Gotham Gazette http://www.gothamgazette.com/component/tags/tag/449 Thu, 19 Oct 2017 14:53:59 +0000 Joomla! - Open Source Content Management en-gb webmaster@gothamgazette.com (Webmaster) City Council Members Still Navigating Outside Income Divestment Ahead of Deadline http://www.gothamgazette.com/?id=7234:city-council-members-still-navigating-outside-income-divestment-ahead-of-deadline http://www.gothamgazette.com/?id=7234:city-council-members-still-navigating-outside-income-divestment-ahead-of-deadline paul vallone by john mccarten

Council Member Paul Vallone (photo: John McCarten)


Legislation barring City Council members from making outside income will go into effect on January 1, forcing several sitting and incoming Council members to make tough decisions about their side jobs.

The regulations, which were linked to a significant pay increase for all city elected officials, including a salary bump from $112,500 to $148,000 for City Council members, were approved by Mayor Bill de Blasio and the City Council last year. Only three current City Council members, two of whom voted against the new restrictions, continue to be involved in their private sector businesses, and each is still in the process of figuring out divestment as mandated by the new law.

Council Members Peter Koo, Chaim Deutsch, and Paul Vallone -- all still in the process of being reelected to another term -- were required to submit letters to City Council Speaker Melissa Mark Viverito by March 1, 2016 indicating whether or not they intended to continue earning outside income and stating an intention to comply with the rules by the January deadline -- in time for the 2018-2021 Council session.

When reached by Gotham Gazette, each of the three Council members or a representative described legal and logistical complexities in divesting from or dissolving a limited liability company (LLC), resigning from a job, or recusing oneself from duties in anticipation of the deadline.

Meanwhile, some still question whether the Council should have gone to a near-complete ban on outside income (small allowances are provided for members who teach a college course, for example), or if the model should have been akin to the cap on what members of Congress are allowed to make outside of their governmental duty -- a small percentage of their salaries.

Vallone, a Democrat who represents District 19 in Eastern Queens, reported earning between $5,000 and $47,999 from his family’s law practice on his 2016 financial disclosure forms. In opposing the new outside income restrictions on Council members, he introduced a last-ditch amendment -- citing a statement made by good government group Citizens Union -- that Council members’ outside income should be capped at 15 percent of their Council salaries rather than eliminated. The amendment did not pass, and a spokesperson for Vallone said he is working with his lawyers to figure out how the rules apply to the family’s legal firm, which was founded by his grandfather Judge Charles J. Vallone in 1932, and where three generations of Vallones have since practiced.

As managing Partner of Vallone & Vallone, the Council member oversees the company’s day-to-day operations and serves as general counsel for corporate clients, according to the firm’s website. The firm also handles estate law, real estate transactions, civil and personal injury litigation, and criminal law.

Also a Democrat, Deutsch represents the 48th Council District, in Southern Brooklyn, and currently makes between $100,000 and $250,000 a year through a real estate management company he owns. He said he intends to shut down the business by January, but has not yet determined the process for doing so.

“It’s going to take some time to shut down the corporation. I don’t know exactly what the process is,” said Deutsch, who voted against the bills. “What I do know, is that I’m not accepting any more managing fees. I could keep the corporation open for the next five years, and maybe reopen it after term limits. But I will not be receiving the outside income.”

Deutsch, like Vallone and Koo, will be term-limited out of office at the end of 2021 if successful on Election Day this year, which each is expected to be.

Koo is a Democrat who owns a chain of pharmacies and represents the 20th Council District in Queens. He reported making between $60,000 and $99,999 as the president of a pharmacy, and another $5,000 to $47,999 at another pharmacy. He did not respond to multiple requests for comment, but he was the only one of the three who voted in favor of the legislation.

Other newly elected Democratic nominees for the City Council said that they had already quit their jobs to focus on their campaigns and that they have no intentions to returning to work before January.

“I quit in 2017 in April to be a full-time candidate,” said Keith Powers, who won a crowded District 4 Democratic primary and is the favorite to win the seat in November. “No matter what job I had at the time, I would have given it up; you want to make sure you have all the time to talk to voters.”

Like Powers, most candidates for City Council either leave their jobs entirely or take a leave of absence for the key months of the campaign.

Powers, a former government aide and, more recently, lobbyist who ran partly on a reform and transparency platform, said he hopes that the City Council rules can be a model for the state Legislature, where the salaries are far lower but the outside income restrictions are minimal and the job is considered part-time.

“You should be fully committed to the job that you’ve been elected to for the district. In the district that I am in, I don’t know how you would even have time to do both,” Powers said.

