[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6594 Introduced in House (IH)]







110th CONGRESS
  2d Session
                                H. R. 6594

     To amend the Public Health Service Act 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.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             July 24, 2008

 Mrs. Maloney of New York (for herself, Mr. Nadler, Mr. Fossella, Mr. 
  King of New York, Mr. Rangel, Mr. Engel, Mr. Towns, and Mr. Weiner) 
 introduced the following bill; which was referred to the Committee on 
Energy and Commerce, and in addition to the Committees on the Judiciary 
   and the Budget, 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 amend the Public Health Service Act 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.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``James Zadroga 9/11 
Health and Compensation Act of 2008''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.
Sec. 3. Emergency funding.
               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

Sec. 101. World Trade Center Health Program.
             ``TITLE XXX--WORLD TRADE CENTER HEALTH PROGRAM

     ``Subtitle A--Establishment of Program; Advisory and Steering 
                               Committees

        ``Sec. 3001. Establishment of World Trade Center Health Program 
                            within NIOSH.
        ``Sec. 3002. WTC Health Program Scientific/Technical Advisory 
                            Committee.
        ``Sec. 3003. WTC Health Program Steering Committees.
        ``Sec. 3004. Community education and outreach.
        ``Sec. 3005. Uniform data collection.
        ``Sec. 3006. Centers of excellence.
        ``Sec. 3007. Programs regarding attack at Pentagon.
        ``Sec. 3008. Entitlement authorities.
        ``Sec. 3009. Definitions.
           ``Subtitle B--Program of Monitoring and Treatment

                      ``Part 1--For WTC Responders

        ``Sec. 3011. Identification of eligible WTC responders and 
                            provision of WTC-related monitoring 
                            services.
        ``Sec. 3012. Treatment of eligible WTC responders for WTC-
                            related health conditions.
                      ``Part 2--Community Program

        ``Sec. 3021. Identification of eligible WTC residents and other 
                            non-responders and provision of WTC-related 
                            monitoring services.
        ``Sec. 3022. Treatment of eligible WTC residents and other non-
                            responders for WTC-related health 
                            conditions.
        ``Sec. 3023. Treatment of other individuals with WTC-related 
                            health conditions.
 ``Part 3--National Arrangement for Benefits for Eligible Individuals 
                            Outside New York

        ``Sec. 3031. National arrangement for benefits for eligible 
                            individuals outside New York.
                 ``Subtitle C--Research Into Conditions

        ``Sec. 3041. Research regarding certain health conditions 
                            related to September 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. Immediate aftermath defined.
Sec. 204. Eligible individuals to include eligible WTC responders and 
                            eligible WTC residents and other non-
                            responders.
Sec. 205. Limited coverage for additional individuals.
Sec. 206. World Trade Center collapse and disaster rescue, recovery, 
                            debris removal, cleanup, remediation, and 
                            response indemnification.

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 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, 
        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) A variety of tests conducted by independent scientists 
        have concluded that significant WTC contamination settled in 
        indoor environments surrounding the disaster site. The 
        Environmental Protection Agency's (EPA) cleanup programs for 
        indoor residential spaces, in 2003 and 2005, though limited, 
        are an acknowledgement that indoor contamination continued 
        after the WTC attacks.
            (7) The United States Geological Survey (USGS) reported on 
        November 27, 2001 that certain outdoor dust samples collected 
        by the agency in September 2001 at Varick and Houston Streets 
        (approximately 1.2 miles north of Ground Zero) registered 
        higher than 11 on the pH scale, a level the USGS characterized 
        as being ``as caustic as liquid drain cleaners''.
            (8) According to both the EPA's own Inspector General's 
        (EPA IG) report of August 21, 2003 and General Accountability 
        Offices's (GAO) report of September 2007, no comprehensive 
        program has ever been conducted in order to characterize the 
        full extent of WTC contamination, and therefore the full impact 
        of that contamination--geographic or otherwise--remains 
        unknown.
            (9) Such reports found that there has never been a 
        comprehensive program to remediate WTC toxins from indoor 
        spaces. Thus, area residents, workers and students may 
        continued to be exposed to WTC contamination in their homes, 
        workplaces and schools.
            (10) Because of the failure to release federally 
        appropriated funds for community care, a lack of sufficient 
        outreach, the fact that many community members are receiving 
        care from physicians outside the current City-funded World 
        Trade Center Environmental Health Center program and thus fall 
        outside data collection efforts, and other factors, the number 
        of community members being treated at the World Trade Center 
        Environmental Health Center underrepresents the total number in 
        the community that have been affected by exposure to Ground 
        Zero toxins.
            (11) Research by Columbia University's Center for 
        Children's Environmental Health has shown negative health 
        effects on babies born to women living within 2 miles of the 
        World Trade Center in the month following 9/11.
            (12) 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.
            (13) A significant portion of those who have developed 
        health problems as result of exposures to airborne toxins or 
        other hazards resulting from the September 11, 2001, attacks on 
        the World Trade Center have no health insurance, have lost 
        their health insurance as a result of the attacks, or have 
        inadequate health insurance.
            (14) 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 has no 
        certain long-term funding.
            (15) 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.
            (16) 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 responders 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.
            (17) Since the 5th anniversary of the attack (September 11, 
        2006), hundreds of workers a month have been signing up with 
        the monitoring and treatment programs.
            (18) In April 2008, the Department of Health and Human 
        Services reported to Congress that in fiscal year 2007 11,359 
        patients received medical treatment in the existing WTC 
        Responder Medical and Treatment program for WTC-related health 
        problems, and that number of responders who need treatment and 
        the severity of health problems is expected to increase.
            (19) 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.
            (20) The deadline for filing claims for compensation under 
        the Victim Compensation Fund was December 22, 2003.
            (21) 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.
            (22) 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.
            (23) Research is needed regarding possible treatment for 
        the illnesses and injuries of September 11.
            (24) 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.
            (25) The failure to extend the appointment of Dr. John 
        Howard as Director of the National Institute for Occupational 
        Safety and Health in July 2008 is not in the interests of the 
        administration of such Institute nor the continued operation of 
        the World Trade Center Medical Monitoring and Treatment Program 
        which he has headed, and the Secretary of Health and Human 
        Services should reconsider extending such appointment.

SEC. 3. EMERGENCY FUNDING.

    Amounts appropriated pursuant to this Act (other than amounts 
appropriated for the WTC Health Program Steering Committees or for the 
WTC Health Program Scientific/Technical Advisory Committee) are 
designated as emergency requirements and necessary to meet emergency 
needs pursuant to section 204(a) of S. Con. Res. 21 (110th Congress) 
and section 301(b)(2) of S. Con. Res. 70 (110th Congress), the 
concurrent resolutions on the budget for fiscal years 2008 and 2009.

               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

SEC. 101. WORLD TRADE CENTER HEALTH PROGRAM.

    The Public Health Service Act is amended by adding at the end the 
following new title:

             ``TITLE XXX--WORLD TRADE CENTER HEALTH PROGRAM

     ``Subtitle A--Establishment of Program; Advisory and Steering 
                               Committees

``SEC. 3001. ESTABLISHMENT OF WORLD TRADE CENTER HEALTH PROGRAM WITHIN 
              NIOSH.

