‘‘(A) there shall be no fee charged to the 
applicant for making an application for such 
determination; 
‘‘(B) the Administrator shall make a deter-
mination on such an application not later than 
60 days after the date of filing the application; 
and 
‘‘(C) an individual who is determined not 
to be an eligible WTC community member shall 
have an opportunity to appeal such determina-
tion before an administrative law judge in a 
manner established under such process. 
‘‘(4) CERTIFICATION.— 
‘‘(A) IN GENERAL.—In the case of an indi-
vidual who is described in paragraph (1)(A) or 
who is determined under paragraph (3) (con-
sistent with paragraph (5)) to be an eligible 
WTC community member, the WTC Program 
Administrator shall provide an appropriate cer-
tification of such fact and of eligibility for fol-
lowup monitoring and treatment benefits under 
this part. The Administrator shall make deter-
minations of eligibility relating to an applicant’s 
compliance 
with 
this 
title, 
including 
the 
verification of information submitted in support 
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of the application and shall not deny such a 
certification to an individual unless the Admin-
istrator determines that— 
‘‘(i) based on the application sub-
mitted, the individual does not meet the 
eligibility criteria; or 
‘‘(ii) the numerical limitation on cer-
tification of eligible WTC community mem-
bers set forth in paragraph (5) has been 
met. 
‘‘(B) TIMING.— 
‘‘(i) CURRENTLY IDENTIFIED COMMU-
NITY MEMBERS.—In the case of an indi-
vidual who is described in paragraph 
(1)(A), the WTC Program Administrator 
shall provide the certification under sub-
paragraph (A) not later than 60 days after 
the date of the enactment of this title. 
‘‘(ii) OTHER MEMBERS.—In the case 
of another individual who is determined 
under paragraph (3) and consistent with 
paragraph (5) to be an eligible WTC com-
munity member, the WTC Program Ad-
ministrator shall provide the certification 
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under subparagraph (A) at the time of 
such determination. 
‘‘(5) NUMERICAL
LIMITATION
ON
CERTIFI-
CATION OF ELIGIBLE WTC COMMUNITY MEMBERS.— 
‘‘(A) IN GENERAL.—The total number of 
individuals not described in subparagraph (C) 
who may be certified as eligible WTC commu-
nity members under paragraph (4) shall not ex-
ceed 15,000. In applying the previous sentence, 
any individual who at any time so qualifies as 
an eligible WTC community member shall be 
counted against such numerical limitation. 
‘‘(B) PROCESS.—In implementing subpara-
graph (A), the WTC Program Administrator 
shall— 
‘‘(i) limit the number of certifications 
provided under paragraph (4) in accord-
ance with such subparagraph; and 
‘‘(ii) provide priority in such certifi-
cations in the order in which individuals 
apply for a determination under paragraph 
(4). 
‘‘(C) INDIVIDUALS CURRENTLY RECEIVING 
TREATMENT
NOT
COUNTED.—Individuals de-
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scribed in this subparagraph are individuals 
who— 
‘‘(i) 
are 
described 
in 
paragraph 
(1)(A); or 
‘‘(ii) before the date of the enactment 
of this title, have received monitoring or 
treatment at the World Trade Center En-
vironmental Health Center at Bellevue 
Hospital Center, Gouverneur Health Care 
Services, or Elmhurst Hospital Center. 
The New York City Health and Hospitals Cor-
poration shall, not later than 6 months after 
the date of enactment of this title, enter into 
arrangements with the Mt. Sinai Data and 
Clinical Coordination Center for the reporting 
of medical data concerning eligible WTC re-
sponders described in paragraph (1)(A), as de-
termined by the WTC Program Administrator 
and consistent with applicable Federal and 
State laws and regulations relating to confiden-
tiality of individually identifiable health infor-
mation. 
‘‘(D) REPORT
TO
CONGRESS
IF
NUMER-
ICAL
LIMITATION
TO
BE
REACHED.—If the 
WTC Program Administrator determines that 
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the number of individuals subject to the numer-
ical limitation of subparagraph (A) is likely to 
exceed such numerical limitation, the Adminis-
trator shall submit to Congress a report on 
such determination. Such report shall include 
an estimate of the number of such individuals 
in excess of such numerical limitation and of 
the additional expenditures that would result 
under this title if such numerical limitation 
were removed. 
