110th CONGRESS
1st Session
H. R. 1638
To extend and improve protections and services to individuals directly
impacted by the terrorist attack in New York City on September 11, 2001,
and for other purposes.
IN THE HOUSE OF REPRESENTATIVES
March 22, 2007
Mrs. MALONEY of New York (for herself, Mr. FOSSELLA, Mr. SERRANO, Mr. SHAYS,
Mr. HINCHEY, Mr. MCHUGH, Mr. HALL of New York, Mr. MCNULTY, Mr. CROWLEY,
Mr. GRIJALVA, and Mr. MCCOTTER) introduced the following bill; which was
referred to the Committee on Energy and Commerce, and in addition to the
Committee on the Judiciary, 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 extend and improve protections and services to individuals directly
impacted by the terrorist attack in New York City on September 11, 2001,
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; TABLE OF CONTENTS.
(a) Short Title- This Act may be cited as the `James Zadroga 9/11 Health
and Compensation Act'.
(b) Table of Contents- The table of contents of this Act is as follows:
Sec. 1. Short title; table of contents.
TITLE I--EXTENDING PROTECTIONS AND SERVICES TO THOSE EXPOSED TO TOXINS
FROM 9/11
Sec. 101. Extending protections and services to those exposed to toxins
from 9/11.
Sec. 102. Research regarding certain health conditions.
Sec. 103. Programs regarding attack at Pentagon.
TITLE II--9/11 HEALTH EMERGENCY COORDINATING COUNCIL
Sec. 205. Authorization of appropriations.
TITLE III--SEPTEMBER 11 VICTIM COMPENSATION FUND OF 2001
Sec. 301. Deadline extension for certain claims under September 11 Victim
Compensation Fund of 2001.
Sec. 302. Exception to single claim requirement in certain circumstances.
Sec. 303. Eligibility of claimants suffering from psychological harm.
Sec. 304. Immediate aftermath defined.
TITLE IV--PROGRAMS OF THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL
HYGIENE
Sec. 401. World Trade Center Health Registry.
Sec. 402. Mental health services.
SEC. 2. FINDINGS.
Congress finds the following:
(1) Thousands of rescue workers who responded to the areas devastated
by the terrorist attacks of September 11, local residents, office and
area workers, and school children continue to suffer significant medical
problems as a result of compromised air quality and the release of other
toxins from the attack sites.
(2) In a September 2006 peer-reviewed study conducted by the World Trade
Center Medical Monitoring Program, of 9,500 World Trade Center responders,
almost 70 percent of World Trade Center responders had a new or worsened
respiratory symptom that developed during or after their time working
at the World Trade Center; among the responders who were asymptomatic
before 9/11, 61 percent developed respiratory symptoms while working at
the World Trade Center; close to 60 percent still had a new or worsened
respiratory symptom at the time of their examination; one-third had abnormal
pulmonary function tests; and severe respiratory conditions including
pneumonia were significantly more common in the 6 months after 9/11 than
in the prior 6 months.
(3) An April 2006 study documented that, on average, a New York City firefighter
who responded to the World Trade Center has experienced a loss of 12 years
of lung capacity.
(4) A peer-reviewed study of residents who lived near the World Trade
Center titled `The World Trade Center Residents' Respiratory Health Study:
New Onset Respiratory Symptoms and Pulmonary Function', found that data
demonstrated a three fold increase in new-onset, persistent lower respiratory
symptoms in residents near the former World Trade Center as compared to
a control population.
(5) Previous research on the health impacts of the devastation caused
by the September 11 terrorist attacks has shown relationships between
the air quality from Ground Zero and a host of health impacts, including
lower pregnancy rates, lower birth weights in babies born 9 months after
the disaster, higher rates of respiratory and lung disorders, and a variety
of post-disaster mental health conditions (including posttraumatic stress
disorder) in workers and residents near Ground Zero.
(6) Federal funding allocated for the monitoring of rescue workers' health
is not sufficient to ensure the long-term study of health impacts of September
11.
