At a press conference in September 2008, Mayor Bloomberg announced that all 15 recommendations had been completed or were underway.
Recommendation 1:
The Mayor should establish a World Trade Center (WTC) Medical Working Group of public health, mental health, environmental health, and medical professionals and researchers from within and outside City government. The Group should review existing and emerging scientific data on the potential health effects of WTC exposure and its applicability to different subpopulations to identify evidence of clinical risks and potential gaps in information.
Actions Taken In 2008:
The WTC Medical Working Group released its first annual report on the state of 9/11 health in September. The report included key findings about the mental and physical health conditions associated with WTC exposure and recommendations regarding funding, research and evaluation, and education.
Actions Taken In 2007:
Mayor Michael R. Bloomberg appointed the Medical Working Group. The group began reviewing scientific data on WTC health and identifying gaps in WTC knowledge and service.
Recommendation 2:
To ensure that treatment is available to whomever needs it, the City should vigorously advocate for federal resources sufficient to fully fund 9/11-related physical and mental health needs for all affected and potentially affected populations, including first responders, laborers and other contractors, residents, office workers, and students. The federal commitment should be long-term and sufficient to maintain the three existing 9/11-related centers of excellence, as well as any need-based expansion of services. In addition, the federal government should fully fund the WTC Health Registry and additional NYPD-led monitoring and research.
Actions Taken In 2009:
Mayor Michael R. Bloomberg attended a press conference where New York Senator Kirsten Gillibrand introduced the Senate version(S. 1334) of the 9/11 Health and Compensation Act.
Caswell F. Holloway, Chief of Staff to Deputy Mayor for Operations Edward Skyler and Special Advisor to Mayor Bloomberg, testified in support of a proposed New York City Council resolution that calls on Congress to pass the 9/11 Health and Compensation Act (H.R. 847) after reducing its cost to the city.
Dr. Joan Reibman, Medical Director of the WTC Environmental Health Center and Caswell F. Holloway, Chief of Staff to Deputy Mayor for Operations Edward Skyler and Special Advisor to Mayor Bloomberg, testified in support of a steady funding stream for the WTC Centers of Excellence before a subcommittee of the House Committee on Energy and Commerce.
Mayor Bloomberg released the fourth annual New York City Card, a credit-card sized guide for New York's political donor community. This year's card included long-term federal funding of a WTC treatment program for responders, workers, and community members.
Mayor Bloomberg sent a letter to President Obama recommending the reappointment of Dr. John Howard, the former director of the National Institute for Occupational Safety and Health, as federal 9/11 Health Coordinator.
Actions Taken In 2008:
Mayor Michael R. Bloomberg met with Nancy Pelosi, Speaker of the House, about the James Zadroga 9/11 Health and Compensation Act and urged Michael Leavitt, Secretary of Health and Human Services (HHS), to release federal funds for the treatment of New York City residents, area workers and students. In September, HHS awarded a $30 million grant over three years to the World Trade Center Environmental Health Center for this purpose.
Mayor Bloomberg and Caswell F. Holloway, Chief of Staff to NYC Deputy Mayor for Operations Edward Skyler and a special advisor to the Mayor, testified in support of the James Zadroga 9/11 Health and Compensation Act before the House Committee on Energy and Commerce (Health Subcommittee).
David Prezant MD, Chief Medical Officer of the New York City Fire Department and Joan Reibman MD, Medical Director of the WTC Environmental Health Center testified in support of additional federal funding for 9/11 health treatment before a subcommittee of the House Committee on Appropriations. Lorna Thorpe, PhD, MPH, the New York City Health Department's Deputy Commissioner of Epidemiology, submitted written testimony.
Mayor Michael R. Bloomberg met in Washington DC with members of the New York State Congressional delegation, other House and Senate leaders, and officials at the US Department of Health and Human Services to advocate for sustained federal funding for 9/11 health.
Mayor Michael R. Bloomberg called Senator Arlen Specter, ranking Republican on the U.S. Senate Appropriations Committee for Labor, Health and Human Services, Education and Related Agencies, to request $145 million for 9/11 health.
