Gotham Gazette Wed, 24 Apr 2019 11:12:06 +0000 en-gb (Webmaster) The Power to Prevent New Infections is In Our Hands eric adams credit

Brooklyn BP Eric Adams, the author (photo: Erica Sherman/Brooklyn BP's Office)

The world of medicine has advanced significantly in the battle against many chronic diseases, including the discovery of the polio vaccine and reversing the effects of diabetes and heart disease. However, one battle continues to be fought in research labs and on the ground in communities across America and around the world — the fight to end the HIV/AIDS epidemic.

While New York State has been a fearless leader on a national level in the effort to end this disease, Brooklyn remains the epicenter of a persistent health crisis. To tackle this head-on, the State set an ambitious goal of ending the epidemic by 2020. Thanks to the diligent work of advocates, community-based organizations, and health care providers, the target is within reach.

Yet statistics reveal a disturbing trend that must be addressed to complete the mission. Data from the New York City Department of Health and Mental Hygiene (DOHMH) reveals that 2017 HIV diagnoses were down to a record low of 2,157 citywide. Though this progress is encouraging, the rate of reduction is slowing, from an 8.6% decline in new diagnoses in 2016 to 5.4% in 2017. Brooklyn bears a disproportionate burden of the HIV/AIDS epidemic, with more than 30,000 of our neighbors living with HIV.

In 2017, our borough experienced 640 new HIV diagnoses, representing a 10.15% increase in new diagnoses from the previous year — making Brooklyn the only borough with an increase. Most alarmingly, Bedford-Stuyvesant and Crown Heights are the hardest-hit neighborhoods citywide, accounting for a quarter of new diagnoses in our borough.

Today -- Wednesday, April 10 -- we recognize National Youth HIV and AIDS Awareness Day. I continue to be concerned that each year since 2013 Brooklyn has more HIV diagnoses among youth aged 13-29 than any other borough. We owe it to our community’s young people to allow them to live in a world without AIDS.  

We cannot let the promise of an end to HIV miss the mark by neglecting our most susceptible communities that have already been neglected through generational poverty, institutional racism, and unequal access to quality health care. We have tools at our disposal to end this epidemic, particularly by expanding Medicaid Special Needs Health Plans (SNPs), which are designed to address the needs of individuals living with or at higher risk for HIV. These specialized health plans help members access treatment so that the virus becomes suppressed or “undetectable,” meaning they are unable to transmit HIV to others.

The more people we help achieve undetectable status, the closer we are to a society without HIV and AIDS. SNPs also have the expertise to connect HIV-negative individuals with effective prevention methods such as pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) so they can remain negative, saving $1 billion in state Medicaid costs for every 2,000 new infections.

The sectors of the population most at risk for contracting the virus are certainly those who will benefit most from an expansion of this crucial program. The State’s “Blueprint to End the HIV/AIDS Epidemic by 2020” lists include men who have sex with men (MSM), people of transgender experience, women of color, HIV-negative partners in couples in which one person is HIV negative and the other is HIV positive, and people who are intravenous drug users as populations at higher risk for HIV.

To reduce the rate of HIV in Brooklyn and reach the 2020 eradication target, we must reach these vulnerable populations and ensure they receive the culturally competent services needed to remain HIV negative. At present, of the populations identified by the State as being at higher risk, only HIV-negative transgender individuals are currently eligible to enroll in SNPs. To reach the end of this epidemic, this must change. 

Consider the clear scientific evidence that PrEP is more than 90 percent effective in preventing HIV transmission, yet the largest portion of New York State Medicaid recipients taking PrEP – 37% – are white gay and bisexual men despite black and Latino gay and bisexual men being hardest hit by the epidemic. We need to expand SNP eligibility and outreach to communities of color in the hardest-hit parts of our city to connect them to the services they need to get tested, treated, and enrolled.

We have the tools at our disposal to revolutionize the way we combat the HIV/AIDS epidemic. The power to prevent new infections is in our hands.