State government appeared to be moving toward pay raises for state legislators and others in government last year, but the process was stalled amid disagreements among Governor Andrew Cuomo, members of the Legislature, and appointees to a special panel tasked with determining pay raises and, potentially, other reforms to the relevant jobs. Legislators haven’t had a salary increase in nearly 20 years, with base pay stuck at $79,000, though many legislators receive additional bonuses as well as per diem payouts for trips to Albany.

There were and continue to be criticisms about the requirement that City Council members relinquish virtually all outside income. Some stemmed from concerns that an outright ban on outside income could discourage small business owners from running for office, according to Council Member Ben Kallos, who co-sponsored the legislation and chairs the governmental operations committee. The bill was tweaked to make allowances for passive income and would not force electeds to dissolve their business entities completely.

“It’s just what we could reasonably expect from people. So, if somebody has spent their career as a small business person, and brought that small business experience to the City Council,  which can be invaluable…,” said Kallos. “After four years or eight years, [that person] could return to their community, and continue doing what they did to begin with.”

Rather than stripping a small number of elected officials of their non-governmental livelihoods, the goal was to ensure that Council members focus on their districts full-time, and to avoid any real or apparent conflicts of interest.

“It is a concern for me that someone with business before the city could hire a member of the City Council in the hopes of gaining influence,” said Kallos, who represents Manhattan’s 5th Council District.

Kallos said that before taking office in 2014, he personally retired from the practice of law in three states and dissolved LLCs for companies he had started. He said he is still in the process of dissolving several non-profits he created.

“All of them have had, literally had no business since I got elected. But, it can be a complicated and weird, long process,” he said.

While dissolving these entities is not required by the bill, Kallos said, “I felt that as the author of the law in question, I have to set a good example and go one step further than the law requires.”

Certain passive income, such as interest, dividends, rent, annuities, capital gains, copyright royalties, or retirement payouts are acceptable under the new rules. Council members may also accept compensation for speaking engagements or artistic performances, with advance approval by the Conflicts of Interest Board (COIB), and income for teaching an accredited college course, “so long as such compensation does not exceed that normally received by others at the institution for a comparable type and amount of instruction.”

The language also leaves room for jobs drawing “minimal income, involving a limited time commitment,” with advance approval by the Office of General Counsel, as long as the role does not interfere with the member’s official duties.

The pay raise at the City Council may have helped attract a number of candidates from state government, where legislative salaries have been frozen since 1999. But, the new city guidelines can also create complications for an Assembly member and state senator earning outside income on the verge of election to the City Council. Three state lawmakers won Democratic City Council primaries in September and are either heavily favored or guaranteed to win the seat in November.

State Senator Ruben Diaz Sr., who won the primary for Council District 18 in the Bronx, earns between $5,000 and $20,000 for his role as pastor at the Christian Community Neighborhood Church, which he founded, according to his most recent financial disclosure forms. Diaz Sr. could not be reached for comment.

Assemblymember Mark Gjonaj, who won the primary for Council District 13 in the Bronx, has earned between $75,000  and $100,000 from a real estate brokerage firm he owns with a family member. A spokesperson for Gjonai said he has started the process with his lawyers and accountants to take the necessary steps to comply with city law.

“It's difficult for him to comment, because he's learning himself about that process,” said Jennifer Blatus, a spokesperson for Gjonaj. “I can say that it’s something the Assemblyman is happy to do in order to better serve his constituents.”

Assemblymember Francisco Moya, who won the primary in Queen’s 21st Council District, receives between $5,000 and $20,000 in rental income, according to his state disclosure filings, and will not be obligated to give up the income.

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by Rachel Silberstein, State government reporter, Gotham Gazette
     

Read more by this writer.

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City Council Members Still Navigating Outside Income Divestment Ahead of Deadline Wed, 04 Oct 2017 04:00:00 +0000
Protecting the Soul of Flushing, and Beyond http://www.gothamgazette.com/?id=6407:protecting-the-soul-of-flushing-beyond http://www.gothamgazette.com/?id=6407:protecting-the-soul-of-flushing-beyond soul flushing 

132-40 Sanford Ave in Flushing, a Treetop Development-owned rent-stabilized building


After more than a year of intensive community engagement, Flushing’s "under the radar" rezoning study of an 11-block waterfront area dubbed Flushing West was suddenly withdrawn by the Department of City Planning (DCP). The decision was prompted by a letter from City Council Member Peter Koo, who outlined a comprehensive list of outstanding concerns including “that the numbers don’t add up” for developers who perceive that the rezoning amounts to a “downzoning.”

