‘‘PART 3—NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE 
INDIVIDUALS OUTSIDE NEW YORK 
‘‘Sec. 3031. National arrangement for benefits for eligible individuals out-
side New York. 
‘‘Subtitle C—Research Into Conditions 
‘‘Sec. 3041. Research regarding certain health conditions related to Sep-
tember 11 terrorist attacks in New York City. 
‘‘Subtitle D—Programs of the New York City Department of Health and 
Mental Hygiene 
‘‘Sec. 3051. World Trade Center Health Registry. 
‘‘Sec. 3052. Mental health services. 
TITLE II—SEPTEMBER 11 VICTIM COMPENSATION FUND OF 2001 
Sec. 201. Deadline extension for certain claims under September 11 Victim 
Compensation Fund of 2001. 
Sec. 202. Exception to single claim requirement in certain circumstances. 
Sec. 203. Eligibility of claimants suffering from psychological harm. 
Sec. 204. Immediate aftermath defined. 
Sec. 205. Eligible individuals to include eligible WTC responders and eligible 
WTC residents and other non-responders. 
SEC. 2. FINDINGS. 
Congress finds the following: 
(1) Thousands of rescue workers who responded 
to the areas devastated by the terrorist attacks of 
September 11, local residents, office and area work-
ers, and school children continue to suffer significant 
medical problems as a result of compromised air 
quality and the release of other toxins from the at-
tack sites. 
(2) In a September 2006 peer-reviewed study 
conducted by the World Trade Center Medical Moni-
toring Program, of 9,500 World Trade Center re-
sponders, almost 70 percent of World Trade Center 
responders had a new or worsened respiratory symp-
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tom that developed during or after their time work-
ing at the World Trade Center; among the respond-
ers who were asymptomatic before 9/11, 61 percent 
developed respiratory symptoms while working at the 
World Trade Center; close to 60 percent still had a 
new or worsened respiratory symptom at the time of 
their examination; one-third had abnormal pul-
monary function tests; and severe respiratory condi-
tions including pneumonia were significantly more 
common in the 6 months after 9/11 than in the 
prior 6 months. 
(3) An April 2006 study documented that, on 
average, a New York City firefighter who responded 
to the World Trade Center has experienced a loss of 
12 years of lung capacity. 
(4) A peer-reviewed study of residents who lived 
near the World Trade Center titled ‘‘The World 
Trade Center Residents’ Respiratory Health Study: 
New Onset Respiratory Symptoms and Pulmonary 
Function’’, found that data demonstrated a three 
fold increase in new-onset, persistent lower res-
piratory symptoms in residents near the former 
World Trade Center as compared to a control popu-
lation. 
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(5) Previous research on the health impacts of 
the devastation caused by the September 11 terrorist 
attacks has shown relationships between the air 
quality from Ground Zero and a host of health im-
pacts, including lower pregnancy rates, higher rates 
of respiratory and lung disorders, and a variety of 
post-disaster mental health conditions (including 
posttraumatic stress disorder) in workers and resi-
dents near Ground Zero. 
(6) Launched in December 2001 by researchers 
at Columbia University’s Center for Children’s Envi-
ronmental Health, the World Trade Center Preg-
nancy Study is ongoing. Thus far, the results of the 
study show that babies born to women living within 
2 miles of the World Trade Center in the month fol-
lowing 9/11 were significantly smaller and lighter 
than babies born to women who lived farther away, 
and that in utero exposure to WTC-derived 
Polycyclic Aromatic Hydrocarbons may have in-
creased the carcinogenic risk to cohort children and 
contributed to a modest reduction in their cognitive 
development. 
(7) Federal funding allocated for the moni-
toring of rescue workers’ health is not sufficient to 
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ensure the long-term study of health impacts of Sep-
tember 11. 
(8) The Federal funding allocated for medical 
monitoring does not provide for the medical moni-
toring of New York City area residents, office and 
area workers, schoolchildren, or Federal employees 
who responded to the terrorist attacks of September 
11, 2001. 
(9) A significant portion of those who re-
sponded to the September 11 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. 
(10) The Federal program to provide medical 
treatments to those who responded to the September 
11 aftermath, and who continue to experience health 
problems as a result, was finally established more 
than five years after the attacks, but is not ade-
quately funded and is projected to exhaust all Fed-
eral funding before the end of fiscal year 2007. 
(11) Rescue workers and volunteers seeking 
workers compensation have reported that their appli-
cations have been denied, delayed for months, or re-
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directed, instead of receiving assistance in a timely 
and supportive manner. 
(12) A February 2007 report released by the 
City of New York estimated that approximately 
410,000 people were the most heavily exposed to the 
environmental hazards and trauma of the September 
11 terrorist attacks. More than 30 percent of the 
Fire Department of the City of New York first re-
sponders were still experiencing some respiratory 
symptoms more than five years after the attacks and 
according to the report, 59 percent of those seen by 
the WTC Environmental Health Center at Bellevue 
Hospital (which serves non-responders) are without 
insurance and 65 percent have incomes less than 
$15,000 per year. The report also found a need to 
continue and expand mental health services. 
(13) Since the 5th anniversary of the attack 
(September 11, 2006), about 500 workers a month 
have been signing up with the monitoring and treat-
ment programs, more than at any time since early 
2004. 
