WTC exposure survey form for four distinct populations, October 2006

NYC 9/11 Public Portal Document

1

Confidential For Internal Agency use Only

(1) [For contractors’ employees and volunteer organizations] Has your agency had any communications with relevant contractors and volunteer organizations about treatment for WTC-related health conditions of exposed individuals or requested any information about such conditions and treatment?

(a) If so, please indicate the contractor’s or volunteer organization’s response to the request and whether you can provide the information submitted.

D. Since the completion of the rescue and recovery efforts, what mechanisms exist or have existed for exposed City employees, contractors’ employees, volunteers and/or clients and other constituencies to communicate with agency personnel about WTC health-related issues? How is such information received, catalogued and acted on?

E. Please provide a summary of health-related services available since September 11, 2001 to exposed City employees, contractors’ employees, volunteers and/or clients and other constituencies, including whether your agency provided and/or provides any treatrhent services to these populations. Responses to this request should include:

0) A description of available treatment(s); (2) Whether such treatments are covered by participating populations’ health insurance (or any relevant health insurance data);

(3) Any data on the extent to which exposed City employees, contractors’ employees, volunteers and/or clients and other constituencies have used such services and the quality of such services;

(4) The approximate annual cost of providing these services to exposed City employees, contractors’ employees, volunteers and/or clients and other constituencies, and projected annual costs for as many years as you are able to provide;

(5) If these services are not covered by health insurance, explain how these services are funded (e.g., tax-levy, state/federal grants, philanthropy, etc.);

(a) To the extent possible, please identify any known shortfalls in available funding in future years; and

(6) Out of pocket costs incurred by exposed City employees, contractors’ employees, volunteers and/or clients and other constituencies for services not covered by insurance or other funding (if any).

3

NYC-WTC_000164529