Res Communis

HR 1117 IH

112th CONGRESS

1st Session

H. R. 1117

To recognize and clarify the authority of the States to regulate the medical aspects of intrastate air ambulance services pursuant to their authority over health care services, patient safety and protection, emergency medical care, the quality and coordination of medical care, and the practice of medicine within their jurisdictions.

IN THE HOUSE OF REPRESENTATIVES

March 16, 2011

Mrs. MILLER of Michigan (for herself and Mr. ALTMIRE) introduced the following bill; which was referred to the Committee on Transportation and Infrastructure, and in addition to the Committee on Energy and Commerce, 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 recognize and clarify the authority of the States to regulate the medical aspects of intrastate air ambulance services pursuant to their authority over health care services, patient safety and protection, emergency medical care, the quality and coordination of medical care, and the practice of medicine within their jurisdictions.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Air Ambulance Patient Safety, Protection, and Coordination Act’.

SEC. 2. CLARIFICATION OF STATE AUTHORITY OVER THE MEDICAL ASPECTS OF AIR AMBULANCE SERVICES.

(a) In General- Chapter 401 of title 49, United States Code, is amended by adding at the end the following:

`Sec. 40130. Clarification of State authority over the medical aspects of air ambulance services

`(a) Clarification of State Authority- Pursuant to a State’s authority over the licensure and regulation of health care services within its borders, a State may prescribe licensing and other regulatory requirements related to the medical aspects of intrastate air ambulance services in the same manner that it regulates other health care services within its borders and may integrate such services into the State’s emergency medical services system, including by establishing requirements related to the following:

`(1) The quality of emergency medical care provided to patients by air ambulances, including–

`(A) the medical qualifications and medical training of medical personnel;

`(B) medical records and data collection and reporting;

`(C) outcome and proficiency measures;

`(D) affiliation with health care institutions for medical oversight, critical care medical education, and clinical experience in critical care settings;

`(E) participation in patient safety and quality control initiatives, such as peer review, utilization review, and error reporting;

`(F) medical accreditation;

`(G) licensing of personnel including scope of practice and credentialing; and

`(H) medical oversight.

`(2) The availability of air ambulance services provided to patients with emergency medical conditions, including–

`(A) service during specified hours and days to ensure the availability of life-saving medical services as part of the State’s emergency medical services system; and

`(B) coordination of services, agreements, and flight requests for patients with emergency medical conditions being transported from the scene at which the patient’s injury or accident, or other event resulting in the need for medical services for the patient, occurred.

`(3) Communication between–

`(A) emergency medical and public safety agencies and hospitals; and

`(B) the flightcrew and air ambulance medical personnel to the extent that the communications do not interfere with the safe operation of the flight.

`(4) The accessibility of emergency medical care provided by air ambulances and the incorporation and integration of air ambulance services into State emergency medical services systems, including–

`(A) access to air ambulance services in regions of a State;

`(B) the provision of services to all persons for whom such services are medically necessary and appropriate regardless of ability to pay;

`(C) the proffer of gifts of monetary value to referring entities;

`(D) medical criteria, based on the patient’s medical need for transport from the scene at which the patient’s injury or accident, or other event resulting in the need for medical services for the patient occurred, for determining the appropriate–

`(i) mode of transport (ground versus air) utilizing evidence-based triage criteria to the extent available;

`(ii) air ambulance to be utilized to transport a patient in accordance with its capability to meet the patient’s medical need; and

`(iii) medical institution to receive the patient.

`(5) The acceptability of air ambulance services to ensure the adequate and appropriate provision of medically necessary emergency medical care provided by air ambulances to protect critically ill and injured patients, including–

`(A) medical equipment, devices, and supplies to be carried on board or affixed to the air ambulance;

`(B) sanitation and infection control;

`(C) licensing of the air ambulance agency or program;

`(D) licensing of the ambulance vehicle;

`(E) truth in advertising requirements;

`(F) physical attributes of the air ambulance necessary for the provision of quality medical care, including–

`(i) permanently installed climate control systems capable of meeting specified temperature settings;

`(ii) a configuration that allows adequate access to the patient, medical equipment, and medical supplies by the medical personnel;

`(iii) the use of materials in the air ambulance that are appropriate for proper patient care;

`(iv) sufficient electrical supply to support medical equipment without compromising the ambulance power; and

`(v) the ability of the air ambulance to transport a patient a certain distance without refueling within the State.

`(6) Physical attributes of the air ambulance necessary–

`(A) for the protection of the ambulance, ground, and emergency response personnel; and

`(B) to ensure that the air ambulance has no structural or functional defects that may adversely affect such personnel, such as by requiring the provision of tailrotor illumination for loading patients at night or external search lights.

