[House Report 115-565]
[From the U.S. Government Publishing Office]
115th Congress } { Report
HOUSE OF REPRESENTATIVES
2d Session } { 115-565
======================================================================
TO AUTHORIZE THE SECRETARY OF THE INTERIOR TO ESTABLISH FEES FOR
MEDICAL SERVICES PROVIDED IN UNITS OF THE NATIONAL PARK SYSTEM, AND FOR
OTHER PURPOSES
_______
February 15, 2018.--Committed to the Committee of the Whole House on
the State of the Union and ordered to be printed
_______
Mr. Bishop of Utah, from the Committee on Natural Resources, submitted
the following
R E P O R T
[To accompany H.R. 3607]
[Including cost estimate of the Congressional Budget Office]
The Committee on Natural Resources, to whom was referred
the bill (H.R. 3607) to authorize the Secretary of the Interior
to establish fees for medical services provided in units of the
National Park System, and for other purposes, having considered
the same, report favorably thereon with an amendment and
recommend that the bill as amended do pass.
The amendment is as follows:
Strike all after the enacting clause and insert the
following:
SECTION 1. FEES FOR MEDICAL SERVICES.
(a) Fees Authorized.--The Secretary may establish and collect fees
for medical services provided to persons in units of the National Park
System or for medical services provided by National Park Service
personnel outside units of the National Park System.
(b) National Park Medical Services Fund.--There is hereby established
in the Treasury a fund to be known as the ``National Park Medical
Services Fund''. The Fund shall consist of--
(1) donations to the Fund; and
(2) fees collected under subsection (a).
(c) Availability of Amounts.--All amounts deposited into the Fund
shall be available to the Secretary, to the extent provided in advance
by Acts of appropriation, for the following in units of the National
Park System:
(1) Services listed in subsection (a).
(2) Preparing needs assessments or other programmatic
analyses for medical facilities, equipment, vehicles, and other
needs and costs of providing services listed in subsection (a).
(3) Developing management plans for medical facilities,
equipment, vehicles, and other needs and costs of services
listed in subsection (a).
(4) Training related to providing services listed in
subsection (a).
(5) Obtaining or improving medical facilities, equipment,
vehicles, and other needs and costs of providing services
listed in subsection (a).
(d) Definitions.--For the purposes of this section:
(1) Fund.--The term ``Fund'' means the National Park Medical
Services Fund established by subsection (b).
(2) Secretary.--The term ``Secretary'' means the Secretary of
the Interior.
PURPOSE OF THE BILL
The purpose of H.R. 3607 is to authorize the Secretary of
the Interior to establish fees for medical services provided in
units of the National Park System.
BACKGROUND AND NEED FOR LEGISLATION
The National Park Service (NPS) currently manages eleven
units that provide medical services, including ambulance
transport, EMT services, and clinical services. These units are
remote and visitors and staff have few or no other options for
receiving timely medical care, especially in emergency
situations.
Under current law, NPS has the authority and responsibility
to provide medical services, but does not have authority to
retain revenues from insurance payments or other payments,
which go to the general Treasury. NPS does not collect fees
directly but instead works with third-party agencies to bill
insurance companies or individuals. The ability to retain
revenues to offset the costs of medical services would help NPS
to provide higher quality patient care with industry-standard
equipment and technology. H.R. 3607 allows the Secretary of the
Interior to establish and collect fees for medical services
provided at national parks.
The following tables provided by NPS show the amounts that
were collected for medical services and the amounts allocated
to run medical services at each of the eleven units in Fiscal
Year (FY) 2016:
COMMITTEE ACTION
H.R. 3607 was introduced on July 28, 2017, by Congressman
Tom McClintock (R-CA). The bill was referred to the Committee
on Natural Resources, and within the Committee to the
Subcommittee on Federal Lands. On October 11, 2017, the
Subcommittee held a hearing on the legislation. On November 29,
2017, the Natural Resources Committee met to consider the bill.
The Subcommittee was discharged by unanimous consent.
Congressman Tom McClintock offered an amendment designated #1;
it was adopted by unanimous consent. No further amendments were
offered, and the bill, as amended, was ordered favorably
reported to the House of Representatives by unanimous consent
on November 30, 2017.
COMMITTEE OVERSIGHT FINDINGS AND RECOMMENDATIONS
Regarding clause 2(b)(1) of rule X and clause 3(c)(1) of
rule XIII of the Rules of the House of Representatives, the
Committee on Natural Resources' oversight findings and
recommendations are reflected in the body of this report.