    ``(a) In General.--There is hereby established within 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 recovery and 
        clean-up workers (including those who are Federal employees) 
        who responded to the September 11, 2001, terrorist attacks on 
        the World Trade Center; and
            ``(2) to residents and other building occupants and area 
        workers in New York City who were directly impacted and 
        adversely affected by such attacks.
    ``(b) Components of Program.--The WTC program includes the 
following components:
            ``(1) Medical monitoring.--Medical monitoring under 
        sections 3011 and 3021, 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, or to other hazards, as a result of 
        the September 11, 2001, terrorist attacks on the World Trade 
        Center.
            ``(2) Treatment for wtc-related conditions.--Provision 
        under sections 3012, 3022, and 3023 of treatment and payment, 
        subject to the provisions of subsection (d), for all medically 
        necessary health and mental health care expenses (including 
        necessary prescription drugs) of individuals with a WTC-related 
        health condition.
            ``(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.--Establishment under 
        subtitle C of a research program on health conditions resulting 
        from the September 11, 2001, terrorist attacks on the World 
        Trade Center.
    ``(c) No Cost-Sharing.--Monitoring and treatment benefits are 
provided under subtitle B without any deductibles, copayments, or other 
cost-sharing to an eligible WTC responder or any eligible WTC resident 
or other non-responder.
    ``(d) Payor.--
            ``(1) In general.--Except as provided in paragraphs (2) and 
        (3), the cost of monitoring and treatment benefits provided 
        under subtitle B shall be paid for by the WTC program.
            ``(2) Workers' compensation payment.--Payment for treatment 
        under subtitle B of a WTC-related condition in an individual 
        that is work-related shall be reduced or recouped to the extent 
        that a payment is made under a workers' compensation law or 
        plan of the United States or a State for such treatment.
            ``(3) Health insurance coverage.--
                    ``(A) In general.--If an individual has a WTC-
                related condition that is not work-related and has 
                health coverage for such condition through any public 
                or private health plan, the WTC program shall be 
                secondary payor with respect to the payment for items 
                and services for such condition to the extent such 
                items and services are covered under such plan and such 
                plan has an arrangement with the health care provider 
                or facility allowing such payment.
                    ``(B) Billing health plan.--In the case described 
                in subparagraph (A), the Clinical Center of Excellence 
                providing the items or services involved shall bill the 
                public or private health plan for such items or 
                services. The health plan shall be responsible for 
                payment for such items or services to the extent that 
                the health plan has or had a responsibility under the 
                terms of coverage of that health plan to make such 
                payment with respect to such items or services. If the 
                health plan refuses to make such payment to such 
                Clinical Center, the WTC Program Administrator shall 
                seek to recover such payment with respect to the item 
                or service involved to the extent it is demonstrated 
                that the health plan has or had a responsibility to 
                make payment with respect to such item or service.
                    ``(C) Remaining costs under title.--Any costs for 
                such covered items and services that are not reimbursed 
                by such health plan, due to the application of 
                deductibles, copayments, coinsurance, other cost-
                sharing, or otherwise, are reimbursable under this 
                title to the extent that they are covered under the WTC 
                program.
            ``(4) Work-related described.--For the purposes of this 
        subsection, a WTC-related condition diagnosed in an eligible 
        WTC responder, or in an individual who qualifies as an eligible 
        WTC resident or other non-responder on the basis of being a 
        rescue, recovery, clean-up worker, or area worker, shall be 
        treated as a condition that is work-related.
    ``(e) Quality Assurance and Monitoring of Clinical Expenditures.--
            ``(1) Quality assurance.--The WTC Program Administrator 
        working with the Clinical Centers of Excellence shall develop 
        and implement a quality assurance program for the medical 
        monitoring and treatment delivered by such Centers of 
        Excellence and any other participating health care providers.
            ``(2) Fraud prevention.--The WTC Program Administrator 
        shall develop and implement a program to review the program's 
        health care expenditures to detect fraudulent or duplicate 
        billing and payment for inappropriate services. Such program 
        shall be similar to current methods used in connection with the 
        Medicare program under title XVIII of the Social Security Act. 
        This title is a Federal health care program (as defined in 
        section 1128B(f) of such Act) and is a health plan (as defined 
        in section 1128C(c) of such Act) for purposes of applying 
        sections 1128 through 1128E of such Act.
    ``(f) WTC Program Administration.--The WTC program shall be 
administered by the Director of the National Institute for Occupational 
Safety and Health, or a designee of such Director.
    ``(g) Annual Program Report.--
            ``(1) In general.--Not later than 6 months after the end of 
        each fiscal year in which the WTC program is in operation, the 
        WTC Program Administrator shall submit an annual report to the 
        Congress on the operations of this title for such fiscal year 
        and for the entire period of operation of the program.
            ``(2) Contents of report.--Each annual report under 
        paragraph (1) shall include the following:
                    ``(A) Eligible individuals.--Information for each 
                clinical program described in paragraph (3)--
                            ``(i) on the number of individuals who 
                        applied for certification under subtitle B and 
                        the number of such individuals who were so 
                        certified;
                            ``(ii) of the individuals who were 
                        certified, on the number who received medical 
                        monitoring under the program and the number of 
                        such individuals who received medical treatment 
                        under the program;
                            ``(iii) with respect to individuals so 
                        certified who received such treatment, on the 
                        WTC-related health conditions for which they 
                        were treated; and
                            ``(iv) on the projected number of 
                        individuals who will be certified under 
                        subtitle B in the succeeding fiscal year.
                    ``(B) Monitoring and treatment costs.--For each 
                clinical program so described--
                            ``(i) information on the costs of 
                        monitoring and the costs of treatment and on 
                        the estimated costs of such monitoring and 
                        treatment in the succeeding fiscal year; and
                            ``(ii) an estimate of the cost of medical 
                        treatment for WTC-related conditions that have 
                        been paid for or reimbursed by workers' 
                        compensation, by public or private health 
                        plans, or by the City of New York under section 
                        3012(c)(4).
                    ``(C) Administrative costs.--Information on the 
                cost of administering the program, including costs of 
                program support, data collection and analysis, and 
                research conducted under the program.
                    ``(D) Administrative experience.--Information on 
                the administrative performance of the program, 
                including--
                            ``(i) the performance of the program in 
                        providing timely evaluation of and treatment to 
                        eligible individuals; and
                            ``(ii) a list of the Clinical Centers of 
                        Excellence and other providers that are 
                        participating in the program.
                    ``(E) Scientific reports.--A summary of the 
                findings of any new scientific reports or studies on 
                the health effects associated with WTC center 
                exposures.
                    ``(F) Advisory committee recommendations.--A list 
                of recommendations by the WTC Scientific/Technical 
                Advisory Committee on additional WTC program 
                eligibility criteria and on additional WTC-related 
                health conditions and the action of the WTC Program 
                Administrator concerning each such recommendation.
                    ``(G) Research results.--The findings research 
                conducted under section 3041(a).
            ``(3) Separate clinical programs described.--In paragraph 
        (2), each of the following shall be treated as a separate 
        clinical program of the WTC program:
                    ``(A) FDNY responders.--The benefits provided for 
                eligible WTC responders described in section 
                3006(b)(1)(A).
                    ``(B) Other eligible wtc responders.--The benefits 
                provided for eligible WTC responders not described in 
                subparagraph (A).
                    ``(C) Eligible wtc residents and other non-
                responders.--The benefits provided for eligible WTC 
                residents and other non-responders.
    ``(h) Notification to Congress When Reach 80 Percent of Eligibility 
Numerical Limits.--The WTC Program Administrator shall promptly notify 
the Congress--
            ``(1) when the number of certifications for eligible WTC 
        responders subject to the limit established under section 
        3011(a)(5) has reached 80 percent of such limit; and
            ``(2) when the number of certifications for eligible WTC 
        residents or other non-responders subject to the limit 
        established under section 3021(a)(5) has reached 80 percent of 
        such limit.

``SEC. 3002. WTC HEALTH PROGRAM SCIENTIFIC/TECHNICAL ADVISORY 
              COMMITTEE.

    ``(a) Establishment.--The WTC Program Administrator 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 additional WTC program 
eligibility criteria and on additional WTC-related health conditions.
    ``(b) Composition.--The WTC Program Administrator shall appoint the 
members of the Advisory Committee and shall include at least--
            ``(1) 4 occupational physicians, at least two of whom have 
        experience treating WTC rescue and recovery workers;
            ``(2) 2 environmental medicine or environmental health 
        specialists;
            ``(3) 2 representatives of eligible WTC responders;
            ``(4) 2 representatives of WTC residents and other non-
        responders;
            ``(5) an industrial hygienist;
            ``(6) a toxicologist;
            ``(7) an epidemiologist; and
            ``(8) 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, not to exceed $100,000, for each fiscal year 
beginning with fiscal year 2009.
    ``(f) Duration.--Notwithstanding any other provision of law, the 
Advisory Committee shall continue in operation 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 subject to the Federal 
Advisory Committee Act.

``SEC. 3003. WTC HEALTH PROGRAM STEERING COMMITTEES.