Linda Gibbs, Deputy Mayor for Health and Human Services, and Edward Skyler, Deputy Mayor for Administration, advocated for sustained federal funding for 9/11 health when they testified at 9/11 Health Effects: Federal Monitoring and Treatment of Residents and Responders, a hearing before the US House of Representatives Committee on Oversight and Government Reform (Subcommittee on Government Management, Organization, and Procurement).
Deputy Mayors Gibbs and Skyler met with members of the New York State Congressional delegation, other House and Senate leaders, and members of President Bush's administration to advocate for sustained federal funding for 9/11 health.
Recommendation 3:
Congress should reopen the Victim Compensation Fund (VCF), authorized by Congress in 2001, so that victims can quickly get fair compensation without the need to prove liability. At the same time the fund is re-opened, Congress should eliminate the liability of the City and its contractors for claims arising out of the clean-up at the World Trade Center. Since the WTC Captive Insurance Company ("CIC") would no longer be needed, Congress could also liquidate the CIC and use its $1 billion to help fund the reopened VCF.
Actions Taken In 2009:
New York City Corporation Counsel Michael Cardozo testified at a Congressional hearing in support of the 9/11 Health and Compensation Act (H.R 847). The bill would re-open the September 11th Victim Compensation Fund and also provide long-term federal funding for the monitoring and treatment of those exposed to the WTC disaster.
Actions Taken In 2008:
New York City Corporation Counsel Michael Cardozo, Kenneth Feinberg, former Special Master of the September 11th Victim Compensation Fund and other witnesses testified at a congressional hearing in support of re-opening the federal September 11th Victim Compensation Fund.
Linda Gibbs, Deputy Mayor for Health and Human Services, and Edward Skyler, Deputy Mayor for Administration, advocated for reopening the VCF when they testified at 9/11 Health Effects: Federal Monitoring and Treatment of Residents and Responders, a hearing before the US House of Representatives Committee on Oversight and Government Reform (Subcommittee on Government Management, Organization, and Procurement).
Recommendation 4:
The Mayor should direct the Commissioner of the Department of Health and Mental Hygiene (DOHMH) to appoint a WTC Health Coordinator to foster and coordinate communication and outreach to all those affected or potentially affected by 9/11-related health issues. The coordinator should oversee an Internet site targeted at populations with WTC-related or potentially related health issues and should work with the Mayor's Medical Working Group to ensure that relevant information is conveyed to affected populations. In addition, the coordinator should meet regularly with community groups, residents, local businesses and other interested parties to solicit feedback and suggestions regarding 9/11 health issues.
Actions Taken In 2007:
DOHMH hired Jeffrey Hon as World Trade Center Health Coordinator on June 4, 2007. Among his responsibilities, Mr. Hon has overseen the development of an Internet site (see below), visited all three Centers of Excellence, and has begun soliciting feedback about 9/11 health issues from a wide range of constituencies and enhancing communication between service providers, researchers and affected populations.
Recommendation 5:
The City should establish an Internet site that will be a comprehensive “one-stop” resource for information about 9/11-related physical and mental health issues.
Actions Taken In 2008:
As of September 2008, there were more than 300,000 visits to the city's 9/11 health web site. The site is updated every week. The top five pages visited in 2008 were the WTC Health Registry, the NYC 9/11 Benefit Program, City Employees, Rescue and Recovery Workers and Monitoring and Treatment.
Actions Taken In 2007:
The City launched nyc.gov/9-11HealthInfo. Additional functionality will be added during a second phase of development.
Recommendation 6:
To ensure a consistent standard of care for WTC-related illness, the City should extend the distribution of its WTC clinical guidelines to all health care providers and health plans, who should distribute them to all doctors in their respective networks.
Actions Taken In 2009:
In July 2009, the Health Department released the first clinical guidelines for health care providers on how to treat children exposed to the World Trade Center disaster. To ensure a consistent standard of care for WTC-related health conditions, the guidelines were mailed to more than 33,000 medical professionals citywide. They were also emailed to more than 21,000 City Health Information subscribers.
