I welcome every day for the need to reauthorize the Compensation Fund i recognize myself for a opening statement. September 11 is one of the deadliest days with almost 3000 lives lost because the terrorist attacks in the United States on the day with casualty numbers much higher and offsite and the fact that we dont know the full casualty count almost 18 years later, thats because years after 9 11 tens of thousands of First Responders who ran towards the toxic clouds unleashed on that day as well as members of the community surrounding the crash site continue to develop cancers and other diseases that prematurely end their lives. We undermined their employment like prospects with related illnesses and many people may not even be aware of that fact we continue suffering congress and in september 11 and legislation passed in 2010. We found in law and authorized the fund for five years and congress established the original fund 11 days after 9 11 to provide compensation for those physically injured and for relatives of those killed. The original fund operated from 2001 through 2004 and had over 7 billion. They reopen the fund in 2011 and they expanded the Eligibility Criteria for workers who assisted in re arrival of the attacks. Congress reauthorize the fund for an additional five years and is set to expire in 2020. The reopening was addressing the fact that responders and recovery workers reported significant high risk set up her respiratory diseases and 79 of First Responders suffer from respiratory systems in that time period. Each disease has worsened as they developed into Interstitial Lung disease and conditions in which a Long Prevention prevents oxygen from entering the bloodstream leading to other conditions like pulmonary disease. We see that one of our witnesses , jacqueline characterizes this as a third wave of illnesses and eating increase cancer rate among First Responders since 2015. Part of the reason is that cancer can have a long latency period meaning symptoms may not manifest for decades after the initial exposure to carcinogens. In the face of the fund overseeing the department of justice theyve done a admiral bull job. An admirable job. Received 50,000 claims and 24 claimants are eligible for compensation in about half made awards for 20,000 claims and were awarded more than 5 billion as of april 30. The fund now faces a funding crisis, one not of its own making when congress reauthorize the victims Compensation Fund and prohibited the fund from spending more than the appropriated sevenpoint 4 million to pay awards and administrative expenses. Bylaw the fund must reassess its policies and procedures to ensure that it doesnt exceed the spending. The fund driven by various fact yours had a market increasing cancer claims and claims for the survivor population. The results show the fund was forced to perform 50 , and 70 cuts for claims filed thereafter. Congress has proposed a solution that never forget the heroes or the Victim Compensation act authorizing until 2090 two ensure sufficient funds are available to pay future claims and payment of any award amounts , and make a number of other useful changes. They will not have to force survivors to bake Congress Every five years to step up and do the right thing. Im proud to be a cosponsor of this bill and im proud because this is not simp leah new york event i see representation here and the champion of the issue and as chairman of the committee. Primarily responsible for the hearing. If this was an american tragedy or american event i would recall it so vividly guy was in new york within a month and going to a baseball championship game and ran into giuliani who at the time was a friendly guy and i went down to 9 11 and had my mask and walked around in the debris. I commend all of you for what you did, you put yourself in your life at risk and you need to be compensated, you are american heroes. They introduce a bill and affect the work on behalf of 9 11 responders and i think representative collins for his sponsorship thank you to the responders for the survivors and witnesses and to testify for us today. This is a bit unusual because this is my subcommittee which i chair and im chairing it now. , its a special moment, its an issue close to him and his constituents and for that reason i will surrender the chair to him to oversee the meeting which is a probe, this is the time i will do it, i dont know if its the right time but this is the time im doing it. I recognize mr. Johnson. Thank you. Thank you mister chairman, the tragic events of september 11, 2001 in new york took innocent lives on american soil on a scale not seen since the attack in pearl harbor line unified the country is First Responders search for bodies and headed a mass recovery effort. First responders did this amid a smoldering pile of 20 stories of building question to a dense accumulated mountain of hot toxic chemicals that burned for months. My wife and i visited and it was on fire. Many sacrifice their own health and efforts to help their fellow americans including two steel beams in the shape of a cross that now rest in the memorial museum. This crossed it is a sign of hope for so many and so to do our programs to help take care of those to whom we own our deepest gratitude. A federally funded program that created to compensate and pay medical expenses for those who develop respiratory and other illnesses relating primarily to the rehabilitation to the side of the World Trade Center. Payments arm administered by a special master who announced the fund is running out of money and with current claims currently unpaid. The fund was authorized in the manner in which all federal programs should be