    ``(a) Establishment.--The WTC Program Administrator shall establish 
two steering committees (each in this section referred to as a 
`Steering Committee') as follows:
            ``(1) WTC responders steering committee.--One steering 
        committee, to be known as the WTC Responders Steering 
        Committee, for the purpose of facilitating the coordination of 
        medical monitoring and treatment programs for the eligible WTC 
        responders under part 1 of subtitle B.
            ``(2) WTC community program steering committee.--One 
        steering committee, to be known as the WTC Community Program 
        Steering Committee, for the purpose of facilitating the 
        coordination of medical monitoring and treatment programs for 
        eligible WTC residents and other non-responders under part 2 of 
        subtitle B.
    ``(b) Membership.--
            ``(1) Initial membership of wtc responders steering 
        committee.--The WTC Responders Steering Committee shall 
        initially be composed of members of the WTC Monitoring and 
        Treatment Program Steering Committee (as in existence on the 
        day before the date of the enactment of this title).
            ``(2) Initial membership of wtc community program steering 
        committee.--
                    ``(A) In general.--The WTC Community Program 
                Steering Committee shall initially be composed of the 
                following:
                            ``(i) The Medical Director of the WTC 
                        Environmental Health Center.
                            ``(ii) The Executive Director of the WTC 
                        Environmental Health Center.
                            ``(iii) Three physicians, one each 
                        representing the three WTC Environmental Health 
                        Center treatment sites of Bellevue Hospital 
                        Center, Gouverneur Healthcare Services, and 
                        Elmhurst Hospital Center.
                            ``(iv) Three physicians or specialists, 
                        including a pediatrician, an epidemiologist, a 
                        psychiatrist or psychologist, with experience 
                        with non-responder WTC diseases.
                            ``(v) One environmental/occupational 
                        specialist with WTC experience.
                            ``(vi) One social worker with experience 
                        treating non-responders at a WTC Environmental 
                        Health Center treatment site.
                            ``(vii) 10 representatives of the affected 
                        populations of residents, students, area 
                        workers, and other non-responders.
                Such Committee shall also include, as nonvoting 
                members, members of the WTC Environmental Health Center 
                Community Advisory Committee (as in existence on the 
                day before the date of the enactment of this title) who 
                are not otherwise appointed under clause (vii).
                    ``(B) Appointments.--
                            ``(i) NYC health and hospitals 
                        corporation.--The New York City Health and 
                        Hospitals Corporation shall nominate members 
                        for positions described in clauses (iii) 
                        through (vi) of subparagraph (A).
                            ``(ii) WTC ehc community advisory 
                        committee.--The WTC Environmental Health Center 
                        Community Advisory Committee as in existence on 
                        the date of the enactment of this title shall 
                        nominate members for positions described in 
                        subparagraph (A)(vii).
                            ``(iii) Timing.--Nominations under clauses 
                        (i) and (ii) shall be recommended to the WTC 
                        Program Administrator not later than 60 days 
                        after the date of the enactment of this title.
                            ``(iv) Appointment.--The WTC Program 
                        Administrator shall appoint members of the WTC 
                        Community Program Steering Committee not later 
                        than 90 days after the date of the enactment of 
                        this title.
                            ``(v) General representatives.--Of the 
                        members appointed under subparagraph (A)(vii)--
                                    ``(I) the representation shall 
                                reflect the broad and diverse WTC-
                                affected populations and constituencies 
                                and the diversity of impacted 
                                neighborhoods, including residents, 
                                hard-to-reach populations, students, 
                                area workers, school parents, 
                                community-based organizations, 
                                Community Boards, WTC Environmental 
                                Health Center patients, labor unions, 
                                and labor advocacy organizations; and
                                    ``(II) no one individual 
                                organization can have more than one 
                                representative.
            ``(3) Additional appointments.--Each Steering Committee may 
        appoint additional members to the Committee, subject to the 
        approval of the WTC Program Administrator.
            ``(4) Vacancies.--A vacancy in a Steering Committee shall 
        be filled by the Steering Committee, subject to the approval of 
        the WTC Program Administrator, so long as--
                    ``(A) in the case of the WTC Responders Steering 
                Committee, the composition of the Committee includes 
                representatives of eligible WTC responders and 
                representatives of each Clinical Center of Excellence 
                and each Coordinating Center of Excellence that serves 
                eligible WTC responders; or
                    ``(B) in the case of the WTC Community Program 
                Steering Committee, the composition of the Committee 
                includes representatives includes representatives of 
                eligible WTC residents and other non-responders and 
                representatives of each Clinical Center of Excellence 
                and each Coordinating Center of Excellence that serves 
                eligible WTC residents and other non-responders.
            ``(5) Co-chairs of wtc community program steering 
        committee.--The WTC Community Program Steering Committee shall 
        have two Co-Chairs as follows:
                    ``(A) Environmental health clinic co-chair.--A WTC 
                Environmental Health Clinic Co-Chair who shall be 
                chosen by the WTC Environmental Health Center members 
                on the Steering Committee.
                    ``(B) Community/Labor co-chair.--A Community/Labor 
                Co-Chair who shall be chosen by the community and 
                labor-based members of the Steering Committee.
    ``(c) Relation to FACA.--Each Steering Committee shall not be 
subject to the Federal Advisory Committee Act.
    ``(d) Meetings.--Each Steering Committee shall meet at such 
frequency necessary to carry out its duties, but not less than 4 times 
each calendar year and at least two such meetings each year shall be a 
joint meeting with the other Steering Committee for the purpose of 
exchanging information regarding the WTC program.
    ``(e) Duration.--Notwithstanding any other provision of law, each 
Steering Committee shall continue in operation during the period in 
which the WTC program is in operation.

``SEC. 3004. COMMUNITY EDUCATION AND OUTREACH.

    ``(a) In General.--The WTC Program Administrator shall institute a 
program that provides education and outreach on the existence and 
availability of services 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 possible, in carrying 
out this section, the WTC Program Administrator shall enter into 
partnerships with local governments and organizations with experience 
performing outreach to the affected populations, including community 
and labor-based organizations.

``SEC. 3005. UNIFORM DATA COLLECTION.

    ``(a) In General.--The WTC Program Administrator 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 treatment 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 Excellence.--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 requirements.

``SEC. 3006. CENTERS OF EXCELLENCE.

    ``(a) In General.--
            ``(1) Contracts with clinical centers of excellence.--The 
        WTC Program Administrator shall enter into contracts with 
        Clinical Centers of Excellence specified 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 and follow-up to individuals who are enrolled 
                in the program;
                    ``(C) for the provision of counseling for benefits 
                under subtitle B, with respect to WTC-related health 
                conditions, for individuals eligible for such benefits;
                    ``(D) for the provision of counseling for benefits 
                for WTC-related health conditions that may be available 
                under Workers' Compensation, health insurance, 
                disability insurance, or other insurance plans or 
                through public or private social service agencies and 
                assisting eligible individuals in applying for such 
                benefits;
                    ``(E) for the provision of translational and 
                interpretive services as for program participants who 
                are not English language proficient; and
                    ``(F) for the collection and reporting of data in 
                accordance with section 3005.
            ``(2) Contracts with coordinating centers of excellence.--
        The WTC Program Administrator shall enter into contracts with 
        Coordinating Centers of Excellence specified in subsection 
        (b)(2)--
                    ``(A) for receiving, analyzing, and reporting 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 monitoring and 
                treatment protocols, with respect to WTC-related health 
                conditions;
                    ``(C) for coordinating the outreach activities 
                conducted under paragraph (1)(B) by each corresponding 
                Clinical Center of Excellence;
                    ``(D) for establishing criteria for the 
                credentialing of medical providers participating in the 
                nationwide network under section 3031; and
                    ``(E) for coordinating and administrating the 
                activities of the WTC Health Program Steering 
                Committees established under section 3003(a).
        The medical providers under subparagraph (D) shall be selected 
        by the WTC Program Administrator on the basis of their 
        experience treating or diagnosing the medical conditions 
        included in the list of identified WTC-related conditions for 
        responders and of identified WTC-related conditions for 
        residents and other non-responders.
    ``(b) Centers of Excellence Defined.--
            ``(1) Clinical center of excellence.--In this title, the 
        term `Clinical Center of Excellence' means the following:
                    ``(A) For fdny responders in new york.--With 
                respect to an eligible WTC responder 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 treatment of such responders).
                    ``(B) Other eligible wtc responders in new york.--
                With respect to other eligible WTC responders who 
                reside in the New York Metropolitan area, the Mt. Sinai 
                coordinated consortium, 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-responders 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 Health and Hospitals Corporation, as 
                are identified by the WTC Program Administrator.
                    ``(D) All eligible wtc responders and eligible wtc 
                residents and other non-responders.--With respect to 
                all eligible WTC responders and eligible WTC residents 
                and other non-responders, such other hospitals or other 
                facilities as are identified by the WTC Program 
                Administrator.
        The WTC Program Administrator shall limit the number of 
        additional Centers of Excellence identified under subparagraph 
        (D) to ensure that the participating centers have adequate 
        experience in the treatment and diagnosis of identified WTC-
        related medical conditions.
            ``(2) Coordinating center of excellence.--In this title, 
        the term `Coordinating Center of Excellence' means the 
        following:
                    ``(A) For fdny responders.--With respect to an 
                eligible WTC responder who responded 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 respect 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 Center of Excellence 
        shall be treated as `corresponding' to the extent that such 
        Clinical Center and Coordinating Center serve the same 
        population group.
    ``(c) Reimbursement for Non-Treatment, Non-Monitoring Program 
Costs.--A Clinical or Coordinating Center of Excellence with a contract 
under this section shall be reimbursed for the costs of such Center in 
carrying out the activities described in subsection (a), other than 
those described in subsection (a)(1)(A), subject to the provisions of 
section 3001(d), as follows:
            ``(1) Clinical centers of excellence.--For carrying out 
        subparagraphs (B) through (F) of subsection (a)(1)--
                    ``(A) Clinical center for fdny responders in new 
                york.--The Clinical Center of Excellence for FDNY 
                Responders in New York specified in subsection 
                (b)(1)(A) shall be reimbursed--
                            ``(i) in the first year of the contract 
                        under this section, $900 per participant in the 
                        medical treatment program, and $400 per 
                        participant in the monitoring program; and
                            ``(ii) in each subsequent contract year, 
                        subject to paragraph (3), at the rates 
                        specified in this subparagraph for the previous 
                        contract year adjusted by the WTC Program 
                        Administrator to reflect the rate of medical 
                        care inflation during the previous contract 
                        year.
                    ``(B) Clinical centers serving other eligible wtc 
                responders in new york.--A Clinical Center of 
                Excellence for other WTC responders in New York 
                specified in subsection (b)(1)(B) shall be reimbursed 
                the amounts specified in subparagraph (A).
                    ``(C) Clinical centers serving wtc residents and 
                other non-responders.--A Clinical Center of Excellence 
                for eligible WTC residents and other non-responders in 
                New York specified in subsection (b)(1)(C) shall be 
                reimbursed--
                            ``(i) for each participant in a medical 
                        treatment program enrolled at a non-hospital-
                        based facility, the amount specified in 
                        subparagraph (A) per participant in a medical 
                        treatment program; and
                            ``(ii) for each participant in a medical 
                        treatment program enrolled at a hospital-based 
                        facility, \2/3\ of the amount specified in 
                        clause (i).
                    ``(D) Other clinical centers.--A Clinical Center of 
                Excellence or other providers not described in a 
                previous subparagraph shall be reimbursed at a rate set 
                by the WTC Program Administrator.
                    ``(E) Reimbursement rules.--The reimbursement 
                provided under subparagraphs (A), (B) and (C) shall be 
                made for each participant in the WTC program per year, 
                regardless of the volume or cost of services required.
            ``(2) Coordinating centers of excellence.--A Coordinating 
        Centers of Excellence specified in section (a)(2) shall be 
        reimbursed for the provision of services set forth in this 
        section at such levels as are established by the WTC Program 
        Administrator.
            ``(3) Review of rates.--
                    ``(A) Initial review.--Before the end of the fifth 
                contract year of the WTC program, the WTC Program 
                Administrator shall conduct a review to determine 
                whether the reimbursement rates set forth in this 
                subsection provide fair and appropriate reimbursement 
                for such program services. Based on such review, the 
                Administrator may, by rule beginning with the sixth 
                contract year, may modify such rates, taking into 
                account a reasonable and fair rate for the services 
                being provided.
                    ``(B) Subsequent reviews.--After the sixth contract 
                year, the WTC Program Administrator shall conduct 
                periodic reviews to determine whether the reimbursement 
                rates in effect under this subsection provide fair and 
                appropriate reimbursement for such program services. 
                Based upon such a review, the Administrator may by rule 
                modify such rates, taking into account a reasonable and 
                fair rate for the services being provided.
                    ``(C) GAO review.--The Comptroller General of the 
                United States shall review the Secretary's 
                determinations regarding fair and appropriate 
                reimbursement for program services under this 
                paragraph.
    ``(d) Requirements.--The WTC Program Administrator shall not enter 
into a contract with a Clinical Center of Excellence under subsection 
(a)(1) unless--
            ``(1) the Center establishes a formal mechanism for 
        consulting with and receiving input from representatives of 
        eligible populations receiving monitoring and treatment 
        benefits under subtitle B from such Center;
            ``(2) the Center provides for the coordination of 
        monitoring and treatment benefits under subtitle B with routine 
        medical care provided for the treatment of conditions other 
        than WTC-related health conditions;
            ``(3) the Center collects and reports to the corresponding 
        Coordinating Center of Excellence data in accordance with 
        section 3005;
            ``(4) the Center has in place safeguards against fraud that 
        are satisfactory to the Administrator;
            ``(5) the Center agrees to treat or refer for treatment all 
        individuals who are eligible WTC responders or eligible WTC 
        residents and other nonresponders with respect to such Center 
        who present themselves for treatment of a WTC-related health 
        condition; and
            ``(6) the Center agrees to meet all the other applicable 
        requirements of this title, including regulations implementing 
        such requirements.

