[Senate Report 108-183]
[From the U.S. Government Publishing Office]



                                                       Calendar No. 360
108th Congress                                                   Report
                                 SENATE
 1st Session                                                    108-183

======================================================================



 
     DISASTER AREA HEALTH AND ENVIRONMENTAL MONITORING ACT OF 2003

                                _______
                                

                November 3, 2003.--Ordered to be printed

                                _______
                                

    Mr. Inhofe, from the Committee on Environment and Public Works, 
                        submitted the following

                              R E P O R T

                         [to accompany S. 1279]

      [Including cost estimate of the Congressional Budget Office]

    The Committee on Environment and Public Works, to which was 
referred a bill (S. 1279) to amend the Robert T. Stafford 
Disaster Relief and Emergency Assistance Act to authorize the 
President to carry out a program for the protection of the 
health and safety of residents, workers, volunteers, and others 
in a disaster area, having considered the same, reports 
favorably thereon with an amendment and recommends that the 
bill, as amended, do pass.

                    General Statement and Background

    S. 1279, the ``Disaster Area Health and Environmental 
Monitoring Act of 2003'' establishes the framework for the 
Federal Government to protect first responders, as well as the 
health and safety of all involved in a disaster area, including 
residents, workers, and volunteers. The program will enhance 
the capabilities of first responders by allowing precautions, 
assessments, and monitoring to take place at a disaster site.

                      Section-By-Section Analysis

Section 1. Short Title
    This section provides that the title may be cited as the 
``Disaster Area Health and Environmental Monitoring Act of 
2003''.

Sec. 2. Protection of Health and Safety of Individuals in a Disaster 
        Area

                                SUMMARY

    This section amends title IV of the Robert T. Stafford 
Disaster Relief and Emergency Assistance Act (42 U.S.C. 5174). 
The amendment inserts section 409 after section 408 of the Act.

                               DISCUSSION

    The heroic efforts of emergency response personnel in the 
days and weeks following the September 11, 2001, disaster 
underscored the need for a program to monitor and to track the 
health and safety of rescue workers. For example, scores of 
emergency response personnel responding to the World Trade 
Center attacks subsequently developed severe respiratory 
ailments.
    Key terms in this section are ``individual'' which defines 
the scope of the disaster area health and environmental 
monitoring program; and ``substance of concern,'' which defines 
the types of substances that can trigger the establishment of a 
health and environmental monitoring program. ``Individual'' is 
defined to include workers, volunteers, residents, and school, 
child care, and adult day care employees and attendees. Details 
are included in the definition regarding the types of workers 
and volunteers that are included in the definition of 
individual. ``Substance of concern'' is defined as a chemical 
or other substance that is associated with potential acute or 
chronic human health effects, the risk of exposure to which 
could potentially be increased as the result of a disaster, as 
determined by the President.
    If the President determines that one or more substances of 
concern are present in a disaster area, the President may carry 
out a program for the protection, assessment, monitoring, and 
study of the health and safety of individuals. The intent of 
the program is to protect the health and safety of individuals 
exposed or potentially exposed to one or more substance of 
concern as a direct result of the disaster and to prevent the 
recurrence of similar health impacts in future disasters.
    The program may include the collection and analysis of 
environmental exposure data, performance of baseline and 
follow-up clinical health and mental health examinations, 
biological sampling, establishment and maintenance of an 
exposure registry, and study of the short-and long-term health 
impacts of any exposures through epidemiological and other 
health studies. The program also may include development and 
dissemination of educational materials. The committee intends 
that the President select the most appropriate means of 
implementing a program established under this section, 
including through local health departments, medical 
institutions, consortiums of medical institutions, or other 
appropriate means. The committee intends that the program will 
be executed by an entity or entities in the proximate area of 
the disaster or in the residential area of groups of 
individuals that worked or volunteered in response to the 
disaster, and with experience in environmental and occupational 
health, toxicology, and safety, conduct such studies when 
feasible and appropriate. Entities developing and carrying out 
the program may consult with the National Institute of 
Environmental Health Sciences, the Agency for Toxic Substances 
and Disease Registry, the Occupational Safety and Health 
Administration, the Environmental Protection Agency, or other 
agencies with significant experience and expertise in the area 
of worker health and safety.
    Participation in any registry or study under this section 
is voluntary, and the President shall take appropriate measures 
to protect participant privacy. The committee intends that the 
program be inclusive, involving interested and affected 
parties. Not later than 1 year after the establishment of a 
program by the President, and every 5 years thereafter, the 
President, or the institution(s) conducting the study, will 
present a report on programs and studies carried out under the 
program to the Secretary of Homeland Security, the Secretary of 
Health and Human Services, the Secretary of Labor, the 
Administrator of the Environmental Protection Agency, and the 
appropriate committees of Congress.

