II 

109TH CONGRESS 

2D SESSION S. 4022 

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 SENATE OF THE UNITED STATES 

SEPTEMBER 29, 2006 

Mrs. CLINTON (for herself, Mr. SCHUMER, and Mr. KENNEDY) introduced the 

following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

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’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 


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1 (1) Thousands of rescue workers who responded 

2 to the areas devastated by the terrorist attacks of 

3 September 11th and local residents continue to suf4 fer significant medical problems as a result of com5 promised air quality and other toxins at the attack 

6 sites. 

7 (2) To date, the Mount Sinai Center for Occu8 pational and Environmental Medicine in New York 

9 City has examined approximately 9,000 first re10 sponders and Ground Zero workers. Of those exam11 ined, more than 50 percent show physical or mental 

12 health problems that are directly related to their 

13 work at the World Trade Center and Fresh Kill 

14 sites. 

15 (3) Except for funds recently appropriated by 

16 Congress reversing a rescission by the President’s 

17 Budget, it appears that there is no Federal program 

18 currently in existence to support the full medical and 

19 mental health treatment needs of those who re20 sponded to the September 11, 2001 attacks and who 

21 continue to experience health problems as a result. 

22 (4) A significant portion of those who re23 sponded to the September 11th aftermath have no 

24 health insurance, lost their health insurance as a re25 sult of the attacks, or have inadequate health insurVerDate Aug 31 2005 23:48 Oct 04, 2006 Jkt 059196 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S4022.IS S4022

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1 ance for the medical conditions they developed as a 

2 result of recovery work at the World Trade Center 

3 site. 

4 (5) Rescue workers and volunteers seeking 

5 workers compensation apparently have had their ap6 plications denied, delayed for months, or redirected, 

7 instead of receiving assistance in a timely and sup8 portive manner. 

9 (6) Confusion still exists within the population 

10 of recovery workers and first responders about where 

11 to obtain compensation for income losses and med12 ical costs related to their service in the September 

13 11th recovery effort. 

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

15 be included in any health monitoring program to 

16 best protect their long-term health. 

17 (8) Federal aid allocated for the monitoring of 

18 rescue workers’ health may need to be increased to 

19 ensure the long-term study of the health impacts of 

20 9/11. 

21 (9) Research on the health impacts of the dev22 astation caused by the September 11th terrorist at23 tacks has started, with initial findings of relation24 ships between the air quality from Ground Zero and 

25 a host of health impacts including, lower pregnancy 


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1 rates, lower birth weights in babies born 9 months 

2 after the disaster, and higher rates of respiratory 

3 and lung disorders in workers and residents near 

4 Ground Zero. 

5 (10) Further research is needed to evaluate 

6 more comprehensively the health impacts of the 

7 events of September 11, 2001 and research is need8 ed regarding possible treatment for the illnesses and 

9 injuries as a result of such events. 

10 (11) The Federal response to medical issues 

11 arising from September 11th response efforts needs 

12 to be improved to meet the needs of rescue workers 

13 and local residents still suffering health problems 

14 from the disaster. 

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

16 designated to coordinate and monitor the overall 

17 Federal response to the health impacts of the events 

18 of September 11, 2001. 

19 SEC. 3. HEALTH CARE INSURANCE. 

20 Subtitle B of title VI of the Robert T. Stafford Dis21 aster Relief and Emergency Assistance Act (42 U.S.C. 

22 5197 et seq.) is amended by adding at the end the fol23 lowing: 


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

2 ‘‘(a) WORK INJURIES.—For purposes of subchapter 

3 I of chapter 81 of title 5, United States Code (relating 

4 to compensation to Federal employees for work injuries), 

5 eligible recipients (as defined in subsection (d)) shall be 

6 deemed civil employees of the United States within the 

7 meaning of the term ‘employee’ as defined in section 8101 

8 of title 5, United States Code, and the provisions of such 

9 subchapter shall apply to such recipients. 

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

11 claims relating to damage to, or loss of, the personal prop12 erty of an eligible recipient incident to service, an eligible 

13 recipient shall be considered in the same manner as if such 

14 eligible recipient was a civil employee of the Government 

15 of the United States, except that an eligible recipient shall 

16 not be responsible for the payment of any health care ex17 penses, including mental health coverage, prescription 

18 drugs, or copayments for any health or mental health care 

19 expenses that result from exposure to the adverse condi20 tions existing after the terrorist attack on September 11, 

21 2001. 

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

23 for in this section, an eligible recipient shall not be deemed 

24 a Federal employee and shall not be subject to the provi25 sions of law relating to Federal employment, including 

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


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1 leave, unemployment compensation, and Federal employee 

2 benefits. 

