What This Bill Does
This bill expands who can receive health care benefits through the World Trade Center Health Program. It adds federal workers and military members who helped with rescue and cleanup efforts at the Pentagon and Shanksville, Pennsylvania after September 11, 2001. The bill also allows other licensed health care providers (not just doctors) to conduct health evaluations and provides additional federal funding for the program.
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Who It Affects
- Federal government workers and contractors from the Department of Defense or other federal agencies
- Military members from regular or reserve components of the uniformed services
- People who performed rescue, recovery, demolition, or debris cleanup work at the Pentagon or Shanksville sites
- The WTC Program Administrator (the official who oversees the program)
- Licensed health care providers who conduct health evaluations
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Key Provisions
- Federal workers, contractors, and military members who worked at the Pentagon or Shanksville cleanup sites between September 11-18, 2001, or during the entire cleanup period can enroll in the program. The total enrollment for these responders cannot exceed 500 people at any time. (Sec. 2)
- Licensed health care providers (not just physicians) may conduct initial health evaluations and make health determinations within categories set by the WTC Program Administrator within 180 days of the bill's enactment. (Sec. 3)
- Deceased individuals will not be counted as enrollees in the program. (Sec. 5)
- The time period to add new health conditions to the list for WTC responders increases from 90 days to 180 days. (Sec. 6)
- Two new funding sources are created: a Special Fund with $1,784,358,336 available through fiscal year 2033, and a Pentagon/Shanksville Fund with $257,000,000 available through fiscal year 2033. (Sec. 7)
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What Changes
The program now includes federal workers and military members who worked at the Pentagon and Shanksville sites. Other licensed health care providers can now conduct evaluations instead of only doctors. The program receives two new dedicated funding streams. Enrollment calculations no longer include deceased individuals. New health conditions can be added to the covered list on a slower timeline (180 days instead of 90).
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Important Definitions
- "Federal agency" means an agency, office, or establishment in the executive, legislative, or judicial branch of the federal government. (Sec. 2)
- "Uniformed services" has the meaning given in federal law (title 10, United States Code, section 101(a)). (Sec. 2)
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Effective Date
Not specified in bill text
II
118TH CONGRESS
1ST SESSION
S. 569
To amend title XXXIII of the Public Health Service Act with respect to
flexibility and funding for the World Trade Center Health Program.
IN THE SENATE OF THE UNITED STATES
FEBRUARY 28, 2023
Mrs. GILLIBRAND (for herself, Mr. SCHUMER, Mr. BOOKER, Mr. MENENDEZ,
and Mr. BLUMENTHAL) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and
Pensions
A BILL
To amend title XXXIII of the Public Health Service Act
with respect to flexibility and funding for the World
Trade Center Health Program.
Be it enacted by the Senate and House of Representa-
1
tives of the United States of America in Congress assembled,
2
SECTION 1. SHORT TITLE.
3
This Act may be cited as the ‘‘9/11 Responder and
4
Survivor Health Funding Correction Act of 2023’’.
5
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•S 569 IS
SEC. 2. DEPARTMENT OF DEFENSE, ARMED FORCES, OR
1
OTHER FEDERAL WORKER RESPONDERS TO
2
THE SEPTEMBER 11 ATTACKS AT THE PEN-
3
TAGON AND SHANKSVILLE, PENNSYLVANIA.
