**GAO-08-537R**                      Published: Mar 11, 2008. Publicly Released: Mar 11, 2008.                  

-   
-   
-   
-   

    Jump To:  
-  Elder Abuse 
-  Services for Older Adults 
-  State and Local-Level Drivers and Trends 
-  State and Local Fiscal Projections 
-  Federal Borrowing 
-  Managing the Debt 
-  Summary of Funding Provisions 
-  Auditing the Government's Books 
-  Unpacking the Financial Report 
-  Highlights 
-  Recommendations 
-  Background 
-  About This Work 
-  About This Work 
-  Trends 
-  About the Center 
-  Why It's High Risk 
-  What Remains To Be Done 
-  Key Reports 
-  Newest COVID-Related Reports 
-  AI Use Cases 
-  Flood Insurance 
-  Past Pandemic-Related Reports 
-  CARES Act Oversight Reports 
-  All COVID-19 Reports 
-  Report Suspected Fraud 
-  Subjects 
-  How to Get Notified 
-  Past Reports 
-  Public Health Threats 
-  Explore the FY 2022 and 2023 Funds 
-  Status of FY22 Projects 
-  Lessons Learned 
-  Agency Reports 
-  Recent Reports 
-  Recommendations 
-  Supplemental Material 
-  Full Report 
-  Additional Data 
-  View Decision 
-  Downloads 
-  Previously Identified Actions 
-  Related Pages 
-  Associated Agencies 
-  Tough Choices and Opportunities Ahead 
-  Americas Fiscal Future Key Areas 
-  Retirement Security Key Areas 
-  Current List 
-  About The High Risk List 
-  Area Ratings 
-  Previous High Risk Products 
-  Search Federal Vacancies 
-  Past Federal Vacancies 
-  Violation Letters 
-  About the Yellow Book 
-  Advisory Council 
-  Related Resources 
-  Comment Letters 
-  Related Publications 
-  Contacts and Resources 
-  Major Issues Facing the Nation 
-  Meeting Strategic Challenges 
-  Additional Resources 
-  Resources 
-  GAO Contacts 
-  Mission Teams 
-  Operations and Staff Offices  
-  Organization Chart  
-  Why a Career at GAO? 
-  Am I Qualified? 
-  Company Culture 
-  Reasonable Accommodations 
-  Video Gallery 
-  Paid Internships 
-  Student Volunteers 
-  Professional Development Program 
-  Advancement 
-  Executive Candidate Program 
-  Summer Associates 
-  Externships 
-  Benefits 
-  Contacts 

Skip to Highlights

## Highlights

Following the World Trade Center (WTC) attack, federal funding was provided to government agencies and private organizations to establish programs for screening, monitoring, or treating responders for illnesses and conditions related to the WTC disaster. Within the Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention's (CDC) National Institute for Occupational Safety and Health (NIOSH) awards grants for and oversees the WTC health programs that provide services for responders to the WTC attack. Federal funds appropriated or awarded for the WTC health programs from October 2001 through November 2007 have totaled $261.1 million. These funds were provided for screening and monitoring services, outpatient and inpatient treatment, and program support. NIOSH has awarded the bulk of the funding. For fiscal year 2007, NIOSH estimated that medical monitoring, treatment services, and associated program support services for WTC health programs could range in cost from about $230 million to $283 million. However, in July 2007 we reported that NIOSH did not have a reliable cost estimation process. We found that NIOSH and its grantees had included potential costs for certain program changes that might not be implemented and, in the absence of actual treatment cost data, had relied on questionable assumptions. We noted that HHS officials had required the two largest grantees--New York City Fire Department's WTC Medical Monitoring and Treatment Program (FDNY) and the New York/New Jersey (NY/NJ) WTC Consortium--to report detailed cost data to improve future cost estimates. In fall 2007 the NIOSH director briefed congressional staff on the cost estimate for the WTC health programs for fiscal year 2008 and on changes NIOSH made to its cost estimation process for that year. In light of our findings on NIOSH's cost estimation process for fiscal year 2007 and of the development of a cost estimate for fiscal year 2008, Congress asked us to identify the changes that NIOSH made for fiscal year 2008 and to determine whether these changes represent an improvement.

## Full Report

Full Report (25 pages)

Accessible Text 

## Office of Public Affairs

### Media Inquiries

Sarah Kaczmarek
kaczmareks@gao.gov

(202) 512-4800

### Public Inquiries

Public Affairs
PublicAffairs@gao.gov

(202) 512-4800

## Topics

Budget and Spending

Appropriated fundsCost analysisEmergency medical response teamsEmergency response personnelEmergency response teamsFederal fundsFederal grantsFirst respondersFunds managementGrant monitoringHealth care programsHealth care servicesMonitoringOccupational health and safety programsProgram evaluationProgram managementCost estimatesProgram costs