(14) According to press reports, documents pre-
pared by the National Institute for Occupational 
Safety and Health reveal that the number of recov-
ery workers getting sick is increasing, and their ill-
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‘‘TITLE XXX—WORLD TRADE 
CENTER HEALTH PROGRAM 
‘‘Subtitle A—Establishment of Pro-
gram; Steering and Advisory 
Committees 
‘‘SEC. 3001. ESTABLISHMENT OF WORLD TRADE CENTER 
HEALTH PROGRAM WITHIN NIOSH. 
‘‘(a) IN GENERAL.—There is hereby established with-
in the National Institute for Occupational Safety and 
Health a program to be known as the ‘World Trade Center 
Health Program’ (in this title referred to as the ‘WTC 
program’) to provide medical monitoring and treatment 
benefits— 
‘‘(1) to eligible emergency responders and re-
covery and clean-up workers (including those who 
are Federal employees) who responded to the 9/11 
NYC terrorist attacks; and 
‘‘(2) to residents and other building occupants 
and area workers in New York City who were di-
rectly impacted and adversely affected by such at-
tacks. 
‘‘(b) COMPONENTS OF PROGRAM.—The WTC pro-
gram includes the following components: 
‘‘(1) MEDICAL
MONITORING.—Medical moni-
toring under sections 3011 and 3021, including 
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screening, clinical examinations, and long-term 
health monitoring and analysis for individuals who 
were likely to have been exposed to airborne toxins 
that were released as a result of the 9/11 NYC ter-
rorist attacks. 
‘‘(2) TREATMENT
FOR
WTC-RELATED
CONDI-
TIONS.—Provision under sections 3012 and 3022 of 
treatment and payment, without any cost-sharing, 
for all medically necessary health and mental health 
care expenses (including necessary prescription 
drugs) of individuals with a WTC-related health con-
dition. 
‘‘(3) OUTREACH.—Establishment under section 
3004 of an outreach program to potentially eligible 
individuals concerning the benefits under this title. 
‘‘(4) UNIFORM DATA COLLECTION.—Collection 
under section 3005 of health and mental health data 
on individuals receiving monitoring or treatment 
benefits, using a uniform system of data collection. 
‘‘(5) RESEARCH ON WTC CONDITIONS.—Estab-
lishment under subtitle C of a research program on 
health conditions resulting from the 9/11 NYC ter-
rorist attacks. 
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‘‘(c) NO COST-SHARING.—Monitoring and treatment 
benefits are provided under subtitle B without any 
deductibles, co-payments, or other cost-sharing. 
‘‘(d) PRIMARY PAYER.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
monitoring and treatment benefits are provided 
under subtitle B without regard to whether an indi-
vidual may have coverage for some or all of such 
benefits through health insurance or otherwise. 
‘‘(2) WORKERS’ COMPENSATION EXCEPTION.— 
Payment for treatment under subtitle B of a WTC- 
related health condition of an individual shall be re-
duced or recouped to the extent that payment is 
made under a workers’ compensation law or plan of 
the United States or a State for such treatment. 
‘‘(e) WTC PROGRAM ADMINISTRATION.—The WTC 
program shall be administered by the Director of the Na-
tional Institute for Occupational Safety and Health, or a 
designee of such Director. 
‘‘SEC. 3002. WTC HEALTH PROGRAM STEERING COMMITTEE. 
‘‘(a) ESTABLISHMENT.—The WTC program adminis-
trator shall establish an advisory committee to be known 
as the WTC Health Program Steering Committee (in this 
section referred to as the ‘Steering Committee’) for the 
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purpose of providing the administrator with advice and 
oversight on the WTC program. 
‘‘(b) MEMBERSHIP.— 
‘‘(1) 
INITIAL
MEMBERSHIP.—The 
Steering 
Committee shall initially be composed of the fol-
lowing: 
‘‘(A) WTC MONITORING AND TREATMENT 
PROGRAM
STEERING
COMMITTEE.—The mem-
bers of the WTC Monitoring and Treatment 
Program Steering Committee (as in existence 
on the day before the date of the enactment of 
this title). 
‘‘(B) APPOINTMENTS
BY
INITIAL
MEM-
BERS.—The following members, appointed by 
the Steering Committee described under sub-
paragraph (A) and subject to the approval of 
the WTC program administrator: 
‘‘(i) One representative of the World 
Trade Center Environmental Health Cen-
ter at Bellevue Hospital. 
‘‘(ii) Two representatives of the resi-
dent and other non-responder population. 
‘‘(2) ADDITIONAL APPOINTMENTS.—The Steer-
ing Committee may appoint additional members to 
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the Committee, subject to the approval of the WTC 
program administrator. 
‘‘(3) VACANCIES.—A vacancy in the Steering 
Committee shall be filled by the Steering Committee, 
subject to the approval of the WTC program admin-
istrator, so long as the composition of the Com-
mittee includes representatives of affected workers 
and residents, representatives described in para-
graph (1)(B), representatives of the Clinical Centers 
of Excellence, and a representative of each Coordi-
nating Center of Excellence. 
‘‘(c) RELATION TO FACA.—The Steering Committee 
shall not be subject to the Federal Advisory Committee 
Act. 
‘‘(d) MEETINGS.—The Steering Committee shall 
meet at such frequency necessary to carry out its duties, 
but not less than 4 times each calendar year. 
‘‘(e) REPORTS.—Not less than once each calendar 
year, the Steering Committee shall submit to the Congress 
a report on the recommendations of the Committee. 