3 ‘‘(d) ELIGIBLE RECIPIENT DEFINED.— 

4 ‘‘(1) ELIGIBLE RECIPIENT.—Except as pro5 vided in paragraph (2), for purposes of this section, 

6 the term ‘eligible recipient’ means— 

7 ‘‘(A) an emergency service personnel or 

8 rescue and recovery personnel who responded to 

9 the terrorist attacks that occurred on Sep10 tember 11, 2001, in New York City, in the 

11 State of New York, any time during the period 

12 of September 11, 2001, through August 31, 

13 2002; 

14 ‘‘(B) any other worker or volunteer who re15 sponded to such attacks, including— 

16 ‘‘(i) a police officer; 

17 ‘‘(ii) a firefighter; 

18 ‘‘(iii) an emergency medical techni19 cian; 

20 ‘‘(iv) a transit worker; 

21 ‘‘(v) any participating member of an 

22 urban search and rescue team; 

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


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1 ‘‘(vii) any other relief or rescue work2 er or volunteer whom the Secretary deter3 mines to be appropriate; 

4 ‘‘(viii) an individual who assisted in 

5 the recovery of human remains; and 

6 ‘‘(ix) an individual who assisted in the 

7 criminal investigation; 

8 ‘‘(C) a worker who responded to such at9 tacks by assisting in the cleanup or restoration 

10 of critical infrastructure in and around New 

11 York City; 

12 ‘‘(D) an individual whose place of resi13 dence is in the declared disaster area; 

14 ‘‘(E) an individual who was employed in or 

15 attended school, child care, or adult day care in 

16 a building located in the declared disaster area 

17 any time during the period of September 11, 

18 2001, through August 31, 2002; or 

19 ‘‘(F) any other individual who the Sec20 retary determines to be appropriate. 

21 ‘‘(2) FAMILY MEMBERS.—Notwithstanding 

22 paragraph (1), the immediate family members of an 

23 individual who is an eligible recipient under para24 graph (1) may receive benefits under this section if 

25 the eligible recipient— 


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1 ‘‘(A) is or was on September 11th, 2001 

2 the policyholder for such family; and 

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

4 September 11, 2001.’’. 

5 SEC. 4. HEALTH SCREENINGS, EXAMINATIONS, AND MONI6 TORING SERVICES. 

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

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

9 by inserting after section 317S the following: 

10 ‘‘SEC. 317T. CERTAIN HEALTH SERVICES FOR INDIVIDUALS 

11 ASSISTING WITH RESPONSE TO SEPTEMBER 

12 11 TERRORIST ATTACKS IN NEW YORK CITY. 

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

14 the Director of the Centers for Disease Control and Pre15 vention shall award grants or cooperative agreements for 

16 the purpose of establishing a program to carry out base17 line and follow-up screening and clinical examinations, and 

18 long-term health monitoring and analysis, for covered indi19 viduals who meet the eligibility criteria under subsection 

20 (d). 

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

22 section, the term ‘covered individuals’ means— 

23 ‘‘(1) an emergency service personnel or rescue 

24 and recovery personnel who responded to the ter25 rorist attacks that occurred on September 11, 2001, 


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

2 time during the period of September 11, 2001, 

3 through August 31, 2002; 

4 ‘‘(2) any other worker or volunteer who re5 sponded to such attacks, including— 

6 ‘‘(A) a police officer; 

7 ‘‘(B) a firefighter; 

8 ‘‘(C) an emergency medical technician; 

9 ‘‘(D) a transit worker; 

10 ‘‘(E) any participating member of an 

11 urban search and rescue team; 

12 ‘‘(F) Federal and State employees; 

13 ‘‘(G) an individual who worked to recover 

14 human remains; 

15 ‘‘(H) an individual who worked on the 

16 criminal investigation; and 

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

18 volunteer who the Secretary determines to be 

19 appropriate; 

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

21 assisting in the cleanup or restoration of critical in22 frastructure in and around the designated disaster 

23 area; 


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1 ‘‘(4) an individual whose place of residence was 

2 in the declared disaster area during the period of 

3 September 11, 2001, through August 31, 2002; 

4 ‘‘(5) an individual who is employed in or at5 tends school, child care, or adult day care in a build6 ing located in the declared disaster area during the 

7 period of September 11, 2001, through August 31, 

8 2002; and 

9 ‘‘(6) any other individual who the Secretary de10 termines to be appropriate. 

