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Winning the Public Health Recovery from Covid


Mayor Adams visits health care workers (photo: Michael Appleton/Mayoral Photography Office)


In its battle against COVID-19, New York City, even under a notably disorganized mayor, arrived at an impressive level of health organization. As may be recalled, Mayor de Blasio switched the lead role in the covid fight to Health + Hospitals, the city’s public hospital system, from the Department of Health and Mental Hygiene (DOHMH), which retained major responsibilities but not its usual lead position in epidemics. It is to the credit of both agencies that, under this forced and rather resented bureaucratic marriage, they managed to develop a level of cooperation that saw the city, for one thing, consistently attain the highest COVID-19 testing rate of any large U.S. city.

 But, beyond that, something else happened. For the first time, the city funded an extensive network of community organizations coordinated in a singular mission — fighting a horrible infectious epidemic. Outreach workers and health educators from these organizations were constantly in the streets when almost no one else would be, promoting COVID-19 testing, prevention, masks, proper quarantine, and, of course, vaccination.

 The community-based organizations (CBOs) also formed a Community Advisory Board providing constant insight to refine city covid programming. Today in New York City, which had the nation’s highest COVID-19 death rate in the first surge, 87% of adults have received at least one vaccination shot, with 78% fully vaccinated, the highest rate of any big U.S. city.

 It is time to use this unprecedented health infrastructure to immediately address our other health crises, especially diabetes and the chronic diseases that fuel both COVID-19 and the city’s disturbing levels of preventable ill health.

 New York City is very, very sick.

Between chronic disease, uncountable cases of long covid, and the increasing evidence that those who had covid are at elevated risk for diabetes, the city faces staggering levels of illness. To forestall this disaster, New York must widely assure that thousands of people in neighborhoods overwhelmed by chronic diseases directly learn chronic disease prevention and self-care. With its COVID-19 infrastructure, the city absolutely already has the necessary vehicle to move forward. The neighborhoods and the Black, Latino, and low-income populations most devastated by COVID-19 are, tragically, the neighborhoods also most devastated by chronic disease.

 Yet, the city seems to be letting its COVID-19 infrastructure collapse. Instead of starting to deliver proven health-building services, the first group of some 35 CBOs that the city partnered with to fight covid will be defunded by the city in a few months. In losing these CBOs, the city loses their neighborhood staffs of community health workers, outreach teams, and peer educators — people uniquely able to engage very distressed communities in trying to rebuild health.

For an example of the kind of effective health education these groups could provide, consider the following. A few years ago, with special federal funding, Health People instituted a four-week training course to prepare local Bronx people with diabetes and pre-diabetes to deliver the Diabetes Self-Management Program (DSMP). This six-session course reduces blood sugar -- immediately reducing vulnerability to the worst covid outcomes -- as well as overall complications, and the high rates of co-morbid depression seen in diabetes. It also slashes emergency room visits by 40% or more -- an extraordinary benefit.

The peer educators fanned out to dozens of community sites -- churches, homeless shelters, mental health programs, public housing -- and enrolled almost 2,000 Medicaid recipients with Type 2 diabetes in the DSMP. This was evidently the largest community mobilization for diabetes self-management ever to occur in the United States. And it was defunded just as covid struck and preyed upon those with underlying chronic conditions.

By contrast to its impressive fight against covid, the city has long failed to make any credible effort to control chronic disease. In a city that had a staggering 356% increase in diabetes deaths in the first covid surge, DOHMH doesn’t now -- and never has -- supported a single DSMP group where those with Type 2 diabetes could learn better self-management.

And it’s not just specific diseases. For example, with that same now-ended federal funding, Public Health Solutions worked with NYC Health + Hospitals to form community networks that included 275 diverse community-based partners, which helped 16,000 H+H patients, mainly those just discharged, linking them to vital services -- such as programs to provide nutritious food. This generated approximately $1.4 million in health-care savings through the improved well-being even of very sick people.

If DOHMH and H+H don’t use their large shares of the city’s billions in federal emergency funds to support and coordinate the many health-building services that the CBOs who worked on covid can so clearly provide, New York will have largely won the fight against COVID-19 only to totally and tragically lose the recovery.

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Chris Norwood is Executive Director of Health People. Lisa David is President of Public Health Solutions. On Twitter @HealthPeopleOrg & @wearephsny.

