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1 1 (May 13, 2015)

handle is hein.crs/govccvy0001 and id is 1 raw text is: FF.ri E~$~ & May 13, 2015 The September 11, 2001 Terrorist Attacks: Reauthorization of Health and Injury Compensation Programs The September 11, 2001, terrorist attacks claimed nearly 3,000 lives that day, at the World Trade Center (WTC) in New York City, the Pentagon, and a field in Shanksville, Pennsylvania. Rescue, recovery, and clean-up operations took more than a year and involved thousands of workers. Figure I. New York City Firefighters at WTC Site September 14, 2001 Source: Federal Emergency Management Agency (FEMA) Multimedia Library, http://www.fema.gov/media-library. Shortly after the attacks Congress established the September '11 Victim Compensation Fund (VCF, P.L. 107-42, Title IV) to compensate families of those who died in the attacks, and survivors who suffered disabling injury during or in the immediate aftermath of the attacks. Over time it became apparent that some people who worked at the WTC site, or who lived or worked near it, had become ill, possibly as a result of exposure to toxins and other hazards in the aftermath of the attack. Starting in 2004, the Centers for Disease Control and Prevention (CDC) provided grants to a group of occupational medicine clinics in the New York City area to provide care for WTC responders for these exposure-related illnesses. In 2011 Congress passed the James Zadroga 9/11 Health and Compensation Act (the Zadroga Act, P.L. 111-347). It replaced the CDC grant program with the World Trade Center Health Program (WTCHP). Through a mandatory funding mechanism, the WTCHP funds a program of health services for responders at the three crash sites, as well as for residents and others in the vicinity of the WTC site (called survivors), for health conditions related to exposures from the attacks and the response. The Zadroga Act also reopened the VCF to provide compensation for lost wages and other economic losses experienced by these responders and survivors. WTCHP authority sunsets at the end of FY2015. However, annual funding caps have not been met, and unexpended funds may be carried into FY2016. Compensation under the reopened VCF is available for applications filed by October 3, 2016. Awards under the reopened VCF are capped at $2.775 billion in total. As of March 31, 2015, about $1 billion in total had been awarded. Th. W,' C He . M 1,:, Pro,,-a.-,,- ('WT,'H-P The WTCHP consists of the following: * Medical services for responders and survivors, including (1) periodic medical monitoring for responders; (2) initial health evaluation for survivors and medical monitoring if indicated; and (3) medically necessary treatment for WTC-related health conditions, including mental health conditions, for responders and survivors. * Caps on new enrollments (responders and survivors) after enactment, and grandfathering of enrollees in the original CDC program. (See Table 1.) * A network of Clinical Centers of Excellence and Data Centers to provide medical services, develop treatment protocols, and conduct research (among other activities), and a nationwide program for responders and survivors who live outside the New York City area. * A Scientific/Technical Advisory Committee, data analysis, research, outreach to eligible individuals, quality assurance, continued support for the WTC Health Registry (a roster of people directly exposed to the WTC site), and other specified activities. * A list of conditions that may be presumed to be related to exposures after the attacks (depending on individual circumstances), and procedures to list new conditions. As enacted the list did not include any types of cancer, but a number of types of cancer were subsequently listed administratively. (See 42 C.F.R. §88.1 for current list.) * Payment for medical services provided to enrollees, less any payments available from workers' compensation, private health insurance, Medicaid, or the Children's Health Insurance Program (CHIP). The WTCHP assumes all applicable costs for Medicare beneficiaries. As of 2014, all enrollees must have health insurance coverage pursuant to the Affordable Care Act (P.L. 111- 148, as amended). * Mandatory funding, with annual and aggregate federal spending caps, from the last quarter of FY20 11 through FY2015, and a 10% matching requirement for New York City. If spending caps are not met, unexpended funds may be carried into FY2016. (See Table 2.) .O 'T gognpo goo g , q 'S a X 11LULANJILiN,

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