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) in-
troduced the following bill; which was referred to the Committee on En-
ergy 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Remember 9/11 Health 
Act’’.
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Thousands of rescue workers who responded 
to the areas devastated by the terrorist attacks of 
September 11th and local residents continue to suf-
fer significant medical problems as a result of com-
promised air quality and other toxins at the attack 
sites. 
(2) To date, the Mount Sinai Center for Occu-
pational and Environmental Medicine in New York 
City has examined approximately 9,000 first re-
sponders and Ground Zero workers. Of those exam-
ined, more than 50 percent show physical or mental 
health problems that are directly related to their 
work at the World Trade Center and Fresh Kill 
sites. 
(3) It appears that no Federal program exists 
to support fully the medical treatment of those who 
responded to the September 11th aftermath and who 
continue to experience health problems as a result. 
(4) A significant portion of those who re-
sponded to the September 11th aftermath have no 
health insurance, lost their health insurance as a re-
sult of the attacks, or have inadequate health insur-
ance for the medical conditions they developed as a
result of recovery work at the World Trade Center 
site. 
(5) Rescue workers and volunteers seeking 
workers compensation apparently have had their ap-
plications denied, delayed for months, or redirected, 
instead of receiving assistance in a timely and sup-
portive manner. 
(6) Confusion still exists within the population 
of recovery workers and first responders about where 
to obtain compensation for income losses and med-
ical costs related to their service in the September 
11th recovery effort. 
(7) Residents of the City of New York need to 
be included in any health monitoring program to 
best protect their long-term health. 
(8) Federal aid allocated for the monitoring of 
rescue workers’ health may need to be increased to 
ensure the long-term study of health impacts of 9/ 
11. 
(9) Research on the health impacts of the dev-
astation caused by the September 11th terrorist at-
tacks has started, with initial findings of relation-
ships between the air quality from Ground Zero and 
a host of health impacts including, lower pregnancy 
rates, lower birth weights in babies born nine
months after the disaster, and higher rates of res-
piratory and lung disorders in workers and residents 
near Ground Zero. 
(10) Further research is needed to evaluate 
more comprehensively the health impacts of Sep-
tember 11 and research is needed regarding possible 
treatment for the illnesses and injuries of September 
11. 
(11) The Federal response to medical issues 
arising from September 11th response efforts need 
improvement to meet the needs of rescue workers 
and local residents still suffering health problems 
from the disaster. 
(12) A Federal agency or official needs to be 
designated to coordinate and monitor the overall 
Federal response to the health impacts of September 
11. 
SEC. 3. HEALTH CARE INSURANCE. 
Subtitle B of title VI of the Robert T. Stafford Dis-
aster Relief and Emergency Assistance Act is amended by 
adding at the end the following: 
‘‘SEC. 630. PROTECTIONS FOR CERTAIN INDIVIDUALS. 
‘‘(a) WORK INJURIES.—For the purposes of sub-
chapter I of chapter 81 of title 5, United States Code, 
relating to compensation to Federal employees for work
injuries, eligible recipients as defined in subsection (d) 
under this Act shall be deemed civil employees of the 
United States within the meaning of the term ‘employee’ 
as defined in section 8101 of title 5, United States Code, 
and the provisions of that subchapter shall apply. 
‘‘(b) PERSONAL PROPERTY.—For the purpose of 
claims relating to damage to, or loss of, personal property 
of an eligible recipient incident to service, an eligible re-
cipient under this Act shall be considered in the same 
manner as if such eligible recipient was a civil employee 
of the Government of the United States, except that an 
eligible recipient shall not be responsible for the payment 
of any health care expenses, including mental health cov-
erage, prescription drugs, or copayments for all health and 
mental health care expenses that result from exposure to 
the adverse conditions after the terrorist attack on Sep-
tember 11, 2001. 
‘‘(c) GENERAL RULE.—Except as otherwise provided 
in this section, an eligible recipient shall not be deemed 
a Federal employee and shall not be subject to the provi-
sions of law relating to Federal employment, including 
those relating to hours of work, rates of compensation, 
leave, unemployment compensation, and Federal employee 
benefits. 