`(b) Applicability of Federal Aviation Safety Authority- No State health-related regulation established pursuant to this section shall supersede or be inconsistent with any Federal operating requirement with respect to aviation safety.

`(c) Limitations-

`(1) IN GENERAL- State requirements and regulations prescribed pursuant to this section must be in accordance with objective, competitive, and transparent processes designed to ensure the highest quality of emergency medical care and patient safety, best outcomes, and access to life-saving emergency medical services as part of an integrated emergency medical services system.

`(2) PRICES- This section shall not be construed to allow State regulation of the prices charged by air ambulances for their services.

`(3) PROVIDERS LICENSED IN MULTIPLE STATES- If an air ambulance is licensed to provide services in more than one State and the regulations established pursuant to this subsection by the States are inconsistent, the provider shall comply with the most stringent of such regulations.

`(4) NONDELEGATION REQUIREMENT- A State may not delegate authority provided under this section to a political subdivision of the State.

`(d) Interstate Agreements- In regulating the provision of air ambulance services pursuant to this section, a State shall, if necessary, establish regulations or negotiate mutual aid agreements with adjacent States or air ambulances to ensure access to air ambulance services across State borders.

`(e) Definitions-

`(1) AIR AMBULANCE SERVICES- The term `air ambulance services’ means the transport by an air ambulance of a patient, in both emergency and nonemergency situations, as well as the medical services provided to such patient in the course of transport by such air ambulance.

`(2) FEDERAL OPERATING REQUIREMENTS- The term `Federal operating requirements’ means requirements under part A of subtitle VII of title 49, United States Code, and Federal aviation regulations set forth in title 14, Code of Federal Regulations.

`(3) REFERRING ENTITIES- The term `referring entity’ means any entity that dispatches or provides a referral for a provider of air ambulance services, such as a medical institution, an agency providing emergency medical services, or a first responder.’.

(b) Conforming Amendment- The analysis for such chapter is amended by adding at the end the following:

`40130. Clarification of State authority over the medical aspects of air ambulance services.’.

HR 1079 IH

112th CONGRESS

1st Session

H. R. 1079

To amend the Internal Revenue Code of 1986 to extend the funding and expenditure authority of the Airport and Airway Trust Fund, to amend title 49, United States Code, to extend the airport improvement program, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

March 15, 2011

Mr. MICA (for himself, Mr. CAMP, Mr. PETRI, Mr. RAHALL, and Mr. COSTELLO) introduced the following bill; which was referred to the Committee on Transportation and Infrastructure, 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 the Internal Revenue Code of 1986 to extend the funding and expenditure authority of the Airport and Airway Trust Fund, to amend title 49, United States Code, to extend the airport improvement program, 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.

This Act may be cited as the `Airport and Airway Extension Act of 2011′.

SEC. 2. EXTENSION OF TAXES FUNDING AIRPORT AND AIRWAY TRUST FUND.

(a) Fuel Taxes- Subparagraph (B) of section 4081(d)(2) of the Internal Revenue Code of 1986 is amended by striking `March 31, 2011′ and inserting `May 31, 2011′.

(b) Ticket Taxes-

(1) PERSONS- Clause (ii) of section 4261(j)(1)(A) of the Internal Revenue Code of 1986 is amended by striking `March 31, 2011′ and inserting `May 31, 2011′.

(2) PROPERTY- Clause (ii) of section 4271(d)(1)(A) of such Code is amended by striking `March 31, 2011′ and inserting `May 31, 2011′.

(c) Effective Date- The amendments made by this section shall take effect on April 1, 2011.

SEC. 3. EXTENSION OF AIRPORT AND AIRWAY TRUST FUND EXPENDITURE AUTHORITY.

(a) In General- Paragraph (1) of section 9502(d) of the Internal Revenue Code of 1986 is amended–

(1) by striking `April 1, 2011′ and inserting `June 1, 2011′; and

(2) by inserting `or the Airport and Airway Extension Act of 2011′ before the semicolon at the end of subparagraph (A).

(b) Conforming Amendment- Paragraph (2) of section 9502(e) of such Code is amended by striking `April 1, 2011′ and inserting `June 1, 2011′.

(c) Effective Date- The amendments made by this section shall take effect on April 1, 2011.

SEC. 4. EXTENSION OF AIRPORT IMPROVEMENT PROGRAM.

(a) Authorization of Appropriations-

(1) IN GENERAL- Section 48103 of title 49, United States Code, is amended by striking the 2 paragraphs designated as paragraph (8) and inserting the following:

`(8) $2,466,666,667 for the 8-month period beginning on October 1, 2010.’.