Eric L. Adams is the Brooklyn borough president. On Twitter @BPEricAdams.

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The Power to Prevent New Infections is In Our Hands Tue, 09 Apr 2019 04:00:00 +0000
The City’s New Pharmacy Ban and Next Steps in Fighting Cigarette Smoking de Blasio New York City anti-smoking

(photo: Michael Appleton/Mayor's Office)

Shoppers at pharmacies are there to buy products that will make them healthier, whether that’s tissue boxes to help with colds or prescription medication for a chronic issue. Pharmacies shouldn’t be home to items that make people sick.

CVS recognized this in 2014 when it took the unprecedented step of stopping the sale of tobacco products in its stores. Many public health professionals thought this would be the beginning of a wave of pharmacies following CVS’ lead. That didn’t happen.

Until January 1 of this year New Yorkers could still buy tobacco products at 500 pharmacies throughout the city. That’s when a new law went into effect that banned New York City pharmacies from selling tobacco products. This rule was part of a package of legislation signed into law by Mayor de Blasio in August 2017 aimed at reducing the number of smokers in the city by 160,000 by 2020. More than 5 decades after the U.S. Surgeon General first warned against the dangers of smoking, more than 880,000 adults in New York City still smoke.

The ban on tobacco sales in pharmacies is another important step in the long fight against tobacco use in New York City. Despite many years of progress, that fight is far from over, and we’re now facing unprecedented challenges. Policymakers need to continue pushing for a healthier, smoke-free city by taking an even more restrictive approach to purchasing tobacco products and turning their attention more closely to the dangers of products that can act as a gateway to traditional cigarettes.

There are many ways to continue building on the anti-smoking momentum that has been accelerating since the passage of the Smoke Free Air Act in 2002.

Now that pharmacies no longer sell cigarettes, policymakers should turn their attention to where else New Yorkers are buying tobacco products. After it pulled tobacco products from its shelves, CVS found that 38 percent of people who exclusively bought cigarettes at their stores were more likely to stop buying them at all. Imagine the impact that can be made if access were further restricted at other stores that traditionally sell cigarettes, along with restricting access near places that young people frequent, including schools, houses of worship, playgrounds, and libraries. An aggressive campaign to reduce access – whether through halting sales altogether or continuing to increase prices – will pay dividends in public health and lower the number of smokers in New York City.

Looking beyond traditional cigarettes, one of the most pressing new challenges in public health is the rise of addictive e-cigarettes, which have exploded in popularity among youth. More than 20 percent of U.S. 12th-graders reported that they vaped nicotine in 2018. Alarmingly, a study found that teens that used e-cigarettes had three times the level of cancer-causing chemicals in a urine test than their non-using peers.

The New York CIty pharmacy ban includes e-cigarettes, but there are still too many avenues through which young people can buy these dangerous products. There is also a persistent, misleading narrative that e-cigarettes help people quit smoking, despite the blatant lack of evidence to support this assertion. Policymakers need to take comprehensive action to prevent the further spread of e-cigarettes by continuing to limit sales and launching comprehensive education programs, or we risk reversing decades of progress in curbing smoking.

While we celebrate the critical milestone achieved by this ban and its companion legislation, we must turn our attention to the next frontier in reducing the number of smokers and improving the health of all New Yorkers. There are still too many places to buy tobacco products, and the looming threat of e-cigarettes grows bigger every day. We’ve recognized the dangers of smoking for long enough, and it has only become clearer that increasingly firm action is critical to combatting this problem.

Lisa David is president and CEO at Public Health Solutions (PHS). PHS’ NYC Smoke-Free program has contributed to changes in tobacco control measures in New York City. On Twitter @wearephsny.