‘‘(d) ELIGIBLE RECIPIENT DEFINED.—
‘‘(1) ELIGIBLE
RECIPIENT.—Except as pro-
vided in paragraph (2), for purposes of this section, 
the term ‘eligible recipient’ means— 
‘‘(A) emergency service personnel and res-
cue and recovery personnel who responded to 
the terrorist attacks that occurred on Sep-
tember 11, 2001, in New York City, in the 
State of New York, any time during the period 
of September 11, 2001, through August 31, 
2002; 
‘‘(B) any other worker or volunteer who re-
sponded to such attacks, including— 
‘‘(i) a police officer; 
‘‘(ii) a firefighter; 
‘‘(iii) an emergency medical techni-
cian; 
‘‘(iv) a transit worker; 
‘‘(v) any participating member of an 
urban search and rescue team; 
‘‘(vi) a Federal or State employee; 
‘‘(vii) any other relief or rescue work-
er or volunteer whom the Secretary deter-
mines to be appropriate; 
‘‘(viii) a person who assisted in the re-
covery of human remains; and
‘‘(ix) a person who assisted in the 
criminal investigation; 
‘‘(C) a worker who responded to such at-
tacks by assisting in the cleanup or restoration 
of critical infrastructure in and around New 
York City; 
‘‘(D) a person whose place of residence is 
in the declared disaster area; 
‘‘(E) a person who was employed in or at-
tended school, child care, or adult day care in 
a building located in the declared disaster area 
any time during the period of September 11, 
2001, through August 31, 2002; and 
‘‘(F) any other person whom the Secretary 
determines to be appropriate. 
‘‘(2) Notwithstanding the determination re-
quirements of paragraph (1), the immediate family 
members of an individual who is an eligible recipient 
under paragraph (1) may receive benefits under this 
section if the eligible recipient— 
‘‘(A) is or was on the date of the Sep-
tember 11th attacks the policy holder for such 
family; and 
‘‘(B) received family health insurance as of 
September 11, 2001.’’.
SEC. 4. HEALTH SCREENINGS, EXAMINATIONS, AND MONI-
TORING SERVICES. 
(a) IN GENERAL.—Part B of title III of the Public 
Health Service Act (42 U.S.C. 243 et seq.) is amended 
by inserting after section 317R the following section: 
‘‘SEC. 317S. CERTAIN HEALTH SERVICES FOR INDIVIDUALS 
ASSISTING WITH RESPONSE TO SEPTEMBER 
11 TERRORIST ATTACKS IN NEW YORK CITY. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Centers for Disease Control and Pre-
vention, shall make awards of grants or cooperative agree-
ments for the purpose of carrying out baseline and follow- 
up screening and clinical examinations, and long-term 
health monitoring and analysis, for covered individuals 
who meet the eligibility criteria under subsection (d). 
‘‘(b) COVERED INDIVIDUALS.—For purposes of this 
section, the term ‘covered individuals’ means— 
‘‘(1) emergency service personnel and rescue 
and recovery personnel who responded to the ter-
rorist attacks that occurred on September 11, 2001, 
in New York City, in the State of New York, any 
time during the period of September 11, 2001, 
through August 31, 2002; 
‘‘(2) any other worker or volunteer who re-
sponded to such attacks, including— 
‘‘(A) a police officer;
‘‘(B) a firefighter; 
‘‘(C) an emergency medical technician; 
‘‘(D) a transit worker; 
‘‘(E) any participating member of an 
urban search and rescue team; 
‘‘(F) Federal and State employees; 
‘‘(G) a person who worked to recover 
human remains; 
‘‘(H) a person who worked on the criminal 
investigation; and 
‘‘(I) any other relief or rescue worker or 
volunteer whom the Secretary determines to be 
appropriate; 
‘‘(3) a worker who responded to such attacks by 
assisting in the cleanup or restoration of critical in-
frastructure in and around the designated disaster 
area; 
‘‘(4) a person whose place of residence is in the 
declared disaster area; 
‘‘(5) a person who is employed in or attends 
school, child care, or adult day care in a building lo-
cated in the declared disaster area; and 
‘‘(6) any other person whom the Secretary de-
termines to be appropriate. 
‘‘(c) AWARD RECIPIENT.—
‘‘(1) IN GENERAL.—Subject to the submission 
of an application satisfactory to the Secretary, 
awards under subsection (a) shall be made only to— 
‘‘(A) the consortium of medical entities 
that, pursuant to the program referred to in 
subsection (g), provided health services de-
scribed in subsection (a) during fiscal year 
2003 for the personnel described in subsection 
(b)(1), subject to the consortium meeting the 
criteria established in paragraph (2); and 
‘‘(B) the separate program carried out by 
the New York City Fire Department. 
‘‘(2) CRITERIA.—For purposes of paragraph 
(1)(A), the criteria described in this paragraph for 
the consortium referred to in such paragraph are 
that the consortium has appropriate experience in 
the areas of environmental or occupational health, 
toxicology, and safety, including experience in— 
‘‘(A) developing clinical protocols and con-
ducting clinical health examinations, including 
mental health assessments; 
‘‘(B) conducting long-term health moni-
toring and epidemiological studies; 
‘‘(C) conducting long-term mental health 
studies; and
‘‘(D) establishing and maintaining medical 
surveillance programs and environmental expo-
sure or disease registries. 
