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H.R. 1638 (110th): James Zadroga 9/11 Health and Compensation Act


The text of the bill below is as of Mar 22, 2007 (Introduced). The bill was not enacted into law.


I

110th CONGRESS

1st Session

H. R. 1638

IN THE HOUSE OF REPRESENTATIVES

March 22, 2007

(for herself, Mr. Fossella, Mr. Serrano, Mr. Shays, Mr. Hinchey, Mr. McHugh, Mr. Hall of New York, Mr. McNulty, Mr. Crowley, Mr. Grijalva, and Mr. McCotter) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on the Judiciary, 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 extend and improve protections and services to individuals directly impacted by the terrorist attack in New York City on September 11, 2001, and for other purposes.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the James Zadroga 9/11 Health and Compensation Act.

(b)

Table of contents

The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Findings.

Title I—Extending Protections and Services to Those Exposed to Toxins From 9/11

Sec. 101. Extending protections and services to those exposed to toxins from 9/11.

Sec. 102. Research regarding certain health conditions.

Sec. 103. Programs regarding attack at Pentagon.

Title II—9/11 Health Emergency Coordinating Council

Sec. 201. Establishment.

Sec. 202. Membership.

Sec. 203. Meetings.

Sec. 204. Reports.

Sec. 205. Authorization of appropriations.

Title III—September 11 Victim Compensation Fund of 2001

Sec. 301. Deadline extension for certain claims under September 11 Victim Compensation Fund of 2001.

Sec. 302. Exception to single claim requirement in certain circumstances.

Sec. 303. Eligibility of claimants suffering from psychological harm.

Sec. 304. Immediate aftermath defined.

Title IV—Programs of the New York City Department of Health and Mental Hygiene

Sec. 401. World Trade Center Health Registry.

Sec. 402. Mental health services.

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 workers, and school children continue to suffer significant medical problems as a result of compromised air quality and the release of other toxins from the attack sites.

(2)

In a September 2006 peer-reviewed study conducted by the World Trade Center Medical Monitoring Program, of 9,500 World Trade Center responders, almost 70 percent of World Trade Center responders had a new or worsened respiratory symptom that developed during or after their time working at the World Trade Center; among the responders 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 pulmonary function tests; and severe respiratory conditions 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 respiratory symptoms in residents near the former World Trade Center as compared to a control population.

(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 impacts, including lower pregnancy rates, lower birth weights in babies born 9 months after the disaster, higher rates of respiratory and lung disorders, and a variety of post-disaster mental health conditions (including posttraumatic stress disorder) in workers and residents near Ground Zero.

(6)

Federal funding allocated for the monitoring of rescue workers’ health is not sufficient to ensure the long-term study of health impacts of September 11.

(7)

The Federal funding allocated for medical monitoring does not provide for the medical monitoring of New York City area residents, office and area workers, schoolchildren, or Federal employees who responded to the terrorist attacks of September 11, 2001.

(8)

A significant portion of those who responded to the September 11 aftermath have no health insurance, lost their health insurance as a result of the attacks, or have inadequate health insurance for the medical conditions they developed as a result of recovery work at the World Trade Center site.

(9)

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 adequately funded and is projected to exhaust all Federal funding before the end of fiscal year 2007.

(10)

Rescue workers and volunteers seeking workers compensation have reported that their applications have been denied, delayed for months, or redirected, instead of receiving assistance in a timely and supportive manner.

(11)

A February 2007 report released by the City of New York revealed that 410,000 people were heavily exposed, to the toxins of Ground Zero. The report also found that an estimated 30,000 responders are sick yet 21,000 of them do not have adequate health insurance.

(12)

The September 11 Victim Compensation Fund of 2001 was established to provide compensation to individuals who were physically injured or killed as a result of the terrorist-related aircraft crashes of September 11, 2001.

(13)

The deadline for filing claims for compensation under the Victim Compensation Fund was December 22, 2003.