4
Title XXXIII of the Public Health Service Act (42
5
U.S.C. 300mm et seq.) is amended—
6
(1) in section 3306 (42 U.S.C. 300mm–5)—
7
(A)
by
redesignating
paragraphs
(5)
8
through (11) and paragraphs (12) through (17)
9
as paragraphs (6) through (12) and paragraphs
10
(14) through (19), respectively;
11
(B) by inserting after paragraph (4) the
12
following:
13
‘‘(5) The term ‘Federal agency’ means an agen-
14
cy, office, or other establishment in the executive,
15
legislative, or judicial branch of the Federal Govern-
16
ment.’’; and
17
(C) by inserting after paragraph (12), as
18
so redesignated, the following:
19
‘‘(13) The term ‘uniformed services’ has the
20
meaning given the term in section 101(a) of title 10,
21
United States Code.’’; and
22
(2) in section 3311(a) (42 U.S.C. 300mm–
23
21(a))—
24
(A) in paragraph (2)(C)(i)—
25
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•S 569 IS
(i) in subclause (I), by striking ‘‘; or’’
1
and inserting a semicolon;
2
(ii) in subclause (II), by striking ‘‘;
3
and’’ and inserting a semicolon; and
4
(iii) by adding at the end the fol-
5
lowing:
6
‘‘(III) was an employee of the Depart-
7
ment of Defense or any other Federal
8
agency, worked during the period begin-
9
ning on September 11, 2001, and ending
10
on September 18, 2001, for a contractor of
11
the Department of Defense or any other
12
Federal agency, or was a member of a reg-
13
ular or reserve component of the uni-
14
formed services; and performed rescue, re-
15
covery, demolition, debris cleanup, or other
16
related services at the Pentagon site of the
17
terrorist-related aircraft crash of Sep-
18
tember 11, 2001, during the period begin-
19
ning on September 11, 2001, and ending
20
on the date on which the cleanup of the
21
site was concluded, as determined by the
22
WTC Program Administrator; or
23
‘‘(IV) was an employee of the Depart-
24
ment of Defense or any other Federal
25
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•S 569 IS
agency, worked during the period begin-
1
ning on September 11, 2001, and ending
2
on September 18, 2001, for a contractor of
3
the Department of Defense or any other
4
Federal agency, or was a member of a reg-
5
ular or reserve component of the uni-
6
formed services; and performed rescue, re-
7
covery, demolition, debris cleanup, or other
8
related services at the Shanksville, Penn-
9
sylvania, site of the terrorist-related air-
10
craft crash of September 11, 2001, during
11
the period beginning on September 11,
12
2001, and ending on the date on which the
13
cleanup of the site was concluded, as deter-
14
mined by the WTC Program Adminis-
15
trator; and’’; and
16
(B) in paragraph (4)(A)—
17
(i) by striking ‘‘(A) IN GENERAL.—
18
The’’ and inserting the following:
19
‘‘(A) LIMIT.—
20
‘‘(i) IN GENERAL.—The’’;
21
(ii) by inserting ‘‘or subclause (III) or
22
(IV) of paragraph (2)(C)(i)’’ after ‘‘or
23
(2)(A)(ii)’’; and
24
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•S 569 IS
(iii) by adding at the end the fol-
1
lowing:
2
‘‘(ii) CERTAIN RESPONDERS TO THE
3
SEPTEMBER
11
ATTACKS
AT
THE
PEN-
4
TAGON
AND
SHANKSVILLE,
PENNSYL-
5
VANIA.—The total number of individuals
6
who may be enrolled under paragraph
7
(3)(A)(ii) based on eligibility criteria de-
8
scribed in subclause (III) or (IV) of para-
9
graph (2)(C)(i) shall not exceed 500 at any
10
time.’’.
11
SEC. 3. FLEXIBILITY FOR CERTIFICATIONS UNDER THE
12
WORLD TRADE CENTER HEALTH PROGRAM.
13
(a) IN GENERAL.—Section 3305(a) of the Public
14
Health Service Act (42 U.S.C. 300mm–4(a)) is amend-
15
ed—
16
(1) in paragraph (1)(A), by inserting ‘‘subject
17
to paragraph (6),’’ before ‘‘for’’; and
18
(2) by adding at the end the following:
19
‘‘(6)
LICENSED
HEALTH
CARE
PROVIDER
20
FLEXIBILITY.—
21
‘‘(A) IN GENERAL.—For purposes of an
22
initial health evaluation described in paragraph
23
(1)(A) (including any such evaluation provided
24
under section 3321(b) or through the nation-
25
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•S 569 IS
wide network under section 3313), such evalua-
1
tion may be conducted by a physician or any
2
other licensed health care provider in a category
3
of health care providers determined by the
4
WTC Program Administrator under subpara-
5
graph (B).
6
‘‘(B) CATEGORIES OF LICENSED HEALTH
7
CARE
PROVIDERS.—Not later than 180 days
8
after the date of enactment of the 9/11 Re-
9
sponder and Survivor Health Funding Correc-
10
tion Act of 2023, the WTC Program Adminis-
11
trator shall issue regulations for the categories
12
of licensed health care providers who, in addi-
13
tion to licensed physicians, may conduct evalua-
14
tions under subparagraph (A) and make deter-
15
minations under section 3312(b).’’.