(2) OBLIGATION OF AMOUNTS- Subject to limitations specified in advance in appropriation Acts, sums made available pursuant to the amendment made by paragraph (1) may be obligated at any time through September 30, 2011, and shall remain available until expended.

(3) PROGRAM IMPLEMENTATION- For purposes of calculating funding apportionments and meeting other requirements under sections 47114, 47115, 47116, and 47117 of title 49, United States Code, for the 8-month period beginning on October 1, 2010, the Administrator of the Federal Aviation Administration shall–

(A) first calculate funding apportionments on an annualized basis as if the total amount available under section 48103 of such title for fiscal year 2011 were $3,700,000,000; and

(B) then reduce by 20 percent–

(i) all funding apportionments calculated under subparagraph (A); and

(ii) amounts available pursuant to sections 47117(b) and 47117(f)(2) of such title.

(b) Project Grant Authority- Section 47104(c) of such title is amended by striking `March 31, 2011,’ and inserting `May 31, 2011,’.

SEC. 5. EXTENSION OF EXPIRING AUTHORITIES.

(a) Section 40117(l)(7) of title 49, United States Code, is amended by striking `April 1, 2011.’ and inserting `June 1, 2011.’.

(b) Section 44302(f)(1) of such title is amended–

(1) by striking `March 31, 2011,’ and inserting `May 31, 2011,’; and

(2) by striking `June 30, 2011,’ and inserting `August 31, 2011,’.

(c) Section 44303(b) of such title is amended by striking `June 30, 2011,’ and inserting `August 31, 2011,’.

(d) Section 47107(s)(3) of such title is amended by striking `April 1, 2011.’ and inserting `June 1, 2011.’.

(e) Section 47115(j) of such title is amended by striking `April 1, 2011,’ and inserting `June 1, 2011,’.

(f) Section 47141(f) of such title is amended by striking `March 31, 2011.’ and inserting `May 31, 2011.’.

(g) Section 49108 of such title is amended by striking `March 31, 2011,’ and inserting `May 31, 2011,’.

(h) Section 161 of the Vision 100–Century of Aviation Reauthorization Act (49 U.S.C. 47109 note) is amended by striking `April 1, 2011,’ and inserting `June 1, 2011,’.

(i) Section 186(d) of such Act (117 Stat. 2518) is amended by striking `April 1, 2011,’ and inserting `June 1, 2011,’.

(j) The amendments made by this section shall take effect on April 1, 2011.

HR 1165 IH

112th CONGRESS

1st Session

H. R. 1165

To amend title 49, United States Code, to establish an Ombudsman Office within the Transportation Security Administration for the purpose of enhancing transportation security by providing confidential, informal, and neutral assistance to address work-place related problems of Transportation Security Administration employees, and for other purposes.

IN THE HOUSE OF REPRESENTATIVES

March 17, 2011

Ms. JACKSON LEE of Texas (for herself, Ms. SPEIER, Mr. THOMPSON of Mississippi, and Mr. DAVIS of Illinois) introduced the following bill; which was referred to the Committee on Homeland Security

A BILL

To amend title 49, United States Code, to establish an Ombudsman Office within the Transportation Security Administration for the purpose of enhancing transportation security by providing confidential, informal, and neutral assistance to address work-place related problems of Transportation Security Administration employees, 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.

This Act may be cited as the `Transportation Security Administration Ombudsman Act of 2011′.

SEC. 2. TRANSPORTATION SECURITY ADMINISTRATION OMBUDSMAN OFFICE.

(a) In General- Subchapter II of chapter 449 of title 49, United States Code is amended by adding at the end the following new section:

`Sec. 44946. Ombudsman

`(a) In General-

`(1) ESTABLISHMENT- There is established an Office of the Ombudsman in the Transportation Security Administration.

`(2) OMBUDSMAN-

`(A) IN GENERAL- The Office shall be under the direction of the Ombudsman of the Transportation Security Administration, who shall be appointed by the Chief Human Capital Officer of the Department of Homeland Security on behalf of the Secretary of Homeland Security.

`(B) QUALIFICATIONS- An individual may not be appointed as the Ombudsman unless the individual has demonstrated expertise in–

`(i) labor and employment relations; and

`(ii) dispute resolution.

`(C) VACANCIES- If a vacancy occurs in the position of Ombudsman, the Chief Human Capital Officer of the Department of Homeland Security shall appoint an individual as Ombudsman by not later than 120 days after the date the vacancy first occurs.