11 ‘‘(c) AWARD RECIPIENT.— 

12 ‘‘(1) IN GENERAL.—Subject to the submission 

13 of an application satisfactory to the Secretary, 

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

15 ‘‘(A) the consortium of medical entities 

16 that, pursuant to the program referred to in 

17 subsection (g), provided health services de18 scribed in subsection (a) during fiscal year 

19 2003 for the personnel described in subsection 

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

21 criteria established in paragraph (2); and 

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

23 the New York City Fire Department. 

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

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


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1 the consortium referred to in such paragraph (1)(A) 

2 are that the consortium has appropriate experience 

3 in the areas of environmental or occupational health, 

4 toxicology, and safety, including experience in— 

5 ‘‘(A) developing clinical protocols and con6 ducting clinical health examinations, including 

7 mental health assessments; 

8 ‘‘(B) conducting long-term health moni9 toring and epidemiological studies; 

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

11 studies; and 

12 ‘‘(D) establishing and maintaining medical 

13 surveillance programs and environmental expo14 sure or disease registries. 

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

16 Secretary shall determine eligibility criteria for covered in17 dividuals to receive health services under subsection (a). 

18 Such criteria shall include the requirement that a covered 

19 individual may not receive services through the program 

20 under such subsection unless the individual enrolls in the 

21 program. 

22 ‘‘(e) CERTAIN PROGRAM REQUIREMENTS.—With re23 spect to the program under subsection (a), the Secretary 

24 shall provide for the following: 


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1 ‘‘(1) Awards under subsection (a) shall des2 ignate an amount to be available only for covered in3 dividuals who— 

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

5 New York City; and 

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

7 of September 11, 2001, provided services in the 

8 immediate vicinity of the World Trade Center. 

9 ‘‘(2) A covered individual enrolled in the pro10 gram may not receive services under the program for 

11 a period exceeding 20 years after the date on which 

12 the individual first received services under the pro13 gram, except that the Secretary may designate a 

14 longer period if the Secretary determines that a 

15 longer period is appropriate with respect to the 

16 health of covered individuals. 

17 ‘‘(3) The program may not establish a max18 imum enrollment number of fewer than 40,000 cov19 ered individuals. 

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

21 Secretary may, to the extent determined appropriate by 

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

23 to provide treatment services to covered individuals who 

24 have no other means of obtaining such treatment. 


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

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

3 9/11 Health Act, the two programs carried out pursuant 

4 to the appropriation of $90,000,000 made in the 2002 

5 Supplemental Appropriations Act for Further Recovery 

6 From and Response To Terrorist Attacks on the United 

7 States (Public Law 107–206) under the heading ‘Public 

8 Health and Social Services Emergency Fund’, which pro9 grams provide health services described in subsection (a) 

10 for the personnel described in subsection (b)(1), shall be 

11 considered to be carried out under authority of this section 

12 and shall be subject to the requirements of this section, 

13 except for any period of transition determined appropriate 

14 by the Secretary, not to exceed 1 year after such date of 

15 enactment. 

16 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 

17 are authorized to be appropriated to carry out this section, 

18 such sums as may be necessary for each of the fiscal years 

19 2007 through 2024, in addition to any other amounts ap20 propriated for such purpose.’’. 

21 SEC. 5. RESEARCH REGARDING CERTAIN HEALTH CONDI22 TIONS. 

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

24 (42 U.S.C. 284 et seq.) is amended by inserting after sec25 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 317T(b), the Director of the 

7 National Institutes of Health shall 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 1 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 medical entities referred 

26 to in section 317T(c)(1); and 


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1 ‘‘(2) the New York City Fire Department and 

2 the union for the firefighters of such department. 

3 ‘‘(d) ANNUAL REPORT.—The Director of the Na4 tional Institutes of Health shall annually submit to the 

5 Congress a report describing the findings of research 

6 under subsection (a). 

7 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

8 are authorized to be appropriated to carry out this section, 

9 such sums as may be necessary for each of the fiscal years 

10 2007 through 2011, in addition to any other amounts ap11 propriated for such purpose.’’. 

12 SEC. 6. ESTABLISHMENT OF APPROPRIATE PROGRAMS. 

13 The Secretary of Health and Human Services may, 

14 to the extent determined appropriate by the Secretary, es15 tablish with respect to the terrorist attack at the Pentagon 

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

17 that are established in sections 317T and 409J of the 

18 Public Health Service Act (as added by this Act) with re19 spect to the terrorist attacks on such date in New York 

20 City, in the State of New York. 

21 SEC. 7. 9/11 HEALTH EMERGENCY COORDINATING COUN22 CIL. 

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

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

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1 tion referred to as the ‘‘Council’’), for the following pur2 poses: 

3 (1) Discussing, examining, and formulating rec4 ommendations with respect to the adequacy and co5 ordination of the following: 

6 (A) Response by the Federal Government, 

7 State governments, local governments, and the 

8 private sector to the terrorist attacks of Sep9 tember 11, 2001. 

