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A Message from the Administrator

Members,

It is hard to believe 20 years have passed since the fateful day of September 11th, 2001. As the nation commemorates this somber occasion, I am reminded of the courage, sacrifice, and resilience demonstrated by the responders and survivors that I and the rest of the World Trade Center (WTC) Health Program have been honored to serve.

I am also reminded of the unique challenges of this past year and a half. We worked hard to adapt the Program to maintain our high standards of care and service during the COVID-19 pandemic for our over 110,000 members. It remains our top priority to serve you and provide expert healthcare for your WTC-related health conditions.

We also understand that this time may be emotionally difficult for you. In this newsletter, the WTC Health Program Mental Health Forum—a group of mental health experts from across the Program— offers important information on commemoration, reflection, and healing. You will also find important Program updates, health tips, and more. I hope you find this information helpful, and that the resilience of the 9/11 community continues to shine bright.

Sincerely,

John Howard, M.D.
Administrator, WTC Health Program

Program At-A-Glance*


Enrollment by member type (total=112,042)
63,392 General Responders (57%)
30,582 WTC Survivors (27%)
17,031 FDNY Responders (15%)
1,037 Pentagon/Shanksville Responders (1%)
New members since June 2020: 6,789
Members with at least one certified condition: 65,037
Top 5 certified conditions:
Number 1 is chronic rhinosinusitis
Number 2 is gastroesophegeal reflux disease
Number 3 is cancers
Number 4 is sleep apnea
Number 5 is asthma

Top 5 certified cancers: 1 Skin (non-melanoma) 2 Prostate 3 Breast 4 Skin (melanoma) 5 Lymphoma

See more program data at: www.cdc.gov.ataglance.html

Program At-A-Glance

*Data is current as of June 30, 2021


Program News

COVID-19 Updates

Information on WTC Health Program COVID-19 policies related to COVID-19 vaccines, treatment, resources, and more is available at www.cdc.gov/wtc/covid19.html

30-Day Fill Limit at Retail Pharmacies Reinstated

Effective August 1, 2021, the WTC Health Program reinstated the 30-day fill limit at retail or community pharmacies. This limit was suspended in early 2020 in response to the COVID-19 pandemic to allow members to make fewer trips to an in-person pharmacy. For prescription fills over 30 days and up to 90 days, you must use OptumRx Home Delivery. Learn more at www.cdc.gov/wtc/pharmacy.html

Lung Cancer and Colon Cancer Screening Guidelines: Expanded Coverage

The WTC Health Program follows the cancer screening guidelines set by the U.S. Preventive Services Task Force (USPSTF). This past year, the USPSTF revised the screening guidelines for both lung cancer and colon cancer.

Lung cancer screening is now recommended for those age 50 to 80 with a history of smoking 1 pack a day for 20 years, or 2 packs a day for 10 years. Colon cancer screening is now recommended to start at age 45 until age 75.

More Program information on cancer screening is available in the Member Handbook at www.cdc.gov/wtc/Handbook.html#cancerservices and on the Cancer Screening Fact Sheets at www.cdc.gov/wtc/cancerfactsheets.html

Coming Soon: Health Effects after 9/11—A New CDC Museum Exhibition

In honor of the precious lives lost and those still struggling with 9/11-related health effects, the WTC Health Program is proud to announce that a museum exhibition will launch online this fall. This exhibition will feature information on 9/11 exposures and the emergence of WTC-related health conditions, the events and advocacy that established the Program, and research achievements that have led to improvement in medical treatment and knowledge.

The exhibition is expected to open in-person at the Centers for Disease Control and Prevention Roybal Campus in Atlanta, GA at a future date.

For updates on the exhibition, visit www.cdc.gov/wtc/exhibition/

New Program Research Page Launched

Looking for the latest on WTC Health Program Research? Visit www.cdc.gov/wtc/research.html to learn how research helps inform the Program’s care, see the most recent 9/11 health research publications, and access the Program’s Research Gateway.

Sleep Tips and Sleep Apnea

A woman gets a good night's rest in a dimly lit room. Photo credit: iStock/RyanKing999
Having sleep problems?

It’s not news that untreated sleep problems can harm your health. If you aren’t getting restorative sleep each night, it could make a health condition worse or complicate treatment.

What you can do to improve sleep quality

    • Get exercise early in your day.
    • Make a consistent sleep schedule and allow for at least 6–8 hours of sleep
    • Make a designated space for sleep with a soothing atmosphere.
    • Avoid caffeine, alcohol, and large meals prior to bedtime.
    • Remove electronic screens from the bedroom.

    Many factors can cause sleep problems like medications, other health conditions, or stress. If sleep problems begin to disrupt your normal daily life or work, it’s important to speak to a doctor.