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The City’s New Pharmacy Ban and Next Steps in Fighting Cigarette Smoking Sun, 06 Jan 2019 05:00:00 +0000
What's The [Data] Point? 1,441, with Health Commissioner Dr. Mary Bassett whats the data point

What's The [Data] Point? Episode 46 -- 1,441, with Dr. Mary Bassett, Commissioner of the NYC Department of Health and Mental Hygiene [You can download What's The [Data] Point? wherever you get your podcasts, including on iTunes]

wtpd dr bassett w maria and ben

Dr. Mary Bassett is the city's health commissioner, a position she has held since 2014, when newly-elected Mayor Bill de Blasio appointed her. Her portfolio includes helping New Yorkers achieve better health practices and outcomes, fighting the opioid addiction epidemic, combatting lead poisoning of children, and more. She joined the podcast to discuss some of her efforts to improve health equity in New York City.

Listen to the conversation and let us know what you think: Ben Max of GG (@TweetBenMax), Maria Doulis of CBC (@MariaDoulis). Listen below or download wherever you get your podcasts!

by Ben Max, Gotham Gazette

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What's The [Data] Point? 1,441, with Health Commissioner Dr. Mary Bassett Wed, 11 Jul 2018 04:00:00 +0000
Community Health Centers, Essential But At Risk, Must Be Funded Now doctors and nurses hearts

Doctors and nurses (photo via @NYCHealthSystem)

It is no secret that a war is here – a war on immigrants, on LGBTQ people, and communities of color, on the 99%, and more. Health, a part of politics that affects all facets of life, has suffered a brutal onslaught. While some of 2017’s greatest grassroots successes were in defeating Affordable Care Act repeal efforts, recent federal tax overhauls and budget proposals threaten to further strain a healthcare system millions have come to rely on.

Lost in the conversation have been critical federal health programs like the Community Health Center Fund. Introduced as part of the original Affordable Care Act legislation in 2010, the Community Health Center Fund has come to represent 70% of federal grant funding for the nation’s community health centers.

Community health centers reaffirm the fundamental right to health for all. They provide health care for low costs regardless of age, ability to pay, insurance access, or immigration status. Community health centers are culturally responsive neighborhood clinics families rely on, not just for primary care but also for specialized services like dental, vision, and behavioral health. Without the full funding they and the communities they serve have come to depend upon, these centers may not be able to serve their patients to their full ability.

The Community Health Center Fund was renewed for two years in 2015 as part of the funding renewal for the Children’s Health Insurance Program (CHIP) – and in September, these programs and others expired. The last continuing resolution to address this issue, signed by President Trump on December 22, included short-term renewal funding of CHIP, community health centers, and other vital health programs. However, this resolution provided only a portion of the funds these programs need to operate at full strength, and only through March, thus jeopardizing their long-term sustainability.

While the latest continuing resolution reopening the federal government through this Thursday, February 8, included a six- year renewal of CHIP, community health centers were one of several health initiatives that were surprisingly left once again without any updates. Thus, thanks to Congressional inaction, anywhere between 10 and 50 percent of revenue dollars for over 400 New York City and over 700 New York State community health centers serving 2.2 million residents across the state, is now at risk. 

FPWA counts community health centers among its member agencies and coalition partners across New York City – and these organizations are alarmed at this political failure.

Community Healthcare Network (CHN), which includes 14 community health centers and a fleet of mobiles operating across four boroughs, says that while CHN centers are not at risk of cutting services or staff, cuts to funding will force many centers in New York to curtail care. Care for the Homeless, a social and health services provider that includes substance abuse among its treatment focuses, believes that without federal funding, health centers may have to consider cutting less financially-sustainable services like Medication Assisted Treatment, a tactic critical to combating the opioid epidemic.

Without the Community Health Center Fund, New York City will lose over $88 million in 2018, affecting more than a million patients. In addition, Medicaid and CHIP patients make up 50% of patients served at health centers - and threats to these programs also threaten these centers. While losing this money doesn’t necessarily mean these centers will close, it does impact what services they’re able to provide, how many hours they are able to put in, how many people they can staff, which puts more pressure on the resources they have left. It also limits patients’ other options – and taxes those other options significantly by forcing these other health providers, such as New York City’s fiscally-challenged public hospitals, to provide potentially uncompensated care. This isn’t responsible, nor is it healthy.

