[Congressional Record Volume 156, Number 173 (Wednesday, December 22, 2010)]
[House]
[Pages H8947-H8966]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




         JAMES ZADROGA 9/11 HEALTH AND COMPENSATION ACT OF 2010

  Mr. ARCURI. Madam Speaker, I ask unanimous consent that it be in 
order at any time to take from the Speaker's table the bill H.R. 847, 
with the Senate amendment thereto, and to consider in the House, 
without intervention of any point of order except those arising under 
clause 10 in rule XXI, a motion offered by the chair of the Committee 
on Energy and Commerce or his designee that the House concur in the 
Senate amendment; that the Senate amendment be considered as read; that 
the motion be debatable for 30 minutes equally divided and controlled 
by the Chair and ranking minority member of the Committee on Energy and 
Commerce; and that the previous question be considered as ordered on 
the motion to final adoption without intervening motion.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New York?
  There was no objection.
  Mr. PALLONE. Madam Speaker, pursuant to the order of the House of 
today, I call up the bill (H.R. 847) 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, with the Senate amendment thereto, 
and I have a motion at the desk.
  The Clerk read the title of the bill.
  The SPEAKER pro tempore. The Clerk will designate the Senate 
amendment.
  The text of the Senate amendment is as follows:

       Senate amendment:
       Strike all after the enacting clause and insert the 
     following:

     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 2010''.
       (b) Table of Contents.--The table of contents of this Act 
     is as follows:

Sec. 1. Short title; table of contents.

               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

Sec. 101. World Trade Center Health Program.

           ``TITLE XXXIII--WORLD TRADE CENTER HEALTH PROGRAM

       ``Subtitle A--Establishment of Program; Advisory Committee

``Sec. 3301. Establishment of World Trade Center Health Program.
``Sec. 3302. WTC Health Program Scientific/Technical Advisory 
              Committee; WTC Health Program Steering Committees.
``Sec. 3303. Education and outreach.
``Sec. 3304. Uniform data collection and analysis.
``Sec. 3305. Clinical Centers of Excellence and Data Centers.
``Sec. 3306. Definitions.

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

                        ``PART 1--WTC Responders

``Sec. 3311. Identification of WTC responders and provision of WTC-
              related monitoring services.
``Sec. 3312. Treatment of enrolled WTC responders for WTC-related 
              health conditions.
``Sec. 3313. National arrangement for benefits for eligible individuals 
              outside New York.

                        ``PART 2--WTC Survivors

``Sec. 3321. Identification and initial health evaluation of screening-
              eligible and certified-eligible WTC survivors.
``Sec. 3322. Followup monitoring and treatment of certified-eligible 
              WTC survivors for WTC-related health conditions.
``Sec. 3323. Followup monitoring and treatment of other individuals 
              with WTC-related health conditions.

                       ``PART 3--Payor Provisions

``Sec. 3331. Payment of claims.
``Sec. 3332. Administrative arrangement authority.

                 ``Subtitle C--Research Into Conditions

``Sec. 3341. Research regarding certain health conditions related to 
              September 11 terrorist attacks.
``Sec. 3342. World Trade Center Health Registry.

                         ``Subtitle D--Funding

``Sec. 3351. World Trade Center Health Program Fund.

       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. 205. Funding; attorney fees.

                 TITLE III--REVENUE RELATED PROVISIONS

Sec. 301. Excise tax on foreign procurement.
Sec. 302. Renewal of fees for visa-dependent employers.

                      TITLE IV--BUDGETARY EFFECTS

Sec. 401. Compliance with Statutory Pay-As-You-Go Act of 2010.

               TITLE I--WORLD TRADE CENTER HEALTH PROGRAM

     SEC. 101. WORLD TRADE CENTER HEALTH PROGRAM.

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

           ``TITLE XXXIII--WORLD TRADE CENTER HEALTH PROGRAM

       ``Subtitle A--Establishment of Program; Advisory Committee

     ``SEC. 3301. ESTABLISHMENT OF WORLD TRADE CENTER HEALTH 
                   PROGRAM.

       ``(a) In General.--There is hereby established within the 
     Department of Health and Human Services a program to be known 
     as the World Trade Center Health Program, which shall be 
     administered by the WTC Program Administrator, to provide 
     beginning on July 1, 2011--
       ``(1) medical monitoring and treatment benefits to eligible 
     emergency responders and recovery and cleanup workers 
     (including those who are Federal employees) who responded to 
     the September 11, 2001, terrorist attacks; 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 3311, including clinical 
     examinations and long-term health monitoring and analysis for 
     enrolled WTC responders 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.
       ``(2) Initial health evaluation for survivors.--An initial 
     health evaluation under section 3321, including an evaluation 
     to determine eligibility for followup monitoring and 
     treatment.

[[Page H8948]]

       ``(3) Followup monitoring and treatment for wtc-related 
     health conditions for responders and survivors.--Provision 
     under sections 3312, 3322, and 3323 of followup monitoring 
     and treatment and payment, subject to the provisions of 
     subsection (d), for all medically necessary health and mental 
     health care expenses of an individual with respect to a WTC-
     related health condition (including necessary prescription 
     drugs).
       ``(4) Outreach.--Establishment under section 3303 of an 
     education and outreach program to potentially eligible 
     individuals concerning the benefits under this title.
       ``(5) Clinical data collection and analysis.--Collection 
     and analysis under section 3304 of health and mental health 
     data relating to individuals receiving monitoring or 
     treatment benefits in a uniform manner in collaboration with 
     the collection of epidemiological data under section 3342.
       ``(6) Research on health conditions.--Establishment under 
     subtitle C of a research program on health conditions 
     resulting from the September 11, 2001, terrorist attacks.
       ``(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 enrolled WTC responder or certified-eligible 
     WTC survivor. Initial health evaluation benefits are provided 
     under subtitle B without any deductibles, copayments, or 
     other cost sharing to a screening-eligible WTC survivor.
       ``(d) Preventing Fraud and Unreasonable Administrative 
     Costs.--
       ``(1) Fraud.--The Inspector General of the Department of 
     Health and Human Services shall develop and implement a 
     program to review the WTC Program's health care expenditures 
     to detect fraudulent or duplicate billing and payment for 
     inappropriate services. This title is a Federal health care 
     program (as defined in section 1128B(f) of the Social 
     Security 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.
       ``(2) Unreasonable administrative costs.--The Inspector 
     General of the Department of Health and Human Services shall 
     develop and implement a program to review the WTC Program for 
     unreasonable administrative costs, including with respect to 
     infrastructure, administration, and claims processing.
       ``(e) Quality Assurance.--The WTC Program Administrator 
     working with the Clinical Centers of Excellence shall develop 
     and implement a quality assurance program for the monitoring 
     and treatment delivered by such Centers of Excellence and any 
     other participating health care providers. Such program shall 
     include--
       ``(1) adherence to monitoring and treatment protocols;
       ``(2) appropriate diagnostic and treatment referrals for 
     participants;
       ``(3) prompt communication of test results to participants; 
     and
       ``(4) such other elements as the Administrator specifies in 
     consultation with the Clinical Centers of Excellence.
       ``(f) 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 included in report.--Each annual report 
     under paragraph (1) shall include at least 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 monitoring under the program and the number of 
     such individuals who received medical treatment under the 
     program;
       ``(iii) with respect to individuals so certified who 
     received such treatment, on the WTC-related health conditions 
     for which they were treated; and
       ``(iv) on the projected number of individuals who will be 
     certified under subtitle B in the succeeding fiscal year and 
     the succeeding 10-year period.
       ``(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 New York City under section 3331.
       ``(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 exposure described in section 3306(1), 
     including the findings of research conducted under section 
     3341(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) Firefighters and related personnel.--The benefits 
     provided for enrolled WTC responders described in section 
     3311(a)(2)(A).
       ``(B) Other wtc responders.--The benefits provided for 
     enrolled WTC responders not described in subparagraph (A).
       ``(C) WTC survivors.--The benefits provided for screening-
     eligible WTC survivors and certified-eligible WTC survivors 
     in section 3321(a).
       ``(g) Notification to Congress Upon Reaching 80 Percent of 
     Eligibility Numerical Limits.--The Secretary shall promptly 
     notify the Congress of each of the following:
       ``(1) When the number of enrollments of WTC responders 
     subject to the limit established under section 3311(a)(4) has 
     reached 80 percent of such limit.
       ``(2) When the number of certifications for certified-
     eligible WTC survivors subject to the limit established under 
     section 3321(a)(3) has reached 80 percent of such limit.
       ``(h) Consultation.--The WTC Program Administrator shall 
     engage in ongoing outreach and consultation with relevant 
     stakeholders, including the WTC Health Program Steering 
     Committees and the Advisory Committee under section 3302, 
     regarding the implementation and improvement of programs 
     under this title.

     ``SEC. 3302. WTC HEALTH PROGRAM SCIENTIFIC/TECHNICAL ADVISORY 
                   COMMITTEE; WTC HEALTH PROGRAM STEERING 
                   COMMITTEES.

       ``(a) Advisory Committee.--
       ``(1) Establishment.--The WTC Program Administrator shall 
     establish an advisory committee to be known as the WTC Health 
     Program Scientific/Technical Advisory Committee (in this 
     subsection 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.
       ``(2) Composition.--The WTC Program Administrator shall 
     appoint the members of the Advisory Committee and shall 
     include at least--
       ``(A) 4 occupational physicians, at least 2 of whom have 
     experience treating WTC rescue and recovery workers;
       ``(B) 1 physician with expertise in pulmonary medicine;
       ``(C) 2 environmental medicine or environmental health 
     specialists;
       ``(D) 2 representatives of WTC responders;
       ``(E) 2 representatives of certified-eligible WTC 
     survivors;
       ``(F) an industrial hygienist;
       ``(G) a toxicologist;
       ``(H) an epidemiologist; and
       ``(I) a mental health professional.
       ``(3) Meetings.--The Advisory Committee shall meet at such 
     frequency as may be required to carry out its duties.
       ``(4) Reports.--The WTC Program Administrator shall provide 
     for publication of recommendations of the Advisory Committee 
     on the public Web site established for the WTC Program.
       ``(5) 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.
       ``(6) Application of faca.--Except as otherwise 
     specifically provided, the Advisory Committee shall be 
     subject to the Federal Advisory Committee Act.
       ``(b) WTC Health Program Steering Committees.--
       ``(1) Consultation.--The WTC Program Administrator shall 
     consult with 2 steering committees (each in this section 
     referred to as a `Steering Committee') that are established 
     as follows:
       ``(A) WTC responders steering committee.--One Steering 
     Committee, to be known as the WTC Responders Steering 
     Committee, for the purpose of receiving input from affected 
     stakeholders and facilitating the coordination of monitoring 
     and treatment programs for the enrolled WTC responders under 
     part 1 of subtitle B.
       ``(B) WTC survivors steering committee.--One Steering 
     Committee, to be known as the WTC Survivors Steering 
     Committee, for the purpose of receiving input from affected 
     stakeholders and facilitating the coordination of initial 
     health evaluations, monitoring, and treatment programs for 
     screening-eligible and certified-eligible WTC survivors under 
     part 2 of subtitle B.
       ``(2) Membership.--
       ``(A) WTC responders steering committee.--
       ``(i) Representation.--The WTC Responders Steering 
     Committee shall include--

       ``(I) representatives of the Centers of Excellence 
     providing services to WTC responders;
       ``(II) representatives of labor organizations representing 
     firefighters, police, other New York City employees, and 
     recovery and cleanup workers who responded to the September 
     11, 2001, terrorist attacks; and
       ``(III) 3 representatives of New York City, 1 of whom will 
     be selected by the police commissioner of New York City, 1 by 
     the health commissioner of New York City, and 1 by the mayor 
     of New York City.

       ``(ii) Initial membership.--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).

[[Page H8949]]

       ``(B) WTC survivors steering committee.--
       ``(i) Representation.--The WTC Survivors Steering Committee 
     shall include representatives of--

       ``(I) the Centers of Excellence providing services to 
     screening-eligible and certified-eligible WTC survivors;
       ``(II) the population of residents, students, and area and 
     other workers affected by the September 11, 2001, terrorist 
     attacks;
       ``(III) screening-eligible and certified-eligible survivors 
     receiving initial health evaluations, monitoring, or 
     treatment under part 2 of subtitle B and organizations 
     advocating on their behalf; and
       ``(IV) New York City.

       ``(ii) Initial membership.--The WTC Survivors Steering 
     Committee shall initially be composed of members of the WTC 
     Environmental Health Center Survivor Advisory Committee (as 
     in existence on the day before the date of the enactment of 
     this title).
       ``(C) Additional appointments.--Each Steering Committee may 
     recommend, if approved by a majority of voting members of the 
     Committee, additional members to the Committee.
       ``(D) Vacancies.--A vacancy in a Steering Committee shall 
     be filled by an individual recommended by the Steering 
     Committee.

     ``SEC. 3303. EDUCATION AND OUTREACH.

       ``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 Web site with 
     information about the WTC Program;
       ``(B) meetings with potentially eligible populations;
       ``(C) development and dissemination of outreach materials 
     informing people about the 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.

     ``SEC. 3304. UNIFORM DATA COLLECTION AND ANALYSIS.

       ``(a) In General.--The WTC Program Administrator shall 
     provide for the uniform collection of data, including claims 
     data (and analysis of data and regular reports to the 
     Administrator) on 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. The 
     WTC Program Administrator shall provide, through the Data 
     Centers or otherwise, for the integration of such data into 
     the monitoring and treatment program activities under this 
     title.
       ``(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 Data 
     Center for analysis by such Data Center.
       ``(c) Collaboration With WTC Health Registry.--The WTC 
     Program Administrator shall provide for collaboration between 
     the Data Centers and the World Trade Center Health Registry 
     described in section 3342.
       ``(d) Privacy.--The data collection and analysis under this 
     section shall be conducted and maintained in a manner that 
     protects the confidentiality of individually identifiable 
     health information consistent with applicable statutes and 
     regulations, including, as applicable, HIPAA privacy and 
     security law (as defined in section 3009(a)(2)) and section 
     552a of title 5, United States Code.

     ``SEC. 3305. CLINICAL CENTERS OF EXCELLENCE AND DATA CENTERS.

       ``(a) In General.--
       ``(1) Contracts with clinical centers of excellence.--The 
     WTC Program Administrator shall, subject to subsection 
     (b)(1)(B), enter into contracts with Clinical Centers of 
     Excellence (as defined in subsection (b)(1)(A))--
       ``(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 
     followup 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 for program participants who are not English 
     language proficient; and
       ``(F) for the collection and reporting of data, including 
     claims data, in accordance with section 3304.
       ``(2) Contracts with data centers.--
       ``(A) In general.--The WTC Program Administrator shall 
     enter into contracts with one or more Data Centers (as 
     defined in subsection (b)(2))--
       ``(i) for receiving, analyzing, and reporting to the WTC 
     Program Administrator on data, in accordance with section 
     3304, that have been collected and reported to such Data 
     Centers by the corresponding Clinical Centers of Excellence 
     under subsection (b)(1)(B)(iii);
       ``(ii) for the development of monitoring, initial health 
     evaluation, and treatment protocols, with respect to WTC-
     related health conditions;
       ``(iii) for coordinating the outreach activities conducted 
     under paragraph (1)(B) by each corresponding Clinical Center 
     of Excellence;
       ``(iv) for establishing criteria for the credentialing of 
     medical providers participating in the nationwide network 
     under section 3313;
       ``(v) for coordinating and administering the activities of 
     the WTC Health Program Steering Committees established under 
     section 3002(b); and
       ``(vi) for meeting periodically with the corresponding 
     Clinical Centers of Excellence to obtain input on the 
     analysis and reporting of data collected under clause (i) and 
     on the development of monitoring, initial health evaluation, 
     and treatment protocols under clause (ii).
       ``(B) Medical provider selection.--The medical providers 
     under subparagraph (A)(iv) shall be selected by the WTC 
     Program Administrator on the basis of their experience 
     treating or diagnosing the health conditions included in the 
     list of WTC-related health conditions.
       ``(C) Clinical discussions.--In carrying out subparagraph 
     (A)(ii), a Data Center shall engage in clinical discussions 
     across the WTC Program to guide treatment approaches for 
     individuals with a WTC-related health condition.
       ``(D) Transparency of data.--A contract entered into under 
     this subsection with a Data Center shall require the Data 
     Center to make any data collected and reported to such Center 
     under subsection (b)(1)(B)(iii) available to health 
     researchers and others as provided in the CDC/ATSDR Policy on 
     Releasing and Sharing Data.
       ``(3) Authority for contracts to be class specific.--A 
     contract entered into under this subsection with a Clinical 
     Center of Excellence or a Data Center may be with respect to 
     one or more class of enrolled WTC responders, screening-
     eligible WTC survivors, or certified-eligible WTC survivors.
       ``(4) Use of cooperative agreements.--Any contract under 
     this title between the WTC Program Administrator and a Data 
     Center or a Clinical Center of Excellence may be in the form 
     of a cooperative agreement.
       ``(5) Review on feasibility of consolidating data 
     centers.--Not later than July 1, 2011, the Comptroller 
     General of the United States shall submit to the Committee on 
     Energy and Commerce of the House of Representatives and the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate a report on the feasibility of consolidating Data 
     Centers into a single Data Center.
       ``(b) Centers of Excellence.--
       ``(1) Clinical centers of excellence.--
       ``(A) Definition.--For purposes of this title, the term 
     `Clinical Center of Excellence' means a Center that 
     demonstrates to the satisfaction of the Administrator that 
     the Center--
       ``(i) uses an integrated, centralized health care provider 
     approach to create a comprehensive suite of health services 
     under this title that are accessible to enrolled WTC 
     responders, screening-eligible WTC survivors, or certified-
     eligible WTC survivors;
       ``(ii) has experience in caring for WTC responders and 
     screening-eligible WTC survivors or includes health care 
     providers who have been trained pursuant to section 3313(c);
       ``(iii) employs health care provider staff with expertise 
     that includes, at a minimum, occupational medicine, 
     environmental medicine, trauma-related psychiatry and 
     psychology, and social services counseling; and
       ``(iv) meets such other requirements as specified by the 
     Administrator.
       ``(B) Contract requirements.--The WTC Program Administrator 
     shall not enter into a contract with a Clinical Center of 
     Excellence under subsection (a)(1) unless the Center agrees 
     to do each of the following:
       ``(i) Establish 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.
       ``(ii) Coordinate monitoring and treatment benefits under 
     subtitle B with routine medical care provided for the 
     treatment of conditions other than WTC-related health 
     conditions.
       ``(iii) Collect and report to the corresponding Data Center 
     data, including claims data, in accordance with section 
     3304(b).
       ``(iv) Have in place safeguards against fraud that are 
     satisfactory to the Administrator, in consultation with the 
     Inspector General of the Department of Health and Human 
     Services.
       ``(v) Treat or refer for treatment all individuals who are 
     enrolled WTC responders or certified-eligible WTC survivors 
     with respect to such Center who present themselves for 
     treatment of a WTC-related health condition.
       ``(vi) Have in place safeguards, consistent with section 
     3304(c), 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.
       ``(vii) Use amounts paid under subsection (c)(1) only for 
     costs incurred in carrying out the activities described in 
     subsection (a), other than those described in subsection 
     (a)(1)(A).
       ``(viii) Utilize health care providers with occupational 
     and environmental medicine expertise to conduct physical and 
     mental health assessments, in accordance with protocols 
     developed under subsection (a)(2)(A)(ii).
       ``(ix) Communicate with WTC responders and screening-
     eligible and certified-eligible WTC survivors in appropriate 
     languages and conduct outreach activities with relevant 
     stakeholder worker or community associations.
       ``(x) Meet all the other applicable requirements of this 
     title, including regulations implementing such requirements.