    If you allow 6–8 hours of sleep in bed each night but still experience any of the following symptoms, notify your primary care physician.

    • You often feel tired, fatigued, and irritable or emotional.
    • You take frequent naps in the day or fall asleep when you don’t mean to.
    • You wake up multiple times in the night and have trouble going back to sleep.
    • You take more than 30 minutes to fall asleep at bedtime.
    • You snore or experience pauses or interruptions in breathing when sleeping.
    • You have tingling or jerking in your legs or arms when you try to sleep.
    • You have difficulty paying attention or remembering things.


    One specific cause of poor sleep quality is sleep apnea. The WTC Health Program may cover your sleep apnea if your condition meets Program criteria for coverage.

    What is sleep apnea?

    A person with sleep apnea experiences short pauses in breathing while asleep. Untreated sleep apnea can lead to other serious health problems like high blood pressure, weight gain, memory loss, or stroke.

    If you often experience overwhelming daytime sleepiness or are told you snore loudly, talk to a Program doctor about whether a sleep apnea evaluation is appropriate.

    Monitoring Exams

    Don’t Skip Your Monitoring Exam!


    A stethoscope rests on a calendar. Photo credit: Getty/Kwangmooza
    Don’t Skip Your Monitoring Exam!

    Have you been putting off your annual monitoring exam* because of the COVID-19 pandemic? The WTC Health Program encourages you to get moving on your monitoring!

    Early detection of WTC-related conditions is key to successful treatment. The annual monitoring exam helps ensure that your health is monitored properly over time and that any new conditions are diagnosed early.

    Concerned about safety during the COVID-19 pandemic? The Clinical Centers of Excellence and Nationwide Provider Network have robust safety measures in place for in-person appointments. Many are also using video or phone visits for parts of the exam to reduce the amount of time spent at the clinic.

    Contact your Program provider to schedule your annual monitoring exam today!

    *Monitoring benefits are available to WTC Health Program Responders and Certified-Eligible Survivors only.

    Generic Drugs and the WTC Health Program

    Did you know that the WTC Health Program requires prescriptions for certified WTC-related health conditions to be filled using the generic form of the medication when one is available?
    Facts about generic drugs:

    • They must meet the same high-quality standards as brand name drugs to be approved by the U.S. Food and Drug Administration (FDA).
    • Although they may look different from a brand medication, they are the same in active ingredients, dosage, safety, stability, strength, quality, and how you take them.
    • Multiple generic versions may be available, improving drug availability.
    • 9 in 10 prescriptions filled in the U.S. are for generic drugs. In 2019 alone, 4 billion generic prescriptions were filled in the U.S.

    But what if a drug does not have an approved generic version? The Program then uses a common practice known as preferred medications. The Program’s Pharmacy Benefits team reviews the medications available to treat the WTC-related health condition and cover the medication that provides an effective treatment at the most reasonable cost.

    More information about pharmacy benefits is available in the WTC Health Program Member Handbook at www.cdc.gov/wtc/handbook.html#treatment

    Sources:

    www.fda.gov/drugs/generic-drugs/generic-drug-facts

    accessiblemeds.org/sites/default/files/2020-09/AAM-2020-Generic-Drug-Biosimilars-Savings-US-Fact-Sheet.pdf

    www.cdc.gov/wtc/handbook.html#pharmacybenefitsWTC

    20 Years: Commemoration, Reflection, Healing

    Adults in various situations reflecting, connecting, and coping in their own ways.

    The following article was written by guest writers from the World Trade Center (WTC) Health Program Mental Health Forum. The Mental Health Forum is a group of mental health specialists from across the Clinical Centers of Excellence that meets regularly to discuss mental health topics in the Program.


    The 20th anniversary of September 11, 2001 comes at a troubled time. The entire WTC Health Program community has experienced hardships stemming from the COVID-19 pandemic including health problems, the stress of disrupted daily activities, and the loss of valued social connections.

    During these challenging times, it is more important than ever that the members of this community, formed through their shared experience of another catastrophe, are there for each other, to share wisdom, support, and connection. Know that you are not alone and that the WTC Health Program is here to help in times of crisis.

    Commemoration, Reflection, Healing

    As the Nation commemorates those who were lost at the time of the attacks and those lost in the intervening years, you may experience strong emotions. Allowing these emotions to come forth can empower you and aid your emotional health and healing.

    There are many ways to commemorate including:

    • taking part in collective rituals, such as the reading of names;
    • developing personal, private rituals to symbolically recognize elements of your 9/11 experience; and
    • using coping skills and strategies you have learned or developed during the years post–9/11.


