Emergency Medical Services

Empowering Response, Ensuring Safety: Federal Support for Fire Service-Based EMS

Prehospital 9-1-1 emergency response is one of the essential public safety functions provided by the United States fire service in support of community health, security, and prosperity. Fire service-based emergency medical services (EMS) systems are strategically positioned to deliver time-critical response and effective patient care. Fire service-based EMS provides this pivotal public safety service while also emphasizing responder safety, competent and compassionate workers, and cost-effective operations.

In doing their work, fire service-based EMS personnel face a variety of challenges, including ensuring personal safety on the job and addressing behavioral and physical health challenges that stem from the job. More systemically, fire service-based EMS faces significant challenges with staffing shortages, as well as reimbursement and other issues affecting departmental finances.

Reimbursement

CFSI advocates for many initiatives to help address the financial challenges facing fire service-based EMS, including supporting legislation to extend and increase Medicare add-on payments, initiatives to provide options for Treatment in Place, and more to increase flexibility in the provision of emergency medical services.

Physical Health and Wellness

Physical health, including cardiovascular health, is of particular importance in the fire and emergency services. CFSI advocates for policies and programs to support physical health in the fire and emergency services, including funding for AFG and SAFER that can be used to establish wellness programs at departments.

Behavioral Health

CFSI advocates for policies and programs that support the behavioral health of fire and EMS personnel. This includes advocating for funding for the AFG and SAFER grant programs, which can help departments to set up or access behavioral health resources including peer-to-peer counseling programs, treatment programs, and much more.

CFSI also supports legislation such as the HERO Act that will help to fund training for peer counseling, establish behavioral health and wellness programs, increase data collection regarding public safety officer suicides, and more.

For more information, view our educational one-pager on First Responder Mental Health and Wellness.

Current Legislation

Current Legislation

Comprehensive Alternative Response for Emergencies (CARE) Act

Summary:
The legislation would create a pilot program to test a reimbursement model for EMS treatment in place.

Background:

Under current Medicare policy, Emergency Medical Services (EMS) providers are generally reimbursed only when a patient is transported to a hospital emergency department. When EMS personnel are able to assess, treat, and resolve a patient’s condition on scene without transport, no reimbursement is provided.
This reimbursement structure affects fire service-based EMS systems that routinely respond to 9-1-1 medical calls where transport may not be medically necessary. Additionally, transporting patients unnecessarily contributes to emergency room backlogs across the country.

Click here to download the CARE Act one-pager

Status:
The bill has been introduced (H.R. 2538 / S. 3145)

Current Legislation

Helping Emergency Responders Overcome (HERO) Act

Summary:
The legislation provides funding for peer counseling programs for public safety officers, and collects data on post-traumatic stress among public safety officers to assist in developing best practices and improve measures to recognize, prevent, and treat mental health issues among public safety officers.

Background:

On the job, fire and EMS personnel are frequently exposed to scenes including traumatic injury and loss of life.
The psychological impacts of such exposure can have severe negative effects on fire and EMS personnel.
There is a great need for more robust mental health awareness, treatment, and support in the fire and emergency services.

Click here to download the HERO Act One Pager.

Status:
The bill has been introduced (H.R.1902)

Senator Paul S. Sarbanes Fire Service Safety Leadership Award Nomination Form

Submission Deadline: November 14, 2025

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Mason Lankford Fire Service Leadership Award Nomination Form

Submission Deadline: November 14, 2025

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Dr. Anne W. Phillips Award for Leadership in Fire Safety Education Nomination Form

Submission Deadline: November 14, 2025

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CFSI/Masimo Excellence in Fire Service-Based EMS Award Program Nomination Form

Submission Deadline: November 14, 2025

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Congressional Fire Services Institute

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Emergency Medical Services

Reimbursement

Physical Health and Wellness

Behavioral Health

Current Legislation

Comprehensive Alternative Response for Emergencies (CARE) Act

Helping Emergency Responders Overcome (HERO) Act

CFSI Corporate Partners

Nominator Information

Nominee Information