[[Page H8950]]

       ``(C) Transition rule to ensure continuity of care.--The 
     WTC Program Administrator shall to the maximum extent 
     feasible ensure continuity of care in any period of 
     transition from monitoring and treatment of an enrolled WTC 
     responder or certified-eligible WTC survivor by a provider to 
     a Clinical Center of Excellence or a health care provider 
     participating in the nationwide network under section 3313.
       ``(2) Data centers.--For purposes of this title, the term 
     `Data Center' means a Center that the WTC Program 
     Administrator determines has the capacity to carry out the 
     responsibilities for a Data Center under subsection (a)(2).
       ``(3) Corresponding centers.--For purposes of this title, a 
     Clinical Center of Excellence and a Data Center shall be 
     treated as `corresponding' to the extent that such Clinical 
     Center and Data Center serve the same population group.
       ``(c) Payment for Infrastructure Costs.--
       ``(1) In general.--The WTC Program Administrator shall 
     reimburse a Clinical Center of Excellence for the fixed 
     infrastructure costs of such Center in carrying out the 
     activities described in subtitle B at a rate negotiated by 
     the Administrator and such Centers. Such negotiated rate 
     shall be fair and appropriate and take into account the 
     number of enrolled WTC responders receiving services from 
     such Center under this title.
       ``(2) Fixed infrastructure costs.--For purposes of 
     paragraph (1), the term `fixed infrastructure costs' means, 
     with respect to a Clinical Center of Excellence, the costs 
     incurred by such Center that are not otherwise reimbursable 
     by the WTC Program Administrator under section 3312(c) for 
     patient evaluation, monitoring, or treatment but which are 
     needed to operate the WTC program such as the costs involved 
     in outreach to participants or recruiting participants, data 
     collection and analysis, social services for counseling 
     patients on other available assistance outside the WTC 
     program, and the development of treatment protocols. Such 
     term does not include costs for new construction or other 
     capital costs.
       ``(d) GAO Analysis.--Not later than July 1, 2011, the 
     Comptroller General shall submit to the Committee on Energy 
     and Commerce of the House of Representatives and the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate an analysis on whether Clinical Centers of Excellence 
     with which the WTC Program Administrator enters into a 
     contract under this section have financial systems that will 
     allow for the timely submission of claims data for purposes 
     of section 3304 and subsections (a)(1)(F) and (b)(1)(B)(iii).

     ``SEC. 3306. 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, 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 term `certified-eligible WTC survivor' has the 
     meaning given such term in section 3321(a)(2).
       ``(3) The terms `Clinical Center of Excellence' and `Data 
     Center' have the meanings given such terms in section 3305.
       ``(4) The term `enrolled WTC responder' means a WTC 
     responder enrolled under section 3311(a)(3).
       ``(5) 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.
       ``(6) The term `list of WTC-related health conditions' 
     means--
       ``(A) for WTC responders, the health conditions listed in 
     section 3312(a)(3); and
       ``(B) for screening-eligible and certified-eligible WTC 
     survivors, the health conditions listed in section 3322(b).
       ``(7) The term `New York City disaster area' means the area 
     within New York City that is--
       ``(A) the area of Manhattan that is south of Houston 
     Street; and
       ``(B) any block in Brooklyn that is wholly or partially 
     contained within a 1.5-mile radius of the former World Trade 
     Center site.
       ``(8) The term `New York metropolitan area' means an area, 
     specified by the WTC Program Administrator, within which WTC 
     responders and eligible WTC screening-eligible survivors 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 subparagraphs (A), (B), or (C) of section 
     3305(b)(1).
       ``(9) The term `screening-eligible WTC survivor' has the 
     meaning given such term in section 3321(a)(1).
       ``(10) Any reference to `September 11, 2001' shall be 
     deemed a reference to the period on such date subsequent to 
     the terrorist attacks at the World Trade Center, Shanksville, 
     Pennsylvania, or the Pentagon, as applicable, on such date.
       ``(11) The term `September 11, 2001, terrorist attacks' 
     means the terrorist attacks that occurred on September 11, 
     2001, in New York City, in Shanksville, Pennsylvania, and at 
     the Pentagon, and includes the aftermath of such attacks.
       ``(12) The term `WTC Health Program Steering Committee' 
     means such a Steering Committee established under section 
     3302(b).
       ``(13) The term `WTC Program' means the Word Trade Center 
     Health Program established under section 3301(a).
       ``(14)(A) The term `WTC Program Administrator' means--
       ``(i) subject to subparagraph (B), with respect to 
     paragraphs (3) and (4) of section 3311(a) (relating to 
     enrollment of WTC responders), section 3312(c) and the 
     corresponding provisions of section 3322 (relating to payment 
     for initial health evaluation, monitoring, and treatment, 
     paragraphs (1)(C), (2)(B), and (3) of section 3321(a) 
     (relating to determination or certification of screening-
     eligible or certified-eligible WTC responders), and part 3 of 
     subtitle B (relating to payor provisions), an official in the 
     Department of Health and Human Services, to be designated by 
     the Secretary; and
       ``(ii) with respect to any other provision of this title, 
     the Director of the National Institute for Occupational 
     Safety and Health, or a designee of such Director.
       ``(B) In no case may the Secretary designate under 
     subparagraph (A)(i) the Director of the National Institute 
     for Occupational Safety and Health or a designee of such 
     Director with respect to section 3322 (relating to payment 
     for initial health evaluation, monitoring, and treatment).
       ``(15) The term `WTC-related health condition' is defined 
     in section 3312(a).
       ``(16) The term `WTC responder' is defined in section 
     3311(a).
       ``(17) The term `WTC Scientific/Technical Advisory 
     Committee' means such Committee established under section 
     3302(a).

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

                        ``PART 1--WTC RESPONDERS

     ``SEC. 3311. IDENTIFICATION OF WTC RESPONDERS AND PROVISION 
                   OF WTC-RELATED MONITORING SERVICES.

       ``(a) WTC Responder Defined.--
       ``(1) In general.--For purposes of this title, the term 
     `WTC responder' means any of the following individuals, 
     subject to paragraph (4):
       ``(A) Currently identified responder.--An individual who 
     has been identified as eligible for monitoring under the 
     arrangements as in effect on the date of the enactment of 
     this title between the National Institute for Occupational 
     Safety and Health and--
       ``(i) the consortium coordinated by Mt. Sinai Hospital in 
     New York City that coordinates the monitoring and treatment 
     for enrolled WTC responders other than with respect to those 
     covered under the arrangement with the Fire Department of New 
     York City; or
       ``(ii) the Fire Department of New York City.
       ``(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, 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 as 
     the WTC Program Administrator, after consultation with 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 
     enrollments of WTC responders has reached 80 percent of the 
     limit described in paragraph (4) or on or after the date that 
     the number of certifications for certified-eligible WTC 
     survivors under section 3321(a)(2)(B) has reached 80 percent 
     of the limit described in section 3321(a)(3).
       ``(2) Current eligibility criteria.--The eligibility 
     criteria described in this paragraph for an individual is 
     that the individual is described in any of the following 
     categories:
       ``(A) Firefighters and related personnel.--The individual--
       ``(i) was a member of the Fire Department of New York City 
     (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 Landfill, and the New 
     York City 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 New 
     York City (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 health 
     condition described in section 3312(a)(1)(A)(ii) (relating to 
     mental health conditions) on or before September 1, 2008.
       ``(B) Law enforcement officers and wtc rescue, recovery, 
     and cleanup workers.--The individual--
       ``(i) worked or volunteered onsite in rescue, recovery, 
     debris cleanup, or related support services in lower 
     Manhattan (south of Canal St.), the Staten Island Landfill, 
     or the barge loading piers, for at least 4 hours during the 
     period beginning on September 11, 2001, and ending on 
     September 14, 2001, for at least 24 hours during the period 
     beginning on September 11, 2001, and ending on September 30, 
     2001, or for at least 80 hours during the period beginning on 
     September 11, 2001, and ending on July 31, 2002;
       ``(ii)(I) was a member of the Police Department of New York 
     City (whether active or retired) or a member of the Port 
     Authority Police

[[Page H8951]]

     of the Port Authority of New York and New Jersey (whether 
     active or retired) who participated onsite in rescue, 
     recovery, debris cleanup, or related services in lower 
     Manhattan (south of Canal St.), 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 onsite in rescue, recovery, debris 
     cleanup, 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 onsite in rescue, recovery, debris 
     cleanup, 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 onsite in rescue, recovery, debris 
     cleanup, 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 New York City involved in the examination and 
     handling of human remains from the World Trade Center 
     attacks, 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;
       ``(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, and maintaining vehicles 
     contaminated by airborne toxins from the September 11, 2001, 
     terrorist attacks during a duration and period described in 
     subparagraph (A).
       ``(C) Responders to the september 11 attacks at the 
     pentagon and shanksville, pennsylvania.--The individual--
       ``(i)(I) was a member of a fire or police department 
     (whether fire or emergency personnel, active or retired), 
     worked for a recovery or cleanup contractor, or was a 
     volunteer; and performed rescue, recovery, demolition, debris 
     cleanup, or other related services at the Pentagon site of 
     the terrorist-related aircraft crash of September 11, 2001, 
     during the period beginning on September 11, 2001, and ending 
     on the date on which the cleanup of the site was concluded, 
     as determined by the WTC Program Administrator; or
       ``(II) was a member of a fire or police department (whether 
     fire or emergency personnel, active or retired), worked for a 
     recovery or cleanup contractor, or was a volunteer; and 
     performed rescue, recovery, demolition, debris cleanup, or 
     other related services at the Shanksville, Pennsylvania, site 
     of the terrorist-related aircraft crash of September 11, 
     2001, during the period beginning on September 11, 2001, and 
     ending on the date on which the cleanup of the site was 
     concluded, as determined by the WTC Program Administrator; 
     and
       ``(ii) is determined by the WTC Program Administrator to be 
     at an increased risk of developing a WTC-related health 
     condition as a result of exposure to airborne toxins, other 
     hazards, or adverse conditions resulting from the September 
     11, 2001, terrorist attacks, and meets such eligibility 
     criteria related to such exposures, as the WTC Program 
     Administrator determines are appropriate, after consultation 
     with the WTC Scientific/Technical Advisory Committee.
       ``(3) Enrollment process.--
       ``(A) In general.--The WTC Program Administrator shall 
     establish a process for enrolling WTC responders in the WTC 
     Program. Under such process--
       ``(i) WTC responders described in paragraph (1)(A) shall be 
     deemed to be enrolled in such Program;
       ``(ii) subject to clause (iii), the Administrator shall 
     enroll in such program individuals who are determined to be 
     WTC responders;
       ``(iii) the Administrator shall deny such enrollment to an 
     individual if the Administrator determines that the numerical 
     limitation in paragraph (4) on enrollment of WTC responders 
     has been met;
       ``(iv) there shall be no fee charged to the applicant for 
     making an application for such enrollment;
       ``(v) the Administrator shall make a determination on such 
     an application not later than 60 days after the date of 
     filing the application; and
       ``(vi) an individual who is denied enrollment in such 
     Program shall have an opportunity to appeal such 
     determination in a manner established under such process.
       ``(B) Timing.--
       ``(i) Currently identified responders.--In accordance with 
     subparagraph (A)(i), the WTC Program Administrator shall 
     enroll an individual described in paragraph (1)(A) in the WTC 
     Program not later than July 1, 2011.
       ``(ii) Other responders.--In accordance with subparagraph 
     (A)(ii) and consistent with paragraph (4), the WTC Program 
     Administrator shall enroll any other individual who is 
     determined to be a WTC responder in the WTC Program at the 
     time of such determination.
       ``(4) Numerical limitation on eligible wtc responders.--
       ``(A) In general.--The total number of individuals not 
     described in paragraph (1)(A) or (2)(A)(ii) who may be 
     enrolled under paragraph (3)(A)(ii) shall not exceed 25,000 
     at any time, of which no more than 2,500 may be individuals 
     enrolled based on modified eligibility criteria established 
     under paragraph (1)(C).
       ``(B) Process.--In implementing subparagraph (A), the WTC 
     Program Administrator shall--
       ``(i) limit the number of enrollments made under paragraph 
     (3)--

       ``(I) in accordance with such subparagraph; and
       ``(II) to such number, as determined by the Administrator 
     based on the best available information and subject to 
     amounts available under section 3351, that will ensure 
     sufficient funds will be available to provide treatment and 
     monitoring benefits under this title, with respect to all 
     individuals who are enrolled through the end of fiscal year 
     2020; and

       ``(ii) provide priority (subject to paragraph (3)(A)(i)) in 
     such enrollments in the order in which individuals apply for 
     enrollment under paragraph (3).
       ``(5) Disqualification of individuals on terrorist watch 
     list.--No individual who is on the terrorist watch list 
     maintained by the Department of Homeland Security shall 
     qualify as an eligible WTC responder. Before enrolling any 
     individual as a WTC responder in the WTC Program under 
     paragraph (3), the Administrator, in consultation with the 
     Secretary of Homeland Security, shall determine whether the 
     individual is on such list.
       ``(b) Monitoring Benefits.--
       ``(1) In general.--In the case of an enrolled WTC responder 
     (other than one described in subsection (a)(2)(A)(ii)), the 
     WTC Program shall provide for monitoring benefits that 
     include 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 enrolled WTC responder who is an active member of the Fire 
     Department of New York City, 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 3313.

     ``SEC. 3312. TREATMENT OF ENROLLED 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 condition that--
       ``(A)(i) is 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, based on an examination by a medical 
     professional with experience in treating or diagnosing the 
     health conditions included in the applicable list of 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
       ``(ii) is a mental health condition for which such attacks, 
     based on an examination by a medical professional with 
     experience in treating or diagnosing the health conditions 
     included in the applicable list of WTC-related health 
     conditions, is substantially likely to be a significant 
     factor in aggravating, contributing to, or causing the 
     condition, as determined under paragraph (2); and
       ``(B) is included in the applicable list of WTC-related 
     health conditions or--
       ``(i) with respect to a WTC responder, is provided 
     certification of coverage under subsection (b)(2)(B)(iii); or
       ``(ii) with respect to a screening-eligible WTC survivor or 
     certified-eligible WTC survivor, is provided certification of 
     coverage under subsection (b)(2)(B)(iii), as applied under 
     section 3322(a).
     In the case of a WTC responder described in section 
     3311(a)(2)(A)(ii) (relating to a surviving immediate family 
     member of a firefighter), such term does not include an 
     illness or health condition described in subparagraph (A)(i).
       ``(2) Determination.--The determination under paragraph (1) 
     or subsection (b) of whether the September 11, 2001, 
     terrorist attacks 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 health conditions 
     included on the list of WTC-related health conditions.
       ``(B) The type of symptoms and temporal sequence of 
     symptoms. Such symptoms shall be--
       ``(i) assessed through the use of a standardized, 
     population-appropriate medical questionnaire approved by the 
     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 health conditions for wtc responders.--The 
     list of health conditions for WTC responders consists of the 
     following:
       ``(A) Aerodigestive disorders.--
       ``(i) Interstitial lung diseases.
       ``(ii) Chronic respiratory disorder--fumes/vapors.
       ``(iii) Asthma.
       ``(iv) Reactive airways dysfunction syndrome (RADS).

