I 

108TH CONGRESS 

2D SESSION H. R. 4059 

To provide protections and services to certain individuals after the terrorist 

attack on September 11, 2001, in New York City, in the State of 

New York, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 30, 2004 

Mrs. MALONEY (for herself, Mr. SHAYS, Mr. NADLER, Mr. MCHUGH, Mr. 

HINCHEY, Mr. MCNULTY, Mr. OWENS, Mr. WEINER, Mr. SERRANO, Mr. 

TOWNS, Mr. GRIJALVA, Mr. BISHOP of New York, and Mr. RANGEL) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Transportation 

and Infrastructure, 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 provide protections and services to certain individuals 

after the terrorist attack on September 11, 2001, in 

New York City, in the State of New York, and for 

other purposes. 

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 ‘‘Remember 9/11 Health 

5 Act’’. 
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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) Thousands of rescue workers who responded 

4 to the areas devastated by the terrorist attacks of 

5 September 11th and local residents continue to suf6 fer significant medical problems as a result of com7 promised air quality and other toxins at the attack 

8 sites. 

9 (2) To date, the Mount Sinai Center for Occu10 pational and Environmental Medicine in New York 

11 City has examined approximately 9,000 first re12 sponders and Ground Zero workers. Of those exam13 ined, more than 50 percent show physical or mental 

14 health problems that are directly related to their 

15 work at the World Trade Center and Fresh Kill 

16 sites. 

17 (3) It appears that no Federal program exists 

18 to support fully the medical treatment of those who 

19 responded to the September 11th aftermath and who 

20 continue to experience health problems as a result. 

21 (4) A significant portion of those who re22 sponded to the September 11th aftermath have no 

23 health insurance, lost their health insurance as a re24 sult of the attacks, or have inadequate health insur25 ance for the medical conditions they developed as a 
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1 result of recovery work at the World Trade Center 

2 site. 

3 (5) Rescue workers and volunteers seeking 

4 workers compensation apparently have had their ap5 plications denied, delayed for months, or redirected, 

6 instead of receiving assistance in a timely and sup7 portive manner. 

8 (6) Confusion still exists within the population 

9 of recovery workers and first responders about where 

10 to obtain compensation for income losses and med11 ical costs related to their service in the September 

12 11th recovery effort. 

13 (7) Residents of the City of New York need to 

14 be included in any health monitoring program to 

15 best protect their long-term health. 

16 (8) Federal aid allocated for the monitoring of 

17 rescue workers’ health may need to be increased to 

18 ensure the long-term study of health impacts of 9/ 

19 11. 

20 (9) Research on the health impacts of the dev21 astation caused by the September 11th terrorist at22 tacks has started, with initial findings of relation23 ships between the air quality from Ground Zero and 

24 a host of health impacts including, lower pregnancy 

25 rates, lower birth weights in babies born nine 
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1 months after the disaster, and higher rates of res2 piratory and lung disorders in workers and residents 

3 near Ground Zero. 

4 (10) Further research is needed to evaluate 

5 more comprehensively the health impacts of Sep6 tember 11 and research is needed regarding possible 

7 treatment for the illnesses and injuries of September 

8 11. 

9 (11) The Federal response to medical issues 

10 arising from September 11th response efforts need 

11 improvement to meet the needs of rescue workers 

12 and local residents still suffering health problems 

13 from the disaster. 

14 (12) A Federal agency or official needs to be 

15 designated to coordinate and monitor the overall 

16 Federal response to the health impacts of September 

17 11. 

18 SEC. 3. HEALTH CARE INSURANCE. 

19 Subtitle B of title VI of the Robert T. Stafford Dis20 aster Relief and Emergency Assistance Act is amended by 

21 adding at the end the following: 

22 ‘‘SEC. 630. PROTECTIONS FOR CERTAIN INDIVIDUALS. 

23 ‘‘(a) WORK INJURIES.—For the purposes of sub24 chapter I of chapter 81 of title 5, United States Code, 

25 relating to compensation to Federal employees for work 
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1 injuries, eligible recipients as defined in subsection (d) 

2 under this Act shall be deemed civil employees of the 

3 United States within the meaning of the term ‘employee’ 

4 as defined in section 8101 of title 5, United States Code, 

5 and the provisions of that subchapter shall apply. 

