Rhonda Villamia spent weeks in the vicinity of ground zero following the Sept. 11 terror attacks.
Within the first few days after the collapse of the towers, she was handing out snacks and other necessities out of a Salvation Army tent, near the corner of North Moore Street and the West Side Highway, to first responders and others taking part in the recovery and cleanup.
Villamia, a Queens resident at the time, then joined with the Red Cross, helping to open a respite center at what was then St. John University’s Manhattan campus on Murray Street, three blocks from where the towers fell. When that closed, she joined with the Salvation Army, again distributing nourishment to responders.
Altogether, Villamia spent about three days each week for nine months in lower Manhattan. “I had to do something,” she said last week.
But within a month, she had developed lower respiratory illnesses — sinusitis, bronchitis, rhinitis, a cough — later attributed to the time she spent downtown in the aftermath of the attacks.
Within a few years, she had developed about 10 mostly respiratory and musculo-skeletal difficulties, as well as vocal-chord disfunction, symptoms that the Centers for Disease Control and Prevention would later call certified WTC-related health conditions. In time, tens of thousands of uniformed first responders, private-sector workers and volunteers would experience similar symptoms but also, in thousands of cases, contract cancers and debilitating illnesses traced to the toxic dust and debris from the collapsed towers.
Villamia enrolled in the World Trade Center Health Program run by the CDC soon after it went live in 2011, getting monitored and cared for by city clinicians.
But when she moved to Tampa, Florida, in 2013, she had to enroll with the third-party vendor that operates the WTC Health Program’s so-called “national provider network” — at the time administered by Logistics Health Incorporated — which provides services to the responders and survivors of the 9/11 attacks who live outside of the New York City metropolitan area.
LHI had its shortcomings, with service delivery, inadequate provider recruitment and other issues, and in November 2021, following a bidding process, the CDC’s National Provider Network contract was awarded to Managed Care Advisors/Sedgwick.
It's now been two years since MCA/Sedgwick took over the operation of the program, on Aug. 2, 2022, but problems with how the National Provider Network program is run persist.
Although she noted that the WTC Health Program is unique, Villamia nonetheless said there is a worrying lack of clarity among Sedgwick administrators about health-care protocols. Villamia, who will turn 70 in December, said she is getting the care that she needs. But, she added, she has experienced delays and confusion securing pre-authorizations for treatment and significant delays in claims payments.
“I appreciate the program for being in place, but you also have to equip, you have to give the providers the tools that they need to be able to navigate the program on behalf of the patient so that the patient doesn't have to wait four months to get their first appointment,” she said by phone from Florida last week.
Congress members step in
Lawmakers are also concerned. In a July 10 letter to the CDC’s director, Dr. Mandy Cohen, seven members of Congress expressed uneasiness with how Managed Care Advisors/Sedgwick was administering WTC Health Program services.
“While there have been improvements in service, such as the wait time to get an answer from the call centers and the expansion of the number of providers in the Network, we are concerned that there are still serious deficiencies in MCA Sedgwick’s ability to deliver services,” they wrote.
Among other issues, the lawmakers noted that some program members could not secure the annual monitoring exam to which they are entitled. There also appear to be “serious problems” with program providers getting paid. Members are also being sent bills for their medical care that Sedgwick should have paid, with some embroiled in collections.
The lawmakers, including New York Senators Kirsten Gillibrand and Chuck Schumer and Congress Members Andrew Garbarino, Anthony D’Esposito and Jerry Nadler, noted that soon after the “go-live” date two years ago, NPN members experienced “serious issues with the delivery of services.”
“We are committed to ensuring that the World Trade Center Health Program continues to provide health care and medical monitoring and would like to request an update on what actions are being taken to address the serious issues plaguing the NPN,” the letter continues.
A MCA/Sedgwick representative did not respond to an emailed inquiry regarding the lawmakers’ concerns. A CDC representative said only that the Centers was in receipt of the letter and that the CDC "will respond accordingly."
Benjamin Chevat, the executive director of 9/11 Health Watch, a nonprofit watchdog organization advocating on behalf of September 11 responders and survivors, said that while there have been changes for the better with the provider network, there are outstanding issues. “Clearly there have been improvements in service overall in the National Program but if you are one of those still not getting services then those improvements don’t matter, and Sedgwick still needs to do a better job,” Chevat said by email.
He noted that Sedgwick manages workers’ comp claims and other matters for Amazon and contracts with Walmart as a third-party administrator for some matters, “so you can imagine that they do not provide quality health care,” he said.
“I just think the culture of Sedgwick doesn’t understand this community,” he said in a phone interview last week.
But he also noted that a good portion of the blame for the shortcomings within the program lies with the federal contract system. “That's why the letters are to the CDC and not to Doctor Howard [the WTC Health Program’s administrator], because it is the CDC contract office that manages the contract,” Chevat said by phone.
But, he added, “if I'm a responder in Florida and I'm not getting services, that doesn’t matter and it shouldn’t.”
[Chevat encouraged responders and survivors encountering problems with the National Provider Network to contact the WTC Health Program directly by calling 888-982-4748 or emailing WTC@cdc.gov or going to 9/11 Health Watch’s website and clicking on “need help” at the bottom of the homepage.]
Several of the lawmakers who wrote the CDC’s director recently introduced bipartisan legislation that would provide mandatory, permanent funding for the WTC Health Program, which is facing a funding shortfall that could oblige it to turn away would-be enrollees within a few years.
A few days later, the president of the NYC Organization of Public Service Retirees, Marianne Pizzitola, implored lawmakers to address the issues plaguing Sedgwick’s administration of the national provider network.
“The current vendor has continued its inadequacy while ignoring calls from 9/11 heroes and operating a ghost provider network. Their inability to live up to the contract places undue stress and anxiety on an already struggling population,” Pizzitola, a retired EMT who has experienced respiratory difficulties from working the bucket brigade at ground zero, said in a statement. “While we respectfully honor those who lost their lives on or due to 9/11, we should also hold and support our survivors and ensure they have the best care possible.”
Sedgwick, whose majority shareholder is the multinational private equity and financial services corporation Carlyle Group, acquired Maryland-based Managed Care Advisors in September 2021, just two months before MCA/Sedgwick won the bid to become the health program’s national provider network.
“Sedgwick and Managed Care Advisors have a shared focus on delivering excellence and taking care of people,” Elizabeth Demaret, who at the time was Sedgwick’s president of specialty operations, said then. “We are well aligned to optimize outcomes for our clients and look forward to bringing our combination of value-added services to the employees of federal government agencies.”
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namrogm
Thanks, Richard, for your excellent article on such an important issue. The 9-11 Health Program provides critically important benefits to those who sacrificed for others. It must be preserved and protected for current and future victims.
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