(14)

Some individuals did not know they were eligible to file claims for compensation for injuries or did not know they had suffered physical harm as a result of the terrorist-related aircraft crashes until after the December 22, 2003, deadline.

(15)

Further research is needed to evaluate more comprehensively the extent of the health impacts of September 11, including research for emerging health problems such as cancer, which have been predicted.

(16)

Research is needed regarding possible treatment for the illnesses and injuries of September 11.

(17)

The Federal response to medical and financial issues arising from the September 11 response efforts needs a comprehensive, coordinated long-term response in order to meet the needs of all the individuals who were exposed to the toxins of Ground Zero and are suffering health problems from the disaster.

I

Extending Protections and Services to Those Exposed to Toxins From 9/11

101.

Extending protections and services to those exposed to toxins from 9/11

Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317S the following section:

317T.

Extending protections and services to those exposed to toxins from 9/11

(a)

Program extension

For the purpose of ensuring on-going monitoring, treatment, and data collection for victims of the September 11 terrorist attacks in New York City, the Secretary, acting through the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention, shall extend and expand, in accordance with this section, the arrangements in effect as of January 1, 2007, with the coordinating consortium body and with the Fire Department of the City of New York that provide for the following:

(1)

Medical monitoring, including 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 aftermath of the terrorist attacks that occurred on September 11, 2001, in New York City. The extent and frequency of such monitoring shall be in accordance with guidelines developed by the program steering committee.

(2)

Provision of treatment and payment, without any cost-sharing, for all health and mental health care expenses (including necessary prescription drugs) of individuals with a qualifying health condition, using a uniform standard of coverage for all eligible individuals.

(3)

Collection of health and mental health data on such individuals, using a uniform system of data collection.

(b)

Covered individuals

The program administered by the coordinating consortium body under subsection (a) shall be expanded so as to include, among the individuals described in subsection (a)(1) and under the arrangement with such body, any of the following individuals if they are not otherwise covered under either of the arrangements described in such subsection:

(1)

Emergency service personnel and rescue and recovery personnel who responded in the New York City disaster area to the terrorist attacks that occurred on September 11, 2001, in New York City, any time during the period of September 11, 2001, through August 31, 2002.

(2)

Any other worker or volunteer who responded in such area to such attacks at any time during such period, 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; and

(H)

a person who worked on the criminal investigation.

(3)

A worker who responded at any time during such period to such attacks by assisting in the cleanup or restoration of critical infrastructure in the New York City disaster area.

(4)

A worker who assisted at any time during such period in the cleaning of a building situated in the New York City disaster area.

(5)

A person whose place of residence at any time during such period was in the New York City disaster area.

(6)

A person who was working at any time during such period in the New York City disaster area.

(7)

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.

(8)

A person who was employed at any time during such period at the Fresh Kills recovery site on Staten Island.

(9)

A person who was present in the New York City disaster area on September 11, 2001.

(10)

Any other person whom the Secretary determines to be appropriate.

(c)

Extension of services

In order to ensure reasonable access to monitoring and treatment for individuals under subsection (a) who reside in the Downtown Manhattan area or who reside outside of the New York City disaster area, the arrangements under such subsection shall be expanded—

(1)

to enter into arrangements with the World Trade Center Environmental Health Center at Bellevue Hospital to coordinate and provide services for residents, office and area workers, and students in Downtown Manhattan and nearby areas; and

(2)

to establish a nationwide network of health care providers to provide such monitoring and treatment near such individuals’ areas of residence, or to establish a mechanism whereby individuals who receive monitoring or treatment for a qualifying health condition can be reimbursed for the cost of such monitoring or treatment.

(d)

Administrative arrangement authority

Arrangements under subsection (a) may be modified, so as to provide for timely and accurate processing of claims, through entering into arrangements for the administration of benefits using insurance companies or other third-party administrators.

