Eighteen years after the attacks on Sept. 11, thousands of people still need help.

They are the first responders who rushed to the scene, the business people who worked in nearby offices, the children who were attending school and the pedestrians who hustled down the sidewalk when two planes crashed into the World Trade Center in Manhattan. Many are sick or injured as a result of their exposure to Ground Zero — or worried that they may fall ill in the future.

Thousands of these individuals have registered with the 9/11 Victim Compensation Fund, which reviews the claims and gives financial awards to people impacted by the plane crashes at the World Trade Center, Pentagon and in Pennsylvania so they can pay their health care bills.

Nearly 76,000 New York residents had registered with the fund by the end of 2019 — the most by far of any state — according to the fund's annual report. Over 32,000 New Yorkers submitted claims and less than half had received federal dollars by the start of 2019.

While many of these individuals are concentrated in the New York City area, nearly 1,600 people from Albany, Columbia, Dutchess, Greene, Rensselaer, Saratoga, Schenectady, Schoharie, Ulster and Washington Counties have registered with the fund as of June 12, 2019.

Those people were 9/11 first responders or exposed to the scenes of the attacks in other ways. They are classified by their residence at the time they registered, not their residence on Sept. 11, 2001.

About 700 people from the 10 upstate counties have submitted claims to the fund and only 309 have received an award decision, data shared by the U.S. Department of Justice shows.

For the nearly 1,000 people from those counties, Congress's decision to permanently finance the 9/11 Victim Compensation Fund means they have the option of getting financial help in the future, if they need it.

"We have already lost too many 9/11 heroes, and sadly, many more will become sick and die in the years to come," said U.S. Sen. Kirsten Gillibrand, D-N.Y. "But now, because the permanent reauthorization of the 9/11 Victim Compensation Fund is the law of the land, our 9/11 first responders, survivors, and their families can finally have some peace of mind as they continue to fight through illnesses linked to the 9/11 attacks."

In a bipartisan step, the House and Senate voted in July to reauthorize the fund for the next 73 years. The move ended years of uncertainty about the program, which was scheduled to sunset in 2020, ending survivors' rights to file and receive claims.

"It was delayed for far too long," said U.S. Rep. Paul Tonko, D-Amsterdam. "They are deserving of all our attention. This was attack on America. These people showed courage. They responded in way that was a role model, a badge of citizenship. They deserve our respect."

The fund started with a $7 billion price tag and the bill President Donald Trump signed allocated $10.2 billion over the next 10 years and billions more later. When some lawmakers balked at the cost of the fund, 9/11 first responders gave emotional testimony about its importance, along with comedian and advocate Jon Stewart.

Thousands of first responders have become sick in the past decade with respiratory diseases, digestive illnesses and cancer linked to their exposure to Ground Zero. In the first hours following the attacks, many first responders lacked proper safety equipment and masks to protect them.

"It was a day where there was some pure evil on display but there was also a profound sense of heroism and courage and bravery that was displayed," said U.S. Rep. Antonio Delgado, D-Rhinebeck. "That's what I choose to hang onto and remember, the amount of sacrifice that people were able to put themselves through for the greater good, for the cause, for the country."

On Monday, Gov. Andrew M. Cuomo signed legislation establishing Sept. 11 Remembrance Day, allowing for a moment of silence to be held at public schools around the state each year.