6 ‘‘(b) PERSONAL PROPERTY.—For the purpose of 

7 claims relating to damage to, or loss of, personal property 

8 of an eligible recipient incident to service, an eligible re9 cipient under this Act shall be considered in the same 

10 manner as if such eligible recipient was a civil employee 

11 of the Government of the United States, except that an 

12 eligible recipient shall not be responsible for the payment 

13 of any health care expenses, including mental health cov14 erage, prescription drugs, or copayments for all health and 

15 mental health care expenses that result from exposure to 

16 the adverse conditions after the terrorist attack on Sep17 tember 11, 2001. 

18 ‘‘(c) GENERAL RULE.—Except as otherwise provided 

19 in this section, an eligible recipient shall not be deemed 

20 a Federal employee and shall not be subject to the provi21 sions of law relating to Federal employment, including 

22 those relating to hours of work, rates of compensation, 

23 leave, unemployment compensation, and Federal employee 

24 benefits. 

25 ‘‘(d) ELIGIBLE RECIPIENT DEFINED.— 
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1 ‘‘(1) ELIGIBLE RECIPIENT.—Except as pro2 vided in paragraph (2), for purposes of this section, 

3 the term ‘eligible recipient’ means— 

4 ‘‘(A) emergency service personnel and res5 cue and recovery personnel who responded to 

6 the terrorist attacks that occurred on Sep7 tember 11, 2001, in New York City, in the 

8 State of New York, any time during the period 

9 of September 11, 2001, through August 31, 

10 2002; 

11 ‘‘(B) any other worker or volunteer who re12 sponded to such attacks, including— 

13 ‘‘(i) a police officer; 

14 ‘‘(ii) a firefighter; 

15 ‘‘(iii) an emergency medical techni16 cian; 

17 ‘‘(iv) a transit worker; 

18 ‘‘(v) any participating member of an 

19 urban search and rescue team; 

20 ‘‘(vi) a Federal or State employee; 

21 ‘‘(vii) any other relief or rescue work22 er or volunteer whom the Secretary deter23 mines to be appropriate; 

24 ‘‘(viii) a person who assisted in the re25 covery of human remains; and 
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1 ‘‘(ix) a person who assisted in the 

2 criminal investigation; 

3 ‘‘(C) a worker who responded to such at4 tacks by assisting in the cleanup or restoration 

5 of critical infrastructure in and around New 

6 York City; 

7 ‘‘(D) a person whose place of residence is 

8 in the declared disaster area; 

9 ‘‘(E) a person who was employed in or at10 tended school, child care, or adult day care in 

11 a building located in the declared disaster area 

12 any time during the period of September 11, 

13 2001, through August 31, 2002; and 

14 ‘‘(F) any other person whom the Secretary 

15 determines to be appropriate. 

16 ‘‘(2) Notwithstanding the determination re17 quirements of paragraph (1), the immediate family 

18 members of an individual who is an eligible recipient 

19 under paragraph (1) may receive benefits under this 

20 section if the eligible recipient— 

21 ‘‘(A) is or was on the date of the Sep22 tember 11th attacks the policy holder for such 

23 family; and 

24 ‘‘(B) received family health insurance as of 

25 September 11, 2001.’’. 
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1 SEC. 4. HEALTH SCREENINGS, EXAMINATIONS, AND MONI2 TORING SERVICES. 

3 (a) IN GENERAL.—Part B of title III of the Public 

4 Health Service Act (42 U.S.C. 243 et seq.) is amended 

5 by inserting after section 317R the following section: 

6 ‘‘SEC. 317S. CERTAIN HEALTH SERVICES FOR INDIVIDUALS 

7 ASSISTING WITH RESPONSE TO SEPTEMBER 

8 11 TERRORIST ATTACKS IN NEW YORK CITY. 

9 ‘‘(a) IN GENERAL.—The Secretary, acting through 

10 the Director of the Centers for Disease Control and Pre11 vention, shall make awards of grants or cooperative agree12 ments for the purpose of carrying out baseline and follow13 up screening and clinical examinations, and long-term 

14 health monitoring and analysis, for covered individuals 

15 who meet the eligibility criteria under subsection (d). 