``SEC. 3007. PROGRAMS REGARDING ATTACK AT PENTAGON.

    ``The Secretary 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 subtitles B and C with respect to the September 11, 
2001, terrorist attacks on the World Trade Center.

``SEC. 3008. ENTITLEMENT AUTHORITIES.

    ``Subtitle B constitutes budget authority in advance of 
appropriations Acts and represents the obligation of the Federal 
Government to provide for the payment for monitoring and treatment in 
accordance with such subtitle and section 3006(c) constitutes such 
budget authority and represents the obligation of the Federal 
Government to provide for the payment described in such section.

``SEC. 3009. DEFINITIONS.

    ``In this title:
            ``(1) The term `aggravating' means, with respect to a 
        health condition, a health condition that existed on September 
        11, 2001, and that, as a result of exposure to airborne toxins, 
        any other hazard, or any other adverse condition resulting from 
        the September 11, 2001, terrorist attacks on the World Trade 
        Center requires medical treatment that is (or will be) in 
        addition to, more frequent than, or of longer duration than the 
        medical treatment that would have been required for such 
        condition in the absence of such exposure.
            ``(2) The terms `Clinical Center of Excellence' and 
        `Coordinating Center of Excellence' have the meanings given 
        such terms in section 3006(b).
            ``(3) The term `current consortium arrangements' means the 
        arrangements as in effect on the date of the enactment of this 
        title between the National Institute for Occupational Safety 
        and Health and the Mt. Sinai-coordinated consortium and the 
        Fire Department of the City of New York.
            ``(4) The terms `eligible WTC responder' and `eligible WTC 
        resident or other non-responder' are defined in sections 
        3011(a) and 3021(a), respectively.
            ``(5) The term `list of identified WTC-related health 
        conditions' means--
                    ``(A) for eligible WTC responders, the identified 
                WTC-related health condition for eligible WTC 
                responders under section 3012(a)(3); or
                    ``(B) for eligible WTC residents and other non-
                responders, the identified WTC-related health condition 
                for WTC residents and other responders under section 
                3022(b)(1).
            ``(6) The term `Mt.-Sinai-coordinated consortium' means the 
        consortium coordinated by Mt. Sinai hospital in New York City 
        that coordinates the monitoring and treatment under the current 
        consortium arrangements for eligible WTC responders other than 
        with respect to those covered under the arrangement with the 
        Fire Department for the City of New York.
            ``(7) The term `New York City disaster area' means the area 
        within New York City that is--
                    ``(A) the area of Manhattan that is south of 
                Houston Street; and
                    ``(B) any block in Brooklyn that is wholly or 
                partially contained within a 1.5-mile radius of the 
                former World Trade Center site.
            ``(8) The term `New York metropolitan area' means an area, 
        specified by the WTC Program Administrator, within which 
        eligible WTC responders and eligible WTC residents and other 
        non-responders who reside in such area are reasonably able to 
        access monitoring and treatment benefits under this title 
        through a Clinical Centers of Excellence described in 
        subparagraphs (A), (B), or (C) of section 3006(b)(1).
            ``(9) The term `September 11, 2001, terrorist attacks on 
        the World Trade Center' means the terrorist attacks that 
        occurred on September 11, 2001, in New York City and includes 
        the aftermath of such attacks.
            ``(10) The term `WTC Health Program Steering Committee' 
        means such a Steering Committee established under section 3003.
            ``(11) The term `WTC Program Administrator' means the 
        individual responsible under section 3001(d) for the 
        administration of the WTC program.
            ``(12) The term `WTC-related health condition' is defined 
        in section 3012(a).
            ``(13) The term `WTC Scientific/Technical Advisory 
        Committee' means such Committee established under section 3002.

