[Congressional Record Volume 155, Number 96 (Wednesday, June 24, 2009)]
[Senate]
[Pages S6995-S7013]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




          STATEMENTS ON INTRODUCED BILLS AND JOINT RESOLUTIONS

      By Mrs. GILLIBRAND (for herself, Mr. Schumer, Mr. Menendez, and 
        Mr. Lautenberg):
  S.. 1334. 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; to the Committee on Health, Education, Labor, and 
Pensions.
  Mrs. GILLIBRAND. Mr. President, I ask unanimous consent that the text 
of the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1334

       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 2009''.
       (b) Table of Contents.--The table of contents for this Act 
     is as follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings.

               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

Sec. 101. World Trade Center Health Program.

            ``TITLE XXXI--WORLD TRADE CENTER HEALTH PROGRAM

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

``Sec. 3101. Establishment of World Trade Center Health Program within 
              NIOSH.
``Sec. 3102. WTC Health Program Scientific/Technical Advisory 
              Committee.
``Sec. 3103. WTC Health Program Steering Committees.
``Sec. 3104. Community education and outreach.
``Sec. 3105. Uniform data collection.
``Sec. 3106. Centers of excellence.
``Sec. 3107. Entitlement authorities.
``Sec. 3108. Definitions.

 ``Subtitle B--Program of Monitoring, Initial Health Evaluations, and 
                               Treatment

                      ``PART 1--For WTC Responders

``Sec. 3111. Identification of eligible WTC responders and provision of 
              WTC-related monitoring services.
``Sec. 3112. Treatment of certified eligible WTC responders for WTC-
              related health conditions.

                      ``PART 2--Community Program

``Sec. 3121. Identification and initial health evaluation of eligible 
              WTC community members.
``Sec. 3122. Followup monitoring and treatment of certified eligible 
              WTC community members for WTC-related health conditions.
``Sec. 3123. Followup monitoring and treatment of other individuals 
              with WTC-related health conditions.

 ``PART 3--National Arrangement for Benefits for Eligible Individuals 
                            Outside New York

``Sec. 3131. National arrangement for benefits for eligible individuals 
              outside New York.

                 ``Subtitle C--Research Into Conditions

``Sec. 3141. 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. 3151. World Trade Center Health Registry.
``Sec. 3152. Mental health services.

       TITLE II--SEPTEMBER 11TH VICTIM COMPENSATION FUND OF 2001

Sec. 201. Definitions.
Sec. 202. Extended and expanded eligibility for compensation.
Sec. 203. Requirement to update regulations.
Sec. 204. Limited liability for certain claims.

     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, 2001, 
     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 September 11, 2001, 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 September 11, 2001 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, 2001, 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 World Trade Center (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 acknowledgment that indoor 
     contamination continued after the WTC attacks.
       (7) At the request of the Department of Energy, the Davis 
     DELTA Group at the University of California conducted outdoor 
     dust sampling in October 2001 at Varick and Houston Streets 
     (approximately 1.2 miles north of Ground Zero) and found that 
     the contamination from the World Trade Center ``outdid even 
     the worst pollution from the Kuwait oil fields fires''. 
     Further, the United States Geological Survey (USGS) reported 
     on November 27, 2001, that dust samples collected from indoor 
     surfaces in this area registered at levels that were ``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 the Governmental 
     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 September 11, 2001.
       (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, 2001.
       (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

[[Page S6996]]

     the September 11, 2001, 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, 2001, 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 community 
     members) are without insurance and 65 percent have incomes of 
     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, 2001, 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, 2001.
       (24) The Federal response to medical and financial issues 
     arising from the September 11, 2001, 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.

               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

     SEC. 101. WORLD TRADE CENTER HEALTH PROGRAM.

       The Public Health Service Act (42 U.S.C. 201 et seq.) is 
     amended by adding at the end the following new title:

            ``TITLE XXXI--WORLD TRADE CENTER HEALTH PROGRAM

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

     ``SEC. 3101. 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--
       ``(1) medical monitoring and treatment benefits 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) initial health evaluation, monitoring, and treatment 
     benefits 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 for responders.--Medical 
     monitoring under section 3111, including 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) Initial health evaluation for community members.--An 
     initial health evaluation under section 3121, including an 
     evaluation to determine eligibility for followup monitoring 
     and treatment.
       ``(3) Follow-up monitoring and treatment for wtc-related 
     conditions for responders and community members.--Provision 
     under sections 3112, 3122, and 3123 of follow-up monitoring 
     and 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.
       ``(4) Outreach.--Establishment under section 3104 of an 
     outreach program to potentially eligible individuals 
     concerning the benefits under this title.
       ``(5) Uniform data collection.--Collection under section 
     3105 of health and mental health data on individuals 
     receiving monitoring or treatment benefits, using a uniform 
     system of data collection.
       ``(6) 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 
     and initial health evaluation benefits are provided under 
     subtitle B without any deductibles, copayments, or other 
     cost-sharing to an eligible WTC responder or any eligible WTC 
     community member.
       ``(d) Payor.--
       ``(1) In general.--Except as provided in paragraphs (2) and 
     (3), the cost of monitoring and treatment benefits and 
     initial health evaluation benefits provided under subtitle B 
     shall be paid for by the WTC program.
       ``(2) Workers' compensation payment.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     payment for treatment under subtitle B of a WTC-related 
     health condition in an individual that is work-related shall 
     be reduced or recouped to the extent that the Secretary 
     determines that payment has been made, or can reasonably be 
     expected to be made, under a workers' compensation law or 
     plan of the United States or a State, or other work-related 
     injury or illness benefit plan of the employer of such 
     individual, for such treatment. The provisions of clauses 
     (iii), (iv), (v), and (vi) of paragraph (2)(B) of section 
     1862(b) of the Social Security Act (42 U.S.C. 1395y(b)(2)) 
     and paragraph (3) of such section shall apply to the 
     recoupment under this paragraph of a payment to the WTC 
     program with respect to a workers' compensation law or plan, 
     or other work-related injury or illness plan of the employer 
     involved, and such individual in the same manner as such 
     provisions apply to the reimbursement of a payment under 
     section 1862(b)(2) of such Act to the Secretary, with respect 
     to such a law or plan and an individual entitled to benefits 
     under title XVIII of such Act.
       ``(B) Exception.--If the WTC Program Administrator 
     certifies that the City of New York has contributed the 
     matching contribution required under section 3106(a)(3) for a 
     12-month period (specified by the WTC Program Administrator), 
     subparagraph (A) shall not apply for that 12-month period 
     with respect to a workers' compensation law or plan, 
     including line of duty compensation, to which the City is 
     obligated to make payments.
       ``(3) Health insurance coverage.--
       ``(A) In general.--In the case of an individual who has a 
     WTC-related health condition that is not work-related and has 
     health coverage for such condition through any public or 
     private health plan, the provisions of section 1862(b) of the 
     Social Security Act (42 U.S.C. 1395y(b)) shall apply to such 
     a health plan and such individual in the same manner as they 
     apply to a group health plan and an individual entitled to 
     benefits under title XVIII of such Act pursuant to section 
     226(a). Any costs for items and services covered under such 
     plan 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.
       ``(B) Recovery by individual providers.--Nothing in 
     subparagraph (A) shall be construed as requiring an entity 
     providing monitoring and treatment under this title to seek 
     reimbursement under a health plan with which the entity has 
     no contract for reimbursement
       ``(4) Work-related described.--For the purposes of this 
     subsection, a WTC-related health condition shall be treated 
     as a condition that is work-related if--
       ``(A) the condition is diagnosed in an eligible WTC 
     responder, or in an individual who qualifies as an eligible 
     WTC community member on the basis of being a rescue, 
     recovery, or clean-up worker; or
       ``(B) with respect to the condition the individual has 
     filed and had established a claim under a workers' 
     compensation law or plan of the United States or a State, or 
     other work-related injury or illness benefit plan of the 
     employer of such individual.
       ``(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. 
     Such program shall include--
       ``(A) adherence to medical monitoring and treatment 
     protocols;

[[Page S6997]]

       ``(B) appropriate diagnostic and treatment referrals for 
     participants;
       ``(C) prompt communication of test results to participants; 
     and
       ``(D) such other elements as the Administrator specifies in 
     consultation with the Clinical Centers of Excellence.
       ``(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 the individuals were treated; and
       ``(iv) on the projected number of individuals who will be 
     certified under subtitle B in the succeeding fiscal year.
       ``(B) Monitoring, initial health evaluation, and treatment 
     costs.--For each clinical program so described--
       ``(i) information on the costs of monitoring and initial 
     health evaluation and the costs of treatment and on the 
     estimated costs of such monitoring, evaluation, and treatment 
     in the succeeding fiscal year; and
       ``(ii) an estimate of the cost of medical treatment for 
     WTC-related health 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 
     3106(a)(3).
       ``(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 exposures, including the findings of 
     research conducted under section 3141(a).
       ``(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.
       ``(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 3106(b)(1)(A).
       ``(B) Other eligible wtc responders.--The benefits provided 
     for eligible WTC responders not described in subparagraph 
     (A).
       ``(C) Eligible wtc community members.--The benefits 
     provided for eligible WTC community members in section 
     3106(b)(1)(C).
       ``(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 
     3111(a)(5) has reached 80 percent of such limit; and
       ``(2) when the number of certifications for eligible WTC 
     community members subject to the limit established under 
     section 3121(a)(5) has reached 80 percent of such limit.
       ``(i) GAO Report.--Not later than 3 years after the date of 
     the enactment of the James Zadroga 9/11 Health and 
     Compensation Act of 2009, the Comptroller General of the 
     United States shall submit to the Congress a report on the 
     costs of the monitoring and treatment programs provided under 
     this title.
       ``(j) NYC Recommendations.--The City of New York may make 
     recommendations to the WTC Program Administrator on ways to 
     improve the monitoring and treatment programs under this 
     title for both eligible WTC responders and eligible WTC 
     community members.

     ``SEC. 3102. 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) 1 physician with expertise in pulmonary medicine;
       ``(3) 2 environmental medicine or environmental health 
     specialists;
       ``(4) 2 representatives of eligible WTC responders;
       ``(5) 2 representatives of WTC community members;
       ``(6) an industrial hygienist;
       ``(7) a toxicologist;
       ``(8) an epidemiologist; and
       ``(9) 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. 3103. 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 initial health evaluations, monitoring, and 
     treatment programs for eligible WTC community members 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). In 
     addition, the committee membership shall include--
       ``(A) a representative of the Police Commissioner of the 
     City of New York;
       ``(B) a representative of the Department of Health of the 
     City of New York;
       ``(C) a representative of another agency of the City of New 
     York, selected by the Mayor of New York City, which had a 
     large number of non-uniformed City workers who responded to 
     the September 11, 2001, terrorist attacks on the World Trade 
     Center; and
       ``(D) three representatives of eligible WTC responders;

     in order that eligible WTC responders constitute half the 
     members of the Steering Committee.
       ``(2) Initial membership of wtc community program steering 
     committee.--
       ``(A) In general.--The WTC Community Program Steering 
     Committee shall initially be composed of 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) and shall initially have, as voting members, the 
     following:
       ``(i) 11 representatives of the affected populations of 
     residents, students, area workers, and other community 
     members.
       ``(ii) The Medical Director of the WTC Environmental Health 
     Center.
       ``(iii) The Executive Director of the WTC Environmental 
     Health Center.
       ``(iv) Three physicians, one each representing the three 
     WTC Environmental Health Center treatment sites of Bellevue 
     Hospital Center, Gouverneur Healthcare Services, and Elmhurst 
     Hospital Center.
       ``(v) Five specialists with WTC related expertise or 
     experience in treating non-responder WTC diseases, such as a 
     pediatrician, an epidemiologist, a psychiatrist or 
     psychologist, an environmental/occupational specialist, or a 
     social worker from a WTC

[[Page S6998]]

     Environmental Health Center treatment site, or other relevant 
     specialists.
       ``(vi) A representative of the Department of Health and 
     Mental Hygiene of the City of New York.
       ``(B) Appointments.--
       ``(i) 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)(i).
       ``(ii) NYC health and hospitals corporation.--The New York 
     City Health and Hospitals Corporation shall nominate members 
     for positions described in clauses (iv) and (v) of 
     subparagraph (A).
       ``(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)(i)--

       ``(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, parents of 
     school-aged students, community-based organizations, 
     Community Boards, WTC Environmental Health Center patients, 
     labor unions, and labor advocacy organizations; and
       ``(II) no one individual organization shall have more than 
     one representative.