    For some members, it is most helpful to spend the day on activities not associated with 9/11, such as planning time with loved ones or engaging in a favorite pastime.

    And remember, it is never too late to connect with others, rekindle hope, and learn new ways to cope.

    Lessons learned from 9/11

    At various times since 9/11, and especially over the past year and a half, you may have found yourself experiencing grief, worsened anxiety, sadness, or feeling disconnected from loved ones. This emotional toll may be even greater for those recovering from 9/11 trauma. Your recovery may be a slow process as everyone recovers in a different way.

    During times of crisis, WTC Health Program members have learned important lessons about resilience:

    • Belonging to a supportive community is protective.
    • Resilience is something that we cultivate whenever we tend to ourselves and each other
    • Voicing our distress without fear of stigma reinforces that we truly are in this together
    • Sharing the traumatic experience with others helps to re-establish hope, trust, and a sense of a meaning to the world.

    Role of the WTC Health Program

    The WTC Health Program was created during a crisis and has maintained its presence through the pandemic. The Program will continue to be here for members and remains committed to sustaining a growing community where all can feel safe, hopeful, connected, and can rely on each other for support.

    If you have questions or concerns about your emotional well-being, experience symptoms that cause distress or do not improve, please contact your Program doctor. The WTC Health Program has expert mental health providers with experience providing care to Program members.

    Resources

    If you or someone you know is thinking about suicide—whether you’re in crisis or not—call the National Suicide Prevention Lifeline at 1-800-273-8255.

    If you feel unsafe or are being abused, call the National Domestic Violence Hotline at 1-800-799-SAFE (7233)

    For more mental health or social assistance resources, visit these WTC Health Program pages:

    9/11 Health Research: Members Helping Other Members

    The WTC Health Program has funded health research since it was established in 2011. This research defines what we know about exposure during 9/11 and what to expect for those who become diagnosed with WTC-related health conditions.

    Research guides the Administrator of the WTC Health Program in determining what conditions the Program covers and which conditions should be added. It also improves the detection, diagnosis, and treatment experience for members.

    How can you help?

    In the NY metropolitan area, new members are asked if they agree to be part of WTC Health Program research by allowing their health information to be used for 9/11-related health research. This information is de-identified, meaning you cannot be identified by researchers, but details on your condition become part of large set of data about 9/11 health impacts. Participation is optional.

    If you choose to be included, you’re helping improve care for those who were exposed and are now sick because of 9/11. You’re also contributing to knowledge on how best to respond and provide treatment for survivors of other disasters.

    If you choose not to participate, you will continue to receive your monitoring exam and treatment.

    Information collected from members of the WTC Health Program is maintained in accordance with strict requirements for privacy and confidentiality. For more information about how health data is stored and used, please refer to the Member Handbook at www.cdc.gov/wtc/handbook.html#rights.

    How research informs care

    Research for the WTC Health Program is conducted with high standards of quality and ethics. This means that each step of the research process requires serious consideration and review. A team of experts considers evidence from peer-reviewed, published scientific studies to form consensus among scientists and clinicians.

    As your provider learns more about 9/11 health conditions from emerging research findings, they may learn ways to improve treatment. New and important findings are presented to the Administrator before proposing any changes to Program policies.

    Curious about what research the Program has funded the last 10 years? Access the Research Gateway and read the latest research updates through the WTC Health Program Research Page at www.cdc.gov/wtc/research.html.

    What are Maximum Time Intervals?

    Before the WTC Health Program can certify an airway or digestive disorder (also known as an aerodigestive disorder), a requirement known as “maximum time interval” must be met.

    In the WTC Health Program, the maximum time interval is the longest amount of time that could have passed between the member’s last day of 9/11 exposure and the initial onset of their aerodigestive disorder symptoms. Your symptoms of the aerodigestive disorder must have started within that time frame in order to be certified by the Program. WTC-related aerodigestive disorders are divided into 6 different categories, each with a specific maximum time interval. Visit www.cdc.gov/wtc/handbook.html#mtiAerodigestive to see the categories for specific conditions and read more about maximum time intervals


    From the last date of 9/11 exposure to the onset of aerodigestive disorder symptoms.

    Transferring Clinics: It Begins with You!

    Have you recently moved or are you interested in transferring to another Clinical Center of Excellence (CCE) or the Nationwide Provider Network (NPN)?

    First step: talk to your current CCE or the NPN and let them know you’re interested in a transfer. They will discuss the transfer process with you and let you know if you’re eligible.

    Please note: In most cases, WTC Health Program members can transfer clinics once a year.

    You can also get more detailed information on transferring clinics at www.cdc.gov/wtc/clinic_transfer.html.

    Get the Latest Member Handbook!