[[Page H8952]]

       ``(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) Gastroesophageal reflux disorder (GERD).
       ``(xii) Sleep apnea exacerbated by or related to a 
     condition described in a previous clause.
       ``(B) Mental health conditions.--
       ``(i) Posttraumatic 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.
       ``(C) Musculoskeletal disorders for certain wtc 
     responders.--In the case of a WTC responder described in 
     paragraph (4), a condition described in such paragraph.
       ``(D) Additional conditions.--Any cancer (or type of 
     cancer) or other condition added, pursuant to paragraph (5) 
     or (6), to the list under this paragraph.
       ``(4) Musculoskeletal disorders.--
       ``(A) In general.--For purposes of this title, in the case 
     of a WTC responder who received any treatment for a WTC-
     related musculoskeletal disorder on or before September 11, 
     2003, the list of health conditions in paragraph (3) shall 
     include:
       ``(i) Low back pain.
       ``(ii) Carpal tunnel syndrome (CTS).
       ``(iii) Other musculoskeletal disorders.
       ``(B) Definition.--The term `WTC-related musculoskeletal 
     disorder' means a chronic or recurrent disorder of the 
     musculoskeletal system caused by heavy lifting or repetitive 
     strain on the joints or musculoskeletal system occurring 
     during rescue or recovery efforts in the New York City 
     disaster area in the aftermath of the September 11, 2001, 
     terrorist attacks.
       ``(5) Cancer.--
       ``(A) In general.--The WTC Program Administrator shall 
     periodically conduct a review of all available scientific and 
     medical evidence, including findings and recommendations of 
     Clinical Centers of Excellence, published in peer-reviewed 
     journals to determine if, based on such evidence, cancer or a 
     certain type of cancer should be added to the applicable list 
     of WTC-related health conditions. The WTC Program 
     Administrator shall conduct the first review under this 
     subparagraph not later than 180 days after the date of the 
     enactment of this title.
       ``(B) Proposed regulations and rulemaking.--Based on the 
     periodic reviews under subparagraph (A), if the WTC Program 
     Administrator determines that cancer or a certain type of 
     cancer should be added to such list of WTC-related health 
     conditions, the WTC Program Administrator shall propose 
     regulations, through rulemaking, to add cancer or the certain 
     type of cancer to such list.
       ``(C) Final regulations.--Based on all the available 
     evidence in the rulemaking record, the WTC Program 
     Administrator shall make a final determination of whether 
     cancer or a certain type of cancer should be added to such 
     list of WTC-related health conditions. If such a 
     determination is made to make such an addition, the WTC 
     Program Administrator shall by regulation add cancer or the 
     certain type of cancer to such list.
       ``(D) Determinations not to add cancer or certain types of 
     cancer.--In the case that the WTC Program Administrator 
     determines under subparagraph (B) or (C) that cancer or a 
     certain type of cancer should not be added to such list of 
     WTC-related health conditions, the WTC Program Administrator 
     shall publish an explanation for such determination in the 
     Federal Register. Any such determination to not make such an 
     addition shall not preclude the addition of cancer or the 
     certain type of cancer to such list at a later date.
       ``(6) Addition of health conditions to list for wtc 
     responders.--
       ``(A) In general.--Whenever the WTC Program Administrator 
     determines that a proposed rule should be promulgated to add 
     a health condition to the list of health conditions in 
     paragraph (3), the Administrator may request a recommendation 
     of the Advisory Committee or may publish such a proposed rule 
     in the Federal Register in accordance with subparagraph (D).
       ``(B) Administrator's options after receipt of petition.--
     In the case that the WTC Program Administrator receives a 
     written petition by an interested party to add a health 
     condition to the list of health conditions in paragraph (3), 
     not later than 60 days after the date of receipt of such 
     petition the Administrator shall--
       ``(i) request a recommendation of the Advisory Committee;
       ``(ii) publish a proposed rule in the Federal Register to 
     add such health condition, in accordance with subparagraph 
     (D);
       ``(iii) publish in the Federal Register the Administrator's 
     determination not to publish such a proposed rule and the 
     basis for such determination; or
       ``(iv) publish in the Federal Register a determination that 
     insufficient evidence exists to take action under clauses (i) 
     through (iii).
       ``(C) Action by advisory committee.--In the case that the 
     Administrator requests a recommendation of the Advisory 
     Committee under this paragraph, with respect to adding a 
     health condition to the list in paragraph (3), the Advisory 
     Committee shall submit to the Administrator such 
     recommendation not later than 60 days after the date of such 
     request or by such date (not to exceed 180 days after such 
     date of request) as specified by the Administrator. Not later 
     than 60 days after the date of receipt of such 
     recommendation, the Administrator shall, in accordance with 
     subparagraph (D), publish in the Federal Register a proposed 
     rule with respect to such recommendation or a determination 
     not to propose such a proposed rule and the basis for such 
     determination.
       ``(D) Publication.--The WTC Program Administrator shall, 
     with respect to any proposed rule under this paragraph--
       ``(i) publish such proposed rule in accordance with section 
     553 of title 5, United States Code; and
       ``(ii) provide interested parties a period of 30 days after 
     such publication to submit written comments on the proposed 
     rule.
     The WTC Program Administrator may extend the period described 
     in clause (ii) upon a finding of good cause. In the case of 
     such an extension, the Administrator shall publish such 
     extension in the Federal Register.
       ``(E) Interested party defined.--For purposes of this 
     paragraph, the term `interested party' includes a 
     representative of any organization representing WTC 
     responders, a nationally recognized medical association, a 
     Clinical or Data Center, a State or political subdivision, or 
     any other interested person.
       ``(b) Coverage of Treatment for WTC-Related Health 
     Conditions.--
       ``(1) Determination for enrolled wtc responders based on a 
     wtc-related health condition.--
       ``(A) In general.--If a physician at a Clinical Center of 
     Excellence that is providing monitoring benefits under 
     section 3311 for an enrolled WTC responder makes a 
     determination that the responder has a WTC-related health 
     condition that is in the list in subsection (a)(3) and that 
     exposure to airborne toxins, other hazards, or adverse 
     conditions resulting from the September 1, 2001, terrorist 
     attacks is substantially likely to be a significant factor in 
     aggravating, contributing to, or causing the condition--
       ``(i) the physician shall promptly transmit such 
     determination to the WTC Program Administrator and provide 
     the Administrator with the medical facts supporting such 
     determination; and
       ``(ii) on and after the date of such transmittal and 
     subject to 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).
       ``(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 a WTC-related health condition in the list 
     in subsection (a)(3) or that exposure to airborne toxins, 
     other hazards, or adverse conditions resulting from the 
     September 1, 2001, terrorist attacks is not substantially 
     likely to be a significant factor in aggravating, 
     contributing to, or causing the condition.
       ``(iii) Appeal process.--The Administrator shall establish, 
     by rule, a process for the appeal of determinations under 
     clause (ii).
       ``(2) Determination based on medically associated wtc-
     related health conditions.--
       ``(A) In general.--If a physician at a Clinical Center of 
     Excellence determines pursuant to subsection (a) that the 
     enrolled WTC responder has a health condition described in 
     subsection (a)(1)(A) that is not in the list in subsection 
     (a)(3) but which is medically associated with a WTC-related 
     health condition--
       ``(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) Procedures for review, certification, and appeal.--
     The WTC Program Administrator shall, by rule, establish 
     procedures for the review and certification of physician 
     determinations under subparagraph (A). Such rule shall 
     provide for--
       ``(i) the timely review of such a determination by a 
     physician panel with appropriate expertise for the condition 
     and recommendations to the WTC Program Administrator;
       ``(ii) not later than 60 days after the date of the 
     transmittal under subparagraph (A)(i), a determination by the 
     WTC Program Administrator on whether or not the condition 
     involved is described in subsection (a)(1)(A) and is 
     medically associated with a WTC-related health condition;
       ``(iii) certification in accordance with paragraph 
     (1)(B)(ii) of coverage of such condition if determined to be 
     described in subsection (a)(1)(A) and medically associated 
     with a WTC-related health condition; and
       ``(iv) a process for appeals of determinations relating to 
     such conditions.
       ``(C) Inclusion in list of health conditions.--If the WTC 
     Program Administrator provides certification under 
     subparagraph (B)(iii) for coverage of a condition, the 
     Administrator may, pursuant to subsection (a)(6), add the 
     condition to the list in subsection (a)(3).
       ``(D) Conditions already declined for inclusion in list.--
     If the WTC Program Administrator publishes a determination 
     under subsection (a)(6)(B) not to include a condition in the 
     list in subsection (a)(3), the WTC Program Administrator 
     shall not provide certification under subparagraph (B)(iii) 
     for coverage of the condition. In the case of an individual 
     who is certified under subparagraph (B)(iii) with respect to 
     such condition before the date of the publication of such 
     determination the previous sentence shall not apply.

[[Page H8953]]

       ``(3) Requirement of medical necessity.--
       ``(A) In general.--In providing treatment for a WTC-related 
     health condition, a physician or other provider shall provide 
     treatment that is medically necessary and in accordance with 
     medical treatment protocols established under subsection (d).
       ``(B) Regulations relating to medical necessity.--For the 
     purpose of this title, the WTC Program Administrator shall 
     issue regulations specifying a standard for determining 
     medical necessity with respect to health care services and 
     prescription pharmaceuticals, a process for determining 
     whether treatment furnished and pharmaceuticals prescribed 
     under this title meet such standard (including any prior 
     authorization requirement), and a process for appeal of a 
     determination under subsection (c)(3).
       ``(4) Scope of treatment covered.--
       ``(A) In general.--The scope of treatment covered under 
     this subsection includes services of physicians and other 
     health care providers, diagnostic and laboratory tests, 
     prescription drugs, inpatient and outpatient hospital 
     services, and other medically necessary treatment.
       ``(B) Pharmaceutical coverage.--With respect to ensuring 
     coverage of medically necessary outpatient prescription 
     drugs, such drugs shall be provided, under arrangements made 
     by the WTC Program Administrator, directly through 
     participating Clinical Centers of Excellence or through one 
     or more outside vendors.
       ``(C) Transportation expenses for nationwide network.--The 
     WTC Program Administrator may provide for necessary and 
     reasonable transportation and expenses incident to the 
     securing of medically necessary treatment through the 
     nationwide network under section 3313 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.--With 
     respect to an enrolled WTC responder for whom a determination 
     is made by an examining physician under paragraph (1) or (2), 
     but for whom the WTC Program Administrator has not yet 
     determined whether to certify the determination, the WTC 
     Program Administrator may establish by rule a process through 
     which the Administrator may approve the provision of medical 
     treatment under this subsection (and payment under subsection 
     (c)) with respect to such responder and such responder's WTC-
     related health condition (under such terms and conditions as 
     the Administrator may provide) until the Administrator makes 
     a decision on whether to certify the determination.
       ``(c) Payment for Initial Health Evaluation, Monitoring, 
     and Treatment of WTC-Related Health Conditions.--
       ``(1) Medical treatment.--
       ``(A) Use of feca payment rates.--
       ``(i) In general.--Subject to clause (ii):

       ``(I) Subject to subparagraphs (B) and (C), 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.
       ``(II) For treatment not covered under subclause (i) or 
     subparagraph (B), the WTC Program Administrator shall 
     establish by regulation a reimbursement rate for such 
     treatment.

       ``(ii) Exception.--In no case shall payments for products 
     or services under clause (i) be made at a rate higher than 
     the Office of Worker's Compensation Programs in the 
     Department Labor would pay for such products or services 
     rendered at the time such products or services were provided.
       ``(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 enter into an agreement with a separate 
     vendor to provide pharmaceutical benefits to enrolled WTC 
     responders for whom the Clinical Center of Excellence is 
     described in section 3305 if such an arrangement is deemed 
     necessary and beneficial to the program by the WTC Program 
     Administrator.
       ``(iv) Pharmaceuticals.--Not later than July 1, 2011, the 
     Comptroller General of the United States shall submit to the 
     Committee on Energy and Commerce of the House of 
     Representatives and the Committee on Health, Education, 
     Labor, and Pensions of the Senate a report on whether 
     existing Federal pharmaceutical purchasing programs can 
     provide pharmaceutical benefits more efficiently and 
     effectively than through the WTC program.
       ``(C) Improving quality and efficiency through modification 
     of payment amounts and methodologies.--The WTC Program 
     Administrator may modify the amounts and methodologies for 
     making payments for initial health evaluations, monitoring, 
     or treatment, if, taking into account utilization and quality 
     data furnished by the Clinical Centers of Excellence under 
     section 3305(b)(1)(B)(iii), the Administrator determines that 
     a bundling, capitation, pay for performance, or other payment 
     methodology would better ensure high quality and efficient 
     delivery of initial health evaluations, monitoring, or 
     treatment to an enrolled WTC responder, screening-eligible 
     WTC survivor, or certified-eligible WTC survivor.
       ``(2) Monitoring and initial health evaluation.--The WTC 
     Program Administrator shall reimburse the costs of monitoring 
     and the costs of an initial health evaluation provided under 
     this title at a rate set by the Administrator by regulation.
       ``(3) Determination of medical necessity.--
       ``(A) Review of medical necessity and protocols.--As part 
     of the process for reimbursement or payment under this 
     subsection, the WTC Program Administrator shall provide for 
     the review of claims for reimbursement or payment for the 
     provision of medical treatment to determine if such treatment 
     is medically necessary and in accordance with medical 
     treatment protocols established under subsection (d).
       ``(B) Withholding of payment for medically unnecessary 
     treatment.--The Administrator shall withhold such 
     reimbursement or payment for treatment that the Administrator 
     determines is not medically necessary or is not in accordance 
     with such medical treatment protocols.
       ``(d) Medical Treatment Protocols.--
       ``(1) Development.--The Data Centers shall develop medical 
     treatment protocols for the treatment of enrolled WTC 
     responders and certified-eligible WTC survivors for health 
     conditions included in the applicable list of WTC-related 
     health conditions.
       ``(2) Approval.--The medical treatment protocols developed 
     under paragraph (1) shall be subject to approval by the WTC 
     Program Administrator.

     ``SEC. 3313. 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 enrolled 
     WTC responders, screening-eligible WTC survivors, or 
     certified-eligible WTC survivors 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 
     Data Centers;
       ``(2) follow the monitoring, initial health evaluation, and 
     treatment protocols developed under section 
     3305(a)(2)(A)(ii);
       ``(3) collect and report data in accordance with section 
     3304; and
       ``(4) meet such fraud, quality assurance, and other 
     requirements as the WTC Program Administrator establishes, 
     including sections 1128 through 1128E of the Social Security 
     Act, as applied by section 3301(d).
       ``(c) Training and Technical Assistance.--The WTC Program 
     Administer may provide, including through contract, for the 
     provision of training and technical assistance to health care 
     providers participating in the network under subsection (a).
       ``(d) Provision of Services Through the VA.--
       ``(1) In general.--The WTC Program Administrator may enter 
     into an agreement with the Secretary of Veterans Affairs for 
     the Secretary to provide services under this section through 
     facilities of the Department of Veterans Affairs.
       ``(2) National program.--Not later than July 1, 2011, the 
     Comptroller General of the United States shall submit to the 
     Committee on Energy and Commerce of the House of 
     Representatives and the Committee on Health, Education, 
     Labor, and Pensions of the Senate a report on whether the 
     Department of Veterans Affairs can provide monitoring and 
     treatment services to individuals under this section more 
     efficiently and effectively than through the nationwide 
     network to be established under subsection (a).

                        ``PART 2--WTC SURVIVORS

     ``SEC. 3321. IDENTIFICATION AND INITIAL HEALTH EVALUATION OF 
                   SCREENING-ELIGIBLE AND CERTIFIED-ELIGIBLE WTC 
                   SURVIVORS.

       ``(a) Identification of Screening-Eligible WTC Survivors 
     and Certified-Eligible WTC Survivors.--
       ``(1) Screening-eligible wtc survivors.--
       ``(A) Definition.--In this title, the term `screening-
     eligible WTC survivor' means, subject to subparagraph (C) and 
     paragraph (3), an individual who is described in any of the 
     following clauses:
       ``(i) Currently identified survivor.--An individual, 
     including a WTC responder, who has been identified as 
     eligible for medical treatment and monitoring by the WTC 
     Environmental Health Center as of the date of enactment of 
     this title.
       ``(ii) Survivor who meets current eligibility criteria.--An 
     individual who is not a WTC responder, for purposes of the 
     initial health evaluation under subsection (b), claims 
     symptoms of a WTC-related health condition and meets any of 
     the current eligibility criteria described in subparagraph 
     (B).
       ``(iii) Survivor who meets modified eligibility criteria.--
     An individual who is not a WTC responder, for purposes of the 
     initial health evaluation under subsection (b), claims 
     symptoms of a WTC-related health condition and meets such 
     eligibility criteria relating to exposure to airborne toxins, 
     other hazards, or adverse conditions resulting from the 
     September 11,

[[Page H8954]]

     2001, terrorist attacks as the WTC Administrator determines, 
     after consultation with the Data Centers described in section 
     3305 and the WTC Scientific/Technical Advisory Committee and 
     WTC Health Program Steering Committees under section 3302.
     The Administrator shall not modify such criteria under clause 
     (iii) on or after the date that the number of certifications 
     for certified-eligible WTC survivors under paragraph (2)(B) 
     has reached 80 percent of the limit described in paragraph 
     (3) or on or after the date that the number of enrollments of 
     WTC responders has reached 80 percent of the limit described 
     in section 3311(a)(4).
       ``(B) Current eligibility criteria.--The eligibility 
     criteria described in this subparagraph for an individual are 
     that the individual is described in any of the following 
     clauses:
       ``(i) A person who was present in the New York City 
     disaster area in the dust or dust cloud on September 11, 
     2001.
       ``(ii) A person who worked, resided, or attended school, 
     childcare, or adult daycare in the New York City disaster 
     area for--

       ``(I) at least 4 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.

       ``(iii) Any person who worked as a cleanup 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.
       ``(iv) 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.
       ``(v) 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.

       ``(C) Application and determination process for screening 
     eligibility.--
       ``(i) In general.--The WTC Program Administrator in 
     consultation with the Data Centers shall establish a process 
     for individuals, other than individuals described in 
     subparagraph (A)(i), to be determined to be screening-
     eligible WTC survivors. Under such process--

       ``(I) there shall be no fee charged to the applicant for 
     making an application for such determination;
       ``(II) the Administrator shall make a determination on such 
     an application not later than 60 days after the date of 
     filing the application;
       ``(III) the Administrator shall make such a determination 
     relating to an applicant's compliance with this title and 
     shall not determine that an individual is not so eligible or 
     deny written documentation under clause (ii) to such 
     individual unless the Administrator determines that--

       ``(aa) based on the application submitted, the individual 
     does not meet the eligibility criteria; or
       ``(bb) the numerical limitation on certifications of 
     certified-eligible WTC survivors set forth in paragraph (3) 
     has been met; and

       ``(IV) an individual who is determined not to be a 
     screening-eligible WTC survivor shall have an opportunity to 
     appeal such determination in a manner established under such 
     process.