16
(b) FLEXIBILITY FOR WTC RESPONDERS.—Section
17
3312(b) of such Act (42 U.S.C. 300mm–22(b)) is amend-
18
ed—
19
(1) in paragraph (1), by striking ‘‘physician’’
20
each place it appears and inserting ‘‘physician or
21
other licensed health care provider in a category de-
22
termined by the WTC Program Administrator under
23
section 3305(a)(6)(B)’’;
24
(2) in paragraph (2)—
25
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•S 569 IS
(A) in subparagraph (A)—
1
(i) in the matter preceding clause (i),
2
by striking ‘‘physician’’ and inserting
3
‘‘physician or other licensed health care
4
provider in a category determined by the
5
WTC Program Administrator under sec-
6
tion 3305(a)(6)(B)’’;
7
(ii) in clause (i), by striking ‘‘physi-
8
cian’’ and inserting ‘‘physician or other li-
9
censed health care provider’’; and
10
(iii) in clause (ii), by striking ‘‘such
11
physician’s determination’’ and inserting
12
‘‘the determination of such physician or
13
other licensed health care provider’’; and
14
(B) in subparagraph (B)—
15
(i) in the matter preceding clause (i),
16
by striking ‘‘physician determinations’’ and
17
inserting ‘‘determinations by physicians or
18
other licensed health care providers in cat-
19
egories determined by the WTC Program
20
Administrator
under
section
21
3305(a)(6)(B)’’; and
22
(ii) in clause (i), by striking ‘‘physi-
23
cian panel’’ and inserting ‘‘panel of physi-
24
cians or other licensed health care pro-
25
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•S 569 IS
viders in categories determined by the
1
WTC Program Administrator under sec-
2
tion 3305(a)(6)(B)’’; and
3
(3) in paragraph (5), by striking ‘‘examining
4
physician’’ and inserting ‘‘examining physician or
5
other licensed health care provider in a category de-
6
termined by the WTC Program Administrator under
7
section 3305(a)(6)(B)’’.
8
SEC. 4. CRITERIA FOR CREDENTIALING HEALTH CARE
9
PROVIDERS PARTICIPATING IN THE NATION-
10
WIDE NETWORK.
11
Title XXXIII of the Public Health Service Act (42
12
U.S.C. 300mm et seq.) is amended—
13
(1) in section 3305(a)(2) (42 U.S.C. 300mm–
14
4(a)(2))—
15
(A) in subparagraph (A)—
16
(i) by striking clause (iv); and
17
(ii) by redesignating clauses (v) and
18
(vi) as clauses (iv) and (v), respectively;
19
(B) by striking subparagraph (B); and
20
(C) by redesignating subparagraphs (C)
21
and (D) as subparagraphs (B) and (C), respec-
22
tively; and
23
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•S 569 IS
(2) in section 3313(b)(1) (42 U.S.C. 300mm–
1
23(b)(1)), by striking ‘‘Data Centers’’ and inserting
2
‘‘WTC Program Administrator’’.
3
SEC. 5. CLARIFYING CALCULATION OF ENROLLMENT.
4
(a) RESPONDERS.—Section 3311(a) of such Act (42
5
U.S.C. 300mm–21(a)) is amended by adding at the end
6
the following:
7
‘‘(6) DECEASED WTC RESPONDERS.—An indi-
8
vidual known to the WTC Program Administrator to
9
be deceased shall not be included in any count of en-
10
rollees under this subsection or section 3351.’’.
11
(b) SURVIVORS.—Section 3321(a) of such Act (42
12
U.S.C. 300mm–31(a)) is amended by adding at the end
13
the following:
14
‘‘(5) DECEASED
WTC
SURVIVORS.—An indi-
15
vidual known to the WTC Program Administrator to
16
be deceased shall not be included in any count of
17
certified-eligible survivors under this section or in
18
any count of enrollees under section 3351.’’.
19
SEC. 6. TIME PERIOD FOR ADDING HEALTH CONDITIONS
20
TO LIST FOR WTC RESPONDERS.
21
Section 3312(a)(6) of the Public Health Service Act
22
(42 U.S.C. 300mm–22(a)(6)) is amended—
23
(1) in subparagraph (B), by striking ‘‘90’’ and
24
inserting ‘‘180’’; and
25
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•S 569 IS
(2) in subparagraph (C), in the second sen-
1
tence, by striking ‘‘90’’ and inserting ‘‘180’’.
2
SEC. 7. FUNDING FOR THE WORLD TRADE CENTER HEALTH
3
PROGRAM.