           ``Subtitle B--Program of Monitoring and Treatment

                      ``PART 1--FOR WTC RESPONDERS

``SEC. 3011. IDENTIFICATION OF ELIGIBLE WTC RESPONDERS AND PROVISION OF 
              WTC-RELATED MONITORING 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, subject to paragraph (5):
                    ``(A) Currently identified responder.--An 
                individual who has been identified as eligible for 
                medical monitoring under the current consortium 
                arrangements (as defined in section 3009(3)).
                    ``(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--
                            ``(i) performed rescue, recovery, 
                        demolition, debris cleanup, or other related 
                        services in the New York City disaster area in 
                        response to the September 11, 2001, terrorist 
                        attacks on the World Trade Center, regardless 
                        of whether such services were performed by a 
                        State or Federal employee or member of the 
                        National Guard or otherwise; and
                            ``(ii) meets such eligibility criteria 
                        relating to exposure to airborne toxins, other 
                        hazards, or adverse conditions resulting from 
                        the September 11, 2001, terrorist attacks on 
                        the World Trade Center as the WTC Program 
                        Administrator, after consultation with the WTC 
                        Responders Steering Committee and the WTC 
                        Scientific/Technical Advisory Committee, 
                        determines 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 personnel.--All 
                members of the Fire Department of the City of New York 
                (whether fire or emergency personnel, active or 
                retired) who participated at least one day in the 
                rescue and recovery effort at any of the former World 
                Trade sites (including Ground Zero, Staten Island land 
                fill, and the NYC Chief Medical Examiner's office) for 
                any time during the period beginning 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 September 11, 
                        2001, and ending on September 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 processing of 
                        human remains, or other morgue worker who 
                        performed similar post-September 11 functions 
                        for such Office staff;
                            ``(iii) was a worker in the Port Authority 
                        Trans-Hudson Corporation tunnel for at least 24 
                        hours during the period beginning on February 
                        1, 2002, and ending on July 1, 2002; or
                            ``(iv) was a vehicle-maintenance worker who 
                        was exposed to debris from the former World 
                        Trade Center while retrieving, driving, 
                        cleaning, repairing, and maintaining vehicles 
                        contaminated by airborne toxins from the 
                        September 11, 2001, terrorist attacks on the 
                        World Trade Center during a duration and period 
                        described in subparagraph (A).
            ``(3) Application process.--The WTC Program Administrator 
        in consultation with the Coordinating Centers of Excellence 
        shall establish a process for individuals, other than eligible 
        WTC responders described in paragraph (1)(A), to apply to be 
        determined to be eligible WTC responders. Under such process--
                    ``(A) there shall be no fee charged to the 
                applicant for making an application for such 
                determination; and
                    ``(B) the Administrator shall make a determination 
                on such an application not later than 60 days after the 
                date of filing the application.
            ``(4) Certification.--
                    ``(A) In general.--In the case of an individual who 
                is described in paragraph (1)(A) or who is determined 
                under paragraph (3) (consistent with paragraph (5)) to 
                be an eligible WTC responder, the WTC Program 
                Administrator shall provide an appropriate 
                certification of such fact and of eligibility for 
                monitoring and treatment benefits under this part. The 
                Administrator shall make determinations of eligibility 
                relating to an applicant's compliance with this title, 
                including the verification of information submitted in 
                support of the application, and shall not deny such a 
                certification to an individual unless the Administrator 
                determines that--
                            ``(i) based on the application submitted, 
                        the individual does not meet the eligibility 
                        criteria; or
                            ``(ii) the numerical limitation on eligible 
                        WTC responders set forth in paragraph (5) has 
                        been met.
                    ``(B) Timing.--In the case of an individual who is 
                determined under paragraph (3) and consistent with 
                paragraph (5) to be an eligible WTC responder, the WTC 
                Program Administrator shall provide the certification 
                under subparagraph (A) at the time of the 
                determination.
            ``(5) Numerical limitation on eligible wtc responders.--
                    ``(A) In general.--Notwithstanding any other 
                provision of this title, the total number of 
                individuals not described in subparagraph (C) who may 
                qualify as eligible WTC responders for purposes of this 
                title, and be certified as eligible WTC responders 
                under paragraph (4), shall not exceed 35,000.
                    ``(B) Process.--In implementing subparagraph (A), 
                the WTC Program Administrator shall--
                            ``(i) limit the number of certifications 
                        provided under paragraph (4) in accordance with 
                        such subparagraph; and
                            ``(ii) provide priority in such 
                        certifications in the order in which 
                        individuals apply for a determination under 
                        paragraph (3).
                    ``(C) Currently identified responders not 
                counted.--Individuals described in this subparagraph 
                are individuals who are described in paragraph (1)(A).
    ``(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 Program 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 receive 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 Excellence for the type of individual 
        involved or, in the case of an individual residing outside the 
        New York metropolitan area, under an arrangement under section 
        3031.

``SEC. 3012. TREATMENT OF ELIGIBLE WTC RESPONDERS FOR WTC-RELATED 
              HEALTH CONDITIONS.

