I 

118TH CONGRESS 

1ST SESSION H. R. 1294 

To amend title XXXIII of the Public Health Service Act with respect to 

flexibility and funding for the World Trade Center Health Program. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 1, 2023 

Mr. GARBARINO (for himself, Mr. NADLER, Mr. D’ESPOSITO, Mr. GOLDMAN

of New York, Mr. LALOTA, Mr. MEEKS, Ms. MENG, Ms. VELA ́ZQUEZ, 

Ms. CLARKE of New York, Ms. MALLIOTAKIS, Mr. ESPAILLAT, Mr. 

TORRES of New York, Mr. LAWLER, Mr. RYAN, Mr. MOLINARO, Mr. 

TONKO, Ms. STEFANIK, Mr. WILLIAMS of New York, Mr. LANGWORTHY, 

Ms. TENNEY, Mr. MORELLE, Mr. HIGGINS of New York, Mr. PAYNE, Mr. 

LARSON of Connecticut, Ms. NORTON, Mrs. WATSON COLEMAN, Mr. 

GOTTHEIMER, Ms. SCHAKOWSKY, Mr. PASCRELL, Mr. CASTEN, and Ms. 

BARRAGA ́N) introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XXXIII of the Public Health Service Act 

with respect to flexibility and funding for the World 

Trade Center Health Program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘9/11 Responder and 

5 Survivor Health Funding Correction Act of 2023’’. 


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1 SEC. 2. DEPARTMENT OF DEFENSE, ARMED FORCES, OR 

2 OTHER FEDERAL WORKER RESPONDERS TO 

3 THE SEPTEMBER 11 ATTACKS AT THE PEN4 TAGON AND SHANKSVILLE, PENNSYLVANIA. 

5 Title XXXIII of the Public Health Service Act (42 

6 U.S.C. 300mm et seq.) is amended— 

7 (1) in section 3306 (42 U.S.C. 300mm–5)— 

8 (A) by redesignating paragraphs (5) 

9 through (11) and paragraphs (12) through (17) 

10 as paragraphs (6) through (12) and paragraphs 

11 (14) through (19), respectively; 

12 (B) by inserting after paragraph (4) the 

13 following: 

14 ‘‘(5) The term ‘Federal agency’ means an agen15 cy, office, or other establishment in the executive, 

16 legislative, or judicial branch of the Federal Govern17 ment.’’; and 

18 (C) by inserting after paragraph (12), as 

19 so redesignated, the following: 

20 ‘‘(13) The term ‘uniformed services’ has the 

21 meaning given the term in section 101(a) of title 10, 

22 United States Code.’’; and 

23 (2) in section 3311(a) (42 U.S.C. 300mm– 

24 21(a))— 

25 (A) in paragraph (2)(C)(i)— 


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1 (i) in subclause (I), by striking ‘‘; or’’ 

2 and inserting a semicolon; 

3 (ii) in subclause (II), by striking ‘‘; 

4 and’’ and inserting a semicolon; and 

5 (iii) by adding at the end the fol6 lowing: 

7 ‘‘(III) was an employee of the Depart8 ment of Defense or any other Federal 

9 agency, worked during the period begin10 ning on September 11, 2001, and ending 

11 on September 18, 2001, for a contractor of 

12 the Department of Defense or any other 

13 Federal agency, or was a member of a reg14 ular or reserve component of the uni15 formed services; and performed rescue, re16 covery, demolition, debris cleanup, or other 

17 related services at the Pentagon site of the 

18 terrorist-related aircraft crash of Sep19 tember 11, 2001, during the period begin20 ning on September 11, 2001, and ending 

21 on the date on which the cleanup of the 

22 site was concluded, as determined by the 

23 WTC Program Administrator; or 

24 ‘‘(IV) was an employee of the Depart25 ment of Defense or any other Federal 


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1 agency, worked during the period begin2 ning on September 11, 2001, and ending 

3 on September 18, 2001, for a contractor of 

4 the Department of Defense or any other 

5 Federal agency, or was a member of a reg6 ular or reserve component of the uni7 formed services; and performed rescue, re8 covery, demolition, debris cleanup, or other 

9 related services at the Shanksville, Penn10 sylvania, site of the terrorist-related air11 craft crash of September 11, 2001, during 

12 the period beginning on September 11, 

13 2001, and ending on the date on which the 

14 cleanup of the site was concluded, as deter15 mined by the WTC Program Adminis16 trator; and’’; and 