Sec. 3. National Academy of Sciences Report on Disaster Area Health and 
        Environmental Protection and Monitoring
    This section requires that the Secretary of Homeland 
Security, the Secretary of Health and Human Services, and the 
Administrator of the Environmental Protection Agency together 
enter into a contract with the National Academy of Sciences to 
conduct a study and prepare a report on disaster area health 
and environmental protection and monitoring. The report will be 
prepared with the participation of individuals who are experts 
in fields relating to health and environmental protection and 
monitoring.
    The report will make recommendations regarding protecting 
and monitoring the health and safety of individuals potentially 
exposed to any chemical or other substance. The purpose of this 
report is to improve the protection and monitoring of 
individual health and safety at disaster sites of all types by 
identifying standardized approaches, methods, and procedures to 
be used by Federal, State, and local agencies. Specifically, 
the report will make recommendations regarding the 
establishment of protocols for the monitoring of and response 
to chemical or substance releases in a disaster area for the 
purpose of protecting public health and safety. Protocol 
recommendations will address items such as which chemicals and 
substances should be monitored, sampling and analysis 
methodologies, health-based thresholds for individual chemical 
or substances, procedures for distributing monitoring results, 
division of responsibilities among Federal, State, and local 
agencies, Federal Government capacity, and other issues.

                          Legislative History

    On June 18, 2003, Senators Voinovich, Clinton, DeWine, and 
Schumer introduced S. 1279, the ``Disaster Area Health and 
Environmental Monitoring Act of 2003,'' which was referred to 
the Committee on Environment and Public Works. The committee 
ordered the bill to be reported favorably with an amendment on 
July 30, 2003, by voice vote.
    Prior to the introduction of S. 1279, the Committee on 
Environment and Public Works held four hearings and one 
business meeting on emergency response issues.
    On October 16, 2001, the committee held a hearing on the 
Federal response to the September 11, 2001 attacks, receiving 
testimony from Hon. Joseph Allbaugh, Director, Federal 
Emergency Management Agency; Edward P. Plaugher, Chief, 
Arlington County Fire Department Arlington, VA; Jeffrey L. 
Metzinger, Chief, Sacramento Metropolitan Fire Department and 
Member, FEMA Urban Search and Rescue Team; and Robert 
Hessinger, Member, Ohio Task Force One.
    On February 11, 2002, the Subcommittee on Clean Air, 
Wetlands, and Climate Change held a field hearing in New York 
to receive testimony on the impacts of the September 11 attack 
on air quality and possible related health impacts in the area 
of the World Trade Center and how to address any such impacts, 
receiving testimony from Rep. Jerrold Nadler, U.S. House of 
Representatives; Liz Berger, Resident, NY; Dr. Kerry Kelly, 
Chief Medical Officer, New York City Fire Department, NY; Dr. 
George Thurston, Associate Professor of Environmental Medicine, 
New York University Medical School, Nelson Institute of 
Environmental Medicine, NY; Eric Goldstein, New York Urban 
Program Director, Natural Resources Defense Council, NY; 
Marianne Jackson, Deputy Federal Coordinating Officer for the 
World Trade Center Event, Federal Emergency Management Agency; 
Jane M. Kenny, Administrator, U.S. Environmental Protection 
Agency Region 2; Carl Johnson, Deputy Commissioner for Air and 
Waste Management, Department of Environmental Conservation, 
State of New York; Commissioner Joel Miele, Department of 
Environmental Protection, City of New York (With: Commissioner 
Thomas Frieden, Department of Health, City of New York); Tom 
Scotto, President, Detectives Endowment Association, NY; Edward 
J. Malloy, President, Building and Construction Trades Council 
of Greater New York; Dr. Stephen Levin, Medical Director, 
Irving J. Selikoff Occupational Health Clinical Center, The 
Mount Sinai Medical Center, NY; Marilena Christodoulou; 
President; Stuyvesant High School Parents' Association, NY; 
Julie Hiraga, Second Grade Teacher, PS-89, NY; Bernard Orlan, 
Director of Environmental Health and Safety, New York City 
Board of Education; and Dr. Phil Landrigan, Ethel H. Wise 
Professor and Chairman, Department of Community and Preventive 
Medicine, The Mount Sinai School of Medicine, NY.
    On March 12, 2002, the committee held a hearing to consider 
the President's budget request for first response to disasters, 
receiving testimony from Hon. Joe Allbaugh, Director, Federal 
Emergency Management Agency; Woodbury P. Fogg, P.E., on behalf 
of the National Emergency Management Association; Ed Wilson, 
Chief, City of Portland Fire Department, Portland, OR; Mike 
O'Neil, Chief, South Burlington Fire Department, Burlington, 
VT; and Kenneth E. Zirkle, President, The University of 
Findlay, Findlay, OH.
    On September 24, 2002, the committee held a hearing to 
review the responses of EPA and FEMA to the September 11, 2001 
attacks, receiving testimony from Hon. Christine Todd Whitman, 
Administrator, U.S. Environmental Protection Agency; Hon. Joe 
Allbaugh, Director, Federal Emergency Management Agency; Dr. 
Kerry Kelly, Chief Medical Officer, New York City Fire 
Department, NY; Madeline Wils, Member, Community Board 1, NY; 
Danny Greenberg, President and Attorney in Chief, Legal Aid 
Society, NY; and Jack Reall, Task Force Leader, Ohio Task Force 
One, OH.
    On June 27, 2002, the committee ordered S. 2664 reported 
favorably. Senate bill, S. 2664, introduced by Senators 
Jeffords and Smith of New Hampshire, contained a section 
similar to S. 1279. The main addition to S. 1279 is the 
creation of the National Academy of Sciences report.