Recent Capitol Hill rumors indicate that community health center funding would be addressed in the next round of budget negotiations in the coming weeks. But these centers, and the communities they serve, have been waiting long enough.

For many Americans, health care is anything but routine. When you’re forced to make the choice between your family’s dinner or your dentist co-pay, between your MetroCard for the week or your prescription glasses, what might you choose? Health shouldn’t be a privilege – it should be a norm. Community health centers validate that right every single day.

Congressional legislative efforts and comments over the past few months have made it clear – the Trump administration wants tax cuts for the wealthy now at the expense of programs that help everyday Americans access affordable care while still making ends meet.

Renewing federal funding for community health centers and other health programs is absolutely a priority and it should have happened by now. It must happen immediately.

Tuesday, February 6, is a nationwide Day of Demonstration for America’s Health Centers. Centers have been waiting for over four months to get their federal funding renewed and we need to do everything in our power to get this prioritized in the next piece of budget legislation.

It was a battle to keep CHIP and the Affordable Care Act alive – but the war on health isn’t over. As an umbrella organization for New York social services agencies with strong ties to community health centers, FPWA urges all New Yorkers to not let our health care fall victim to politics.

Call your senators and representatives – tell them to demand legislation that fully funds the Community Health Center Fund and other crucial health programs now without jeopardizing the health of millions.

Winn Periyasamy is a health policy analyst at FPWA, an advocacy and anti-poverty nonprofit based in New York. On Twitter @FPWA.

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Community Health Centers, Essential But At Risk, Must Be Funded Now Mon, 05 Feb 2018 05:00:00 +0000
Trump Administration’s Edict to CDC Puts Millions of Lives at Risk ppstand

The Washington Post recently reported that, in an unprecedented and dangerous move, the Trump-Pence administration has banned the Centers for Disease Control and Prevention (CDC) from using seven key words and phrases: “evidence-based,” “science-based,” “transgender,” “fetus,” “vulnerable,” “entitlement,” and “diversity.”

As a health care provider committed to fighting health disparities and caring for everyone who comes through our doors, we are horrified by these reports. This is dangerously ideological, and will put the health and well-being of millions at risk.

It’s not just about these seven terms. The Trump-Pence administration is trying to make a radical change in the focus of the entire agency—pushing a science- and evidence-based agency to one seeking to advance extreme ideology. The CDC is a non-partisan, non-ideological federal agency charged with scientific research and improving and protecting public health. This move is a direct contradiction to the pledge the agency has made to the American people.

This is just one more attempt by the Trump-Pence administration to prioritize a fact-free, ideological agenda over people’s health. From day one, this administration has shown a complete disdain for women, LGBTQ people, people of color, and science—from the policies they’ve enacted to the people they have put in charge of important programs. This effort further reveals their agenda: using the federal government to push harmful, politically driven policies at the expense of science and medicine.

This is only the latest of a long string of dangerous policies and rhetoric coming out of the Trump-Pence administration. Just a few weeks before this, Trump decided that reliable birth control methods should be replaced with the “calendar method,” which fails nearly a quarter of those who use it every year.

It’s clear that this administration is attempting to infiltrate all areas and agencies of government—and of our private lives—with their harmful ideologies. And it’s not just the administration. Under House Speaker Paul Ryan’s leadership, the House has worked tirelessly to restrict access to sex education, birth control, and abortion. In fact, when recently discussing the GOP tax cut plan, Speaker Ryan proclaimed that women need to have more babies.

The edict to the CDC is an affront to women, to transgender people, and to all communities that experience health disparities—this is an affront to the patients that we serve every day in New York City and elsewhere. It’s also an affront to the professionals who work at the CDC, to the science and medical communities whose work will be deeply affected, and to anyone who has benefited from scientific research or medicine in the United States and around the world.

The Trump administration is using the federal government to try and control women’s bodies and erase LGBTQ people and people of color. This goes directly against the will and values of New Yorkers—and of Americans—and we will not stand by and let this happen.