16 ‘‘(b) COVERED INDIVIDUALS.—For purposes of this 

17 section, the term ‘covered individuals’ means— 

18 ‘‘(1) emergency service personnel and rescue 

19 and recovery personnel who responded to the ter20 rorist attacks that occurred on September 11, 2001, 

21 in New York City, in the State of New York, any 

22 time during the period of September 11, 2001, 

23 through August 31, 2002; 

24 ‘‘(2) any other worker or volunteer who re25 sponded to such attacks, including— 

26 ‘‘(A) a police officer; 
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1 ‘‘(B) a firefighter; 

2 ‘‘(C) an emergency medical technician; 

3 ‘‘(D) a transit worker; 

4 ‘‘(E) any participating member of an 

5 urban search and rescue team; 

6 ‘‘(F) Federal and State employees; 

7 ‘‘(G) a person who worked to recover 

8 human remains; 

9 ‘‘(H) a person who worked on the criminal 

10 investigation; and 

11 ‘‘(I) any other relief or rescue worker or 

12 volunteer whom the Secretary determines to be 

13 appropriate; 

14 ‘‘(3) a worker who responded to such attacks by 

15 assisting in the cleanup or restoration of critical in16 frastructure in and around the designated disaster 

17 area; 

18 ‘‘(4) a person whose place of residence is in the 

19 declared disaster area; 

20 ‘‘(5) a person who is employed in or attends 

21 school, child care, or adult day care in a building lo22 cated in the declared disaster area; and 

23 ‘‘(6) any other person whom the Secretary de24 termines to be appropriate. 

25 ‘‘(c) AWARD RECIPIENT.— 
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1 ‘‘(1) IN GENERAL.—Subject to the submission 

2 of an application satisfactory to the Secretary, 

3 awards under subsection (a) shall be made only to— 

4 ‘‘(A) the consortium of medical entities 

5 that, pursuant to the program referred to in 

6 subsection (g), provided health services de7 scribed in subsection (a) during fiscal year 

8 2003 for the personnel described in subsection 

9 (b)(1), subject to the consortium meeting the 

10 criteria established in paragraph (2); and 

11 ‘‘(B) the separate program carried out by 

12 the New York City Fire Department. 

13 ‘‘(2) CRITERIA.—For purposes of paragraph 

14 (1)(A), the criteria described in this paragraph for 

15 the consortium referred to in such paragraph are 

16 that the consortium has appropriate experience in 

17 the areas of environmental or occupational health, 

18 toxicology, and safety, including experience in— 

19 ‘‘(A) developing clinical protocols and con20 ducting clinical health examinations, including 

21 mental health assessments; 

22 ‘‘(B) conducting long-term health moni23 toring and epidemiological studies; 

24 ‘‘(C) conducting long-term mental health 

25 studies; and 
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1 ‘‘(D) establishing and maintaining medical 

2 surveillance programs and environmental expo3 sure or disease registries. 

4 ‘‘(d) ELIGIBILITY OF COVERED INDIVIDUALS.—The 

5 Secretary shall determine eligibility criteria for covered in6 dividuals to receive health services under subsection (a). 

7 Such criteria shall include the requirement that a covered 

8 individual may not receive services through the program 

9 under such section unless the individual enrolls in the pro10 gram. 

11 ‘‘(e) CERTAIN PROGRAM REQUIREMENTS.—With re12 spect to the program under subsection (a), the Secretary 

13 shall provide for the following: 

14 ‘‘(1) Awards under subsection (a) shall des15 ignate an amount to be available only for covered in16 dividuals who— 

17 ‘‘(A) are active or retired firefighters of 

18 New York City; and 

19 ‘‘(B) in responding to the terrorist attacks 

20 of September 11, 2001, provided services in the 

21 immediate vicinity of the World Trade Center. 

22 ‘‘(2) A covered individual enrolled in the pro23 gram may not receive services under the program for 

24 a period exceeding 20 years after the date on which 

25 the individual first receive services under the pro-
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1 gram, except that the Secretary may designate a 

2 longer period if the Secretary determines that a 

3 longer period is appropriate with respect to the 

4 health of covered individuals. 

5 ‘‘(3) The program may not establish a max6 imum enrollment number of fewer than 40,000 cov7 ered individuals. 

8 ‘‘(f) AUTHORITY REGARDING TREATMENT.—The 

9 Secretary may, to the extent determined appropriate by 

10 the Secretary, authorize the program under subsection (a) 

11 to provide treatment services to covered individuals who 

12 have no other means of obtaining treatment. 

