On January 2, 2011, the President signed into law the James Zadroga 9/11 Health and Compensation Act of 2010 (the Zadroga Act). The Act established the WTC Health Program within the Department of Health and Human Services, to provide medical monitoring, screening, and treatment for responders and survivors of the 9/11 terrorist attacks. Responders include workers or volunteers who provided services in the aftermath of the September 11, 2001, attacks on the World Trade Center, the Pentagon, and the airliner crash site near Shanksville, PA. Survivors include persons who worked, lived, or attended school, childcare, or adult day care in the New York City disaster area, and were adversely affected by the attacks in New York City. In order to enroll in the Program, survivors and responders must meet certain criteria described in the Zadroga Act.
The WTC Health Program is a limited-benefit program: treatment is covered only for a limited set of health conditions and only when a member’s 9/11 exposure is substantially likely to have been a significant factor in aggravating, contributing to, or causing the member’s condition. There is a list of applicable WTC-related health conditions that must be diagnosed by a Program provider; meet specified exposure, latency, and symptom-onset requirements; and be certified by the Program for the Program to cover the member’s treatment. Information on the Program is available at http://www.cdc.gov/wtc.
The WTC Health Program plans to work with an independent health program evaluation contractor to evaluate performance and utilization of the Program, identifying areas for improvement and development.
Currently, eight (8) Clinical Centers of Excellence (CCEs) in the New York metropolitan area (NYMA) and one Nationwide Provider Network (NPN) administer the benefits to members. The CCEs provide monitoring, treatment, and case management to members within the NYMA. The NPN contractor manages the nationwide provider network and provides monitoring, treatment, and case management to members living outside of the NYMA.
Since the inception of the Program, the WTC Health Program, with support from external vendors, has monitored membership, certification, and utilization/cost. The Program uses this data to identify and monitor trends. The WTC Health Program shares data on membership, member demographics, and certified conditions quarterly at: https://www.cdc.gov/wtc/ataglance.html. Data on healthcare services is also shared quarterly at: https://www.cdc.gov/wtc/reports.html.
In addition to routine analyses, the WTC Health Program is interested in data that addresses emerging issues in healthcare. Recently, this has included topics such as COVID-19 and the increase in utilization of telemedicine (e.g., https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8562919/; https://pubmed.ncbi.nlm.nih.gov/38298086/).
In recent years, the Program has examined trends in membership, certification, and utilization data, projected medical and pharmacy costs, and identified a comprehensive list of metrics and indicators. The Program hopes to continue and expand many of these efforts. The Program understands that best practices, benchmarks, and industry standards change over time; thus, the Program is interested in gaining an understanding of the landscape to enhance WTC Health Program services and the member experience.