    ``(a) WTC-Related Health Condition Defined.--
            ``(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 September 
                11, 2001, terrorist attacks on the World Trade Center, 
                based on an examination by a medical professional with 
                experience in treating or diagnosing the medical 
                conditions included in the applicable list of 
                identified WTC-related conditions, is substantially 
                likely to be a significant factor in aggravating, 
                contributing to, or causing the illness or health 
                condition, as determined under paragraph (2); or
                    ``(B) a mental health condition for which such 
                attacks, based on an examination by a medical 
                professional with experience in treating or diagnosing 
                the medical conditions included in the applicable list 
                of identified WTC-related conditions, is substantially 
                likely be a significant factor in aggravating, 
                contributing to, or causing the condition, as 
                determined under paragraph (2).
            ``(2) Determination.--The determination of whether the 
        September 11, 2001, terrorist attacks on the World Trade Center 
        were substantially likely to be a significant factor in 
        aggravating, contributing to, or causing an individual's 
        illness or health condition shall be made based on an 
        assessment of the following:
                    ``(A) The individual's exposure to airborne toxins, 
                any other hazard, or any other adverse condition 
                resulting from the terrorist attacks. Such exposure 
                shall be--
                            ``(i) evaluated and characterized through 
                        the use of a standardized, population 
                        appropriate questionnaire approved by the 
                        Director of the National Institute for 
                        Occupational Safety and Health; and
                            ``(ii) assessed and documented by a medical 
                        professional with experience in treating or 
                        diagnosing medical conditions included on the 
                        list of identified WTC-related conditions.
                    ``(B) The type of symptoms and temporal sequence of 
                symptoms. Such symptoms shall be--
                            ``(i) assessed through the use of a 
                        standardized, population appropriate medical 
                        questionnaire approved by Director of the 
                        National Institute for Occupational Safety and 
                        Health and a medical examination; and
                            ``(ii) diagnosed and documented by a 
                        medical professional described in subparagraph 
                        (A)(ii).
            ``(3) List of identified wtc-related health conditions for 
        eligible wtc responders.--For purposes of this title, the term 
        `identified WTC-related health condition for eligible WTC 
        responders' means any of the following health conditions, and 
        any condition specified under paragraph (4):
                    ``(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 obstructive 
                        pulmonary disease (COPD).
                            ``(vi) Chronic cough syndrome.
                            ``(vii) Upper airway hyperreactivity.
                            ``(viii) Chronic rhinosinusitis.
                            ``(ix) Chronic nasopharyngitis.
                            ``(x) Chronic laryngitis.
                            ``(xi) Gastro-esophageal reflux disorder 
                        (GERD).
                            ``(xii) Sleep apnea exacerbated by or 
                        related to a condition described in a previous 
                        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 
                        specified).
                            ``(vii) Acute stress disorder.
                            ``(viii) Dysthymic disorder.
                            ``(ix) Adjustment disorder.
                            ``(x) Substance abuse.
                            ``(xi) V codes (treatments not specifically 
                        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.
            ``(4) Application for additional identified wtc-related 
        health conditions for eligible wtc responders.--
                    ``(A) Application.--Any individual or organization 
                can apply to the WTC Program Administrator for an 
                illness or health condition not described in paragraph 
                (3) to be added to the list of identified WTC-related 
                conditions for eligible WTC responders.
                    ``(B) Review.--The WTC Program Administrator shall 
                establish a public process for receiving public input 
                and comments on any application under subparagraph (A).
                    ``(C) Considerations.--In making determinations on 
                such applications, the WTC Program Administrator shall 
                give deference to the findings and recommendations of 
                Clinical Centers of Excellence published in peer 
                reviewed journals in the determination of whether an 
                additional illness or health condition, such as cancer, 
                should be added to the list of identified WTC-related 
                health conditions for eligible WTC responders.
                    ``(D) Consultation.--The WTC Program Administrator 
                shall consult with the WTC Responders Steering 
                Committee and the WTC Scientific/Technical Advisory 
                Committee in making a determination on whether an 
                additional health condition should be added to the list 
                of identified WTC-related conditions for eligible WTC 
                responders.
                    ``(E) Determination.--The WTC Program Administrator 
                shall add an illness or health condition to the list of 
                identified WTC-related health conditions for eligible 
                WTC responders if, based on a review of the evidence 
                and consultations conducted under subparagraphs (B), 
                (C), and (D), the Administrator determines that 
                exposure to airborne toxins, other hazards, or other 
                adverse conditions resulting from the September 11, 
                2001, terrorist attacks on the World Trade Center is 
                substantially likely 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 an identified wtc-related 
        health condition for eligible wtc responders.--
                    ``(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 responder has an 
                identified WTC-related health condition, and the 
                physician makes a clinical determination that exposure 
                to airborne toxins, other hazards, or adverse 
                conditions resulting from the 9/11 terrorist attacks is 
                substantially likely to be a significant factor in 
                aggravating, contributing to, or causing the 
                condition--
                            ``(i) the physician shall promptly transmit 
                        such determination to the WTC Program 
                        Administrator and provide the Administrator 
                        with the medical facts supporting such 
                        determination; and
                            ``(ii) on and after the date of such 
                        transmittal and subject to paragraph (2), the 
                        WTC program shall provide for payment under 
                        subsection (c) for medically necessary 
                        treatment for such condition.
                    ``(B) Review; certification; appeals.--
                            ``(i) Review.--A Federal employee 
                        designated by the WTC Program Administrator 
                        shall review determinations made under 
                        subparagraph (A)(i) of a WTC-related health 
                        condition.
                            ``(ii) Certification.--The Administrator 
                        shall provide a certification of coverage of 
                        the treatment of such condition based upon 
                        reviews conducted under clause (i). Such a 
                        certification shall be provided unless the 
                        Administrator determines that the responder's 
                        condition is not an identified WTC-related 
                        health condition or that exposure to airborne 
                        toxins, other hazards, or adverse conditions 
                        resulting from the 9/11 terrorist attacks is 
                        not substantially likely to be a significant 
                        factor in significantly aggravating, 
                        contributing to, or causing the condition.
                            ``(iii) Appeal process.--The Administrator 
                        shall provide a process for the appeal of 
                        determinations under clause (ii).
            ``(2) Determination based on other wtc-related health 
        condition.--
                    ``(A) In general.--If a physician at a Clinical 
                Center of Excellence determines pursuant to subsection 
                (a) that the eligible WTC responder has a WTC-related 
                health condition that is not an identified WTC-related 
                health condition for eligible WTC responders--
                            ``(i) the physician shall promptly transmit 
                        such determination to the WTC Program 
                        Administrator and provide the Administrator 
                        with the facts supporting such determination; 
                        and
                            ``(ii) on and after the date of such 
                        transmittal and pending a determination by the 
                        Administrator under subparagraph (B), the WTC 
                        program shall provide for payment under 
                        subsection (c) for medically necessary 
                        treatment for such condition.
                    ``(B) Review; certification.--
                            ``(i) Use of physician panel.--The WTC 
                        Program Administrator shall provide for the 
                        review of each determination made under 
                        subparagraph (A)(i) of a WTC-related health 
                        condition to be made by a physician panel with 
                        appropriate expertise appointed by the WTC 
                        Program Administrator. Such a panel shall make 
                        recommendations to the Administrator on the 
                        evidence supporting such determination.
                            ``(ii) Review of recommendations of panel; 
                        certification.--The Administrator, based on 
                        such recommendations shall determine whether or 
                        not the condition 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 
                        determinations 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 necessary for a WTC-related health condition shall 
        be made by physicians at the appropriate Clinical Center of 
        Excellence, taking into account, for identified WTC-related 
        health conditions, medical treatment protocols established 
        under subsection (d).
            ``(4) Scope of treatment covered.--
                    ``(A) In general.--The scope of treatment covered 
                under such paragraphs includes services of physicians 
                and other health care providers, diagnostic and 
                laboratory tests, prescription drugs, inpatient and 
                outpatient hospital services, and other medically 
                necessary treatment.
                    ``(B) Pharmaceutical coverage.--With respect to 
                ensuring coverage of medically necessary outpatient 
                prescription drugs, such drugs shall be provided, under 
                arrangements made by the WTC Program Administrator, 
                directly through participating Clinical Centers of 
                Excellence or through one or more outside vendors.
            ``(5) Provision of treatment pending certification.--In the 
        case of an eligible WTC responder who has been determined by an 
        examining physician under subsection (b)(1) to have an 
        identified WTC-related health condition, but for whom a 
        certification of the determination has not yet been made by the 
        WTC Program Administrator, medical treatment may be provided 
        under this subsection until the Administrator makes a decision 
        on such certification. Medical treatment provided under this 
        paragraph shall be considered to be medical treatment for which 
        payment may be made under subsection (c).
    ``(c) Payment for Medical Monitoring and Treatment of WTC-Related 
Health Conditions.--
            ``(1) Medical treatment.--
                    ``(A) Use of medicare payment rates.--
                            ``(i) In general.--Subject to subparagraph 
                        (B), the WTC Program Administrator shall 
                        reimburse costs for medically necessary 
                        treatment under this title for WTC-related 
                        health conditions provided under this title in 
                        a facility for which a payment rate is 
                        established under the Medicare program under 
                        title XVIII of the Social Security Act at the 
                        applicable percentage of such Medicare payment 
                        rate.
                            ``(ii) Applicable percentage.--For purposes 
                        of this subparagraph, the term `applicable 
                        percentage' means--
                                    ``(I) 115 percent for treatment 
                                provided by a hospital or an ambulatory 
                                care facility; or
                                    ``(II) 130 percent for other 
                                treatment.
                    ``(B) Pharmaceuticals.--
                            ``(i) In general.--The WTC Program 
                        Administrator shall establish a program for 
                        paying for the medically necessary outpatient 
                        prescription pharmaceuticals prescribed under 
                        this title for WTC-related conditions through 
                        one or more contracts with outside vendors.
                            ``(ii) Competitive bidding.--Under such 
                        program the Administrator shall--
                                    ``(I) select one or more 
                                appropriate vendors through a Federal 
                                competitive bid process; and
                                    ``(II) select the lowest bidder (or 
                                bidders) meeting the requirements for 
                                providing pharmaceutical benefits for 
                                participants in the WTC program.
                            ``(iii) Treatment of fdny participants.--
                        Under such program the Administrator may enter 
                        select a separate vendor to provide 
                        pharmaceutical benefits to eligible WTC 
                        responders for whom the Clinical Center of 
                        Excellence is described in section 
                        3006(b)(1)(A) if such an arrangement is deemed 
                        necessary and beneficial to the program by the 
                        WTC Program Administrator.
                    ``(C) Other treatment.--For treatment not covered 
                under a preceding subparagraph, the WTC Program 
                Administrator shall designate a reimbursement rate for 
                each such service based upon the rates of reimbursement 
                specified in the preceding subparagraphs.
            ``(2) Medical monitoring.--The WTC Program Administrator 
        shall reimburse the costs of medical monitoring provided under 
        this title at a rate set by the Administrator.
            ``(3) Administrative arrangement authority.--The WTC 
        Program Administrator may enter into arrangements with other 
        government agencies, insurance companies, or other third-party 
        administrators to provide for timely and accurate processing of 
        claims under this section.
            ``(4) Participation by new york city in treatment costs.--
                    ``(A) In general.--The amount of the covered 
                treatment payment (as defined in subparagraph (B)) for 
                a fiscal year shall be reduced by an amount equal to 5 
                percent of the amount of the covered treatment payment 
                that would be made for the fiscal year but for this 
                paragraph.
                    ``(B) Covered treatment payment defined.--For 
                purposes of this paragraph, the term `covered treatment 
                payment' means payment under paragraph (1), including 
                under such paragraph as applied under section 3022(a), 
                for items and services furnished by a Clinical Center 
                of Excellence within the New York City Health and 
                Hospitals Corporation to eligible WTC responders and to 
                eligible WTC residents or other non-responders. Such 
                payment shall be determined after the application of 
                paragraphs (2) and (3) of section 3001(d).
    ``(d) Medical Treatment Protocols.--
            ``(1) Development.--The Coordinating Centers of Excellence 
        shall develop medical treatment protocols for the treatment of 
        eligible WTC responders and eligible WTC residents and other 
        non-responders for identified WTC-related health conditions 
        under subsection (b).
            ``(2) Approval.--The WTC Program Administrator shall 
        approve the medical treatment protocols, in consultation with 
        the WTC Health Program Steering Committees.

                      ``PART 2--COMMUNITY PROGRAM

``SEC. 3021. IDENTIFICATION OF ELIGIBLE WTC RESIDENTS AND OTHER NON-
              RESPONDERS AND PROVISION OF WTC-RELATED MONITORING 
              SERVICES.

