9/11 Responder and Survivor Health Funding Correction Act of 2023

Subjects: Health, Administrative law and regulatory procedures, Appropriations, Department of Health and Human Services, First responders and emergency personnel, Government employee pay, benefits, personnel management, Government trust funds, Health information and medical records, Health personnel, Military personnel and dependents

Summary:  <p><b>9/11 Responder and Survivor Health Funding Correction Act of 2023</b></p> <p>This bill modifies the funding of, expands eligibility for, and makes other changes to the World Trade Center Health Program. This program provides medical monitoring and treatment to responders and survivors who suffer from health conditions related to the terrorist attacks on September 11, 2001.</p> <p>Specifically, the bill provides additional funding for the program through FY2033 to cover program costs. It also sets out a new formula to determine funding amounts for the program from FY2034 through FY2090.</p> <p>Additionally, the bill expands eligibility for the program to include members of the Armed Forces and federal employees and contractors who provided rescue, recovery, demolition, debris clean-up, or related services in response to the attacks at the Pentagon and in Shanksville, PA on September 11, 2001. The bill limits the enrollment of newly eligible individuals in the program to 500 at any given time.</p> <p>Other changes in the bill include (1) allowing certain health care providers other than physicians to determine whether an individual's health condition is related to an attack, and (2) making the program administrator (rather than the centers that collect and analyze health data generated from the program) responsible for establishing criteria for credentialing health care providers that participate in the program.</p>

<html><body><pre>[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 569 Introduced in Senate (IS)]

&lt;DOC&gt;






118th CONGRESS
  1st Session
                                 S. 569

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 SENATE OF THE UNITED STATES

                           February 28, 2023

 Mrs. Gillibrand (for herself, Mr. Schumer, Mr. Booker, Mr. Menendez, 
and Mr. Blumenthal) introduced the following bill; which was read twice 
and referred to the Committee on Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``9/11 Responder and Survivor Health 
Funding Correction Act of 2023''.

SEC. 2. DEPARTMENT OF DEFENSE, ARMED FORCES, OR OTHER FEDERAL WORKER 
              RESPONDERS TO THE SEPTEMBER 11 ATTACKS AT THE PENTAGON 
              AND SHANKSVILLE, PENNSYLVANIA.

    Title XXXIII of the Public Health Service Act (42 U.S.C. 300mm et 
seq.) is amended--
            (1) in section 3306 (42 U.S.C. 300mm-5)--
                    (A) by redesignating paragraphs (5) through (11) 
                and paragraphs (12) through (17) as paragraphs (6) 
                through (12) and paragraphs (14) through (19), 
                respectively;
                    (B) by inserting after paragraph (4) the following:
            ``(5) The term `Federal agency' means an agency, office, or 
        other establishment in the executive, legislative, or judicial 
        branch of the Federal Government.''; and
                    (C) by inserting after paragraph (12), as so 
                redesignated, the following:
            ``(13) The term `uniformed services' has the meaning given 
        the term in section 101(a) of title 10, United States Code.''; 
        and
            (2) in section 3311(a) (42 U.S.C. 300mm-21(a))--
                    (A) in paragraph (2)(C)(i)--
                            (i) in subclause (I), by striking ``; or'' 
                        and inserting a semicolon;
                            (ii) in subclause (II), by striking ``; 
                        and'' and inserting a semicolon; and
                            (iii) by adding at the end the following:
                            ``(III) was an employee of the Department 
                        of Defense or any other Federal agency, worked 
                        during the period beginning on September 11, 
                        2001, and ending on September 18, 2001, for a 
                        contractor of the Department of Defense or any 
                        other Federal agency, or was a member of a 
                        regular or reserve component of the uniformed 
                        services; and performed rescue, recovery, 
                        demolition, debris cleanup, or other related 
                        services at the Pentagon site of the terrorist-
                        related aircraft crash of September 11, 2001, 
                        during the period beginning on September 11, 
                        2001, and ending on the date on which the 
                        cleanup of the site was concluded, as 
                        determined by the WTC Program Administrator; or
                            ``(IV) was an employee of the Department of 
                        Defense or any other Federal agency, worked 
                        during the period beginning on September 11, 
                        2001, and ending on September 18, 2001, for a 
                        contractor of the Department of Defense or any 
                        other Federal agency, or was a member of a 
                        regular or reserve component of the uniformed 
                        services; and performed rescue, recovery, 
                        demolition, debris cleanup, or other related 
                        services at the Shanksville, Pennsylvania, site 
                        of the terrorist-related aircraft crash of 
                        September 11, 2001, during the period beginning 
                        on September 11, 2001, and ending on the date 
                        on which the cleanup of the site was concluded, 
                        as determined by the WTC Program Administrator; 
                        and''; and
                    (B) in paragraph (4)(A)--
                            (i) by striking ``(A) In general.--The'' 
                        and inserting the following:
                    ``(A) Limit.--
                            ``(i) In general.--The'';
                            (ii) by inserting ``or subclause (III) or 
                        (IV) of paragraph (2)(C)(i)'' after ``or 
                        (2)(A)(ii)''; and
                            (iii) by adding at the end the following:
                            ``(ii) Certain responders to the september 
                        11 attacks at the pentagon and shanksville, 
                        pennsylvania.--The total number of individuals 
                        who may be enrolled under paragraph (3)(A)(ii) 
                        based on eligibility criteria described in 
                        subclause (III) or (IV) of paragraph (2)(C)(i) 
                        shall not exceed 500 at any time.''.