authorized, for a limited duration within which Time Congress can periodic the revisit the program for potentially reauthorizing and finding it further as it goes forward in the future. The special master who runs the program and is here today is a wellregarded Public Servant and im aware of no programs with the administration and we have confidence in the program. I support reauthorizing the program in a manner fair to everyone. This is the right thing to do and i expect the bill will pass with broad bipartisan support. I am personally, myself the son of a firefighter who was permanently disabled in the line of duty in 84 and i know the sacrifices and the needs of the heroes and their families personally. In addition to my dad being burned over 80 of his body, he inhaled toxic chemicals in a fire and suffered the remaining 32 years of his life as a result of that tragedy. The only concern we have here, you will hear people talk about is the latest proposal to reauthorize the program creating an unlimited authorization for procreations for the fund extending it to 2090. The Congressional Budget Office is able to determine the cost and right now we have a 22 trillion federal debt keeping us up at night. And its possible everyone here feels the burden. The objection is fairness to all and by all we mean all americans including First Responders for terrorist attacks and the wreckage following kansas and the floods in louisiana and disasters and tragedies everywhere. We have to appropriate the fund and as we compensate First Responders in similar circumstances in a way capable of making future Funds Available for future heroes. We look forward to hearing from other Witnesses Today including those who work selflessly under dangerous conditions to help our nation heal. I yield back. Thank you mr. Johnson, i now recognize myself for an opening statement. 18 years ago, on september 11, 2001, Osama Bin Laden orchestrated the deadliest terror attack in u. S. History killing almost 3000 people in a single day and in new york city the attack happened in this system. And environmental nightwear where the twin towers collapsed and hundreds of contaminants poured onto the streets and First Responders, Office Workers and students left in a cloud of dust. I want to share the images with you today, as you can see you can look at the jumbotrons. As you can see new york city was covered in toxic ash filled with debris that dust and deadly toxins. Many constituents were forced to flee their homes and firefighters, police and rescue and recovery workers from around the country came to our aid, working in horrible dangerous conditions to help one another and help the United States get back on its feet. I was in washington with my wife when the attacks began and we immediately rushed to return to new york city since all flights had been grounded but what sticks with me is the eerie silence that greeted us when we stepped out of penn station. The city seemed empty, nothing moving, no people, no cars, no buses, no subway trains, nothing. The only thing that was there was a strange odor that hung in the air. On september 12 i walked the streets of Lower Manhattan with the rivers of ash and debris and saw the end the double damage. I was then with mayor giuliani and joined by george bush and Hillary Clinton and chuck schumer. Theres no question in our minds that we must Work Together in a bipartisan manner to do what it took to get new york back on its feet to get the country moving again and get help for everyone affected by the attack. From the days following the attack a problem arose in the epa insisted that brooklyn was safe to breathe the air but it was not truth, it was an untruth that caused thousands of people to become sick and for tragically some people to die. It was an untruth i worked many years to expose because we knew even then the air was not safe to breathe and in fact it was that the. Thousands of responders from all over the country worked on the site and thousands and thousands of responders and workers and residents were exposed to horrible toxins and were not provided with protective equipment. The federal government did not step in to conduct a proper comprehensive cleanup in Lower Manhattan. They told my constituents to clean up as best they could with a cloth with no protective equipment. Today, as a result of the attacks and as a result of those lies more than 95,000 responders and survivors are sick. It was for the tens of thousands of brave, selfless and innocent responders and survivors that congress came together in 2010 after years of struggles and negotiations , to pass the 9 11 health and compensation act and to fulfill the moral obligation to care for him who shall have borne the battle. Theres a drug act in this program to made to to those made sick by the 9 11 attack and also reopened the vick compensation act to provide support for sick responders are survivors. As the programs are set to expire in 2015, congress once again came together in a bipartisan manner to reauthorize them. They made the Health Program permanent and set the Expiration Date far into the future in 2090, ensuring that all those effect for the attack with the healthcare they need for as long as they needed. The only extended bcs for five years, today the programs are mostly working. Residents of 433 out of 435 congressional districts receive care to the 9 11 healthcare program. We already see the impact of long delays with nearly 11,000 responders and diagnosis diagnosed with cancer to date, a number that will only go up. Its clear this was not long enough. Further, as a number of responders continue to rise, limited resources that congress provided