(7) The Federal funding allocated for medical monitoring does not provide
for the medical monitoring of New York City area residents, office and
area workers, schoolchildren, or Federal employees who responded to the
terrorist attacks of September 11, 2001.
(8) A significant portion of those who responded to the September 11 aftermath
have no health insurance, lost their health insurance as a result of the
attacks, or have inadequate health insurance for the medical conditions
they developed as a result of recovery work at the World Trade Center
site.
(9) The Federal program to provide medical treatments to those who responded
to the September 11 aftermath, and who continue to experience health problems
as a result, was finally established more than five years after the attacks,
but is not adequately funded and is projected to exhaust all Federal funding
before the end of fiscal year 2007.
(10) Rescue workers and volunteers seeking workers compensation have reported
that their applications have been denied, delayed for months, or redirected,
instead of receiving assistance in a timely and supportive manner.
(11) A February 2007 report released by the City of New York revealed
that 410,000 people were `heavily exposed', to the toxins of Ground Zero.
The report also found that an estimated 30,000 responders are sick yet
21,000 of them do not have adequate health insurance.
(12) The September 11 Victim Compensation Fund of 2001 was established
to provide compensation to individuals who were physically injured or
killed as a result of the terrorist-related aircraft crashes of September
11, 2001.
(13) The deadline for filing claims for compensation under the Victim
Compensation Fund was December 22, 2003.
(14) Some individuals did not know they were eligible to file claims for
compensation for injuries or did not know they had suffered physical harm
as a result of the terrorist-related aircraft crashes until after the
December 22, 2003, deadline.
(15) Further research is needed to evaluate more comprehensively the extent
of the health impacts of September 11, including research for emerging
health problems such as cancer, which have been predicted.
(16) Research is needed regarding possible treatment for the illnesses
and injuries of September 11.
(17) The Federal response to medical and financial issues arising from
the September 11 response efforts needs a comprehensive, coordinated long-term
response in order to meet the needs of all the individuals who were exposed
to the toxins of Ground Zero and are suffering health problems from the
disaster.
TITLE I--EXTENDING PROTECTIONS AND SERVICES TO THOSE EXPOSED TO TOXINS
FROM 9/11
SEC. 101. EXTENDING PROTECTIONS AND SERVICES TO THOSE EXPOSED TO TOXINS
FROM 9/11.
Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.)
is amended by inserting after section 317S the following section:
`SEC. 317T. EXTENDING PROTECTIONS AND SERVICES TO THOSE EXPOSED TO TOXINS
FROM 9/11.
`(a) Program Extension- For the purpose of ensuring on-going monitoring,
treatment, and data collection for victims of the September 11 terrorist
attacks in New York City, the Secretary, acting through the National Institute
for Occupational Safety and Health of the Centers for Disease Control and
Prevention, shall extend and expand, in accordance with this section, the
arrangements in effect as of January 1, 2007, with the coordinating consortium
body and with the Fire Department of the City of New York that provide for
the following:
`(1) Medical monitoring, including screening, clinical examinations, and
long-term health monitoring and analysis, for individuals who were likely
to have been exposed to airborne toxins that were released as a result
of the aftermath of the terrorist attacks that occurred on September 11,
2001, in New York City. The extent and frequency of such monitoring shall
be in accordance with guidelines developed by the program steering committee.
`(2) Provision of treatment and payment, without any cost-sharing, for
all health and mental health care expenses (including necessary prescription
drugs) of individuals with a qualifying health condition, using a uniform
standard of coverage for all eligible individuals.
`(3) Collection of health and mental health data on such individuals,
using a uniform system of data collection.
`(b) Covered Individuals- The program administered by the coordinating consortium
body under subsection (a) shall be expanded so as to include, among the
individuals described in subsection (a)(1) and under the arrangement with
such body, any of the following individuals if they are not otherwise covered
under either of the arrangements described in such subsection:
`(1) Emergency service personnel and rescue and recovery personnel who
responded in the New York City disaster area to the terrorist attacks
that occurred on September 11, 2001, in New York City, any time during
the period of September 11, 2001, through August 31, 2002.