    ``(a) Eligible WTC Resident and Other Non-Responder Defined.--
            ``(1) In general.--In this title, the term `eligible WTC 
        resident and other non-responder' means, subject to paragraph 
        (3), an individual who is not an eligible WTC responder and is 
        described in any of the following subparagraphs:
                    ``(A) A person who was present in the New York City 
                disaster area in the dust or dust cloud on September 
                11, 2001.
                    ``(B) A person who worked, resided or attended 
                school, child care or adult day care in the New York 
                City disaster area for--
                            ``(i) at least four days during the 4-month 
                        period beginning on September 11, 2001, and 
                        ending on January 10, 2002; or
                            ``(ii) at least 30 days during the period 
                        beginning on September 11, 2001, and ending on 
                        July 31, 2002.
                    ``(C) Any person who worked as a clean-up worker or 
                performed maintenance work in the New York City 
                disaster area during the 4-month period described in 
                subparagraph (B)(i) and had extensive exposure to WTC 
                dust as a result of such work.
                    ``(D) A person who was deemed eligible to receive a 
                grant from the Lower Manhattan Development Corporation 
                Residential Grant Program, who possessed a lease for a 
                residence or purchased a residence in the New York City 
                disaster area, and who resided in such residence during 
                the period beginning on September 11, 2001, and ending 
                on May 31, 2003.
                    ``(E) A person whose place of employment--
                            ``(i) at any time during the period 
                        beginning on September 11, 2001, and ending 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 Development 
                        Corporation WTC Small Firms Attraction and 
                        Retention Act program or other government 
                        incentive program designed to revitalize the 
                        Lower Manhattan economy after the September 11, 
                        2001, terrorist attacks on the World Trade 
                        Center.
                    ``(F) A person who was receiving treatment as of 
                the date of the enactment of this title at the World 
                Trade Center Environmental Health Center operated by 
                the New York City Health and Hospitals Corporation.
            ``(2) Eligibility criteria.--In establishing eligibility 
        criteria for purposes of subparagraphs (A) through (C) of 
        paragraph (1) and for purposes of section 3011(a)(1)(D), the 
        WTC Program Administrator shall--
                    ``(A) take into account the period, and, to the 
                extent feasible, intensity, of exposure to airborne 
                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 Community Program 
                Steering Committee, Coordinating Centers 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 enactment of this title.
            ``(3) Application process.--The WTC Program Administrator 
        in consultation with the Coordinating Centers of Excellence 
        shall establish a process for individuals to be determined 
        eligible WTC residents and other non-responders. Under such 
        process--
                    ``(A) there shall be no fee charged to the 
                applicant for making an application for such 
                determination; and
                    ``(B) the Administrator shall make a determination 
                on such an application not later than 60 days after the 
                date of filing the application.
            ``(4) Certification.--
                    ``(A) In general.--In the case of an individual who 
                is determined under paragraph (3) and consistent with 
                paragraph (5) to be an eligible WTC resident or other 
                non-responder, the WTC Program Administrator shall 
                provide an appropriate certification of such fact and 
                of eligibility for monitoring and treatment benefits 
                under this part. The Administrator shall make 
                determinations of eligibility relating to an 
                applicant's compliance with this title, including the 
                verification of information submitted in support of the 
                application and shall not deny such a certification to 
                an individual unless the Administrator determines 
                that--
                            ``(i) based on the application submitted, 
                        the individual does not meet the eligibility 
                        criteria; or
                            ``(ii) the numerical limitation on eligible 
                        WTC residents and other non-responders set 
                        forth in paragraph (5) has been met.
                    ``(B) Timing.--In the case of an individual who is 
                determined under paragraph (3) and consistent with 
                paragraph (5) to be an eligible WTC resident or other 
                non-responder, the WTC Program Administrator shall 
                provide the certification under subparagraph (A) at the 
                time of such determination.
            ``(5) Numerical limitation on eligible wtc residents and 
        other non-responders.--
                    ``(A) In general.--Notwithstanding any other 
                provision of this title, the total number of 
                individuals not described in subparagraph (C) who may 
                qualify as eligible WTC residents and other non-
                responders for purposes of this title, and be certified 
                as eligible WTC residents and other non-responders 
                under paragraph (4), shall not exceed 35,000.
                    ``(B) Process.--In implementing subparagraph (A), 
                the WTC Program Administrator shall--
                            ``(i) limit the number of certifications 
                        provided under paragraph (4) in accordance with 
                        such subparagraph; and
                            ``(ii) provide priority in such 
                        certifications in the order in which 
                        individuals apply for a determination under 
                        paragraph (3).
                    ``(C) Individuals currently receiving monitoring or 
                treatment not counted.--Individuals described in this 
                subparagraph are individuals who, before the date of 
                the enactment of this title, have received any 
                monitoring described in subsection (b)(1) or have 
                received any treatment described in section 3022(a) for 
                an identified WTC-related condition for eligible WTC 
                residents and other non-responders.
    ``(b) Monitoring Benefits.--
            ``(1) In general.--In the case of an eligible WTC resident 
        or other non-responder, the WTC program shall provide for 
        monitoring benefits that include medical monitoring consistent 
        with protocols approved by the WTC Program Administrator, in 
        consultation with the World Trade Center Environmental Health 
        Center at Bellevue Hospital and the WTC Community Program 
        Steering Committee, and including 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-RELATED 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 provisions apply to the treatment of identified 
WTC-related health conditions for eligible WTC responders, except that 
an eligible WTC resident or other non-responder need not be receiving 
monitoring benefits to receive treatment for a WTC-related health 
condition for eligible WTC residents and other non-responders.
    ``(b) List of Identified WTC-Related Health Conditions for WTC 
Residents and Other Non-Responders.--
            ``(1) Identified wtc-related health conditions for wtc 
        residents and other non-responders.--For purposes of this 
        title, the term `identified WTC-related health conditions for 
        WTC residents and non-responder' means any of the following 
        health conditions, and any condition specified under paragraph 
        (2):
                    ``(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 obstructive 
                        pulmonary disease (COPD).
                            ``(vi) Chronic cough syndrome.
                            ``(vii) Upper airway hyperreactivity.
                            ``(viii) Chronic rhinosinusitis.
                            ``(ix) Chronic nasopharyngitis.
                            ``(x) Chronic laryngitis.
                            ``(xi) Gastro-esophageal reflux disorder 
                        (GERD).
                            ``(xii) Sleep apnea exacerbated by or 
                        related to a condition described in a previous 
                        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 
                        specified).
                            ``(vii) Acute stress disorder.
                            ``(viii) Dysthymic disorder.
                            ``(ix) Adjustment disorder.
                            ``(x) Substance abuse.
                            ``(xi) V codes (treatments not specifically 
                        related to psychiatric disorders, such as 
                        marital problems, parenting problems, etc.)
            ``(2) Application for additional identified wtc-related 
        health conditions for wtc residents and other non-responders.--
        The provisions of paragraph (4) of section 3012(a) shall apply 
        with respect to an addition to the list of identified WTC-
        related conditions for eligible WTC residents and other non-
        responders under paragraph (1) in the same manner as such 
        provisions apply to the addition to the list of identified WTC-
        related conditions for eligible WTC responders under section 
        3012(a)(3).

``SEC. 3023. TREATMENT OF OTHER INDIVIDUALS WITH WTC-RELATED HEALTH 
              CONDITIONS.

    ``(a) In General.--Subject to subsection (c), the provisions of 
section 3022 shall apply to the treatment of WTC-related health 
conditions for eligible WTC residents and other non-responders in the 
case of individuals described in subsection (b) in the same manner as 
such provisions apply to the treatment of WTC-related health conditions 
for WTC residents and other non-responders.
    ``(b) Individuals Described.--An individual described in this 
subsection is an individual who, regardless of location of residence--
            ``(1) is not a eligible WTC responder or an eligible WTC 
        resident or other non-responder; and
            ``(2) is diagnosed at a Clinical Center of Excellence (with 
        respect to an eligible WTC resident or other non-responder) 
        with an identified WTC-related health condition for WTC 
        residents and other non-responders.
    ``(c) Limitation.--
            ``(1) In general.--The WTC Program Administrator shall 
        limit benefits for any fiscal year under subsection (a) in a 
        manner so that payments under this section for such fiscal year 
        do not exceed the amount specified in paragraph (2) for such 
        fiscal year.
            ``(2) Limitation.--The amount specified in this paragraph 
        for--
                    ``(A) fiscal year 2009 is $20,000,000; or
                    ``(B) a succeeding fiscal year is the amount 
                specified in this paragraph for the previous fiscal 
                year increased by the annual percentage increase in the 
                medical care component of the consumer price index for 
                all urban consumers.

 ``PART 3--NATIONAL ARRANGEMENT FOR BENEFITS 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 access to 
monitoring and treatment benefits under this subtitle for individuals 
who are eligible WTC responders or eligible WTC residents or other 
nonresponders and who reside in any State, as defined in section 2(f), 
outside the New York metropolitan area, the WTC Program Administrator 
shall establish a nationwide 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 mechanism whereby 
individuals who are entitled to benefits for such monitoring or 
treatment can be reimbursed for the cost of such monitoring or 
treatment. Nothing in this subsection shall be construed as preventing 
such individuals from being provided such monitoring and treatment 
benefits through a Clinical Center of Excellence.
    ``(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 protocols 
        developed under section 3006(a)(1); and
            ``(3) collect and report data in accordance with section 
        3005.

                 ``Subtitle C--Research Into Conditions

``SEC. 3041. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS RELATED TO 
              SEPTEMBER 11 TERRORIST ATTACKS IN NEW YORK CITY.

    ``(a) In General.--With respect to individuals, including eligible 
WTC responders and non-responders, receiving monitoring under subtitle 
B, the WTC Program Administrator shall conduct or support--
            ``(1) research on physical and mental health conditions 
        that may be related to the September 11, 2001, terrorist 
        attacks;
            ``(2) research on diagnosing WTC-related health conditions 
        of such individuals, in the case of conditions for which there 
        has been diagnostic uncertainty; and
            ``(3) research on treating WTC-related health conditions of 
        such individuals, in the case of conditions for which there has 
        been treatment uncertainty.
The Administrator may provide such support through continuation and 
expansion of research that was initiated before the date of the 
enactment of this title and through the World Trade Center Health 
Registry (referred to in section 3051).
    ``(b) Types of Research.--The research under subsection (a)(1) 
shall include epidemiologic studies on WTC-related conditions or 
emerging conditions--
            ``(1) among WTC responders, residents, and non-responders 
        under treatment; and
            ``(2) in sampled populations outside the New York City 
        disaster area in Manhattan as far north as 14th Street and in 
        Brooklyn, along with control populations, to identify potential 
        for long-term adverse health effects in less exposed 
        populations.
    ``(c) Consultation.--The WTC Program Administrator shall carry out 
this section in consultation with the WTC Health Program Steering 
Committees and the WTC Scientific/Technical Advisory Committee.
    ``(d) 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.
    ``(e) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $15,000,000 
for each fiscal year, 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 ensuring on-going data 
collection for victims of the September 11, 2001, terrorist attacks on 
the World Trade Center, the WTC Program Administrator, shall extend and 
expand the arrangements in effect as of January 1, 2008, with the New 
York City Department of Health and Mental Hygiene that provide for the 
World Trade Center Health Registry.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated $7,000,000 for each fiscal year to carry out this section.