       ``(3) Additional appointments.--Each Steering Committee may 
     appoint, if approved by a majority of voting members of the 
     Committee, additional members to the Committee.
       ``(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--
       ``(i) the composition of the Steering 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; and
       ``(ii) such composition has eligible WTC responders 
     constituting half of the membership of the Steering 
     Committee; or
       ``(B) in the case of the WTC Community Program Steering 
     Committee--
       ``(i) the composition of the Committee includes 
     representatives of eligible WTC community members and 
     representatives of each Clinical Center of Excellence and 
     each Coordinating Center of Excellence that serves eligible 
     WTC community members; and
       ``(ii) the nominating process is consistent with paragraph 
     (2)(B).
       ``(5) Co-chairs of wtc community program steering 
     committee.--The WTC Community Program Steering Committee 
     shall have two Co-Chairs as follows:
       ``(A) Community/labor co-chair.--A Community/Labor Co-Chair 
     who shall be chosen by the community and labor-based members 
     of the Steering Committee.
       ``(B) 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.
       ``(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 voting 
     membership of 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. 3104. 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--
       ``(A) the establishment of a public website with 
     information about the WTC program;
       ``(B) meetings with potentially eligible populations;
       ``(C) development and dissemination of outreach materials 
     informing people about the WTC program; and
       ``(D) the establishment of phone information services; 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. 3105. 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 community members, 
     the prevalence of WTC-related health conditions, and the 
     identification of new WTC-related health 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 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.
       ``(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. 3106. 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 and initial health evaluation benefits under 
     subtitle B;
       ``(B) for the provision of outreach activities to 
     individuals eligible for such monitoring and treatment 
     benefits, for initial health evaluation benefits, and for 
     follow-up to individuals who are enrolled in the monitoring 
     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 or other benefit programs for work-
     related injuries or illnesses, 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 3105.
       ``(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 
     3105, 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, initial 
     health evaluation, 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 3131;
       ``(E) for coordinating and administrating the activities of 
     the WTC Health Program Steering Committees established under 
     section 3103(a); and
       ``(F) for meeting periodically with the corresponding 
     Clinical Centers of Excellence to obtain input on the 
     analysis and reporting of data collected under subparagraph 
     (A) and on the development of medical monitoring, initial 
     health evaluation, and treatment protocols under subparagraph 
     (B).

     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 
     health conditions for responders and of identified WTC-
     related health conditions for community members.
       ``(3) Required participation by new york city in monitoring 
     and treatment program and costs.--
       ``(A) In general.--In order for New York City, any agency 
     or Department thereof, or the New York City Health and 
     Hospitals Corporation to qualify for a contract for the 
     provision of monitoring and treatment benefits and other 
     services under this section, New York City is required to 
     contribute a matching amount of 20 percent of the amount of 
     the covered monitoring and treatment payment (as defined in 
     subparagraph (B)).
       ``(B) Covered monitoring and treatment payment defined.--
     For the purposes of this paragraph, the term `covered 
     monitoring and treatment payment' means payment under 
     paragraphs (1) and (2) including under each such paragraph as 
     applied under sections 3121(b) and 3122(a) for WTC community 
     members, and section 3123 for other individuals with WTC-
     related health conditions, and reimbursement under section 
     3106(c)(1)(C) for

[[Page S6999]]

     items and services furnished by a Clinical Center of 
     Excellence or Coordinating Center of Excellence, after the 
     application of paragraphs (2) and (3) of section 3101(d).
       ``(C) Payment of new york city share of monitoring and 
     treatment costs.--The WTC Program Administrator shall--
       ``(i) bill the amount specified in subparagraph (A) 
     directly to New York City; and
       ``(ii) certify periodically, for purposes of section 
     3101(d)(2), whether or not New York City has paid the amount 
     so billed.
       ``(D) Limitation on required amount.--In no case is New 
     York City required under this paragraph to contribute more 
     than a total of $250,000,000 over any 10-year period.
       ``(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.--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--
       ``(i) is an active employee of such Department--

       ``(I) with respect to monitoring, such Fire Department; and
       ``(II) with respect to treatment, such Fire Department (or 
     such entity as has entered into a contract with the Fire 
     Department for treatment of such responders) or any other 
     Clinical Center of Excellence described in subparagraph (B), 
     (C), or (D); or

       ``(ii) is not an active employee of such Department, such 
     Fire Department (or such entity as has entered into a 
     contract with the Fire Department for monitoring or treatment 
     of such responders) or any other Clinical Center of 
     Excellence described in subparagraph (B), (C), or (D).
       ``(B) Other eligible wtc responders.--With respect to other 
     eligible WTC responders, whether or not the responders 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 community members.--With respect to eligible WTC 
     community members, whether or not the members 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 
     community members.--With respect to all eligible WTC 
     responders and eligible WTC community members, 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 health 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 community members.--With respect to eligible WTC 
     community members, 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 3101(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, 
     $600 per certified eligible WTC responder in the medical 
     treatment program, and $300 per certified eligible WTC 
     responder 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 community members.--A 
     Clinical Center of Excellence for eligible WTC community 
     members in New York specified in subsection (b)(1)(C) shall 
     be reimbursed--
       ``(i) in the first year of the contract under this section, 
     for each certified eligible WTC community member in a medical 
     treatment program enrolled at a non-hospital-based facility, 
     $600, and for each certified eligible WTC community member in 
     a medical treatment program enrolled at a hospital-based 
     facility, $300; 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.
       ``(D) Other clinical centers.--A Clinical Center of 
     Excellence for 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 
     certified eligible WTC responder and for each WTC community 
     member in the WTC program per year that the member receives 
     such services, regardless of the volume or cost of services 
     required.
       ``(2) Coordinating centers of excellence.--A Coordinating 
     Center 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 third 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 
     fourth contract year, modify such rates, taking into account 
     a reasonable and fair rate for the services being provided.
       ``(B) Subsequent reviews.--After the fourth 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 WTC Program Administrator'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 3105;
       ``(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 
     community members with respect to such Center who present 
     themselves for treatment of a WTC-related health condition;
       ``(6) the Center has in place safeguards to ensure the 
     confidentiality of an individual's individually identifiable 
     health information, including requiring that such information 
     not be disclosed to the individual's employer without the 
     authorization of the individual;
       ``(7) the Center provides assurances that the amounts paid 
     under subsection (c)(1) are used only for costs incurred in 
     carrying out the activities described in subsection (a), 
     other than those described in subsection (a)(1)(A); and
       ``(8) the Center agrees to meet all the other applicable 
     requirements of this title, including regulations 
     implementing such requirements.
       ``(e) NYC Right of Inspection and Audit.--
       ``(1) In general.--The City of New York, for any program 
     under this title for which the City contributes a matching 
     amount pursuant to subsection (a)(3)(C), shall have the right 
     to, independently but in coordination with the WTC Program 
     Administrator--
       ``(A) inspect or otherwise evaluate the quality, 
     appropriateness, and timeliness of services provided to 
     recipients of assistance under a contract under such program; 
     and
       ``(B) audit and inspect any books and records of any 
     Clinical Center of Excellence or Coordinating Center of 
     Excellence that pertain to--
       ``(i) the ability of the Center of Excellence to provide 
     services to program recipients under the contract; or
       ``(ii) expenditures made utilizing City funds.
       ``(2) Memorandum of understanding.--The WTC Program 
     Administrator shall enter into a memorandum of understanding 
     with the City of New York setting forth the terms and 
     conditions of how the inspections and audits conducted by the 
     City under paragraph (1)

[[Page S7000]]

     shall be carried out. The memorandum of understanding shall 
     include provisions requiring that any audits conducted by the 
     City of New York under paragraph (1) will be done in a manner 
     to protect the confidentiality of program participants and in 
     accordance with the Health Insurance Portability and 
     Accountability Act of 1996 and other applicable Federal and 
     State medical confidentiality requirements.

     ``SEC. 3107. ENTITLEMENT AUTHORITIES.

       ``Subject to subsections (b)(4)(C) and (c)(4) of section 
     3112--
       ``(1) 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, 
     initial health evaluations, and treatment in accordance with 
     such subtitle; and
       ``(2) section 3106(c) constitutes such budget authority and 
     represents the obligation of the Federal Government to 
     provide for the payment described in such section.

     ``SEC. 3108. 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 `certified eligible WTC responder' and 
     `certified eligible WTC community member' mean an individual 
     who has been certified as an eligible WTC responder under 
     section 3111(a)(4) or an eligible WTC community member under 
     section 3121(a)(4), respectively.
       ``(3) The terms `Clinical Center of Excellence' and 
     `Coordinating Center of Excellence' have the meanings given 
     such terms in section 3106(b).
       ``(4) 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.
       ``(5) The terms `eligible WTC responder' and `eligible WTC 
     community member' are defined in sections 3111(a) and 
     3121(a), respectively.
       ``(6) The term `initial health evaluation' includes, with 
     respect to an individual, a medical and exposure history, a 
     physical examination, and additional medical testing as 
     needed to evaluate whether the individual has a WTC-related 
     health condition and is eligible for treatment under the WTC 
     program.
       ``(7) The term `list of identified WTC-related health 
     conditions' means--
       ``(A) for eligible WTC responders, the identified WTC-
     related health conditions for eligible WTC responders under 
     paragraph (3) or (4) of section 3112(a); or
       ``(B) for eligible WTC community members, the identified 
     WTC-related health conditions for WTC community members under 
     paragraph (1) or (2) of section 3122(b).
       ``(8) 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 of the City of New York.
       ``(9) 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.
       ``(10) The term `New York metropolitan area' means an area, 
     specified by the WTC Program Administrator, within which 
     eligible WTC responders and eligible WTC community members 
     who reside in such area are reasonably able to access 
     monitoring and treatment benefits and initial health 
     evaluation benefits under this title through a Clinical 
     Center of Excellence described in subparagraph (A), (B), or 
     (C) of section 3106(b)(1).
       ``(11) Any reference to `September 11, 2001' shall be 
     deemed a reference to the period on such date subsequent to 
     the terrorist attacks on the World Trade Center on such date.
       ``(12) 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.
       ``(13) The term `WTC Health Program Steering Committee' 
     means such a Steering Committee established under section 
     3103.
       ``(14) The term `WTC Program Administrator' means the 
     individual responsible under section 3101(f) for the 
     administration of the WTC program.
       ``(15) The term `WTC-related health condition' is defined 
     in section 3112(a).
       ``(16) The term `WTC Scientific/Technical Advisory 
     Committee' means the WTC Health Program Scientific/Technical 
     Advisory Committee established under section 3102.

 ``Subtitle B--Program of Monitoring, Initial Health Evaluations, and 
                               Treatment

                      ``PART 1--FOR WTC RESPONDERS

     ``SEC. 3111. 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 
     3108(4)).
       ``(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.

     The WTC Program Administrator shall not modify such 
     eligibility criteria on or after the date that the number of 
     certifications for eligible responders has reached 80 percent 
     of the limit described in paragraph (5) or on or after the 
     date that the number of certifications for eligible community 
     members has reached 80 percent of the limit described in 
     section 3121(a)(5).
       ``(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.--The 
     individual--
       ``(i) was a member 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 Center 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; or
       ``(ii)(I) is a surviving immediate family member of an 
     individual who was a member of the Fire Department of the 
     City of New York (whether fire or emergency personnel, active 
     or retired) and was killed at the World Trade site on 
     September 11, 2001; and
       ``(II) received any treatment for a WTC-related mental 
     health condition described in section 3112(a)(1)(B) on or 
     before September 1, 2008.
       ``(B) Law enforcement officers and 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 Street), the Staten Island 
     Landfill, or the barge loading piers, for--

       ``(I) at least 4 hours during the period beginning on 
     September 11, 2001, and ending on September 14, 2001;
       ``(II) at least 24 hours during the period beginning on 
     September 11, 2001, and ending on September 30, 2001; or
       ``(III) at least 80 hours during the period beginning on 
     September 11, 2001, and ending on July 31, 2002;

       ``(ii)(I) was a member of the Police Department of the City 
     of New York (whether active or retired) or a member of the 
     Port Authority Police of the Port Authority of New York and 
     New Jersey (whether active or retired) who participated on-
     site in rescue, recovery, debris clean-up, or related support 
     services in lower Manhattan (south of Canal Street), 
     including Ground Zero, the Staten Island Landfill, or the 
     barge loading piers, for at least 4 hours during the period 
     beginning September 11, 2001, and ending on September 14, 
     2001;
       ``(II) participated on-site in rescue, recovery, debris 
     clean-up, or related services at Ground Zero, the Staten 
     Island Landfill or the barge loading piers, for at least one 
     day during the period beginning on September 11, 2001, and 
     ending on July 31, 2002;
       ``(III) participated on-site in rescue, recovery, debris 
     clean-up, or related services in lower Manhattan (south of 
     Canal St.) for at least 24 hours during the period beginning 
     on September 11, 2001, and ending on September 30, 2001; or
       ``(IV) participated on-site in rescue, recovery, debris 
     clean-up, or related services in lower Manhattan (south of 
     Canal St.) for at least 80 hours during the period beginning 
     on September 11, 2001, and ending on July 31, 2002;
       ``(iii) was an employee of the Office of the Chief Medical 
     Examiner of the City of New York involved in the examination 
     and handling of human remains from the September 11, 2001, 
     terrorist attacks on the World Trade Center, or other morgue 
     worker who performed similar post-September 11 functions for 
     such Office staff, during the period beginning on September 
     11, 2001 and ending on July 31, 2002;

[[Page S7001]]