SEC. 3. FLEXIBILITY FOR CERTIFICATIONS UNDER THE WORLD TRADE CENTER 
              HEALTH PROGRAM.

    (a) In General.--Section 3305(a) of the Public Health Service Act 
(42 U.S.C. 300mm-4(a)) is amended--
            (1) in paragraph (1)(A), by inserting ``subject to 
        paragraph (6),'' before ``for''; and
            (2) by adding at the end the following:
            ``(6) Licensed health care provider flexibility.--
                    ``(A) In general.--For purposes of an initial 
                health evaluation described in paragraph (1)(A) 
                (including any such evaluation provided under section 
                3321(b) or through the nationwide network under section 
                3313), such evaluation may be conducted by a physician 
                or any other licensed health care provider in a 
                category of health care providers determined by the WTC 
                Program Administrator under subparagraph (B).
                    ``(B) Categories of licensed health care 
                providers.--Not later than 180 days after the date of 
                enactment of the 9/11 Responder and Survivor Health 
                Funding Correction Act of 2023, the WTC Program 
                Administrator shall issue regulations for the 
                categories of licensed health care providers who, in 
                addition to licensed physicians, may conduct 
                evaluations under subparagraph (A) and make 
                determinations under section 3312(b).''.
    (b) Flexibility for WTC Responders.--Section 3312(b) of such Act 
(42 U.S.C. 300mm-22(b)) is amended--
            (1) in paragraph (1), by striking ``physician'' each place 
        it appears and inserting ``physician or other licensed health 
        care provider in a category determined by the WTC Program 
        Administrator under section 3305(a)(6)(B)'';
            (2) in paragraph (2)--
                    (A) in subparagraph (A)--
                            (i) in the matter preceding clause (i), by 
                        striking ``physician'' and inserting 
                        ``physician or other licensed health care 
                        provider in a category determined by the WTC 
                        Program Administrator under section 
                        3305(a)(6)(B)'';
                            (ii) in clause (i), by striking 
                        ``physician'' and inserting ``physician or 
                        other licensed health care provider''; and
                            (iii) in clause (ii), by striking ``such 
                        physician's determination'' and inserting ``the 
                        determination of such physician or other 
                        licensed health care provider''; and
                    (B) in subparagraph (B)--
                            (i) in the matter preceding clause (i), by 
                        striking ``physician determinations'' and 
                        inserting ``determinations by physicians or 
                        other licensed health care providers in 
                        categories determined by the WTC Program 
                        Administrator under section 3305(a)(6)(B)''; 
                        and
                            (ii) in clause (i), by striking ``physician 
                        panel'' and inserting ``panel of physicians or 
                        other licensed health care providers in 
                        categories determined by the WTC Program 
                        Administrator under section 3305(a)(6)(B)''; 
                        and
            (3) in paragraph (5), by striking ``examining physician'' 
        and inserting ``examining physician or other licensed health 
        care provider in a category determined by the WTC Program 
        Administrator under section 3305(a)(6)(B)''.