‘‘(b) INITIAL HEALTH EVALUATION TO DETERMINE 
ELIGIBILITY FOR FOLLOWUP MONITORING OR TREAT-
MENT.— 
‘‘(1) IN GENERAL.—In the case of a certified el-
igible WTC community member, the WTC program 
shall provide for an initial health evaluation to deter-
mine if the member has a WTC-related health condi-
tion and is eligible for followup monitoring and 
treatment benefits under the WTC program. Initial 
health evaluation protocols shall be approved by the 
WTC Program Administrator, in consultation with 
the World Trade Center Environmental Health Cen-
ter at Bellevue Hospital and the WTC Community 
Program Steering Committee. 
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‘‘(2) 
INITIAL
HEALTH
EVALUATION
PRO-
VIDERS.—The initial health evaluation described in 
paragraph (1) shall be provided through a Clinical 
Center of Excellence with respect to the individual 
involved. 
‘‘(3) LIMITATION ON INITIAL HEALTH EVALUA-
TION BENEFITS.—Benefits for initial health evalua-
tion under this part for an eligible WTC community 
member shall consist only of a single medical initial 
health evaluation consistent with initial health eval-
uation protocols described in paragraph (1). Nothing 
in this paragraph shall be construed as preventing 
such an individual from seeking additional medical 
initial health evaluations at the expense of the indi-
vidual. 
‘‘SEC. 3022. FOLLOWUP MONITORING AND TREATMENT OF 
CERTIFIED ELIGIBLE WTC COMMUNITY MEM-
BERS FOR WTC-RELATED HEALTH CONDI-
TIONS. 
‘‘(a) IN GENERAL.—Subject to subsection (b), the 
provisions of sections 3011 and 3012 shall apply to fol-
lowup monitoring and treatment of WTC-related health 
conditions for certified eligible WTC community members 
in the same manner as such provisions apply to the moni-
toring and treatment of identified WTC-related health 
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conditions for certified eligible WTC responders, except 
that such monitoring shall only be available to those cer-
tified as eligible for treatment under this title. Under sec-
tion 3006(a)(3), the City of New York is required to con-
tribute a share of the costs of such treatment. 
‘‘(b) LIST OF IDENTIFIED WTC-RELATED HEALTH 
CONDITIONS FOR WTC COMMUNITY MEMBERS.— 
‘‘(1) IDENTIFIED WTC-RELATED HEALTH CON-
DITIONS FOR WTC COMMUNITY MEMBERS.—For pur-
poses of this title, the term ‘identified WTC-related 
health conditions for WTC community members’ 
means any of the following health conditions: 
‘‘(A) AERODIGESTIVE DISORDERS.— 
‘‘(i) Interstitial lung diseases. 
‘‘(ii) Chronic respiratory disorder— 
fumes/vapors. 
‘‘(iii) Asthma. 
‘‘(iv) Reactive airways dysfunction 
syndrome (RADS). 
‘‘(v) WTC-exacerbated chronic ob-
structive pulmonary disease (COPD). 
‘‘(vi) Chronic cough syndrome. 
‘‘(vii) Upper airway hyperreactivity. 
‘‘(viii) Chronic rhinosinusitis. 
‘‘(ix) Chronic nasopharyngitis. 
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‘‘(x) Chronic laryngitis. 
‘‘(xi) Gastro-esophageal reflux dis-
order (GERD). 
‘‘(xii) Sleep apnea exacerbated by or 
related to a condition described in a pre-
vious clause. 
‘‘(B) MENTAL HEALTH CONDITIONS.— 
‘‘(i) Post traumatic stress disorder 
(PTSD). 
‘‘(ii) Major depressive disorder. 
‘‘(iii) Panic disorder. 
‘‘(iv) Generalized anxiety disorder. 
‘‘(v) Anxiety disorder (not otherwise 
specified). 
‘‘(vi) Depression (not otherwise speci-
fied). 
‘‘(vii) Acute stress disorder. 
‘‘(viii) Dysthymic disorder. 
‘‘(ix) Adjustment disorder. 
‘‘(x) Substance abuse. 
‘‘(xi) V codes (treatments not specifi-
cally related to psychiatric disorders, such 
as marital problems, parenting problems 
etc.), secondary to another identified 
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WTC-related health condition for WTC 
community members. 
‘‘(2) ADDITIONS TO IDENTIFIED WTC-RELATED 
HEALTH CONDITIONS FOR WTC COMMUNITY MEM-
BERS.—The provisions of paragraph (4) of section 
3012(a) shall apply with respect to an addition to 
the list of identified WTC-related conditions for eli-
gible WTC community members under paragraph 
(1) in the same manner as such provisions apply to 
an addition to the list of identified WTC-related con-
ditions for eligible WTC responders under section 
3012(a)(3). 
‘‘SEC. 3023. FOLLOWUP MONITORING AND TREATMENT OF 
OTHER INDIVIDUALS WITH WTC-RELATED 
HEALTH CONDITIONS. 
