[Congressional Bills 108th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4974 Introduced in House (IH)]






108th CONGRESS
  2d Session
                                H. R. 4974

To provide health services for individuals assisting with the response 
 to the terrorist attacks in New York City on September 11, 2001, and 
                          for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 22, 2004

Mr. Meeks of New York introduced the following bill; which was referred 
    to the Committee on Energy and Commerce, and in addition to the 
Committee on Ways and Means, for a period to be subsequently determined 
 by the Speaker, in each case for consideration of such provisions as 
        fall within the jurisdiction of the committee concerned

_______________________________________________________________________

                                 A BILL


 
To provide health services for individuals assisting with the response 
 to the terrorist attacks in New York City on September 11, 2001, and 
                          for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Post 9/11 Health Protection Act of 
2004''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) On September 11, 2001, in New York City, firefighters, 
        paramedics, emergency medical technicians, police officers, 
        laborers, survivors, and others risked their lives far and 
        beyond what was expected of them. They took upon themselves a 
        burden that weighed so heavily that they still carry the 
        repercussions almost three years later.
            (2) It is not only necessary but obligatory upon our Nation 
        to address the health consequences from the environmental 
        exposures these individuals experienced after the World Trade 
        Centers disaster, which are, as demonstrated by extensive 
        research, directly associated with significant adverse effects 
        on health.
            (3) The dust from the disaster produced bronchial 
        hyperactivity, persistent cough, and increased risk of asthma, 
        as well as plausible causes of observed increase in the number 
        of infants with lower birthweights.
            (4) Substantial research has in addition demonstrated that 
        these individuals have an increased future risk of 
        mesothelioma, especially those exposed to asbestos.
            (5) According to the National Institutes of Health, the 
        attacks have confirmed a ``positive relationship between the 
        intensity of their exposure to airborne pollutants and the 
        severity of their pulmonary symptoms.''.
            (6) In an article published September 5, 2003, the Agency 
        for Toxic Substances and Disease Registry stated that ``The 
        effects of 9/11 are still being felt today by all New Yorkers, 
        and all Americans.''. In that article, Dr. Frieden stated that 
        ``Hundreds of thousands of people from all walks of life were 
        in the vicinity of the twin towers when they collapsed, and 
        were exposed to a combination of smoke, dust, and debris.''.
            (7) Research has proved that the smoke and debris have been 
        detrimental in that they have caused various health ailments 
        such as respiratory problems, birth defects, and cancer.
            (8) Out of 10,116 firefighters, 332 have displayed 
        persistent cough accompanied by other respiratory symptoms 
        severe enough to require up to four weeks leave of absence. 
        Among the firefighters without a cough, many were diagnosed 
        with bronchial hyperactivity.
            (9) Of iron workers that were involved in cleaning and 
        recovery, approximately 1/3 have a chronic cough, 24 percent 
        have reported a new onset of phlegm production, and more than 
        17 percent have complained of a new onset of wheeze.
            (10) One of the greater health risks has been exposure to 
        asbestos, which was found in the rubble in concentrations as 
        high as 20 percent. This material may cause lung cancer and 
        malignant mesothelioma.
            (11) Researchers studied 187 pregnant women, and discovered 
        that, for women within a half mile of ground zero who inhaled 
        the soot, pulverized glass, and other toxins, the effects were 
        detrimental enough to result in the delivery of infants who 
        averaged a half-pound lighter than infants of unexposed 
        mothers, a condition known as smaller-for-gestational-age 
        (``SGA'').
            (12) In the Journal of the American Medical Association, 
        researchers of Mount Sinai Medical Center explained the 
        pollutants as a toxic cocktail, with a potential for long-term 
        adverse health effects. Other studies have associated the 
        pollutants with a direct connection to heart disease and an 
        array of chronic disorders. One example is the condition known 
        as the World Trade Center cough; firefighters and other rescue 
        workers have complained of this persistent respiratory illness.
            (13) According to Inter Press Service, 2.5 years after the 
        attacks laborers are still suffering from severe breathing 
        problems, skin rashes, nausea, depression, or anxiety.
            (14) Of emergency respondents, 80 percent have reported of 
        having at least one respiratory symptom, such as sore throat, 
        chest tightness, or cough and wheezing. One half complained of 
        having problems one year later.
            (15) Dr. Rafael de la Hoz noted that, of about 150 day 
        workers examined at Mount Sinai Medical Center, about 75 
        percent are suffering from upper airway diseases, and some have 
        reported aggravated asthma or bronchial disease, back and 
        musculoskeletal pain, or psychological problems such as post 
        traumatic stress syndrome.