17 (B) in paragraph (4)(A)— 

18 (i) by striking ‘‘(A) IN GENERAL.— 

19 The’’ and inserting the following: 

20 ‘‘(A) LIMIT.— 

21 ‘‘(i) IN GENERAL.—The’’; 

22 (ii) by inserting ‘‘or subclause (III) or 

23 (IV) of paragraph (2)(C)(i)’’ after ‘‘or 

24 (2)(A)(ii)’’; and 


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1 (iii) by adding at the end the fol2 lowing: 

3 ‘‘(ii) CERTAIN RESPONDERS TO THE

4 SEPTEMBER 11 ATTACKS AT THE PEN5 TAGON AND SHANKSVILLE, PENNSYL6 VANIA.—The total number of individuals 

7 who may be enrolled under paragraph 

8 (3)(A)(ii) based on eligibility criteria de9 scribed in subclause (III) or (IV) of para10 graph (2)(C)(i) shall not exceed 500 at any 

11 time.’’. 

12 SEC. 3. FLEXIBILITY FOR CERTIFICATIONS UNDER THE 

13 WORLD TRADE CENTER HEALTH PROGRAM. 

14 (a) IN GENERAL.—Section 3305(a) of the Public 

15 Health Service Act (42 U.S.C. 300mm–4(a)) is amend16 ed— 

17 (1) in paragraph (1)(A), by inserting ‘‘subject 

18 to paragraph (6),’’ before ‘‘for’’; and 

19 (2) by adding at the end the following: 

20 ‘‘(6) LICENSED HEALTH CARE PROVIDER

21 FLEXIBILITY.— 

22 ‘‘(A) IN GENERAL.—For purposes of an 

23 initial health evaluation described in paragraph 

24 (1)(A) (including any such evaluation provided 

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1 wide network under section 3313), such evalua2 tion may be conducted by a physician or any 

3 other licensed health care provider in a category 

4 of health care providers determined by the 

5 WTC Program Administrator under subpara6 graph (B). 

7 ‘‘(B) CATEGORIES OF LICENSED HEALTH

8 CARE PROVIDERS.—Not later than 180 days 

9 after the date of enactment of the 9/11 Re10 sponder and Survivor Health Funding Correc11 tion Act of 2023, the WTC Program Adminis12 trator shall issue regulations for the categories 

13 of licensed health care providers who, in addi14 tion to licensed physicians, may conduct evalua15 tions under subparagraph (A) and make deter16 minations under section 3312(b).’’. 

17 (b) FLEXIBILITY FOR WTC RESPONDERS.—Section 

18 3312(b) of such Act (42 U.S.C. 300mm–22(b)) is amend19 ed— 

20 (1) in paragraph (1), by striking ‘‘physician’’ 

21 each place it appears and inserting ‘‘physician or 

22 other licensed health care provider in a category de23 termined by the WTC Program Administrator under 

24 section 3305(a)(6)(B)’’; 

25 (2) in paragraph (2)— 


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1 (A) in subparagraph (A)— 

2 (i) in the matter preceding clause (i), 

3 by striking ‘‘physician’’ and inserting 

4 ‘‘physician or other licensed health care 

5 provider in a category determined by the 

6 WTC Program Administrator under sec7 tion 3305(a)(6)(B)’’; 

8 (ii) in clause (i), by striking ‘‘physi9 cian’’ and inserting ‘‘physician or other li10 censed health care provider’’; and 

11 (iii) in clause (ii), by striking ‘‘such 

12 physician’s determination’’ and inserting 

13 ‘‘the determination of such physician or 

14 other licensed health care provider’’; and 

15 (B) in subparagraph (B)— 

16 (i) in the matter preceding clause (i), 

17 by striking ‘‘physician determinations’’ and 

18 inserting ‘‘determinations by physicians or 

19 other licensed health care providers in cat20 egories determined by the WTC Program 

21 Administrator under section 

22 3305(a)(6)(B)’’; and 

23 (ii) in clause (i), by striking ‘‘physi24 cian panel’’ and inserting ‘‘panel of physi25 cians or other licensed health care proVerDate Sep 11 2014 22:35 Mar 16, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H1294.IH H1294

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1 viders in categories determined by the 

2 WTC Program Administrator under sec3 tion 3305(a)(6)(B)’’; and 

4 (3) in paragraph (5), by striking ‘‘examining 

5 physician’’ and inserting ‘‘examining physician or 

6 other licensed health care provider in a category de7 termined by the WTC Program Administrator under 

8 section 3305(a)(6)(B)’’. 