‘‘(f) DURATION.—Notwithstanding any other provi-
sion of law, the Steering Committee shall continue in oper-
ation during the period in which the WTC program is in 
operation. 
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‘‘(g) 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 fiscal year beginning with fiscal year 2008. 
‘‘SEC. 3003. WTC HEALTH PROGRAM SCIENTIFIC/TECH-
NICAL ADVISORY COMMITTEE. 
‘‘(a) ESTABLISHMENT.—The WTC program adminis-
trator shall establish an advisory committee to be known 
as the WTC Health Program Scientific/Technical Advisory 
Committee (in this section referred to as the ‘Advisory 
Committee’) to review scientific and medical evidence and 
to make recommendations to the administrator on addi-
tional WTC program eligibility criteria and on additional 
WTC-related health conditions. 
‘‘(b) COMPOSITION.—The WTC program adminis-
trator shall appoint the members of the Advisory Com-
mittee and shall include at least— 
‘‘(1) 4 occupational physicians, at least two of 
whom have experience treating WTC rescue and re-
covery workers; 
‘‘(2) 2 representatives of WTC responders; 
‘‘(3) 2 representatives of WTC residents and 
other non-responders; 
‘‘(4) an industrial hygienist; 
‘‘(5) a toxicologist; 
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‘‘(6) an epidemiologist; and 
‘‘(7) a mental health professional. 
‘‘(c) MEETINGS.—The Advisory Committee shall 
meet at such frequency as may be required to carry out 
its duties. 
‘‘(d) REPORTS.—The WTC program administrator 
shall provide for publication of recommendations of the 
Advisory Committee on the public website established for 
the WTC program. 
‘‘(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 fiscal year beginning with fiscal year 2008. 
‘‘(f) DURATION.—Notwithstanding any other provi-
sion of law, the Advisory Committee shall continue in op-
eration during the period in which the WTC program is 
in operation. 
‘‘(g) APPLICATION OF FACA.—Except as otherwise 
specifically provided, the Advisory Committee shall be sub-
ject to the Federal Advisory Committee Act. 
‘‘SEC. 3004. COMMUNITY EDUCATION AND OUTREACH. 
‘‘(a) IN GENERAL.—The WTC program adminis-
trator shall institute a program that provides education 
and outreach on the existence and availability of services 
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under the WTC program. The outreach and education 
program— 
‘‘(1) shall include the establishment of a public 
website with information about the WTC program; 
and 
‘‘(2) shall be conducted in a manner intended— 
‘‘(A) to reach all affected populations; and 
‘‘(B) to include materials for culturally and 
linguistically diverse populations. 
‘‘(b) PARTNERSHIPS.—To the greatest extent pos-
sible, in carrying out this section, the WTC program ad-
ministrator shall enter into partnerships with local govern-
ments and organizations with experience performing out-
reach to the affected populations, including community 
and labor-based organizations. 
‘‘SEC. 3005. UNIFORM DATA COLLECTION. 
‘‘(a) IN GENERAL.—The WTC program adminis-
trator shall provide for the uniform collection of data (and 
analysis of data and regular reports to the administrator) 
on the utilization of monitoring and treatment benefits 
provided to eligible WTC responders and eligible WTC 
residents and other non-responders, the prevalence of 
WTC-related health conditions, and the identification of 
new WTC-related medical conditions. Such data shall be 
collected for all individuals provided monitoring or treat-
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ment benefits under subtitle B and regardless of their 
place of residence or Clinical Center of Excellence through 
which the benefits are provided. 
‘‘(b) COORDINATING THROUGH CENTERS OF EXCEL-
LENCE.—Each Clinical Center of Excellence shall, under 
section 3006(d)(3), collect data described in subsection (a) 
and report such data to the corresponding Coordinating 
Center of Excellence for analysis by such Coordinating 
Center of Excellence under section 3006(a)(2)(A). 
‘‘(c) PRIVACY.—The data collection and analysis 
under this section shall be conducted in a manner that 
protects the confidentiality of individually identifiable 
health information consistent with applicable legal require-
ments. 
‘‘SEC. 3006. CENTERS OF EXCELLENCE. 
‘‘(a) IN GENERAL.—The WTC program adminis-
trator shall enter into contracts— 
‘‘(1) with Clinical Centers of Excellence speci-
fied in subsection (b)(1)— 
‘‘(A) for the provision of monitoring and 
treatment benefits under subtitle B; 
‘‘(B) for the provision of outreach activities 
to individuals eligible for such monitoring and 
treatment benefits; 
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‘‘(C) for the provision of counseling for 
benefits under subtitle B, with respect to WTC- 
related health conditions, for individuals eligible 
for such benefits; and 
‘‘(D) for the credentialing of other medical 
providers participating in the national network; 
and 
‘‘(2) with Coordinating Centers of Excellence 
specified in subsection (b)(2)— 
‘‘(A) for receiving, analyzing, and report-
ing to the WTC program administrator on data, 
in accordance with section 3005, that has been 
collected and reported to such Coordinating 
Centers by the corresponding Clinical Centers 
of Excellence under subsection (d)(3); 
‘‘(B) for the development of medical moni-
toring and treatment protocols, with respect to 
WTC-related health conditions; and 
‘‘(C) for coordinating the outreach activi-
ties conducted under paragraph (1)(B) by each 
corresponding Clinical Center of Excellence. 