    The WTC Health Program Member Handbook has important information, including:

    • Updated treatment policies
    • Updated Member Rights and Responsibilities
    • Detailed Coordination of Benefits information for Survivors

    View and download the Member Handbook at www.cdc.gov/wtc/handbook.html

The September 11th Victim Compensation Fund Updates

Image shows an American Flag hanging in the foreground of the Lower Manhattan skyline.

The September 11th Victim Compensation Fund (VCF) has provided the following updates that may be of interest to WTC Health Program members. Remember! The VCF is a separate program administered by the U.S. Department of Justice.

  • New Videos about the VCF: The VCF and 9/11 Health Watch collaborated recently on a series of short informational videos. To learn about who’s eligible for the VCF, how to register and file a claim, and hear a message from VCF Special Master Rupa Bhattacharyya, visit www.vcf.gov/videos-vcf .
  • VCF is now on Twitter: Stay up-to-date with the latest official VCF news, updates, policy announcements, and outreach event information by following them on Twitter at @Sept11VCF .

Please note: Membership in the WTC Health Program does not register you for the VCF. To learn more and check your VCF eligibility, please visit www.vcf.gov or call their Helpline at 1-855-885-1555.

Fairness and Respect in the WTC Health Program

From members to clinic staff and providers to Program representatives, everyone participating in the WTC Health Program has a right to be treated with fairness and respect. We all play a role in creating a safe, healing environment!

Please do:

  • Ask questions about Program benefits or policies that may be unclear. Contact the Program call center at 1-888-982-4748 or visit www.cdc.gov/wtc/faq.html for answers to frequently asked questions.
  • Talk with your Program provider about your WTC-related medical monitoring and treatment. Your provider can also explain some Program requirements, policies, and processes related to your certified WTCrelated health condition.
  • Work with your Clinical Center of Excellence or the Nationwide Provider Network to ensure you get the most out of your Program benefits and services.

We strive to provide high-quality, compassionate care for members. Please don’t treat others in the Program inappropriately. This includes verbal or physical abuse, threats, or requests to break Program rules and regulations.

Inappropriate member behavior may result in the member being subject to Program action, including, but not limited to, requiring the member to sign a behavioral agreement, delaying or reassigning the member’s care, or, if appropriate, involving law enforcement authorities.

Learn more about your rights and responsibilities as a WTC Health Program member and see the Program’s statement on disruptive and abusive behavior at www.cdc.gov/wtc/handbook.html#rights

Who do I call when I have questions about...?

  • Enrollment
  • Appeals
  • Program Benefits
  • Program Policies
  • Updating Contract Information
  • Appointments
  • Care and treatment
  • Medications
  • Case management
  • Clinic transfers
  • Pharmacy benefits
  • Issues filling your prescriptions
  • Home delivery service

Important Phone Numbers

WTC Health Program Call Center

1-888–982-4748

Monday–Friday 9am to 5pm Eastern

1-888–982-4748

Pharmacy Benefits Manager

Optum

1-855-640-0005

Nationwide Provider Network

Logistics Health Inc. (LHI)

1-877-498-2911

Survivor Clinics

NYC Health + Hospitals

Elmhurst & Bellevue: 1-877-982-0107

Gouverneur: 1-212-238-7400

William Street Clinic (LHI)

1-800-714-7426

General Responder Clinics

Icahn School of Medicine at Mount Sinai

1-888-702-0630

New York University Grossman School of Medicine

1-212-263-7335

Northwell Health

1-718-267-2420

Rutgers, The State University of New Jersey

1-848-445-0123

State University of New York, Stony Brook

1-631-855-1200

FDNY Clinics

All FDNY locations:

1-718-999-1858



Moving? If you have moved or are planning to move, please let us know right away. Call 1–888–982–4748 to update your contact information to be sure you receive important Program information.


Follow the WTC Health Program

Facebook: Search @WTCHealthProgram or visit facebook.com/WTCHealthProgram

Twitter: Follow @WTCHealthPrgm or visit twitter.com/WTCHealthPrgm


Help Us Help Others!

Do you know someone who was there on 9/11 or in the days, weeks, or months after? Thousands of people young and old may qualify for health benefits under the World Trade Center (WTC) Health Program but may not know it. We need your help to spread the word!

The WTC Health Program covers:

  • WTC general responders (police, workers, volunteers)
  • Active or retired FDNY responders
  • WTC survivors (people who were present on 9/11 or who lived, worked, visited, or went to school or daycare in the NYC Disaster Area)
  • Responders to the Pentagon and Shanksville, PA sites

If you know someone in one of these groups, encourage them to visit www.cdc.gov/wtc/apply.html or call the Program call center toll free at 1-888-982-4748 to learn more.


New York City skyline graphic