have been strained, the number of sick people anticipated, thousands of sick responders are facing up to 70 cuts in compensation, because the money is running out, the cuts were certainly not intended by congress when we know that they are not making these cuts maliciously. They are working to keep the program funded as long as possible to give every responder at least some compensation. That does not mean we can simply accept the cuts and so many young women and adults will make compensation and care that that is what brings us here today, as somebody percent, is simply intolerable and Congress Must not allow it. Congress must not allow the vcf to expire while people are still sick and the World Trade Program is still operational. The time has come to act. In the past and we need a hearing to markup legislation to address the problems and today is chairman of the committee im able to convene this hearing and announce we will not wait to markup the legislation. We will hold the markup of the legislation tomorrow. There are to moral imperatives that dictate why we must act. Number one, it was america attacked in 9 11 not and number two it was the federal government that bears responsibility because they told everyone it was safe to return to Lower Manhattan when they knew it was not, now the federal government must bear the burden to care for and support to people affected by the september 11 attack and again, i am proud to work in a bipartisan colleague to reorganize the critical programs. Im pleased we have the support of sentator koury gardner and the Judiciary Committee representative doug collins. We have more than 300 bipartisan cosponsors of his bill in the house and i want to thank the people in the room to get congressional cosponsors so quickly. I urge all of my colleagues to work in support of reauthorization to move the bill through the president s desk as quickly as possible. We stayed together as a nation in the days following 2011 and as we stood together in 2010 and 15 to authorize and fund vital programs, we now join forces one more time to ensure that heroes of 911 are not abandoned when they need us most. We must sustained and protect the heroes and survivors and must pass a never forget heroes act of 2019 and we will. But i will add one more thing. For more people in the country and people in the committee, 9 11 ended that day perhaps they light a candle every year on the anniversary and perhaps the pray for the victim but for our panel of Witnesses Today, for many people in the audience, with congressman maloney and king and for me and my staff 9 11 never ended. We live every day with the events of that morning and the impact of the decisions made by the federal government and the aftermath. While i know it can be frustrating with the body as large as Congress Work its will, when we do act we can bring tremendous resources and the strength of the entire federal government to bear the problem and improve the lives of so many. Its my hope and sincere wish that congress will act swiftly to stop devastating cuts, extend the program and to provide as much peace of mind as we possibly can to those who continue to suffer for the 9 11 attacks. I yield back. Its now my pleasure to recognize the Ranking Member of the committee, the gentleman from georgia, mr. Collins in his opening statement. Thank you mister chairman, this is the day in which we do come together and i want to thank all of you and a number of folks in the district. Either that day or in the future, the attacks killed almost 3000 people and left a smoldering pile of debris and thousands of rescuers responded with courage, smoking piles of debris was in victims with dignity and restored ground zero of a loving resilient community, a place that includes the september 11 memorial. Even yesterday, i heard a story just yesterday that they identified another victim, 18 years later. No one is forgotten , no one is left behind, that is what our country symbolizes. Its also fitting that congress do more than memorials, we must help take care of the heroes, the First Responders, like all First Responders they deserve to have their sacrifices recognize. Program will mitigate the damage these Public Service and their families experience as a sacrifice on behalf of others. Legislation has been introduced to the fund and its clear at the moment that the collective duty to see that First Responders are treated fairly in accordance with what they have already given to a grateful nation. I must also say and a personal note, you never forget, i carried the images and i am proud the chairman show them this morning, i carried them with me interact. The time i served there was a reminder of the service that had already been given, not knowing on that morning what would happen, but knowing on that morning it would not be forgotten. What we are seeing today, as i remember back with the chaplain in the air force, i remember the chaplain judge being carried out, the first, the honest sacrifice of one serving others and the many that were to follow. Those are the images that bring this to the hearing today we can have differences, but they became heroes, angels in heaven if you would, without asking. They began that day with hope, love on a morning very similar to today. Out of the fires of tear revealed that the strength of our country still revealed in our country today and its our time to act and finish this and our time to remember. The work, the life, the pictures and the families. We will never forget that in fact we will look back on and find our strength in those who went before and are suffering now. With that, i packed. Thank you mr. Collins. Before i introduce the witnesses