9 SEC. 4. CRITERIA FOR CREDENTIALING HEALTH CARE 

10 PROVIDERS PARTICIPATING IN THE NATION11 WIDE NETWORK. 

12 Title XXXIII of the Public Health Service Act (42 

13 U.S.C. 300mm et seq.) is amended— 

14 (1) in section 3305(a)(2) (42 U.S.C. 300mm– 

15 4(a)(2))— 

16 (A) in subparagraph (A)— 

17 (i) by striking clause (iv); and 

18 (ii) by redesignating clauses (v) and 

19 (vi) as clauses (iv) and (v), respectively; 

20 (B) by striking subparagraph (B); and 

21 (C) by redesignating subparagraphs (C) 

22 and (D) as subparagraphs (B) and (C), respec23 tively; and 


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1 (2) in section 3313(b)(1) (42 U.S.C. 300mm– 

2 23(b)(1)), by striking ‘‘Data Centers’’ and inserting 

3 ‘‘WTC Program Administrator’’. 

4 SEC. 5. CLARIFYING CALCULATION OF ENROLLMENT. 

5 (a) RESPONDERS.—Section 3311(a) of such Act (42 

6 U.S.C. 300mm–21(a)) is amended by adding at the end 

7 the following: 

8 ‘‘(6) DECEASED WTC RESPONDERS.—An indi9 vidual known to the WTC Program Administrator to 

10 be deceased shall not be included in any count of en11 rollees under this subsection or section 3351.’’. 

12 (b) SURVIVORS.—Section 3321(a) of such Act (42 

13 U.S.C. 300mm–31(a)) is amended by adding at the end 

14 the following: 

15 ‘‘(5) DECEASED WTC SURVIVORS.—An indi16 vidual known to the WTC Program Administrator to 

17 be deceased shall not be included in any count of 

18 certified-eligible survivors under this section or in 

19 any count of enrollees under section 3351.’’. 

20 SEC. 6. TIME PERIOD FOR ADDING HEALTH CONDITIONS 

21 TO LIST FOR WTC RESPONDERS. 

22 Section 3312(a)(6) of the Public Health Service Act 

23 (42 U.S.C. 300mm–22(a)(6)) is amended— 

24 (1) in subparagraph (B), by striking ‘‘90’’ and 

25 inserting ‘‘180’’; and 


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1 (2) in subparagraph (C), in the second sen2 tence, by striking ‘‘90’’ and inserting ‘‘180’’. 

3 SEC. 7. FUNDING FOR THE WORLD TRADE CENTER HEALTH 

4 PROGRAM. 

5 (a) FEDERAL FUNDING.—Section 3351 of the Public 

6 Health Service Act (42 U.S.C. 300mm–61) is amended— 

7 (1) in subsection (a)— 

8 (A) in paragraph (2)(A)— 

9 (i) in clause (x), by striking ‘‘and’’; 

10 (ii) in clause (xi)— 

11 (I) by striking ‘‘subsequent fiscal 

12 year through fiscal year 2090’’ and 

13 inserting ‘‘of fiscal years 2026 

14 through 2033’’; and 

15 (II) by striking ‘‘plus’’ and in16 serting ‘‘and’’; and 

17 (iii) by adding at the end the fol18 lowing: 

19 ‘‘(xii) for each of fiscal years 2034 

20 through 2090— 

21 ‘‘(I) the amount determined 

22 under this subparagraph for the pre23 vious fiscal year (plus the sum of any 

24 amount expended in the previous fis25 cal year from the World Trade Center 


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1 Health Program Special Fund estab2 lished under section 3353 or the 

3 World Trade Center Health Program 

4 Fund for Certain WTC Responders at 

5 the Pentagon and Shanksville, Penn6 sylvania established under section 

7 3354 and any amount expended from 

8 the World Trade Center Health Pro9 gram Fund established under this sec10 tion in the previous fiscal year that 

11 was carried over from any fiscal year 

12 prior to the previous fiscal year in13 cluding as carried over pursuant to a 

14 deposit into such Fund under para15 graph (6)) multiplied by 1.05; multi16 plied by 