`(2) Any other worker or volunteer who responded in such area to such
attacks at any time during such period, including--
`(C) an emergency medical technician;
`(E) any participating member of an urban search and rescue team;
`(F) Federal and State employees;
`(G) a person who worked to recover human remains; and
`(H) a person who worked on the criminal investigation.
`(3) A worker who responded at any time during such period to such attacks
by assisting in the cleanup or restoration of critical infrastructure
in the New York City disaster area.
`(4) A worker who assisted at any time during such period in the cleaning
of a building situated in the New York City disaster area.
`(5) A person whose place of residence at any time during such period
was in the New York City disaster area.
`(6) A person who was working at any time during such period in the New
York City disaster area.
`(7) A person who attended school, child care, or adult day care at any
time during such period in a building located in the New York City disaster
area.
`(8) A person who was employed at any time during such period at the Fresh
Kills recovery site on Staten Island.
`(9) A person who was present in the New York City disaster area on September
11, 2001.
`(10) Any other person whom the Secretary determines to be appropriate.
`(c) Extension of Services- In order to ensure reasonable access to monitoring
and treatment for individuals under subsection (a) who reside in the Downtown
Manhattan area or who reside outside of the New York City disaster area,
the arrangements under such subsection shall be expanded--
`(1) to enter into arrangements with the World Trade Center Environmental
Health Center at Bellevue Hospital to coordinate and provide services
for residents, office and area workers, and students in Downtown Manhattan
and nearby areas; and
`(2) to establish a nationwide network of health care providers to provide
such monitoring and treatment near such individuals' areas of residence,
or to establish a mechanism whereby individuals who receive monitoring
or treatment for a qualifying health condition can be reimbursed for the
cost of such monitoring or treatment.
`(d) Administrative Arrangement Authority- Arrangements under subsection
(a) may be modified, so as to provide for timely and accurate processing
of claims, through entering into arrangements for the administration of
benefits using insurance companies or other third-party administrators.
`(e) Requirement of Medical Necessity- If a monitoring or treating physician,
pursuant to an arrangement under subsection (a), determines that an item
or service for the provision of health or mental health care under subsection
(a)(2) is medically necessary for an individual, payment under such subsection
shall be made available for the item or service.
`(f) Eligibility Certification for Treatment Benefits- Effective for treatment
benefits furnished more than 60 days after the date of the enactment of
this section, no individual shall be eligible for treatment benefits described
in paragraph (2) of subsection (a) under the arrangements described in such
subsection unless a Federal employee designated by the Secretary has determined
that the individual meets the applicable eligibility criteria under such
arrangements (as modified by the section) for the receipt of such treatment
benefits. Such Federal employee shall not deny certification if the individual
meets the applicable eligibility criteria.
`(g) Community Outreach- The Secretary shall institute a program that provides
education and outreach on the existence and availability of services provided
for under this section. Any such education and outreach shall be done in
a manner intended to reach all affected populations and to include materials
for culturally and linguistically diverse populations. To the greatest extent
possible, in carrying out this subsection, the Secretary should enter into
partnerships with local governments and organizations with experience performing
outreach.
`(h) Continuation of Treatment While Being Enrolled in Medical Monitoring
Program- In the case of an individual receiving medical treatment under
the arrangements described in paragraph (2) of subsection (a) but who is
not enrolled in the medical monitoring program referred to in paragraph
(1) of such subsection, the individual may continue to receive such treatment
while the individual is being enrolled in such medical monitoring program.
`(i) Definitions- In this section:
`(1) The term `coordinating consortium body' means the body of medical
providers that coordinates the monitoring and treatment under the arrangement
under subsection (a) that covers individuals who are not covered under
the arrangement with the Fire Department for the City of New York.