                             Rollcall Votes

    The Committee on Environment and Public Works met to 
consider S. 1279 on July 30, 2003. The committee voted 
favorably to report S. 1279 by voice vote. By voice vote, the 
committee agreed to an amendment offered by Senators Voinovich 
and Clinton.

                      Regulatory Impact Statement

    In compliance with section 11(b) of rule XXVI of the 
Standing Rules of the Senate, the committee makes evaluation of 
the regulatory impact of the reported bill.
    The bill does not create any additional regulatory burdens, 
nor will it cause any adverse impact on the personal privacy of 
individuals.

                          Mandates Assessment

    In compliance with the Unfunded Mandates Reform Act of 1995 
(Public Law 104-4), the committee finds that S. 1279 would 
impose no Federal intergovernmental unfunded mandates on State, 
local, or tribal governments.

                          Cost of Legislation

    Section 403 of the Congressional Budget and Impoundment 
Control Act requires that a statement of the cost of the 
reported bill, prepared by the Congressional Budget Office, be 
included in the report. That statement follows:

                                     U.S. Congress,
                               Congressional Budget Office,
                                   Washington, DC, August 11, 2003.

Hon. James M. Inhofe, Chairman,
Committee on Environment and Public Works,
U.S. Senate, Washington, DC.

    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for S. 1279, the Disaster 
Area Health and Environmental Monitoring Act of 2003.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Julie 
Middleton who can be reached at 226-2860.
            Sincerely,
                                        Douglas Holtz-Eakin
                              ----------                              

S. 1279, Disaster Area Health and Environmental Monitoring Act of 2003, 
        as ordered reported by the Senate Committee on Environment and 
        Public Works on July 30, 2003

Summary
    S. 1279 would amend title IV of the Robert T. Stafford 
Disaster Relief and Emergency Assistance Act to authorize a new 
program to protect the health and safety of disaster relief 
workers such as firefighters, police officers, and emergency 
medical technicians. Under this bill, Federal agencies would be 
authorized to collect and analyze environmental data at 
disaster areas to determine whether substances that may be 
harmful to human health are present. In addition, this bill 
would authorize those agencies to disseminate educational 
materials to affected communities and to conduct long-term 
epidemiological studies of affected populations. Finally, the 
bill would authorize the National Academy of Sciences to study 
and prepare a report on disaster area health and environmental 
protection and monitoring.
    Assuming appropriation of the necessary funds, CBO 
estimates that implementing S. 1279 would cost $35 million over 
the 2004-2008 period. Enacting S. 1279 would not affect direct 
spending or revenues. S. 1279 contains no intergovernmental or 
private-sector mandates as defined in the Unfunded Mandates 
Reform Act (UMRA) and would impose no costs on the budgets of 
State, local, or tribal governments.
Estimated Cost to the Federal Government
    The estimated budgetary impact of S. 1279 is shown in the 
following table. The costs of this legislation fall within 
budget function 450 (community and regional development).