i want to note the presence of our colleague and take the opportunity to thank him for his great work in supporting the bill and gathering cosponsors. I will now introduce the witnesses on the first panel. The honorable Carolyn Maloney represents the 12th district of new york and has been a member of Congress Since 1993. Among her many accomplishments are hr 2037 and never forget the service, and hes been a staunch advocate for the Compensation Fund. And hes also been a member of Congress Since 1993 and among other things has been a tireless champion and his long work with me to create the World Trade Center to sustain the victim Compensation Fund. They will be entered in in their entirety. Yesterday they summarize the testimony in five minutes supposed to read which you know to help stay within the timing light on the table the light switches from green to yellow with one minute to conclude your testimony. When the light is red your five minutes have expired. Maloney, you may begin. Thank you, thank you chairman mather the Ranking Member collins and johnson i want to thank you for inviting me to testify i will never forget the heroes permanent authorization of a september 11 him Compensation Fund. , today we are proud to have a strongly bipartisan bill with 306 cosponsors, 80 of them are republican and im grateful that the committee recognizes the importance of supporting 9 11 responders, survivors and their families and the urgency of passing this bill as soon as possible. The recently remembered d day, a day when all americans teamed together to defend a democracy, liberty and freedom. Though we are not members of the greatest generation, our First Responders defend and mitigate their lives for just the same values. On september 11, this country was horrifically attacked, killing exactly 2997 innocent people. They were murdered and thousands more were injured. In new york, pennsylvania and at the pentagon. Simply for being american or being on american soil. Yet, it still gets worse. The death toll from that terrible day continues to grow. In the year since 9 11, tens of thousands more men and women, including First Responders, relief workers, local residents have lost their lives or gotten sick as a result of their exposure to toxic chemicals, pulverized glass and even though the u. S. Government told them repeatedly over and over again that it was safe to work at the site, to deaths from 9 11 diseases may outnumber those loss. 9 11 was an attack on american in response our nation committed to finding those responsible and holding them accountable. The first of veterans were the First Responders for volunteers and survivors of 9 11. Today they live all over the country in 433 out of 400 and 35 congressional districts. They are firefighters, police officers, construction workers, electrical engineers, volunteers and from every single state who answered the call and traveled to new york, dc or pennsylvania to help with recovery. We have a moral obligation to provide to or in compensation to the heroes and their families , not only did they come to our aid when we needed them but many were sick because they trusted the federal government when it said the air around ground zero was safe to breathe. In october 2011 a nine year fight, with the 9 11 health and compensation act signed into law establishing the World Trade Center and reopening the victim Compensation Fund. These programs provide Health Monitoring and financial compensation to First Responders, survivors and families. In 2015, i am proud to say that congress permanently reauthorized the Health Program. The victim Compensation Fund will expire next year if we dont act because it was only given a fiveyear extension. Making matters worse, the special master of the fund announced in february that the fund would not make it to 20 20 because of a funding shortfall, partly due to the increase in cancer claims. In order to extend its life, dcf was forced to cut off all awards by 50 to 70 . This was devastating to survivors and their families. For the last 3 1 2 months theyve not been getting the help they deserve the health that our nation owes them. February 2019 more than 830 compensation recipients have received reduced awards from the dcf because of the shortfall. This is unacceptable and we need to correct it. They shouldnt have to worry about the Program Running after funding and they should not have to come back to Congress Every five years to bag for program reauthorization. That kind of uncertainty is unfair and unsustainable. Our legislation would make these families whole by requiring the special master to revisit the reduced claims and pay out the differences. I must tell you that as evidence by the more than 300 cosponsors of the never forget the heroes act, its not a democrat or republican issue or new york issue these are americans of all political persuasions in every corner of our country who are counting on us. Our whole country owes them at that, a debt that we could never fully repay. And, look at the people who are sitting here with us today. These are the heroes and the herons and the reason we are fighting so hard for this program, i want to conclude by recognizing them and thanking them and their families for the hours they have spent lobbying to get this program reauthorize. You will hear from a few of them today as they continue to be our inspiration every single day for their healthcare and financial security. As much as i love being with them and talking to them, they should not have to come back to congress for another reauthorization. Were counting on you to make the program permanent, to reauthorize it, thats the least that we can do as a grateful