       ``(iv) 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
       ``(v) was a vehicle-maintenance worker who was exposed to 
     debris from the former World Trade Center while retrieving, 
     driving, cleaning, repairing, or 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;
       ``(B) the Administrator shall make a determination on such 
     an application not later than 60 days after the date of 
     filing the application; and
       ``(C) an individual who is determined not to be an eligible 
     WTC responder shall have an opportunity to appeal such 
     determination before an administrative law judge in a manner 
     established under such process.
       ``(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.--
       ``(i) Currently identified responders.--In the case of an 
     individual who is described in paragraph (1)(A), the WTC 
     Program Administrator shall provide the certification under 
     subparagraph (A) not later than 60 days after the date of the 
     enactment of this title.
       ``(ii) Other responders.--In the case of another 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.--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 
     15,000, subject to adjustment under paragraph (6), of which 
     no more than 2,500 may be individuals certified based on 
     modified eligibility criteria established under paragraph 
     (1)(C). In applying the previous sentence, any individual who 
     at any time so qualifies as an eligible WTC responder shall 
     be counted against such numerical limitation.
       ``(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).
       ``(6) Potential adjustment in numerical limitations 
     dependent upon actual spending relative to estimated 
     spending.--
       ``(A) Initial calculation for fiscal years 2009 through 
     2011.--If the WTC Program Administrator determines as of 
     December 1, 2011, that the WTC expenditure-to-CBO-estimate 
     percentage (as defined in subparagraph (D)(iii)) for fiscal 
     years 2009 through 2011 does not exceed 90 percent, then, 
     effective January 1, 2012, the WTC Program Administrator may 
     increase the numerical limitation under paragraph (5)(A), the 
     numerical limitation under section 3121(a)(5), or both, by a 
     number of percentage points not to exceed the number of 
     percentage points specified in subparagraph (C) for such 
     period of fiscal years.
       ``(B) Subsequent calculation for fiscal years 2009 through 
     2015.--If the Secretary determines as of December 1, 2015, 
     that the WTC expenditure-to-CBO-estimate percentages for 
     fiscal years 2009 through 2015 and for fiscal years 2012 
     through 2015 do not exceed 90 percent, then, effective 
     January 1, 2015, the WTC Program Administrator may increase 
     the numerical limitation under paragraph (5)(A), the 
     numerical limitation under section 3121(a)(5), or both, as in 
     effect after the application of subparagraph (A), by a number 
     of percentage points not to exceed twice the lesser of--
       ``(i) the number of percentage points specified in 
     subparagraph (C) for fiscal years 2009 through 2012, or
       ``(ii) the number of percentage points specified in 
     subparagraph (C) for fiscal years 2012 through 2015.
       ``(C) Maximum percentage increase in numerical limitations 
     for period of fiscal years.--The number of percentage points 
     specified in this clause for a period of fiscal years is--
       ``(i) 100 percentage points, multiplied by
       ``(ii) one minus a fraction the numerator of which is the 
     net Federal WTC spending for such period, and the denominator 
     of which is the CBO WTC spending estimate under this title 
     for such period.
       ``(D) Definitions.--For purposes of this paragraph:
       ``(i) Net federal wtc spending.--The term `net Federal WTC 
     spending' means, with respect to a period of fiscal years, 
     the net Federal spending under this title for such fiscal 
     years.
       ``(ii) CBO wtc medical spending estimate under this 
     title.--The term `CBO WTC medical spending estimate under 
     this title' means, with respect to--

       ``(I) fiscal years 2009 through 2011, $900,000,000;
       ``(II) fiscal years 2012 through 2015, $1,890,000,000; and
       ``(III) fiscal years 2009 through 2015, the sum of the 
     amounts specified in subclauses (I) and (II).

       ``(iii) WTC expenditure-to-cbo-estimate percentage.--The 
     term `WTC expenditure-to-estimate percentage' means, with 
     respect to a period of fiscal years, the ratio (expressed as 
     a percentage) of--

       ``(I) the net Federal WTC spending for such period, to
       ``(II) the CBO WTC medical spending estimate under this 
     title for such period.

       ``(b) Monitoring Benefits.--
       ``(1) In general.--In the case of an eligible WTC responder 
     under section 3111(a)(4) (other than one described in 
     subsection (a)(2)(A)(ii)), the WTC program shall provide for 
     monitoring benefits that include medical monitoring 
     consistent with protocols approved by the WTC Program 
     Administrator and including 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 3131.

     ``SEC. 3112. TREATMENT OF CERTIFIED 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 health 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 
     health conditions, is substantially likely be a significant 
     factor in aggravating, contributing to, or causing the 
     condition, as determined under paragraph (2).
     In the case of an eligible WTC responder described in section 
     3111(a)(2)(A)(ii), such term only includes the mental health 
     condition described in subparagraph (B).
       ``(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 health 
     conditions.
       ``(B) The type of symptoms and temporal sequence of 
     symptoms. Such symptoms shall be--

[[Page S7002]]

       ``(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:
       ``(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.), secondary to another identified WTC-related 
     health condition for WTC eligible responders.
       ``(C) Musculoskeletal disorders.--
       ``(i) Low back pain.
       ``(ii) Carpal tunnel syndrome (CTS).
       ``(iii) Other musculoskeletal disorders.
       ``(4) Addition of identified wtc-related health conditions 
     for eligible wtc responders.--
       ``(A) In general.--The WTC Program Administrator may 
     promulgate regulations to add an illness or health condition 
     not described in paragraph (3) to the list of identified WTC-
     related conditions for eligible WTC responders. In 
     promulgating such regulations, the Secretary shall provide 
     for notice and opportunity for a public hearing and at least 
     90 days of public comment. In promulgating such regulations, 
     the WTC Program Administrator shall take into account 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.
       ``(B) Petitions.--Any person (including the WTC Health 
     Program Scientific/Technical Advisory Committee) may petition 
     the WTC Program Administrator to propose regulations 
     described in subparagraph (A). Unless clearly frivolous, or 
     initiated by such Committee, any such petition shall be 
     referred to such Committee for its recommendations. 
     Following--
       ``(i) receipt of any recommendation of the Committee; or
       ``(ii) 180 days after the date of the referral to the 
     Committee,

     whichever occurs first, the WTC Program Administrator shall 
     conduct a rulemaking proceeding on the matters proposed in 
     the petition or publish in the Federal Register a statement 
     of reasons for not conducting such proceeding.
       ``(C) Effectiveness.--Any addition under subparagraph (A) 
     of an illness or health condition shall apply only with 
     respect to applications for benefits under this title which 
     are filed after the effective date of such regulation.
       ``(D) Role of advisory committee.--Except with respect to a 
     regulation recommended by the WTC Scientific/Technical 
     Advisory Committee, the WTC Program Administrator may not 
     propose a regulation under this paragraph, unless the 
     Administrator has first provided to the Committee a copy of 
     the proposed regulation, requested recommendations and 
     comments by the Committee, and afforded the Committee at 
     least 90 days to make such recommendations.
       ``(b) Coverage of Treatment for WTC-Related Health 
     Conditions.--
       ``(1) Determination based on an identified wtc-related 
     health condition for certified eligible wtc responders.--
       ``(A) In general.--If a physician at a Clinical Center of 
     Excellence that is providing monitoring benefits under 
     section 3111 for a certified 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 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 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 subparagraph (B), 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) of a WTC-related health condition.
       ``(ii) Certification.--The Administrator shall provide a 
     certification 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 September 11, 2001, 
     terrorist attacks on the World Trade Center 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) 
     before an administrative law judge.
       ``(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 a 
     certified 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) the Administrator shall make a determination under 
     subparagraph (B) with respect to such physician's 
     determination.
       ``(B) Review; certification.--
       ``(i) Use of physician panel.--With respect to each 
     determination relating to a WTC-related health condition 
     transmitted under subparagraph (A)(i), the WTC Program 
     Administrator shall provide for the review of the 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, within 60 days after the date of the transmittal 
     under subparagraph (A)(i), 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 before an administrative 
     law judge.
       ``(3) Requirement of medical necessity.--
       ``(A) In general.--In providing treatment for a WTC-related 
     health condition, a physician shall provide treatment that is 
     medically necessary and in accordance with medical protocols 
     established under subsection (d).
       ``(B) Medically necessary standard.--For the purpose of 
     this title, health care services shall be treated as 
     medically necessary for an individual if a physician, 
     exercising prudent clinical judgment, would consider the 
     services to be medically necessary for the individual for the 
     purpose of evaluating, diagnosing, or treating an illness, 
     injury, disease or its symptoms, and that are--
       ``(i) in accordance with the generally accepted standards 
     of medical practice;
       ``(ii) clinically appropriate, in terms of type, frequency, 
     extent, site, and duration, and considered effective for the 
     individual's illness, injury, or disease; and
       ``(iii) not primarily for the convenience of the patient or 
     physician, or another physician, and not more costly than an 
     alternative service or sequence of services at least as 
     likely to produce equivalent therapeutic or diagnostic 
     results as to the diagnosis or treatment of the individual's 
     illness, injury, or disease.
       ``(C) Determination of medical necessity.--
       ``(i) Review of medical necessity.--As part of the 
     reimbursement payment process under subsection (c), the WTC 
     Program Administrator shall review claims for reimbursement 
     for the provision of medical treatment to determine if such 
     treatment is medically necessary.
       ``(ii) Withholding of payment for medically unnecessary 
     treatment.--The Administrator may withhold such payment for 
     treatment that the Administrator determines is not medically 
     necessary.
       ``(iii) Review of determinations of medical necessity.--The 
     Administrator shall provide a process for providers to appeal 
     a determination under clause (ii) that medical treatment is 
     not medically necessary. Such appeals shall be reviewed 
     through the use of a physician panel with appropriate 
     expertise.
       ``(4) Scope of treatment covered.--
       ``(A) In general.--The scope of treatment covered under 
     paragraphs (1) through (3) includes services of physicians 
     and other

[[Page S7003]]

     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.
       ``(C) Transportation expenses.--To the extent provided in 
     advance in appropriations Acts, the WTC Program Administrator 
     may provide for necessary and reasonable transportation and 
     expenses incident to the securing of medically necessary 
     treatment involving travel of more than 250 miles and for 
     which payment is made under this section in the same manner 
     in which individuals may be furnished necessary and 
     reasonable transportation and expenses incident to services 
     involving travel of more than 250 miles under regulations 
     implementing section 3629(c) of the Energy Employees 
     Occupational Illness Compensation Program Act of 2000 (title 
     XXXVI of Public Law 106-398; 42 U.S.C. 7384t(c)).
       ``(5) Provision of treatment pending certification.--In the 
     case of a certified 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, subject to paragraph (6), 
     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).
       ``(6) Prior approval process for non-certified non-
     emergency inpatient hospital services.--Non-emergency 
     inpatient hospital services for a WTC-related health 
     condition identified by an examining physician under 
     paragraph (1) that is not certified under paragraph 
     (1)(B)(ii) is not covered unless the services have been 
     determined to be medically necessary and approved through a 
     process established by the WTC Program Administrator. Such 
     process shall provide for a decision on a request for such 
     services within 15 days of the date of receipt of the 
     request. The WTC Administrator shall provide a process for 
     the appeal of a decision that the services are not medically 
     necessary.
       ``(c) Payment for Initial Health Evaluation, Medical 
     Monitoring, and Treatment of WTC-Related Health Conditions.--
       ``(1) Medical treatment.--
       ``(A) Use of feca payment rates.--Subject to subparagraph 
     (B), the WTC Program Administrator shall reimburse costs for 
     medically necessary treatment under this title for WTC-
     related health conditions according to the payment rates that 
     would apply to the provision of such treatment and services 
     by the facility under the Federal Employees Compensation Act.
       ``(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 health 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 select a separate vendor to provide 
     pharmaceutical benefits to certified eligible WTC responders 
     for whom the Clinical Center of Excellence is described in 
     section 3106(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.
       ``(2) Medical monitoring and initial health evaluation.--
     The WTC Program Administrator shall reimburse the costs of 
     medical monitoring and the costs of an initial health 
     evaluation 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) Claims processing subject to appropriations.--The 
     payment by the WTC Program Administrator for the processing 
     of claims under this title is limited to the amounts provided 
     in advance in appropriations Acts.
       ``(d) Medical Treatment Protocols.--
       ``(1) Development.--The Coordinating Centers of Excellence 
     shall develop medical treatment protocols for the treatment 
     of certified eligible WTC responders and certified eligible 
     WTC community members for identified WTC-related health 
     conditions.
       ``(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. 3121. IDENTIFICATION AND INITIAL HEALTH EVALUATION OF 
                   ELIGIBLE WTC COMMUNITY MEMBERS.

       ``(a) Eligible WTC Community Member Defined.--
       ``(1) In general.--In this title, the term `eligible WTC 
     community member' means, subject to paragraphs (3) and (5), 
     an individual who claims symptoms of a WTC-related health 
     condition and is described in any of the following 
     subparagraphs:
       ``(A) Currently identified community member.--An 
     individual, including an eligible WTC responder, who has been 
     identified as eligible for medical treatment or monitoring by 
     the WTC Environmental Health Center as of the date of 
     enactment of this title.
       ``(B) Community member who meets current eligibility 
     criteria.--An individual who is not an eligible WTC responder 
     and meets any of the current eligibility criteria described 
     in a subparagraph of paragraph (2).
       ``(C) Community member who meets modified eligibility 
     criteria.--An individual who is not an eligible WTC responder 
     and 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 Administrator determines 
     after consultation with the WTC Community Program Steering 
     Committee, the Coordinating Centers of Excellence described 
     in section 3106(b)(1)(C), and the WTC Scientific/Technical 
     Advisory Committee.