COMPLIANCE WITH HOUSE RULE XIII AND CONGRESSIONAL BUDGET ACT
1. Cost of Legislation and the Congressional Budget Act.
With respect to the requirements of clause 3(c)(2) and (3) of
rule XIII of the Rules of the House of Representatives and
sections 308(a) and 402 of the Congressional Budget Act of
1974, the Committee has received the following estimate for the
bill from the Director of the Congressional Budget Office:
U.S. Congress,
Congressional Budget Office,
Washington, DC, February 7, 2018.
Hon. Rob Bishop,
Chairman, Committee on Natural Resources,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 3607, a bill to
authorize the Secretary of the Interior to establish fees for
medical services provided in units of the National Park System,
and for other purposes.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Janani
Shankaran.
Sincerely,
Keith Hall
Director.
Enclosure.
H.R. 3607--A bill to authorize the Secretary of the Interior to
establish fees for medical services provided in units of the
National Park System, and for other purposes
H.R. 3607 would authorize (but not require) the National
Park Service (NPS) to collect fees for medical services
provided within the National Park System in addition to any
payments it already receives for such services. The bill would
establish a separate fund in the Treasury in which to deposit
those new collections. Under the bill, the deposited amounts
would be available to the NPS to the extent provided in advance
by appropriation acts for medical services within the National
Park System and to upgrade medical facilities and equipment.
According to the NPS, the agency typically contracts out
the operation of its medical clinics, but operates medical
clinics in 11 system units where third parties choose not to
compete for contracts to do that work. The NPS pays for medical
costs at those facilities, which total about $4 million a year,
using a mix of appropriated funds and direct spending of
collections from park entrance fees and concession franchise
fees. CBO expects that under the bill, the NPS would continue
to operate clinics using funds from the same sources, in
addition to any amounts that would be collected under this bill
and thereafter appropriated.
Under current law, the NPS does not have the authority to
retain and spend payments it receives for medical services from
people or insurance providers. Those offsetting receipts (about
$2 million a year) are treated as reductions in direct spending
and deposited into the general fund of the Treasury.
Enacting H.R. 3607 could increase offsetting receipts. How
or whether the proposed fees would be collected is unclear,
however CBO estimates that those increases would not be
significant. Because enacting the bill could affect direct
spending, pay-as-you-go procedures apply. Enacting the bill
would not affect revenues.
CBO expects that the NPS would incur administrative costs
associated with collecting those fees. Based on the costs for
similar activities, CBO estimates that those costs would be
less than $500,000 annually; such spending would be subject to
the availability of appropriated funds. Any appropriation of
the newly collected funds also would increase spending by less
than $500,000, CBO estimates.
CBO estimates that enacting H.R. 3607 would not increase
net direct spending or on-budget deficits in any of the four
consecutive 10-year periods beginning in 2028.
H.R. 3607 contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act.
The CBO staff contact for this estimate is Janani
Shankaran. The estimate was approved by H. Samuel Papenfuss,
Deputy Assistant Director for Budget Analysis.
2. General Performance Goals and Objectives. As required by
clause 3(c)(4) of rule XIII, the general performance goal or
objective of this bill is to authorize the Secretary of the
Interior to establish fees for medical services provided in
units of the National Park System.
EARMARK STATEMENT
This bill does not contain any Congressional earmarks,
limited tax benefits, or limited tariff benefits as defined
under clause 9(e), 9(f), and 9(g) of rule XXI of the Rules of
the House of Representatives.
COMPLIANCE WITH PUBLIC LAW 104-4
This bill contains no unfunded mandates.
COMPLIANCE WITH H. RES. 5
Directed Rule Making. This bill does not contain any
directed rule makings.
Duplication of Existing Programs. This bill does not
establish or reauthorize a program of the federal government
known to be duplicative of another program. Such program was
not included in any report from the Government Accountability
Office to Congress pursuant to section 21 of Public Law 111-139
or identified in the most recent Catalog of Federal Domestic
Assistance published pursuant to the Federal Program
Information Act (Public Law 95-220, as amended by Public Law
98-169) as relating to other programs.
PREEMPTION OF STATE, LOCAL OR TRIBAL LAW
This bill is not intended to preempt any State, local or
tribal law.
CHANGES IN EXISTING LAW
If enacted, this bill would make no changes to existing
law.
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