H.R. 4646House118th Congress (2023-2025)In Committee

SIREN Reauthorization Act

Introduced July 14, 2023

AI-Generated Summary

Updated January 20, 2026 at 9:57 AM UTC

The SIREN Reauthorization Act renews the Rural Emergency Medical Service (EMS) Training and Equipment Assistance Program and updates how it operates. It shifts program oversight to the Assistant Secretary, extends funding through 2025‑2029, and adds new priorities for EMS workers, including training on mental‑health and substance‑use issues and the ability to obtain FDA‑approved drugs or devices for overdose emergencies. The changes affect rural EMS agencies and the communities they serve.

Key Provisions

  • Changes the designated program official from the HRSA Administrator to the Assistant Secretary
  • Requires EMS personnel to receive training on mental health and substance‑use disorders and how to care for patients with those conditions
  • Allows the program to acquire FDA‑approved drugs or devices for emergency treatment of suspected overdoses
  • Extends the program’s authorization period to cover fiscal years 2025 through 2029
  • Reorganizes and renumbers the relevant section of the Public Health Service Act, removing an old subsection and moving the program to a new location in the statute

Legislative Activity

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8 earlier actions
HouseCalendars Latest Action

Placed on the Union Calendar, Calendar No. 443.

May 31, 2024

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HouseIntro Referral

Introduced in House

July 14, 2023

HouseIntro Referral

Referred to the House Committee on Energy and Commerce.

July 14, 2023

HouseCommittee

Referred to the Subcommittee on Health.

July 21, 2023

HouseCommittee

Subcommittee Consideration and Mark-up Session Held

March 12, 2024

HouseCommittee

Forwarded by Subcommittee to Full Committee (Amended) by the Yeas and Nays: 24 - 0.

March 12, 2024

HouseCommittee

Committee Consideration and Mark-up Session Held

March 20, 2024

HouseCommittee

Ordered to be Reported (Amended) by the Yeas and Nays: 46 - 0.

March 20, 2024

HouseCommittee

Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 118-532.

May 31, 2024

HouseCalendars

Placed on the Union Calendar, Calendar No. 443.

May 31, 2024

Floor Debate

2 members

What members said about H.R. 4646 on the floor

1 Republican1 Democrat
Frank Pallone, Jr.
Rep. Frank Pallone, Jr.D-NJ-6 · Sep 17, 2024

Mr. Speaker, I yield myself such time as I may consume. Mr. Speaker, I rise today to speak in support of S. 265, the Supporting and Improving Rural EMS Needs Reauthorization Act, or the SIREN…

Cathy McMorris Rodgers
Rep. Cathy McMorris RodgersR-WA-5 · Sep 17, 2024

Mr. Speaker, I move to suspend the rules and pass the bill (S. 265) to reauthorize the rural emergency medical service training and equipment assistance program, and for other purposes. Mr. Speaker,…

Bill Text

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Reported in HouseIssued May 31, 2024

IB

Union Calendar No. 443

118th CONGRESS

2d Session

H. R. 4646

[Report No. 118–532]

IN THE HOUSE OF REPRESENTATIVES

July 14, 2023

Mr. Joyce of Ohio (for himself, Mrs. Dingell, Mr. Armstrong, Mr. Carey, Mr. Fitzpatrick, Mr. Phillips, and Mrs. Miller of West Virginia) introduced the following bill; which was referred to the Committee on Energy and Commerce

May 31, 2024

Additional sponsors: Mr. Pappas, Ms. Lee of Nevada, Mrs. Miller-Meeks, Mrs. Cammack, Mr. Thompson of Pennsylvania, Ms. Perez, Ms. Pingree, Mr. Trone, Ms. Tokuda, Mr. Ruiz, Mr. Ryan, Mr. Gottheimer, Mr. Lawler, Mr. Vasquez, Ms. Norton, and Ms. Lee of Pennsylvania

May 31, 2024

Reported with an amendment; committed to the Committee of the Whole House on the State of the Union and ordered to be printed

Strike out all after the enacting clause and insert the part printed in italic

For text of introduced bill, see copy of bill as introduced on July 14, 2023


A BILL

To reauthorize the rural emergency medical service training and equipment assistance program, and for other purposes.


1.

Short title

This Act may be cited as the Supporting and Improving Rural EMS Needs Reauthorization Act or the SIREN Reauthorization Act.

2.

Rural emergency medical service training and equipment assistance program

Section 330J of the Public Health Service Act (42 U.S.C. 254c–15) is amended—

(1)

in subsection (a), by striking the Administrator of the Health Resources and Services Administration (referred to in this section as the Secretary) and inserting the Assistant Secretary,;

(2)

in subsection (c)—

(A)

in paragraph (1)—

(i)

in subparagraph (C), by striking ; and and inserting a semicolon; and

(ii)

by adding at the end the following:

(E)

ensure emergency medical services personnel are trained on mental health and substance use disorders and care for individuals with such disorders in emergency situations; and

; and

(B)

in paragraph (2)—

(i)

in subparagraph (B), by striking ; or and inserting a semicolon;

(ii)

in subparagraph (C), by striking the period and inserting ; or; and

(iii)

by adding at the end the following:

(D)

acquire drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose.

;

(3)

by striking subsection (f);

(4)

by redesignating subsection (g) as subsection (f);

(5)

in subsection (f)(1), as so redesignated, by striking 2019 through 2023 and inserting 2025 through 2029;

(6)

by redesignating such section 330J as section 553 of the Public Health Service Act; and

(7)

by transferring such section 553, as so redesignated, to appear at the end of part D of title V of the Public Health Service Act (42 U.S.C. 290dd et seq.).

May 31, 2024

Reported with an amendment, committed to the Committee of the Whole House on the State of the Union, and ordered to be printed