     The Administrator shall not modify such criteria under 
     subparagraph (C) on or after the date that the number of 
     certifications for eligible WTC community members has reached 
     80 percent of the limit described in paragraph (5) or on or 
     after the date that the number of certifications for eligible 
     WTC responders has reached 80 percent of the limit described 
     in section 3111(a)(5).
       ``(2) Current eligibility criteria.--The eligibility 
     criteria described in this paragraph for an individual are 
     that the individual 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) A 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.
       ``(3) Application process.--The WTC Program Administrator 
     in consultation with the Coordinating Centers of Excellence 
     shall establish a process for individuals, other than 
     individuals described in paragraph (1)(A), to be determined 
     eligible WTC community members. Under such process--
       ``(A) there shall be no fee charged to the applicant for 
     making an application for such determination;
       ``(B) the Administrator shall make a determination on such 
     an application not later than 60 days after the date of 
     filing the application; and
       ``(C) an individual who is determined not to be an eligible 
     WTC community member shall have an opportunity to appeal such 
     determination before an administrative law judge in a manner 
     established under such process.
       ``(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 community member, the WTC Program Administrator 
     shall provide an appropriate certification of such fact and 
     of eligibility for followup 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

[[Page S7004]]

     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 certification of 
     eligible WTC community members set forth in paragraph (5) has 
     been met.
       ``(B) Timing.--
       ``(i) Currently identified community members.--In the case 
     of an individual who is described in paragraph (1)(A), the 
     WTC Program Administrator shall provide the certification 
     under subparagraph (A) not later than 60 days after the date 
     of the enactment of this title.
       ``(ii) Other members.--In the case of another individual 
     who is determined under paragraph (3) and consistent with 
     paragraph (5) to be an eligible WTC community member, the WTC 
     Program Administrator shall provide the certification under 
     subparagraph (A) at the time of such determination.
       ``(5) Numerical limitation on certification of eligible wtc 
     community members.--
       ``(A) In general.--The total number of individuals not 
     described in subparagraph (C) who may be certified as 
     eligible WTC community members under paragraph (4) shall not 
     exceed 15,000. In applying the previous sentence, any 
     individual who at any time so qualifies as an eligible WTC 
     community member shall be counted against such numerical 
     limitation.
       ``(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 (4).
       ``(C) Individuals currently receiving treatment not 
     counted.--Individuals described in this subparagraph are 
     individuals who--
       ``(i) are described in paragraph (1)(A); or
       ``(ii) before the date of the enactment of this title, have 
     received monitoring or treatment at the World Trade Center 
     Environmental Health Center at Bellevue Hospital Center, 
     Gouverneur Health Care Services, or Elmhurst Hospital Center.

     The New York City Health and Hospitals Corporation shall, not 
     later than 6 months after the date of enactment of this 
     title, enter into arrangements with the Mt. Sinai Data and 
     Clinical Coordination Center for the reporting of medical 
     data concerning eligible WTC responders described in 
     paragraph (1)(A), as determined by the WTC Program 
     Administrator and consistent with applicable Federal and 
     State laws and regulations relating to confidentiality of 
     individually identifiable health information.
       ``(D) Report to congress if numerical limitation to be 
     reached.--If the WTC Program Administrator determines that 
     the number of individuals subject to the numerical limitation 
     of subparagraph (A) is likely to exceed such numerical 
     limitation, the Administrator shall submit to Congress a 
     report on such determination. Such report shall include an 
     estimate of the number of such individuals in excess of such 
     numerical limitation and of the additional expenditures that 
     would result under this title if such numerical limitation 
     were removed.
       ``(b) Initial Health Evaluation To Determine Eligibility 
     for Followup Monitoring or Treatment.--
       ``(1) In general.--In the case of a certified eligible WTC 
     community member, the WTC program shall provide for an 
     initial health evaluation to determine if the member has a 
     WTC-related health condition and is eligible for followup 
     monitoring and treatment benefits under the WTC program. 
     Initial health evaluation protocols shall be 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.
       ``(2) Initial health evaluation providers.--The initial 
     health evaluation described in paragraph (1) shall be 
     provided through a Clinical Center of Excellence with respect 
     to the individual involved.
       ``(3) Limitation on initial health evaluation benefits.--
     Benefits for initial health evaluation under this part for an 
     eligible WTC community member shall consist only of a single 
     medical initial health evaluation consistent with initial 
     health evaluation protocols described in paragraph (1). 
     Nothing in this paragraph shall be construed as preventing 
     such an individual from seeking additional medical initial 
     health evaluations at the expense of the individual.

     ``SEC. 3122. FOLLOWUP MONITORING AND TREATMENT OF CERTIFIED 
                   ELIGIBLE WTC COMMUNITY MEMBERS FOR WTC-RELATED 
                   HEALTH CONDITIONS.

       ``(a) In General.--Subject to subsection (b), the 
     provisions of sections 3111 and 3112 shall apply to followup 
     monitoring and treatment of WTC-related health conditions for 
     certified eligible WTC community members in the same manner 
     as such provisions apply to the monitoring and treatment of 
     identified WTC-related health conditions for certified 
     eligible WTC responders, except that such monitoring shall 
     only be available to those certified as eligible for 
     treatment under this title. Under section 3106(a)(3), the 
     City of New York is required to contribute a share of the 
     costs of such treatment.
       ``(b) List of Identified WTC-Related Health Conditions for 
     WTC Community Members.--
       ``(1) Identified wtc-related health conditions for wtc 
     community members.--For purposes of this title, the term 
     `identified WTC-related health conditions for WTC community 
     members' means any of the following health conditions:
       ``(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.), secondary to another identified WTC-related 
     health condition for WTC community members.
       ``(2) Additions to identified wtc-related health conditions 
     for wtc community members.--The provisions of paragraph (4) 
     of section 3112(a) shall apply with respect to an addition to 
     the list of identified WTC-related health conditions for 
     eligible WTC community members under paragraph (1) in the 
     same manner as such provisions apply to an addition to the 
     list of identified WTC-related health conditions for eligible 
     WTC responders under section 3112(a)(3).

     ``SEC. 3123. FOLLOWUP MONITORING AND TREATMENT OF OTHER 
                   INDIVIDUALS WITH WTC-RELATED HEALTH CONDITIONS.

       ``(a) In General.--Subject to subsection (c), the 
     provisions of section 3122 shall apply to the followup 
     monitoring and treatment of WTC-related health conditions for 
     eligible WTC community members in the case of individuals 
     described in subsection (b) in the same manner as such 
     provisions apply to the followup monitoring and treatment of 
     WTC-related health conditions for WTC community members. 
     Under section 3106(a)(3), the City of New York is required to 
     contribute a share of the costs of such monitoring and 
     treatment.
       ``(b) Individuals Described.--An individual described in 
     this subsection is an individual who, regardless of location 
     of residence--
       ``(1) is not an eligible WTC responder or an eligible WTC 
     community member; and
       ``(2) is diagnosed at a Clinical Center of Excellence (with 
     respect to an eligible WTC community member) with an 
     identified WTC-related health condition for WTC community 
     members.
       ``(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. 3131. NATIONAL ARRANGEMENT FOR BENEFITS FOR ELIGIBLE 
                   INDIVIDUALS OUTSIDE NEW YORK.

       ``(a) In General.--In order to ensure reasonable access to 
     benefits under this subtitle for individuals who are eligible 
     WTC responders or eligible WTC community members 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 monitoring and treatment benefits and initial 
     health evaluations near such individuals' areas of residence 
     in such States. Nothing in this subsection shall be construed 
     as preventing such individuals from being provided such 
     monitoring and treatment benefits or initial health 
     evaluation through any 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, initial health evaluation, and 
     treatment protocols developed under section 3106(a)(2)(B);

[[Page S7005]]

       ``(3) collect and report data in accordance with section 
     3105; and
       ``(4) meet such fraud, quality assurance, and other 
     requirements as the WTC Program Administrator establishes.

                 ``Subtitle C--Research Into Conditions

     ``SEC. 3141. 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 eligible WTC community members, 
     receiving monitoring or treatment 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 on the World Trade Center;
       ``(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 3151), through a Clinical Center of Excellence, or 
     through a Coordinating Center of Excellence.
       ``(b) Types of Research.--The research under subsection 
     (a)(1) shall include epidemiologic and other research studies 
     on WTC-related health conditions or emerging conditions--
       ``(1) among WTC responders and community members 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. 3151. 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. 3152. 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 11TH VICTIM COMPENSATION FUND OF 2001

     SEC. 201. DEFINITIONS.

       Section 402 of the Air Transportation Safety and System 
     Stabilization Act (49 U.S.C. 40101 note) is amended--
       (1) in paragraph (6) by inserting ``, or debris removal, 
     including under the World Trade Center Health Program 
     established under section 3101 of the Public Health Service 
     Act,'' after ``September 11, 2001'';
       (2) by inserting after paragraph (6) the following new 
     paragraphs and redesignating subsequent paragraphs 
     accordingly:
       ``(7) Contractor and subcontractor.--The term `contractor 
     and subcontractor' means any contractor or subcontractor (at 
     any tier of a subcontracting relationship), including any 
     general contractor, construction manager, prime contractor, 
     consultant, or any parent, subsidiary, associated or allied 
     company, affiliated company, corporation, firm, organization, 
     or joint venture thereof that participated in debris removal 
     at any 9/11 crash site. Such term shall not include any 
     entity, including the Port Authority of New York and New 
     Jersey, with a property interest in the World Trade Center, 
     on September 11, 2001, whether fee simple, leasehold or 
     easement, direct or indirect.
       ``(8) Debris removal.--The term `debris removal' means 
     rescue and recovery efforts, removal of debris, cleanup, 
     remediation, and response during the immediate aftermath of 
     the terrorist-related aircraft crashes of September 11, 2001, 
     with respect to a 9/11 crash site.'';
       (3) by inserting after paragraph (10), as so redesignated, 
     the following new paragraph and redesignating the subsequent 
     paragraphs accordingly:
       ``(11) Immediate aftermath.--The term `immediate aftermath' 
     means any period beginning with the terrorist-related 
     aircraft crashes of September 11, 2001, and ending on August 
     30, 2002.''; and
       (4) by adding at the end the following new paragraph:
       ``(14) 9/11 crash site.--The term `9/11 crash site' means--
       ``(A) the World Trade Center site, Pentagon site, and 
     Shanksville, Pennsylvania site;
       ``(B) the buildings or portions of buildings that were 
     destroyed as a result of the terrorist-related aircraft 
     crashes of September 11, 2001;
       ``(C) any area contiguous to a site of such crashes that 
     the Special Master determines was sufficiently close to the 
     site that there was a demonstrable risk of physical harm 
     resulting from the impact of the aircraft or any subsequent 
     fire, explosions, or building collapses (including the 
     immediate area in which the impact occurred, fire occurred, 
     portions of buildings fell, or debris fell upon and injured 
     individuals); and
       ``(D) any area related to, or along, routes of debris 
     removal, such as barges and Fresh Kills.''.

     SEC. 202. EXTENDED AND EXPANDED ELIGIBILITY FOR COMPENSATION.

       (a) Information on Losses Resulting From Debris Removal 
     Included in Contents of Claim Form.--Section 405(a)(2)(B) of 
     the Air Transportation Safety and System Stabilization Act 
     (49 U.S.C. 40101 note) is amended--
       (1) in clause (i), by inserting ``, or debris removal 
     during the immediate aftermath'' after ``September 11, 
     2001''; and
       (2) in clause (ii), by inserting ``or debris removal during 
     the immediate aftermath'' after ``crashes''.
       (3) in clause (iii), by inserting ``or debris removal 
     during the immediate aftermath'' after ``crashes''.
       (b) Extension of Deadline for Claims Under September 11th 
     Victim Compensation Fund of 2001.--Section 405(a)(3) of such 
     Act 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 the date that 
     is 2 years after the date on which regulations are 
     promulgated under section 407(a).
       ``(B) Exception.--A claim may be filed under paragraph (1), 
     in accordance with subsection (c)(3)(A)(i), by an individual 
     (or by a personal representative on behalf of a deceased 
     individual) during the period beginning on the date on which 
     the regulations are updated under section 407(b) and ending 
     on December 22, 2031.''.
       (c) Requirements for Filing Claims During Extended Filing 
     Period.--Section 405(c)(3) of such Act is amended--
       (1) by redesignating subparagraphs (A) and (B) as 
     subparagraphs (B) and (C), respectively; and
       (2) by inserting before subparagraph (B), as so 
     redesignated, the following new subparagraph:
       ``(A) Requirements for filing claims during extended filing 
     period.--
       ``(i) Timing requirements for filing claims.--An individual 
     (or a personal representative on behalf of a deceased 
     individual) may file a claim during the period described in 
     subsection (a)(3)(B) as follows:

       ``(I) In the case that the Special Master determines the 
     individual knew (or reasonably should have known) before the 
     date specified in clause (iii) that the individual suffered a 
     physical harm at a 9/11 crash site as a result of the 
     terrorist-related aircraft crashes of September 11, 2001, or 
     as a result of debris removal, and that the individual knew 
     (or should have known) before such specified date that the 
     individual was eligible to file a claim under this title, the 
     individual may file a claim not later than the date that is 2 
     years after such specified date.
       ``(II) In the case that the Special Master determines the 
     individual first knew (or reasonably should have known) on or 
     after the date specified in clause (iii) that the individual 
     suffered such a physical harm or that the individual first 
     knew (or should have known) on or after such specified date 
     that the individual was eligible to file a claim under this 
     title, the individual may file a claim not later than the 
     last day of the 2-year period beginning on the date the 
     Special Master determines the individual first knew (or 
     should have known) that the individual both suffered from 
     such harm and was eligible to file a claim under this title.

       ``(ii) Other eligibility requirements for filing claims.--
     An individual may file a claim during the period described in 
     subsection (a)(3)(B) only if--

       ``(I) the individual was treated by a medical professional 
     for suffering from a physical harm described in clause (i)(I) 
     within a reasonable time from the date of discovering such 
     harm; and
       ``(II) the individual's physical harm is verified by 
     contemporaneous medical records created by or at the 
     direction of the medical professional who provided the 
     medical care.

       ``(iii) Date specified.--The date specified in this clause 
     is the date on which the regulations are updated under 
     section 407(a).''.