SEC. 4. CRITERIA FOR CREDENTIALING HEALTH CARE PROVIDERS PARTICIPATING 
              IN THE NATIONWIDE NETWORK.

    Title XXXIII of the Public Health Service Act (42 U.S.C. 300mm et 
seq.) is amended--
            (1) in section 3305(a)(2) (42 U.S.C. 300mm-4(a)(2))--
                    (A) in subparagraph (A)--
                            (i) by striking clause (iv); and
                            (ii) by redesignating clauses (v) and (vi) 
                        as clauses (iv) and (v), respectively;
                    (B) by striking subparagraph (B); and
                    (C) by redesignating subparagraphs (C) and (D) as 
                subparagraphs (B) and (C), respectively; and
            (2) in section 3313(b)(1) (42 U.S.C. 300mm-23(b)(1)), by 
        striking ``Data Centers'' and inserting ``WTC Program 
        Administrator''.

SEC. 5. CLARIFYING CALCULATION OF ENROLLMENT.

    (a) Responders.--Section 3311(a) of such Act (42 U.S.C. 300mm-
21(a)) is amended by adding at the end the following:
            ``(6) Deceased wtc responders.--An individual known to the 
        WTC Program Administrator to be deceased shall not be included 
        in any count of enrollees under this subsection or section 
        3351.''.
    (b) Survivors.--Section 3321(a) of such Act (42 U.S.C. 300mm-31(a)) 
is amended by adding at the end the following:
            ``(5) Deceased wtc survivors.--An individual known to the 
        WTC Program Administrator to be deceased shall not be included 
        in any count of certified-eligible survivors under this section 
        or in any count of enrollees under section 3351.''.

SEC. 6. TIME PERIOD FOR ADDING HEALTH CONDITIONS TO LIST FOR WTC 
              RESPONDERS.

    Section 3312(a)(6) of the Public Health Service Act (42 U.S.C. 
300mm-22(a)(6)) is amended--
            (1) in subparagraph (B), by striking ``90'' and inserting 
        ``180''; and
            (2) in subparagraph (C), in the second sentence, by 
        striking ``90'' and inserting ``180''.