This move is beyond ideologically twisted, and will put millions of lives in danger, including our patients’. The Trump-Pence administration should be ashamed, and must end this dictate immediately.

Laura McQuade is President and CEO of Planned Parenthood of New York City.

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Trump Administration’s Edict to CDC Puts Millions of Lives at Risk Wed, 27 Dec 2017 05:00:00 +0000
Top Cuomo Aide Moves to Avoid Conflicts of Interest Before Leaving for Private Sector malatras cuomo site

Jim Malatras, right, with Gov. Cuomo, center (Kevin P. Coughlin/Governor's Office)

Jim Malatras, director of state operations for the Cuomo administration, has walled himself off from healthcare issues as he prepares to leave his post early next year to join the Healthcare Association of New York State as its new chief operating officer. Precautions, including guidance from a state ethics panel, are being taken so that Malatras will avoid conflicts of interest as he continues working for Cuomo for the next several months before moving into a top role with one of the state’s most powerful lobbying entities.

Politico New York first reported that Malatras will be resigning soon after the Governor’s next State of the State address, in January. Known as a policy wonk, Malatras started his public career in 2001 working for Assembly Member Richard Brodsky. In 2007, he joined the office of Andrew Cuomo, then-Attorney General of New York State. He has been by Cuomo’s side since, save for a one-year stint as vice chancellor for policy and chief of staff at the State University of New York from 2013 to 2014. For the last two years, he has held his current position as state operations director.

In August, Malatras was approached by the Healthcare Association for its top managerial position, as current COO Richard Cook is resigning, according to HANYS. The association is one of the state’s largest trade groups and represents about 550 hospitals, nursing homes, and health care facilities. It is a $30-million operation, part for-profit and part nonprofit, which employs more than 200 people. The group also has a large lobbying presence in Albany. “The COO is the chief management role at the organization,” said Darren Dopp, senior vice president of corporate communications at HANYS. “It’s not a lobbying role, it’s not a political role. It’s a purely management position.”

Considering the scope of healthcare issues in New York State and Malatras’ position as essentially the overseer of all state agencies, the move provokes a number of questions about conflicts or the appearance of conflicts of interest. These are questions that the Cuomo administration says are being accounted for as Malatras continues to work for the governor.

“If you include federal aid, healthcare is the biggest part of the state budget,” said Bill Hammond, director of health policy at the Empire Center for Public Policy. “Even without federal aid, it’s the second biggest behind school aid.” Hammond pointed out that healthcare has “receded as a political fight” in Albany in the last few years after having been one of the major sticking points that led to budget delays in the past.

Still, there are key healthcare and hospitals-related issues facing the state. Medicaid funding levels for the city through the state budget became a sticking point this past budget season. Hammond pointed out that the Healthcare Reform Act is due to expire on December 31, 2017 and he expects that the governor will address it either in his State of the State or the next budget. Surcharges under the act bring in millions of dollars for the state and large amounts of that funding are funneled to hospitals. The act will likely be extended, as it has been in the past.

Another issue is permanent guarantee funds, which insulate healthcare providers if insurance companies go bankrupt. These funds were the subject of much debate this year following the closure of Health Republic Insurance of New York State. Hammond also said a perennial issue in Albany is whether the legislature should establish nurse staffing ratios. A “sleeper issue,” he said, for the state could be New York City Health + Hospitals, the city’s municipal health care system which is currently being overhauled to compensate for massive deficits. “At some point, there might be a push for the state Legislature to do something,” Hammond said.

Malatras has put measures in place to avoid any possible conflicts. Before even receiving an official offer from HANYS, he filed two written notifications recusing himself from all healthcare matters on August 11 and August 18. He then sought guidance from the Joint Commission on Public Ethics on the prospective job. In an informal advisory on August 26 and a supplemental informal opinion on September 12, copies of which were provided to Gotham Gazette by the Cuomo administration, JCOPE approved of the precautions that Malatras has taken and informed him of the restrictions he will face with his new employer.