‘‘(d) ELIGIBILITY OF COVERED INDIVIDUALS.—The 
Secretary shall determine eligibility criteria for covered in-
dividuals to receive health services under subsection (a). 
Such criteria shall include the requirement that a covered 
individual may not receive services through the program 
under such section unless the individual enrolls in the pro-
gram. 
‘‘(e) CERTAIN PROGRAM REQUIREMENTS.—With re-
spect to the program under subsection (a), the Secretary 
shall provide for the following: 
‘‘(1) Awards under subsection (a) shall des-
ignate an amount to be available only for covered in-
dividuals who— 
‘‘(A) are active or retired firefighters of 
New York City; and 
‘‘(B) in responding to the terrorist attacks 
of September 11, 2001, provided services in the 
immediate vicinity of the World Trade Center. 
‘‘(2) A covered individual enrolled in the pro-
gram may not receive services under the program for 
a period exceeding 20 years after the date on which 
the individual first receive services under the pro-
gram, except that the Secretary may designate a 
longer period if the Secretary determines that a 
longer period is appropriate with respect to the 
health of covered individuals. 
‘‘(3) The program may not establish a max-
imum enrollment number of fewer than 40,000 cov-
ered individuals. 
‘‘(f) AUTHORITY
REGARDING
TREATMENT.—The 
Secretary may, to the extent determined appropriate by 
the Secretary, authorize the program under subsection (a) 
to provide treatment services to covered individuals who 
have no other means of obtaining treatment. 
‘‘(g) RELATION TO CERTAIN PROGRAM.—Effective 
on and after the date of the enactment of the Remember 
9/11 Health Act, the two programs carried out pursuant 
to the appropriation of $90,000,000 made in Public Law 
107–206 under the heading ‘Public Health and Social 
Services Emergency Fund’, which programs provide 
health services described in subsection (a) for the per-
sonnel described in subsection (b)(1), shall be considered 
to be carried out under authority of this section and shall 
be subject to the requirements of this section, except for 
any period of transition determined appropriate by the 
Secretary, not to exceed one year after such date of enact-
ment.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of awards under subsection (a), there are author-
ized to be appropriated such sums as may be necessary 
for each of the fiscal years 2004 through 2023, in addition 
to any other authorizations of appropriations that are 
available for such purpose.’’. 
(b) PROGRAMS
REGARDING
ATTACK
AT
PEN-
TAGON.—The Secretary of Health and Human Services 
may, to the extent determined appropriate by the Sec-
retary, establish with respect to the terrorist attack at the 
Pentagon on September 11, 2001, programs similar to the 
programs that are established in sections 317S and 409J 
of the Public Health Service Act with respect to the ter-
rorist attacks on such date in New York City, in the State 
of New York. 
SEC. 5. RESEARCH REGARDING CERTAIN HEALTH CONDI-
TIONS. 
Part B of title IV of the Public Health Service Act 
(42 U.S.C. 284 et seq.) is amended by inserting after sec-
tion 409I the following section:
‘‘SEC. 409J. RESEARCH REGARDING CERTAIN HEALTH CON-
DITIONS OF INDIVIDUALS ASSISTING WITH 
RESPONSE TO SEPTEMBER 11 TERRORIST AT-
TACKS IN NEW YORK CITY. 
‘‘(a) IN GENERAL.—With respect to covered individ-
uals as defined in section 317S, the Director of NIH shall 
conduct or support— 
‘‘(1) diagnostic research on qualifying health 
conditions of such individuals, in the case of condi-
tions for which there has been diagnostic uncer-
tainty; and 
‘‘(2) research on treating qualifying health con-
ditions of such individuals, in the case of conditions 
for which there has been treatment uncertainty. 
‘‘(b) QUALIFYING HEALTH CONDITIONS.—For pur-
poses of this section, the term ‘qualifying health condi-
tions’ means adverse health conditions that are considered 
by the Secretary to be associated with exposure to one or 
more of the sites of the terrorist attacks that occurred on 
September 11, 2001, in New York City, in the State of 
New York. 
‘‘(c) CONSULTATION WITH CERTAIN MEDICAL CON-
SORTIUM.—The Secretary shall carry out this section in 
consultation with— 
‘‘(1) the consortium of medicine entities re-
ferred to in section 317S(c)(1); and
‘‘(2) the firefighters department of New York 
City, and the union for the firefighters of such de-
partment. 
‘‘(d) ANNUAL REPORT.—The Director of NIH shall 
annually submit to the Congress a report describing the 
findings of research under subsection (a). 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated such sums as may be necessary for 
each of the fiscal years 2005 through 2008, in addition 
to any other authorizations of appropriations that are 
available for such purpose.’’. 