‘‘(b) CENTERS OF EXCELLENCE DEFINED.— 
‘‘(1) CLINICAL CENTER OF EXCELLENCE.—In 
this title, the term ‘Clinical Center of Excellence’ 
means the following: 
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‘‘(A) FOR
FDNY
RESPONDERS
IN
NEW 
YORK.—With respect to an eligible WTC re-
sponder who responded to the 9/11 attacks as 
an employee of the Fire Department of the City 
of New York and who resides in the New York 
Metropolitan area, such Fire Department (or 
such entity as has entered into a contract with 
the Fire Department for monitoring or treat-
ment of such responders). 
‘‘(B) OTHER
WTC
RESPONDERS
IN
NEW 
YORK.—With respect to other eligible WTC re-
sponders who reside in the New York Metro-
politan area, the Mt. Sinai coordinated consor-
tium, Queens College, State University of New 
York at Stony Brook, University of Medicine 
and Dentistry of New Jersey, and Bellevue 
Hospital. 
‘‘(C) WTC RESIDENTS AND OTHER NON- 
RESPONDERS IN NEW YORK.—With respect to 
eligible WTC residents and other non-respond-
ers who reside in the New York Metropolitan 
area, the World Trade Center Environmental 
Health Center at Bellevue Hospital and such 
hospitals or other facilities, including but not 
limited to those within the New York City 
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Health and Hospitals Corporation, as are iden-
tified by the WTC program administrator. 
‘‘(D) ALL WTC RESPONDERS AND NON-RE-
SPONDERS.—With respect to all eligible WTC 
responders and non-responders, such other hos-
pitals or other facilities as are identified by the 
WTC program administrator. 
‘‘(2) 
COORDINATING
CENTER
OF
EXCEL-
LENCE.—In this title, the term ‘Coordinating Center 
of Excellence’ means the following: 
‘‘(A) FOR FDNY RESPONDERS.—With re-
spect to an eligible WTC responder who re-
sponded to the 9/11 attacks as an employee of 
the Fire Department of the City of New York, 
such Fire Department. 
‘‘(B) OTHER WTC RESPONDERS.—With re-
spect to other eligible WTC responders, the Mt. 
Sinai coordinated consortium. 
‘‘(C) WTC RESIDENTS AND OTHER NON- 
RESPONDERS.—With respect to eligible WTC 
residents and other non-responders, the World 
Trade Center Environmental Health Center at 
Bellevue Hospital. 
‘‘(3) CORRESPONDING CENTERS.—In this title, 
a Clinical Center of Excellence and a Coordinating 
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reviewed research that has demonstrated potential 
exposure to such toxins at a distance of within 5 
miles from the former World Trade Center. 
‘‘(6) The term ‘New York metropolitan area’ 
means an area, specified by the WTC program ad-
ministrator, within which eligible WTC responders 
and eligible WTC residents and other non-respond-
ers who reside in such area are reasonably able to 
access monitoring and treatment benefits under this 
title through a Clinical Centers of Excellence de-
scribed in subparagraphs (A), (B), or (C) of section 
3006(b)(1). 
‘‘(7) The term ‘9/11 NYC terrorist attacks’ 
means the terrorist attacks that occurred on Sep-
tember 11, 2001, in New York City and includes the 
aftermath of such attacks. 
‘‘(8) The term ‘WTC Health Program Steering 
Committee’ means such Committee established 
under section 3002. 
‘‘(9) The term ‘WTC program administrator’ 
means the individual responsible under section 
3001(d) for the administration of the WTC pro-
gram. 
‘‘(10) The term ‘WTC-related health condition’ 
is defined in section 3012(a). 
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‘‘(11) The term ‘WTC Scientific/Technical Ad-
visory Committee’ means such Committee estab-
lished under section 3003. 
‘‘Subtitle B—Program of 
Monitoring and Treatment 
‘‘PART 1—FOR WTC RESPONDERS 
‘‘SEC. 3011. IDENTIFICATION OF ELIGIBLE WTC RESPOND-
ERS AND PROVISION OF WTC-RELATED MONI-
TORING SERVICES. 
‘‘(a) ELIGIBLE WTC RESPONDER DEFINED.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘eligible WTC responder’ means any of the 
following individuals: 
‘‘(A) 
CURRENTLY
IDENTIFIED
RE-
SPONDER.—An individual who has been identi-
fied as eligible for medical monitoring under the 
current consortium arrangements (as defined in 
section 3009(2)). 
‘‘(B) RESPONDER WHO MEETS CURRENT 
ELIGIBILITY
CRITERIA.—An individual who 
meets the current eligibility criteria described in 
paragraph (2). 
‘‘(C) RESPONDER WHO MEETS MODIFIED 
ELIGIBILITY CRITERIA.—An individual who— 
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‘‘(i) performed rescue, recovery, demo-
lition, debris cleanup, or other related serv-
ices in the New York City disaster area in 
response to the 9/11 NYC terrorist at-
tacks, regardless of whether such services 
were performed by a State or Federal em-
ployee or member of the National Guard or 
otherwise; and 
‘‘(ii) meets such eligibility criteria re-
lating to exposure to airborne toxins, other 
hazards, or adverse conditions resulting 
from the 9/11 NYC terrorist attacks as the 
WTC program administrator, after con-
sultation with the WTC Health Program 
Steering Committee and the WTC Sci-
entific/Technical Advisory Committee, de-
termines appropriate. 