[[Page S7006]]

       (d) Clarifying Applicability to All 9/11 Crash Sites.--
     Section 405(c)(2)(A)(i) of such Act is amended by striking 
     ``or the site of the aircraft crash at Shanksville, 
     Pennsylvania'' and inserting ``the site of the aircraft crash 
     at Shanksville, Pennsylvania, or any other 9/11 crash site''.
       (e) Inclusion of Physical Harm Resulting From Debris 
     Removal.--Section 405(c) of such Act is amended in paragraph 
     (2)(A)(ii), by inserting ``or debris removal'' after ``air 
     crash''.
       (f) Limitations on Civil Actions.--
       (1) Application to damages related to debris removal.--
     Clause (i) of section 405(c)(3)(C) of such Act, as 
     redesignated by subsection (c), is amended by inserting ``, 
     or for damages arising from or related to debris removal'' 
     after ``September 11, 2001''.
       (2) Pending actions.--Clause (ii) of such section, as so 
     redesignated, is amended to read as follows:
       ``(ii) Pending actions.--In the case of an individual who 
     is a party to a civil action described in clause (i), such 
     individual may not submit a claim under this title--

       ``(I) during the period described in subsection (a)(3)(A) 
     unless such individual withdraws from such action by the date 
     that is 90 days after the date on which regulations are 
     promulgated under section 407(a); and
       ``(II) during the period described in subsection (a)(3)(B) 
     unless such individual withdraws from such action by the date 
     that is 90 days after the date on which the regulations are 
     updated under section 407(b).''.

       (3) Authority to reinstitute certain lawsuits.--Such 
     section, as so redesignated, is further amended by adding at 
     the end the following new clause:
       ``(iii) Authority to reinstitute certain lawsuits.--In the 
     case of a claimant who was a party to a civil action 
     described in clause (i), who withdrew from such action 
     pursuant to clause (ii), and who is subsequently determined 
     to not be an eligible individual for purposes of this 
     subsection, such claimant may reinstitute such action without 
     prejudice during the 90-day period beginning after the date 
     of such ineligibility determination.''.

     SEC. 203. REQUIREMENT TO UPDATE REGULATIONS.

       Section 407 of the Air Transportation Safety and System 
     Stabilization Act (49 U.S.C. 40101 note) is amended--
       (1) by striking ``Not later than'' and inserting ``(a) In 
     General.--Not later than''; and
       (2) by adding at the end the following new subsection:
       ``(b) Updated Regulations.--Not later than 90 days after 
     the date of the enactment of the James Zadroga 9/11 Health 
     and Compensation Act of 2009, the Special Master shall update 
     the regulations promulgated under subsection (a) to the 
     extent necessary to comply with the provisions of title II of 
     such Act.''.

     SEC. 204. LIMITED LIABILITY FOR CERTAIN CLAIMS.

       Section 408(a) 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 paragraphs:
       ``(4) Liability for certain claims.--
       ``(A) In general.--Notwithstanding any other provision of 
     law, subject to subparagraph (B), liability for all claims 
     and actions (including claims or actions that have been 
     previously resolved, that are currently pending, and that may 
     be filed through December 22, 2031) for compensatory damages, 
     contribution or indemnity, or any other form or type of 
     relief, arising from or related to debris removal, against 
     the City of New York, any entity (including the Port 
     Authority of New York and New Jersey) with a property 
     interest in the World Trade Center on September 11, 2001 
     (whether fee simple, leasehold or easement, or direct or 
     indirect) and any contractors and subcontractors thereof, 
     shall not be in an amount that exceeds the sum of the 
     following:
       ``(i) The amount of funds of the WTC Captive Insurance 
     Company, including the cumulative interest.
       ``(ii) The amount of all available insurance identified in 
     schedule 2 of the WTC Captive Insurance Company insurance 
     policy.
       ``(iii) The amount that is the greater of the City of New 
     York's insurance coverage or $350,000,000. In determining the 
     amount of the City's insurance coverage for purposes of the 
     previous sentence, any amount described in clauses (i) and 
     (ii) shall not be included.
       ``(iv) The amount of all available liability insurance 
     coverage maintained by any entity, including the Port 
     Authority of New York and New Jersey, with a property 
     interest in the World Trade Center, on September 11, 2001, 
     whether fee simple, leasehold or easement, or direct or 
     indirect.
       ``(v) The amount of all available liability insurance 
     coverage maintained by contractors and subcontractors.
       ``(B) Exception.--Subparagraph (A) shall not apply to 
     claims or actions based upon conduct held to be intentionally 
     tortious in nature or to acts of gross negligence or other 
     such acts to the extent to which punitive damages are awarded 
     as a result of such conduct or acts.
       ``(5) Priority of claims payments.--Payments to plaintiffs 
     who obtain a settlement or judgment with respect to a claim 
     or action to which paragraph (4)(A) applies, shall be paid 
     solely from the following funds in the following order:
       ``(A) The funds described in clause (i) or (ii) of 
     paragraph (4)(A).
       ``(B) If there are no funds available as described in 
     clause (i) or (ii) of paragraph (4)(A), the funds described 
     in clause (iii) of such paragraph.
       ``(C) If there are no funds available as described in 
     clause (i), (ii), or (iii) of paragraph (4)(A), the funds 
     described in clause (iv) of such paragraph.
       ``(D) If there are no funds available as described in 
     clause (i),(ii), (iii), or (iv) of paragraph (4)(A), the 
     funds described in clause (v) of such paragraph.
       ``(6) Declaratory judgment actions and direct action.--Any 
     party to a claim or action to which paragraph (4)(A) applies 
     may, with respect to such claim or action, either file an 
     action for a declaratory judgment for insurance coverage or 
     bring a direct action against the insurance company 
     involved.''.
                                 ______
                                 
      By Mr. AKAKA (for himself, Mr. Inouye, Mr. Kennedy, and Ms. 
        Cantwell):
  S. 1337. A bill to exempt children of certain Filipino World War II 
veterans from the numerical limitations on immigrant visas; to the 
Committee on the Judiciary.
  Mr. AKAKA. Mr. President, I am introducing the Filipino Veterans 
Family Reunification Act of 2009. I am pleased that my colleagues, 
Senators Inouye, Kennedy and Cantwell, have joined me in introducing 
this bill. Our bill will reunite Filipino World War II veterans who are 
U.S. citizens and U.S. residents with their children in the 
Philippines, who have languished for years on the visa waiting list. In 
seeking an exemption from the numerical limitation on immigrant visas 
for the children of the Filipino veterans, our bill will address and 
resolve an issue rooted in a set of historical circumstances that are 
now nearly 7 decades old.
  In 1934, the Philippines, an American possession since 1898, was 
placed on the path to independence. The enactment of the Philippine 
Independence Act established the Philippines as a commonwealth with 
certain powers over its internal affairs but with the United States 
retaining sovereign power. It also set a 10-year timetable for the 
commonwealth's independence from the U.S.
  In 1941, President Franklin D. Roosevelt responded to Japan's 
increasingly aggressive military posture in Asia and the Pacific by 
issuing a presidential order that called and ordered into the service 
of the Armed Forces of the United States all of the organized military 
forces of the Commonwealth of the Philippines. The authority for this 
presidential order was the Philippine Independence Act, which retained 
for the United States sovereign power over the commonwealth. 
Accordingly, over 200,000 Filipinos were drafted into the United States 
armed forces, and served honorably during World War II.
  In 1942, Congress passed the Second War Powers Act, including 
Sections 701 and 702, Nationality Act of 1940, which authorized the 
naturalization of all aliens serving in the U.S. armed forces. Pursuant 
to this act, about 7,000 Filipinos serving in the U.S. armed forces 
outside the Philippines became U.S. citizens. Naturalization of the 
Filipinos who had served in the U.S. armed forces in the Philippines 
began in Manila in August 1945, but was halted two months later when 
the American vice consul's naturalization authority was revoked.
  At the time, U.S. officials indicated that the government of the 
Commonwealth of the Philippines had expressed concerns that the 
naturalization, and likely emigration to the U.S., of the Filipino 
veterans would drain the soon-to-be-independent Philippines of 
essential manpower and undermine the new nation's postwar 
reconstruction efforts. Others, however, believed this was a pretext 
for what came to be known as the Rescissions Act of 1946.
  In February and May 1946, the 79th Congress passed the First 
Supplemental Surplus Appropriations Rescission Act, PL 79-301, and the 
Second Supplemental Surplus Appropriations Rescission Act, PL 79-391, 
respectively. Now collectively known as the Rescissions Act of 1946, PL 
79-301 authorized a $200 million appropriation to the Commonwealth Army 
of the Philippines conditioned on a provision that service in the 
Commonwealth Army of the Phillippines should not be deemed to have been 
service in the active military or air service of the U.S.
  It would take Congress more than four decades to acknowledge that the 
Filipino World War II veterans had, indeed, served in the U.S. armed 
forces.

[[Page S7007]]

The Immigration Act of 1990 included a provision that offered the 
opportunity to obtain U.S. citizenship to those Filipino veterans who 
had not been naturalized pursuant to the Nationality Act of 1940. And 
nineteen years later, the American Recovery and Reinvestment Act, ARRA, 
of 2009 included a provision that authorized the payment of benefits to 
the 30,000 surviving Filipino veterans in the amount of $15,000 for 
those who are citizens and $9,000 for those who are non-citizens.
  Of the 30,000 surviving Filipino World War II veterans, 7,000 are 
U.S. citizens and reside in this country. Many of these U.S. citizens 
filed visa petitions for their children, who remained in the 
Philippines. Now in their eighties and nineties, these men continue to 
wait for their children, who languish on the visa waiting lists, to 
join them. The Filipino Veterans Family Reunification Act exempts the 
veterans' children, about 20,000 individuals in all, from the numerical 
limitation on immigrant visas. It does not require any appropriation 
and will serve to not only reunite these veterans with their children, 
but also honor their too-long-forgotten World War II service to this 
Nation.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1337

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Filipino Veterans Family 
     Reunification Act of 2009''.

     SEC. 2. EXEMPTION FROM IMMIGRANT VISA LIMIT.

       Section 201(b)(1) of the Immigration and Nationality Act (8 
     U.S.C. 1151(b)(1)) is amended by adding at the end the 
     following:
       ``(F) Aliens who are eligible for a visa under paragraph 
     (1) or (3) of section 203(a) and who have a parent who was 
     naturalized pursuant to section 405 of the Immigration Act of 
     1990 (Public Law 101-649; 8 U.S.C. 1440 note).''.
                                 ______
                                 
      By Mr. LEAHY (for himself and Mr. Crapo):
  S. 1340. A bill to establish a minimum funding level for programs 
under the Victims of Crime Act of 1984 for fiscal years 2010 to 2014 
that ensures a reasonable growth in victim programs without 
jeopardizing the long-term sustainability of the Crime Victims Fund; to 
the Committee on the Judiciary.
  Mr. LEAHY. Mr. President, I am pleased to join with Senator Crapo to 
introduce the Crime Victims Fund Preservation Act of 2009, which would 
restore and increase critical funding for direct services and 
compensation to victims of crime under the Victims of Crime Act.
  I was honored to support the passage of the Victims of Crime Act of 
1984, VOCA, which has been the principal means by which the Federal 
Government has supported essential services for crime victims and their 
families. The Victims of Crime Act provides grants for direct services 
to victims, such as state crime victim compensation programs, emergency 
shelters, crisis intervention, counseling, and assistance in 
participating in the criminal justice system. These services are all 
financed by a reserve fund created from fines and penalties paid by 
Federal criminal offenders, at no cost to taxpayers.
  A number of us have worked hard over the years to protect the Crime 
Victims Fund. State victim compensation and assistance programs serve 
nearly four million crime victims each year, including victims of 
violent crime, domestic violence, sexual assault, child abuse, elder 
abuse, and drunk driving. The Crime Victims Fund makes these programs 
possible and has helped hundreds of thousands of victims of violent 
crime bravely move forward with their lives.
  Several years ago, I worked to make sure that the Crime Victims Fund 
would be there in good times, and in bad. We made sure it had a ``rainy 
day'' capacity so that in lean years, victims and their advocates would 
not have to worry that the fund would run out of money and that they 
would be left stranded. More recently, an annual cap has been set on 
the level of funding to be spent from the Fund in a given year, in part 
to help preserve adequate funds from year to year. When this cap was 
established, and when President Bush then sought to empty the Crime 
Victims Fund of unexpended funds, I joined with Senator Crapo, Senator 
Mikulski and others from both political parties to make sure that the 
Crime Victims Fund was preserved. Fortunately Congress has consistently 
rejected efforts to rob crime victims of resources that are 
appropriately set aside to assist them and their families.
  Unfortunately, the cap on the fund has not kept pace with the demand 
for compensation and services. From 2006 to 2008, VOCA victim 
assistance formula grants were cut by $87 billion or 22 percent. This 
reduction in funding, coupled with the current economic climate, was 
devastating to victim service providers who were forced to curtail 
services, lay off staff, and close their doors, jeopardizing the well-
being and recovery of many crime victims.
  In addition, victim service professionals have seen a clear increase 
in victimization and victim need in the past year as job losses and 
economic stress translate into increased violence in the home and in 
our communities. The National Crime Victims Helpline reported a 25 
percent increase in calls in recent months and the National Domestic 
Violence Hotline reported a similar increase. Local shelters and crisis 
lines are also reporting a rise in demand as the shortage of affordable 
housing and rising unemployment are increasing the time that victims 
stay in emergency shelters. The rising unemployment rate also means 
victims are less likely to have insurance to cover their crime-related 
expenses.
  At a Judiciary Committee hearing I chaired in April on the Victim of 
Crime Act, witnesses testified that there has also been an increase in 
the variety of crimes being committed. The National Crime Victims 
Helpline has seen an increase in calls from fraud victims people 
falling prey to ``work at home'' scams, secret shopper scams, 
investment scams, mortgage fraud, and construction fraud. Such victims 
are in desperate need of financial counseling and mental health 
counseling to overcome the stress and emotional impact of falling 
victim to these scams. Under Federal regulations, States may use 
compensation and victim assistance programs to aid financial crime 
victims, but services are not available. Victim service providers are 
reluctant to expand their outreach and services without assured 
increased funding and there is already too much competition for the 
limited funds available. The National Census of Domestic Violence 
Services conducted last fall showed that in one day, nearly 9,000 
victims were turned away from shelter, counseling, and other crucial 
services because local programs were unable to serve them.
  The need for victim assistance and compensation has grown. The Crime 
Victims Fund can provide more help. Recent years have seen an increase 
in collections from criminal fines and penalties. Accordingly, Congress 
has the ability to provide stable and predictable growth without 
jeopardizing the sustainability of the fund, and should do so through 
this legislation. The Crime Victims Fund Preservation Act would 
establish a minimum funding level for programs under VOCA to ensure 
reasonable and predictable growth in victim services through fiscal 
year 2014. Providing a stable and predictable funding stream will 
enable states to expand their programs and outreach to the thousands of 
victims who have nowhere to turn. Again, I emphasize that it does not 
cost a dime of taxpayer funds but will come exclusively from Federal 
criminal fines and penalties.
  I want to commend Senator Mikulski, the Chairwoman of the Commerce, 
Justice, and Science Appropriations Subcommittee, and Senator Shelby, 
the Ranking Member, for working with the President to provide $100 
million in the economic recovery package for crime victims. That 
additional funding is sorely needed right now and I know it was 
sincerely appreciated by victim service providers. Funding in the 
Omnibus Appropriations Act of 2009 together with the Recovery Act 
funds, restored funding to the 2006 level, adjusted for inflation. A 
2010 cap on total VOCA obligations of $705 million is expected to 
maintain the funding level for assistance grants provided in 2009 
through the Recovery Act funding and annual appropriations. I believe 
that

