OMB Proposal Threatens Health of Injured and Ill 9/11 Responders and Survivors

Jon Stewart leads a press conference in Washington urging OMB Director Mick Mulvaney leave the World Trade Center Health Program alone
Jon Stewart leads a press conference in Washington urging OMB Director Mick Mulvaney leave the World Trade Center Health Program alone, in front of the Capitol with Representatives Carolyn Maloney, Jerold Nadler and Peter King along with 9/11 advocate John Feal, Citizens for the Extension of the James Zadroga Act Board Member Peg Seminario of the AFL-CIO.

This is an archived page. Click here for an update on the current status of this proposal.

The President’s Proposed Budget for Fiscal Year 2019 contains an existential threat to the carefully established and designed management and administration of the World Trade Center Health Program and could result in adversely impacting the health and wellbeing of thousands of injured and ill 9/11 responders and survivors.

OMB Director Mick Mulvaney is proposing to tear the World Trade Center Health Program (WTCHP) from the National Institute of Occupational Safety and Health (NIOSH) moving NIOSH to the National Institute of Health and leaving the WTCHP as a free-standing entity within the Centers for Disease Control (CDC).

This would disrupt the management of the World Trade Center Health Program that has been running the Health Program that is providing medical treatment and monitoring to injured and ill 9/11 responders from the World Trade Center and lower Manhattan, the Pentagon and the Shanksville Crash site and medical treatment for survivors who were exposed to the toxins at Ground Zero.

The proposal was presented with no information on how this will be done or any discussion or acknowledgment of the impact it will have on the 83,000 9/11 responder sand survivors who are in the program and are in every State and in 433 out of 435 Congressional Districts. All there is one line from the bottom of the page 44 of the budget document titled 2019 Major Savings and Reforms “The World Trade Center Health Program, currently administered by NIOSH, would continue to be administered by the CDC.” That’s it. There is no other explanation. You can see the sentence here.

This proposal directly contradicts the legislation Congress passed just three years ago to renew the NIOSH program for 75 years and will unnecessarily put at risk the health of those who have been made ill by the toxins at Ground Zero and are still suffering and in too many cases still dying from their injuries now 17 years later.

NIOSH is dedicated to occupational health, as its name indicates — the exact specialized medical expertise that then Health and Human Services Secretary Tommy Thompson knew was needed for this health crisis when he originally selected Dr. Howard, a Bush Administration appointee, to lead the administration’s response to the health impact of the toxins at Ground Zero.


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Because of its knowledge and expertise, NIOSH has been at the forefront of responding to the injuries caused by the toxins at Ground Zero, first through the original monitoring and treatment program and then with the first statutory program created by the original James Zadroga 9/11 Health and Compensation Act of 2010 that we also led the fight for.

Much of the staff of top staff of NIOSH are shared employees between the two programs, NIOSH and the World Trade Center Health Program, drawing on their expertise. There is no explanation as to how this will be unraveled, or how the WTC Health Program would retain their expertise.

The reauthorization statute had specific language and procedures that were carefully developed and negotiated that tie these two programs together. There is no explanation of how the World Trade Center Health Program will operate and function if it is separated from NIOSH, nor do they address how they propose to change its operations without adversely impacting the health delivery to 911 responders and survivors.

This will have a direct impact on the care injured 911 responders and survivors will receive for example:

  • NIOSH has made tremendous progress improving service delivery to those both in the New York region, as well as the National Program outside the New York area, this will disrupt that.
  • The WTC Health Program is a complex medical treatment and monitoring program that NIOSH has built over the years, this would separate the program from the career public servants and expertise that resides within NIOSH.
  • Health care is complicated, if you removed the established leadership of a Hospital you will end up impacting patient care.
  • For example, the contract for mail order prescriptions was recently awarded to a new vendor. NIOSH staff are working to ensure that no patients will be at risk of missing their prescriptions, this is particularly important for those receiving cancer medications.
  • While this would be clearly disruptive to the administration of the program, we also fear the emotional toll that even this suggestion will have on the injured 9/11 community. This is a community that had to work for years to get this program fully implemented. Many who are facing cancer and other disabling injuries will now have the added burden of fear and uncertainty that this proposal will impact their care after having to fight for years for Washington to respond.

The President’s proposed budget for Fiscal Year 2019, that starts this October 1st, also proposes cuts to NIOSH non-WTC programs from 335 million dollars to 200 million dollars.

The bipartisan original sponsors of the James Zadroga, 9/11 Health and Compensation Reauthorization, Representatives, Carolyn Maloney, Jerrold Nader, and Peter King who fought for years to get the legislation passed, have written to OMB Director Mick Mulvaney who proposed this change to demand that he withdraw this proposal immediately. You can see their letter here. And you can see the Letter to OMB Director Mick Mulvaney from Senators Gillibrand, Schumer, Menendez, Booker and Blumenthal here.

Last Modified: July 3, 2018