II 118th CONGRESS 2d Session S. 4724 IN THE SENATE OF THE UNITED STATES July 11 (legislative day, July 10), 2024 Mrs. Gillibrand (for herself, Mr. Schumer , Mr. Casey , Mr. Warner , Mr. Kaine , and Mr. Braun ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend title XXXIII of the Public Health Service Act with respect to flexibility and funding for the World Trade Center Health Program.

1. Short title This Act may be cited as the 9/11 Responder and Survivor Health Funding Correction Act of 2024 . 2. Flexibility for mental health condition certifications under the World Trade Center Health Program (a) In general Section 3305(a) of the Public Health Service Act ( 42 U.S.C. 300mm–4(a) ) is amended— (1) in paragraph (1)(A), by inserting subject to paragraph (6), before for ; and (2) by adding at the end the following: (6) Licensed mental health provider flexibility for mental health condition certifications (A) In general For purposes of an initial health evaluation described in paragraph (1)(A) with respect to a mental health condition (including any such evaluation provided under section 3321(b) or through the nationwide network under section 3313), such evaluation may be conducted by a physician or any other licensed mental health provider in a category of mental health care providers determined by the WTC Program Administrator under subparagraph (B). (B) Categories of licensed mental health providers Not later than 180 days after the date of enactment of the 9/11 Responder and Survivor Health Funding Correction Act of 2024 , the WTC Program Administrator shall issue regulations for the categories of licensed mental health providers who, in addition to licensed physicians, may conduct evaluations under subparagraph (A) with respect to a mental health condition and make determinations under section 3312(b) with respect to such a condition. . (b) Flexibility for WTC responders Section 3312(b) of such Act ( 42 U.S.C. 300mm–22(b) ) is amended— (1) in paragraph (1)(A)— (A) in the matter preceding clause (i), by striking physician and inserting physician (or, in the case of a mental health condition, a physician or any other qualified mental health provider) ; and (B) in clause (i), by striking physician and inserting physician or other qualified mental health provider ; (2) in paragraph (2)— (A) in subparagraph (A)— (i) in the matter preceding clause (i), by striking physician and inserting physician (or, in the case of a mental health condition, a physician or any other qualified mental health provider) ; (ii) in clause (i), by striking physician and inserting physician or other qualified mental health provider ; and (iii) in clause (ii), by striking such physician's determination and inserting the determination of such physician or other qualified mental health provider ; and (B) in subparagraph (B)— (i) in the matter preceding clause (i), by striking physician determinations and inserting determinations by physicians (or, in the case of a mental health condition, physicians or other qualified mental health providers) ; and (ii) in clause (i), by striking physician panel and inserting panel of physicians (or, in the case of a mental health condition, physicians or other qualified mental health providers) ; (3) in paragraph (5), by striking examining physician and inserting examining physician (or, in the case of a mental health condition, examining physician or other qualified mental health provider) ; and (4) by adding at the end the following: (6) Definition of qualified mental health provider For purposes of this subsection, the term qualified mental health provider means a licensed mental health provider in a category determined by the WTC Program Administrator under section 3305(a)(6)(B). . 3. Criteria for credentialing health care providers participating in the nationwide network Title XXXIII of the Public Health Service Act ( 42 U.S.C. 300mm et seq. ) is amended— (1) in section 3305(a)(2) ( 42 U.S.C. 300mm–4(a)(2) )— (A) in subparagraph (A)— (i) by striking clause (iv); and (ii) by redesignating clauses (v) and (vi) as clauses (iv) and (v), respectively; (B) by striking subparagraph (B); and (C) by redesignating subparagraphs (C) and (D) as subparagraphs (B) and (C), respectively; and (2) in section 3313(b)(1) ( 42 U.S.C. 300mm–23(b)(1) ), by striking Data Centers and inserting WTC Program Administrator . 4. Clarifying calculation of enrollment (a) Responders Section 3311(a) of such Act ( 42 U.S.C. 300mm–21(a) ) is amended by adding at the end the following: (6) Deceased WTC responders An individual known to the WTC Program Administrator to be deceased shall not be included in any count of enrollees under this subsection or section 3351. . (b) Survivors Section 3321(a) of such Act ( 42 U.S.C. 300mm–31(a) ) is amended by adding at the end the following: (5) Deceased WTC survivors An individual known to the WTC Program Administrator to be deceased shall not be included in any count of certified-eligible survivors under this section or in any count of enrollees under section 3351. . 5. Time period for adding health conditions to list for WTC responders Section 3312(a)(6) of the Public Health Service Act ( 42 U.S.C. 300mm–22(a)(6) ) is amended— (1) in subparagraph (B), by striking 90 and inserting 180 ; and (2) in subparagraph (C), in the second sentence, by striking 90 and inserting 180 . 