‘‘(a) IN GENERAL.—Subject to subsection (c), the 
provisions of section 3022 shall apply to the followup mon-
itoring and treatment of WTC-related health conditions 
for eligible WTC community members in the case of indi-
viduals described in subsection (b) in the same manner 
as such provisions apply to the followup monitoring and 
treatment of WTC-related health conditions for WTC 
community members. Under section 3006(a)(3), the City 
of New York is required to contribute a share of the costs 
of such monitoring and treatment. 
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‘‘(b) INDIVIDUALS DESCRIBED.—An individual de-
scribed in this subsection is an individual who, regardless 
of location of residence— 
‘‘(1) is not a eligible WTC responder or an eli-
gible WTC community member; and 
‘‘(2) is diagnosed at a Clinical Center of Excel-
lence (with respect to an eligible WTC community 
member) with an identified WTC-related health con-
dition for WTC community members. 
‘‘(c) LIMITATION.— 
‘‘(1) IN GENERAL.—The WTC Program Admin-
istrator shall limit benefits for any fiscal year under 
subsection (a) in a manner so that payments under 
this section for such fiscal year do not exceed the 
amount specified in paragraph (2) for such fiscal 
year. 
‘‘(2) LIMITATION.—The amount specified in 
this paragraph for— 
‘‘(A) fiscal year 2009 is $20,000,000; or 
‘‘(B) a succeeding fiscal year is the 
amount specified in this paragraph for the pre-
vious fiscal year increased by the annual per-
centage increase in the medical care component 
of the consumer price index for all urban con-
sumers. 
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‘‘PART 3—NATIONAL ARRANGEMENT FOR BENE-
FITS FOR ELIGIBLE INDIVIDUALS OUTSIDE 
NEW YORK 
‘‘SEC. 3031. NATIONAL ARRANGEMENT FOR BENEFITS FOR 
ELIGIBLE INDIVIDUALS OUTSIDE NEW YORK. 
‘‘(a) IN GENERAL.—In order to ensure reasonable ac-
cess to benefits under this subtitle for individuals who are 
eligible WTC responders or eligible WTC community 
members and who reside in any State, as defined in sec-
tion 2(f), outside the New York metropolitan area, the 
WTC Program Administrator shall establish a nationwide 
network of health care providers to provide monitoring 
and treatment benefits and initial health evaluations near 
such individuals’ areas of residence in such States. Noth-
ing in this subsection shall be construed as preventing 
such individuals from being provided such monitoring and 
treatment benefits or initial health evaluation through any 
Clinical Center of Excellence. 
‘‘(b) NETWORK REQUIREMENTS.—Any health care 
provider participating in the network under subsection (a) 
shall— 
‘‘(1) meet criteria for credentialing established 
by the Coordinating Centers of Excellence; 
‘‘(2) follow the monitoring, initial health evalua-
tion, and treatment protocols developed under sec-
tion 3006(a)(2)(B); 
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‘‘(3) collect and report data in accordance with 
section 3005; and 
‘‘(4) meet such fraud, quality assurance, and 
other requirements as the WTC Program Adminis-
trator establishes. 
‘‘Subtitle C—Research Into 
Conditions 
‘‘SEC. 3041. RESEARCH REGARDING CERTAIN HEALTH CON-
DITIONS RELATED TO SEPTEMBER 11 TER-
RORIST ATTACKS IN NEW YORK CITY. 
‘‘(a) IN GENERAL.—With respect to individuals, in-
cluding eligible WTC responders and eligible WTC com-
munity members, receiving monitoring or treatment under 
subtitle B, the WTC Program Administrator shall conduct 
or support— 
‘‘(1) research on physical and mental health 
conditions that may be related to the September 11, 
2001, terrorist attacks; 
‘‘(2) research on diagnosing WTC-related 
health conditions of such individuals, in the case of 
conditions for which there has been diagnostic un-
certainty; and 
‘‘(3) research on treating WTC-related health 
conditions of such individuals, in the case of condi-
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tions for which there has been treatment uncer-
tainty. 
The Administrator may provide such support through con-
tinuation and expansion of research that was initiated be-
fore the date of the enactment of this title and through 
the World Trade Center Health Registry (referred to in 
section 3051), through a Clinical Center of Excellence, or 
through a Coordinating Center of Excellence. 