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The Question Isn’t Whether Antonio Delgado is Latino, It’s Whether He’ll Stand Up For Our Community


Antonio Delgado (photo: Mike Groll/Office of Governor Kathy Hochul)


The recent appointment of new Lieutenant Governor Antonio Delgado was marred by a debate about his ethnicity – specifically, whether he is Latino. 

The debate about Mr. Delgado’s ethnicity misses the point. The question that Latino New Yorkers should be asking is not whether he is Latino. As his opponent in the June primary and a Latina myself, if that’s how he identifies himself, I’ll take him at his word.

The more important question is: will he stand up for Latino New Yorkers in office? Sadly, on that question, his record is mixed.

As a member of Congress, Delgado has repeatedly been on the wrong side of key issues affecting Latino and immigrant communities.

Let’s start with immigration. In 2019, when the Trump administration was terrorizing immigrant communities across the country, Rep. Delgado sided with Trump and Congressional Republicans to dramatically increase funding for the same Immigration and Customs Enforcement (ICE) and Customs and Border Protection (CBP) that were tearing children from their parents’ arms at the border and terrorizing immigrants nationwide. Shockingly, the bill also allocated funds to the Pentagon to support troops that Trump sent to the southern border.

The Congressional Hispanic Caucus called the bill “a betrayal of our American values,” and 102 Democrats, including New York Reps. Velazquez, Espaillat, and Ocasio-Cortez, voted no. Many other Latino leaders like me also expressed vocal opposition. Delgado voted yes.

On other key Congressional fights for Latino communities, Delgado was completely absent. Latinos all too often lack access to affordable, quality health care–in fact, we are three times as likely to be uninsured as our white counterparts. We thus stand to gain enormously from a universal health care system. But Delgado refused to co-sponsor Medicare for All legislation.

Latino communities are also often at the front lines of the climate crisis, and we need bold solutions to transition to a clean and renewable energy economy, create jobs, and ensure a just transition. But Delgado refused to co-sponsor the Green New Deal.

His record has also been weak on other issues specific to New York’s Latino communities. Earlier this year, Delgado penned a letter to the Governor opposing giving farmworkers access to overtime pay after 40 hours of work. These workers are largely Latino immigrants and have done back-breaking work before and during the pandemic. They deserve the same wages and protections as anyone else. 

Meanwhile, while he was writing his own letter to prevent these essential workers from getting overtime pay, he was refusing to sign on to a letter signed by 11 of his congressional colleagues to expand tenant protections and prevent evictions without good cause across the state. Ensuring these protections is a crucial issue for Latino and immigrant tenants who pay enormous rent burdens, often for substandard housing, and have been decimated by displacement from their homes.

All of these positions are worrying enough on their own. But they’re made worse by the fact that Delgado has joined a ticket with Governor Hochul, who herself has a history of anti-immigrant positions. The Governor first rose to prominence as a county clerk demagoguing against immigrants and opposing the restoration of access to drivers’ licenses to undocumented immigrants as county clerk. She didn’t just oppose the measure – she threatened to have undocumented immigrant applicants arrested and put at risk of deportation.  

While Hochul eventually changed her position as lieutenant governor, just this year she led the effort to callously exclude undocumented immigrant children from the expansion of access to childcare in the state budget, while opposing replenishing a fund for excluded workers and blocking legislative efforts to pass Coverage for All, which would have ensured health coverage to low-income New Yorkers regardless of immigration status.

Particularly with a Governor who has proven apathetic at best, and hostile at worst, to the needs of Latino and immigrant New Yorkers, we need a Lieutenant Governor who will be an independent voice of accountability. When the Governor is proving unresponsive to the needs of Latino New Yorkers, we need a Lieutenant Governor who will stand up to her and secure better outcomes, instead of providing cover from policies that continue to exclude our communities. Mr. Delgado’s record leaves little grounds for optimism. 

What does give me hope is that Latino and immigrant New Yorkers are organizing all over the state, and partnering with visionary legislators to win historic victories, like the $2.1 billion Excluded Workers Fund they won last year. Our communities deserve better and will continue to demand better. Our eyes are on the prize of a more just society, not representation in name only. 

***
Ana María Archila is a Democratic candidate for Lieutenant Governor of New York. On Twitter @anamariaforny.

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Judicial Selection is Crucial at Every Level


Courtroom (photo: Governor's Office)


As early as primary school, we are taught about the United States Constitution’s system of checks and balances, and that the judicial branch was created to temper the actions of the executive and legislative branches of government. We learn about the importance of an independent judiciary, but beyond that, the vast majority of us don't think about the role and function of judges unless we find ourselves involved in a court case. We need to be more keenly aware, nationally and at home, of the tremendous power the judiciary and judicial selection have in most facets of our everyday lives.