4
(a) FEDERAL FUNDING.—Section 3351 of the Public
5
Health Service Act (42 U.S.C. 300mm–61) is amended—
6
(1) in subsection (a)—
7
(A) in paragraph (2)(A)—
8
(i) in clause (x), by striking ‘‘and’’;
9
(ii) in clause (xi)—
10
(I) by striking ‘‘subsequent fiscal
11
year through fiscal year 2090’’ and
12
inserting
‘‘of
fiscal
years
2026
13
through 2033’’; and
14
(II) by striking ‘‘plus’’ and in-
15
serting ‘‘and’’; and
16
(iii) by adding at the end the fol-
17
lowing:
18
‘‘(xii) for each of fiscal years 2034
19
through 2090—
20
‘‘(I)
the
amount
determined
21
under this subparagraph for the pre-
22
vious fiscal year (plus the sum of any
23
amount expended in the previous fis-
24
cal year from the World Trade Center
25
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•S 569 IS
Health Program Special Fund estab-
1
lished under section 3353 or the
2
World Trade Center Health Program
3
Fund for Certain WTC Responders at
4
the Pentagon and Shanksville, Penn-
5
sylvania established under section
6
3354 and any amount expended from
7
the World Trade Center Health Pro-
8
gram Fund established under this sec-
9
tion in the previous fiscal year that
10
was carried over from any fiscal year
11
prior to the previous fiscal year in-
12
cluding as carried over pursuant to a
13
deposit into such Fund under para-
14
graph (6)) multiplied by 1.05; multi-
15
plied by
16
‘‘(II) the ratio of—
17
‘‘(aa) the total number of
18
individuals enrolled in the WTC
19
Program on July 1 of such pre-
20
vious fiscal year; to
21
‘‘(bb) the total number of
22
individuals so enrolled on July 1
23
of the fiscal year prior to such
24
previous fiscal year; plus’’; and
25
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•S 569 IS
(B) by adding at the end the following:
1
‘‘(6) REMAINING
AMOUNTS
FROM
SPECIAL
2
FUND
AND
PENTAGON/SHANKSVILLE
FUND.—Any
3
amounts that remain available, on September 30,
4
2033, in the World Trade Center Health Program
5
Special Fund under section 3353 or the World
6
Trade Center Health Program Fund for Certain
7
WTC Responders at the Pentagon and Shanksville,
8
Pennsylvania under section 3354 shall be deposited
9
into the Fund.’’; and
10
(2) in subsection (c)—
11
(A) in paragraph (4)—
12
(i) by amending subparagraph (A) to
13
read as follows:
14
‘‘(A) for fiscal year 2023, the amount de-
15
termined for such fiscal year under this para-
16
graph as in effect on the day before the date of
17
enactment of the 9/11 Responder and Survivor
18
Health Funding Correction Act of 2023;’’; and
19
(ii) in subparagraph (B), by striking
20
‘‘2017, $15,000,000’’ and inserting ‘‘2024,
21
$20,000,000’’; and
22
(B) in paragraph (5)—
23
(i) by amending subparagraph (A) to
24
read as follows:
25
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•S 569 IS
‘‘(A) for fiscal year 2023, the amount de-
1
termined for such fiscal year under this para-
2
graph as in effect on the day before the date of
3
enactment of the 9/11 Responder and Survivor
4
Health Funding Correction Act of 2023;’’;
5
(ii) by redesignating subparagraph
6
(B) as subparagraph (C); and
7
(iii) by inserting after subparagraph
8
(A) the following:
9
‘‘(B) for fiscal year 2024, the greater of—
10
‘‘(i) the amount determined for such
11
fiscal year under this paragraph as in ef-
12
fect on the day before the date of enact-
13
ment of the 9/11 Responder and Survivor
14
Health Funding Correction Act of 2023; or
15
‘‘(ii) $20,000,000; and’’.
16
(b) ADDITIONAL FUNDING FOR THE WORLD TRADE
17
CENTER HEALTH PROGRAM.—
18
(1) IN GENERAL.—Title XXXIII of the Public
19
Health Service Act (42 U.S.C. 300mm et seq.) is
20
amended by adding at the end the following:
21
‘‘SEC. 3353. SPECIAL FUND.
22
‘‘(a) IN GENERAL.—There is established a fund to
23
be known as the World Trade Center Health Program
24
Special Fund (referred to in this section as the ‘Special
25
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