‘‘(2) CURRENT
ELIGIBILITY
CRITERIA.—The 
eligibility criteria described in this paragraph for an 
individual is that the individual is described in either 
of the following categories: 
‘‘(A) FIRE FIGHTERS AND RELATED PER-
SONNEL.—All members of the Fire Department 
of the City of New York (whether fire or emer-
gency personnel, active or retired) who partici-
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pated at least one day in the rescue and recov-
ery effort at any of the former World Trade 
sites (including Ground Zero, Staten Island 
land fill, and the NYC Chief Medical Exam-
iner’s office) for any time during the period be-
ginning on September 11, 2001, and ending on 
July 31, 2002. 
‘‘(B) OTHER
WTC
RESCUE, RECOVERY, 
AND CLEAN-UP WORKERS.—The individual— 
‘‘(i) worked or volunteered on-site in 
rescue, recovery, debris-cleanup or related 
support services in lower Manhattan (south 
of Canal St.), the Staten Island Landfill, 
or the barge loading piers, for at least 4 
hours during the period beginning on Sep-
tember 11, 2001, and ending on Sep-
tember 14, 2001, for at least 24 hours 
during the period beginning on September 
11, 2001, and ending on September 30, 
2001, or for at least 80 hours during the 
period beginning on September 11, 2001, 
and ending on July 31, 2002; 
‘‘(ii) was an employee of the Office of 
the Chief Medical Examiner of the City of 
New York involved in the examination and 
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processing of human remains, or other 
morgue worker who performed similar 
post- September 11 functions for such Of-
fice staff; 
‘‘(iii) was a worker in the Port Au-
thority Trans-Hudson Corporation tunnel 
for at least 24 hours during the period be-
ginning on February 1, 2002, and ending 
on July 1, 2002; or 
‘‘(iv) was a vehicle-maintenance work-
er who was exposed to debris from the 
former World Trade Center while retriev-
ing, driving, cleaning, repairing, and main-
taining vehicles contaminated by airborne 
toxins from the 9/11 NYC terrorist attacks 
during a duration and period described in 
subparagraph (A). 
‘‘(3) 
APPLICATION
PROCESS.—The 
Coordi-
nating Centers of Excellence shall establish a proc-
ess for individuals, other than eligible WTC respond-
ers described in paragraph (1)(A), to apply to be de-
termined to be eligible WTC responders. 
‘‘(4) CERTIFICATION.— 
‘‘(A) IN GENERAL.—In the case of an indi-
vidual described in paragraph (1)(A) or who is 
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determined under paragraph (3) to be an eligi-
ble WTC responder, the WTC program admin-
istrator shall provide an appropriate certifi-
cation of such fact and of eligibility for moni-
toring and treatment benefits under this part. 
The administrator shall not deny such a certifi-
cation to an individual who is an eligible WTC 
responder. 
‘‘(B) TIMING.—In the case of an individual 
who is determined under paragraph (3) to be 
an eligible WTC responder, the WTC program 
administrator shall provide the certification 
under subparagraph (A) within 60 days of such 
determination. 
‘‘(b) MONITORING BENEFITS.— 
‘‘(1) IN GENERAL.—In the case of an eligible 
WTC responder, the WTC program shall provide for 
monitoring benefits that include medical monitoring 
consistent with protocols approved by the WTC pro-
gram administrator and including screening, clinical 
examinations, and long-term health monitoring and 
analysis. In the case of an eligible WTC responder 
who is an active member of the Fire Department of 
the City of New York, the responder shall receiving 
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such benefits as part of the individual’s periodic 
company medical exams. 
‘‘(2) PROVISION OF MONITORING BENEFITS.— 
The monitoring benefits under paragraph (1) shall 
be provided through the Clinical Center of Excel-
lence for the type of individual involved or, in the 
case of an individual residing outside the New York 
metropolitan area, under an arrangement under sec-
tion 3031. 
‘‘SEC. 3012. TREATMENT OF ELIGIBLE WTC RESPONDERS 
FOR WTC-RELATED HEALTH CONDITIONS. 
‘‘(a) WTC-RELATED
HEALTH
CONDITION
DE-
FINED.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘WTC-related health condition’ means— 
‘‘(A) an illness or health condition for 
which exposure to airborne toxins, any other 
hazard, or any other adverse condition resulting 
from the 9/11 NYC terrorist attacks is at least 
as likely as not to be a significant factor in ag-
gravating, contributing to, or causing the illness 
or health condition; 
‘‘(B) a mental health condition for which 
such attacks are at least as likely as not to be 
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a significant factor in aggravating, contributing 
to, or causing the condition; and 
‘‘(C) any presumed WTC-related health 
condition (as defined in paragraph (2)). 
‘‘(2) PRESUMED WTC-RELATED HEALTH CONDI-
TION.—For purposes of this title, the term ‘pre-
sumed WTC-related health condition’ means any of 
the following health conditions, and any condition 
specified under paragraph (3): 
‘‘(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. 
‘‘(x) Chronic laryngitis. 
‘‘(xi) Gastro-esophageal reflux dis-
order (GERD). 
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‘‘(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.) 
‘‘(C) MUSCULOSKELETAL DISORDERS.— 
‘‘(i) Low back pain. 
‘‘(ii) Carpal tunnel syndrome (CTS). 
‘‘(iii) Other musculoskeletal disorders. 