                 By Fiscal Year, in Millions of Dollars
------------------------------------------------------------------------
                                   2004    2005    2006    2007    2008
------------------------------------------------------------------------
 CHANGES IN SPENDING SUBJECT TO
          APPROPRIATION
Estimated Authorization Level...       5       5       9       9      13
Estimated Outlays...............       3       5       7       9      11
------------------------------------------------------------------------

Basis of Estimate
    Based on information from the Agency for Toxic Substances 
and Disease Registry (ATSDR) and the National Academy of 
Sciences, CBO estimates that implementing the provisions in S. 
1279 would cost about $35 million over the 2004-2008 period, 
assuming appropriation of the necessary funds.
    Under S. 1279, CBO assumes that the ATSDR would be tasked 
with conducting long-term epidemiological studies in certain 
disaster areas that are called for under the legislation. We 
expect such long-term health studies would be conducted at 
disaster areas where harmful pollutants are released into the 
environment. According to the ATSDR, each long-term study 
conducted under this bill would cost $3 million to $5 million a 
year and could last from five to 15 years. It is impossible to 
predict the number of such studies that might be required in 
the future. For this estimate, CBO assumes that one new study 
would be initiated every other year at an average cost of $4 
million per year. Based on information from the National 
Academy of Sciences, CBO estimates that the long-term study on 
disaster-area health would cost $5 million over 5 years.

Intergovernmental and Private-Sector Impact
    S. 1279 contains no intergovernmental or private-sector 
mandates as defined in UMRA and would impose no costs on the 
budgets of State, local, or tribal governments.

Estimate Prepared By: Federal Costs: Julie Middleton; Impact on 
State, Local, and Tribal Governments: Melissa Merrell; Impact 
on the Private Sector: Cecil McPherson.

Estimate Approved By: Peter H. Fontaine, Deputy Assistant 
Director for Budget Analysis.

  THE ROBERT T. STAFFORD DISASTER RELIEF AND EMERGENCY ASSISTANCE ACT

    AN ACT Entitled the ``Disaster Relief Act Amendments of 1974''.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Robert T. Stafford Disaster 
Relief and Emergency Assistance Act''.

           *       *       *       *       *       *       *


              TITLE IV--MAJOR DISASTER ASSISTANCE PROGRAMS

SEC. 401. PROCEDURE FOR DECLARATION.

           *       *       *       *       *       *       *


    [Sec. 409 repealed by section 104(c)(2) of Public Law 106-
390 (114 Stat. 1559).]

SEC. 409. PROTECTION OF HEALTH AND SAFETY OF INDIVIDUALS IN A DISASTER 
                    AREA.

