Dr. John Howard was NOT Reinstated as Administrator of the World Trade Center Health Program
Citizens for the Extension of the James Zadroga Act released the following statement:
Dr. John Howard was NOT Reinstated as Administrator of the World Trade Center Health Program
The World Trade Center Health Program has stopped providing treatment to new cases of cancer and has stopped enrolling new responders and survivors.
It appears that Dr. John Howard, Director of the National Institute of Occupational Safety and Health (NIOSH) and the Administrator of the World Trade Center Health Program (WTCHP) was not properly reinstated as Administrator of the World Trade Center Health Program, as the Health and Human Services Department told the NY Republican Members of Congress which they announced on April 5.
While Rep. Garbarino (R-NY) and colleagues were told by HHS that Howard was being restored—and they announced that in good faith—the truth is he was not restored as Director of the WTCHP and has apparently been in limbo since then.
An internal email from the program on April 11, 2025, clearly documents that Dr. Howard’s status is in question and that is preventing the program from functioning.
Also, the HHS press office has been unresponsive to reporter inquiries seeking confirmation that Dr. Howard was in fact restored.
Just today, in a story “World Trade Center Health Program: Do Trump cuts imperil sickened responders? What we know” by Nancy Cutler of the Rockland Westchester Journal News:
HHS in its statement also did not respond to a specific request about the employment status of NIOSH Director and 9/11 health program administrator Dr. John Howard. The news of his apparent dismissal in early April drew sharp criticism; while it’s been reported that he has returned, there was no verification that he is back.
While New York-area World Trade Center Health Program Clinics report that the World Trade Center Health Program has stopped approving treatment of new cases of cancer and has stopped enrolling new responders and survivors, HHS press staff are saying everything is fine.
The World Trade Center (WTC) Health Program’s Clinical Centers of Excellence and Nationwide Provider Network are continuing to provide services to program members at this time. The program continues to accept and review new enrollment applications and certification requests.
(“We’re all ticking time bombs’: Budget cuts gut 9/11 health protections as community braces for crisis Staffing cuts may prevent a 9/11 health care program from providing timely care.” Liz Neporent, ABC News, April 30, 2025.)
Here is what we know:
Certifying WTC conditions for treatment—including cancers—has stopped.
According to Dr. David Prezant, Chief Medical Officer, Director, FDNY World Trade Center Health Program, as of April 29th, 2025:
TODAY EVERYTHING CHANGED. First, the NIOSH SFTP site no longer showed approvals. Then when we called to find out the approval status we were told that no new certifications can occur. When we asked it that also applied to expedited approval for life-threatening acute conditions, we were told they too could not be approved. Not even as “initial approvals” The staff person at NIOSH informed us that they can no longer approve any new certification requests even if they are expedited urgent requests for certification.
THIS MEANS THAT THREE PATIENTS TODAY COULD NOT BE CERTIFIED. One of these patients has life-threatening pancreatic cancer and we cannot authorize treatment because he is enrolled in the WTC Health Program but that program is refusing to certify him.
We know that every month on average the program certifies for treatment of over 1,200 conditions, including cancer. The program has ceased certifying conditions for treatment because it lacks the authority to issue a certification without Dr. Howard being confirmed as head of the program. (see internal email) Under the statute, before a WTCHP-affiliated clinic or the National Program can treat a responder or survivor for a cancer or any covered condition, the clinic doctor must request a “certification” from WTCHP in Washington that must be approved by the program. The program cannot provide that certification without an Administrator in place. While treatment can proceed “pending certification”, that can only happen for a short period of time and that apparently has gone on too long resulting in the determination that the program will no longer approve treatment for new conditions.
Enrollment in the program for responders and survivors has stopped. This means 9/11 responders and survivors seeking medical treatment are being denied. Every month the WTCHP enrolls 700 to 800 new responders and survivors needing care and since April 1, it is our understanding that no 9/11 responder or survivor has been enrolled in the program.
The WTCHP has officially informed the WTC Clinical Centers of Excellence that they could not enroll new members as there is no one to sign off on these applications. As of today, April 30, this is still the case and will be until Dr Howard is restored fully as the program administrator and the staff that have been fired that support enrollments are rehired. (Enrollment #’s from WTCHP)
Compensation for injuries will be delayed. When a member’s condition is “certified” by the WTCHP, that allows the responder or survivor to file a claim with the September 11th Victim Compensation Fund (VCF). Without letters of certification the compensation process cannot proceed.
Intensive Treatments cannot be approved. High-cost treatments need special approval before they can be provided to program members. Without Dr Howard restored, lifesaving, time sensitive treatments such as lung transplants, stem cell transplants, and chemotherapy cannot be provided by the program. For these treatments, time delays result in death. It is only a matter of time until a high-cost treatment needs to be approved or a responder who needs a transplant, and unless Dr. Howard is restored there is no way for the program to procced with providing the care. Also, the CDC and NIOSH staff that process these approvals need to be reinstated.
Program Bill payments are being delayed. Bills from the clinics for services provided are being delayed in payment since much of the staff that process these have been terminated.
WTCHP Staff have been fired. While the administration has stated that none of the remaining 86 staff members of the WTCHP were fired, that is not accurate. In fact 16 WTCHP staffers, 13 in Cincinnati (OH) and three in Morgantown (WV) have received RIF notices. As of today, the WTCHP staff are still being terminated.
NIOSH and CDC staff that support the WTCHP have been fired. The WTCHP had been supported by dozens of NIOSH and CDC staff who have been fired. WTCHP cannot operate without them. They include doctors who are required by statue to approve certification for treatment, staff that approve enrollment of new responders and survivors, staff that supervise research grants and contracts, staff that process bills from clinics, epidemiologists who review petitions for covering new conditions.
Contract Oversight Staff Fired. Apparently, the CDC Contracting Office and the Extramural Grants Office that supported WTCHP have all been fired as well. Since the WTCHP utilized CDC staff to administer all contracts and grants, the firings will impact the ability of the WTCHP health providers and researchers to deliver services to 9/11 responders and survivors. In addition, there is now no direct oversight of program contractors, hardly a good way to fight waste fraud and abuse or if you actually care about running an effective program.
Petitions for the addition of new WTC health conditions will not be considered. Under the Zadroga statute, a “petitioning” process is used to add additional conditions to those covered by the WTCHP. Petitions were reviewed by NIOSH staff epidemiologists—who have been fired—and there are several pending petitions covering additional conditions including autoimmune and cardiac conditions. The WTCHP had said last December that these petitions would be decided in March, 2025—and that did not happen.
Research Grants cannot be administered. The WTCHP used NIOSH staff to handle the administration of some $20 million in research grants, such as the work being done on the possible connection of 9/11 to cognitive decline, autoimmune cardiac conditions and other conditions have has been fired. Normally those grants start their RFP process in March, and that is not happening.
Communications Pause. The continuing pause in all public communications by HHS has impacted many of the normal functions of the program and will delay research on 9/11 conditions and improvements in the program’s contracts to better serve the program members.
The bottom line is that it is crystal clear that the new HHS leadership, and the DOGE’s AI bots that made these cuts, do not understand how the WTCHP was integrated into NIOSH and CDC. If the World Trade Center Health Program is to function, Dr. Howard needs to be fully restored to his position, the WTCHP staff needs to be brought to full strength, permanently reinstating medical, epidemiologists, contract and grant staff. This needs to be done immediately.
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