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‘‘(3) APPLICATION FOR ADDITIONAL PRESUMED 
WTC-RELATED HEALTH CONDITIONS.— 
‘‘(A) APPLICATION.—Any individual or or-
ganization can apply to the WTC program ad-
ministrator for an illness or health condition 
not described in paragraph (2) to be added to 
the list of presumed WTC-related conditions. 
‘‘(B) REVIEW.—The administrator shall 
establish a public process for receiving public 
input and comments on any application under 
subparagraph (A). 
‘‘(C) CONSIDERATIONS.—In making deter-
minations on such applications, the findings 
and recommendations of Clinical Centers of Ex-
cellence published in peer reviewed journals 
should be given deference in the determination 
of whether an additional illness or health condi-
tion, such as cancer, should be added to the list 
of presumed WTC-related health conditions. 
‘‘(D) CONSULTATION.—The WTC program 
administrator shall consult with the WTC 
Health Program Steering Committee and the 
WTC Scientific/Technical Advisory Committee 
in making a determination on whether an addi-
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tional health condition should be added to the 
list of presumed WTC-related conditions. 
‘‘(E) DETERMINATION.—The WTC pro-
gram administrator shall add an illness or 
health condition to the list of presumed WTC- 
related health conditions if, based on a review 
of the evidence and consultations conducted 
under subparagraphs (B), (C), and (D), the ad-
ministrator determines that exposure to air-
borne toxins, other hazards, or other adverse 
conditions resulting form the 9/11 NYC ter-
rorist attacks is at least as likely as not to be 
a significant factor in aggravating, contributing 
to, or causing the illness or health condition. 
‘‘(b) COVERAGE OF TREATMENT FOR WTC-RELATED 
HEALTH CONDITIONS.— 
‘‘(1) DETERMINATION
BASED
ON
PRESUMED 
WTC-RELATED HEALTH CONDITION.— 
‘‘(A) IN GENERAL.—If a physician at a 
Clinical Center of Excellence that is providing 
monitoring benefits under section 3011 for an 
eligible WTC responder determines that the re-
sponder has a presumed WTC-related health 
condition, and the physician makes a clinical 
determination that exposure to airborne toxins, 
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other hazards, or adverse conditions resulting 
from the 9/11 terrorist attacks is at least as 
likely as not to be a significant factor in aggra-
vating, contributing to, or causing the condi-
tion— 
‘‘(i) the physician shall promptly 
transmit such determination to the WTC 
program administrator and provide the ad-
ministrator with the medical facts sup-
porting such determination; and 
‘‘(ii) on and after the date of such 
transmittal and subject to paragraph (2), 
the WTC program shall provide for pay-
ment under subsection (c) of the costs of 
medically necessary treatment for such 
condition. 
‘‘(B) 
REVIEW; 
CERTIFICATION; 
AP-
PEALS.— 
‘‘(i) REVIEW.—A Federal employee 
designated by the WTC program adminis-
trator shall review determinations made 
under subparagraph (A)(i) of a WTC-re-
lated health condition. 
‘‘(ii) CERTIFICATION.—The adminis-
trator shall provide a certification of cov-
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trator, based on such recommendations 
shall determine whether or not the condi-
tion is a WTC-related health condition 
and, if it is, provide for a certification 
under paragraph (1)(B)(ii) of coverage of 
such condition. The administrator shall 
provide a process for the appeal of deter-
minations that the responder’s condition is 
not a WTC-related health condition. 
‘‘(3) REQUIREMENT OF MEDICAL NECESSITY.— 
The determination under paragraphs (1)(A)(ii) and 
(2)(A)(ii) of whether treatment is medically nec-
essary for a WTC-related health condition shall be 
made by physicians at the appropriate Clinical Cen-
ter of Excellence, taking into account, for presumed 
WTC-related health conditions, medical treatment 
protocols established under subsection (d). 
‘‘(4) SCOPE
OF
TREATMENT
COVERED.—The 
scope of treatment covered under such paragraphs 
includes physician services, diagnostic and laboratory 
tests, prescription drugs, inpatient and outpatient 
hospital services, and other medically necessary 
treatment. 
‘‘(5) CONTINUATION
OF
TREATMENT
WHILE 
BEING
ENROLLED
IN
MEDICAL
MONITORING
PRO-
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GRAM.—In the case of a WTC responder receiving 
medical treatment under the current consortium ar-
rangements but who has not been determined to be 
an eligible WTC responder or enrolled in the medical 
monitoring program under section 3011, while the 
individual is being enrolled in such program the 
treatment shall be considered to be treatment under 
this subsection for which payment may be made 
under subsection (c). 
‘‘(c) PAYMENT FOR COSTS OF TREATMENT OF WTC- 
RELATED HEALTH CONDITIONS.— 
‘‘(1) IN GENERAL.—The WTC program shall 
provide for payment of the costs of medically nec-
essary treatment of WTC-related health conditions 
of eligible WTC responders. The WTC program ad-
ministrator shall establish methods for determining 
the costs for such treatment. 
‘‘(2) ADMINISTRATIVE ARRANGEMENT AUTHOR-
ITY.—The WTC program administrator may enter 
into arrangements with other government agencies, 
insurance companies, or other third-party adminis-
trators to provide for timely and accurate processing 
of claims under this section. 