‘‘(b) TYPES
OF RESEARCH.—The research under 
subsection (a)(1) shall include epidemiologic and other re-
search studies on WTC-related conditions or emerging 
conditions— 
‘‘(1) among WTC responders and community 
members under treatment; and 
‘‘(2) in sampled populations outside the New 
York City disaster area in Manhattan as far north 
as 14th Street and in Brooklyn, along with control 
populations, to identify potential for long-term ad-
verse health effects in less exposed populations. 
‘‘(c) CONSULTATION.—The WTC Program Adminis-
trator shall carry out this section in consultation with the 
WTC Health Program Steering Committees and the WTC 
Scientific/Technical Advisory Committee. 
‘‘(d) APPLICATION OF PRIVACY AND HUMAN SUB-
JECT PROTECTIONS.—The privacy and human subject 
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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. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $15,000,000 for each fiscal year, in 
addition to any other authorizations of appropriations that 
are available for such purpose. 
‘‘Subtitle D—Programs of the New 
York City Department of Health 
and Mental Hygiene 
‘‘SEC. 3051. WORLD TRADE CENTER HEALTH REGISTRY. 
‘‘(a) PROGRAM EXTENSION.—For the purpose of en-
suring on-going data collection for victims of the Sep-
tember 11, 2001, terrorist attacks on the World Trade 
Center, the WTC Program Administrator, shall extend 
and expand the arrangements in effect as of January 1, 
2008, with the New York City Department of Health and 
Mental Hygiene that provide for the World Trade Center 
Health Registry. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $7,000,000 for each fis-
cal year to carry out this section. 
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100 
‘‘SEC. 3052. MENTAL HEALTH SERVICES. 
‘‘(a) IN GENERAL.—The WTC Program Adminis-
trator may make grants to the New York City Department 
of Health and Mental Hygiene to provide mental health 
services to address mental health needs relating to the 
September 11, 2001, terrorist attacks on the World Trade 
Center. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated $8,500,000 for each fis-
cal year to carry out this section.’’. 
TITLE II—SEPTEMBER 11TH VIC-
TIM COMPENSATION FUND OF 
2001 
SEC. 201. DEFINITIONS. 
Section 402 of the Air Transportation Safety and 
System Stabilization Act (49 U.S.C. 40101 note) is 
amended— 
(1) in paragraph (6) by inserting ‘‘, or debris 
removal, including under the World Trade Center 
Health Program established under section 3001 of 
the Public Health Service Act,’’ after ‘‘September 
11, 2001’’; 
(2) by inserting after paragraph (6) the fol-
lowing new paragraphs and redesignating subse-
quent paragraphs accordingly: 
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101 
‘‘(7) CONTRACTOR AND SUBCONTRACTOR.—The 
term ‘contractor and subcontractor’ means any con-
tractor or subcontractor (at any tier of a subcon-
tracting relationship), including any general con-
tractor, construction manager, prime contractor, 
consultant, or any parent, subsidiary, associated or 
allied company, affiliated company, corporation, 
firm, organization, or joint venture thereof that par-
ticipated in debris removal at any 9/11 crash site. 
Such term shall not include any entity, including the 
Port Authority of New York and New Jersey, with 
a property interest in the World Trade Center, on 
September 11, 2001, whether fee simple, leasehold 
or easement, direct or indirect. 
‘‘(8) DEBRIS REMOVAL.—The term ‘debris re-
moval’ means rescue and recovery efforts, removal of 
debris, cleanup, remediation, and response during 
the immediate aftermath of the terrorist-related air-
craft crashes of September 11, 2001, with respect to 
a 9/11 crash site.’’; 
(3) by inserting after paragraph (10), as so re-
designated, the following new paragraph and redes-
ignating the subsequent paragraphs accordingly: 
‘‘(11) IMMEDIATE AFTERMATH.—The term ‘im-
mediate aftermath’ means any period beginning with 
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102 
the terrorist-related aircraft crashes of September 
11, 2001, and ending on August 30, 2002.’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(14) 9/11 CRASH SITE.—The term ‘9/11 crash 
site’ means— 
‘‘(A) the World Trade Center site, Pen-
tagon site, and Shanksville, Pennsylvania site; 
‘‘(B) the buildings or portions of buildings 
that were destroyed as a result of the terrorist- 
related aircraft crashes of September 11, 2001; 
‘‘(C) any area contiguous to a site of such 
crashes that the Special Master determines was 
sufficiently close to the site that there was a de-
monstrable risk of physical harm resulting from 
the impact of the aircraft or any subsequent 
fire, explosions, or building collapses (including 
the immediate area in which the impact oc-
curred, fire occurred, portions of buildings fell, 
or debris fell upon and injured individuals); and 
‘‘(D) any area related to, or along, routes 
of debris removal, such as barges and Fresh 
Kills.’’. 
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