In June 2009, the Health Department sent the World Trade Center Health Bulletin to more than 65,000 Health Bulletin subscribers. Entitled "Is 9/11 affecting your health?, the bulletin is available in English, Spanish and Chinese through 311. It is also available at city hospitals and through Spanish and Chinese community-based organizations.
Actions Taken In 2008:
In June 2008, the Health Department released updated clinical guidelines for health care providers on how to treat adults exposed to the World Trade Center disaster. To ensure a consistent standard of care for WTC-related health conditions, the guidelines were distributed to more than 40,000 physicians citywide and over 200 college health clinics in the Northeast.
Actions Taken In 2007:
Upon publication in 2006, the New York City Department of Health and Mental Hygiene (DOHMH) distributed Clinical Guidelines for Adults Exposed to the World Trade Center Disaster to 26,000 physicians in New York State. Since the Panel report was issued, DOHMH has met with the New York Health Plan Association to discuss wider distribution of the guidelines.
In 2007, DOHMH staff have reconvened clinical experts to update and revise the Clinical Guidelines for adults and assembled an additional team of experts to develop Pediatric Clinical Guidelines.
DOHMH staff has developed a plan that will ensure a wide and efficient distribution of the guidelines after they have been revised to reflect the latest scientific research.
Recommendation 7:
The WTC Environmental Health Center at Bellevue should be expanded and actively promoted to all those who are potentially eligible, including residents, commercial workers, and laborers with a reasonable history of dust exposure and symptoms that may be 9/11-related. Bellevue is currently the only evaluation and treatment program available to all affected and potentially affected individuals, and the City should ensure that the program is federally funded over the long term and that evaluation and treatment continue to be provided in a culturally and linguistically sensitive manner.
Actions Taken In 2009:
The WTC Environmental Health Center re-launched its advertising campaign focusing primarily on New York City subways, which produced the greatest number of referrals in 2008. Recognizing that continued advertising was likely to reach people eligible for services at the Mount Sinai Consortium, 311 incorporated information about this program into its referral system. This made it possible for 311 to transfer hundreds of callers directly to the WTC EHC or the toll-free number operated by the Consortium for the first time.
Actions Taken In 2008:
The WTC Environmental Health Center launched major outreach and advertising campaigns to promote its services, including $2.1 million in grants to Beyond Ground Zero (BGZ) Network, Henry Street Settlement, Lin Sing Association, United Jewish Council, Ecuadorian International Center, Inc., Communications Workers of America, DC 37 Safety & Health, NY Committee for Occupational Safety & Health (NYCOSH) and the Organization of Staff Analysts. The community and labor organizations used the funding to raise awareness of the Health Center. As part of the campaign, the Health Center also produced multilingual videos about its services.
Actions Taken In 2007:
With increased City funding, the New York City Health and Hospitals Corporation (HHC), which oversees the City's public health care system, including the WTC Environmental Health Center at Bellevue, expanded the WTC Environmental Health Center to two additional locations: Gouverneur Healthcare Services in lower Manhattan and Elmhurst Hospital in Queens. Both centers have begun evaluating patients for WTC-related illnesses.
The WTC Environmental Health Center has hired staff that speak Spanish, Russian, Polish and Mandarin.
HHC awarded grants to community organizations that have worked with WTC patient populations at Bellevue, Gouverneur and Elmhurst to promote WTC-related health services before and after the 6th anniversary of the September 11, 2001.
HHC is planning a broad outreach and advertising campaign, which will be launched early next year, to promote the expanded WTC Environmental Health Center.
Recommendation 8:
The Department of Health and Mental Hygiene (DOHMH) should replace and expand the American Red Cross mental health benefit--which will no longer be available after 2007--with a program that provides community-based treatment options for individuals who are or suspect they may be experiencing 9/11-related mental health conditions. DOHMH should expand its current mental health public outreach campaign to include promotion of this new program.
