The WTC health programs that are providing screening and monitoring are  tracking thousands of individuals who were affected by the WTC disaster. NIOSH Has Not Ensured the Availability of Services for Nonfederal Responders Residing outside the NYC Metropolitan Area

NIOSH has not ensured the availability of screening and monitoring  services for nonfederal responders residing outside the NYC metropolitan  area, although it has taken steps toward expanding the availability of these  services. AOEC experienced challenges in providing these screening  services. Mount Sinai’s subcontract with AOEC ended in July 2004, and from August  2004 until June 2005 NIOSH did not fund any organization to provide  services to nonfederal responders outside the NYC metropolitan area. In June  2005, NIOSH began its second effort by awarding $776,000 to the Mount  Sinai School of Medicine Data and Coordination Center (DCC) to provide  both screening and monitoring services for nonfederal responders residing  outside the NYC metropolitan area. DCC, however, had  difficulty establishing a network of providers that could serve nonfederal  responders residing throughout the country—ultimately contracting with  only 10 clinics in seven states to provide screening and monitoring  services. In this request, NIOSH described the  scope of a national program as offering screening, monitoring, and  treatment services to about 3,000 nonfederal responders through a  national network of occupational health facilities. Therefore we recommended in July 2007 that the  Secretary of HHS take expeditious action to ensure that health screening  and monitoring services are available to all people who responded to the  attack on the WTC, regardless of where they reside. As of January 2008,  the department has not responded to this recommendation. Appendix I: Abbreviations

Related GAO Products

September 11: Improvements Needed in Availability of Health Screening  and Monitoring Services for Responders. GAO-07-1229T. Washington,  D.C.: September 10, 2007. September 11: HHS Needs to Ensure the Availability of Health Screening  and Monitoring for All Responders. GAO-07-892. Washington, D.C.:   July 23, 2007. September 11: Health Effects in the Aftermath of the World Trade Center  Attack.
Why GAO Did This Study

Six years after the attack on the World Trade Center (WTC), concerns persist about health effects experienced by WTC responders and the availability of health care services for those affected. Several federally funded programs provide screening, monitoring, or treatment services to responders. GAO has previously reported on the progress made and implementation problems faced by these WTC health programs. This testimony is based primarily on GAO's testimony, September 11: Improvements Needed in Availability of Health Screening and Monitoring Services for Responders ( GAO-07-1229T , Sept. 10, 2007), which updated GAO's report, September 11: HHS Needs to Ensure the Availability of Health Screening and Monitoring for All Responders ( GAO-07-892 , July 23, 2007). In this testimony, GAO discusses efforts by the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health (NIOSH) to provide services for nonfederal responders residing outside the New York City (NYC) area. For the July 2007 report, GAO reviewed program documents and interviewed Department of Health and Human Services (HHS) officials, grantees, and others. GAO updated selected information in August and September 2007 and conducted work for this statement in January 2008.

What GAO Found

In July 2007, following a reexamination of the status of the WTC health programs, GAO recommended that the Secretary of HHS take expeditious action to ensure that health screening and monitoring services are available to all people who responded to the WTC attack, regardless of where they reside. As of January 2008, the department has not responded to this recommendation. As GAO testified in September 2007, NIOSH has not ensured the availability of screening and monitoring services for nonfederal responders residing outside the NYC area, although it has taken steps toward expanding the availability of these services. In late 2002, NIOSH arranged for a network of occupational health clinics to provide screening services. This effort ended in July 2004, and until June 2005 NIOSH did not fund screening or monitoring services for nonfederal responders outside the NYC area. In June 2005, NIOSH funded the Mount Sinai School of Medicine Data and Coordination Center (DCC) to provide screening and monitoring services; however, DCC had difficulty establishing a nationwide network of providers and contracted with only 10 clinics in seven states. In 2006, NIOSH began to explore other options for providing these services, and in 2007 it took steps toward expanding the provider network.