DCP’s decision to pause the study elicited mixed reactions, in part because the rezoning study did spotlight the heavy infrastructural strain of Flushing’s white hot real estate market and unified multiple community stakeholders to protect the neighborhood’s rapidly diminishing affordable housing and advocate for equitable community development.

Mayor Bill de Blasio recently penned a Huffington Post column proposing that in the current market climate of hyper-gentrification, the city’s existential identity is defined by residents of public housing and rent-stabilized apartments. As the mayor opines, “It’s in protecting these people that we protect the soul of our neighborhoods.” I dare say the soul of Flushing has been under attack and protecting its diverse, working-class residents is long overdue.

Like many neighborhoods of color, affordable housing in Flushing is threatened by predatory equity investment. Investors target “underperforming” and “undervalued” multi-family residential buildings in strategic markets (i.e., “up and coming” and gentrifying areas). They count on capturing unrealized market value through replacing current tenants with those that can afford to pay higher rents or reselling properties at huge profits after making nominal capital improvements. Treetop Development LLC, one of the largest real estate companies in the New York City area, has a business model based on these “multi-faceted” strategies, to the detriment of communities.

Treetop’s online profile notes, “We actively acquire and transform existing rental properties in the region by modernizing living spaces, common areas and building systems before returning them to market. We are well-known for creating cutting-edge projects in neighborhoods coming up as desirable new addresses.” Since its establishment in 2005, Treetop Development LLC has been one of the region’s most active investors in multi-family properties including federally subsidized, project-based Section 8 developments and rent-regulated buildings.

In the past few years, Treetop has acquired and flipped numerous rent-stabilized buildings, generating huge profits. In July 2013, Treetop purchased 17-27 West 125th Street, a 50-unit rent-stabilized building in Harlem for $13.6 million. According to Treetop’s website, “17-27 West 125th Street boasts large apartments, which will be renovated upon vacancy to include new wide plank hardwood flooring, modern and chic kitchens and bathrooms, and stainless steel appliances.” After spending only $1.5 million on “signature” capital improvements, Treetop sold the building to Thor Equities for a whopping $30.6 million in August 2015 (a $17 million gross profit after 25 months of ownership).

Similarly in 2014, Treetop acquired a portfolio of six rent-stabilized buildings with a total of 139 rental and seven retail units in Washington Heights for $23 million. These properties, referred to as the "Columbia Audubon" portfolio due to their proximity to Columbia University Hospital and Audubon Avenue, were sold a little over a year later, in December 2015, for $36 million to a group of private investors.

In describing Treetop’s strategy to purchase and flip a multi-family portfolio in Central Harlem, co-principal Adam Mermelstein explained, “This portfolio is the perfect example of how picking the neighborhoods, identifying underutilized properties, effective management and recognizing the right time to buy and sell can pay tremendous dividends.” The portfolio purchased by Treetop for $22 million in 2013 was comprised of 12 five-story walk-up apartments and included rent-stabilized buildings on St. Nicholas Ave and Frederick Douglass Blvd. Two years later, Treetop sold the portfolio to a newly formed investment firm for $35 million, generating a profit equal to 59% of Treetop’s original purchase price.

Treetop Development LLC was featured in Crain’s New York Business for its enormous $138.8 million acquisition of eight rent-stabilized buildings in Queens representing the county’s largest multi-family transaction in 2015. Seven of the rent-stabilized buildings (totaling 489 apartments) are clustered in a three-block area near downtown Flushing and one building is in Elmhurst. Treetop wasted no time in making cosmetic upgrades to common areas such as lobbies and hallways, and renovating vacated apartments. A recent visit and conversation with a long-time, rent-stabilized tenant in one of Treetop’s Flushing buildings indicated that the common areas had already undergone capital improvements which permitted the prior landlord to increase rents.

Since Treetop’s acquisition, tenants have reported construction-related disruption and dust, spotty heat and hot water, and a sudden increase in vacant apartments. City Council Member Koo’s office has submitted a list of complaints pertaining to these buildings to 311.

This past year has been very busy for Treetop as it expands its extensive portfolio of rent-stabilized buildings in Harlem and Flushing, sold “select holdings at high profit margins,” and refinanced some properties through mortgage consolidation, as in the case of four Brooklyn properties including 188 South 3rd St., a rent-stabilized building in Southside Williamsburg. Among its early acquisitions in New York City’s multi-family market, Treetop paid a little over $5 million in August 2006 for the 41-unit building, intending to convert the apartments into upscale rentals. A few months later, various publications including the Metropolitan Council for Housing’s newsletter detailed the reasons why Treetop’s Mermelstein was named the city’s “most abusive landlord” by a group of tenant advocacy organizations.

