Like thousands of other Americans, Judy Wolff, a nurse's aide at Holmen High School near La Crosse, dropped everything and rushed to New York after the Sept. 11, 2001, terrorist attacks to see how she could help.
A volunteer with the American Red Cross, Wolff went to the World Trade Center site to help victims and their families get food vouchers and pay bills as they coped with the stunning loss of life, injuries and joblessness caused by the attacks.
After three weeks of breathing in a toxic cloud of crushed concrete, asbestos, lead and fumes from burned jet fuel, Wolff herself now is fully disabled - one of thousands struggling with a constellation of ailments common to those who helped victims and pulled bodies from the wreckage seven years ago.
Adding to her troubles: The 51-year-old Wolff has had to fight to get insurance coverage for her prescriptions, medical appointments and upcoming surgeries, even though Congress has set aside money specifically to care for her and the estimated 4,000 other responders living outside of the New York area. (Responders living near Ground Zero are cared for at a network of New York area hospitals.) The problem began in June, Wolff and others say, when Logistics Health Inc., of La Crosse, headed by former U.S. Health and Human Services Secretary Tommy Thompson, won an $11 million federal contract to provide medical care and health monitoring from the agency Thompson once led - a decision that continues to raise eyebrows on Capitol Hill.
Prior to June 1, responders living outside New York were served by a small nonprofit funded by the Red Cross with donations it got to help the victims of 9/11. Five months into Logistics Health's one-year federal contract, just a fraction of those patients have gotten the required medical monitoring, according to figures from the National Institute for Occupational Safety and Health (NIOSH).
And while NIOSH officials say all of the patients, such as Wolff, are now getting needed treatment, the claim is difficult to verify. Responders come in and out of the program at different times, depending on their health, said Fred Blosser, spokesman for the federal agency. As of last week, 187 patients were actively being treated for medical problems, Blosser said. In addition, he said 274 patients - out of 4,000 responders - have received testing and medical monitoring services.
Dr. Jim Melius, chairman of the World Trade Center Medical Monitoring and Treatment Steering Committee, which coordinates care for 9/11 responders, said some patients may have simply dropped out of the program during the rocky transition to LHI. He said HHS should cancel the contract.
"I just don't have any confidence that they (LHI) have the capacity or the understanding to do this," Melius said. "They are doing a disservice to these people. There are hundreds more in the medical treatment program and thousands more that need medical monitoring, and they're not getting it."
Logistics Health spokeswoman Tracey Armstrong referred all questions to NIOSH, saying its federal contract prohibits the company from answering any questions from the media. But Blosser said the contract only requires that the company submit to NIOSH for review any statistics it plans to disseminate to the press.
Blosser said the agency was "pleased" that "progress is being made and additional responders are being brought into the program." But he said he's aware of the criticism that LHI is moving too slowly.
"We will be monitoring that information as time goes on to make sure that progress is being made and that responders who want to receive treatment ... are being served," he said.
\ 'Just like that'
Anne Marie Baumann, senior vice president of the FealGood Foundation, which helps injured and ailing 9/11 responders, said she's heard from about three dozen responders around the country, including Wolff, about problems getting reimbursement for prescriptions and treatment from LHI.
"All of them were receiving services, and then all the services stopped, just like that," Baumann said. "I lose enough responders with cancer and leukemia and suicide. I don't need to lose them because they couldn't get their medications."
U.S. Rep. Carolyn Maloney, the Democratic congresswoman representing Queens and Manhattan who has spearheaded the effort to care for 9/11 responders, said it's not clear where the blame for the delay lies, "but even administration officials admit that the start of this program was anything but smooth."
After Logistics Health Inc. took over this summer, Wolff said, her claims for reimbursement for expensive cough medicine and an inhaler came back as denied. And it wasn't until mid-October - more than four months into the one-year contract - that the company agreed to pay for her treatment for a respiratory ailment that afflicts many 9/11 responders.
Wolff, who lives just 15 minutes' drive from the Logistics Health office in downtown La Crosse, said she doesn't want to single out anyone for blame. But John Feal, founder of the FealGood Foundation, isn't so circumspect. Feal points the finger directly at Wisconsin's former governor, who is also president of Logistics Health.
"I know Judy Wolff really well, and she's suffering. And I know Tommy Thompson and his group, and they're neglecting these people," Feal said.
Thompson spokesman Jason Denby referred questions about the contract to Logistics Health. But he said that Thompson - who is on boards and in management and consulting positions at 22 companies - "has been working closely with the team (at LHI) to ensure that the contract is carried out properly."
\ Partner at law firm
Thompson, 66, came to Logistics Health shortly after being President George W. Bush's secretary of Health and Human Services, which includes NIOSH, during Bush's first term. Upon leaving his federal post in December 2004, Thompson quickly assembled a large portfolio of private sector positions, including partner in one of Washington, D.C.'s most influential law firms, board directorships on medical device and pharmaceutical companies he once regulated, and as an executive with Deloitte & Touche, a major federal contractor that provides health-care consulting services.