SEC. 6. 9/11 HEALTH EMERGENCY COORDINATING COUN-
CIL. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services shall convene a council, to be known as 
‘‘9/11 Health Emergency Coordinating Council’’ (in this 
section referred to as the ‘‘Council’’), for the following 
purposes: 
(1) Discussing, examining, and formulating rec-
ommendations with respect to the adequacy and co-
ordination of the following: 
(A) Response by the Federal Government, 
State governments, local governments, and the
private sector to the terrorist attacks of Sep-
tember 11, 2001. 
(B) Care and compensation for the victims 
of such attacks. 
(C) Federal tracking of the monitoring of, 
and possible treatment for, individuals who are 
directly suffering from, or may have long-term 
health effects from, such attacks. 
(D) Coordination among the members of 
the Council in responding to the terrorist at-
tacks of September 11, 2001. 
(2) In accordance with subsection (c), rendering 
advisory opinions on the scope of any obligation of 
the Federal Government resulting from the terrorist 
attacks of September 11, 2001, relative to any obli-
gation of an insurance company resulting from such 
attacks. 
(b) MEMBERSHIP.— 
(1) CHAIRPERSON.—The Secretary of Health 
and Human Services (or the Secretary’s designee) 
shall serve as the chairperson of the Council. 
(2) REQUIRED MEMBERS.—The members of the 
Council shall include the following: 
(A) The Secretary of Defense (or the Sec-
retary’s designee).
(B) The Secretary of Labor (or the Sec-
retary’s designee). 
(C) The Director of the Federal Emer-
gency Management Agency (or the Director’s 
designee). 
(D) The Director of the National Insti-
tutes of Health (or the Director’s designee). 
(E) The Director of the National Institute 
for Occupational Safety and Health (or the Di-
rector’s designee). 
(F) A representative of the Crime Victims 
Fund established under section 1402 of the Vic-
tims of Crime Act of 1984 (42 U.S.C. 10601). 
(3) INVITEES.—The Secretary of Health and 
Human Services shall invite the following individuals 
to serve as members of the Council: 
(A) The Governor of the State of New 
York (or the Governor’s designee). 
(B) The Mayor of New York City (or the 
Mayor’s designee). 
(C) 1 representative of the New York City 
Fire Department. 
(D) 2 representatives of the unions of New 
York City Fire Department employees.
(E) 1 representative of the New York City 
Police Department. 
(F) 2 representatives of the unions of New 
York City Police Department employees. 
(G) 1 representative of the police depart-
ment of the Port Authority of New York and 
New Jersey. 
(H) 2 representatives of the union of the 
police department of the Port Authority of New 
York and New Jersey. 
(I) 1 representative of the New York State 
Department of Health. 
(J) 1 representative of the New York State 
Workers’ Compensation Board. 
(K) 1 representative of the New York City 
Department of Health. 
(L) 1 representative of the New York City 
Office of Emergency Management. 
(M) 1 representative of the Association of 
Occupational and Environmental Clinics. 
(N) 1 representative of the New York 
Committee for Occupational Safety and Health 
(NYCOSH). 
(O) 1 representative of charitable organiza-
tions that had volunteers at Ground Zero.
(P) 10 representatives of labor unions in 
New York City that— 
(i) are not otherwise listed in this 
paragraph; and 
(ii) reflect a cross section of labor 
unions (including construction, municipal, 
and other labor unions) whose members re-
sponded to, or assisted with the cleanup 
resulting from, the attacks of September 
11, 2001. 
(Q) 5 representatives of nonprofit volun-
teer entities that assisted in recovery efforts fol-
lowing the terrorist attacks of September 11, 
2001. 
(R) 5 representatives of a regional occupa-
tional provider that— 
(i) works with the World Trade Cen-
ter Worker and Volunteer Medical Screen-
ing Program; and 
(ii) is under the direction of the 
Mount Sinai Center for Occupational and 
Environmental Medicine. 
(c) ADVISORY OPINIONS.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the Council may render an advisory opinion on the
scope of any obligation of the Federal Government 
resulting from the terrorist attacks of September 11, 
2001, relative to any obligation of an insurance com-
pany resulting from such attacks. 
(2) LIMITATION.—The Council may issue an 
advisory opinion described in this subsection only at 
the request of a party to one of the obligations in-
volved. 
(d) MEETINGS.—The Council shall meet not less than 
4 times each calendar year. 
(e) REPORTS.—Not less than once each calendar 
year, the Council shall submit to the Congress a report 
on the recommendations of the Council. 
(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2005 through 2014. 
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