`(2) The term `New York City disaster area' means an area, specified by
the Secretary of Health and Human Services, within which individuals who
resided, worked, or otherwise were regularly present during the period
beginning on September 11, 2001, and ending on August 31, 2002, were likely
to have been exposed to airborne toxins that were released as a result
of the aftermath of the terrorist attacks that occurred on September 11,
2001, in New York City, and includes the area within 2 miles of the perimeter
of the former World Trade Center site. In determining the boundaries of
the New York City disaster area, the Secretary shall take into consideration
peer-reviewed research that has demonstrated potential exposure to such
toxins at a distance of 5 miles or greater from the former World Trade
Center.
`(3) The term `program steering committee' means the committee, made up
of a number of representatives of the medical providers from the coordinating
consortium body and the Fire Department of the City of New York, and an
equal number of representatives of the covered individuals described in
subsection (b), that is responsible for the governance and coordination
of the programs administered by the coordinating consortium body and the
Fire Department of the City of New York under subsection (a).
`(4) The term `qualifying health condition' means an adverse health condition
that is presumed by the program steering committee, in consultation with
the Secretary, to be associated with exposure to one or more of the sites
of the terrorist attacks that occurred on September 11, 2001, in New York
City.
`(j) Financing- Out of any funds in the Treasury not otherwise appropriated,
there are hereby appropriated to the Secretary--
`(1) for the period of fiscal years 2007 through 2012, $1,900,000,000
and such additional sums as may be necessary to carry out this section;
and
`(2) for fiscal years 2013 through 2026, such sums as may be necessary
to carry out this section.'.
SEC. 102. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS.
Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et seq.)
is amended by inserting after section 409I the following section:
`SEC. 409J. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS OF INDIVIDUALS
ASSISTING WITH RESPONSE TO SEPTEMBER 11 TERRORIST ATTACKS IN NEW YORK CITY.
`(a) In General- With respect to individuals receiving monitoring under
section 317T, the Secretary shall conduct or support--
`(1) research on physical and mental health conditions that may be related
to the September 11 terrorist attacks;
`(2) research on diagnosing qualifying health conditions of such individuals,
in the case of conditions for which there has been diagnostic uncertainty;
and
`(3) research on treating qualifying health conditions of such individuals,
in the case of conditions for which there has been treatment uncertainty.
`(b) Consultation- The Secretary shall carry out this section in consultation
with such program steering committee.
`(c) Application of Privacy and Human Subject Protections- The privacy and
human subject protections applicable to research conducted under this section
shall not be less than such protections applicable to research otherwise
conducted by the National Institutes of Health.
`(d) Annual Report- The Secretary shall annually submit to the Congress
a report describing the findings of research under subsection (a).
`(e) Definitions- In this section, the terms `program steering committee'
and `qualifying health condition' have the meanings given to those terms
in section 317T(i).
`(f) Authorization of Appropriations- For the purpose of carrying out this
section, there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2008 through 2026, in addition to any other authorizations
of appropriations that are available for such purpose.'.
SEC. 103. PROGRAMS REGARDING ATTACK AT PENTAGON.
The Secretary of Health and Human Services may, to the extent determined
appropriate by the Secretary, establish with respect to the terrorist attack
at the Pentagon on September 11, 2001, programs similar to the programs
that are established in sections 317T and 409J of the Public Health Service
Act with respect to the terrorist attacks on such date in New York City.
TITLE II--9/11 HEALTH EMERGENCY COORDINATING COUNCIL
SEC. 201. ESTABLISHMENT.
The Secretary of Health and Human Services shall convene a council, to be
known as `9/11 Health Emergency Coordinating Council' (in this title referred
to as the `Council'), for the purpose of discussing, examining, and formulating
recommendations with respect to the adequacy and coordination of the following:
(1) Care and compensation for the victims of the terrorist attacks of
September 11, 2001.
(2) Federal tracking of the monitoring of, and treatment for, individuals
who are directly suffering from, or may have long-term health effects
from, such attacks.
SEC. 202. MEMBERSHIP.
(a) Chairperson- The Secretary of Health and Human Services (or the Secretary's
designee) shall serve as the chairperson of the Council.
(b) Required Members- The members of the Council shall include the following:
(1) The Secretary of Defense (or the Secretary's designee).