``SEC. 3052. MENTAL HEALTH SERVICES.

    ``(a) In General.--The WTC Program Administrator may make grants to 
the New York City Department of Health and Mental Hygiene to provide 
mental health services to address mental health needs relating to the 
September 11, 2001, terrorist attacks on the World Trade Center.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated $8,500,000 for each fiscal year to carry out this 
section.''.

        TITLE II--SEPTEMBER 11 VICTIM COMPENSATION FUND OF 2001

SEC. 201. 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.--
                            ``(i) In general.--A claim may be filed 
                        under paragraph (1) by an individual (or by a 
                        personal representative on behalf of a deceased 
                        individual) during the period described in 
                        clause (ii), if the Special Master determines 
                        that--
                                    ``(I) the individual first knew 
                                that the individual had suffered a 
                                physical harm as a result of the 
                                terrorist-related aircraft crashes of 
                                September 11, 2001, or the aftermath of 
                                such attacks, after December 22, 2003, 
                                and before the date that is 5 years 
                                after the date of the enactment of the 
                                James Zadroga 9/11 Health and 
                                Compensation Act of 2008;
                                    ``(II) the individual 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) the individual filed a 
                                claim under this title before, on, or 
                                after December 22, 2003, and suffered a 
                                significantly greater physical harm as 
                                a result of the terrorist-related 
                                aircraft crashes of September 11, 2001, 
                                or the aftermath of such attacks, than 
                                was known to the individual as of the 
                                date the most recent previous claim was 
                                filed, and before the date that is 5 
                                years after the date of the enactment 
                                of the James Zadroga 9/11 Health and 
                                Compensation Act of 2008; or
                                    ``(IV) the individual was not 
                                eligible to file a claim under this 
                                title before December 22, 2003, but who 
                                becomes so eligible because of the 
                                amendments made by the James Zadroga 9/
                                11 Health and Compensation Act of 2008.
                            ``(ii) Period.--
                                    ``(I) In general.--Except as 
                                provided in subclause (II), the period 
                                described in this clause is the two-
                                year period beginning on the date of 
                                the enactment of the James Zadroga 9/11 
                                Health and Compensation Act of 2008.
                                    ``(II) Exception.--In the case of 
                                an individual who first knew on a date 
                                after such date of enactment that the 
                                individual had suffered physical harm 
                                described in subclause (I) of clause 
                                (i) or a significantly greater harm, 
                                described in subclause (III) of such 
                                clause, the period described in this 
                                clause is the two-year period beginning 
                                on the date the individual first 
                                acquired such knowledge.''.

SEC. 202. 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 clause (i)(II), 
                        (i)(III), or (ii)(II) of subsection 
                        (a)(3)(B).''.

SEC. 203. 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 beginning with 
        the terrorist-related aircraft crashes of September 11, 2001, 
        and ending on July 31, 2002.''.

SEC. 204. ELIGIBLE INDIVIDUALS TO INCLUDE ELIGIBLE WTC RESPONDERS AND 
              ELIGIBLE WTC RESIDENTS 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 ``within the New York City 
        disaster area (as defined in section 3009 of the Public Health 
        Service Act) or any area (such as marine transport stations, 
        barges, trucks in transit, and Fresh Kills in Staten Island, 
        and including loading, unloading, sorting, and sifting areas) 
        at which debris from the former World Trade Center was handled, 
        at the Pentagon (Arlington, Virginia), or at'';
            (2) in subparagraph (A)(ii), by inserting ``or the handling 
        of such debris'' after ``such an air crash'';
            (3) in subparagraph (B), at the end by striking ``or'';
            (4) in subparagraph (C), by striking ``subparagraph (A) or 
        (B)'' and inserting ``subparagraph (A), (B), or (C)'';
            (5) by redesignating subparagraph (C) as subparagraph (D); 
        and
            (6) by adding after subparagraph (B) the following 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''.

SEC. 205. LIMITED COVERAGE FOR ADDITIONAL INDIVIDUALS.

    (a) Additional Individuals.--Section 405(c) of the Air 
Transportation Safety and System Stabilization Act (49 U.S.C. 40101 
note) is amended--
            (1) in paragraph (2), by inserting ``, or is described in 
        paragraph (4)'' before the semicolon at the end; and
            (2) by adding at the end the following new paragraph:
            ``(4) Additional individuals.--An individual described in 
        this paragraph is an individual who--
                    ``(A) is diagnosed at a Clinical Center of 
                Excellence (with respect to an eligible WTC resident or 
                other non-responder) under title XXX of the Public 
                Health Service Act with an identified WTC-related 
                health condition for residents and or other non-
                responders; and
                    ``(B) but for this paragraph would not be a 
                claimant described in paragraph (2).''.
    (b) Limitation.--Section 406 of the Air Transportation and Safety 
Stabilization Act (49 U.S.C. 40101 note) is amended by adding at the 
end the following new subsection:
    ``(d) Limitation on Funding for Certain Claimants.--
            ``(1) In general.--Notwithstanding any other provision of 
        this title, in the case of claimants described in section 
        405(c)(4)--
                    ``(A) the total payments that may be made under 
                this title for such claimants shall not exceed 
                $50,000,000; and
                    ``(B) no such payment shall be made to compensate 
                for items and services for which payment is made under 
                title XXX of the Public Health Service Act.
            ``(2) Criteria for distribution.--If the Special Master 
        determines that the amount provided under paragraph (1)(A) is 
        not adequate to pay claims under this title for all such 
        claimants, the Special Master shall establish criteria for the 
        distribution of such amount among such claimants.''.

SEC. 206. WORLD TRADE CENTER COLLAPSE AND DISASTER RESCUE, RECOVERY, 
              DEBRIS REMOVAL, CLEANUP, REMEDIATION, AND RESPONSE 
              INDEMNIFICATION.

    Section 408 of the Air Transportation and Safety Stabilization Act 
(49 U.S.C. 40101 note) is amended by adding at the end the following 
new subsection:
    ``(d) Indemnification.--
            ``(1) In general.--Notwithstanding any other provision of 
        Federal, State, local, or other law, the United States hereby 
        indemnifies and shall defend and hold harmless all contractors 
        and subcontractors (at any tier), including any general 
        contractor, construction manager, prime contractor, or any 
        parent, subsidiary, affiliated company, or joint venture 
        thereof, and the City of New York, for any and all pending or 
        future claims and actions and for any and all liability arising 
        from or related to the rescue and recovery efforts and the 
        debris removal, cleanup, remediation, and response to the World 
        Trade Center collapse and disaster subsequent to the terrorist-
        related aircraft crashes of September 11, 2001, whether such 
        claims and actions and liability are for compensatory or 
        punitive damages, for contribution or indemnity, or for any 
        other form or type of relief. The indemnification provided 
        herein shall apply to any and all liability, damages, or other 
        obligation to pay any sums (including attorneys fees, other 
        litigation costs, fines, penalties, or other assessments) of 
        the aforementioned parties, except conduct held to be 
        intentionally tortious in nature, regardless of whether such 
        liability, damages, or obligation to pay arises from a finding 
        of liability by a court of competent jurisdiction, through 
        arbitration or another method of dispute resolution, through 
        settlement of claims, or any other method of resolution. No 
        such indemnification payment shall be made to the extent such 
        payment would duplicate payments made under title XXX of the 
        Public Health Service Act.
            ``(2) Recovery of payments.--To the extent that insurance 
        coverage exists that is applicable and available to cover a 
        claim, action, or liability for which the indemnification 
        provided under paragraph (1) applies, the United States shall 
        have the right to seek recovery for any payments made under 
        this subsection from any insurer that provided such insurance 
        coverage.
            ``(3) Contingency.--Paragraph (1) shall not apply with 
        respect to the City of New York unless, within 30 days after 
        the date of the enactment of this subsection, the City provides 
        for the dissolution of the WTC Captive Insurance Company and 
        the payment to the Treasury of the United States of all 
        remaining funds of such company. Payment of such funds shall be 
        credited against expenditures made under this title as a result 
        of amendments made by title II of the James Zadroga 9/11 Health 
        and Compensation Act of 2008. The previous sentence shall not 
        be construed to limit the funds available to carry out such 
        amendments.''.
                                 <all>