9/11 Workers Not Getting Enough Care, Report Says

By ANTHONY DePALMA

Almost six years after the terrorist attack on New York, the federal government still does not have an adequate array of health programs for ground zero workers — or a reliable estimate of how much treating their illnesses will cost — according to a federal report released yesterday.

The report, produced by the Government Accountability Office, an arm of Congress, concluded that thousands of federal workers and responders who came to ground zero from other parts of the country do not have access to suitable health programs.

The report also said that an estimate of health care costs made late last year by the National Institute for Occupational Safety and Health was based on questionable assumptions, inconsistent data and instances of double billing. As a result, the report concluded, “It is unclear whether the overall estimate overstated or understated the costs of monitoring and treating responders.”

But officials at the institute, the federal agency that coordinates spending on the ground zero health programs, said the new report looked at outdated estimates, which they admitted were shaky.

New estimates by the institute, made public last week, considered recommendations by the Government Accountability Office and are based on the first few months of treatment costs reported by the Fire Department of New York and a consortium of regional health care institutions led by the Mount Sinai Medical Center.

An estimate for 9/11 health programs released late last year and analyzed by the accountability office put the annual cost of monitoring and treatment services, along with associated expenses, at $230 million to $283 million, depending on the number of workers who seek help.

The institute’s revised estimate last week put this year’s costs at $195 million. But it said the total figure for 2007 and 2008 could be between $428 million and $712 million if more workers register to participate in the programs and a greater percentage of them need medical or mental health treatment.

Mayor Michael R. Bloomberg said that while the accountability office indicated that previous health program cost estimates have been imprecise, the report “leaves no doubt that substantial federal resources are needed for the foreseeable future.”

A government official who worked on the institute’s cost estimates acknowledged that the treatment program had been in existence for only a few months and that actual costs could turn out to be quite different. The official was not authorized to speak about the program and asked to be quoted anonymously.

Part of the problem in estimating costs is the piecemeal way in which the health programs have been created and financed. Beginning in October 2001, federal funds from a variety of sources established and later supported programs to screen and monitor thousands of people who worked at ground zero during the cleanup and recovery operation, which lasted about nine months after Sept. 11. The money went to the Fire Department, the Mount Sinai consortium and two mental health and counseling programs run for members of the New York Police Department.

Treatment money from the federal government became available only last year. Additional funds were approved this year and could be included in next year’s federal budget.

The G.A.O. found that the occupational health institute’s earlier estimates relied on workers’ compensation reimbursement rates. Those figures were adjusted to reflect the special treatment needs of ground zero workers, who have developed respiratory and digestive ailments.

But the estimates proved unreliable for a number of reasons, according to the G.A.O. report. The occupational health institute relied on “questionable assumptions” that were not based on sound data to revise the workers’ compensation rates, the G.A.O. report said. Estimates often included program changes, like more frequent monitoring visits, that had not yet been put into place. And the institute mistakenly counted indirect costs twice.

The report also criticized the on-again, off-again health program for federal employees. It said that nonfederal workers around the country do not have access to the same level of health care as those in the New York region, and it called for the creation of a national health plan for ground zero workers.

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