13 ‘‘(g) RELATION TO CERTAIN PROGRAM.—Effective 

14 on and after the date of the enactment of the Remember 

15 9/11 Health Act, the two programs carried out pursuant 

16 to the appropriation of $90,000,000 made in Public Law 

17 107–206 under the heading ‘Public Health and Social 

18 Services Emergency Fund’, which programs provide 

19 health services described in subsection (a) for the per20 sonnel described in subsection (b)(1), shall be considered 

21 to be carried out under authority of this section and shall 

22 be subject to the requirements of this section, except for 

23 any period of transition determined appropriate by the 

24 Secretary, not to exceed one year after such date of enact25 ment. 
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1 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 

2 purpose of awards under subsection (a), there are author3 ized to be appropriated such sums as may be necessary 

4 for each of the fiscal years 2004 through 2023, in addition 

5 to any other authorizations of appropriations that are 

6 available for such purpose.’’. 

7 (b) PROGRAMS REGARDING ATTACK AT PEN8 TAGON.—The Secretary of Health and Human Services 

9 may, to the extent determined appropriate by the Sec10 retary, establish with respect to the terrorist attack at the 

11 Pentagon on September 11, 2001, programs similar to the 

12 programs that are established in sections 317S and 409J 

13 of the Public Health Service Act with respect to the ter14 rorist attacks on such date in New York City, in the State 

15 of New York. 

16 SEC. 5. RESEARCH REGARDING CERTAIN HEALTH CONDI17 TIONS. 

18 Part B of title IV of the Public Health Service Act 

19 (42 U.S.C. 284 et seq.) is amended by inserting after sec20 tion 409I the following section: 
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1 ‘‘SEC. 409J. RESEARCH REGARDING CERTAIN HEALTH CON2 DITIONS OF INDIVIDUALS ASSISTING WITH 

3 RESPONSE TO SEPTEMBER 11 TERRORIST AT4 TACKS IN NEW YORK CITY. 

5 ‘‘(a) IN GENERAL.—With respect to covered individ6 uals as defined in section 317S, the Director of NIH shall 

7 conduct or support— 

8 ‘‘(1) diagnostic research on qualifying health 

9 conditions of such individuals, in the case of condi10 tions for which there has been diagnostic uncer11 tainty; and 

12 ‘‘(2) research on treating qualifying health con13 ditions of such individuals, in the case of conditions 

14 for which there has been treatment uncertainty. 

15 ‘‘(b) QUALIFYING HEALTH CONDITIONS.—For pur16 poses of this section, the term ‘qualifying health condi17 tions’ means adverse health conditions that are considered 

18 by the Secretary to be associated with exposure to one or 

19 more of the sites of the terrorist attacks that occurred on 

20 September 11, 2001, in New York City, in the State of 

21 New York. 

22 ‘‘(c) CONSULTATION WITH CERTAIN MEDICAL CON23 SORTIUM.—The Secretary shall carry out this section in 

24 consultation with— 

25 ‘‘(1) the consortium of medicine entities re26 ferred to in section 317S(c)(1); and 
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1 ‘‘(2) the firefighters department of New York 

2 City, and the union for the firefighters of such de3 partment. 

4 ‘‘(d) ANNUAL REPORT.—The Director of NIH shall 

5 annually submit to the Congress a report describing the 

6 findings of research under subsection (a). 

7 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 

8 purpose of carrying out this section, there are authorized 

9 to be appropriated such sums as may be necessary for 

10 each of the fiscal years 2005 through 2008, in addition 

11 to any other authorizations of appropriations that are 

12 available for such purpose.’’. 

13 SEC. 6. 9/11 HEALTH EMERGENCY COORDINATING COUN14 CIL. 

15 (a) ESTABLISHMENT.—The Secretary of Health and 

16 Human Services shall convene a council, to be known as 

17 ‘‘9/11 Health Emergency Coordinating Council’’ (in this 

18 section referred to as the ‘‘Council’’), for the following 

19 purposes: 

20 (1) Discussing, examining, and formulating rec21 ommendations with respect to the adequacy and co22 ordination of the following: 

23 (A) Response by the Federal Government, 

24 State governments, local governments, and the 
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1 private sector to the terrorist attacks of Sep2 tember 11, 2001. 

3 (B) Care and compensation for the victims 

4 of such attacks. 

5 (C) Federal tracking of the monitoring of, 

6 and possible treatment for, individuals who are 

7 directly suffering from, or may have long-term 

8 health effects from, such attacks. 