       ``(ii) Written documentation of screening-eligibility.--

       ``(I) In general.--In the case of an individual who is 
     described in subparagraph (A)(i) or who is determined under 
     clause (i) (consistent with paragraph (3)) to be a screening-
     eligible WTC survivor, the WTC Program Administrator shall 
     provide an appropriate written documentation of such fact.
       ``(II) Timing.--

       ``(aa) Currently identified survivors.--In the case of an 
     individual who is described in subparagraph (A)(i), the WTC 
     Program Administrator shall provide the written documentation 
     under subclause (I) not later than July 1, 2011.
       ``(bb) Other members.--In the case of another individual 
     who is determined under clause (i) and consistent with 
     paragraph (3) to be a screening-eligible WTC survivor, the 
     WTC Program Administrator shall provide the written 
     documentation under subclause (I) at the time of such 
     determination.
       ``(2) Certified-eligible wtc survivors.--
       ``(A) Definition.--The term `certified-eligible WTC 
     survivor' means, subject to paragraph (3), a screening-
     eligible WTC survivor who the WTC Program Administrator 
     certifies under subparagraph (B) to be eligible for followup 
     monitoring and treatment under this part.
       ``(B) Certification of eligibility for monitoring and 
     treatment.--
       ``(i) In general.--The WTC Program Administrator shall 
     establish a certification process under which the 
     Administrator shall provide appropriate certification to 
     screening-eligible WTC survivors who, pursuant to the initial 
     health evaluation under subsection (b), are determined to be 
     eligible for followup monitoring and treatment under this 
     part.
       ``(ii) Timing.--

       ``(I) Currently identified survivors.--In the case of an 
     individual who is described in paragraph (1)(A)(i), the WTC 
     Program Administrator shall provide the certification under 
     clause (i) not later than July 1, 2011.
       ``(II) Other members.--In the case of another individual 
     who is determined under clause (i) to be eligible for 
     followup monitoring and treatment, the WTC Program 
     Administrator shall provide the certification under such 
     clause at the time of such determination.

       ``(3) Numerical limitation on certified-eligible wtc 
     survivors.--
       ``(A) In general.--The total number of individuals not 
     described in paragraph (1)(A)(i) who may be certified as 
     certified-eligible WTC survivors under paragraph (2)(B) shall 
     not exceed 25,000 at any time.
       ``(B) Process.--In implementing subparagraph (A), the WTC 
     Program Administrator shall--
       ``(i) limit the number of certifications provided under 
     paragraph (2)(B)--

       ``(I) in accordance with such subparagraph; and
       ``(II) to such number, as determined by the Administrator 
     based on the best available information and subject to 
     amounts made available under section 3351, that will ensure 
     sufficient funds will be available to provide treatment and 
     monitoring benefits under this title, with respect to all 
     individuals receiving such certifications through the end of 
     fiscal year 2020; and

       ``(ii) provide priority in such certifications in the order 
     in which individuals apply for a determination under 
     paragraph (2)(B).
       ``(4) Disqualification of individuals on terrorist watch 
     list.--No individual who is on the terrorist watch list 
     maintained by the Department of Homeland Security shall 
     qualify as a screening-eligible WTC survivor or a certified-
     eligible WTC survivor. Before determining any individual to 
     be a screening-eligible WTC survivor under paragraph (1) or 
     certifying any individual as a certified eligible WTC 
     survivor under paragraph (2), the Administrator, in 
     consultation with the Secretary of Homeland Security, shall 
     determine whether the individual is on such list.
       ``(b) Initial Health Evaluation To Determine Eligibility 
     for Followup Monitoring or Treatment.--
       ``(1) In general.--In the case of a screening-eligible WTC 
     survivor, the WTC Program shall provide for an initial health 
     evaluation to determine if the survivor has a WTC-related 
     health condition and is eligible for followup monitoring and 
     treatment benefits under the WTC Program. Initial health 
     evaluation protocols under section 3305(a)(2)(A)(ii) shall be 
     subject to approval by the WTC Program Administrator.
       ``(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 an initial health evaluation under this part for 
     a screening-eligible WTC survivor 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. 3322. FOLLOWUP MONITORING AND TREATMENT OF CERTIFIED-
                   ELIGIBLE WTC SURVIVORS FOR WTC-RELATED HEALTH 
                   CONDITIONS.

       ``(a) In General.--Subject to subsection (b), the 
     provisions of sections 3311 and 3312 shall apply to followup 
     monitoring and treatment of WTC-related health conditions for 
     certified-eligible WTC survivors in the same manner as such 
     provisions apply to the monitoring and treatment of WTC-
     related health conditions for enrolled WTC responders.
       ``(b) List of WTC-Related Health Conditions for 
     Survivors.--The list of health conditions for screening-
     eligible WTC survivors and certified-eligible WTC survivors 
     consists of the following:
       ``(1) Aerodigestive disorders.--
       ``(A) Interstitial lung diseases.
       ``(B) Chronic respiratory disorder--fumes/vapors.
       ``(C) Asthma.
       ``(D) Reactive airways dysfunction syndrome (RADS).
       ``(E) WTC-exacerbated chronic obstructive pulmonary disease 
     (COPD).
       ``(F) Chronic cough syndrome.
       ``(G) Upper airway hyperreactivity.
       ``(H) Chronic rhinosinusitis.
       ``(I) Chronic nasopharyngitis.
       ``(J) Chronic laryngitis.
       ``(K) Gastroesophageal reflux disorder (GERD).
       ``(L) Sleep apnea exacerbated by or related to a condition 
     described in a previous clause.
       ``(2) Mental health conditions.--
       ``(A) Posttraumatic stress disorder (PTSD).
       ``(B) Major depressive disorder.
       ``(C) Panic disorder.
       ``(D) Generalized anxiety disorder.
       ``(E) Anxiety disorder (not otherwise specified).
       ``(F) Depression (not otherwise specified).
       ``(G) Acute stress disorder.
       ``(H) Dysthymic disorder.
       ``(I) Adjustment disorder.
       ``(J) Substance abuse.
       ``(3) Additional conditions.--Any cancer (or type of 
     cancer) or other condition added to the list in section 
     3312(a)(3) pursuant to paragraph (5) or (6) of section 
     3312(a), as such provisions are applied under subsection (a) 
     with respect to certified-eligible WTC survivors.

     ``SEC. 3323. FOLLOWUP MONITORING AND TREATMENT OF OTHER 
                   INDIVIDUALS WITH WTC-RELATED HEALTH CONDITIONS.

       ``(a) In General.--Subject to subsection (c), the 
     provisions of section 3322 shall apply to the followup 
     monitoring and treatment of WTC-related health conditions in 
     the case of individuals described in subsection (b) in the 
     same

[[Page H8955]]

     manner as such provisions apply to the followup monitoring 
     and treatment of WTC-related health conditions for certified-
     eligible WTC survivors.
       ``(b) Individuals Described.--An individual described in 
     this subsection is an individual who, regardless of location 
     of residence--
       ``(1) is not an enrolled WTC responder or a certified-
     eligible WTC survivor; and
       ``(2) is diagnosed at a Clinical Center of Excellence with 
     a WTC-related health condition for certified-eligible WTC 
     survivors.
       ``(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) the last calendar quarter of fiscal year 2011 is 
     $5,000,000;
       ``(B) fiscal year 2012 is $20,000,000; or
       ``(C) 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--PAYOR PROVISIONS

     ``SEC. 3331. PAYMENT OF CLAIMS.

       ``(a) In General.--Except as provided in subsections (b) 
     and (c), the cost of monitoring and treatment benefits and 
     initial health evaluation benefits provided under parts 1 and 
     2 of this subtitle shall be paid for by the WTC Program from 
     the World Trade Center Health Program Fund.
       ``(b) Workers' Compensation Payment.--
       ``(1) In general.--Subject to paragraph (2), payment for 
     treatment under parts 1 and 2 of this subtitle of a WTC-
     related health condition of an individual that is work-
     related shall be reduced or recouped to the extent that the 
     WTC Program Administrator 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, a 
     State, or a locality, 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 and paragraphs (3) and (4) of such section shall 
     apply to the recoupment under this subsection 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) except that any reference in 
     such paragraph (4) to payment rates under title XVIII of the 
     Social Security Act shall be deemed a reference to payment 
     rates under this title.
       ``(2) Exception.--Paragraph (1) shall not apply for any 
     quarter, with respect to any workers' compensation law or 
     plan, including line of duty compensation, to which New York 
     City is obligated to make payments, if, in accordance with 
     terms specified under the contract under subsection 
     (d)(1)(A), New York City has made the full payment required 
     under such contract for such quarter.
       ``(3) Rules of construction.--Nothing in this title shall 
     be construed to affect, modify, or relieve any obligations 
     under a worker's compensation law or plan, other work-related 
     injury or illness benefit plan of an employer, or any health 
     insurance plan.
       ``(c) Health Insurance Coverage.--
       ``(1) 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 (including health benefits under title 
     XVIII, XIX, or XXI of the Social Security Act) the provisions 
     of section 1862(b) of the Social Security Act shall apply to 
     such a health plan and such individual in the same manner as 
     they apply to group health plan and an individual entitled to 
     benefits under title XVIII of such Act pursuant to section 
     226(a) of such Act. 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. The program under this title 
     shall not be treated as a legally liable party for purposes 
     of applying section 1902(a)(25) of the Social Security Act.
       ``(2) Recovery by individual providers.--Nothing in 
     paragraph (1) 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.
       ``(3) Maintenance of required minimum essential coverage.--
     No payment may be made for monitoring and treatment under 
     this title for an individual for a month (beginning with July 
     2014) if with respect to such month the individual--
       ``(A) is an applicable individual (as defined in subsection 
     (d) of section 5000A of Internal Revenue Code of 1986) for 
     whom the exemption under subsection (e) of such section does 
     not apply; and
       ``(B) is not covered under minimum essential coverage, as 
     required under subsection (a) of such section.
       ``(d) Required Contribution by New York City in Program 
     Costs.--
       ``(1) Contract requirement.--
       ``(A) In general.--No funds may be disbursed from the World 
     Trade Center Health Program Fund under section 3351 unless 
     New York City has entered into a contract with the WTC 
     Program Administrator under which New York City agrees, in a 
     form and manner specified by the Administrator, to pay the 
     full contribution described in subparagraph (B) in accordance 
     with this subsection on a timely basis, plus any interest 
     owed pursuant to subparagraph (E)(i). Such contract shall 
     specify the terms under which New York City shall be 
     considered to have made the full payment required for a 
     quarter for purposes of subsection (b)(2).
       ``(B) Full contribution amount.--Under such contract, with 
     respect to the last calendar quarter of fiscal year 2011 and 
     each calendar quarter in fiscal years 2012 through 2015 the 
     full contribution amount under this subparagraph shall be 
     equal to 10 percent of the expenditures in carrying out this 
     title for the respective quarter and with respect to calendar 
     quarters in fiscal year 2016, such full contribution amount 
     shall be equal to \1/9\ of the Federal expenditures in 
     carrying out this title for the respective quarter.
       ``(C) Satisfaction of payment obligation.--The payment 
     obligation under such contract may not be satisfied through 
     any of the following:
       ``(i) An amount derived from Federal sources.
       ``(ii) An amount paid before the date of the enactment of 
     this title.
       ``(iii) An amount paid to satisfy a judgment or as part of 
     a settlement related to injuries or illnesses arising out of 
     the September 11, 2001, terrorist attacks.
       ``(D) Timing of contribution.--The payment obligation under 
     such contract for a calendar quarter in a fiscal year shall 
     be paid not later than the last day of the second succeeding 
     calendar quarter.
       ``(E) Compliance.--
       ``(i) Interest for late payment.--If New York City fails to 
     pay to the WTC Program Administrator pursuant to such 
     contract the amount required for any calendar quarter by the 
     day specified in subparagraph (D), interest shall accrue on 
     the amount not so paid at the rate (determined by the 
     Administrator) based on the average yield to maturity, plus 1 
     percentage point, on outstanding municipal bonds issued by 
     New York City with a remaining maturity of at least 1 year.
       ``(ii) Recovery of amounts owed.--The amounts owed to the 
     WTC Program Administrator under such contract shall be 
     recoverable by the United States in an action in the same 
     manner as payments made under title XVIII of the Social 
     Security Act may be recoverable in an action brought under 
     section 1862(b)(2)(B)(iii) of such Act.
       ``(F) Deposit in fund.--The WTC Program Administer shall 
     deposit amounts paid under such contract into the World Trade 
     Center Health Program Fund under section 3351.
       ``(2) Payment of new york city share of monitoring and 
     treatment costs.--With respect to each calendar quarter for 
     which a contribution is required by New York City under the 
     contract under paragraph (1), the WTC Program Administrator 
     shall--
       ``(A) provide New York City with an estimate of such amount 
     of the required contribution at the beginning of such quarter 
     and with an updated estimate of such amount at the beginning 
     of each of the subsequent 2 quarters;
       ``(B) bill such amount directly to New York City; and
       ``(C) certify periodically, for purposes of this 
     subsection, whether or not New York City has paid the amount 
     so billed.

     Such amount shall initially be estimated by the WTC Program 
     Administrator and shall be subject to adjustment and 
     reconciliation based upon actual expenditures in carrying out 
     this title.
       ``(3) Rule of construction.--Nothing in this subsection 
     shall be construed as authorizing the WTC Administrator, with 
     respect to a fiscal year, to reduce the numerical limitation 
     under section 3311(a)(4) or 3321(a)(3) for such fiscal year 
     if New York City fails to comply with paragraph (1) for a 
     calendar quarter in such fiscal year.
       ``(e) Work-Related Described.--For the purposes of this 
     section, a WTC-related health condition shall be treated as a 
     condition that is work-related if--
       ``(1) the condition is diagnosed in an enrolled WTC 
     responder, or in an individual who qualifies as a certified-
     eligible WTC survivor on the basis of being a rescue, 
     recovery, or cleanup worker; or
       ``(2) 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.

     ``SEC. 3332. 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 sections 3312, 3313, 3322, and 
     3323.

                 ``Subtitle C--Research Into Conditions

     ``SEC. 3341. RESEARCH REGARDING CERTAIN HEALTH CONDITIONS 
                   RELATED TO SEPTEMBER 11 TERRORIST ATTACKS.

       ``(a) In General.--With respect to individuals, including 
     enrolled WTC responders and certified-eligible WTC survivors, 
     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;
       ``(2) research on diagnosing WTC-related health conditions 
     of such individuals, in the

[[Page H8956]]

     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 3342), through a Clinical Center of Excellence, or 
     through a Data Center.
       ``(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 enrolled WTC responders and certified-eligible 
     WTC survivors 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 
     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 
     conducted or funded by the Department of Health and Human 
     Services.

     ``SEC. 3342. WORLD TRADE CENTER HEALTH REGISTRY.

       ``For the purpose of ensuring ongoing data collection 
     relating to victims of the September 11, 2001, terrorist 
     attacks, the WTC Program Administrator shall ensure that a 
     registry of such victims is maintained that is at least as 
     comprehensive as the World Trade Center Health Registry 
     maintained under the arrangements in effect as of April 20, 
     2009, with the New York City Department of Health and Mental 
     Hygiene.

                         ``Subtitle D--Funding

     ``SEC. 3351. WORLD TRADE CENTER HEALTH PROGRAM FUND.

       ``(a) Establishment of Fund.--
       ``(1) In general.--There is established a fund to be known 
     as the World Trade Center Health Program Fund (referred to in 
     this section as the `Fund').
       ``(2) Funding.--Out of any money in the Treasury not 
     otherwise appropriated, there shall be deposited into the 
     Fund for each of fiscal years 2012 through 2016 (and the last 
     calendar quarter of fiscal year 2011)--
       ``(A) the Federal share, consisting of an amount equal to 
     the lesser of--
       ``(i) 90 percent of the expenditures in carrying out this 
     title for the respective fiscal year (initially based on 
     estimates, subject to subsequent reconciliation based on 
     actual expenditures); or
       ``(ii)(I) $71,000,000 for the last calendar quarter of 
     fiscal year 2011, $318,000,000 for fiscal year 2012, 
     $354,000,000 for fiscal year 2013, $382,000,000 for fiscal 
     year 2014, and $431,000,000 for fiscal year 2015; and
       ``(II) subject to paragraph (4), an additional amount for 
     fiscal year 2016 from unexpended amounts for previous fiscal 
     years; plus
       ``(B) the New York City share, consisting of the amount 
     contributed under the contract under section 3331(d).
       ``(3) Contract requirement.--
       ``(A) In general.--No funds may be disbursed from the Fund 
     unless New York City has entered into a contract with the WTC 
     Program Administrator under section 3331(d)(1).
       ``(B) Breach of contract.--In the case of a failure to pay 
     the amount so required under the contract--
       ``(i) the amount is recoverable under subparagraph (E)(ii) 
     of such section;
       ``(ii) such failure shall not affect the disbursement of 
     amounts from the Fund; and
       ``(iii) the Federal share described in paragraph (2)(A) 
     shall not be increased by the amount so unpaid.
       ``(4) Aggregate limitation on funding beginning with fiscal 
     year 2016.--Beginning with fiscal year 2016, in no case shall 
     the share of Federal funds deposited into the Fund under 
     paragraph (2) for such fiscal year and previous fiscal years 
     and quarters exceed the sum of the amounts specified in 
     paragraph (2)(A)(ii)(I).
       ``(b) Mandatory Funds for Monitoring, Initial Health 
     Evaluations, Treatment, and Claims Processing.--
       ``(1) In general.--The amounts deposited into the Fund 
     under subsection (a)(2) shall be available, without further 
     appropriation, consistent with paragraph (2) and subsection 
     (c), to carry out subtitle B and sections 3302(a), 3303, 
     3304, 3305(a)(2), 3305(c), 3341, and 3342.
       ``(2) Limitation on mandatory funding.--This title does not 
     establish any Federal obligation for payment of amounts in 
     excess of the amounts available from the Fund for such 
     purpose.
       ``(3) Limitation on authorization for further 
     appropriations.--This title does not establish any 
     authorization for appropriation of amounts in excess of the 
     amounts available from the Fund under paragraph (1).
       ``(c) Limits on Spending for Certain Purposes.--Of the 
     amounts made available under subsection (b)(1), not more than 
     each of the following amounts may be available for each of 
     the following purposes:
       ``(1) Surviving immediate family members of firefighters.--
     For the purposes of carrying out subtitle B with respect to 
     WTC responders described in section 3311(a)(2)(A)(ii)--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $100,000;
       ``(B) for fiscal year 2012, $400,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(2) WTC health program scientific/technical advisory 
     committee.--For the purpose of carrying out section 3302(a)--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $25,000;
       ``(B) for fiscal year 2012, $100,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(3) Education and outreach.--For the purpose of carrying 
     out section 3303--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $500,000;
       ``(B) for fiscal year 2012, $2,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(4) Uniform data collection.--For the purpose of carrying 
     out section 3304 and for reimbursing Data Centers (as defined 
     in section 3305(b)(2)) for the costs incurred by such Centers 
     in carrying out activities under contracts entered into under 
     section 3305(a)(2)--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $2,500,000;
       ``(B) for fiscal year 2012, $10,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(5) Research regarding certain health conditions.--For 
     the purpose of carrying out section 3341--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $3,750,000;
       ``(B) for fiscal year 2012, $15,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.
       ``(6) World trade center health registry.--For the purpose 
     of carrying out section 3342--
       ``(A) for the last calendar quarter of fiscal year 2011, 
     $1,750,000;
       ``(B) for fiscal year 2012, $7,000,000; and
       ``(C) for each subsequent fiscal year, the amount specified 
     under this paragraph for the previous fiscal year increased 
     by the percentage increase in the consumer price index for 
     all urban consumers (all items; United States city average) 
     as estimated by the Secretary for the 12-month period ending 
     with March of the previous year.''.

