Please Contact CMS to Preserve the GEMT Program
On May 22, the Centers for Medicare & Medicaid Services (CMS) published a proposed rule on Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee-for-Service Targeted Medicaid Practitioner Payments in the Federal Register. This rule was proposed in response to the Medicaid reforms from the One Big Beautiful Bill Act (OBBA; P.L. 119-21). Specifically, it caps most Medicaid add-on payments at the Medicare reimbursement rate. Many EMS leaders are concerned that this rule will cap Medicaid payments under Ground Emergency Medical Transportation (GEMT) programs.
The IAFC Government Relations & Policy Department published a blog post breaking down the potential impact of the proposed rule. The public comment portal for the rule is open until July 21. IAFC members are encouraged to comment on the proposed rule's potential impact. Members may use the IAFC Action Center to send prewritten comments to the public comment portal.
Please Apply for the SIREN Rural EMS Training Grants
The Substance Abuse and Mental Health Administration (SAMHSA) opened the Fiscal Year (FY) 2026 Rural Emergency Medical Services Training grants, also known as SIREN Grants. These grants are reserved for rural, public EMS systems, including fire departments, to support EMS training, equipment, and readiness. Grant awards are capped at $300,000. Eligible services are encouraged to visit the Notice of Funding Opportunity page to learn more. Applications are due on July 16.
Federal Government Raises Uniform Allowance for Federal Firefighters
The U.S. Office of Personnel Management (OPM) has officially updated the federal uniform allowance rule Uniform Allowances, raising the maximum from $800 to $1,500 for employees required to wear a uniform on duty.
For years, rising costs for station wear and other required apparel have forced federal firefighters to dig into their own pockets to stay in regulation and ready to respond. OPM’s new rule, effective July 13, 2026, recognizes those real-world costs by updating the cap for the first time since 2007 and clarifying what counts as a “uniform” versus personal protective equipment..
This change does not automatically guarantee every firefighter will receive the full $1,500 –agencies still decide how much they provide — but it gives them the room to better cover the true cost of uniforms for firefighting and other high‑wear, high‑risk jobs. Done right, this should mean fewer out-of-pocket expenses for federal firefighters and more equitable support across duty stations.
Collaborating closely with leadership and local unions is often an effective way to advocate for an increase in uniform allowances. It is important to remind firefighters that this adjustment does not introduce additional funds to their budget. Instead, implementing the higher allowance will require agencies to thoughtfully reallocate existing resources to cover the increased costs of uniforms. This process may involve careful planning and negotiation to ensure that funding is redirected appropriately and the uniform allowance is fully supported.
Now, federal agencies must update their policies and fully implement this authority in a way that reflects the realities on the floor. Federal firefighters deserve uniforms allotments that meet the demands of their work—without having to subsidize them from their paycheck..
(Courtesy of the IAFC’s Federal & Military Fire Services Section) .