For nearly 15 years, the World Trade Center Health Program has provided medical monitoring and treatment for responders and survivors with health conditions linked to their 9/11 exposures. As the 25th anniversary approaches, the Program continues to enroll thousands of new members each year, including responders who may only now be connecting a current diagnosis to exposures from decades ago.
For U.S. Public Health Service Rear Admiral Lisa Delaney, director of the Program, the milestone is also personal. Early in her career at NIOSH, she supported the agency’s 9/11 response from Atlanta, helping deploy staff, identify hazards and provide technical support. The experience shaped the next two decades of her career in emergency preparedness and responder safety. Leading the WTC Health Program, she said, has brought that work full circle, from trying to protect responders during disasters to caring for those who are still living with the consequences of exposures that could not be prevented.
FireRescue1 connected with RDML Delaney to talk about how the Program has evolved, why eligible responders are still enrolling, and what firefighters should know about the care and support available to them.
FireRescue1: For firefighters who may not be familiar with the WTC Health Program, can you explain its mission and how it has evolved?
Delaney: The Program was created under the James Zadroga 9/11 Health and Compensation Act of 2010, which took effect in 2011. Before that, there were grassroots efforts and different funding mechanisms, but the Program was formally established and organized in 2011. It was later reauthorized through 2090, so this program is going to outlive all of us.
Our goal is to build awareness because there are still many people who may be eligible for the Program but have not connected the dots. It has been nearly 25 years, and they may not realize that health conditions they have now could be related to exposures from the day of the attacks, as well as the cleanup and recovery efforts.
We want people to learn about the Program and understand that we are here to help. We are a growing program. We add about 10,000 members a year, and approximately 3,000 of those new members are responders.
People can learn more at cdc.gov/wtc. We have information about eligibility, but it is not one-size-fits-all. Eligibility depends on factors such as where you were, how long you were there and when you were there.
We outline those requirements online, and we also have a call center. If someone needs additional help, the call center can walk them through the application process.
Were you surprised to see that many people are still enrolling? Why do you think some responders wait so long to join the program?
I think it is a combination of people not understanding the Program and people not coming to us until they are sick and need care. They may also be in a different position with their insurance now, and the Program becomes more relevant to them.
We cover conditions that are related to 9/11 exposures. There is a list of covered conditions, including cancers, respiratory disorders, digestive disorders and mental health conditions. A condition must be certified. That means there has to be documentation, and there is a process to determine whether the condition qualifies. Once it is certified, the Program covers treatment for that condition at no out-of-pocket cost. There are no deductibles and no copays. Once people understand that, joining the Program becomes very appealing.
Another issue may be that people assume the Program is limited to New York City, where most of our members are located. But we have a national program in addition to clinics in the New York metropolitan area. We have members in every state, so location should not be an obstacle to receiving care through the Program.
We hope the application process is straightforward because we are not trying to make it complicated. We want to build our membership and serve the people who deserve this care.
Source: WTC Health Program quarterly program summary — May 2026
How has the program evolved as research has identified additional health conditions and cancers?
The Program has evolved and matured. In the beginning, it was a shoestring operation trying to launch very quickly and get care to people. Today, there is a process through which anyone can petition to add a condition to the list of covered conditions. That petition goes through a scientific evaluation to determine whether it meets the criteria. That gives us the ability to add conditions as the science develops. Cancers were added through that petition process several years ago, and the Program now covers all cancers that meet our certification requirements.
Could additional conditions still emerge years from now?
Yes, and that’s because many 9/11-related conditions have a latency period. Just because someone didn’t become sick immediately after their 9/11 exposure doesn’t mean a condition that develops years later isn’t related to it.
That’s why we provide annual monitoring. Members have access to yearly monitoring examinations so we can stay connected with them and follow their health over time. The Program provides treatment, but annual monitoring is also an important component to help catch conditions early to improve health outcomes.
Do members take advantage of the monitoring program?
They do. I hear stories about the clinics in New York where there is such strong camaraderie among members that some schedule their appointments on the same day so they can see one another.
We know there are many obstacles to seeking healthcare, but when people feel comfortable, feel valued and build relationships with their clinicians, they are more likely to seek care. I think that is part of why we are seeing improved health outcomes. Members are going to the doctor. They are receiving early diagnoses and appropriate treatment, and they are doing it in a place where they feel comfortable and safe. That is one of the important benefits of the clinics across the New York metropolitan area and with the providers in our nationwide provider network.
What does the research show about the impact of the Program?
WTC Health Program membership appears to be linked to responder members living longer lives. Compared to non-members, responders had a 13% lower risk of death from any cause (mainly among men) and a 17% lower risk of death from smoking-related conditions.
Additionally, this Program makes a real difference in helping to improve the quality of life and positive health outcomes among our member population. In fact, the cancer-specific mortality rate for WTC Health Program enrollees is 34% lower than demographically similar New York State residents with cancer. This shows that enrollment in the WTC Health Program, which includes access to cancer screening and case management, may improve cancer survival.
How is the Program marking the 25th anniversary of 9/11?
It is an important milestone, and we are trying to balance honoring the memory of those who lost their lives with offering a message of hope. We want people to know that we are here to help those who responded and the survivors who deserve care and support for their health.
A major focus for us is raising awareness among people who may not know the Program exists or may not realize they are eligible. Young adults are a particular focus because they were so young at the time and may not have the same memories of the attacks or recognize the connection between their exposures and current health conditions.
What is your message to firefighters who worked at Ground Zero or supported the response from elsewhere in the country?
We have an extraordinary Program whose goal and mission are to provide high-quality care and treatment to responders and survivors of 9/11. I encourage people to review the enrollment requirements and determine whether they may be eligible. Contact us. We want to walk people through the process. Do not wait or delay considering enrollment.
There are many important benefits, and the Program is not limited to people living in New York. Even if you have never lived in New York but responded to the attacks, the Program has a nationwide network that can provide support.
Learn more about the WTC Health Program.
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