       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 3001 of the Public Health Service 
     Act, and payments made pursuant to the settlement of a civil 
     action described in section 405(c)(3)(C)(iii)'' 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 May 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;

[[Page H8957]]

       ``(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'';
       (2) in clause (ii), by inserting ``or debris removal during 
     the immediate aftermath'' after ``crashes''; and
       (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 the date that is 5 years after the date on which such 
     regulations are updated.''.
       (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).''.
       (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) Settled actions.--Such section, as so redesignated, is 
     further amended by adding at the end the following new 
     clause:
       ``(iii) Settled actions.--In the case of an individual who 
     settled a civil action described in clause (i), such 
     individual may not submit a claim under this title unless 
     such action was commenced after December 22, 2003, and a 
     release of all claims in such action was tendered prior to 
     the date on which the James Zadroga 9/11 Health and 
     Compensation Act of 2010 was enacted.''.

     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 180 days after 
     the date of the enactment of the James Zadroga 9/11 Health 
     and Compensation Act of 2010, 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.--Notwithstanding any 
     other provision of law, liability for all claims and actions 
     (including claims or actions that have been previously 
     resolved, that are currently pending, and that may be filed) 
     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, shall not be in an amount that exceeds the 
     sum of the following, as may be applicable:
       ``(A) The amount of funds of the WTC Captive Insurance 
     Company, including the cumulative interest.
       ``(B) The amount of all available insurance identified in 
     schedule 2 of the WTC Captive Insurance Company insurance 
     policy.
       ``(C) As it relates to the limitation of liability of the 
     City of New York, 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 
     subparagraphs (A) and (B) shall not be included.
       ``(D) As it relates to the limitation of liability of 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), the amount of all available 
     liability insurance coverage maintained by any such entity.
       ``(E) As it relates to the limitation of liability of any 
     individual contractor or subcontractor, the amount of all 
     available liability insurance coverage maintained by such 
     contractor or subcontractor on September 11, 2001.
       ``(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) applies, shall be paid 
     solely from the following funds in the following order, as 
     may be applicable:
       ``(A) The funds described in subparagraph (A) or (B) of 
     paragraph (4).
       ``(B) If there are no funds available as described in 
     subparagraph (A) or (B) of paragraph (4), the funds described 
     in subparagraph (C) of such paragraph.
       ``(C) If there are no funds available as described in 
     subparagraph (A), (B), or (C) of paragraph (4), the funds 
     described in subparagraph (D) of such paragraph.
       ``(D) If there are no funds available as described in 
     subparagraph (A), (B), (C), or (D) of paragraph (4), the 
     funds described in subparagraph (E) of such paragraph.
       ``(6) Declaratory judgment actions and direct action.--Any 
     claimant to a claim or action to which paragraph (4) 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, 
     except that no such action for declaratory judgment or direct 
     action may be commenced until after the funds available in 
     subparagraph (A), (B), (C), and (D) of paragraph (5) have 
     been exhausted consistent with the order described in such 
     paragraph for payment.''.

     SEC. 205. FUNDING; ATTORNEY FEES.

       Section 406 of the Air Transportation Safety and System 
     Stabilization Act (49 U.S.C. 40101 note) is amended--
       (1) in subsection (a), by striking ``Not later than'' and 
     inserting ``Subject to the limitations under subsection (d), 
     not later than'';
       (2) in subsection (b)--
       (A) by inserting ``in the amounts provided under subsection 
     (d)(1)'' after ``appropriations Acts''; and
       (B) by inserting ``subject to the limitations under 
     subsection (d)'' before the period; and

[[Page H8958]]

       (3) by adding at the end the following new subsections:
       ``(d) Limitation.--
       ``(1) In general.--The total amount of Federal funds paid 
     for compensation under this title, with respect to claims 
     filed on or after the date on which the regulations are 
     updated under section 407(b), shall not exceed 
     $2,775,000,000. Of such amounts, not to exceed $875,000,000 
     shall be available to pay such claims during the 5-year 
     period beginning on such date.
       ``(2) Pro-ration and payment of remaining claims.--
       ``(A) In general.--The Special Master shall ratably reduce 
     the amount of compensation due claimants under this title in 
     a manner to ensure, to the extent possible, that--
       ``(i) all claimants who, before application of the 
     limitation under the second sentence of paragraph (1), would 
     have been determined to be entitled to a payment under this 
     title during such 5-year period, receive a payment during 
     such period; and
       ``(ii) the total amount of all such payments made during 
     such 5-year period do not exceed the amount available under 
     the second sentence of paragraph (1) to pay claims during 
     such period.
       ``(B) Payment of remainder of claim amounts.--In any case 
     in which the amount of a claim is ratably reduced pursuant to 
     subparagraph (A), on or after the first day after the 5-year 
     period described in paragraph (1), but in no event later than 
     1 year after such 5-year period, the Special Master shall pay 
     to the claimant the amount that is equal to the difference 
     between--
       ``(i) the amount that the claimant would have been paid 
     under this title during such period without regard to the 
     limitation under the second sentence of paragraph (1) 
     applicable to such period; and
       ``(ii) the amount the claimant was paid under this title 
     during such period.
       ``(C) Termination.--Upon completion of all payments 
     pursuant to this subsection, the Victim's Compensation Fund 
     shall be permanently closed.
       ``(e) Attorney Fees.--
       ``(1) In general.--Notwithstanding any contract, the 
     representative of an individual may not charge, for services 
     rendered in connection with the claim of an individual under 
     this title, more than 10 percent of an award made under this 
     title on such claim.
       ``(2) Limitation.--
       ``(A) In general.--Except as provided in subparagraph (B), 
     in the case of an individual who was charged a legal fee in 
     connection with the settlement of a civil action described in 
     section 405(c)(3)(C)(iii), the representative of the 
     individual may not charge any amount for compensation for 
     services rendered in connection with a claim filed under this 
     title.
       ``(B) Exception.--If the legal fee charged in connection 
     with the settlement of a civil action described in section 
     405(c)(3)(C)(iii) of an individual is less than 10 percent of 
     the aggregate amount of compensation awarded to such 
     individual through such settlement, the representative of 
     such individual may charge an amount for compensation for 
     services rendered to the extent that such amount charged is 
     not more than--
       ``(i) 10 percent of such aggregate amount through the 
     settlement, minus
       ``(ii) the total amount of all legal fees charged for 
     services rendered in connection with such settlement.
       ``(3) Discretion to lower fee.--In the event that the 
     special master finds that the fee limit set by paragraph (1) 
     or (2) provides excessive compensation for services rendered 
     in connection with such claim, the Special Master may, in the 
     discretion of the Special Master, award as reasonable 
     compensation for services rendered an amount lesser than that 
     permitted for in paragraph (1).''.

                 TITLE III--REVENUE RELATED PROVISIONS

     SEC. 301. EXCISE TAX ON CERTAIN FOREIGN PROCUREMENT.

       (a) Imposition of Tax.--
       (1) In general.--Subtitle D of the Internal Revenue Code of 
     1986 is amended by adding at the end the following new 
     chapter:

                   ``CHAPTER 50--FOREIGN PROCUREMENT

``Sec. 5000C. Imposition of tax on certain foreign procurement.

     ``SEC. 5000C. IMPOSITION OF TAX ON CERTAIN FOREIGN 
                   PROCUREMENT.

       ``(a) Imposition of Tax.--There is hereby imposed on any 
     foreign person that receives a specified Federal procurement 
     payment a tax equal to 2 percent of the amount of such 
     specified Federal procurement payment.
       ``(b) Specified Federal Procurement Payment.--For purposes 
     of this section, the term `specified Federal procurement 
     payment' means any payment made pursuant to a contract with 
     the Government of the United States for--
       ``(1) the provision of goods, if such goods are 
     manufactured or produced in any country which is not a party 
     to an international procurement agreement with the United 
     States, or
       ``(2) the provision of services, if such services are 
     provided in any country which is not a party to an 
     international procurement agreement with the United States.
       ``(c) Foreign Person.--For purposes of this section, the 
     term `foreign person' means any person other than a United 
     States person.
       ``(d) Administrative Provisions.--
       ``(1) Withholding.--The amount deducted and withheld under 
     chapter 3 shall be increased by the amount of tax imposed by 
     this section on such payment.
       ``(2) Other administrative provisions.--For purposes of 
     subtitle F, any tax imposed by this section shall be treated 
     as a tax imposed by subtitle A.''.
       (2) Clerical amendment.--The table of chapters for subtitle 
     D of the Internal Revenue Code of 1986 is amended by adding 
     at the end the following new item:

                  ``Chapter 50--Foreign Procurement''.

       (3) Effective date.--The amendments made by this subsection 
     shall apply to payments received pursuant to contracts 
     entered into on and after the date of the enactment of this 
     Act.
       (b) Prohibition on Reimbursement of Fees.--
       (1) In general.--The head of each executive agency shall 
     take any and all measures necessary to ensure that no funds 
     are disbursed to any foreign contractor in order to reimburse 
     the tax imposed under section 5000C of the Internal Revenue 
     Code of 1986.
       (2) Annual review.--The Administrator for Federal 
     Procurement Policy shall annually review the contracting 
     activities of each executive agency to monitor compliance 
     with the requirements of paragraph (1).
       (3) Executive agency.--For purposes of this subsection, the 
     term ``executive agency'' has the meaning given the term in 
     section 4 of the Office of Federal Procurement Policy Act (41 
     U.S.C. 403).
       (c) Application.--This section and the amendments made by 
     this section shall be applied in a manner consistent with 
     United States obligations under international agreements.

     SEC. 302. RENEWAL OF FEES FOR VISA-DEPENDENT EMPLOYERS.

       Subsections (a), (b), and (c) of section 402 of Public Law 
     111-230 are amended by striking ``2014'' each place that such 
     appears and inserting ``2015''.

                      TITLE IV--BUDGETARY EFFECTS

     SEC. 401. COMPLIANCE WITH STATUTORY PAY-AS-YOU-GO ACT OF 
                   2010.

       The budgetary effects of this Act, for the purpose of 
     complying with the Statutory Pay-As-You-Go-Act of 2010, shall 
     be determined by reference to the latest statement titled 
     ``Budgetary Effects of PAYGO Legislation'' for this Act, 
     submitted for printing in the Congressional Record by the 
     Chairman of the Senate Budget Committee, provided that such 
     statement has been submitted prior to the vote on passage.

                            Motion to Concur

  The SPEAKER pro tempore. The Clerk will report the motion.
  The Clerk read as follows:

       Mr. Pallone moves that the House concur in the Senate 
     amendment to H.R. 847.

  The SPEAKER pro tempore. Pursuant to the order of the House of today, 
the motion shall be debatable for 30 minutes equally divided and 
controlled by the Chair and ranking minority Member of the Committee on 
Energy and Commerce.
  The gentleman from New Jersey (Mr. Pallone) and the gentleman from 
Texas (Mr. Burgess) each will control 15 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. Madam Speaker, I ask unanimous consent that all Members 
may have 5 legislative days in which to revise and extend their remarks 
and include extraneous material in the Record.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. Madam Speaker, I yield to myself such time as I may 
consume.
  I rise in strong support of the Senate amendment to H.R. 847, the 
James Zadroga 9/11 Health and Compensation Act of 2019. Today, this 
body, for the third time, will vote on legislation to finally keep our 
promise and take care of the heroes of 9/11.
  I would like to thank the bill's sponsors, Representatives Carolyn 
Maloney and Jerry Nadler, as well as my colleagues from New York on the 
committee, Eliot Engel and Anthony Weiner, also, for their tireless 
work on behalf of this legislation.
  Madam Speaker, this bill would establish the World Trade Center 
Health Program, a program to screen, monitor and treat eligible 
responders and survivors who are suffering from World Trade Center 
related diseases. It also reopens the 9/11 Victim Compensation Fund.
  H.R. 847, as amended, costs $4.2 billion over 10 years. Of that 
amount, $1.5 billion will go to the health program, while $2.7 billion 
will go the VCF. Both programs are now limited to 5 years.
  The amended bill before us today also changes how the two programs 
are paid for by a 2 percent fee on government procurement from foreign 
companies located in nongovernmental procurement, and a 1-year 
extension of H1-B and L-1 visa fees for outsourcing companies.
  Madam Speaker, this bill has long been a huge priority for me and 
many of my colleagues in the House and the Senate. I urge my colleagues 
to pass the bill.

[[Page H8959]]

  I reserve the balance of my time.
  Mr. BURGESS. I yield myself such time as I may consume.
  Madam Speaker, I appreciate the gentleman's efforts in this regard. I 
would like to take a few moments and clear up some of the 
mischaracterizations that have occurred, unfortunately, around the 
debate of this bill as it has worked its way through both Houses.
  There have been some who have claimed that my side, the Republicans, 
do not support providing treatment for 9/11 first responders, and that 
these first responders are currently going without treatment for the 
illnesses and injuries they suffered as a result of serving at the 
World Trade Center. Both of those claims are simply not true.
  According to President Obama's administration's own Centers for 
Disease Control, the agency said, ``We will continue to provide 
monitoring and treatment services for mental and physical health 
conditions related to World Trade Center exposures for both responders 
and for eligible non-responders. The World Trade Center program is 
critical in meeting the ongoing and long-term specialty needs of 
individuals that were exposed to dust, smoke, debris, and psychological 
trauma from the World Trade Center attacks.''
  As of September 30, 2009, the World Trade Center program had enrolled 
over 55,000 responders in its monitoring and treatment programs. This 
is in the CDC's budget justification for 2011.
  At the Energy and Commerce Committee's markup of this legislation, 
Republicans offered an amendment that would authorize the program that 
is already providing treatment and monitoring benefits and authorized 
funding for the program at exactly the level that was requested by the 
President of the United States. That same amendment asked for real 
accountability to ensure that we knew how the tax dollars were being 
spent. Unfortunately, that amendment was defeated.
  I am pleased that work in the Senate has yielded an amendment that 
will provide for increased accountability and increased transparency in 
how these funds are spent. H.R. 847 caps the number of people that can 
be enrolled in the program but it does not require those enrolled to 
verify their citizenship.

                              {time}  1600

  We offered an amendment that would require this program so that 
people in the country without benefit of Social Security numbers would 
not get benefits while Americans were being stuck on the waiting list. 
This amendment was defeated.
  As with any government spending program, there should be limitations 
on who can participate. The government has limited resources, so the 
principal beneficiaries of the 9/11 health program should be the first 
responders. However, H.R. 847 provides more than just benefits to first 
responders; it also provides benefits to anyone who lives and works in 
New York City. Under this bill, even Wall Street millionaires could 
receive benefits with no cost to them, all done at the taxpayers' 
expense.
  In fact, in the Committee on Energy and Commerce I offered an 
amendment that was rejected by the committee. I attempted to offer the 
amendment at Rules when this legislation was brought before the House 
before our adjournment in September, but I was thwarted in that. But it 
remains that we ought to ensure that Federal taxpayers would not have 
to pay for the health care of millionaires.
  The bill passed by the Senate is an improvement over what passed in 
the House. There could have been further improvements to ensure our 
limited resources are being spent in the most efficient manner 
possible. But all in all, the improvements that have been accomplished 
over the last 24 hours are all to the good. This is an important piece 
of legislation. This is something that this Congress or some Congress 
should have passed in the last 8 years. And it is unconscionable that 
we are here today at the last hour of the 111th Congress with still 
this work pending. It's important to get this work done.
  I reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield 1 minute to the chairman of the 
Energy and Commerce Committee, the gentleman from California (Mr. 
Waxman).
  Mr. WAXMAN. I rise in strong support, Madam Speaker, of H.R. 847, the 
James Zadroga 9/11 Health and Compensation Act of 2010. I want to thank 
the chairman of the Health Subcommittee, Frank Pallone, as well as my 
colleagues from New York on the committee, Eliot Engel and Anthony 
Weiner, for their relentless work on behalf of this legislation, as 
well as Representatives Maloney and Nadler, and the whole New York City 
delegation, who were tireless in their support of this bill.
  This is an important piece of legislation that will attempt to 
provide the services to first responders and community residents who 
developed illness as a result of their exposure to the massive toxic 
dust cloud that blanketed Lower Manhattan after the terrorist attack on 
September 11, 2001. I strongly urge all Members to support this 
legislation.
  H.R. 847, was reported by the Energy and Commerce Committee with 
bipartisan support on May 25 by a vote of 33-12.
  The House passed H.R. 847 on September 29; the bill received 
bipartisan support from 268 Members.
  The version of before us this afternoon is one that has been amended 
by the Senate in order to obtain bipartisan support in that Chamber.
  Like the House-passed version, the Senate version is fully paid for 
and will not increase the deficit. It fully complies with all pay-go 
rules.
  The World Trade Center Health Program currently provides services to 
first responders and community residents who developed illnesses as a 
result of their exposure to the massive toxic dust cloud that blanketed 
lower Manhattan after the terrorist attacks on September 11, 2001.
  The current program is not authorized. The House-passed bill 
authorized the Health Program through FY 2019 at a federal funding 
level of $3.2 billion. The federal government will pay 90 percent of 
the cost, while New York City will pay 10 percent.
  The Senate amendment reduces the authorization period to FY 2015 and 
federal funding to $1.5 billion. New York City would still be required 
to pay 10 percent of the costs.
  The Senate amendment makes a number of other changes in the Health 
Program.
  It prohibits the Secretary of HHS from using NIOSH to administer 
payments to Centers of Excellence and other participating providers.
  It clarifies that Centers of Excellence delivering services to 
responders and community residents will have to provide claims-level 
data to the Health Program Administrator.
  It clarifies the Centers of Excellence should be paid for the costs 
of carrying out the program that are not otherwise reimbursable, such 
as outreach, data collection, social services, and development of 
treatment protocols.
  It authorizes the Program Administrator to contract with the VA to 
provide services to responders enrolled in the national program through 
its facilities, but only if the VA chooses to do so.
  Finally, the Senate amendment directs the GAO to conduct studies on 
various aspects of the Health Program and to report to the Committees 
of jurisdiction prior to July 1, 2011. That is the date on which 
Secretary of HHS and the WTC Administrator are responsible for 
implementing the Health Program. In the likely event that the GAO is 
unable to complete all of its work by that date, the Program will 
nonetheless begin furnishing services to responders and survivors.
  The Administration supports this bill for the same reason that all of 
us should: it is the right thing to do.
  The first responders were there for us on 9-11. We should be there 
for them today.
  I urge my colleagues to pass this bill and send it on to the 
President for signature.
  Mr. BURGESS. Madam Speaker, I am pleased to yield 1 minute to the 
gentleman from Oklahoma (Mr. Cole).
  Mr. COLE. I thank the gentleman from Texas for yielding.
  Madam Speaker, long before New York City's first responders rushed to 
save their fellow Americans in the fire and the horror of 9/11, they 
came to help the people of Oklahoma City deal with the death and 
destruction stemming from the terrorist bombing of the Alfred P. Murrah 
Federal Building on April 19, 1995. The people of Oklahoma have never 
forgotten the help that they received in their most difficult days from 
the first responders of New York City and their fellow first responders 
from all across North America.
  When 9/11 occurred, Oklahoma's first responders were proud to join 
their fellow Americans and rush to the aid of a stricken New York City. 
Now it's our turn in this body to help all of those