`(D) NOTIFICATION OF APPOINTMENT AND REMOVAL- The Chief Human Capital Officer of the Department of Homeland Security shall notify the appropriate congressional committees within 30 days after the effective date of any of the following actions:

`(i) The appointment of an individual as Ombudsman.

`(ii) The reappointment as Ombudsman of an individual who is serving as Ombudsman.

`(iii) The removal of an individual from the position of Ombudsman.

`(3) ENSURING INDEPENDENCE OF OMBUDSMAN-

`(A) IN GENERAL- The Ombudsman shall report–

`(i) to the Administrator of the Transportation Security Administration; and

`(ii) to the Chief Human Capital Officer of the Department of Homeland Security with respect to any dispute between the Ombudsman and the Administrator of Transportation Security Administration over matters involving the execution of the Ombudsman’s duties as set forth in subsection (b).

`(B) INSPECTOR GENERAL’S AUTHORITY TO CONDUCT INVESTIGATIONS NOT AFFECTED- Nothing in this section shall prohibit the Inspector General of the Department of Homeland Security from initiating, carrying out, or completing any investigation.

`(4) REGIONAL OMBUDSMEN-

`(A) IN GENERAL- The Ombudsman shall ensure that each of the Transportation Security Administration regions has a regional ombudsman and that no regional ombudsman is responsible for more than three regions.

`(B) APPOINTMENT- The regional ombudsmen shall be appointed by and serve at the discretion of the Ombudsman.

`(C) MEETINGS WITHIN REGIONS- Each regional ombudsman shall travel not less than once each calendar quarter to each region for which he or she is appointed, to meet with Transportation Security Administration employees in that region.

`(b) Duties- The Ombudsman shall–

`(1) conduct outreach to Transportation Security Administration employees, including publicizing a toll-free telephone number to report complaints;

`(2) evaluate each complainant’s claim objectively;

`(3) provide information, advice, and assistance to complainants and, as appropriate, initiate informal, impartial fact-finding and inquiries, on complaints or on the Ombudsman’s own initiative;

`(4) inform each complainant–

`(A) when the Ombudsman decides against conducting a fact-finding inquiry into the complaint;

`(B) on the status of the Ombudsman’s fact-finding inquiry to the complainant, on a regular basis if requested by the complainant; and

`(C) of the Ombudsman’s recommendations and information, as appropriate, for the complainant to formally complain to the appropriate authority;

`(5) work with the Administrator of the Transportation Security Administration to address issues identified through fact-finding and inquiries;

`(6) maintain confidential any matter related to complaints and inquiries, including the identities of the complainants and witnesses; and

`(7) submit an annual report to the appropriate congressional committees in accordance with subsection (c).

`(c) Annual Report-

`(1) IN GENERAL- The Ombudsman shall report no later than September 30 each year to the appropriate congressional committees on the actions taken by the Office of the Ombudsman over the preceding year and the objectives of those actions.

`(2) CONTENTS- Each such report shall, for the period covered by the report, include–

`(A) statistical information, by region, on the volume of complaints received, general nature of complaints, general information on complainants, and the percentage of complaints that resulted in a fact-finding inquiry;

`(B) a summary of problems encountered by complainants, including information on the most pervasive or serious types of problems encountered by complainants;

`(C) policy recommendations that the Office of the Ombudsman made to the Administrator of the Transportation Security Administration;

`(D) an inventory of the items described in subparagraphs (B) and (C) for which action has been taken, and the result of such action;

`(E) an inventory of the items described in subparagraphs (B) and (C) for which action remains to be completed; and

`(F) such other information as the Ombudsman considers relevant.

`(3) REPORT TO BE SUBMITTED DIRECTLY- Each report under this subsection shall be provided directly to the committees described in paragraph (1) without any prior comment or amendment by the Administrator of the Transportation Security Administration. However, the Ombudsman shall seek comment from the Administrator to be submitted by the Ombudsman together with the annual report.

`(4) OTHER REPORTS- Nothing in this subsection shall be construed to preclude the Ombudsman from issuing other reports on the activities of the Office of the Ombudsman.

`(d) Appropriate Congressional Committee Defined- In this section the term `appropriate congressional committee’ means the Committee on Homeland Security of the House of Representatives and any committee of the House of Representatives or the Senate having legislative jurisdiction under the rules of the House of Representatives or Senate, respectively, over the matter concerned.’.

(b) Clerical Amendment- The analysis at the beginning of such chapter is amended by adding at the end the items relating to subchapter II the following new item:

`44946. Ombudsman.’.

(c) Authorization of Appropriations- There are authorized to be appropriated for fiscal years 2012, 2013, and 2014 such sums as are necessary for implementing section 44946 of title 49, United States Code, as amended by this section.