    (a) Definitions.--In this section:
            (1) Individual.--The term ``individual'' includes--
                    (A) a worker or volunteer who responds to a 
                disaster, including--
                            (i) a police officer;
                            (ii) a firefighter;
                            (iii) an emergency medical 
                        technician;
                            (iv) any participating member of an 
                        urban search and rescue team; and
                            (v) any other relief or rescue 
                        worker or volunteer that the President 
                        determines to be appropriate;
                    (B) a worker who responds to a disaster by 
                assisting in the cleanup or restoration of 
                critical infrastructure in and around a 
                disaster area;
                    (C) a person whose place of residence is in 
                a disaster area;
                    (D) a person who is employed in or attends 
                school, child care, or adult day care in a 
                building located in a disaster area; and
                    (E) any other person that the President 
                determines to be appropriate.
            (2) Program.--The term ``program'' means a program 
        described in subsection (b) that is carried out for a 
        disaster area.
            (3) Substance of concern.--The term ``substance of 
        concern'' means a chemical or other substance that is 
        associated with potential acute or chronic human health 
        effects, the risk of exposure to which could 
        potentially be increased as the result of a disaster, 
        as determined by the President.
    (b) Program.--
            (1) In general.--If the President determines that 1 
        or more substances of concern are being, or have been, 
        released in an area declared to be a disaster area 
        under this Act, the President may carry out a program 
        for the protection, assessment, monitoring, and study 
        of the health and safety of individuals to ensure 
        that--
                    (A) the individuals are adequately informed 
                about and protected against potential health 
                impacts of any substance of concern and 
                potential mental health impacts in a timely 
                manner;
                    (B) the individuals are monitored and 
                studied over time, including through baseline 
                and followup clinical health examinations, 
                for--
                            (i) any short- and long-term health 
                        impacts of any substance of concern; 
                        and
                            (ii) any mental health impacts;
                    (C) the individuals receive health care 
                referrals as needed and appropriate; and
                    (D) information from any such monitoring 
                and studies is used to prevent or protect 
                against similar health impacts from future 
                disasters.
            (2) Activities.--A program under paragraph (1) may 
        include such activities as--
                    (A) collecting and analyzing environmental 
                exposure data;
                    (B) developing and disseminating 
                information and educational materials;
                    (C) performing baseline and followup 
                clinical health and mental health examinations 
                and taking biological samples;
                    (D) establishing and maintaining an 
                exposure registry;
                    (E) studying the short- and long-term human 
                health impacts of any exposures through 
                epidemiological and other health studies; and
                    (F) providing assistance to individuals in 
                determining eligibility for health coverage and 
                identifying appropriate health services.
            (3) Timing.--To the maximum extent practicable, 
        activities under any program established under 
        paragraph (1) (including baseline health examinations) 
        shall be commenced in a timely manner that will ensure 
        the highest level of public health protection and 
        effective monitoring.
            (4) Participation in registries and studies.--
                    (A) In general.--Participation in any 
                registry or study that is part of a program 
                under paragraph (1) shall be voluntary.
                    (B) Protection of privacy.--The President 
                shall take appropriate measures to protect the 
                privacy of any participant in a registry or 
                study described in subparagraph (A).
            (5) Cooperative agreements.--
                    (A) In general.--The President may carry 
                out a program under paragraph (1) through a 
                cooperative agreement with a medical 
                institution or a consortium of medical 
                institutions.
                    (B) Selection criteria.--To the maximum 
                extent practicable, the President shall select 
                to carry out a program under paragraph (1) a 
                medical institution or a consortium of medical 
                institutions that--
                            (i) is located near--
                                    (I) the disaster area with 
                                respect to which the program is 
                                carried out; and
                                    (II) any other area in 
                                which there reside groups of 
                                individuals that worked or 
                                volunteered in response to the 
                                disaster; and
                            (ii) has appropriate experience in 
                        the areas of environmental or 
                        occupational health, toxicology, and 
                        safety, including experience in--
                                    (I) developing clinical 
                                protocols and conducting 
                                clinical health examinations, 
                                including mental health 
                                assessments;
                                    (II) conducting long-term 
                                health monitoring and 
                                epidemiological studies;
                                    (III) conducting long-term 
                                mental health studies; and
                                    (IV) establishing and 
                                maintaining medical 
                                surveillance programs and 
                                environmental exposure or 
                                disease registries.
            (6) Involvement.--
                    (A) In general.--In establishing and 
                maintaining a program under paragraph (1), the 
                President shall involve interested and affected 
                parties, as appropriate, including 
                representatives of--
                            (i) Federal, State, and local 
                        government agencies;
                            (ii) groups of individuals that 
                        worked or volunteered in response to 
                        the disaster in the disaster area;
                            (iii) local residents, businesses, 
                        and schools (including parents and 
                        teachers);
                            (iv) health care providers; and
                            (v) other organizations and 
                        persons.
                    (B) Committees.--Involvement under 
                subparagraph (A) may be provided through the 
                establishment of an advisory or oversight 
                committee or board.
    (c) Reports.--Not later than 1 year after the establishment 
of a program under subsection (b)(1), and every 5 years 
thereafter, the President, or the medical institution or 
consortium of such institutions having entered into a 
cooperative agreement under subsection (b)(5), shall submit to 
the Secretary of Homeland Security, the Secretary of Health and 
Human Services, the Secretary of Labor, the Administrator of 
the Environmental Protection Agency, and appropriate committees 
of Congress a report on programs and studies carried out under 
the program.

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