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

    (a) Federal Funding.--Section 3351 of the Public Health Service Act 
(42 U.S.C. 300mm-61) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (2)(A)--
                            (i) in clause (x), by striking ``and'';
                            (ii) in clause (xi)--
                                    (I) by striking ``subsequent fiscal 
                                year through fiscal year 2090'' and 
                                inserting ``of fiscal years 2026 
                                through 2033''; and
                                    (II) by striking ``plus'' and 
                                inserting ``and''; and
                            (iii) by adding at the end the following:
                            ``(xii) for each of fiscal years 2034 
                        through 2090--
                                    ``(I) the amount determined under 
                                this subparagraph for the previous 
                                fiscal year (plus the sum of any amount 
                                expended in the previous fiscal year 
                                from the World Trade Center Health 
                                Program Special Fund established under 
                                section 3353 or the World Trade Center 
                                Health Program Fund for Certain WTC 
                                Responders at the Pentagon and 
                                Shanksville, Pennsylvania established 
                                under section 3354 and any amount 
                                expended from the World Trade Center 
                                Health Program Fund established under 
                                this section in the previous fiscal 
                                year that was carried over from any 
                                fiscal year prior to the previous 
                                fiscal year including as carried over 
                                pursuant to a deposit into such Fund 
                                under paragraph (6)) multiplied by 
                                1.05; multiplied by
                                    ``(II) the ratio of--
                                            ``(aa) the total number of 
                                        individuals enrolled in the WTC 
                                        Program on July 1 of such 
                                        previous fiscal year; to
                                            ``(bb) the total number of 
                                        individuals so enrolled on July 
                                        1 of the fiscal year prior to 
                                        such previous fiscal year; 
                                        plus''; and
                    (B) by adding at the end the following:
            ``(6) Remaining amounts from special fund and pentagon/
        shanksville fund.--Any amounts that remain available, on 
        September 30, 2033, in the World Trade Center Health Program 
        Special Fund under section 3353 or the World Trade Center 
        Health Program Fund for Certain WTC Responders at the Pentagon 
        and Shanksville, Pennsylvania under section 3354 shall be 
        deposited into the Fund.''; and
            (2) in subsection (c)--
                    (A) in paragraph (4)--
                            (i) by amending subparagraph (A) to read as 
                        follows:
                    ``(A) for fiscal year 2023, the amount determined 
                for such fiscal year under this paragraph as in effect 
                on the day before the date of enactment of the 9/11 
                Responder and Survivor Health Funding Correction Act of 
                2023;''; and
                            (ii) in subparagraph (B), by striking 
                        ``2017, $15,000,000'' and inserting ``2024, 
                        $20,000,000''; and
                    (B) in paragraph (5)--
                            (i) by amending subparagraph (A) to read as 
                        follows:
                    ``(A) for fiscal year 2023, the amount determined 
                for such fiscal year under this paragraph as in effect 
                on the day before the date of enactment of the 9/11 
                Responder and Survivor Health Funding Correction Act of 
                2023;'';
                            (ii) by redesignating subparagraph (B) as 
                        subparagraph (C); and
                            (iii) by inserting after subparagraph (A) 
                        the following:
                    ``(B) for fiscal year 2024, the greater of--
                            ``(i) the amount determined for such fiscal 
                        year under this paragraph as in effect on the 
                        day before the date of enactment of the 9/11 
                        Responder and Survivor Health Funding 
                        Correction Act of 2023; or
                            ``(ii) $20,000,000; and''.
    (b) Additional Funding for the World Trade Center Health Program.--
            (1) In general.--Title XXXIII of the Public Health Service 
        Act (42 U.S.C. 300mm et seq.) is amended by adding at the end 
        the following:

``SEC. 3353. SPECIAL FUND.

    ``(a) In General.--There is established a fund to be known as the 
World Trade Center Health Program Special Fund (referred to in this 
section as the `Special Fund'), consisting of amounts deposited into 
the Special Fund under subsection (b).
    ``(b) Amount.--Out of any money in the Treasury not otherwise 
appropriated, there is appropriated for fiscal year 2024 $1,784,358,336 
for deposit into the Special Fund, which amounts shall remain available 
in such Fund through fiscal year 2033.
    ``(c) Uses of Funds.--Amounts deposited into the Special Fund under 
subsection (b) shall be available, without further appropriation and 
without regard to any spending limitation under section 3351(c), to the 
WTC Program Administrator as needed at the discretion of such 
Administrator, for carrying out any provision in this title (including 
sections 3303 and 3341(c)).
    ``(d) Remaining Amounts.--Any amounts that remain in the Special 
Fund on September 30, 2033, shall be deposited into the World Trade 
Center Health Program Fund in accordance with section 3351(a)(6) and 
remain available in accordance with section 3351(a)(5).

``SEC. 3354. PENTAGON/SHANKSVILLE FUND.