In March 2005, Thompson was named president of LHI, which provides "customized health care solutions" for private companies and the federal government using a network of medical and dental providers. Armstrong declined to say how much the privately held company pays Thompson.
Since the former HHS secretary joined Logistics Health three and a half years ago, the company has seen its federal contracting business skyrocket. According to OMB Watch, a nonprofit group that tracks government contracting, the company of 400 employees has gone from $19.9 million in federal contracts in 2003 to $104.8 million in 2007, including part of the first year of a five-year contract to provide health and dental services to military reservists worth an estimated $790 million.
In at least two published interviews, LHI founder and chairman Don Weber has credited the company's recent growth to Thompson's connections in federal government.
"If I were to go in a try to get a meeting with some of the decision makers in these organizations, it would take me a lifetime," Weber told the Milwaukee Journal Sentinel in February 2006. "Tommy is able to make a phone call - and then we get in front of people who make decisions. And when we can show them what we're all about, it expedites decisions."
Weber made a similar statement to the La Crosse Tribune in September 2006.
"He (Thompson) has definitely had an impact" on the company's growth, Weber told the newspaper. "Tommy really is able to get us in to see the right people, the decisionmakers."
Denby insisted that Thompson has never contacted anyone at his former agency to discuss business. "He doesn't talk to HHS about contracts. It's simple," Denby said. Armstrong also didn't respond to messages seeking an interview with Weber.
\ Request was conceled
How Thompson's company won the contract to provide 9/11 responder care has come under scrutiny. Last fall, the administration solicited bids to provide medical and pharmacy care for ailing responders living outside of New York City. In December, a few days before the bids were due, HHS canceled the request for proposals. Knut Ringen, a Seattle consultant, said his client, Zenith Administrators and QTC of Diamond Bar., Calif., was ready to submit its bid when the solicitation was canceled.
Suspicious about the change, one New York City congressman held a hearing in January to try to force HHS to explain why the request for proposals had been scuttled. The agency declined to send a representative to the hearing of the House Subcommittee on Government Management, Organization and Procurement.
Blosser said the process was halted because it wasn't clear how much the government would pay for patients with health insurance, although Congress had appropriated $108 million for that purpose. He said the solicitation also was "structured in a way that inadvertently limited interest from bidders that may have been equipped to address the complexity of the program on both the local and national scale."
U.S. Rep. Ed Towns, chairman of the subcommittee, didn't buy the explanations offered by the health agency.
"It is really a baffling decision, and they can't even get their stories straight for why it happened," the Democrat from Brooklyn said at the hearing. "First they said that the bidders were confused. Well, we talked to bidders, who had invested a lot of time and money in their proposals, and they said they were ready to go. Then the administration said there wasn't enough funding. Well, how could they know that before the bids came in?"
In March, the HHS' Centers for Disease Control and Prevention, which includes NIOSH, issued a new request for proposals. LHI was among four bidders. Ringen prepared a second proposal, this time just from Zenith. He said LHI's $11 million proposal was several million dollars less than those of the other three bidders. Blosser declined to say how much the other proposals would have cost, adding that such information can't be released to the public under federal contracting rules.
"We could not do the project on the budget LHI proposed - at least and do it responsibly," Ringen said. "We couldn't even come close to what they were proposing."
\ In the transition
Before LHI got the contract, the nonprofit Association of Occupational and Environmental Clinics provided heath-care services for 9/11 responders, many of whom had sought for years to get help from the federal government for respiratory, gastrointestinal and mental health problems. After the contract was awarded in May, Katherine Kirkland, the association's executive director, said her group tried to ease the transition for patients.
"We offered to talk with them (LHI) and work with them, and they said they had everything under control and they'd get back to us," she said.
Kirkland said she tried unsuccessfully to contact LHI as dozens of patients began calling her with complaints about lack of service. Finally, she said, the association and the Red Cross agreed to continue paying medical claims for the patients beyond the scheduled end of their program on June 30.
"In spite of everyone saying whoever got the contract, that they'd be ready on Day 1, they weren't," said Kirkland, whose association continued to pay claims through July under its agreement with the Red Cross.
Kirkland said Logistics Health isn't solely to blame. She said the federal government "just didn't allow enough time for the transition" for a program that serves patients scattered across nearly every state. "I just don't think they (LHI) understood and I don't think the federal government understood what was involved in providing treatment for these people," she said.
Wolff said she continues to struggle with the effects of her three weeks at Ground Zero: Depression, looming surgeries and permanent disability that makes her unable to work. She said she's had to cancel doctor appointments because she can't afford the gas to get there.
Towns, the New York City congressman, said the care provided to Wolff and others is "one of the worst-managed programs I've seen. The lack of action for these heroes, and the bureaucracy they've had to go through, is simply unacceptable. It is shameful."