17 ‘‘(II) the ratio of— 

18 ‘‘(aa) the total number of 

19 individuals enrolled in the WTC 

20 Program on July 1 of such pre21 vious fiscal year; to 

22 ‘‘(bb) the total number of 

23 individuals so enrolled on July 1 

24 of the fiscal year prior to such 

25 previous fiscal year; plus’’; and 


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1 (B) by adding at the end the following: 

2 ‘‘(6) REMAINING AMOUNTS FROM SPECIAL

3 FUND AND PENTAGON/SHANKSVILLE FUND.—Any 

4 amounts that remain available, on September 30, 

5 2033, in the World Trade Center Health Program 

6 Special Fund under section 3353 or the World 

7 Trade Center Health Program Fund for Certain 

8 WTC Responders at the Pentagon and Shanksville, 

9 Pennsylvania under section 3354 shall be deposited 

10 into the Fund.’’; and 

11 (2) in subsection (c)— 

12 (A) in paragraph (4)— 

13 (i) by amending subparagraph (A) to 

14 read as follows: 

15 ‘‘(A) for fiscal year 2023, the amount de16 termined for such fiscal year under this para17 graph as in effect on the day before the date of 

18 enactment of the 9/11 Responder and Survivor 

19 Health Funding Correction Act of 2023;’’; and 

20 (ii) in subparagraph (B), by striking 

21 ‘‘2017, $15,000,000’’ and inserting ‘‘2024, 

22 $20,000,000’’; and 

23 (B) in paragraph (5)— 

24 (i) by amending subparagraph (A) to 

25 read as follows: 


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1 ‘‘(A) for fiscal year 2023, the amount de2 termined for such fiscal year under this para3 graph as in effect on the day before the date of 

4 enactment of the 9/11 Responder and Survivor 

5 Health Funding Correction Act of 2023;’’; 

6 (ii) by redesignating subparagraph 

7 (B) as subparagraph (C); and 

8 (iii) by inserting after subparagraph 

9 (A) the following: 

10 ‘‘(B) for fiscal year 2024, the greater of— 

11 ‘‘(i) the amount determined for such 

12 fiscal year under this paragraph as in ef13 fect on the day before the date of enact14 ment of the 9/11 Responder and Survivor 

15 Health Funding Correction Act of 2023; or 

16 ‘‘(ii) $20,000,000; and’’. 

17 (b) ADDITIONAL FUNDING FOR THE WORLD TRADE

18 CENTER HEALTH PROGRAM.— 

19 (1) IN GENERAL.—Title XXXIII of the Public 

20 Health Service Act (42 U.S.C. 300mm et seq.) is 

21 amended by adding at the end the following: 

22 ‘‘SEC. 3353. SPECIAL FUND. 

23 ‘‘(a) IN GENERAL.—There is established a fund to 

24 be known as the World Trade Center Health Program 

25 Special Fund (referred to in this section as the ‘Special 


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1 Fund’), consisting of amounts deposited into the Special 

2 Fund under subsection (b). 

3 ‘‘(b) AMOUNT.—Out of any money in the Treasury 

4 not otherwise appropriated, there is appropriated for fiscal 

5 year 2024 $1,784,358,336 for deposit into the Special 

6 Fund, which amounts shall remain available in such Fund 

7 through fiscal year 2033. 

8 ‘‘(c) USES OF FUNDS.—Amounts deposited into the 

9 Special Fund under subsection (b) shall be available, with10 out further appropriation and without regard to any 

11 spending limitation under section 3351(c), to the WTC 

12 Program Administrator as needed at the discretion of such 

13 Administrator, for carrying out any provision in this title 

14 (including sections 3303 and 3341(c)). 

15 ‘‘(d) REMAINING AMOUNTS.—Any amounts that re16 main in the Special Fund on September 30, 2033, shall 

17 be deposited into the World Trade Center Health Program 

18 Fund in accordance with section 3351(a)(6) and remain 

19 available in accordance with section 3351(a)(5). 

20 ‘‘SEC. 3354. PENTAGON/SHANKSVILLE FUND. 

21 ‘‘(a) IN GENERAL.—There is established a fund to 

22 be known as the World Trade Center Health Program 

23 Fund for Certain WTC Responders at the Pentagon and 

24 Shanksville, Pennsylvania (referred to in this section as 

25 the ‘Pentagon/Shanksville Fund’), consisting of amounts 


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1 deposited into the Pentagon/Shanksville Fund under sub2 section (b). 