Actions Taken in 2009:
As a result of an unanticipated demand (an average of 200 New Yorkers enroll in the NYC 9/11 Benefit Program each month) the Health Department is currently seeking federal funding to assist in covering the costs of providing services.
Actions Taken In 2008:
As of September, the Health Department was covering out-of-pocket costs for 9/11-related mental health and substance use services for more than 1,000 New Yorkers.
The Health Department launched the NYC 9/11 Benefit Program for Mental Health and Substance Use Services for NYC residents affected by 9/11 or those with 9/11-related psychological symptoms. The program helps cover out-of-pocket costs for 9/11-related mental health and substance use services. To help provide coverage continuity for people enrolled in the private 9/11 Mental Health and Substance Abuse Program, it is retroactive to January 2, 2007.
Actions Taken In 2007:
DOHMH has developed specifications for a program to replace and expand the expiring 9/11 Mental Health and Substance Abuse Benefit Program for residents of New York City. The new program will be called the New York City 9/11 Benefit Program for Mental Health and Substance Use. DOHMH has begun the vendor selection process for the program and expects to launch it early next year.
Recommendation 9:
The Office of Emergency Management (OEM), in collaboration with other relevant agencies, should expand outreach to affected communities about construction and deconstruction activities that could pose environmental hazards, and should ensure that policies associated with these activities are coordinated across City agencies.
Actions Taken In 2007:
Outreach has focused on three major decontamination/deconstruction sites (130 Liberty, Fiterman Hall, 130 Cedar) in the vicinity of Ground Zero that are of particular concern to the community. These are the only remaining buildings that were breached on 9/11 and have not been reoccupied. Each project, in coordination with the Lower Manhattan Construction Command Center (LMCCC) and OEM, convenes several regularly scheduled meetings at which the project sponsors, contractors and consultants share information with the public and respond to the public's concerns.
LMCCC added a Lower Manhattan Health and Environmental Impacts page to its website to serve as a resource for information about potential health and environmental impacts from construction and deconstruction in Lower Manhattan. Users can get up-to-date information about the three projects of particular concern, including regulatory documents and other key filings; air quality monitoring efforts; and the broader revitalization of Lower Manhattan.
The City's 311 system is providing information about construction in lower Manhattan to people without internet access.
Recommendation 10:
OEM should convene all relevant City agencies to review and enhance, as necessary, the environmental and health and safety aspects of the City's disaster response plans to ensure the health of residents, responders, and others in the case of future emergencies or disasters.
Actions Taken In 2008:
The City is developing a response capacity within DOHMH and enhancing the response capacity of the Department of Environmental Protection (DEP) to ensure that environmental dangers-such as asbestos and other hazards-are quickly and comprehensively addressed during any emergency. In addition, DOHMH and DEP are currently working with OEM to strengthen the City's response protocols to environmental hazards, including the use of the proper protective equipment, if necessary, by first responders and other workers at the scene of the emergency and the implementation of any necessary protective actions for community residents.
Actions Taken In 2007:
OEM, DOHMH, DEP, the Citywide Office of Occupational Safety (COSH) and other agencies are in the process of reviewing the Citywide Incident Management System; drafting a citywide environmental health and safety response protocol; and discussing options for increasing the DOHMH response during major emergencies of all kinds.
DOHMH is interviewing candidates for staff to lead the environmental health aspects of the agency's disaster response planning effort.
Recommendation 11:
The Mayor should direct all relevant agencies to appoint a WTC Health Liaison to track relevant agency-specific information about WTC-related health issues and distribute WTC-related information to agency employees and retirees who participated in WTC operations.
The Liaisons distributed more than 150,000 postcards about the 9/11 Health web site to City employees.
Actions Taken In 2007:
At the direction of Mayor Michael R. Bloomberg, City agencies with significant numbers of employees and retirees who participated in the WTC operations have appointed WTC Health Liaisons. The WTC Health Liaisons met for the first time on September 4, 2007 to discuss their responsibilities and how to implement them within their respective agencies.