(2) The Secretary of Labor (or the Secretary's designee).
(3) The Director of the Federal Emergency Management Agency (or the Director's
designee).
(4) The Director of the National Institutes of Health (or the Director's
designee).
(5) The Director of the National Institute for Occupational Safety and
Health (or the Director's designee).
(6) A representative of the Crime Victims Fund established under section
1402 of the Victims of Crime Act of 1984 (42 U.S.C. 10601).
(c) Invitees- The Secretary of Health and Human Services shall invite the
following individuals to serve as members of the Council:
(1) The Governor of the State of New York (or the Governor's designee).
(2) The Governor of the State of New Jersey (or the Governor's designee).
(3) The Mayor of New York City (or the Mayor's designee).
(4) 1 representative of the New York City Fire Department.
(5) 1 representative of the New York City Police Department.
(6) 1 representative of the police department of the Port Authority of
New York and New Jersey.
(7) 1 representative of the New York State Department of Health.
(8) 1 representative of the New York State Workers' Compensation Board.
(9) 1 representative of the New York City Department of Health and Mental
Hygiene.
(10) 1 representative of the New York City Office of Emergency Management.
(11) 1 representative of the Association of Occupational and Environmental
Clinics.
(12) 1 representative of the New York Committee for Occupational Safety
and Health (NYCOSH).
(13) 1 representative of charitable organizations that had volunteers
at Ground Zero.
(14) 20 representatives of labor unions reflecting a cross section of
workers who responded to, or assisted in the cleanup resulting from, the
attack on the World Trade Center, including New York City police, fire,
and other municipal employees, Port Authority of New York and New Jersey
police, State and Federal employees, construction employees, and employees
involved in the resumption of services.
(15) 20 representatives of community organizations that reflect a cross
section of the concerns of residents, office workers, and students.
(16) 5 representatives of nonprofit volunteer entities that assisted in
recovery efforts following the terrorist attacks of September 11, 2001.
(17) 5 representatives of a regional occupational provider that--
(A) works with the World Trade Center Worker and Volunteer Medical Screening
Program; and
(B) is under the direction of the Mount Sinai Center for Occupational
and Environmental Medicine.
SEC. 203. MEETINGS.
The Council shall meet not less than 4 times each calendar year.
SEC. 204. REPORTS.
Not less than once each calendar year, the Council shall submit to the Congress
a report on the recommendations of the Council.
SEC. 205. AUTHORIZATION OF APPROPRIATIONS.
For the purpose of carrying out this title, there are authorized to be appropriated
such sums as may be necessary for each of fiscal years 2007 through 2026.
TITLE III--SEPTEMBER 11 VICTIM COMPENSATION FUND OF 2001
SEC. 301. DEADLINE EXTENSION FOR CERTAIN CLAIMS UNDER SEPTEMBER 11 VICTIM
COMPENSATION FUND OF 2001.
Section 405(a)(3) of the Air Transportation Safety and System Stabilization
Act (49 U.S.C. 40101 note) is amended to read as follows:
`(A) IN GENERAL- Except as provided by subparagraph (B), no claim may
be filed under paragraph (1) after December 22, 2003.
`(B) EXCEPTIONS- A claim may be filed under paragraph (1) by an individual
(or by a personal representative on behalf of a deceased individual)--
`(i) during the 5-year period after the date of enactment of this
subparagraph, if the Special Master determines that the individual--
`(I) did not know that the individual had suffered physical harm
as a result of the terrorist-related aircraft crashes of September
11, 2001, until after December 22, 2003, and before the date of
the enactment of this subparagraph;
`(II) did not for any reason other than as described in subclause
(I) know that the individual was eligible to file a claim under
paragraph (1) until after December 22, 2003;
`(III) suffered psychological harm as a result of the terrorist-related
aircraft crashes; or
`(IV) in the case of an individual who had previously filed a claim
under this title, suffered a significantly greater physical harm
than was known to the individual as of the date the claim was filed
and did not know the full extent of the physical harm suffered as
a result of the terrorist-related aircraft crashes until after the
date on which the claim was filed and before the date of enactment
of this subparagraph; and
`(ii) during the 5-year period after the date that the individual--
`(I) first knew that the individual had suffered physical or psychological
harm as a result of the terrorist-related aircraft crashes of September
11, 2001, if the Special Master determines that the individual did
not know that the individual had suffered such physical or psychological
harm until a date that is on or after the date of enactment of this
subparagraph; or
`(II) in the case of an individual who had previously filed a claim
under this title and had suffered a significantly greater physical
harm than was known to the individual as of the date the claim was
filed, or had suffered psychological harm as a result of the terrorist-related
crashes, first knew the full extent of the physical and psychological
harm suffered as a result of the terrorist-related aircraft crashes,
if the Special Master determines that the individual did not know
the full extent of the harm suffered until a date that is on or
after the date of the enactment of this subparagraph.'.