“Jim has been an invaluable member of this administration and spearheaded many of the Governor’s key initiatives – such as the tax cap, Clean Energy Standard and college loan forgiveness – which have improved the lives of New Yorkers and will ensure a better a brighter future for this state,” said Abbey Fashouer, deputy press secretary for the governor, in a statement to Gotham Gazette.

“Per state ethics laws, Jim informed Counsel’s Office upon being approached for his new position as well as sought, received, and followed guidance from JCOPE regarding his ongoing duties to avoid conflicts in post-state employment,” Fashouer continued. “He intends to abide by those ongoing ethical obligations to avoid even the appearance of a conflict both as he concludes his work with the Executive Chamber and in the private sector.”

Blair Horner, executive director of the New York Public Interest Research Group, praised Malatras’ foresight. “That’s why JCOPE exists,” he said, “and it sounds like the correct steps for the administration to have taken.”

As per the Public Officers Law, Malatras will face a two-year bar against appearing before a state agency or receiving any compensation for services related to cases before his former agency. Since he was employed by the executive branch, the two-year bar applies more broadly to all state agencies. He also faces a lifetime ban against providing services that would involve any matter that he directly oversaw or was personally involved in while in state government.

Hammond, describing Malatras as “a sharp guy” and “very capable and intelligent,” also said he was glad that Malatras has tried to preempt any conflicts in his work going forward. “Taking those precautions in and of itself doesn’t necessarily solve the problem,” he said, “but it’s a sign of good faith that he’s acknowledged the issue and taken steps to address it.”

The governor’s office did not make Malatras available for an interview for this article.

Dick Dadey, executive director of Citizens Union, a government watchdog organization, said Malatras will no doubt be constrained by the state’s laws. “However, having a top administration official within a large organization like [HANYS] does provide the association with the unique perspective on the governor’s thinking and the decisions that will be made over the next couple of years,” Dadey said.

Dadey lauded Malatras as a principled public servant but warned of the tough scrutiny he will face in his transition into the private sector. “[Malatras’] last couple of months in government will be examined closely,” he said, “to ensure that he acts with his usual integrity in handling of matters that affect the healthcare industry. He’s a good guy with a strong compass and I’m sure that will guide him in how he exits state government service successfully and with integrity.”

by Samar Khurshid, senior reporter, Gotham Gazette

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Note: Gotham Gazette is an independent publication of Citizens Union Foundation, sister organization of Citizens Union.

Top Cuomo Aide Moves to Avoid Conflicts of Interest Before Leaving for Private Sector Mon, 17 Oct 2016 04:00:00 +0000
NYC Health Commish Highlights Death Disparities bdb bassett

Mayor de Blasio and Health Commissioner Bassett (Rob Bennett/Mayor's Office)

Crisis is part of the gig for the chief health official in the nation's largest city, and Dr. Mary Bassett has dealt with her share of emergencies in the two years she's served as commissioner of the Department of Health and Mental Hygiene. First there was Ebola, followed by Legionnaires', and now comes Zika—and those are just the ones the public has heard about. New York City is also seeing an outbreak of whooping cough, Bassett told a Thursday briefing at the CUNY Graduate School of Journalism.

But as Bassett sees it, her job is as much about confronting the "enduring disparities" that characterize public health in New York City as it is about responding to sudden threats. The map of disease and death in the city reflects "patterns of marginalization," she told members of the Center for Community and Ethnic Media, "patterns that I am determined to talk about and ameliorate."

Among the more striking examples: Life expectancy in Brownsville is 11 years shorter, on average, than for residents of the financial district. "That means Brownsville has a life expectancy more along the lines of Sri Lanka, a developing country," Bassett told the panel moderated by NY1 anchor Errol Louis, the director of urban reporting at the school and joined by Vania Andre, editor-in-chief of the Haitian Times, and I.

There's much more to this story - read the rest here, from our partner City Limits.

NYC Health Commish Highlights Death Disparities Fri, 29 Jan 2016 14:34:35 +0000