10 (B) Care and compensation for the victims 

11 of such attacks. 

12 (C) Federal tracking of the monitoring of, 

13 and possible treatment for, individuals who are 

14 directly suffering from, or may have long-term 

15 health effects from, such attacks. 

16 (D) Coordination among the members of 

17 the Council in responding to the terrorist at18 tacks of September 11, 2001. 

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

20 advisory opinions on the scope of any obligation of 

21 the Federal Government resulting from the terrorist 

22 attacks of September 11, 2001, relative to any obli23 gation of an insurance company resulting from such 

24 attacks. 

25 (b) MEMBERSHIP.— 


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1 (1) CHAIRPERSON.—The Secretary of Health 

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

3 shall serve as the chairperson of the Council. 

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

5 Council shall include the following: 

6 (A) The Secretary of Defense (or the Sec7 retary’s designee). 

8 (B) The Secretary of Labor (or the Sec9 retary’s designee). 

10 (C) The Director of the Federal Emer11 gency Management Agency (or the Director’s 

12 designee). 

13 (D) The Director of the National Insti14 tutes of Health (or the Director’s designee). 

15 (E) The Director of the National Institute 

16 for Occupational Safety and Health (or the Di17 rector’s designee). 

18 (F) A representative of the Crime Victims 

19 Fund established under section 1402 of the Vic20 tims of Crime Act of 1984 (42 U.S.C. 10601). 

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

22 Human Services, shall invite the following individ23 uals to serve as members of the Council: 

24 (A) The Governor of the State of New 

25 York (or the Governor’s designee). 


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

2 Mayor’s designee). 

3 (C) 1 representative of the New York City 

4 Fire Department. 

5 (D) 2 representatives of the unions of New 

6 York City Fire Department employees. 

7 (E) 1 representative of the New York City 

8 Police Department. 

9 (F) 2 representatives of the unions of New 

10 York City Police Department employees. 

11 (G) 1 representative of the police depart12 ment of the Port Authority of New York and 

13 New Jersey. 

14 (H) 2 representatives of the union of the 

15 police department of the Port Authority of New 

16 York and New Jersey. 

17 (I) 1 representative of the New York State 

18 Department of Health. 

19 (J) 1 representative of the New York State 

20 Workers’ Compensation Board. 

21 (K) 1 representative of the New York City 

22 Department of Health. 

23 (L) 1 representative of the New York City 

24 Office of Emergency Management. 


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1 (M) 1 representative of the Association of 

2 Occupational and Environmental Clinics. 

3 (N) 1 representative of the New York 

4 Committee for Occupational Safety and Health 

5 (NYCOSH). 

6 (O) 1 representative of charitable organiza7 tions that had volunteers at Ground Zero. 

8 (P) 10 representatives of labor unions in 

9 New York City that— 

10 (i) are not otherwise described in this 

11 paragraph; and 

12 (ii) reflect a cross section of labor 

13 unions (including construction, municipal, 

14 and other labor unions) whose members re15 sponded to, or assisted with the cleanup 

16 resulting from, the attacks of September 

17 11, 2001. 

18 (Q) 5 representatives of nonprofit volun19 teer entities that assisted in recovery efforts fol20 lowing the terrorist attacks of September 11, 

21 2001. 

22 (R) 5 representatives of a regional occupa23 tional provider that— 


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1 (i) works with the World Trade Cen2 ter Worker and Volunteer Medical Screen3 ing Program; and 

4 (ii) is under the direction of the 

5 Mount Sinai Center for Occupational and 

6 Environmental Medicine. 

7 (c) ADVISORY OPINIONS.— 

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

9 the Council may render an advisory opinion on the 

10 scope of any obligation of the Federal Government 

11 resulting from the terrorist attacks of September 11, 

12 2001, relative to any obligation of an insurance com13 pany resulting from such attacks. 

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

15 advisory opinion described in this subsection only at 

16 the request of a party to one of the obligations in17 volved. 

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

19 4 times each calendar year. 

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

21 year, the Council shall submit to Congress a report on the 

22 recommendations of the Council. 

23 (f) AUTHORIZATION OF APPROPRIATIONS.—There 

24 are authorized to be appropriated to carry out this section 


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

2 2007 through 2015. 

Æ 


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