nation thank you. Thank you and let me also note the presence of another long time and key supporter of the 9 11 drug act new york. Representative king, you may begin now. Thank you mister chairman. Id like to make a few remarks on this vital bill, i want to thank you and thank the Ranking Members and miss johnson, this is a central bill with the human aspect. I also want to mention all of the ems workers and Court Officers and construction workers, students, all of whom have suffered over the years. We went through six months of wakes and funerals after 9 11 and the next few years they started again. Just last week in east meadow about 10 minutes from my home at the Port Authority lieutenant died from 9 11. It something that goes on and on and soon we will have more people dying after 9 11 then died on 9 11. This shows how vital this is, its not new york or new jersey its a national issue. I also want to take the time to think the special master henry m decides what use, the program has been run exceptionally well. The fact that its running out of funds is no reflection at all on the initiation of the program but rather a reflection of how deadly the illnesses are and how long they were dormant and latent and how deadly they are and vicious they are. All of us know a friend, neighbor, constituents, friends of neighbors and constituents that have suffered and died in people going back every three or four months for medical tests taking 20 or 30 medications at day, going back in for biopsies, its a Real National tragedy that did not end it all on september 11 or 12th. Just the other day i got a call from a local radio reporter who was diagnosed several months ago unfinished chemotherapy. He was reporting as to what happened there and what was going on. As brave as the men and women were the rushton onset number 11 , no one can ever question or think of selling at the bravery they showed, you said too often they think they forget about the weeks and months afterwards , people inhaling toxic fumes got involved in recovery and find the remains of loved ones. We owe it to all of them, let me give a special thanks to jon stewart, theres probably not that many issues but ive never seen anyone put themselves into a cause more than this stuff to go in the grunt work and members of congress. He has more patience than i have , he goes in there and it really is just talk and again, its an excellent job and we want to thank them. And all of it wouldve been where we are now so, john i want to thank you for that. And also i want thank elliott his been there from the start and i realize Ranking Member johnson, but we have to find a way to get it done. We have an obligation to get this done. These are real people who are dying that we have an obligation to them and their families because they are there , not through any fault of theirs but because of courage and bravery and because of the congressman, some of the residents were at the wrong place at the wrong time and were told it was safe to continue living there. Innocent victims were the first innocent victims of the first great war of the 21st century. We owe it to them and for future generations. But people who are taking care of the recovery, they know they are sure they will receive compensation that they deserve. So im proud to be here today and i cant emphasize enough how vital the legislation is and to thank the men and women behind us , they are the ones who are suffering. We can talk about it and argue but its nothing compared to every day of our lives so with that i think you for holding this hearing and i think the witnesses for coming after us and they showed true bravery of the American People for the weeks and months after that with the resilience and bravery of the American People and also, if we can get the job done it will show that congress understands and respects those who put their lives on the line for their country. I yield back. Thank you representative king. I obviously share those sentiments and note the presence of a number of advocates youve worked so long for this legislation. One of the leaders of them that we will now hear from the second panel of witnesses and, while they are getting seated i will do the introductions. A special master for the september 11 victim Compensation Fund appointed to the position by the attorney general in july 2016. During your tenure special masses shes overseen the award of over 3. 3 billion to more than 13,000 eligible laymen. She first joined the department of justice in 1996 through the attorney general Honors Program is a Trial Attorney in the Civil Division has spent most of her career there eventually rising prior to her appointment as special master. She received the jv from Harvard Law School and masters degree in International Relations and a bachelors degree from tulane university. Dr. Jekyll and moline is professor of epidemiology and prevention and internal medicine at the donald and Barbara Zucker school of medicine. He is also a in addition she serves as a member of the World Trade CenterHealth Program committee and received her m. D. From the university of Chicago School of medicine, her masters of science from Mount Sinai School of medicine and a ba from the university of chicago. Lailan nordstrom is a 9 11 survivor and a High School Student on september 11, 2001. She currently serves as executive director a position held since may 2006. She creates and coordinates efforts educate young adults about Health Services available to 9 11 survivors. She is testifying interpersonal capacity and has worked as a freelance writer and columnist and received her ba with honors from vassar college. The widow of a construction