9 (D) Coordination among the members of 

10 the Council in responding to the terrorist at11 tacks of September 11, 2001. 

12 (2) In accordance with subsection (c), rendering 

13 advisory opinions on the scope of any obligation of 

14 the Federal Government resulting from the terrorist 

15 attacks of September 11, 2001, relative to any obli16 gation of an insurance company resulting from such 

17 attacks. 

18 (b) MEMBERSHIP.— 

19 (1) CHAIRPERSON.—The Secretary of Health 

20 and Human Services (or the Secretary’s designee) 

21 shall serve as the chairperson of the Council. 

22 (2) REQUIRED MEMBERS.—The members of the 

23 Council shall include the following: 

24 (A) The Secretary of Defense (or the Sec25 retary’s designee). 
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1 (B) The Secretary of Labor (or the Sec2 retary’s designee). 

3 (C) The Director of the Federal Emer4 gency Management Agency (or the Director’s 

5 designee). 

6 (D) The Director of the National Insti7 tutes of Health (or the Director’s designee). 

8 (E) The Director of the National Institute 

9 for Occupational Safety and Health (or the Di10 rector’s designee). 

11 (F) A representative of the Crime Victims 

12 Fund established under section 1402 of the Vic13 tims of Crime Act of 1984 (42 U.S.C. 10601). 

14 (3) INVITEES.—The Secretary of Health and 

15 Human Services shall invite the following individuals 

16 to serve as members of the Council: 

17 (A) The Governor of the State of New 

18 York (or the Governor’s designee). 

19 (B) The Mayor of New York City (or the 

20 Mayor’s designee). 

21 (C) 1 representative of the New York City 

22 Fire Department. 

23 (D) 2 representatives of the unions of New 

24 York City Fire Department employees. 
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1 (E) 1 representative of the New York City 

2 Police Department. 

3 (F) 2 representatives of the unions of New 

4 York City Police Department employees. 

5 (G) 1 representative of the police depart6 ment of the Port Authority of New York and 

7 New Jersey. 

8 (H) 2 representatives of the union of the 

9 police department of the Port Authority of New 

10 York and New Jersey. 

11 (I) 1 representative of the New York State 

12 Department of Health. 

13 (J) 1 representative of the New York State 

14 Workers’ Compensation Board. 

15 (K) 1 representative of the New York City 

16 Department of Health. 

17 (L) 1 representative of the New York City 

18 Office of Emergency Management. 

19 (M) 1 representative of the Association of 

20 Occupational and Environmental Clinics. 

21 (N) 1 representative of the New York 

22 Committee for Occupational Safety and Health 

23 (NYCOSH). 

24 (O) 1 representative of charitable organiza25 tions that had volunteers at Ground Zero. 
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1 (P) 10 representatives of labor unions in 

2 New York City that— 

3 (i) are not otherwise listed in this 

4 paragraph; and 

5 (ii) reflect a cross section of labor 

6 unions (including construction, municipal, 

7 and other labor unions) whose members re8 sponded to, or assisted with the cleanup 

9 resulting from, the attacks of September 

10 11, 2001. 

11 (Q) 5 representatives of nonprofit volun12 teer entities that assisted in recovery efforts fol13 lowing the terrorist attacks of September 11, 

14 2001. 

15 (R) 5 representatives of a regional occupa16 tional provider that— 

17 (i) works with the World Trade Cen18 ter Worker and Volunteer Medical Screen19 ing Program; and 

20 (ii) is under the direction of the 

21 Mount Sinai Center for Occupational and 

22 Environmental Medicine. 

23 (c) ADVISORY OPINIONS.— 

24 (1) IN GENERAL.—Subject to paragraph (2), 

25 the Council may render an advisory opinion on the 
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1 scope of any obligation of the Federal Government 

2 resulting from the terrorist attacks of September 11, 

3 2001, relative to any obligation of an insurance com4 pany resulting from such attacks. 

5 (2) LIMITATION.—The Council may issue an 

6 advisory opinion described in this subsection only at 

7 the request of a party to one of the obligations in8 volved. 

9 (d) MEETINGS.—The Council shall meet not less than 

10 4 times each calendar year. 

11 (e) REPORTS.—Not less than once each calendar 

12 year, the Council shall submit to the Congress a report 

13 on the recommendations of the Council. 

14 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated to carry out this section 

16 such sums as may be necessary for each of fiscal years 

17 2005 through 2014. 

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