[[Page S7008]]

the certainty this legislation will provide will be helpful to the 
states, victim service providers, and the citizens they serve, and will 
help improve this vital program.
  I look forward to working with Senator Crapo, Senator Mikulski and 
many other interested Senators on this initiative to provide increased, 
stable, and predicable funding for to meet the ongoing need for 
essential services for crime victims and their families in the years 
ahead.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1340

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Crime Victims Fund 
     Preservation Act of 2009''.

     SEC. 2. CRIME VICTIMS FUND.

       Section 1402(c) of the Victims of Crime Act of 1984 (42 
     U.S.C. 10601(c)) is amended--
       (1) by inserting ``(1)'' after ``(c)''; and
       (2) by adding at the end the following:
       ``(2) The amount made available from the Fund for the 
     purposes of paragraphs (2), (3), and (4) of subsection (d) 
     shall be not less than--
       ``(A) $705,000,000 for fiscal year 2010;
       ``(B) $867,150,000 for fiscal year 2011;
       ``(C) $1,066,594,500 for fiscal year 2012;
       ``(D) $1,311,911,235 for fiscal year 2013; and
       ``(E) $1,613,650,819 for fiscal year 2014.''.
                                 ______
                                 
      By Mr. MENENDEZ:
  S. 1341. A bill to amend the Internal Revenue Code of 1986 to impose 
an excise tax on certain proceeds received on SILO and LILO 
transactions; to the Committee on Finance.
  Mr. MENENDEZ. Mr. President, today I am introducing the Close the 
SILO/LILO Loophole Act. This legislation will close a loophole in which 
banks and other entities are taking advantage of the financial crisis 
to exploit transit agencies and other local public entities to collect 
windfall payments. This bill seeks to permanently end this abusive 
practice, saving the public scarce resources.
  Sale-In/Lease Out and Lease-In/Lease Out, SILO/LILO, contracts are a 
type of financial transaction in which a public entity transfers 
assets, equipment or infrastructure, to a bank or other entity while 
simultaneously entering into a long-term lease with the same bank or 
other entity. From the 1990's to 2003, public agencies, including 
transit agencies and rural electric coops, entered into these LILO and 
SILO transactions. As part of the agreement, the bank required the 
public agency to pay a AAA-rated entity a fee to make lease payments 
throughout the term of the lease. This arrangement provided security 
for the banks and insured that lease payments would be made.
  When the financial crisis hit last year, many AAA-rated entities 
involved in these transactions were downgraded. Banks took advantage of 
these downgrades and some sued these public agencies, citing a clause 
in the agreements that required only AAA-rated entities to make lease 
payments. They did this even though the public agencies in question did 
not miss any of their regular lease payments to the banks.
  Not only is this predatory, but allowing this practice to continue is 
also contrary to public policy. While the SILO/LILO contracts provided 
much needed resources for capital intensive projects that benefitted 
the public, they also provided tax benefits to the banks--tax benefits 
that Congress found to be tax avoidance schemes and effectively 
eliminated in 2003. In 2008, the Internal Revenue Service proposed a 
settlement of the leases, effectively eliminating all future tax 
benefits while allowing the underlying commercial transactions to 
remain in place. If we let these suits against public agencies 
continue, we are basically allowing banks to get these tax benefits 
through another means--taking taxpayer money from public transit 
agencies and other public agencies around the Nation.
  At this moment in time, we have myriad infrastructure needs. Public 
agencies are working hard to fill the demand for infrastructure 
projects. President Obama and Congress acknowledged the need and 
delivered the American Recovery and Reinvestment Act. Now is not the 
time to financially burden the agencies that we rely on for building, 
repairing, maintaining and preserving our infrastructure. The Close the 
SILO/LILO Loophole Act will help lift the uncertainty under which these 
public agencies are operating, enabling them to serve the public 
better. I hope to work closely with Chairman Baucus to end this crisis 
so public agencies can continue to serve the public and not banks 
seeking a windfall.
                                 ______
                                 
      By Mr. BROWN (for himself, Mr. Bennet, and Mr. Casey):
  S. 1343. A bill to amend the Richard B. Russell National School Lunch 
Act to improve and expand direct certification procedures for the 
national school lunch and school breakfast programs, and for other 
purposes; to the Committee on Agriculture, Nutrition, and Forestry.
  Mr. BROWN. Mr. President, every day during the school year, some 
700,000 Ohio children are eligible to receive a free or reduced-price 
lunch at their school. Every day during the school year, these meals 
could ensure that children get enough to eat, particularly those 
children who are from homes where they don't get enough to eat, and it 
would ensure that children receive the good-quality, nutritious food 
they need. Yet today only about 86 percent of eligible children in Ohio 
receive a free school breakfast, a free school lunch, or a reduced-
price breakfast or lunch. Only 86 percent of those eligible do. That 
means 1 in 10 Ohio children goes without a meal every day at school 
unnecessarily. Thus, tens of thousands of children from large urban 
districts in Cleveland and Cincinnati and Toledo to rural districts in 
Appalachia, children in small towns and medium towns all over the State 
and all over the country don't receive a healthy meal at school. Mr. 
President, about 150,000 children eligible at school for free or 
reduced-price lunch or breakfast don't get the meals at school that 
they are eligible for, and it is unacceptable. We can do something 
about it.
  The application process for free lunch and breakfast is antiquated--
stuck in a low-tech, old-fashioned, file-cabinet kind of system. The 
current paper application process doesn't reflect today's school 
districts. It doesn't adjust to changing demographics. It doesn't take 
advantage of the tremendous advancements in technology our society 
enjoys generally. That is why I will be introducing today the Hunger 
Free Schools Act, along with Senators Casey and Bennet, that would 
dramatically reduce the number of paper applications for the free 
school lunch program. This legislation will directly enroll an 
estimated 100,000 Ohio children and thousands of children around the 
Nation in the National School Lunch Program. The Hunger Free Schools 
Act would modernize the application system for free school meals. The 
Hunger Free Schools Act would ensure that the system functions the way 
it was actually designed to work.
  By increasing the number of children who receive nutritional school 
meals, we can help them receive a better education. Just think of 
children who sit in schools--small children, children of middle-school 
age, children in high school, but particularly small children--with 
their stomachs growling. They haven't really had breakfast or they 
haven't had a nutritious breakfast. Children who think so much about 
their hunger rather than their school work, children who by afternoon 
feel weak because they haven't had the calories and nutrition they 
need, this bill could do something about this. By increasing the number 
of healthy children, we will be more effective in lowering rates of 
child obesity and diabetes. It is not just about not getting enough to 
eat, it is also the quality of food they eat if they don't eat in the 
school cafeteria the school breakfast that is provided for them.
  Nationwide, this bill would reduce paperwork and administrative costs 
to make access to meals easier for nearly 7 million children--hundreds 
of thousands of children in the Presiding Officer's home State of 
Illinois and over 100,000 children in my State of Ohio. Reducing 
paperwork and administrative costs saves time for administrators, 
reduces the burden on schools, and makes it a whole lot easier for 
teachers who don't have to think so much about helping their children 
figure out how to get a free school lunch or a free school breakfast.

[[Page S7009]]

  President Obama cited administrative costs as a barrier to ending 
childhood hunger. His goal of eliminating this moral problem by 2015 is 
within reach, in part because of this legislation. More must be done.
  Another way to combat childhood hunger is to make sure more families 
are aware of summer feeding programs.
  Let me give another number. Some 700,000 children in my State are 
eligible for the reduced or free school breakfast and lunch. Of that 
number, about 500,000 actually get free lunch and breakfast. Those same 
students are eligible for the summer feeding program in June, July, and 
August--a program that is in rec centers, churches, parks, and in other 
kinds of buildings sprinkled across our State. Yet only about 60,000, 
or 1 in 10 children who are eligible, partake in the summer feeding 
program. So those children who, every day, get a free breakfast and 
lunch during the school year are also eligible in the summer to get 
free breakfast, lunch, and a free snack. But very few of them actually 
get those breakfasts and lunches or snacks in the summer.
  You can imagine what that does to the chance for those children to 
become obese or to have a lack of nutrition and what all that means. 
The summer feeding program is every bit as important as the school 
breakfast and lunch program. That is why I remind parents and educators 
and guardians that the summer food service program is available to 
provide children a free breakfast, lunch, or snack during summer 
months. I encourage parents, educators, and guardians in Ohio, and 
around the Nation, to find a local summer feeding location.
  I suggest people watching, if they are from my State, to go on my Web 
site, brown.senate.gov. We have roughly 1,000 summer feeding program 
locations on the Web site. People from Ohio can look on there and find 
out where there might be half a dozen sites in Richland County or 
perhaps 5 or 6 locations in Allen County or 25 or so locations in 
Lorain County, where young people can sign up to go to the summer 
feeding program or they can just show up and be fed. Ohioans can also 
find information through the Ohio Department of Education. Other 
Americans should contact the U.S. Department of Agriculture, which has 
a State-by-State breakdown of resources. Students in summer reading 
programs at the public libraries might be eligible for the summer 
feeding program. They should find out from the library or from a music 
program they are part of or anyplace they might go, if they are 
eligible.
  Again, I remind people that if your son or daughter is eligible for 
the school lunch program, they are also eligible for the summer feeding 
program. The end of the school year doesn't mean that we have an end to 
hunger. It means we need to make some people aware of the summer 
feeding program. Coupled with the summer feeding program, this Hunger 
Free Schools Act can ensure that our children reach their full 
potential.
                                 ______
                                 
      By Mr. REED (for himself, Mr. Grassley, Mr. Akaka, Mr. Bayh, Ms. 
        Collins, Mr. Kerry, Mr. Lautenberg, Mr. Leahy, Mrs. Lincoln, 
        Mr. Lugar, Mrs. Murray, Ms. Stabenow, and Mr. Whitehouse):
  S. 1345. A bill to aid and support pediatric involvement in reading 
and education; to the Committee on Health, Education, Labor, and 
Pensions.
  Mr. REED. Mr. President, today I introduce with my colleague, Senator 
Grassley, the Prescribe A Book Act. I thank Senators Akaka, Bayh, 
Collins, Kerry, Lautenberg, Leahy, Lincoln, Lugar, Murray, Stabenow, 
and Whitehouse for joining us as original cosponsors of this bill.
  Our legislation would create a Federal pediatric early literacy grant 
initiative based on the long-standing, successful Reach Out and Read 
program. The program would award grants to high-quality non-profit 
entities to train doctors and nurses in advising parents about the 
importance of reading aloud and to give books to children at pediatric 
check-ups from six months to 5 years of age, with a priority for 
children from low-income families. It builds on the relationship 
between parents and medical providers and helps families and 
communities encourage early literacy skills so children enter school 
prepared for success in reading.
  The Reach Out and Read model has consistently demonstrated 
effectiveness in increasing parent involvement and boosting children's 
reading proficiency. Research published in peer-reviewed, scientific 
journals has found that parents who have participated in the program 
are significantly more likely to read to their children and include 
more children's books in their home, and that children served by the 
program show an increase of 4-8 points on vocabulary tests. I have seen 
up-close the positive impact of this program on children and their 
families when visiting a number of the 40 Rhode Island Reach Out and 
Read sites.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                S. 1345

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Prescribe A Book Act''.

     SEC. 2. DEFINITIONS.