    ``(a) In General.--There is established a fund to be known as the 
World Trade Center Health Program Fund for Certain WTC Responders at 
the Pentagon and Shanksville, Pennsylvania (referred to in this section 
as the `Pentagon/Shanksville Fund'), consisting of amounts deposited 
into the Pentagon/Shanksville Fund under subsection (b).
    ``(b) Amount.--Out of any money in the Treasury not otherwise 
appropriated, there is appropriated for fiscal year 2024 $257,000,000 
for deposit into the Pentagon/Shanksville Fund, which amounts shall 
remain available in such Fund through fiscal year 2033.
    ``(c) Uses of Funds.--
            ``(1) In general.--Amounts deposited into the Pentagon/
        Shanksville Fund under subsection (b) shall be available, 
        without further appropriation and without regard to any 
        spending limitation under section 3351(c), to the WTC Program 
        Administrator for the purpose of carrying out section 3312 with 
        regard to WTC responders enrolled in the WTC Program based on 
        eligibility criteria described in subclause (III) or (IV) of 
        section 3311(a)(2)(C)(i).
            ``(2) Limitation on other funding.--Notwithstanding 
        sections 3331(a), 3351(b)(1), 3352(c), and 3353(c), and any 
        other provision in this title, for the period of fiscal years 
        2024 through 2033, no amounts made available under this title 
        other than those amounts appropriated under subsection (b) may 
        be available for the purpose described in paragraph (1).
    ``(d) Remaining Amounts.--Any amounts that remain in the Pentagon/
Shanksville Fund on September 30, 2033, shall be deposited into the 
World Trade Center Health Program Fund in accordance with section 
3351(a)(6) and remain available in accordance with section 
3351(a)(5).''.
    (c) Conforming Amendments.--Title XXXIII of the Public Health 
Service Act (42 U.S.C. 300mm et seq.) is amended--
            (1) in section 3311(a)(4)(B)(i)(II) (42 U.S.C. 300mm-
        21(a)(4)(B)(i)(II)), by striking ``sections 3351 and 3352'' and 
        inserting ``this title'';
            (2) in section 3321(a)(3)(B)(i)(II) (42 U.S.C. 300mm-
        31(a)(3)(B)(i)(II)), by striking ``sections 3351 and 3352'' and 
        inserting ``this title'';
            (3) in section 3331 (42 U.S.C. 300mm-41)--
                    (A) in subsection (a), by striking ``the World 
                Trade Center Health Program Fund and the World Trade 
                Center Health Program Supplemental Fund'' and inserting 
                ``(as applicable) the Funds established under sections 
                3351, 3352, 3353, and 3354''; and
                    (B) in subsection (d)--
                            (i) in paragraph (1)(A), by inserting ``or 
                        the World Trade Center Health Program Special 
                        Fund under section 3353'' after ``section 
                        3351'';
                            (ii) in paragraph (1)(B), by inserting ``or 
                        the World Trade Center Health Program Fund for 
                        Certain WTC Responders at the Pentagon and 
                        Shanksville, Pennsylvania under section 3354'' 
                        after ``section 3352''; and
                            (iii) in paragraph (2), in the flush text 
                        following subparagraph (C), by inserting ``or 
                        the World Trade Center Health Program Fund for 
                        Certain WTC Responders at the Pentagon and 
                        Shanksville, Pennsylvania under section 3354'' 
                        after ``section 3352''; and
            (4) in section 3351(b) (42 U.S.C. 300mm-61(b))--
                    (A) in paragraph (1), by striking ``subsection 
                (a)(2)'' and inserting ``paragraph (2) or (6) of 
                subsection (a)'';
                    (B) in paragraph (2), by inserting ``, the World 
                Trade Center Health Program Special Fund under section 
                3353, or the World Trade Center Health Program Fund for 
                Certain WTC Responders at the Pentagon and Shanksville, 
                Pennsylvania under section 3354'' before the period at 
                the end; and
                    (C) in paragraph (3), by inserting ``, the World 
                Trade Center Health Program Special Fund under section 
                3353, or the World Trade Center Health Program Fund for 
                Certain WTC Responders at the Pentagon and Shanksville, 
                Pennsylvania under section 3354'' before the period at 
                the end.
                                 &lt;all&gt;
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