[[Page H8960]]

who answered the call of duty on 9/11. They risked themselves to save 
others and to help one of America's great cities deal with and recover 
from the devastation of the greatest terrorist attack in our history. 
It's time, as our greatest President said in an earlier era and in 
another context, ``to bind up the Nation's wounds, to care for him who 
shall have borne the battle, and for his widow, and for his orphan.''
  Madam Speaker, I urge the passage of H.R. 847, as amended.
  Mr. PALLONE. Madam Speaker, I yield 1 minute to one of the sponsors 
of the bill who has worked tirelessly on this, the gentleman from New 
York (Mr. Nadler).
  Mr. NADLER of New York. Madam Speaker, let me first thank everyone 
who has worked on this bill and say the Senate passed this bill a 
little while ago unanimously. The most conservative Senators, Senators 
Enzi and Coburn, supported it, and I hope we can do the same.
  Nine years ago, Madam Speaker, the heroes of 9/11 ran into the 
buildings, they rushed into the burning buildings, and they worked in a 
toxic environment for weeks and months. They have suffered for that. 
They have suffered for their service to this country by getting sick, 
by dying, by being sick. It is now up to us to see that the United 
States honors its heroes, that the United States does not turn its back 
on those who served us.
  When we pass this bill, we will answer the question of whether the 
United States honors its heroes, and whether the United States honors 
itself. Let us pass this bill, let us redeem the honor of the United 
States after all these years, let us show the world that the United 
States looks after its own. That's what this bill is. I urge everyone 
to support it.
  Mr. BURGESS. Madam Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Brady), a member of the Ways and Means Committee.
  Mr. BRADY of Texas. Madam Speaker, I too support the goal of ensuring 
that the brave men and women that acted as first responders at the 
World Trade Center attack are fairly treated and compensated. But I 
rise today to oppose the troubling provisions the majority has attached 
to pay for this bill.
  This measure would impose a 2 percent tax on goods and services that 
are produced or provided in certain foreign countries from firms that 
are based in foreign countries that are not parties to certain treaties 
or international agreements. It sounds complicated. But some analysis 
suggests that a significant majority of this tax, at least two-thirds, 
if not more, would be raised by taxing contracts that support American 
troops stationed in the Afghan and Iraqi theaters. Even more 
incredible, this tax could apply to American companies that are 
providing goods and services to our troops through local subsidiaries. 
Levying additional taxes on companies that support American troops is 
both illogical and dangerous.
  In addition, there is no reason that other countries wouldn't copy 
this tax and impose it on our U.S. companies that are competing to sell 
goods and services overseas. This would hurt our U.S. economic recovery 
efforts and efforts to boost U.S. sales abroad and create American jobs 
here at home. Moreover, I have real concerns that this excise tax could 
be subject to legal challenge at the World Trade Organization and may 
be inconsistent with our G-20 commitments to avoid imposing new 
protectionist measures.
  Madam Speaker, I urge a ``no'' vote because of these provisions. 
Strangely, the proposed procurement tax doesn't include any of the 
exceptions included in our standard Buy America legislation, such as 
non-availability, unreasonable cost and inconsistency with the public 
interest. As a result, the bill would mandate a tax on the procurement 
of goods from a foreign producer even when U.S. goods aren't available.
  In addition to this new tax, the bill would extend a tax on companies 
that have more than half their employees on certain specialized visas 
to work here in the United States. This tax raises independent concerns 
under our international obligations.
  The SPEAKER pro tempore. The time of the gentleman has expired.
  Mr. BURGESS. I yield the gentleman an additional 30 seconds.
  Mr. BRADY of Texas. Finally, I would like to have printed in the 
Record a letter from 10 key business associations, including the 
Emergency Committee for American Trade and the U.S. Chamber of 
Commerce, that also oppose the use of these pay-for provisions.

                                                December 21, 2010.
     Hon. Nancy Pelosi,
     Speaker, House of Representatives,
     Washington, DC.
     Hon. John Boehner,
     Republican Leader, House of Representatives,
     Washington, DC.
     Hon. Harry Reid,
     Majority Leader, U.S. Senate,
     Washington, DC.
     Hon. Mitch McConnell,
     Republican Leader, U.S. Senate,
     Washington, DC.
       Dear Speaker Pelosi and Leaders Reid, Boehner, and 
     McConnell: We are writing to urge you to remove from the 
     proposed amended version of H.R. 847 the Title III revenue 
     raisers related to international government procurement. 
     First, its purported revenue raising benefits are highly 
     questionable. Second, there is a high risk that it will 
     undermine the international competitiveness of American 
     companies and American workers.
       Title III would impose an excise tax on companies that are 
     from foreign countries which are not members of the World 
     Trade Organization (WTO) Government Procurement Agreement 
     (GPA) or similar procurement arrangements ostensibly for the 
     purpose of helping finance health benefits for the valiant 9/
     11 first responders. In reality, the U.S. federal government 
     is already prohibited from procuring from such countries, 
     except under very limited conditions--when the good or 
     service is not available in the United States or would cost 
     an unreasonable amount or if the procurement is required for 
     the national interest. Moreover, the amount of such 
     procurement is generally regarded as relatively small 
     compared to U.S. sales into the procurement markets of these 
     countries.
       The procurement portions of this legislation would 
     undermine U.S. efforts to succeed in the international 
     economy by both inviting non-GPA countries to take reciprocal 
     action against U.S. companies seeking to participate in their 
     procurement markets and by opening the United States to 
     retaliation for violating its WTO obligations. While U.S. 
     companies certainly face significant and discriminatory 
     procurement barriers in China, India, Brazil and other 
     countries that are not part of the WTO procurement agreement, 
     U.S. companies are still selling more into those government 
     procurement markets than the United States is purchasing from 
     those countries. As a result, there would more than likely be 
     net loss for U.S. exports, U.S. companies and U.S. jobs if 
     this provision became a model for foreign governments.
       Furthermore, the imposition of this discriminatory tax on 
     foreign companies may also violate U.S. international 
     commitments if implemented. If found to be contrary to U.S. 
     WTO commitments, other countries could end up being 
     authorized to retaliate directly against U.S. exports, 
     further undermining U.S. opportunities overseas.
       For all of these reasons, we strongly urge you to remove 
     the Title III procurement provisions from this legislation.
           Respectfully,
         American Association of Exporters and Importers (AAEI);
         Association of Equipment Manufacturers (AEM);
         Business Roundtable;
         Emergency Committee for American Trade (ECAT);
         National Foreign Trade Council (NFTC);
         National Retail Federation (NRF);
         Organization for International Investment (OFII);
         TechAmerica;
         United States Council for International Business (USCIB);
         U.S. Chamber of Commerce;
         U.S.-China Business Council.

  Mr. PALLONE. Madam Speaker, I yield 1 minute to the Speaker of the 
House, who has done so much to make this bill possible.
  Ms. PELOSI. Madam Speaker, I thank the gentleman for yielding. I rise 
to briefly congratulate and thank the Members of the New York 
delegation and others who helped bring this legislation to the floor in 
a strong bipartisan way: Congresswoman Maloney, Congressman Nadler, 
Congressman King. Thank you. We thank you for giving us the opportunity 
to say ``thank you'' in a real way to our first responders, to our 
firefighters, to those who rushed in without question to rescue their 
fellow Americans, and people from all over the country as a matter of 
fact.
  There is an exhilaration, Madam Speaker, that you see in the Chamber, 
because right now we know that any discussion we have ever had about 9/
11 has been a discussion where we have entered holy and sacred ground, 
where people lost their lives. Fewer did because others were willing to 
risk theirs. For over 9 years we have been

[[Page H8961]]

trying to redress the grievance that we have of people not having the 
health benefits and the recognition of their service, their sacrifice, 
and their courage.
  Today Mr. King, Congresswoman Maloney, Congressman Nadler--I should 
say Congressman King, Chairman King to be--and the leadership of this 
House and of the United States Senate, and I thank Senator Gillibrand 
and Senator Schumer as well as Senator Reid and the Republican 
leadership in the Senate for affording us this opportunity to extend 
our patriotic appreciation to those whose love of our country, whose 
care and commitment to their fellow person, who unquestionably made 
sacrifices, and now, almost 9\1/2\ years later, more than 9 years later 
we finally are doing the right thing for them.

                              {time}  1610

  Every day our firefighters, our police officers, our first responders 
leave their homes, willing to risk their lives. Little did they know on 
that day many of them would not return home. How can we ever repay 
their sacrifice and their courage?
  So, today we do so, certainly not enough, but as a token of our 
appreciation for what they have done to strengthen our country.
  Again, I thank all of those who made this important legislation 
possible.
  Mr. BURGESS. May I inquire as to how much time remains?
  The SPEAKER pro tempore. The gentleman from Texas has 7\1/2\ minutes 
remaining, and the gentleman from New Jersey has 10\1/2\ minutes 
remaining.
  Mr. BURGESS. I yield myself 30 seconds.
  Madam Speaker, Congressman Brady articulated very well some of the 
concerns he has with the pay-for that is in this bill, raising new 
revenues through tariffs, and the possibility of retaliatory efforts by 
other countries.
  I would just point out, in section 4002 of the recently passed health 
care law last March, there is a section that calls for a Public Health 
and Wellness Trust Fund. The Secretary of Health and Human Services has 
$15 billion in a slush fund in ObamaCare. This money could have been 
easily used to pay for this legislation. It could have been done last 
April, and we wouldn't be here at the last minute trying to scrounge 
for capital to pay these funds.
  Mr. PALLONE. Madam Speaker, I yield 1 minute to the gentlewoman from 
New York (Mrs. Maloney), who is the prime sponsor of the legislation 
and has worked so hard on this bill.
  (Mrs. MALONEY asked and was given permission to revise and extend her 
remarks.)
  Mrs. MALONEY. I thank all of my colleagues, especially the New York 
delegation and the Speaker and Leader Hoyer.
  Today, Congress repays a long overdue debt and answers the emergency 
calls of our ailing 9/11 first responders and survivors. This bill will 
save lives. It has taken too long, but help finally is here for the 
thousands of Americans who are suffering because of 9/11.
  Our bill will give support and hope to more than 36,000 Americans who 
are ailing because of the attacks on our Nation. It also says to future 
generations that if you are harmed in the service of our country, you 
will be taken care of.
  I couldn't be more proud of everyone who fought like hell to pass 
this bill, our Senators Gillibrand and Schumer, my good friends and 
coauthors Nadler and King, the 9/11 responders and survivors who are 
here with us, and the thousands of their brothers and sisters who could 
not be. John Feal, you have been a warrior for this bill. Thank you.
  Just after the attacks, this body came together. With this bill, we 
put in law that we will never forget and do whatever it takes.
  Madam Speaker, today, I proudly rise to support the James Zadroga 9/
11 Health and Compensation Act. Passing this bill and getting it to the 
President's desk will truly be a Christmas miracle.
  When Jerry Nadler and I first introduced a 9/11 bill, we never would 
have thought it could take 7 years or that it could be the last 
legislative item out the door. It should never have taken so long.
  A TV commentator recently made a good point when he said that Pearl 
Harbor was not just a Hawaii issue and neither should caring for the 
victims of 9/11 be a New York issue. The Twin Towers were attacked as a 
symbol of our Nation and the sick and injured are not just from New 
York. After the attacks, at least 10,000 brave men and women came from 
all 50 states and 428 of 435 Congressional districts.
  I thank my colleagues from across the country for staying to complete 
the last remaining gap in America's response to 9/11. Our bill will 
give support and hope to the more than 36,000 Americans who are ailing 
because of the attacks on our Nation, and it also says to future 
generations that if you are harmed in the service of America, you will 
be taken care of.
  I especially thank my good friends and co-authors Jerry Nadler and 
Peter King, the entire New York Delegation, and Speaker Pelosi and 
Majority Leader Hoyer, who all helped pass this bill in September and 
are working on it today. I thank Senators Gillibrand and Schumer for 
tireless efforts to get this bill done.
  This long-overdue legislation will provide health care and financial 
compensation to the responders and survivors who are sick from exposure 
to toxins at Ground Zero. The cost of the bill has been cut almost in 
half to $4.3 billion from $7.4 billion. The Victim Compensation Fund 
will be funded for 5 years at $2.8 billion and the health programs will 
be fully funded for 5 years at $1.5 billion. I thank Members of the 
other body for coming to this bipartisan compromise.
  The offset has been entirely replaced with two other offsets and in 
addition to fully funding this bill, the procurement payfor will put an 
estimated $450 million in extra revenue toward the deficit.
  We are reminded this holiday season of the importance of giving. But 
today I ask my colleagues to remember all that the heroes of 9/11 have 
already given. These individuals rushed to the site of immeasurable 
danger and first gave their time, and later are giving up their health, 
and in some cases their lives.
  Nine long years have passed since the attacks. It was never the 
intention of the bill's authors to make this a partisan issue and I 
regret that it has become wrapped in party politics.
  I hope that my colleagues on both sides of the aisle can come 
together, just as we stood together on the steps of the Capitol the 
evening of September 11, 2001, to show our gratitude to the responders 
and survivors who have given so much to our country.
  There could be no better gift to America this holiday season than 
helping save the lives of those who came to the aid of our Nation in a 
time of war.
  Mr. BURGESS. I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield to the gentleman from New York (Mr. 
Engel) for the purpose of a unanimous consent request.
  (Mr. ENGEL asked and was given permission to revise and extend his 
remarks.)
  Mr. ENGEL. I rise in strong support of this bill. This is a fitting 
way to end the 111th Congress. This is the proudest moment I have had 
in Congress in 22 years. I believe that our hard work paid off, all of 
us together on the Health Subcommittee of the Energy and Commerce 
Committee.
  I urge my colleagues to support the bill.
  Madam Speaker, I rise in strong support of the James Zadroga 9/11 
Health Compensation Act. As a member of the Energy and Commerce 
Committee I was proud to help shepherd this bill through the committee 
process and am proud to speak in support of this legislation yet again 
on the House floor this year.
  Two days ago, I joined New York City Mayor, Michael Bloomberg, and 
other members of the New York delegation, and first responders to urge 
swift passage of this bill in the Senate.
  Madam speaker, it is shameful that we are approaching the 10-year 
anniversary of 9-11 next year and this bill still has not reached the 
President for his signature.
  Now I am here again today to urge my colleagues to vote in favor of 
the package that we are considering today, which rectifies some of the 
concerns that my colleagues on the other side of the aisle have 
expressed.
  This is not a partisan issue, and the package that we consider today 
reflects that.
  People from all over the country joined to help after the attack 
without concern for their health or wellbeing. Now it is their 
country's time to step-up in their time of need. Victims of 9-11 
continue to suffer from crippling physical ailments. They are dying and 
have been ignored for almost a decade. The House noticed, once already 
this year. I am hopeful that we can send a bill to the Senate that will 
pass.
  I look forward to casting my vote in support of the James Zadroga 9/
11 Health Compensation Act and sending it back to the Senate.
  I am proud of the role that we played on the Health Subcommittee and 
the Energy and Commerce with our hearings and markups in moving this 
bill through. This is not a New

[[Page H8962]]

York issue; this is an American Issue. First responders came from all 
parts of the country. The Federal Government falsely told everyone it 
was safe to return and it wasn't.
  Today we say thank you to our first responders--it is a fitting way 
to end the 111th Congress.
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. I yield to the gentleman from New York (Mr. Crowley) for 
the purpose of a unanimous consent request.
  (Mr. CROWLEY asked and was given permission to revise and extend his 
remarks.)
  Mr. CROWLEY. Madam Speaker, on September 11, my cousin, John Moran, 
was at Tower Two of the World Trade Center. He said, ``Let me off here. 
I want to try and make a difference.''
  We have made a difference today in the lives of the people we're 
saving.
  Today, I rise as the cousin of Battalion Chief John Moran.
  My cousin, along with almost 3,000 others, died on September 11, 
2001.
  His last known words were to the driver of the New York City Fire 
Department vehicle. As he was dropped off at World Trade Center Tower 
2, John said, `Let me off here. I am going to try to make a 
difference.'
  Nothing can replace the loss of my cousin or the thousands of others 
who were killed that day. Nothing can replace the loss of those who 
have perished since.
  But, today we can make proud his memory and the memory of all those 
who served on September 11th and the days following.
  Enactment of the James Zadroga 9-11 Health and Compensation Act 
fulfills a commitment to those who served our Nation honorably, 
tirelessly and without pause.
  Today, I am proud to stand before my colleagues as the cousin of 
Battalion Chief John Moran, and I am proud, in the words of John, to 
`make a difference' for the many heroes who have suffered long enough 
because of their service to our great country.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. A Member asking to insert remarks may 
include a simple declaration of sentiment toward the question under 
debate but should not embellish the request with extended oratory.
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. I yield to the gentlewoman from New York (Ms. Slaughter) 
for the purpose of a unanimous consent request.
  (Ms. SLAUGHTER asked and was given permission to revise and extend 
her remarks.)
  Ms. SLAUGHTER. Madam Speaker, I rise in strong support of this bill. 
A lot of us are going to sleep a lot better now knowing that this bill 
has been passed.
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield to the gentleman from New York 
(Mr. Rangel) for the purpose of a unanimous consent request.
  (Mr. RANGEL asked and was given permission to revise and extend his 
remarks.)
  Mr. RANGEL. All of us from the City of New York and around the Nation 
are so proud to be a Member of this body.