‘‘(d) MEDICAL TREATMENT PROTOCOLS.— 
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‘‘(1) DEVELOPMENT.—The Coordinating Cen-
ters of Excellence shall develop medical treatment 
protocols for the treatment of eligible WTC respond-
ers and eligible WTC residents and other non-re-
sponders for presumed WTC-related health condi-
tions under subsection (b). 
‘‘(2) APPROVAL.—The WTC program adminis-
trator shall approve the medical treatment protocols, 
in consultation with the WTC Health Program 
Steering Committee. 
‘‘PART 2—COMMUNITY PROGRAM 
‘‘SEC. 3021. IDENTIFICATION OF ELIGIBLE WTC RESIDENTS 
AND OTHER NON-RESPONDERS AND PROVI-
SION OF WTC-RELATED MONITORING SERV-
ICES. 
‘‘(a) ELIGIBLE WTC RESIDENT AND OTHER NON- 
RESPONDER DEFINED.— 
‘‘(1) IN GENERAL.—For purposes of this title, 
the term ‘eligible WTC resident and other non-re-
sponder’ means an individual who— 
‘‘(A) is a WTC non-responder (as defined 
in paragraph (2)); 
‘‘(B) is not an eligible WTC responder; 
and 
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‘‘(C) meets such eligibility criteria relating 
to exposure to airborne toxins, any other haz-
ard, or any other adverse condition resulting 
from the 9/11 NYC terrorist attacks as the 
WTC program administrator, after consultation 
with the WTC Health Program Steering Com-
mittee and the WTC Scientific/Technical Advi-
sory Committee, determines appropriate. 
‘‘(2) WTC RESIDENT
AND
OTHER
NON-RE-
SPONDER DEFINED.—In this title, the term ‘WTC 
resident and other non-responder’ means an indi-
vidual who is described in any of the following sub-
paragraphs: 
‘‘(A) A person whose place of residence at 
any time during the period beginning on Sep-
tember 11, 2001, and ending on July 31, 2002, 
was in the New York City disaster area. 
‘‘(B) A person who was working at any 
time during such period in the New York City 
disaster area. 
‘‘(C) A person who attended school, child 
care, or adult day care at any time during such 
period in a building located in the New York 
City disaster area. 
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‘‘(D) A person who was present in the New 
York City disaster area on September 11, 2001. 
‘‘(E) A person who was deemed eligible to 
receive a grant from the Lower Manhattan De-
velopment Corporation Residential Grant Pro-
gram, who possessed a lease for a residence or 
purchased a residence in the New York City 
disaster area, and who resided in such residence 
after September 11, 2001 and prior to May 31, 
2003. 
‘‘(F) A person whose place of employ-
ment— 
‘‘(i) at any time during the period be-
ginning on September 11, 2001, and end-
ing on May 31, 2003, was in the New 
York City disaster area; and 
‘‘(ii) was deemed eligible to receive a 
grant from the Lower Manhattan Develop-
ment Corporation WTC Small Firms At-
traction and Retention Act program or 
other government incentive program de-
signed to revitalize the Lower Manhattan 
economy after the 9/11 NYC terrorist at-
tacks. 
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‘‘(G) Any other person whom the WTC 
program administrator determines to be appro-
priate. 
‘‘(3) ELIGIBILITY
CRITERIA.—In establishing 
eligibility criteria under paragraph (1)(C), the WTC 
program administrator shall— 
‘‘(A) with respect to clause (i) of such 
paragraph, take into account the period, and, to 
the extent feasible, intensity, of exposure to air-
borne toxins, other hazard, or other adverse 
condition; 
‘‘(B) base such criteria on best available 
evidence of exposure and related adverse health 
effects; and 
‘‘(C) consult with the WTC Health Pro-
gram Steering Committee, Coordinating Cen-
ters 
of 
Excellence 
described 
in 
section 
3006(b)(1)(C), and affected populations. 
The administrator shall first establish such criteria 
not later than 90 days after the date of the enact-
ment of this title. 
‘‘(b) MONITORING BENEFITS.— 
‘‘(1) IN GENERAL.—In the case of an eligible 
WTC resident or other non-responder, the WTC pro-
gram shall provide for monitoring benefits that in-
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clude medical monitoring consistent with protocols 
approved by the WTC program administrator, in 
consultation with the World Trade Center Environ-
mental Health Center at Bellevue Hospital and the 
WTC Health Program Steering Committee, and in-
cluding screening, clinical examinations, and long- 
term health monitoring and analysis. 
‘‘(2) SOURCE OF BENEFITS.—The monitoring 
benefits under paragraph (1) shall be provided 
through a Clinical Center of Excellence with respect 
to the individual involved. 
‘‘SEC. 3022. TREATMENT OF ELIGIBLE WTC RESIDENTS AND 
OTHER 
NON-RESPONDERS 
FOR 
WTC-RE-
LATED HEALTH CONDITIONS. 
‘‘(a) IN GENERAL.—Subject to subsection (b), the 
provisions of section 3012 shall apply to the treatment of 
WTC-related health conditions for eligible WTC residents 
and other non-responders in the same manner as such pro-
visions apply to the treatment of WTC-related health con-
ditions for eligible WTC responders. 