(e)

Requirement of medical necessity

If a monitoring or treating physician, pursuant to an arrangement under subsection (a), determines that an item or service for the provision of health or mental health care under subsection (a)(2) is medically necessary for an individual, payment under such subsection shall be made available for the item or service.

(f)

Eligibility certification for treatment benefits

Effective for treatment benefits furnished more than 60 days after the date of the enactment of this section, no individual shall be eligible for treatment benefits described in paragraph (2) of subsection (a) under the arrangements described in such subsection unless a Federal employee designated by the Secretary has determined that the individual meets the applicable eligibility criteria under such arrangements (as modified by the section) for the receipt of such treatment benefits. Such Federal employee shall not deny certification if the individual meets the applicable eligibility criteria.

(g)

Community outreach

The Secretary shall institute a program that provides education and outreach on the existence and availability of services provided for under this section. Any such education and outreach shall be done in a manner intended to reach all affected populations and to include materials for culturally and linguistically diverse populations. To the greatest extent possible, in carrying out this subsection, the Secretary should enter into partnerships with local governments and organizations with experience performing outreach.

(h)

Continuation of treatment while being enrolled in medical monitoring program

In the case of an individual receiving medical treatment under the arrangements described in paragraph (2) of subsection (a) but who is not enrolled in the medical monitoring program referred to in paragraph (1) of such subsection, the individual may continue to receive such treatment while the individual is being enrolled in such medical monitoring program.

(i)

Definitions

In this section:

(1)

The term coordinating consortium body means the body of medical providers that coordinates the monitoring and treatment under the arrangement under subsection (a) that covers individuals who are not covered under the arrangement with the Fire Department for the City of New York.

(2)

The term New York City disaster area means an area, specified by the Secretary of Health and Human Services, within which individuals who resided, worked, or otherwise were regularly present during the period beginning on September 11, 2001, and ending on August 31, 2002, were likely to have been exposed to airborne toxins that were released as a result of the aftermath of the terrorist attacks that occurred on September 11, 2001, in New York City, and includes the area within 2 miles of the perimeter of the former World Trade Center site. In determining the boundaries of the New York City disaster area, the Secretary shall take into consideration peer-reviewed research that has demonstrated potential exposure to such toxins at a distance of 5 miles or greater from the former World Trade Center.

(3)

The term program steering committee means the committee, made up of a number of representatives of the medical providers from the coordinating consortium body and the Fire Department of the City of New York, and an equal number of representatives of the covered individuals described in subsection (b), that is responsible for the governance and coordination of the programs administered by the coordinating consortium body and the Fire Department of the City of New York under subsection (a).

(4)

The term qualifying health condition means an adverse health condition that is presumed by the program steering committee, in consultation with 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.

(j)

Financing

Out of any funds in the Treasury not otherwise appropriated, there are hereby appropriated to the Secretary—

(1)

for the period of fiscal years 2007 through 2012, $1,900,000,000 and such additional sums as may be necessary to carry out this section; and

(2)

for fiscal years 2013 through 2026, such sums as may be necessary to carry out this section.

.

102.

Research regarding certain health conditions

Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et seq.) is amended by inserting after section 409I the following section:

409J.

Research regarding certain health conditions of individuals assisting with response to September 11 terrorist attacks in New York City

(a)

In General

With respect to individuals receiving monitoring under section 317T, the Secretary 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 qualifying health conditions of such individuals, in the case of conditions for which there has been diagnostic uncertainty; and

(3)

research on treating qualifying health conditions of such individuals, in the case of conditions for which there has been treatment uncertainty.

(b)

Consultation

The Secretary shall carry out this section in consultation with such program steering committee.

(c)

Application of privacy and human subject 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 Secretary shall annually submit to the Congress a report describing the findings of research under subsection (a).

(e)

Definitions

In this section, the terms program steering committee and qualifying health condition have the meanings given to those terms in section 317T(i).

(f)

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.

.

103.