worker and 9 11 World Trade Center respondent, a member of the Laborers International union of local 79. Working for contracted sound ground zero in 2002 and died last month from a 9 11 related cancer. Thomas monell retired as a supervisory special agent after a 30 year career with the federal bureau of investigation. On september 11, 2001 he witnessed American Airlines flight 77 crash and explode into the pentagon. Knee immediately responded to the crash site and continued working at the pentagon for the next two months. As a result of the work he incurred a serious illness and received his bachelors degree in criminal justice from college. Michael oconnell retired as the tenant with the Fire Department with the city of new york in 2009 from september 11 through september 18, 2001, he performed rescue and recovery work at the World Trade Center site. He was awarded the 9 11 survivor metal by the s ny and join the sp and why in 1998 and later joined the nypd, the Police Department in 1998, sorry and later joined the Fire Department in 2001. Several other witnesses, incurred a serious illness as a result of his rescue and recovery worked in he stuttered nursing at college. Luis alvarez is a retired bomb squad detective with the new york Lease Department and was a responder at the World Trade Center september 11, 2001 but today he suffers from 9 11 related liver cancer that has metastasized throughout most of his body and is about to have his 69th round of chemotherapy. Prior to joining the nypd he served in the states marine corps. After return on the nypd, became in the elusive ordinance plosive technician with the transportation security intermission. Jon stewart is a former host of the daily show and Comedy Central and the most relevant to todays hearing, an outspoken advocate for 9 11 responders and survivors and for both the victim Compensation Fund and World Trade CenterHealth Program. Hes been a tireless advocate raising awareness about the treatment of 9 11 responders and to this end he invited several of them on the daily show and made numerous trips to capitol hill to advocate on their behalf. Is a graduate. We welcome our distinguished witnesses and thank you for participating in todays hearing. Please rise and raise your right hand and i will begin by swearing you in. To swear and affirm under the penalty of her duties at the testimonial about to give is to incorrect to the best of your knowledge, ability and belief, so help you god . Witnesses may be seated, let the record show the witnesses answered in the affirmative. Please note your written statements will be entered into the record and accordingly they will help you stay within your time and the light switches from green to yellow and you have one minute to conclude your testimony then the light turns red and signals your five minutes have expired. May begin. Chairman nadler and Ranking Member collins and johnson and distinguished members of the subcommittee, thank you for inviting me to testify about the september 11 two Compensation Fund or vcf. Earrings like this remind us that september 11 2001, marked only the beginning of an ongoing and evolving tragedy. To those of you who shared a table with me, who were there and responded to the attack or would not allow terrorism from returning for school, homer workplaces, thank you for your heroism and sacrifice. I have spent my career in Public Service including more than 20 seer years at the Justice Department but since the age of 20 masters and 26 videos irving the strong and resilient 9 11 unity. I was privileged recently to attend the dedication of the memorial glade at the 9 11 museum in new york and reminded of the startling fact that the nearly 3000 lives lost on september 11 may soon be overtaken by the number of lives lost in the years afterwards, the illnesses that stem from exposure to toxins at all three attack sites. While no amount of money can fully compensate for such losses, i am proud that the vcf has been able to provide some needed relief to those who have suffered for so long. The vcf is as an extraordinarily successful program. As of may 31 weve awarded almost 5. 2 billion to nearly 22,500 individuals who suffer physical Health Conditions including to the families of more than 100 50 who have died as a result of their exposure in new york city and in shanksville. Those compensated include workers or volunteers in construction, cleanup and debris removal and people who lived, worked or went to school in affected areas. The vcf has received claims from individuals in every state of the nation, including those who came in from around the country as part of the response efforts and those who have relocated in the years since the attacks. In my three years that weve significantly improved efficiency and claim determination rates but the vcf now issues nearly as many awards each year as it did in total in its first five years. The vcf under my leadership has not documented a single instance of fraud in a paid claim. We work diligently with the office of the Inspector General to ensure that any fraud is investigated and reconciled. Despite the successes, they face a difficult situation. We received a Record Number of new claims in 2018, and we are on pace to exceed the number in 2019. The issue is basic math thomas 5. 