6. Funding for the World Trade Center Health Program (a) In general Section 3351 of the Public Health Service Act ( 42 U.S.C. 300mm–61 ) is amended— (1) in subsection (a)(2)(A)— (A) in clause (x), by striking and ; (B) in clause (xi)— (i) by striking subsequent fiscal year through fiscal year 2090 and inserting of fiscal years 2026 through 2034 ; and (ii) by striking plus and inserting and ; and (C) by adding at the end the following: (xii) for each of fiscal years 2035 through 2090— (I) the amount determined under this subparagraph for the previous fiscal year (plus any amount expended from the Fund in the previous fiscal year that was carried over from any fiscal year prior to the previous fiscal year including as carried over pursuant to a deposit into such Fund under section 3352(d), 3353(d), or 3354(d)) multiplied by 1.05; multiplied by (II) the ratio of— (aa) the total number of individuals enrolled in the WTC Program on July 1 of such previous fiscal year; to (bb) the total number of individuals so enrolled on July 1 of the fiscal year prior to such previous fiscal year; plus ; and (2) in subsection (c)— (A) in paragraph (4)— (i) by amending subparagraph (A) to read as follows: (A) for fiscal year 2024, the amount determined for such fiscal year under this paragraph as in effect on the day before the date of enactment of the 9/11 Responder and Survivor Health Funding Correction Act of 2024 ; ; and (ii) by amending subparagraph (B) to read as follows: (B) for fiscal year 2025, the greater of— (i) the amount determined for such fiscal year under this paragraph as in effect on the day before the date of enactment of the 9/11 Responder and Survivor Health Funding Correction Act of 2024 ; or (ii) $20,000,000; and ; and (B) in paragraph (5)— (i) by amending subparagraph (A) to read as follows: (A) for fiscal year 2024, the amount determined for such fiscal year under this paragraph as in effect on the day before the date of enactment of the 9/11 Responder and Survivor Health Funding Correction Act of 2024 ; ; (ii) by redesignating subparagraph (B) as subparagraph (C); and (iii) by inserting after subparagraph (A) the following: (B) for fiscal year 2025, the greater of— (i) the amount determined for such fiscal year under this paragraph as in effect on the day before the date of enactment of the 9/11 Responder and Survivor Health Funding Correction Act of 2024 ; or (ii) $20,000,000; and . (b) Additional amounts for the World Trade Center Health Program Special Fund Section 3353(b) of the Public Health Service Act ( 42 U.S.C. 300mm–63(b) ) is amended— (1) by striking Out and inserting the following: (1) Initial deposit Out ; and (2) by adding at the end the following: (2) Additional deposit Out of any money in the Treasury not otherwise appropriated, there is appropriated for fiscal year 2024 $2,970,406,593 for deposit into the Special Fund, which amounts shall remain available in such Fund through fiscal year 2033. . (c) Reallocation of any remaining amounts in separate funds (1) Supplemental fund Section 3352(d) of the Public Health Service Act ( 42 U.S.C. 300mm–62(d) ) is amended— (A) in the subsection heading, by striking Return of Funds and inserting Remaining amounts ; and (B) by striking the Treasury as miscellaneous receipts and inserting the World Trade Center Health Program Fund under section 3351 for fiscal year 2033 and, notwithstanding subsections (b) and (c), remain available, for the purposes described in this title, through fiscal year 2090 in accordance with subsection (a)(5) of section 3351 and subject to the spending limitations under subsection (c) of such section . (2) Special fund Section 3353(d) of the Public Health Service Act ( 42 U.S.C. 300mm–63(d) ) is amended by striking the Treasury as miscellaneous receipts and inserting the World Trade Center Health Program Fund under section 3351 for fiscal year 2034 and, notwithstanding subsections (b) and (c), remain available, for the purposes described in this title, through fiscal year 2090 in accordance with subsection (a)(5) of section 3351 and subject to the spending limitations under subsection (c) of such section . (3) Pentagon/shanksville fund Section 3354(d) of the Public Health Service Act ( 42 U.S.C. 300mm–64(d) ) is amended by striking the Treasury as miscellaneous receipts and inserting the World Trade Center Health Program Fund under section 3351 for fiscal year 2034 and, notwithstanding subsections (b) and (c), remain available, for the purposes described in this title, through fiscal year 2090 in accordance with subsection (a)(5) of section 3351 and subject to the spending limitations under subsection (c) of such section . (4) Availability Section 3351 of the Public Health Service Act ( 42 U.S.C. 300mm–61 ) is amended— (A) in subsection (a)(5), by inserting or deposited into the Fund under any other section in this title, before for a fiscal year ; and (B) in subsection (b)(1), by inserting or any other section in this title after subsection (a)(2) . 7. Offset (a) In general Section 251A(6)(D) of the Balanced Budget and Emergency Deficit Control Act of 1985 ( 2 U.S.C. 901a(6)(D) ) is amended— (1) in clause (i), by striking 8 months and inserting 10 months ; and (2) in clause (ii), by striking 4 months and inserting 2 months . (b) Deposit of excess savings in the Medicare Improvement Fund (1) Definition In this subsection, the term excess savings means the difference obtained by subtracting— (A) the amount of the budgetary effects (as determined in accordance with the Statutory Pay-As-You-Go Act of 2010 ( 2 U.S.C. 931 et seq. )) of sections 2 through 6 of this Act; from (B) the amount of the budgetary effects (as determined in accordance with the Statutory Pay-As-You-Go Act of 2010 ( 2 U.S.C. 931 et seq. )) of the amendment made by subsection (a) of this section. (2) Deposit The amount of any excess savings shall be transferred to and merged with amounts in the Medicare Improvement Fund established under section 1898 of the Social Security Act ( 42 U.S.C. 1395iii ). Amounts transferred under this paragraph shall remain available until expended.