We reported in February 2006 that four of the five monitoring programs  had made progress in screening and monitoring affected individuals and  gathering data. In contrast to the progress  made by the other programs, the HHS WTC Federal Responder Screening  Program had lagged behind and accomplished little. New Federal Funding for Monitoring and Treatment

In December 2005, the Congress appropriated $75 million to CDC to fund  programs providing baseline screening, long-term monitoring, and health  care treatment for emergency services and recovery personnel who  responded to the WTC disaster. HHS Has Registered and Screened Additional Federal Responders, and Arrangements for Screening Former Federal Workers outside the New York Metropolitan Area Are under Development

Since February 2006, an additional 1,385 federal responders have  registered for screening examinations, bringing the total number  registered on the WTC Federal Responder Screening Program Web site to  1,762 as of late August 2006, including 283 former federal workers. Because the total number of federal responders involved in the WTC  disaster is uncertain, it is not possible to determine what proportion of the  total number of federal responders have registered. Through OPHEP’s agreement with NIOSH,  the worker and volunteer WTC program has provided screening  examinations to 13 former federal workers and scheduled 11 more. Most  of the former federal workers reside outside the New York metropolitan  area, where the worker and volunteer WTC program is located, and NIOSH  is working to establish a national network of providers to screen these  workers. Of the 1,762 federal responders  who registered, 1,385 had registered since February 2006, including 1,134  current federal workers and 251 former federal workers. HHS Has Screened Additional Current Federal Workers

As of late August 2006, FOH had completed screening examinations for a  total of 907 of the federal workers who had registered; 380 of the 907  were screened since February 2006. As of July 31, 2006, 13 screening examinations  had been completed and 11 were scheduled. CDC Has Awarded a Small Portion of the $75 Million Appropriation and Plans to Make Decisions about Treatment Coverage before Awarding Most of the Funds

CDC plans to award the $75 million appropriated for screening,  monitoring, and treatment to the five organizations that the law identified  as having priority for funding. CDC officials expect to make awards to the  WTC Health Registry, Project COPE, and the POPPA program over a   3-year period and to award funds to the FDNY WTC and worker and  volunteer WTC programs in response to their treatment costs. CDC  officials have a proposed spending plan but told us that because they are  uncertain about how quickly treatment costs could deplete the available  funds, they may need to make adjustments. As of August 2006, CDC awarded about   $4.5 million of the $75 million—about $1.9 million to the WTC Health  Registry, $1.5 million to the FDNY WTC program, and almost $1.1 million  to the worker and volunteer WTC program. In addition, CDC expects to  award $1.5 million to the POPPA program and $3 million to Project COPE  in September 2006. CDC is waiting to make further awards until agency  officials have reached certain decisions about the coverage of treatment  services, such as which prescription drugs would be covered in the FDNY  WTC and worker and volunteer WTC programs. CDC expects to begin  making further awards around February 2007. CDC has made preliminary decisions about how to allocate the $75 million  among the five organizations. As of September 1, 2006, CDC’s proposed  spending plan indicated that awards would be made in the following way:    $53.5 million for treatment and $8 million for monitoring, to be divided  between the FDNY WTC and worker and volunteer WTC programs;    $9 million for the WTC Health Registry;    $3 million for Project COPE; and    $1.5 million for the POPPA program. A CDC official told us that the agency would  award funds to the latter two programs in response to the treatment costs  they incur. Officials from the FDNY WTC and  worker and volunteer WTC programs told us that they expected that their  estimated portion of the appropriated funds would be depleted well before  the end of 3 years.
Why GAO Did This Study

Responders to the World Trade Center (WTC) attack--individuals involved in rescue, recovery, or cleanup--included New York City Fire Department (FDNY) personnel, federal government workers, and others from New York and elsewhere. They were exposed to numerous hazards, and concerns remain about the long-term effects on their physical and mental health. In February 2006, GAO testified that four of the five key federally funded programs that were monitoring health effects in responders had made progress but that the Department of Health and Human Services' (HHS) WTC Federal Responder Screening Program, implemented by the Office of Public Health Emergency Preparedness (OPHEP), lagged behind (GAO-06-481T). GAO also reported that the Congress appropriated $75 million in December 2005 to HHS's Centers for Disease Control and Prevention (CDC) for monitoring and treatment for responders and that CDC was deciding how to allocate the funds. This statement updates GAO's February 2006 testimony. GAO examined (1) progress made by HHS's WTC federal responder program and (2) actions CDC has taken to award the $75 million appropriated. GAO reviewed program documents and interviewed HHS officials and others involved in WTC monitoring and treatment programs.

What GAO Found

The WTC federal responder program has registered and screened additional federal responders since February 2006, and arrangements are being developed to screen responders who are former federal workers residing outside the New York area. An additional 1,385 federal responders have registered for screening, including 1,134 current federal workers and 251 former federal workers, bringing the total number registered as of late August 2006 to 1,762, including 283 former federal workers. Because the total number of federal responders is uncertain, the proportion of the total who have registered is unknown. As of late August 2006, Federal Occupational Health Services (FOH) had completed screening of 907 federal workers, 380 of whom were screened since February 2006. Under an OPHEP agreement with CDC's National Institute for Occupational Safety and Health (NIOSH), former federal workers are being screened through the worker and volunteer WTC program, one of the five key federally funded programs. As of July 31, 2006, the worker and volunteer WTC program provided screenings to 13 former federal workers and scheduled 11 more, and 139 former workers had been screened by FOH as part of the 907 workers. Most of the former federal workers reside outside the New York area, where the worker and volunteer WTC program is located, and NIOSH is working to establish a national network of providers to screen these workers. CDC has awarded a small portion of the $75 million appropriated for screening, monitoring, and treatment and plans to make decisions about treatment coverage before awarding most of the funds. The agency plans to award the $75 million to the five organizations that the law identified as having priority for funding. CDC officials expect to make awards to the WTC Health Registry, the Police Organization Providing Peer Assistance (the POPPA program), and the New York City Police Foundation's Project COPE over a 3-year period and to award funds to the FDNY WTC and worker and volunteer WTC programs in response to the treatment costs they incur. CDC officials have a proposed spending plan that allocates about $53.5 million for the latter two programs' treatment costs, but the officials told GAO that because they are uncertain about how quickly treatment costs could deplete the available funds, they may need to make adjustments. Officials from the FDNY WTC and worker and volunteer WTC programs told GAO that they anticipated that their estimated portion of the funds would be depleted well before the end of 3 years. As of August 2006, CDC awarded about $4.5 million of the $75 million: about $1.9 million to the WTC Health Registry, $1.5 million to the FDNY WTC program, and almost $1.1 million to the worker and volunteer WTC program. In addition, CDC expects to award $1.5 million to the POPPA program and $3 million to Project COPE in September 2006. CDC is waiting to make further awards until it has reached certain decisions about the coverage of treatment services, such as which prescription drugs would be covered. CDC expects to begin making further awards around February 2007.