2 billion awarded to nearly 22,500 individuals just over 2 billion left with over 21,000 claims and amendments still needing a decision and thousands more expected to be filed before the vcf december 18, 2020 deadline. Trends help us understand how we got here and since reauthorization of the drug act in december 2015, weve seen a dramatic increase in claims filed on behalf of those who have died as a result of the 9 11 related exposure. A significant increase in cancer claims in a market increasing claims from survivors those who lived, worked or went to school in affected areas. Taking account of the trends and increasing rates of both claims submission and award determinations. In february, i determined that the vcf had insufficient funding to compensate all pending claims and those projected to be filed under then existing policies. With that determination i was required by law to modify the policies and procedures so that the vcf does not exceed its appropriated limit this making significant reduction in awards. In deciding how to do this i felt strongly that i could not some claimant uncompensated or failed to make allowance for those who suffered most. I can get that the fairest solution was to apply a percentage reduction to all claims, depending on when the claim was submitted, calculated loss values are being reduced by another 50 or 70 of required offsets taken in full. I wish to thank the Judiciary Committee and members of the subcommittee for giving me the opportunity to speak to you about the successful and of porton program along with my dedicated staff and proposal for the Justice Department, i remain strongly committed to serving the 9 11 community. We remain hopeful that the work continues to provide needed relief and stand ready, along with the Justice Department to work with you to ensure that congress has the information it needs to address the appropriate legislative option. Thank you. Thank you dr. Moline. Good morning chairman nadler, chairman cohen and Ranking Member johnson and members of the committee. Were honored to be here this morning, my name is dr. Jacqueline moline and am the chairperson of epidemiology and prevention at the Zucker School of medicine and, i am the director of the north full queens World Trade CenterHealth Program. Of my specialty, occupational and environmental medicine is the impact of Hazardous Substances on the health of individuals. On september 11 i like every person in new york watch in shock and horror as a nation was attacked. My colleagues in mount sinai where i was working the the potential for Health Effects related to asbestos and other toxins. We knew there would be disease in the shortterm and longterm. The immediate concern was for acute Health Effects, the first wave. My colleagues and i have written extensively about this and copies of the publications are attached to my testimony. We have seen patients through tremendous efforts of the new york congressional delegation of organized labor. In april 2002 we were given one year funding to begin medical surveillance programs. For those exposed at the pile, at the beginning we can evaluate patients and tell them Health Conditions, we were not allowed to provide treatment. This program was extended one year and we continued to partnership with stony brook, New York University and rutgers to see patients in locations convenient for them. The surveillance programs continued eventually including treatment and involved into the World Trade CenterHealth Program authorized eventually by the james a drug act of 2010. After reauthorization in 2016 that we had 75 years of funding for medical surveillance and care of World Trade Center related disorders as well as dedicated research but as of march 31, 2019, 95,000 320 First Responders and survivors resident schoolchildren and individuals who worked in Lower Manhattan returned to their businesses and had been evaluated. Yes, the towers were in new york city and the pentagon is here in dc but there was another recommendation, individuals from all over the country participated in this rescue and recovery effort. Over the past 18 years some people who lived in the metro new york area have moved or retired to other parts of the country. Due to these reasons theres a National Component to the World Trade Center program. As of may 2019, 16,684 individuals are enrolled in the National Program in every state. Downtown manhattan is home to thousands of residents who inhaled dust. Schoolchildren like lila sitting here had been evacuated from their places of learning and returned to schools despite fires that continued to rage and amid dust that persisted through may 2002. The survivors are also colored covered by the act and the number of survivors is increased by 327 in eight years. Medical conditions have persisted and thats the second wave. For example, over 50 of firefighters who worked at the World Trade Center site developed persistent respiratory conditions, rates of asthma remain elevated along with other diseases. Here we are, nearly 20 years later and unfortunately that weve moved into the third wave of diseases, the conditions that take years to develop. We dont know a lot about the actual dust and fumes that enveloped Lower Manhattan but id like to reiterate that as medical professionals, we never believe the air was safe to believe and that is now amply clear. The World Trade Center now collects Additional Data on diseases that have been classified as World Trade Center related. This is crucial since already could Data Collection on who was exposed was lacking for the research is ongoing. To determine what new diseases might be added to the approved list to. Since 2012, over 50 cancers were added to the list of World Trade Center conditions and there have been 11,824 World Trade Center certified cancers treated including 2614 prostate, 552 long, 741 breast including over 35 male breast cancers and 667 thyroid 571 cases of lymphoma and hundreds more. Gill estimates have occurred like the one that killed candidates henry you will hear from his widow in this session