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore. The Chair will repeat that a Member asking 
to insert remarks may include a simple declaration of sentiment toward 
the question under debate but should not embellish the request with 
extended oratory.
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. I yield to the gentleman from New York (Mr. McMahon) for 
the purpose of a unanimous consent request.
  (Mr. McMAHON asked and was given permission to revise and extend his 
remarks.)
  Mr. McMAHON. Madam Speaker, I rise in support of this bill on behalf 
of the people of Staten Island and Brooklyn, New York, all of them, and 
in particular Trish and Marty Fullam.
  The SPEAKER pro tempore. The gentleman from New Jersey will be 
charged with the time consumed.
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. I yield to the gentleman from New York (Mr. Ackerman) 
for the purpose of a unanimous consent request.
  (Mr. ACKERMAN asked and was given permission to revise and extend his 
remarks.)
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. Madam Speaker, I yield to the gentlewoman from 
California (Ms. Eshoo) for the purpose of a unanimous consent request.
  (Ms. ESHOO asked and was given permission to revise and extend her 
remarks.)
  Ms. ESHOO. Madam Speaker, I urge all of my colleagues to vote for 
this. How proud I am to have voted as a Californian for the Americans 
that went and took care and did their job.
  The SPEAKER pro tempore. The gentleman will be charged with the time.
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. I yield to the gentleman from Georgia (Mr. Scott) for 
the purpose of a unanimous consent request.
  (Mr. SCOTT of Georgia asked and was given permission to revise and 
extend his remarks.)
  Mr. SCOTT of Georgia. Madam Speaker, I rise in support of this bill 
as a big thank you from a very, very grateful Nation.
  The SPEAKER pro tempore. The gentleman from New Jersey will be 
charged.
  Mr. BURGESS. I continue to reserve the balance of my time.
  Mr. PALLONE. I yield to the gentlewoman from Texas (Ms. Jackson Lee) 
for the purpose of a unanimous consent request.
  (Ms. JACKSON LEE of Texas asked and was given permission to revise 
and extend her remarks.)
  Ms. JACKSON LEE of Texas. I thank the distinguished gentleman, and I 
rise to support the Senate amendment to H.R. 847, to be able to thank 
Carolyn Maloney for the enormous work and to also cite those who I saw 
dying that they might live.
  Madam Speaker I rise today in strong support of H.R. 847, the ``James 
Zadroga 9/11 Health and Compensation Act.'' This bill has been a long 
time coming, and I am glad that it is finally here for us to provide 
medical monitoring and treatment benefits to eligible emergency 
responders and recovery and cleanup workers who responded to the 
September 11, 2001, terrorist attacks. This legislation also allows for 
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 the 9/11 
terrorist attacks.
  I have met firsthand many of these first responders and workers, and 
I know the patriotic sacrifices they have made for their fellow 
Americans. These brave, selfless individuals who put aside their own 
needs and fears to come to the aid of their fellow Americans put their 
lives at risk. They ventured into the wreckage and dust of the World 
Trade Center, not worrying about their own well being, but rather, 
hoping that they could save the lives of strangers. As a result of 
their fearless acts, many of these emergency workers and first 
responders were exposed to airborne toxins and other hazards. Providing 
medical services, including clinical examinations, long-term health 
monitoring, mental health care and necessary prescription drug 
coverage, is the least we can do to repay them for their efforts.
  The James Zadroga 9/11 Health and Compensation Act will provide both 
initial and follow-up medical services for World Trade Center 
responders and workers whose physical and mental health were impacted 
by the 9/11 attacks. H.R. 847 will also establish an outreach program 
to potentially eligible individuals.
  September 11, 2001, is a day that is indelibly etched in the psyche 
of every American and most of the world. Much like the unprovoked 
attack on Pearl Harbor on December 7, 1941, September 11 is a day that 
will live in infamy. And as much as Pearl Harbor changed the course of 
world history by precipitating the global struggle between totalitarian 
fascism and representative democracy, the transformative impact of 
September 11 in the course of American and human history is indelible. 
September 11 was not only the beginning of the Global War on Terror, 
but moreover, it was the day of innocence lost for a new generation of 
Americans.
  Just like my fellow Americans, I remember September 11 as vividly as 
if it was yesterday. In my mind's eye, I can still remember being 
mesmerized by the television as the two airliners crashed into the Twin 
Towers of the World Trade Center, and I remember the sense of terror we 
experienced when we realized that this was no accident, that we had 
been attacked, and that the world as we know it had changed forever. 
The moment in which the Twin Towers collapsed and the nearly 3,000 
innocent Americans died haunts me until this day.
  At this moment, I decided that the protection of our homeland would 
be at the forefront of my legislative agenda. I knew that all of our

[[Page H8963]]

collective efforts as Americans would all be in vain if we did not 
achieve our most important priority: the security of our nation. 
Accordingly, I became then and continue to this day to be an active and 
engaged Member of the Committee on Homeland Security who considers our 
national security paramount.
  Our nation's collective response to the tragedy of September 11 
exemplified what has been true of the American people since the 
inception of our Republic--in times of crisis, we come together and 
always persevere. Despite the depths of our anguish on the preceding 
day, on September 12, the American people demonstrated their compassion 
and solidarity for one another as we began the process of response, 
recovery, and rebuilding. We transcended our differences and came 
together to honor the sacrifices and losses sustained by the countless 
victims of September 11. Let us honor those who served and sacrificed 
by passing H.R. 847.
  Madam Speaker, as I stand here today, my heart still grieves for 
those who perished on flights United Airlines 93, American Airlines 77, 
American Airlines 11, and United Airlines 175. When the sun rose on the 
morning of September 11, none of us knew that it would end in an 
inferno in the magnificent World Trade Center Towers in New York City, 
the Pentagon in Washington, DC, and in the grassy fields of 
Shanksville, Pennsylvania. How I wish we could have hugged and kissed 
and held each of the victims one last time.
  I stand here remembering those who still suffer, whose hearts still 
ache over the loss of so many innocent and interrupted lives. My prayer 
is that for those who lost a father, a mother, a husband, a wife, a 
child, or a friend will in the days and years ahead take comfort in the 
certain knowledge that they have gone on to claim the greatest prize, a 
place in the Lord's loving arms. And down here on the ground, their 
memory will never die so long as any of the many of us who loved them 
lives.
  Again, I would like to reiterate my strong support for H.R. 847, the 
James Zadroga 9/11 Health and Compensation Act, for it is important 
that we take care of those who take care of us in our time of need.
  The SPEAKER pro tempore. The gentleman from New Jersey will be 
charged.
  Mr. BURGESS. Madam Speaker, I yield 3 minutes to the gentleman from 
New York (Mr. King).
  Mr. KING of New York. I thank the gentleman for yielding. I will keep 
my remarks very brief.
  I thank the Congress of the United States for what it is going to do 
today. Especially I want to thank Carolyn Maloney and Jerry Nadler for 
the tremendous work they have done on this bill over the years from the 
very start. I want to thank Congressman Vito Fossella, who was also an 
original cosponsor of this. I want to thank the Speaker of the House, 
Ms. Pelosi, for doing so much to bring this bill forward, and also the 
Republican leader, who this summer managed to have this bill come up in 
a way that was not going to be disruptive at all.

                              {time}  1620

  I want to thank all the members of the New York delegation. Most 
importantly, I want to thank the firefighters, the police officers, the 
construction workers, and all of those who came forward to answer the 
Nation's call on September 11. This is a great victory for the American 
people. It's a great victory for the Congress of the United States. And 
it sends a signal that we stand by those who come to our Nation's 
defense in time of trouble and, indeed, in time of war, because this 
was the first battle of the great war of the 21st century.
  Mr. PALLONE. I have no further speakers, and I reserve the balance of 
my time.
  Mr. BURGESS. Madam Speaker, I yield myself the balance of my time.
  This is an important bill. It's something that should have been done 
a long time ago. I credit a former New York fireman, Richard Lasky, who 
is now my fire chief in Lewisville, Texas, for helping me understand 
the importance of this bill as it has gone forward. It has been 
difficult. In my opinion, there were better ways to do this bill, but 
it's before us today.
  Mr. GENE GREEN of Texas. Madam Speaker, we need to ensure that the 
first responders and individuals who were in the vicinity of the World 
Trade Center have access to the specialized medical treatment they need 
and that means ensuring these programs are properly funded.
  H.R. 847 accomplishes that goal and I am proud to be a cosponser of 
this bill.
  Mr. JOHNSON of Illinois. I find it appalling that a bill of this 
magnitude was amended in the Senate just hours before the House was 
asked to vote on it, with no Member having had the chance to review and 
deliberate on what we were voting on and enacting into law. When 
earlier versions of this bill were brought to the floor I had some 
major reservations and with no way to know if all of these were 
addressed I would not feel comfortable voting yes or no on this bill.
  Mr. HOLT. Madam Speaker, I rise in support of the Senate amendment to 
the Zadroga 9/11 Health and Compensation Act of 2010. As a cosponsor of 
the House bill, I urge passage of this important bill.
  Today, we have the opportunity to honor the rescue and recovery 
workers who served our nation after the devastating attacks at the 
World Trade Center on September 11, 2001 and, more important than empty 
honor, to provide for their care. My district suffered casualities that 
day and nine years later, the memory of that terrible day is still 
fresh in our minds.
  Along with the victims of 9/11, there were thousands of rescue and 
recovery workers who came to the aid of our nation that day. These 
brave women and men rushed to Ground Zero to help the fallen and to 
participate in the clean-up effort without thinking about their health 
or safety. These workers were exposed to environmental hazards and have 
developed significant respiratory illnesses, chronic infections, and 
other medical conditions. Further, many first responders are only now 
being diagnosed with illnesses that are related to their exposure at 
Ground Zero.
  This bill would create the World Trade Center Health Program (WTCHP) 
that would provide medical monitoring and treatment benefits to first 
responders and workers who were directly affected by the attacks. 
Additionally, the program would establish education and outreach 
programs and conduct research on physical and mental health conditions 
related to the 9/11 attacks. The WTCHP program would serve more than 
75,000 survivors, recovery workers, and members of the affected 
communities.
  Additionally, this bill provides long-term health care and 
compensation for thousands of responders and survivors. By passing this 
bill, we will be paying tribute to the sacrifice and courage of these 
women and men and we will be paying a debt. This bill will be paid for 
with a partnership with New York City and by reducing government 
procurement payments and the extension of fees for outsourcing 
companies.
  Unfortunately, this bill is a weaker version of the bill that I 
cosponsored and that the House passed in September. The bill caps 
federal funding for health programs over five years and allows first 
responders only five years to file claims. Unfortunately, some put 
politics over these brave first responders. Although this bill is a 
reduced version of the original bill, we must honor the rescue and 
recovery workers by providing them with the much needed health care. We 
cannot let our first responders down.
  Mr. RYAN of Wisconsin. Madam Speaker, I was absent for legislative 
business and missed rollcall vote 663 on December 21, 2010, and 
rollcall vote 664 on December 22, 2010. Had I been present, I would 
have voted ``yes'' on H.R. 6547, the Protecting Students from Sexual 
and Violent Predators Act, and ``no'' on rollcall vote 664 (H.R. 847).
  The vote I wish to discuss is the bill H.R. 847, the James Zadroga 9/
11 Health and Compensation Act. Without a doubt, Republicans and 
Democrats can agree that both the victims of the attacks on September 
11, 2001, and the first responders who bravely served following the 
attacks deserve to be fairly treated and compensated. However, this 
bill would create a new health care entitlement, the World Trade Center 
Health Program, while also extending eligibility for compensation under 
the September 11th Victim Compensation Fund of 2001. As a result, had I 
been present, I would have voted against passage of the bill.
  Since the terrorist attacks occurred nearly nine years ago, I have 
supported legislation to ensure that these individuals are cared for 
and receive access to the services they deserve. However, rather than 
working with Republicans to craft a bill which truly addressed the 
shortcomings in care provided to those directly impacted by the 
September 11th terrorist attacks, the Majority instead rushed this bill 
to the floor in the waning hours of the 111th Congress, refusing to 
allow an open debate or consider amendments.
  The result is a deeply flawed bill. H.R. 847 creates yet another 
mandatory spending program--increasing spending by $4.2 billion dollars 
over 10 years--and paying for it by an excise tax on foreign 
manufacturers, an extension of Travel Promotion Act fees, and the 
extension of HI-B visa fees.
  There is no doubt that we owe a debt of gratitude to those who came 
to the rescue of countless individuals following the attacks on 
September 11, 2001, but these provisions distort that noble goal. At a 
time when our budget

[[Page H8964]]

deficit is $1.3 trillion and our national debt stands at $13.8 
trillion, we must accurately account for those programs that take 
priority. I remain hopeful that as the 112th Congress convenes, my 
colleagues and I can work together to reform some of my concerns with 
this proposal and truly provide the services these first responders 
deserve.
  Mrs. McCARTHY of New York. Madam Speaker, with the ninth anniversary 
of September 11th having passed, it is important to remember not only 
those who were lost that tragic day, but also the sense of purpose and 
togetherness that shined in the aftermath of, no doubt, one of the most 
difficult days in our nation's history. Heroic first responders deserve 
utmost recognition for selflessly digging through the ruins of Lower 
Manhattan in hope of finding survivors. The James Zadroga 9/11 Health 
and Compensation Act, a bill that I am proud to be an original 
cosponsor of, provides just that by extending and improving protections 
and services to individuals directly impacted by the terrorist attacks 
on September 11, 2001.
  Since our inception, we, as a nation, have grown stronger by 
protecting and honoring the sacrifices of our citizenry. This 
legislation is the embodiment of that mantra. As a New Yorker, not a 
day passes without thought of the horrific attacks of September 11th, 
this legislation will no doubt go a long way to provide first-
responders with peace of mind.
  During House floor consideration and passage of the James Zadroga 9/
11 Health and Compensation Act on Wednesday, I was unavoidably absent 
from Washington due to a family health emergency. I have had the 
privilege of working closely with my New York colleagues in both the 
House and Senate on this legislation, and I am extraordinarily happy 
that the Congress was able to pass this bill before the adjournment of 
the 111th Congress.
  Mr. VAN HOLLEN. Madam Speaker, I rise in support of legislation that 
would help thousands of first responders who were exposed to hazardous 
health conditions in the aftermath of the September 11th attacks.
  Many first responders bravely answered the call of duty and rushed to 
the scene of the attacks. While they were helping out the victims, the 
responders unknowingly were exposed to long-term physical and mental 
health problems due to the residual dust, toxins, and chemicals from 
the attacks. Congress and the federal government have an obligation and 
a responsibility to care and help those who responded to the September 
11th attacks.
  Madam Speaker, let us not forget the sacrifice and service of those 
brave individuals who responded to one of the worst attacks in American 
history. I am pleased that my colleagues in the Senate were able to 
come to a bipartisan agreement on this bill. I urge my House colleagues 
to support this legislation so that the thousands of 9/11 responders 
can get the help they need.
  Mr. RANGEL. Madam Speaker, I rise today, nine years after the tragic 
events of September 11, to recognize the passage of a bill that will 
allow the first responders who rushed to the scene that day to now be 
able to get the health care resources they need.
  Today, both the U.S. House of Representatives and the Senate approved 
an amended version, the James Zadroga 9/11 Health and Compensation Act 
that would provide medical treatment for the ailing first responders 
and recovery workers who were exposed to toxic dust following the 
collapse of the Twin Towers in New York City on September 11, 2001.
  This victory is for what is right; a long overdue thank you to those 
who rushed in to help after what was one of our nation's biggest 
tragedies. After nine long years, these unsung heroes and their 
families no longer have to worry about how they are going to get the 
care and resources they so desperately need.
  The Zadraga bill originally passed the House in September, but had 
been held up in the Senate due to various partisan concerns. It now 
goes to President Barack Obama, who is expected to sign the bill into 
law before the end of the holiday season.
  This should have never been about the money, but about what we should 
do to honor those who thought of their country first and not 
themselves. They answered the call when their country needed them and 
we are all a better nation for it.
  Thanks to the hard work of so many people--from legislators, like our 
Mayor Michael Bloomberg, the New York Congressional Delegation and 
House Leadership, to the NYS AFL-CIO President Dennis Hughes, the 32nd 
Fire Commissioner Salvatore Cassano and the countless union officials 
and 911 families that traveled to Washington to lobby on the bill's 
behalf--these patriotic Americans can spend the holiday seasons with 
some peace of mind.
  What the law would do: Under an agreement worked out by New York 
Senators Charles Schumer and Kristen Gillibrand, the James Zadroga 9/11 
Health and Compensation Act would: provide a total of $4.3 billion in 
funding for the health and compensation titles of the bill; cap federal 
funding for the health program over five years at $1.5 billion (New 
York City will contribute 10% of the cost). Any funds not spent in the 
first five years may be carried over and expended in the sixth year of 
the program; reopen the Victim Compensation Fund (VCF) for five years 
to file claims, with payments to be made over six years. Fund the VCF 
at $2.8 billion for six years, with $.8 billion available for payments 
in the first five years and $2.0 billion available for payment in year 
six. Claims will be paid in 2 installments--one payment in the first 
five years, and a second payment in the sixth year of the program; the 
pay for the House-passed version of the bill has been replaced by a 2 
percent fee on government procurement from foreign companies located in 
non-GPA countries and a one-year extension of H-B 1 and L-1 Visa fees 
for outsourcing companies. These are estimated by CBO to collect $4.59 
billion over the 10-year scoring period for the bill.
  Others changes made in the bill to address Republican concerns: 
requiring that the Centers of Excellence report claims data to HHS so 
that costs and utilization of services can be fully monitored; 
specifying the non-treatment services furnished by Centers of 
Excellence to be funded under the health program (e.g., outreach, 
social services, data collection, and development of treatment 
protocols); authorizing the World Trade Center Program Administrator to 
designate the Veteran's Administration as a provider for WTC health 
services; directing the Special Master to develop rules to implement 
the VCF within 180 days of passage of the legislation.
  Mr. ACKERMAN. Madam Speaker, I rise yet again in the strongest 
possible support of the 9/11 Health and Compensation Act, H.R. 847.
  Today, we must show the American people that their representatives 
can put away their differences and work together to pass this bill. 
Over the past few weeks, this clearly was not the case. Some Members of 
Congress have played political games with this legislation, delaying 
its passage for dubious reasons and causing the measure to be watered 
down. The sick and injured don't care about offsets and they don't care 
whether this is a $6 billion bill or a $7 billion bill. They just care 
about getting the medical care they need, the medical care they rightly 
deserve.
  So Madam Speaker, we are here for the third and I hope final time on 
the floor of the House to consider doing the decent thing: helping the 
living victims of 9/11 who continue to suffer the terrible effects of 
that day. The Federal Government has not stepped up enough to help the 
responders, volunteers, workers and residents that went to Ground Zero 
during and after the horrific 9/11 attack. This Congress has not acted 
to help these victims on a permanent basis--we have the opportunity to 
do that today. Tragically, some of the very people that we want to help 
with this legislation have already died. Thousands of Americans who 
responded need medical treatment now. Thousands more will need 
treatment in the future.
  So, Madam Speaker, I urge all my colleagues to support the 9/11 
Health and Compensation Act so that all the victims of 9/11 will 
receive the medical care and help they need and deserve. Let's pass 
this bill.
  Mr. DAVIS of Illinois. Madam Speaker, I rise today in full support of 
H.R. 847, the James Zadroga 9/11 Health and Compensation Act. This bill 
will provide the needed assistance to the brave men and women who have 
become ill due to the dangerous toxins they inhaled while risking their 
lives to help out the city of New York during that tragic time in 
September of 2001. This is a bipartisan bill and should be supported by 
all Members of Congress.
  These heroes risked their lives to assist their fellow Americans and 
their efforts will never go unnoticed. This bill will allow health 
benefits to a wide range of first responders such as firefighters, 
construction workers, residents, area workers and even school 
children--all of whom have been affected by the toxins that filled the 
air after the attack on the World Trade Center in 2001.
  We all witnessed the terrible attacks on America, September 11, 2001 
and we also witnessed the acts of bravery by our first responders. I 
support the passage of the 9/11 Health and Compensation Act.
  Mr. LANGEVIN. Madam Speaker, I rise in strong support of the James 
Zadroga 9/11 Health and Compensation Act. Every American remembers the 
day the Twin Towers fell and the unparalleled heroism of the first 
responders who saved countless lives without any regard for their own. 
They showed courage in the face of terror and strength in a path of 
destruction. Too many of these brave men and women didn't make it out 
of the wreckage in time. Those who did returned every day for months, 
sifting through rubble, recovering victims and restoring order to 
Ground Zero with little consideration for their own welfare or safety.
  Tragically, many of these selfless workers are now suffering chronic, 
disabling health conditions as a direct result of injuries or toxic 
exposure sustained at the site. The bill before