       In this Act:
       (1) Eligible entity.--The term ``eligible entity'' means a 
     nonprofit organization that has, as determined by the 
     Secretary, demonstrated effectiveness in the following areas:
       (A) Providing peer-to-peer training to healthcare providers 
     in research-based methods of literacy promotion as part of 
     routine pediatric health supervision visits.
       (B) Delivering a training curriculum through a variety of 
     medical education settings, including residency training, 
     continuing medical education, and national pediatric 
     conferences.
       (C) Providing technical assistance to local healthcare 
     facilities to effectively implement a high-quality Pediatric 
     Early Literacy Program.
       (D) Offering opportunities for local healthcare facilities 
     to obtain books at significant discounts, as described in 
     section 7.
       (E) Integrating the latest developmental and educational 
     research into the training curriculum for healthcare 
     providers described in subparagraph (B).
       (2) Pediatric early literacy program.--The term ``Pediatric 
     Early Literacy Program'' means a program that--
       (A) creates and implements a 3-part model through which--
       (i) healthcare providers, doctors, and nurses, trained in 
     research-based methods of early language and literacy 
     promotion, encourage parents to read aloud to their young 
     children, and offer developmentally appropriate 
     recommendations and strategies to parents for the purpose of 
     reading aloud to their children;
       (ii) healthcare providers, at health supervision visits, 
     provide each child between the ages of 6 months and 5 years a 
     new, developmentally appropriate children's book to take home 
     and keep; and
       (iii) volunteers in waiting areas of healthcare facilities 
     read aloud to children, modeling for parents the techniques 
     and pleasures of sharing books together;
       (B) demonstrates, through research published in peer-
     reviewed journals, effectiveness in positively altering 
     parent behavior regarding reading aloud to children, and 
     improving expressive and receptive language in young 
     children; and
       (C) receives the endorsement of nationally-recognized 
     medical associations and academies.
       (3) Secretary.--The term ``Secretary'' means the Secretary 
     of Education.

     SEC. 3. PROGRAM AUTHORIZED.

       The Secretary is authorized to award grants to eligible 
     entities to enable the eligible entities to implement 
     Pediatric Early Literacy Programs.

     SEC. 4. APPLICATIONS.

       An eligible entity that desires to receive a grant under 
     section 3 shall submit an application to the Secretary at 
     such time, in such manner, and including such information as 
     the Secretary may reasonably require.

     SEC. 5. MATCHING REQUIREMENT.

       An eligible entity receiving a grant under section 3 shall 
     provide, either directly or through private contributions, 
     non-Federal matching funds equal to not less than 50 percent 
     of the grant received by the eligible entity under section 3. 
     Such matching funds may be in cash or in-kind.

     SEC. 6. USE OF GRANT FUNDS.

       (a) In General.--An eligible entity receiving a grant under 
     section 3 shall--
       (1) enter into contracts with private nonprofit 
     organizations, or with public agencies, selected based on the 
     criteria described in subsection (b), under which each 
     contractor will agree to establish and operate a Pediatric 
     Early Literacy Program;
       (2) provide such training and technical assistance to each 
     contractor of the eligible entity as may be necessary to 
     carry out this Act; and
       (3) include such other terms and conditions in an agreement 
     with a contractor as the Secretary determines to be 
     appropriate to ensure the effectiveness of such programs.
       (b) Contractor Criteria.--Each contractor shall be selected 
     under subsection

[[Page S7010]]

     (a)(1) on the basis of the extent to which the contractor 
     gives priority to serving a substantial number or percentage 
     of at-risk children, including--
       (1) children from families with an income below 200 percent 
     of the poverty line (as defined by the Office of Management 
     and Budget and revised annually in accordance with section 
     673(2) of the Community Services Block Grant Act (42 U.S.C. 
     9902(2))) applicable to a family of the size involved, 
     particularly such children in high-poverty areas;
       (2) children without adequate medical insurance;
       (3) children enrolled in a State Medicaid program, 
     established under title XIX of the Social Security Act (42 
     U.S.C. 1396 et seq.) or in the State Children's Health 
     Insurance Program established under title XXI of such Act (42 
     U.S.C. 1397aa et seq.);
       (4) children living in rural areas;
       (5) migrant children; and
       (6) children with limited access to libraries.

     SEC. 7. RESTRICTION ON PAYMENTS.

       The Secretary shall make no payment to an eligible entity 
     under this Act unless the Secretary determines that the 
     eligible entity or a contractor of the eligible entity, as 
     the case may be, has made arrangements with book publishers 
     or distributors to obtain books at discounts that are at 
     least as favorable as discounts that are customarily given by 
     such publisher or distributor for book purchases made under 
     similar circumstances in the absence of Federal assistance.

     SEC. 8. REPORTING REQUIREMENT.

       An eligible entity receiving a grant under section 3 shall 
     report annually to the Secretary on the effectiveness of the 
     program implemented by the eligible entity and the programs 
     instituted by each contractor of the eligible entity, and 
     shall include in the report a description of each program.

     SEC. 9. AUTHORIZATION OF APPROPRIATIONS.

       There are authorized to be appropriated to carry out this 
     Act--
       (1) $15,000,000 for fiscal year 2010;
       (2) $16,000,000 for fiscal year 2011;
       (3) $17,000,000 for fiscal year 2012;
       (4) $18,000,000 for fiscal year 2013; and
       (5) $19,000,000 for fiscal year 2014.
                                 ______
                                 
      By Mr. DURBIN (for himself, Mr. Leahy, and Mr. Feingold):
  S. 1346. A bill to penalize crimes against humanity and for other 
purposes; to the Committee on the Judiciary.
  Mr. DURBIN. Mr. President, I rise today to introduce the Crimes 
Against Humanity Act of 2009. This narrowly-tailored legislation would 
make it a violation of U.S. law to commit a crime against humanity. 
Congress must ensure that criminals who commit mass atrocities do not 
find safe haven in our country.
  I would like to thank the other original cosponsors of the Crimes 
Against Humanity Act, Senator Patrick Leahy of Vermont, the Chairman of 
the Senate Judiciary Committee, and Senator Russell Feingold of 
Wisconsin, the Chairman of the Senate Judiciary Subcommittee on the 
Constitution and the Chairman of the Senate Foreign Relations 
Subcommittee on African Affairs.
  For generations, the U.S. has led the struggle for human rights 
around the world and has supported holding perpetrators of crimes 
against humanity accountable. Over 50 years before the Nuremberg 
trials, George Washington Williams, an African-American minister, 
lawyer and historian, called for an international commission to 
investigate ``crimes against humanity'' in the Congo, which was then 
ruled by Belgium's King Leopold II. Under King Leopold's iron fist, 
Congo's population was reduced by half, with up to 10 million people 
losing their lives. In a letter to the U.S. Secretary of State, Mr. 
Williams decried the ``crimes against humanity'' perpetrated by King 
Leopold's regime.
  Over 50 years later, following the Holocaust, the U.S. led the 
efforts to prosecute Nazi perpetrators for crimes against humanity at 
the Nuremberg trials. Crimes against humanity were first defined in the 
Nuremberg Charter in 1945. Sixteen men were found guilty of crimes 
against humanity in the Nuremberg trials, including Hermann Goring, 
commander of the Luftwaffe and the highest-ranking official to order 
the ``Final Solution.''
  Since then, the U.S. has supported efforts to prosecute perpetrators 
of crimes against humanity, including Nazi war criminals who had 
escaped accountability. In 1961, Adolf Eichman, the ``architect of the 
Holocaust,'' was convicted in Israel for committing crimes against 
humanity. Michael Musmanno, a U.S. Naval officer and judge at the 
Nuremberg trials, was a key prosecution witness. In 1987, Klaus Barbie, 
the ``Butcher of Lyon'', was convicted in France for crimes against 
humanity he committed while heading the Gestapo in Lyon.
  The U.S. has also supported the prosecution of crimes against 
humanity before the International Criminal Tribunal for the former 
Yugoslavia, the International Criminal Tribunal for Rwanda, and the 
Special Court for Sierra Leone.
  More recently, we have seen crimes against humanity being committed 
on a massive scale in Darfur in western Sudan. In this region of six 
million people, hundreds of thousands were killed and as many as 2.5 
million were driven from their homes in recent years. Part of the 
solution to the carnage in Darfur is arresting and prosecuting the 
perpetrators. Otherwise, these perpetrators will continue to act with 
impunity and victims will feel they have no recourse but to resort to 
violence themselves.
  We have also seen crimes against humanity being committed in the 
eastern Democratic Republic of Congo, most disturbingly through the use 
of rape as a weapon of war. The systematic and deliberate use of mass 
rape to humiliate, expel and destroy communities in the eastern 
Democratic Republic of Congo offends our common humanity.
  However, it is not only Darfur and the eastern Democratic Republic of 
Congo that are safe havens for the perpetrators of crimes against 
humanity. Perpetrators of mass atrocities have sought to escape 
accountability for their actions by coming to our own country. 
According to the Department of Homeland Security, over 1000 war 
criminals have found safe haven in the United States.
  I am the Chairman of the Judiciary Committee's Human Rights and the 
Law Subcommittee. Last year I held a Human Rights and the Law 
Subcommittee hearing entitled ``From Nuremberg to Darfur: 
Accountability for Crimes Against Humanity.'' This hearing identified a 
glaring loophole in U.S. law--currently, there is no U.S. law 
prohibiting crimes against humanity. As a result, the U.S. government 
is unable to prosecute perpetrators of crimes against humanity found in 
our country. In contrast, other grave human rights violations, 
including genocide, using or recruiting child soldiers, and torture, 
are crimes under U.S. law.
  We heard testimony in the Human Rights and the Law Subcommittee that 
many U.S. allies have incorporated crimes against humanity into their 
criminal codes, including Australia, Canada, Germany, the Netherlands, 
New Zealand, South Africa, Spain, Argentina and the United Kingdom.
  Expert witnesses testified before the Subcommittee about the urgent 
need for the United States to enact similar legislation. Gayle Smith, 
the Co-Founder of the Enough Project, testified that it is in our 
national interest to enact crimes against humanity legislation:

       If unchallenged, the violence that defines crimes against 
     humanity feeds on itself: conflicts spread, institutions 
     crumble, economies decline and young people are taught the 
     dangerous lesson that violence is more potent tool for change 
     than hope. . . . Ensuring that those who commit crimes 
     against humanity are in violation of U.S. law is in our 
     national interests, and clearly in the interests of the 
     victims who have few if any protectors or defenders.

  Diane Orentlicher, a law professor at American University's 
Washington College of Law and one of our country's leading experts on 
human rights crimes, testified:

       The United States has, since Nuremberg, provided 
     indispensable leadership in ensuring prosecution of crimes 
     against humanity by various international tribunals, as well 
     as by other countries we have supported. So it's quite 
     remarkable that we of all countries don't have a law on our 
     books making it possible to prosecute this crime when 
     perpetrators show up in our own territory.

  The crimes against humanity loophole has real consequences. When the 
U.S. government learned that Marko Boskic, who allegedly participated 
in the Srebrenica massacre in the Bosnian conflict, was living in 
Massachusetts, he was charged with visa fraud, rather than crimes 
against humanity. ``They should condemn him for the crime,'' said Emma 
Hidic, whose two brothers were among the estimated 7,000 men and boys 
killed in the Srebrenica massacre, upon learning that Boskic had been 
charged only with visa fraud.
  The Crimes Against Humanity Act would close this loophole in U.S. law

[[Page S7011]]

and give our government the authority to prosecute those found in the 
U.S. who commit crimes against humanity. In keeping with the principles 
the U.S. and our allies established after World War II, this 
legislation would help ensure that the perpetrators of crimes against 
humanity do not find safe haven in our country.
  This bill would make it a violation of U.S. law to commit a crime 
against humanity, i.e. any widespread and systematic attack directed 
against a civilian population that involves murder, enslavement, 
torture, rape, arbitrary detention, extermination, hostage taking or 
ethnic cleansing.
  I am the author of the Genocide Accountability Act, the Child 
Soldiers Accountability Act, and the Trafficking in Persons Act, 
legislation passed unanimously by Congress and signed into law by 
President George W. Bush that denies safe haven in the United States to 
the perpetrators of genocide, child soldier recruitment and use, and 
human trafficking. The Crimes Against Humanity Act is the next logical 
step. It would subject perpetrators of crimes against humanity to 
criminal sanctions, in the same way that perpetrators of genocide, 
child soldier recruitment and human trafficking are subject to criminal 
sanctions under U.S. law.
  Ensuring U.S. law prohibits crimes against humanity is consistent 
with the longstanding U.S. support for the prosecution of crimes 
against humanity perpetrated in World War II, Rwanda, the former 
Yugoslavia and Sierra Leone, among other places.
  This legislation will send a clear message to perpetrators of crimes 
against humanity that there are real consequences to their actions. By 
holding such individuals criminally responsible, our country will help 
to deter crimes against humanity.
  The Crimes Against Humanity Act is supported by a broad coalition of 
human rights and religious groups, including Armenian Assembly of 
America, Center for Justice and Accountability, Center for Victims of 
Torture, Enough Project, the Episcopal Church, Genocide Intervention 
Network, Human Rights First, Human Rights Watch, International Justice 
Mission, Jubilee Campaign USA, Inc., Physicians for Human Rights, 
Robert F. Kennedy Center for Justice & Human Rights, Save Darfur 
Coalition, the United Methodist Church, and U.S. Campaign for Burma. 
Today I received a letter of support for the Crimes Against Humanity 
Act from 29 organizations, including all of those I have named. As the 
letter explains:

       This legislation would fill an existing gap in U.S. law by 
     allowing U.S. prosecutors to hold the perpetrators of mass 
     atrocities accountable for their acts. While often less 
     publicized than genocides, crimes against humanity are as 
     devastating to their victims and as worthy of vigorous and 
     unbending attention from the United States government. We 
     must ensure that perpetrators of mass atrocities cannot evade 
     justice by coming to the United States.