Programs regarding attack at Pentagon

The Secretary of Health and Human Services may, to the extent determined appropriate by the Secretary, establish with respect to the terrorist attack at the Pentagon on September 11, 2001, programs similar to the programs that are established in sections 317T and 409J of the Public Health Service Act with respect to the terrorist attacks on such date in New York City.

II

9/11 Health Emergency Coordinating Council

201.

Establishment

The Secretary of Health and Human Services shall convene a council, to be known as 9/11 Health Emergency Coordinating Council (in this title referred to as the Council), for the purpose of discussing, examining, and formulating recommendations with respect to the adequacy and coordination of the following:

(1)

Care and compensation for the victims of the terrorist attacks of September 11, 2001.

(2)

Federal tracking of the monitoring of, and treatment for, individuals who are directly suffering from, or may have long-term health effects from, such attacks.

202.

Membership

(a)

Chairperson

The Secretary of Health and Human Services (or the Secretary’s designee) shall serve as the chairperson of the Council.

(b)

Required members

The members of the Council shall include the following:

(1)

The Secretary of Defense (or the Secretary’s designee).

(2)

The Secretary of Labor (or the Secretary’s designee).

(3)

The Director of the Federal Emergency Management Agency (or the Director’s designee).

(4)

The Director of the National Institutes of Health (or the Director’s designee).

(5)

The Director of the National Institute for Occupational Safety and Health (or the Director’s designee).

(6)

A representative of the Crime Victims Fund established under section 1402 of the Victims of Crime Act of 1984 (42 U.S.C. 10601).

(c)

Invitees

The Secretary of Health and Human Services shall invite the following individuals to serve as members of the Council:

(1)

The Governor of the State of New York (or the Governor’s designee).

(2)

The Governor of the State of New Jersey (or the Governor's designee).

(3)

The Mayor of New York City (or the Mayor’s designee).

(4)

1 representative of the New York City Fire Department.

(5)

1 representative of the New York City Police Department.

(6)

1 representative of the police department of the Port Authority of New York and New Jersey.

(7)

1 representative of the New York State Department of Health.

(8)

1 representative of the New York State Workers’ Compensation Board.

(9)

1 representative of the New York City Department of Health and Mental Hygiene.

(10)

1 representative of the New York City Office of Emergency Management.

(11)

1 representative of the Association of Occupational and Environmental Clinics.

(12)

1 representative of the New York Committee for Occupational Safety and Health (NYCOSH).

(13)

1 representative of charitable organizations that had volunteers at Ground Zero.

(14)

20 representatives of labor unions reflecting a cross section of workers who responded to, or assisted in the cleanup resulting from, the attack on the World Trade Center, including New York City police, fire, and other municipal employees, Port Authority of New York and New Jersey police, State and Federal employees, construction employees, and employees involved in the resumption of services.

(15)

20 representatives of community organizations that reflect a cross section of the concerns of residents, office workers, and students.

(16)

5 representatives of nonprofit volunteer entities that assisted in recovery efforts following the terrorist attacks of September 11, 2001.

(17)

5 representatives of a regional occupational provider that—

(A)

works with the World Trade Center Worker and Volunteer Medical Screening Program; and

(B)

is under the direction of the Mount Sinai Center for Occupational and Environmental Medicine.

203.

Meetings

The Council shall meet not less than 4 times each calendar year.

204.

Reports

Not less than once each calendar year, the Council shall submit to the Congress a report on the recommendations of the Council.

205.

Authorization of appropriations

For the purpose of carrying out this title, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2007 through 2026.

III

September 11 Victim Compensation Fund of 2001

301.

Deadline extension for certain claims under September 11 Victim Compensation Fund of 2001

Section 405(a)(3) of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended to read as follows:

(3)

Limitation

(A)

In general

Except as provided by subparagraph (B), no claim may be filed under paragraph (1) after December 22, 2003.