[[Page H8965]]

us creates a program to provide medical services and health monitoring 
for first responders and others who have medical conditions related to 
the September 11 terrorist attacks. Madam Speaker, I strongly urge my 
colleagues to support this measure and finally show these heroes the 
same honor and respect they showed us, our families, our friends and 
our country.
  Mr. PASCRELL. Madam Speaker, I am proud to say that we are finally 
doing the right thing to support our heroes from 9/11. The agreement we 
have here today is much less than we originally hoped for--but more 
than four and a half years after the death of NYPD Det. James Zadroga--
I am here to say that we need to pass the James Zadroga 9/11 Health and 
Compensation Act right now because we are losing these brave souls as 
we speak.
  I'm sad to say its now been nine years since 9/11 and it has taken 
this long to pass the James Zadroga 9/11 Health and Compensation Act--
nine years is too long to wait and watch as our first responders from 
that day continue to suffer physically and emotionally--nine years is 
late, BUT its not too late to do the right thing. We need to pass this 
bill and we need to pass it now. Nine years ago we gave those brave 
souls the `all clear' sign, but we now know that we were exposing those 
men and women to a poisonous dust that would stay with them for the 
rest of their lives.
  I am proud to say that we found a way to pay for this bill so that we 
can do the right thing for our 9/11 workers AND for our children who 
will bear the debt of the decisions we make today.
  Let me be clear, this isn't just a bill for New York and New Jersey--
this is a bill for all Americans. We know that people from all 50 
states were in lower Manhattan on or after 9/11 and now are facing 
serious health concerns--there are 435 Congressional Districts and 431 
of them are represented by the names of constituents on the World Trade 
Center Health Registry.
  After 9/11 we all said we would be there for these brave first 
responders--but today if we vote against this bill we are asking those 
same brave individuals to come to Washington, year after year to fight 
for their health benefits--do we expect them to come here ten years 
from now? By then it may be too late for many of these men and women 
who responded to their nation's call of duty.
  I urge all my colleagues to support the James Zadroga 9/11 Health and 
Compensation Act--once and for all let us stand up for these brave 
Americans.
  Mrs. LOWEY. Madam Speaker, today the House will consider the James 
Zadroga 9/11 Health and Compensation Act.
  More than 70,000 Americans from every state descended upon ground 
zero to help recover and rebuild after 9/11. Some have died from 
illnesses as a result and more than 17,000 who are ill lack the care 
they need.
  Just as we provide medical care for our troops, we must care for 
those who heroically responded.
  Passage of the James Zadroga 9/11 Health and Compensation Act is a 
milestone for our nation, as we finally fulfill our obligation to those 
who sacrificed so much for us. Our nation owes a debt of gratitude that 
can never be fully repaid to the September 11 responders who died or 
were sickened as a result of their brave and selfless actions.
  Nearly all of us represent a responder, and almost nine years later, 
have a duty to do what is right--vote for this bill today.
  Mr. BURGESS. I yield back the balance of my time and urge support of 
the bill.
  Mr. PALLONE. Madam Speaker, I would urge passage of this bill and 
send it to the President.
  I yield back the balance of my time.
  The SPEAKER pro tempore. All time for debate has expired.
  Pursuant to the order of the House of today, the previous question is 
ordered.
  The question is on the motion by the gentleman from New Jersey (Mr. 
Pallone).
  The question was taken; and the Speaker pro tempore announced that 
the ayes appeared to have it.
  Mr. BURGESS. Madam Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The vote was taken by electronic device, and there were--yeas 206, 
nays 60, not voting 168, as follows:

                             [Roll No. 664]

                               YEAS--206

     Ackerman
     Aderholt
     Adler (NJ)
     Altmire
     Andrews
     Arcuri
     Austria
     Baldwin
     Barrow
     Bean
     Berkley
     Bilbray
     Bishop (GA)
     Bishop (NY)
     Blunt
     Boren
     Boswell
     Boucher
     Brown, Corrine
     Burgess
     Butterfield
     Capito
     Capps
     Capuano
     Cardoza
     Carnahan
     Carney
     Carson (IN)
     Castle
     Castor (FL)
     Chaffetz
     Chandler
     Clarke
     Cleaver
     Clyburn
     Cole
     Connolly (VA)
     Conyers
     Costa
     Courtney
     Critz
     Crowley
     Cummings
     Dahlkemper
     Davis (CA)
     DeGette
     DeLauro
     Dent
     Dicks
     Dingell
     Donnelly (IN)
     Doyle
     Dreier
     Driehaus
     Edwards (MD)
     Edwards (TX)
     Ellison
     Emerson
     Engel
     Eshoo
     Etheridge
     Farr
     Fattah
     Fortenberry
     Foster
     Frank (MA)
     Frelinghuysen
     Garrett (NJ)
     Gerlach
     Gonzalez
     Gordon (TN)
     Grayson
     Green, Al
     Grijalva
     Hall (NY)
     Halvorson
     Hare
     Hastings (FL)
     Heinrich
     Higgins
     Himes
     Hinchey
     Hirono
     Holden
     Holt
     Hoyer
     Inslee
     Israel
     Jackson (IL)
     Jackson Lee (TX)
     Johnson (GA)
     Kanjorski
     Kaptur
     Kildee
     Kind
     King (NY)
     Kissell
     Klein (FL)
     Kosmas
     Kratovil
     Kucinich
     Lance
     Langevin
     Larsen (WA)
     Larson (CT)
     Lee (NY)
     Levin
     Lewis (GA)
     LoBiondo
     Loebsack
     Lowey
     Lujan
     Lungren, Daniel E.
     Lynch
     Maffei
     Maloney
     Markey (MA)
     Marshall
     Matheson
     Matsui
     McCollum
     McDermott
     McGovern
     McMahon
     McNerney
     Meek (FL)
     Meeks (NY)
     Michaud
     Miller (NC)
     Miller, George
     Mollohan
     Moore (WI)
     Moran (VA)
     Murphy (CT)
     Murphy (NY)
     Murphy, Patrick
     Murphy, Tim
     Nadler (NY)
     Napolitano
     Nye
     Obey
     Olver
     Owens
     Pallone
     Pascrell
     Payne
     Pelosi
     Perriello
     Peters
     Pingree (ME)
     Platts
     Polis (CO)
     Price (NC)
     Quigley
     Rahall
     Rangel
     Reed
     Reichert
     Richardson
     Rogers (AL)
     Rooney
     Ross
     Rothman (NJ)
     Roybal-Allard
     Ruppersberger
     Ryan (OH)
     Sarbanes
     Schakowsky
     Schauer
     Schiff
     Schwartz
     Scott (GA)
     Scott (VA)
     Serrano
     Sestak
     Shea-Porter
     Sherman
     Sires
     Skelton
     Slaughter
     Smith (NJ)
     Snyder
     Sutton
     Teague
     Thompson (CA)
     Thompson (MS)
     Thompson (PA)
     Tierney
     Titus
     Tonko
     Towns
     Tsongas
     Turner
     Van Hollen
     Velazquez
     Visclosky
     Walz
     Wasserman Schultz
     Watson
     Watt
     Waxman
     Weiner
     Wilson (OH)
     Wolf
     Woolsey
     Yarmuth

                                NAYS--60

     Akin
     Alexander
     Bachmann
     Bachus
     Bartlett
     Bilirakis
     Bishop (UT)
     Boozman
     Brady (TX)
     Cantor
     Cassidy
     Coffman (CO)
     Conaway
     Diaz-Balart, M.
     Ehlers
     Fleming
     Foxx
     Franks (AZ)
     Goodlatte
     Graves (GA)
     Guthrie
     Hall (TX)
     Hensarling
     Herger
     Hoekstra
     Inglis
     Jenkins
     Jordan (OH)
     King (IA)
     Kingston
     LaTourette
     Latta
     Lewis (CA)
     Lummis
     Manzullo
     McClintock
     McCotter
     Mica
     Miller (FL)
     Myrick
     Olson
     Paulsen
     Posey
     Rehberg
     Rogers (KY)
     Royce
     Scalise
     Schmidt
     Sessions
     Shuster
     Smith (NE)
     Stutzman
     Taylor
     Terry
     Tiahrt
     Upton
     Walden
     Whitfield
     Wilson (SC)
     Wittman

                            NOT VOTING--168

     Baca
     Baird
     Barrett (SC)
     Barton (TX)
     Becerra
     Berman
     Berry
     Biggert
     Blackburn
     Blumenauer
     Boccieri
     Boehner
     Bonner
     Bono Mack
     Boustany
     Boyd
     Brady (PA)
     Braley (IA)
     Bright
     Broun (GA)
     Brown (SC)
     Brown-Waite, Ginny
     Buchanan
     Burton (IN)
     Buyer
     Calvert
     Camp
     Campbell
     Cao
     Carter
     Childers
     Chu
     Clay
     Coble
     Cohen
     Cooper
     Costello
     Crenshaw
     Cuellar
     Culberson
     Davis (AL)
     Davis (IL)
     Davis (KY)
     Davis (TN)
     DeFazio
     Delahunt
     Deutch
     Diaz-Balart, L.
     Djou
     Doggett
     Duncan
     Ellsworth
     Fallin
     Filner
     Flake
     Forbes
     Fudge
     Gallegly
     Garamendi
     Giffords
     Gingrey (GA)
     Gohmert
     Granger
     Graves (MO)
     Green, Gene
     Griffith
     Gutierrez
     Harman
     Harper
     Hastings (WA)
     Heller
     Herseth Sandlin
     Hill
     Hinojosa
     Hodes
     Honda
     Hunter
     Issa
     Johnson (IL)
     Johnson, E. B.
     Johnson, Sam
     Jones
     Kagen
     Kennedy
     Kilpatrick (MI)
     Kilroy
     Kirkpatrick (AZ)
     Kline (MN)
     Lamborn
     Latham
     Lee (CA)
     Linder
     Lipinski
     Lofgren, Zoe
     Lucas
     Luetkemeyer
     Mack
     Marchant
     Markey (CO)
     McCarthy (CA)
     McCarthy (NY)
     McCaul
     McHenry
     McIntyre
     McKeon
     McMorris Rodgers
     Melancon
     Miller (MI)
     Miller, Gary
     Minnick
     Mitchell
     Moore (KS)
     Moran (KS)
     Neal (MA)
     Neugebauer
     Nunes
     Oberstar
     Ortiz
     Pastor (AZ)
     Paul
     Pence
     Perlmutter
     Peterson
     Petri
     Pitts
     Poe (TX)
     Pomeroy
     Price (GA)
     Putnam
     Radanovich
     Reyes
     Rodriguez
     Roe (TN)
     Rogers (MI)
     Rohrabacher
     Ros-Lehtinen
     Roskam
     Rush
     Ryan (WI)
     Salazar
     Sanchez, Linda T.
     Sanchez, Loretta
     Schock
     Schrader
     Sensenbrenner
     Shadegg
     Shimkus
     Shuler
     Simpson
     Smith (TX)
     Smith (WA)
     Space
     Speier
     Spratt
     Stark
     Stearns
     Stupak
     Sullivan
     Tanner
     Thornberry
     Tiberi
     Wamp
     Waters
     Welch
     Westmoreland
     Wu
     Young (AK)
     Young (FL)


                Announcement by the Speaker Pro Tempore

  The SPEAKER pro tempore (during the vote). The Chair will remind all 
persons in the gallery that they are here as guests of the House and 
that

[[Page H8966]]

any manifestation of approval or disapproval of proceedings is in 
violation of the rules of the House.

                              {time}  1736

  Mr. TERRY and BACHUS changed their vote from ``yea'' to ``nay.''
  So the motion was agreed to.
  The result of the vote was announced as above recorded.
  A motion to reconsider was laid on the table.
  Stated for:
  Mr. BACA. Madam Speaker, I was absent on Wednesday, December 22, 
2010. I had legislative business in the district. Had I been present, I 
would have voted in support of the Motion to Concur in the Senate 
Amendment to H.R. 847--James Zadroga 9/11 Health and Compensation Act.
  Ms. CHU. Madam Speaker, I was absent on December 22, 2010. Had I been 
present, I would have voted ``yes'' on H.R. 847--James Zadroga 9/11 
Health and Compensation Act.
  Mr. BRALEY of Iowa. Madam Speaker, I regret missing floor votes on 
today, December 22, 2010 due to travel. If I was present, I would have 
voted: ``yea'' on rollcall 664, motion to concur in the Senate 
Amendment to H.R. 847--James Zadroga 9/11 Health and Compensation Act.
  Ms. LEE of California. Madam Speaker, today I missed rollcall vote 
664 on H.R. 847. Had I been present I would have voted ``aye.''
  Ms. HERSETH SANDLIN. Madam Speaker, I regret that I was unable to 
participate in one vote on the floor of the House of Representatives 
today.
  The vote was the Motion to Concur in the Senate Amendment to H.R. 
847--James Zadroga 9/11 Health and Compensation Act. Had I been 
present, I would have voted ``yea'' on that question.
  Mr. GUTIERREZ. Madam Speaker, I was unavoidably absent for votes in 
the House Chamber today. I would like the record to show that, had I 
been present, I would have voted ``yea'' on rollcall vote 664.
  Ms. LINDA T. SANCHEZ of California. Madam Speaker, unfortunately, I 
was unable to be present in the Capitol for votes on today, December 
22, 2010. However, had I been present, I would have voted as follows: 
``yea'' on H.R. 847--the James Zadroga 9/11 Health and Compensation 
Act.
  Mr. FILNER. Madam Speaker, on rollcall 664, I was away from the 
Capitol. Had I been present, I would have voted ``yea.''
  Mrs. MILLER of Michigan. Madam Speaker, on rollcall No. 664, had I 
been present, I would have voted ``yes.''
  Mr. BECERRA. Madam Speaker, on Wednesday, December 22, 2010, I missed 
rollcall No. 664. If present, I would have voted ``yea.''
  Ms. EDDIE BERNICE JOHNSON of Texas. Madam Speaker, on Wednesday, 
December 22, 2010, I requested and received a leave of absence for the 
rest of the week.
  Below is how I would have voted on the following vote I missed during 
this time period.
  On rollcall 664, H.R. 847, 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, I would have voted ``yes.''
  Mr. GENE GREEN of Texas. Madam Speaker, I would have voted ``aye'' on 
the Senate amendment to H.R. 847, the James Zadroga 9/11 Health and 
Compensation Act.
  Stated against:
  Mrs. BIGGERT. Madam Speaker, on rollcall No. 664 I was absent. Had I 
been present, I would have voted ``no.''
  Mr. DAVIS of Kentucky. Madam Speaker, on Wednesday, December 22, 
2010, I was absent for one vote. Had I been present I would have voted 
on rollcall No. 664--``no''--Motion to concur in the Senate amendment 
to H.R. 847, James Zadroga 9/11 Health and Compensation Act.

                          ____________________