With the leak of the draft majority decision in Dobbs v. Jackson Women's Health Organization written by Justice Samuel Alito, the Supreme Court is suddenly under intense public scrutiny. Dobbs is only the latest development that highlights the immense repercussions of a partisan Supreme Court, and the dire consequences of elections. In Alito’s view, the right to an abortion is not “deeply rooted” in our nation’s history. He writes for the majority that, “Until the latter part of the 20th century, such a right was entirely unknown in American law.”

Perhaps that’s true, but it’s disingenuous and reverses the women’s rights revolution that began in the mid-nineteenth century with the fight for the right to vote. Fifty-three years after the constitutional amendment granting women the right to vote, in Roe, the Supreme Court recognized women’s bodily autonomy — a relatively compact timeline for the enshrinement in law of the rights of a marginalized population. It also proves how potent “deeply rooted” constitutional liberties are when applied to all. The draft majority in Dobbs discards the court’s procedural norms by flouting abortion jurisprudence and the principles of stare decisis. Roe is settled law for 50 years — an independent, non-partisan judiciary would heed precedent. The leaked decision is a wholesale (not even incremental) rejection of precedent.

Here in our home state of New York, the judiciary’s recent decision that this year’s primary elections would be bifurcated and held on two separate dates due to challenges to the redistricting process is also being treated with skepticism.

Primaries for Congressional and New York State Senate offices will be held in August and primaries for all judicial and other offices will be held in June. There is some irony in the fact that despite this irregular electoral schedule being brought about by the judiciary, highly impactful judicial races were by and large left out of the primary date discussions and legal battles, which focused primarily on races for Governor, Congress, State Senate, and State Assembly. The primary bifurcation raises serious questions about what impact the Court’s decision will have on voter turnout, which is already often below 20% during primaries.  

Putting aside whether the judges were correct in bifurcating the New York primary, the public’s immediate mistrust of the process has larger implications. For example, the fact that the public generally doesn't understand the process by which people become judges does not engender deference and trust in the judiciary. Recently, while petitioning over five weeks for signatures to get on the June Democratic primary ballot for Surrogate's Court judge, many people skeptically asked me why there’s rarely a choice in judicial candidates when they vote.

Part of the problem is that judicial candidates get on the ballot through a process that is little known and poorly understood by most people, even voters who are otherwise quite well-informed. 

Judicial candidates for Surrogate's Court like myself need signatures (4,000) from registered Democrats to appear on the primary ballot. Surrogate’s Court, also known as probate court, oversees wills and estates, as well as the appointment of fiduciaries, guardianships, and adoptions. Judicial candidates for Civil Court positions also need signatures (1,500) to appear on the primary ballot.   

For Supreme Court judges, the Constitution of the State of New York created an alternate method to the petitioning process. In place of a primary election, "judicial delegates" (an elected position), vote at a judicial nominating convention for the Democratic Party candidates who will appear on the general election ballot.  

Both the Democratic primary winners and the “nominated” Supreme Court candidates generally aren’t challenged by other party candidates in the general election and that’s why there’s rarely more than one “choice” on the printed ballot. 

Voters need more information about how people become judges and about the candidates themselves. Exacerbating the perceived lack of choice and imposed apathy, even during a contested primary, voters don’t know where to find information about judicial candidates. The New York State Bar Association and The New York State Board of Elections should collaborate on means and methods of disseminating information to the general public about judicial candidates well in advance of elections.

As things stand now, the impression some have about how people become judges in New York is that it's largely dependent on who you know and how much money you have to finance your candidacy. That's not good enough. We need a judiciary that represents our entire expansive mosaic. 

Now more than ever, we must guard against the appearance of backroom deals and patronage in the judiciary and promote impartiality. Lawyers, judges, legal, civic, and community groups all have a role to play in demystifying the judicial electoral and appointment processes and in advocating for the necessary reforms to restore people’s faith in the judiciary‘s independence and, by extension, the rule of law.  

As Roe illustrates, voter participation lies at the very heart of constitutional progress and the full realization of our deeply rooted rights.

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Elba Rose Galvan is a Surrogate's Court Referee in King's County and candidate for Manhattan Surrogate. She served under Surrogate Margarita Lopes Torrez, and currently serves under Surrogate Rosemarie Montalbano, both considered reformers of the court.

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