SEC. 2. SEPTEMBER 11 EMERGENCY PERSONNEL TRUST FUND.

    (a) Additional Tax on High Income Taxpayers.--Section 1 of the 
Internal Revenue Code of 1986 is amended by adding at the end the 
following new subsection:
    ``(j) Additional Tax on High Income Taxpayers.--The amount 
determined under subsection (a), (b), (c), or (d), as the case may be, 
shall be increased by 1 percent of so much of adjusted gross income as 
exceeds $1,000,000 in the case of individuals to whom subsection (a) 
applies ($500,000 in any other case).''.
    (b) September 11 Emergency Personnel Trust Fund.--Subchapter A of 
chapter 98 of the Internal Revenue Code of 1986 (relating to trust fund 
code) is amended by adding at the end the following new section:

``SEC. 9511. SEPTEMBER 11 EMERGENCY PERSONNEL TRUST FUND.

    ``(a) Creation of Trust Fund.--There is established in the Treasury 
of the United States a trust fund to be known as the `September 11 
Emergency Personnel Trust Fund', consisting of such amounts as may be 
appropriated or credited to such Trust Fund as provided in this section 
or section 9602(b).
    ``(b) Transfers to Trust Fund.--There are hereby appropriated to 
the September 11 Emergency Personnel Trust Fund amounts equivalent to 
the taxes received in the Treasury under section 1(j).
    ``(c) Expenditures.--Amounts in the September 11 Emergency 
Personnel Trust Fund shall be available to carry out sections 317T and 
409J of the Public Health Service Act.''.
    (c) Clerical Amendment.--The table of sections for such subchapter 
is amended by adding at the end thereof the following new item:

``Sec. 9511. September 11 Emergency Personnel Trust Fund.''.
    (d) Effective Date.--The amendments made by this section shall 
apply to taxable years beginning after December 31, 2004.

SEC. 3. CERTAIN HEALTH SERVICES FOR INDIVIDUALS ASSISTING WITH RESPONSE 
              TO SEPTEMBER 11 TERRORIST ATTACKS IN NEW YORK CITY.

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

``SEC. 317T. CERTAIN HEALTH SERVICES FOR INDIVIDUALS ASSISTING WITH 
              RESPONSE TO SEPTEMBER 11 TERRORIST ATTACKS IN NEW YORK 
              CITY.