SEC. 302. EXCEPTION TO SINGLE CLAIM REQUIREMENT IN CERTAIN CIRCUMSTANCES.
Section 405(c)(3)(A) of the Air Transportation Safety and System Stabilization
Act (49 U.S.C. 40101 note) is amended to read as follows:
`(i) IN GENERAL- Except as provided by clause (ii), not more than
1 claim may be submitted under this title by an individual or on behalf
of a deceased individual.
`(ii) EXCEPTION- A second claim may be filed under subsection (a)(1)
by an individual (or by a personal representative on behalf of a deceased
individual) if the individual is an individual described in either
of clauses (i)(IV) or (ii)(II) of subsection (a)(3)(B).'.
SEC. 303. ELIGIBILITY OF CLAIMANTS SUFFERING FROM PSYCHOLOGICAL HARM.
(a) In General- Section 405(c)(2)(A)(ii) of the Air Transportation Safety
and System Stabilization Act (49 U.S.C. 40101 note) is amended by inserting
`, psychological harm,' before `or death'.
(b) Conforming Amendment- Section 405(a)(2)(B)(i) of such Act is amended
by striking `physical harm' and inserting `physical or psychological harm'.
SEC. 304. IMMEDIATE AFTERMATH DEFINED.
Section 402 of the Air Transportation Safety and System Stabilization Act
(49 U.S.C. 40101 note) is amended by adding at the end the following new
paragraph:
`(11) IMMEDIATE AFTERMATH- In section 405(c)(2)(A)(i), the term `immediate
aftermath' means any period of time after the terrorist-related aircraft
crashes of September 11, 2001, as determined by the Special Master, that
was sufficiently close in time to the crashes that there was a demonstrable
risk to the claimant of physical or psychological harm resulting from
the crashes, including the period of time during which rescue, recovery,
and cleanup activities relating to the crashes were conducted.'.
TITLE IV--PROGRAMS OF THE NEW YORK CITY DEPARTMENT OF HEALTH AND MENTAL
HYGIENE
SEC. 401. WORLD TRADE CENTER HEALTH REGISTRY.
(a) Program Extension- For the purpose of ensuring on-going data collection
for victims of the September 11 terrorist attacks in New York City, the
Secretary of Health and Human Services, acting through the National Institute
for Occupational Safety and Health of the Centers for Disease Control and
Prevention, shall extend and expand the arrangements in effect as of January
1, 2007, with the New York City Department of Health and Mental Hygiene
that provide for the World Trade Center Health Registry.
(b) Authorization of Appropriations- To carry out this section, there are
authorized to be appropriated such sums as may be necessary.
SEC. 402. MENTAL HEALTH SERVICES.
(a) Grants- The Secretary of Health and Human Services may make grants to
the New York City Department of Health and Mental Hygiene to provide mental
health services to address the mental health needs of qualified individuals
relating to the terrorist attacks that occurred on September 11, 2001, in
New York City.
(b) Qualified Individual- In this section, the term `qualified individual'
means an individual who resides in the New York City metropolitan area,
but is not a covered individual described in section 317T(b) of the Public
Health Service Act, as added by section 101 of this Act.
END
