.R. 472, The Fighting Post-Traumatic Stress Disorder Act, provisions to provide behavioral health resources to first responders at the Department of Justice. Issues relating to the National EMS Advisory Council. Issues relating to the Advisory Committee on Ground Ambulance and Patient Billing (GAPB). Issues related to fire safety in home oxygen systems. H.R. 5530/S. 2757, the VA Emergency Transportation Access Act, provisions to set requirements before the Department of Veterans Affairs can change reimbursement rates for ambulance transport. H.R. 2574/S. 1115, the EMS Counts Act, provisions to better account for the national EMS workforce.

Client expense: $30,000 · Firm income: Not reported

Fund and Reauthorize the Supporting and Improving Rural EMS Needs (SIREN) Law; Support legislation to reimburse EMS for Treatment in Place (TIP) and Transport to Alternate Destination (TAD); Express opposition and concern over CMMI's decision to end the ET3 model on December 31st; Support Congressional letter to DEA to finalize PPAEMA regulations; Support EMS Workforce: Insufficient reimbursement for EMS care and lack of federal investment in EMS are long-term problems that have been building for decades. The additional burdens placed on EMS systems and personnel during the pandemic made a serious problem even worse, pushing many EMS systems in our country to the breaking point. Most communities are facing crisis-level shortages of EMS personnel, and many have seen EMS agencies close altogether, removing a critical lifeline from these communities. The shortage of EMS personnel threatens to undermine our emergency 9-1-1 response infrastructure; Expand the Hospital Preparedness Program, authorized by the Pandemic and All Hazards Preparedness Act (PAHPA), to include $50 million to fund an EMS Preparedness and Response Workforce Shortage Program. Funds from this grant program would support recruitment, retention, and training of EMS personnel including tuition and associated expenses for paramedic and EMT training courses; expenses for required continuing education courses; and costs related to licensure and certification; Make EMS eligible for federal grants offered through the Department of Labor and other agencies for apprenticeship programs. Apprenticeship programs have historically been used to spur workforce development or expansion in sectors of the economy that need workers. EMS agencies and fire departments struggling to recruit and retain EMS personnel would benefit from access to federal grants to support apprenticeship programs for Paramedics and EMTs; Support Congress to hold congressional hearings on the EMS workforce crisis and the causes for the exodus of the EMS workforce from the profession; Support participation of EMS Caucus; Support S.265/H.R. 4646, to reauthorize the SIREN Act grants for another five years (2024-2028); Support S. 1115/H.R. 2574, EMS Counts; Support H.R. 1666/S.1673, Protecting Access to Ground Ambulance Medical Services Act of 2023; Support letter to Secretary Buttigeig regarding the need for the hot car regulation; Support H.R. 3671/S. 1925, HERO Act; Support S.1528/H.R. 1796, the Disaster Survivor Fairness Act; Support H.R.1784, Next Generation 9-1-1 Act of 2023; Support S.1514/H.R.3170, the HELPER Act; Support S.1176/H.R.2663, Workplace Violence; Support S.977/H.R. 1814, the Fire/EMS Station Act; Support H.R.1719, to amend the Omnibus Crime Control and Safe Streets Act of 1968 to provide public safety officer benefits for exposure-related cancers, and for other purposes Support S.645, the Fighting Post-Traumatic Stress Disorder Act of 2023; Support S.261/H.R. 795, Protecting First Responders from Secondary Exposure Act of 2023; Support S.154/H.R. 621, Preventing Auto Recycling Theft Act (PART Act); Support H.R.1423, 911 Community Crisis Responders Act; Support H.R.3104, Helping Our Heroes Act; Support H.R.2548, the Public Safety Concussions and TBI Health Act; Support H.R.2370: Access to AEDs Act; Support funding for the EMSC program in FY24.