From the early days immediately after the attacks of September 11, HHC doctors, nurses and medical staff have worked in collaboration with community organizations, tenants associations, and advocacy groups to provide community members with the medical and mental health care they needed in the aftermath of 9/11.

On that day, some people had to run for their lives and ended up covered in dust and debris, gasping for air. Others came home to find their apartments covered in heavy dust. Many people witnessed unspeakable horrors.

People who lived, worked or went to school in Lower Manhattan on September 11, or participated in the cleanup afterward, soon started complaining of symptoms including shortness of breath, wheezing and what has come to be known as “the World Trade Center cough.” Patients initially were seen in the asthma clinic run by Dr. Joan Reibman at Bellevue Hospital Center.

As the program has developed and grown through the years, members of the staff have continued to dedicate themselves to treating patients whose medical and mental health symptoms are related to their exposure on 9/11, and studying the health problems associated with the attacks.

“Even today, 10 years later, new patients come to the center who need ongoing care,” said Dr. Meredith Turetz, a WTC pulmonologist. The main physical problems of WTC health center patients include shortness of breath, cough, wheeze, chest tightness, nasal and sinus congestion, and gastroesophageal reflux disease (GERD). The main mental health problems are depression, anxiety and post traumatic stress disorder (PTSD).

The center operates at three HHC facilities: Bellevue, Gouverneur Healthcare Services and Elmhurst Hospital Center. Since its inception in 2005, the WTC program has seen more than 5,800 patients. One of three WTC Centers of Excellence in the city, it is the only one dedicated to treating members of the community rather than first responders and the only program that treats children. The patients are residents, students, workers, passersby and those who helped in the cleanup.

Now under the Zadroga 9/11 Health and Compensation Act, effective July 1, the WTC center is entering a new phase, moving from a grant-based program paid for with city and federal money, to one that has more long-term funding, with federal dollars available through a combination of contracts and a fee-for-service system for the next five years, with a possible sixth year if money remains.

Terry Miles, Executive Director of the WTC center, said for patients, the change will be seamless.

“We want people to know that nothing is changing as far as their healthcare is concerned.” Miles said. “It’s not a different program, it’s not a new program. It’s a continuation of a program that will just have a different funding structure than it had previously.”

The Zadroga law provides $1.5 billion total in federal funding for five years and HHC is one of several WTC Centers of Excellence that can receive money. HHC is expected to receive approximately $10 million annually. Patients can get treatment regardless of their insurance status or ability to pay.

The law also provides the opportunity to do research. The WTC center has gotten approval to do a study on lung function changes in the WTC patient population over time. The center is also submitting a proposal to study 9/11-related illness in children.

“It’s important to understand 9/11 exposure in children and what the effect will be as they get older,” said Dr. Elizabeth Fiorino, a pediatric pulmonologist. “We treat children and work with their pediatricians to coordinate care and serve as a resource for them.”

After a decade, Dr. Reibman said the program is evolving in another important way. “We now have to think of our program not as an acute treatment program but as a chronic disease management program,” she said.

“You can keep people’s symptoms at bay and help them function even though they have chronic symptoms,” Dr. Reibman said. “It doesn’t mean they can’t work and it doesn’t mean they can’t participate in great life events. And that’s important for people to know.”

The toll free number for the HHC WTC program is 1-877-WTC-0107 (1-877-982-0107). There, a person will ask a few questions to determine if the caller qualifies for the program. If so, a follow-up appointment will be scheduled.

September 2011