  Daoud Hari is a refugee from Darfur now living in our country and 
author of The Translator: A Tribesman's Memoir of Darfur. I urge my 
colleagues to contemplate the challenge that Mr. Hari posed at the 
Human Rights Subcommittee hearing on crimes against humanity: while 
none of us individually can stop the crimes against humanity committed 
in Darfur and other countries around the globe, failing to take action 
only ensures that these horrific atrocities will continue.
  With far too few exceptions, we have failed to prevent and stop 
crimes against humanity. The promise of Nuremberg remains unfulfilled. 
We have a moral obligation to take action to help the survivors of 
crimes against humanity around the world and to help prevent this 
horrific crime by holding perpetrators accountable.
  I urge my colleagues to support this legislation.
  Mr. President, I ask unanimous consent that the text of the bill and 
a letter of support be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1346

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Crimes Against Humanity Act 
     of 2009''.

     SEC. 2. ACCOUNTABILITY FOR CRIMES AGAINST HUMANITY.

       (a) In General.--Part 1 of title 18, United States Code, is 
     amended by inserting after chapter 25 the following:

                 ``CHAPTER 25A--CRIMES AGAINST HUMANITY

``Sec.
``519. Crimes against humanity.

     ``Sec. 519. Crimes against humanity

       ``(a) Offense.--It shall be unlawful for any person to 
     commit or engage in, as part of a widespread and systematic 
     attack directed against any civilian population, and with 
     knowledge of the attack--
       ``(1) conduct that, if it occurred in the United States, 
     would violate--
       ``(A) section 1111 of this title (relating to murder);
       ``(B) section 1581(a) of this title (relating to peonage);
       ``(C) section 1583(a)(1) of this title (relating to 
     kidnapping or carrying away individuals for involuntary 
     servitude or slavery);
       ``(D) section 1584(a) of this title (relating to sale into 
     involuntary servitude);
       ``(E) section 1589(a) of this title (relating to forced 
     labor); or
       ``(F) section 1590(a) of this title (relating to 
     trafficking with respect to peonage, slavery, involuntary 
     servitude, or forced labor);
       ``(2) conduct that, if it occurred in the special maritime 
     and territorial jurisdiction of the United States, would 
     violate--
       ``(A) section 1591(a) of this title (relating to sex 
     trafficking of children or by force, fraud, or coercion);
       ``(B) section 2241(a) of this title (relating to aggravated 
     sexual abuse by force or threat); or
       ``(C) section 2242 of this title (relating to sexual 
     abuse);
       ``(3) conduct that, if it occurred in the special maritime 
     and territorial jurisdiction of the United States, and 
     without regard to whether the offender is the parent of the 
     victim, would violate section 1201(a) of this title (relating 
     to kidnapping);
       ``(4) conduct that, if it occurred in the United States, 
     would violate section 1203(a) of this title (relating to 
     hostage taking), notwithstanding any exception under 
     subsection (b) of section 1203;
       ``(5) conduct that would violate section 2340A of this 
     title (relating to torture);
       ``(6) extermination;
       ``(7) national, ethnic, racial, or religious cleansing;
       ``(8) arbitrary detention; or
       ``(9) imposed measures intended to prevent births.
       ``(b) Penalty.--Any person who violates subsection (a), or 
     attempts or conspires to violate subsection (a)--
       ``(1) shall be fined under this title, imprisoned not more 
     than 20 years, or both; and
       ``(2) if the death of any person results from the violation 
     of subsection (a), shall be fined under this title and 
     imprisoned for any term of years or for life.
       ``(c) Jurisdiction.--There is jurisdiction over a violation 
     of subsection (a), and any attempt or conspiracy to commit a 
     violation of subsection (a), if--
       ``(1) the alleged offender is a national of the United 
     States or an alien lawfully admitted for permanent residence;
       ``(2) the alleged offender is a stateless person whose 
     habitual residence is in the United States;
       ``(3) the alleged offender is present in the United States, 
     regardless of the nationality of the alleged offender; or
       ``(4) the offense is committed in whole or in part within 
     the United States.
       ``(d) Nonapplicability of Certain Limitations.--
     Notwithstanding section 3282 of this title, in the case of an 
     offense under this section, an indictment may be found, or 
     information instituted, at any time without limitation.
       ``(e) Definitions.--In this section:
       ``(1) Arbitrary detention.--The term `arbitrary detention' 
     means imprisonment or other severe deprivation of physical 
     liberty except on such grounds and in accordance with such 
     procedure as are established by the law of the jurisdiction 
     where such imprisonment or other severe deprivation of 
     physical liberty took place.
       ``(2) Armed group.--The term `armed group' means any army, 
     militia, or other military organization, whether or not it is 
     state-sponsored, excluding any group assembled solely for 
     nonviolent political association.
       ``(3) Attack directed against any civilian population.--The 
     term `attack directed against any civilian population' means 
     a course of conduct in which a civilian population is a 
     primary rather than an incidental target.
       ``(4) Ethnic group; national group; racial group; religious 
     group.--The terms `ethnic group', `national group', `racial 
     group', and `religious group' have the meanings given those 
     terms in section 1093 of this title.
       ``(5) Extermination.--The term `extermination' means 
     subjecting a civilian population to conditions of life that 
     are intended to cause the physical destruction of the group 
     in whole or in part.
       ``(6) Lawfully admitted for permanent residence; national 
     of the united states.--The terms `lawfully admitted for 
     permanent residence' and `national of the United States' have 
     the meanings give those terms in section 101(a) of the 
     Immigration and Nationality Act (8 U.S.C. 1101(a)).
       ``(7) National, ethnic, racial, or religious cleansing.--
     The term `national, ethnic, racial, or religious cleansing' 
     means the

[[Page S7012]]

     intentional and forced displacement from 1 country to another 
     or within a country of any national group, ethnic group, 
     racial group, or religious group in whole or in part, by 
     expulsion or other coercive acts from the area in which they 
     are lawfully present, except when the displacement is in 
     accordance with applicable laws of armed conflict that permit 
     involuntary and temporary displacement of a population to 
     ensure its security or when imperative military reasons so 
     demand.
       ``(8) Systematic.--The term `systematic' means pursuant to 
     or in furtherance of the policy of a state or armed group.
       ``(9) Widespread.--The term `widespread' means involving 
     multiple victims.''.
       (b) Clerical Amendment.--The table of chapters for part 1 
     of title 18, United States Code, is amended by inserting 
     after the item relating to chapter 25 the following:

519''.rimes against humanity.........................................
                                  ____


                                                    June 24, 2009.
     Hon. Richard J. Durbin,
     Chairman Subcommittee on Human Rights and the Law, Senate 
         Committee on the Judiciary, U.S. Senate, Washington, DC.
       Dear Chairman Durbin: We write to express our strong 
     support for the Crimes Against Humanity Act of 2009. This 
     legislation would fill an existing gap in U.S. law by 
     allowing U.S. prosecutors to hold the perpetrators of mass 
     atrocities accountable for their acts. While often less 
     publicized than genocides, crimes against humanity are as 
     devastating to their victims and as worthy of vigorous and 
     unbending attention from the United States government. We 
     must ensure that perpetrators of mass atrocities cannot evade 
     justice by coming to the United States. We applaud your 
     leadership in ensuring that the United States is well 
     equipped to fight these grave crimes and we urge Congress to 
     enact the bill with all due speed.
       The United States government has long been at the forefront 
     of global efforts to seek accountability for the perpetrators 
     of the worst crimes known to humankind. In the years after 
     World War II, the United States was an essential player in 
     the formation of the Nuremberg Tribunal and the Genocide 
     Convention, two key pieces of the foundation for all 
     international justice efforts that have followed. Since then, 
     in Bosnia, Rwanda, Cambodia, Sierra Leone, and Darfur, among 
     others, the U.S. government has steadfastly supported justice 
     for victims of crimes against humanity, war crimes, and 
     genocide, whether by supporting national justice systems or 
     by assisting in the creation of special tribunals.
       The bill defines crimes against humanity as widespread and 
     systematic attacks directed against a civilian population 
     that involve murder, enslavement, torture, rape, arbitrary 
     detention, extermination, hostage taking, or ethnic 
     cleansing. This category includes some of the most atrocious 
     crimes committed in recent history--the campaigns of 
     mutilation and murder of civilians in Sierra Leone and 
     Uganda, the systematic rape of women in ethnic areas of Burma 
     and in the Democratic Republic of the Congo, the ethnic 
     cleansing in Bosnia and Kosovo. These crimes might look like 
     genocide to a layperson, but they are a distinct category of 
     crime and separate legislation is needed to provide United 
     States courts with jurisdiction to prosecute those who commit 
     them if they are present in the United States.
       Such legislation has not existed before today, despite the 
     U.S. government's sustained efforts to ensure accountability 
     for crimes against humanity elsewhere. Alleged perpetrators 
     of those crimes have therefore been able to escape 
     prosecution in the United States. Though U.S. law prohibits 
     grave human rights violations such as genocide and torture, 
     alleged perpetrators of crimes against humanity may escape 
     accountability due not to their innocence of unforgivable 
     acts but to loopholes in the U.S. criminal code.
       The Crimes Against Humanity Act of 2009 would close this 
     illogical gap in U.S. law. Just as they may pursue those who 
     have committed related and similarly horrific crimes, U.S. 
     prosecutors would have the authority to ensure that those in 
     the United States who have committed crimes against humanity 
     may not evade accountability merely by fleeing to our 
     country.
       The United States has provided a means to prosecute those 
     who commit genocide and torture as well as those who use 
     child soldiers in war. Those who commit the similar crimes 
     that constitute crimes against humanity should face no better 
     future. We therefore urge Congress to enact this bill without 
     delay.
           Sincerely,
       The Advocates for Human Rights.
       Africa Action.
       AIDS-Free World.
       Armenian Assembly of America.
       Center for Justice and Accountability.
       Center for Victims of Torture.
       EarthRights International.
       Enough Project.
       The Episcopal Church.
       Equality Now.
       Citizens for Global Solutions.
       Genocide Intervention Network.
       Harvard Immigration and Refugee Clinical Program.
       Human Rights First.
       Human Rights Watch.
       International Justice Mission.
       Jubilee Campaign USA, Inc.
       National Immigrant Justice Center.
       National Immigration Forum.
       Open Society Policy Center.
       Physicians for Human Rights.
       Refugees International.
       Robert F. Kennedy Center for Justice & Human Rights.
       Rocky Mountain Survivors Center.
       Save Darfur Coalition.
       United Methodist Church, General Board of Church and 
     Society.
       United Nations Association of the United States of America.
       U.S. Campaign for Burma.
       V-Day.

  Mr. LEAHY. Mr. President, today, I am pleased to join Senator Durbin 
and Senator Feingold in introducing the Crimes Against Humanity Act of 
2009. This legislation will make it a violation of United States law to 
commit a crime against humanity, and will help ensure that the 
perpetrators of crimes against humanity do not find safe haven in the 
United States. I commend Senator Durbin for his work on this 
legislation and for his leadership as chairman of the Subcommittee on 
Human Rights and the Law.
  Last Congress, I was pleased to work with Senator Durbin to create 
the Human Rights and the Law Subcommittee, the first-ever congressional 
committee established to address human rights issues. The work that we 
have done through this Subcommittee has helped the Senate focus on 
important and difficult legal human rights issues, including genocide, 
human trafficking, child soldiers, war crimes, corporate accountability 
overseas, systematic rape, and torture.
  The work of the Human Rights and the Law Subcommittee has already 
achieved important results. Last Congress, the President signed into 
law the Child Soldiers Accountability Act, which outlawed the abhorrent 
practice of recruiting and using child soldiers, and the Genocide 
Accountability Act, which closed a loophole that had allowed those who 
commit or incite genocide to seek refuge in our country without fear of 
prosecution for their actions. These legislative initiatives were a 
critical step toward showing the international community that the 
United States will not tolerate human rights abuses at home or abroad, 
and that those who commit these atrocities must be held accountable for 
their actions. I am pleased to join Senator Durbin to take the next 
step to protect victims of crimes against humanity in the United 
States, and to hold those responsible for these terrible crimes to 
account.
  Along with genocide and war crimes, crimes against humanity are among 
the most serious crimes under international law. We see such crimes 
against humanity by groups or governments as part of a widespread or 
systematic attack against a civilian population. These deplorable 
crimes include murder, enslavement, torture, rape, arbitrary detention, 
extermination, hostage taking, and ethnic cleansing, and they continue 
to take place around the world in places like Uganda, Burma, and Sudan.
  Although the United States has strongly and consistently for more 
than 60 years supported the prosecution of perpetrators of crimes 
against humanity, there is currently no United States law prohibiting 
crimes against humanity. As a result, the government is unable to 
prosecute perpetrators of crimes against humanity found in our country. 
This legislation will fix this loophole by enabling the Attorney 
General to prosecute crimes against humanity committed by a U.S. 
national, legal alien or habitual resident in the United States. The 
law will also enable the prosecution of any crimes against humanity 
committed in whole or in part within the United States, as well as 
offenses that occur outside the United States, if the offender is 
currently located in the United States.
  The actions prohibited by the Crimes Against Humanity Act of 2009 are 
appalling. They happen too often throughout the world. We must promote 
accountability for human rights violations committed anywhere in the 
world, and we must do whatever we can to prevent those who commit such 
crimes from escaping justice by finding a safe haven in the United 
States. A foreign policy that seeks to defend human rights will never 
fully achieve its goals if we undermine our own credibility by failing 
in our commitment to uphold the highest standards of human rights here 
at home. I urge

[[Page S7013]]

Senators on both sides of the aisle to support this important 
legislation to help this country take another step toward reclaiming 
our place as a guardian of human rights.

                          ____________________