‘‘(b) SUBSTITUTION OF LIST OF HEALTH CONDI-
TIONS FOR PRESUMED WTC-RELATED HEALTH CONDI-
TIONS.— 
‘‘(1) IN GENERAL.—In applying subsection (a), 
instead of applying the presumed WTC-related 
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health conditions described in section 3102(a)(2), 
the WTC program administrator shall establish, 
with input from the Coordinating Center of Excel-
lence described in section 3006(b)(2)(C), a list of 
WTC-related health conditions and associated expo-
sure criteria for which treatment benefits are pre-
sumptively available for eligible WTC residents and 
other non-responders, or subgroups of eligible WTC 
residents or other non-responders. In establishing 
such list, the WTC program administrator shall re-
view the presumed WTC-related health conditions 
listed in paragraph (2) of section 3012(a) to deter-
mine which of the conditions meets the criteria for 
a WTC-related health condition, as defined in para-
graph (1) of such section, for eligible WTC residents 
and other non-responders or sub-groups of eligible 
WTC residents or other non-responders. 
‘‘(2) CONSIDERATIONS.—The list of health con-
ditions and associated exposure criteria under para-
graph (1) shall, with respect to airborne toxins, 
other hazards, and other adverse conditions, be 
based upon the best available scientific and clinical 
evidence on adverse health effects related to expo-
sures to such toxins, hazards, or adverse conditions, 
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respectively, in the eligible WTC resident and other 
non-responder populations. 
‘‘(3) CONSULTATION.—The WTC program ad-
ministrator shall consult with and receive input from 
the WTC Health Program Steering Committee and 
affected populations, and shall provide an oppor-
tunity for public comment, in establishing the list 
under paragraph (1). 
‘‘(4) DEADLINE.—The WTC program adminis-
trator shall first establish and publish the list under 
paragraph (1) in the Federal Register not later than 
180 days after the date of the enactment of this 
title. 
‘‘(5) TREATMENT DURING INTERIM PERIOD.— 
Until the date on which WTC program adminis-
trator first publishes under paragraph (4) the list 
under paragraph (1) for eligible WTC residents and 
other non-responder populations, the Clinical Cen-
ters of Excellence described in section 3006(b)(1)(C) 
may provide medical treatment to such a resident or 
member of such a population, if a physician at the 
Clinical Center of Excellence involved determines 
that the resident or member, respectively, has a 
WTC-related health condition. Such treatment shall 
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be provided, without regard to the requirements of 
section 3012(b)(2). 
‘‘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 monitoring and treatment benefits under this sub-
title for individuals who reside in any State, as defined 
in section 2(f), outside the New York metropolitan area, 
the WTC program administrator shall establish a nation-
wide network of health care providers to provide such 
monitoring and treatment benefits near such individuals’ 
areas of residence in such States, or to establish a mecha-
nism whereby individuals who are entitled to benefits for 
such monitoring or treatment can be reimbursed for the 
cost of such monitoring or treatment. 
‘‘(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 and treatment proto-
cols developed under section 3006(a)(1); and 
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‘‘(3) collect and report data in accordance with 
section 3005. 
‘‘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 WTC responders and non-responders, receiving 
monitoring under subtitle B, the WTC program adminis-
trator shall conduct or support— 
‘‘(1) research on physical and mental health 
conditions that may be related to the September 11 
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-
tions for which there has been treatment uncer-
tainty. 
‘‘(b) CONSULTATION.—The WTC program adminis-
trator shall carry out this section in consultation with the 
WTC Health Program Steering Committee. 
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‘‘(c) APPLICATION OF PRIVACY AND HUMAN SUB-
JECT PROTECTIONS.—The privacy and human subject 
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. 
‘‘(d) ANNUAL REPORT.—The WTC program admin-
istrator shall annually submit to the Congress a report de-
scribing 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 fiscal years 2008 through 2026, 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 9/11 
NYC terrorist attacks, the WTC program administrator, 
shall extend and expand the arrangements in effect as of 
January 1, 2007, with the New York City Department of 
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‘‘(11) IMMEDIATE
AFTERMATH.—In section 
405(c)(2)(A)(i), the term ‘immediate aftermath’ 
means any period beginning with the terrorist-re-
lated aircraft crashes of September 11, 2001, and 
ending on July 31, 2002.’’. 
SEC. 205. ELIGIBLE INDIVIDUALS TO INCLUDE ELIGIBLE 
WTC RESPONDERS AND ELIGIBLE WTC RESI-
DENTS AND OTHER NON-RESPONDERS. 
Section 405(c)(2) of the Air Transportation Safety 
and System Stabilization Act (49 U.S.C. 40101 note) is 
amended— 
(1) in subparagraph (A)(i), by striking ‘‘at the 
World Trade Center, (New York, New York), the 
Pentagon (Arlington, Virginia), or’’ and inserting 
‘‘in the New York City disaster area, as defined in 
section 3009(5) of the Public Health Service Act, 
(including at the World Trade Center, (New York, 
New York)), at the Pentagon (Arlington, Virginia), 
or at’’; 
(2) in subparagraph (B), at the end by striking 
‘‘or’’; 
(3) in subparagraph (C), by striking ‘‘subpara-
graph (A) or (B)’’ and inserting ‘‘subparagraph (A), 
(B), or (C)’’; 
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(4) by redesignating subparagraph (C) as sub-
paragraph (D); and 
(5) by adding after subparagraph (B) the fol-
lowing new subparagraph: 
‘‘(C) an individual who is an eligible WTC 
responder or an eligible WTC resident or other 
non-responder, as defined in sections 3011(a) 
and 3021(a), respectively, of the Public Health 
Service Act; or’’. 
Æ 
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