Recommendation 12:
The City should undertake a renewed effort to identify City employees and former employees who participated in World Trade Center rescue, recovery and clean-up operations for the purpose of targeting information about and services for 9/11-related health effects to this important group.
Actions Taken In 2008:
The Health Department launched the NYC Employees 9/11 Health Communication Service for city employees. The service includes Taking Care of Our Own, a bi-monthly e-newsletter on the latest 9/11 health news, as well as updates on important 9/11-related developments and program deadlines.
Actions Taken In 2007:
Identifying city employees who participated in WTC rescue, recovery and clean-up operations will be a primary responsibility of the WTC Health Liaisons working with the WTC Health Coordinator and City Hall.
Recommendation 13:
City employees who are eligible for the Mt. Sinai program but are not currently participating should be given the opportunity to do an initial screening on City time. All City employees who participated in WTC operations should be informed about the Bellevue program and should be given the opportunity to have an initial evaluation on City time.
Actions Taken In 2007:
On July 30, 2007, Mayor Michael R. Bloomberg instructed the heads of city agencies to implement procedures that would assist city employees in assessing if they currently have health problems that may be 9/11-related. Specifically, agency heads were instructed to give city employees an excused absence up to four hours with pay for an initial screening or treatment evaluation at the World Trade Center Medical Monitoring and Treatment Program or the Bellevue World Trade Center Environmental Health Center.
Recommendation 14:
City agency WTC Health Liaisons, in coordination with the Citywide WTC Health Coordinator, should encourage enrollment in programs, including those offered outside the auspices of a City agency, that offer treatment for mental health conditions associated with 9/11.
Actions Taken In 2009:
New Yorkers affected by 9/11 can now call 311 or visit 311 Online for information about 9/11-related resources and services. The 311 call center is able to directly connect callers seeking 9/11-related care to the WTC Centers of Excellence at Mount Sinai and the WTC Environmental Health Center.
Actions Taken In 2008:
The Program Director for the NYC 9/11 Benefit Program for Mental Health and Substance Use Services went over the program and its benefits with the WTC Health Liaisons. The WTC Health Coordinator's Office also gave the WTC Health Liaisons materials about the NYC 9/11 Benefit Program and the WTC Centers of Excellence to help increase awareness of treatment options. In addition, the city's 9/11 health web site contains detailed information about programs that offer treatment for 9/11-related mental health conditions. These services are also listed in the 9/11 Resource Guide, which is available to city employees through the WTC Health Liaisons.
Recommendation 15:
The City of New York should actively encourage eligible employees and retirees who participated in the WTC operations to register with the New York State Workers' Compensation Board by August 14, 2007.
Actions Taken In 2008:
New York State extended the deadline to register for WTC-related Workers' Compensation and disability benefits to September 11, 2010.
The WTC Health Liaisons put up posters in city agencies encouraging eligible employees who participated in the WTC rescue and recovery to register their service with the New York State Workers' Compensation Board. The posters were part of the Compensation Board's "Tell Us You Were There" outreach campaign
The 9/11 Health web site, NYC 9/11 Health Update, the Health Department's e-newsletter for the latest 9/11 health news and the NYC Employees 9/11 Health Communication Service provide details about the deadlines and eligibility requirements to file for WTC-related Workers' Compensation and disability benefits.
Actions Taken In 2007:
New York State extended the deadline to register for 9/11 related Workers' Compensation to August 14, 2008. Prior to the extension, New York City reminded all employees about the 2007 deadline on their pay stubs.
On a related matter, New York State extended the deadline for New York City employees to file a WTC-related Notice of Participation with their respective retirement systems to June 14, 2009 (the original deadline was June 14, 2007). Filing a Notice of Participation enables eligible employees to apply for disability retirement benefits under the WTC Disability Law in the future even if they aren't sick now. Prior to the extension, New York City sent an e-mail to all employees reminding them of the 2007 deadline.