(B)

Exceptions

A claim may be filed under paragraph (1) by an individual (or by a personal representative on behalf of a deceased individual)—

(i)

during the 5-year period after the date of enactment of this subparagraph, if the Special Master determines that the individual—

(I)

did not know that the individual had suffered physical harm as a result of the terrorist-related aircraft crashes of September 11, 2001, until after December 22, 2003, and before the date of the enactment of this subparagraph;

(II)

did not for any reason other than as described in subclause (I) know that the individual was eligible to file a claim under paragraph (1) until after December 22, 2003;

(III)

suffered psychological harm as a result of the terrorist-related aircraft crashes; or

(IV)

in the case of an individual who had previously filed a claim under this title, suffered a significantly greater physical harm than was known to the individual as of the date the claim was filed and did not know the full extent of the physical harm suffered as a result of the terrorist-related aircraft crashes until after the date on which the claim was filed and before the date of enactment of this subparagraph; and

(ii)

during the 5-year period after the date that the individual—

(I)

first knew that the individual had suffered physical or psychological harm as a result of the terrorist-related aircraft crashes of September 11, 2001, if the Special Master determines that the individual did not know that the individual had suffered such physical or psychological harm until a date that is on or after the date of enactment of this subparagraph; or

(II)

in the case of an individual who had previously filed a claim under this title and had suffered a significantly greater physical harm than was known to the individual as of the date the claim was filed, or had suffered psychological harm as a result of the terrorist-related crashes, first knew the full extent of the physical and psychological harm suffered as a result of the terrorist-related aircraft crashes, if the Special Master determines that the individual did not know the full extent of the harm suffered until a date that is on or after the date of the enactment of this subparagraph.

.

302.

Exception to single claim requirement in certain circumstances

Section 405(c)(3)(A) of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended to read as follows:

(A)

Single claim

(i)

In general

Except as provided by clause (ii), not more than 1 claim may be submitted under this title by an individual or on behalf of a deceased individual.

(ii)

Exception

A second claim may be filed under subsection (a)(1) by an individual (or by a personal representative on behalf of a deceased individual) if the individual is an individual described in either of clauses (i)(IV) or (ii)(II) of subsection (a)(3)(B).

.

303.

Eligibility of claimants suffering from psychological harm

(a)

In general

Section 405(c)(2)(A)(ii) of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended by inserting , psychological harm, before or death.

(b)

Conforming amendment

Section 405(a)(2)(B)(i) of such Act is amended by striking physical harm and inserting physical or psychological harm.

304.

Immediate aftermath defined

Section 402 of the Air Transportation Safety and System Stabilization Act (49 U.S.C. 40101 note) is amended by adding at the end the following new paragraph:

(11)

Immediate aftermath

In section 405(c)(2)(A)(i), the term immediate aftermath means any period of time after the terrorist-related aircraft crashes of September 11, 2001, as determined by the Special Master, that was sufficiently close in time to the crashes that there was a demonstrable risk to the claimant of physical or psychological harm resulting from the crashes, including the period of time during which rescue, recovery, and cleanup activities relating to the crashes were conducted.

.

IV

Programs of the New York City Department of Health and Mental Hygiene

401.

World Trade Center Health Registry

(a)

Program extension

For the purpose of ensuring on-going data collection for victims of the September 11 terrorist attacks in New York City, the Secretary of Health and Human Services, acting through the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention, shall extend and expand the arrangements in effect as of January 1, 2007, with the New York City Department of Health and Mental Hygiene that provide for the World Trade Center Health Registry.

(b)

Authorization of appropriations

To carry out this section, there are authorized to be appropriated such sums as may be necessary.

402.

Mental health services

(a)

Grants

The Secretary of Health and Human Services may make grants to the New York City Department of Health and Mental Hygiene to provide mental health services to address the mental health needs of qualified individuals relating to the terrorist attacks that occurred on September 11, 2001, in New York City.

(b)

Qualified individual

In this section, the term qualified individual means an individual who resides in the New York City metropolitan area, but is not a covered individual described in section 317T(b) of the Public Health Service Act, as added by section 101 of this Act.