    ``(a) In General.--From the September 11 Emergency Personnel Trust 
Fund under section 9511 of the Internal Revenue Code of 1986, the 
Secretary, acting through the Director of the Centers for Disease 
Control and Prevention, shall make awards of grants or cooperative 
agreements for the purpose of carrying out baseline and follow-up 
screening and clinical examinations, and long-term health monitoring 
and analysis, for covered individuals who meet the eligibility criteria 
under subsection (d).
    ``(b) Covered Individuals.--For purposes of this section, the term 
`covered individuals' means--
            ``(1) emergency service personnel and rescue and recovery 
        personnel who responded to the terrorist attacks that occurred 
        on September 11, 2001, in New York City, in the State of New 
        York, any time during the period of September 11, 2001, through 
        August 31, 2002;
            ``(2) any other worker or volunteer who responded to such 
        attacks, including--
                    ``(A) a police officer;
                    ``(B) a firefighter;
                    ``(C) an emergency medical technician;
                    ``(D) a transit worker;
                    ``(E) any participating member of an urban search 
                and rescue team;
                    ``(F) Federal and State employees;
                    ``(G) a person who worked to recover human remains;
                    ``(H) a person who worked on the criminal 
                investigation; and
                    ``(I) any other relief or rescue worker or 
                volunteer whom the Secretary determines to be 
                appropriate;
            ``(3) a worker who responded to such attacks by assisting 
        in the cleanup or restoration of critical infrastructure in and 
        around;
            ``(4) a person whose place of residence is in the declared 
        disaster area;
            ``(5) a person who is employed in or attends school, child 
        care, or adult day care in a building located in the declared 
        disaster area; and
            ``(6) any other person whom the Secretary determines to be 
        appropriate.
    ``(c) Award Recipient.--
            ``(1) In general.--Subject to the submission of an 
        application satisfactory to the Secretary, awards under 
        subsection (a) shall be made only to--
                    ``(A) the consortium of medical entities that, 
                pursuant to the program referred to in subsection (g), 
                provided health services described in subsection (a) 
                during fiscal year 2003 for the personnel described in 
                subsection (b)(1), subject to the consortium meeting 
                the criteria established in paragraph (2); and
                    ``(B) the separate program carried out by the New 
                York City Fire Department.
            ``(2) Criteria.--For purposes of paragraph (1)(A), the 
        criteria described in this paragraph for the consortium 
        referred to in such paragraph are that the consortium has 
        appropriate experience in the areas of environmental or 
        occupational health, toxicology, and safety, including 
        experience in--
                    ``(A) developing clinical protocols and conducting 
                clinical health examinations, including mental health 
                assessments;
                    ``(B) conducting long-term health monitoring and 
                epidemiological studies;
                    ``(C) conducting long-term mental health studies; 
                and
                    ``(D) establishing and maintaining medical 
                surveillance programs and environmental exposure or 
                disease registries.
    ``(d) Eligibility of Covered Individuals.--The Secretary shall 
determine eligibility criteria for covered individuals to receive 
health services under subsection (a). Such criteria shall include the 
requirement that a covered individual may not receive services through 
the program under such section unless the individual enrolls in the 
program.
    ``(e) Certain Program Requirements.--With respect to the program 
under subsection (a), the Secretary shall provide for the following:
            ``(1) Awards under subsection (a) shall designate an amount 
        to be available only for covered individuals who--
                    ``(A) are active or retired firefighters of New 
                York City; and
                    ``(B) in responding to the terrorist attacks of 
                September 11, 2001, provided services in the immediate 
                vicinity of the World Trade Center.
            ``(2) A covered individual enrolled in the program may not 
        receive services under the program for a period exceeding 20 
        years after the date on which the individual first receives 
        services under the program, except that the Secretary may 
        designate a longer period if the Secretary determines that a 
        longer period is appropriate with respect to the health of 
        covered individuals.
            ``(3) The program may not establish a maximum enrollment 
        number of fewer than 40,000 covered individuals.
    ``(f) Authority Regarding Treatment.--The Secretary may, to the 
extent determined appropriate by the Secretary, authorize the program 
under subsection (a) to provide treatment services to covered 
individuals who have no other means of obtaining treatment.
    ``(g) Relation to Certain Program.--Effective on and after the date 
of the enactment of the Remember 9/11 Health Act, the two programs 
carried out pursuant to the appropriation of $90,000,000 made in Public 
Law 107-206 under the heading `Public Health and Social Services 
Emergency Fund', which programs provide health services described in 
subsection (a) for the personnel described in subsection (b)(1), shall 
be considered to be carried out under authority of this section and 
shall be subject to the requirements of this section, except for any 
period of transition determined appropriate by the Secretary, not to 
exceed one year after such date of enactment.''.
    (b) 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, in the State of New York.

SEC. 4. 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:

``SEC. 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 covered individuals as defined 
in section 317T, the Director of NIH shall conduct or support--
            ``(1) diagnostic research on qualifying health conditions 
        of such individuals, in the case of conditions for which there 
        has been diagnostic uncertainty; and
            ``(2) research on treating qualifying health conditions of 
        such individuals, in the case of conditions for which there has 
        been treatment uncertainty.
    ``(b) Qualifying Health Conditions.--For purposes of this section, 
the term `qualifying health conditions' means adverse health conditions 
that are considered by the Secretary to be associated with exposure to 
one or more of the sites of the terrorist attacks that occurred on 
September 11, 2001, in New York City, in the State of New York.
    ``(c) Consultation With Certain Medical Consortium.--The Secretary 
shall carry out this section in consultation with--
            ``(1) the consortium of medicine entities referred to in 
        section 317T(c)(1); and
            ``(2) the firefighters department of New York City, and the 
        union for the firefighters of such department.
    ``(d) Annual Report.--The Director of NIH shall annually submit to 
the Congress a report describing the findings of research under 
subsection (a).
    ``(e) Funding.--Amounts in the September 11 Emergency Personnel 
Trust Fund under section 9511 of the Internal Revenue Code of 1986 are 
available to the Director of NIH for the purpose of research under this 
section.''.
                                 <all>