I 
118TH CONGRESS 
1ST SESSION H. R. 1294 
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 HOUSE OF REPRESENTATIVES 
MARCH 1, 2023 
Mr. GARBARINO (for himself, Mr. NADLER, Mr. D’ESPOSITO, Mr. GOLDMAN 
of New York, Mr. LALOTA, Mr. MEEKS, Ms. MENG, Ms. VELA´ZQUEZ, 
Ms. CLARKE of New York, Ms. MALLIOTAKIS, Mr. ESPAILLAT, Mr. 
TORRES of New York, Mr. LAWLER, Mr. RYAN, Mr. MOLINARO, Mr. 
TONKO, Ms. STEFANIK, Mr. WILLIAMS of New York, Mr. LANGWORTHY, 
Ms. TENNEY, Mr. MORELLE, Mr. HIGGINS of New York, Mr. PAYNE, Mr. 
LARSON of Connecticut, Ms. NORTON, Mrs. WATSON COLEMAN, Mr. 
GOTTHEIMER, Ms. SCHAKOWSKY, Mr. PASCRELL, Mr. CASTEN, and Ms. 
BARRAGA´N) introduced the following bill; which was referred to the Com-
mittee on Energy and Commerce 
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 Representa-
tives 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’’. 
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SEC. 2. DEPARTMENT OF DEFENSE, ARMED FORCES, OR 
OTHER FEDERAL WORKER RESPONDERS TO 
THE SEPTEMBER 11 ATTACKS AT THE PEN-
TAGON 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 agen-
cy, office, or other establishment in the executive, 
legislative, or judicial branch of the Federal Govern-
ment.’’; 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)— 
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agency, worked during the period begin-
ning 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 reg-
ular or reserve component of the uni-
formed services; and performed rescue, re-
covery, demolition, debris cleanup, or other 
related services at the Shanksville, Penn-
sylvania, site of the terrorist-related air-
craft 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 deter-
mined by the WTC Program Adminis-
trator; 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 
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(iii) by adding at the end the fol-
lowing: 
‘‘(ii) CERTAIN RESPONDERS TO THE 
SEPTEMBER
ATTACKS
AT
THE
PEN-
TAGON
AND
SHANKSVILLE, 
PENNSYL-
VANIA.—The total number of individuals 
who may be enrolled under paragraph 
(3)(A)(ii) based on eligibility criteria de-
scribed in subclause (III) or (IV) of para-
graph (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 amend-
ed— 
(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 nation-
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wide network under section 3313), such evalua-
tion 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 subpara-
graph (B). 
‘‘(B) CATEGORIES OF LICENSED HEALTH 
CARE
PROVIDERS.—Not later than 180 days 
after the date of enactment of the 9/11 Re-
sponder and Survivor Health Funding Correc-
tion Act of 2023, the WTC Program Adminis-
trator shall issue regulations for the categories 
of licensed health care providers who, in addi-
tion to licensed physicians, may conduct evalua-
tions under subparagraph (A) and make deter-
minations under section 3312(b).’’. 
(b) FLEXIBILITY FOR WTC RESPONDERS.—Section 
3312(b) of such Act (42 U.S.C. 300mm–22(b)) is amend-
ed— 
(1) in paragraph (1), by striking ‘‘physician’’ 
each place it appears and inserting ‘‘physician or 
other licensed health care provider in a category de-
termined by the WTC Program Administrator under 
section 3305(a)(6)(B)’’; 
(2) in paragraph (2)— 
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(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 sec-
tion 3305(a)(6)(B)’’; 
(ii) in clause (i), by striking ‘‘physi-
cian’’ and inserting ‘‘physician or other li-
censed 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 cat-
egories determined by the WTC Program 
Administrator 
under 
section 
3305(a)(6)(B)’’; and 
(ii) in clause (i), by striking ‘‘physi-
cian panel’’ and inserting ‘‘panel of physi-
cians or other licensed health care pro-
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viders in categories determined by the 
WTC Program Administrator under sec-
tion 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 de-
termined by the WTC Program Administrator under 
section 3305(a)(6)(B)’’. 
SEC. 4. CRITERIA FOR CREDENTIALING HEALTH CARE 
PROVIDERS PARTICIPATING IN THE NATION-
WIDE 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), respec-
tively; and 
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(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 indi-
vidual known to the WTC Program Administrator to 
be deceased shall not be included in any count of en-
rollees 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 indi-
vidual 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 
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(2) in subparagraph (C), in the second sen-
tence, 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 in-
serting ‘‘and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(xii) for each of fiscal years 2034 
through 2090— 
‘‘(I) 
the 
amount 
determined 
under this subparagraph for the pre-
vious fiscal year (plus the sum of any 
amount expended in the previous fis-
cal year from the World Trade Center 
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Health Program Special Fund estab-
lished under section 3353 or the 
World Trade Center Health Program 
Fund for Certain WTC Responders at 
the Pentagon and Shanksville, Penn-
sylvania established under section 
3354 and any amount expended from 
the World Trade Center Health Pro-
gram Fund established under this sec-
tion in the previous fiscal year that 
was carried over from any fiscal year 
prior to the previous fiscal year in-
cluding as carried over pursuant to a 
deposit into such Fund under para-
graph (6)) multiplied by 1.05; multi-
plied by 
‘‘(II) the ratio of— 
‘‘(aa) the total number of 
individuals enrolled in the WTC 
Program on July 1 of such pre-
vious 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 
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(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 de-
termined for such fiscal year under this para-
graph 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: 
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‘‘(A) for fiscal year 2023, the amount de-
termined for such fiscal year under this para-
graph 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 ef-
fect on the day before the date of enact-
ment 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 
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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, with-
out 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 re-
main 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 
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deposited into the Pentagon/Shanksville Fund under sub-
section (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 sec-
tion 3351(c), to the WTC Program Administrator 
for the purpose of carrying out section 3312 with re-
gard to WTC responders enrolled in the WTC Pro-
gram based on eligibility criteria described in sub-
clause (III) or (IV) of section 3311(a)(2)(C)(i). 
‘‘(2) LIMITATION ON OTHER FUNDING.—Not-
withstanding 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 para-
graph (1). 
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‘‘(d) REMAINING AMOUNTS.—Any amounts that re-
main 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 sec-
tion 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 Sup-
plemental 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 Pro-
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gram Special Fund under section 3353’’ 
after ‘‘section 3351’’; 
(ii) in paragraph (1)(B), by inserting 
‘‘or the World Trade Center Health Pro-
gram Fund for Certain WTC Responders 
at the Pentagon and Shanksville, Pennsyl-
vania 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 Pro-
gram Fund for Certain WTC Responders 
at the Pentagon and Shanksville, Pennsyl-
vania 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 ‘‘sub-
section (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, 
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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. 
Æ 
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