Statement On the Apparent Rehiring of the 16 WTCHP Staff That Were Terminated on Friday Night. But What About Dr. Howard?

According to press reports, late yesterday, the 16 WTCHP staff that were terminated last week received written notification that their terminations were rescinded.

This is good news—we’re glad it’s happening—but there are still major questions about the status of the program and its future operations and its ability to provide care to 9/11 responders and survivors.

What about Dr. John Howard, Administrator of the WTC Health Program? Is he back? For how long?

And what about the NIOSH and CDC staff who supported the WTCHP program and have been fired? Are they to be brought back as well?

Let’s recap the last few months: 

1. In December, the House and Senate, who had agreed to include funding to close a looming budget gap for the World Trade Center Health Program in the Continuing Resolution, withdrew that funding at the request of the incoming Administration. 
2. On Friday, February 14, the day after Robert F. Kennedy, Jr. was confirmed as HHS Secretary, he fired all probationary employees at his agency, among them 20% of the World Trade Center Health Program staff. There was an uproar, and in response Secretary Kennedy said that it was a mistake and restored the WTCHP staff.
3. On April 1, HHS announced immediate layoffs of thousands of employees, including those at the Centers for Disease Control (CDC) and the National Institute of Occupational Safety and Health (NIOSH), including Dr. John Howard, Director of NIOSH who is also, by law, Administrator of the World Trade Center Health Program (and an appointee of the first Trump Administration). Sixteen WTCHP staff were given notice of intent to be fired. (“Reduction in Force” – RIFed.) There was another uproar, and Members of Congress announced on April 5 that Dr. Howard had been reinstated.
4. On April 28, when three 9/11 FDNY staff (and World Trade Center Health Program participants) were denied cancer care by the program, it was disclosed that Dr. Howard had not been fully brought back, but had been in limbo since April 5. That lack of confirmed status put the program into disarray, preventing as many as 1,200 members presenting with new conditions from being officially approved for treatment, and perhaps up to 800 responders and survivors who met program criteria were delayed care and not enrolled in the program.
5. After the actions of April 28, another uproar occurred, and on May 1 it appeared that Dr. Howard was brought back officially, and he was again able to approve treatment for conditions and enroll new members—but apparently his return was only guaranteed through June 2.
6. On the evening of Friday, May 2 (after they had left work), the same 16 WTCHP staff who had been given notice of intent to be RIFed on April 1 were notified they were terminated effective immediately.
7. It appears from press reports that these 16 WTCHP staffers (now 15, as one retired) were being “permanently restored”.

Throughout this timeline, the HHS communications office repeatedly refused to respond to questions about Dr. Howard’s status and repeatedly asserted that the HHS reorganization was not impacting the care of WTCHP responders or survivors. Secretary Kennedy, on Fox News the evening of May 5, asserted that there were no problems with the program.

We know that was not true.

We know that the program had briefly stopped providing cancer care to those coming forward with new cases to be treated.

We know that in April, perhaps 800 responders and survivors who met the program criteria to be enrolled in the program, were not enrolled, delaying their care.

We know that in April, 1,200 members presenting with new conditions did not receive their official written approval that they have a covered 9/11 condition.

While we understand new cases of cancer are getting treated, that all of those who should have been enrolled are now enrolled, and those that have been approved for care are getting written confirmation, we still don’t know why exactly this happened and what is being done to prevent it from happening again.

We know that without sufficient staff in the program, the program will have:

• Reduced capacity to process enrollments;
• Reduced capacity to process certifications;
• Loss of the ability to conduct a scientific review of requests (“petitions”) to add new patient conditions to those covered;
• Loss of medical expertise to supervise clinic care;
• Reduced staff capacity to review and approve requests for covering new types of diagnostic tests and disease treatments, which would produce needless delays in providing life-saving services;
• Complete loss of ability to monitor and renew current and future research grants;
• Reduced ability to formulate new policies to improve efficiency and effectiveness of WTCHP operations, or to track and monitor the health care that members receive to ensure that it is of high quality;
• Loss of the ability to disseminate important 9/11-related research findings through scientific webinars and workshops;  
• Reduced ability to provide benefits advice and guidance to members—especially to respond to problems with care delivery;
• Reduced ability to supervise contractors and provide oversight—increasing the risk of waste, fraud, and abuse.

Citizens for the Extension want to thank the elected officials who repeatedly worked to reverse these decisions over the last few months: Senators Gillibrand and Schumer, Representatives Lawler and LaLota, and particularly Representative Garbarino, who worked tirelessly to protect the World Trade Center Health Program so that it could continue in its mission to provide care of the over 137,000 9/11 responders and survivors, in every state and in 434 Congressional districts.

Again, the restoration of these 16 WTCHP staff is good news, but in the face of this yo-yo of administration actions, firing, rehiring, and firing, and the lack of any information on Dr Howard’s status we have a few questions for Secretary Kennedy:

1. What is Dr Howard’s status? Is he fully restored, and for how long? Will he continue as WTCHP Administrator through the Trump Administration?
2. If he is back, will Dr. Howard be empowered to bring the WTCHP staff head count up to the statutory OMB authorized level of 138 staff, including physicians, nurses, researchers, administrators to do the work that had previously been conducted for WTCHP from within the now-decimated National Institute of Occupational Safety and Health (NIOSH) and the Centers for Disease Control (CDC)?
3. Will the Secretary and the Trump Administration go on record supporting S. 739 (Gillibrand) and H.R. 1410 (Garbarino), which addresses the program’s long term budget issues that—if not resolved—will lead to program cuts in Fiscal year 2027, essentially the same provision that was in last December’s Continuing Resolution before it was pulled?

The Secretary needs to answer these questions, and thankfully there is an opportunity for this at next week’s hearing before the Senate Health, Education, Labor and Pensions (HELP) Committee when he appears on Wednesday, May 14.

We’d like it under oath. 

Those who responded to, and survived near, the attacks on 9/11 just can’t—and don’t deserve to—settle for anything less. They must be allowed to focus on their health, and not on cable TV news appearances, Friday night firings, or delays in care. 

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