3 ‘‘(b) AMOUNT.—Out of any money in the Treasury 

4 not otherwise appropriated, there is appropriated for fiscal 

5 year 2024 $257,000,000 for deposit into the Pentagon/ 

6 Shanksville Fund, which amounts shall remain available 

7 in such Fund through fiscal year 2033. 

8 ‘‘(c) USES OF FUNDS.— 

9 ‘‘(1) IN GENERAL.—Amounts deposited into the 

10 Pentagon/Shanksville Fund under subsection (b) 

11 shall be available, without further appropriation and 

12 without regard to any spending limitation under sec13 tion 3351(c), to the WTC Program Administrator 

14 for the purpose of carrying out section 3312 with re15 gard to WTC responders enrolled in the WTC Pro16 gram based on eligibility criteria described in sub17 clause (III) or (IV) of section 3311(a)(2)(C)(i). 

18 ‘‘(2) LIMITATION ON OTHER FUNDING.—Not19 withstanding sections 3331(a), 3351(b)(1), 3352(c), 

20 and 3353(c), and any other provision in this title, 

21 for the period of fiscal years 2024 through 2033, no 

22 amounts made available under this title other than 

23 those amounts appropriated under subsection (b) 

24 may be available for the purpose described in para25 graph (1). 


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1 ‘‘(d) REMAINING AMOUNTS.—Any amounts that re2 main in the Pentagon/Shanksville Fund on September 30, 

3 2033, shall be deposited into the World Trade Center 

4 Health Program Fund in accordance with section 

5 3351(a)(6) and remain available in accordance with sec6 tion 3351(a)(5).’’. 

7 (c) CONFORMING AMENDMENTS.—Title XXXIII of 

8 the Public Health Service Act (42 U.S.C. 300mm et seq.) 

9 is amended— 

10 (1) in section 3311(a)(4)(B)(i)(II) (42 U.S.C. 

11 300mm–21(a)(4)(B)(i)(II)), by striking ‘‘sections 

12 3351 and 3352’’ and inserting ‘‘this title’’; 

13 (2) in section 3321(a)(3)(B)(i)(II) (42 U.S.C. 

14 300mm–31(a)(3)(B)(i)(II)), by striking ‘‘sections 

15 3351 and 3352’’ and inserting ‘‘this title’’; 

16 (3) in section 3331 (42 U.S.C. 300mm–41)— 

17 (A) in subsection (a), by striking ‘‘the 

18 World Trade Center Health Program Fund and 

19 the World Trade Center Health Program Sup20 plemental Fund’’ and inserting ‘‘(as applicable) 

21 the Funds established under sections 3351, 

22 3352, 3353, and 3354’’; and 

23 (B) in subsection (d)— 

24 (i) in paragraph (1)(A), by inserting 

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1 gram Special Fund under section 3353’’ 

2 after ‘‘section 3351’’; 

3 (ii) in paragraph (1)(B), by inserting 

4 ‘‘or the World Trade Center Health Pro5 gram Fund for Certain WTC Responders 

6 at the Pentagon and Shanksville, Pennsyl7 vania under section 3354’’ after ‘‘section 

8 3352’’; and 

9 (iii) in paragraph (2), in the flush text 

10 following subparagraph (C), by inserting 

11 ‘‘or the World Trade Center Health Pro12 gram Fund for Certain WTC Responders 

13 at the Pentagon and Shanksville, Pennsyl14 vania under section 3354’’ after ‘‘section 

15 3352’’; and 

16 (4) in section 3351(b) (42 U.S.C. 300mm– 

17 61(b))— 

18 (A) in paragraph (1), by striking ‘‘sub19 section (a)(2)’’ and inserting ‘‘paragraph (2) or 

20 (6) of subsection (a)’’; 

21 (B) in paragraph (2), by inserting ‘‘, the 

22 World Trade Center Health Program Special 

23 Fund under section 3353, or the World Trade 

24 Center Health Program Fund for Certain WTC 

25 Responders at the Pentagon and Shanksville, 


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1 Pennsylvania under section 3354’’ before the 

2 period at the end; and 

3 (C) in paragraph (3), by inserting ‘‘, the 

4 World Trade Center Health Program Special 

5 Fund under section 3353, or the World Trade 

6 Center Health Program Fund for Certain WTC 

7 Responders at the Pentagon and Shanksville, 

8 Pennsylvania under section 3354’’ before the 

9 period at the end. 

Æ 


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