Treetop’s 188 South 3rd St. was in the news again in July 2013 when a three-alarm fire erupted between the ceiling of the top floor and the roof. Over one hundred firefighters responded to the early morning blaze that took approximately two hours to extinguish. Several tenants were interviewed noting long-standing electrical problems and non-professional repairs. Charlin Ramos said to Brooklyn News 12, “I knew this was going to happen, I predicted it was going to happen.” Jacqueline Jimenez claimed Treetop ignored numerous calls from tenants. Extensive damage required many tenants to vacate and according to the Department of Buildings, the current status of 188 South 3rd St. is that a partial vacate order remains in effect as well as civil penalties and an outstanding Class 1 violation defined as “immediately hazardous.”

The same weekend that Mayor de Blasio’s column was published by Huffington Post, the New York Times published an opinion piece titled, How to Force Out Rent-Controlled Tenants. The timing and message of these articles underscore the precarity of rent-regulated housing that has been affordable to working-class New Yorkers. Key forces destabilizing the city’s neighborhoods, especially its communities of color, are the tactics deployed by predatory equity investors such as Treetop Development LLC. While the Flushing West rezoning study provided an opportunity to highlight the outstanding need for affordable housing, the current state of the neighborhood’s rent-stabilized housing requires immediate action to protect long-time tenants, or as the mayor would describe them, the soul of Flushing.

In early May, the Flushing West Community Alliance (FRCA) released a comprehensive research report that includes anti-harassment and anti-displacement measures. Based on numerous discussions with rent-stabilized tenants, FRCA recommends that landlords with a history of tenant harassment should not be able to receive permits necessary for renovations that will enable them to increase rents. At minimum, the four bills introduced to the New York City Council earlier this year, including Brad Lander’s “Certificate of No Harassment,” should be acted on immediately. Although the Flushing West rezoning process is temporarily on hold, speculative real estate market conditions have not abated which means rent stabilized tenants need strengthened protections now.

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Tarry Hum is a professor at the City University of New York and author of Making a Global Immigrant Neighborhood: Brooklyn's Sunset Park.

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Have an op-ed idea or submission for Gotham Gazette? Email opinion@gothamgazette.com

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Protecting the Soul of Flushing, and Beyond Wed, 22 Jun 2016 04:00:00 +0000
With Clock Ticking, East New York Negotiations to Heat Up http://www.gothamgazette.com/?id=6262:with-clock-ticking-east-new-york-negotiations-to-heat-up http://www.gothamgazette.com/?id=6262:with-clock-ticking-east-new-york-negotiations-to-heat-up espinal east new york hearing

City Council Member Espinal (photo: William Alatriste) 


With only two weeks left for the City Council to vote on the proposed rezoning of East New York, all eyes are on City Council Member Rafael Espinal, who is leading negotiations with the de Blasio administration and whose approval of a revised plan will determine its fate. Espinal has promised significant improvements to the plan put forward by the city and community organizers and advocates are calling on him to reject the rezoning if it does not deliver what they see as adequate affordable housing, local hiring, and other provisions.

Meanwhile, Espinal's colleagues and many others are looking to him as the East New York negotiations with the de Blasio administration will set the precedent for rezonings across the five boroughs.

The city's proposal to rezone East New York was passed almost unanimously by the City Planning Commission on February 24, giving the City Council the next fifty days to vote on it as part of the city's Uniform Land Use Review Procedure (ULURP). The neighborhood is the first of 15 the city plans to rezone as part of Mayor Bill de Blasio's ambitious plan to create and preserve 200,000 units of affordable housing. The plan aims to change land use rules and implement community improvements in order to make East New York more desirable and liveable, while fostering development that will include thousands of new units of housing, many of them with rent regulations.

Negotiations so far have been slow going, leading to a series of news reports this past week indicating that Espinal and others on the City Council side of the bargaining table are frustrated with the de Blasio administration. The parties are set to hold another meeting on Monday afternoon at City Hall, which participants hope will yield progress.

"There's a lot of frustration because we've proposed changes to the plan and we've been waiting for [the administration] to come back to us," said Espinal, whose district covers a vast swathe of the area in the plan - the City Council traditionally defers to the local Council member to approve or disapprove land use deals.

Espinal has made his priorities clear: "serious anti-displacement measures, a strong jobs plan and truly affordable housing." While he insists there has been no push back from the administration against his demands, the lack of movement seems to be testing his patience.

"The clock is ticking," he said. "We've been working on this for over a year. It's time to talk turkey." Espinal did say that one cause for delay was that both the administration and Council had been preoccupied until last week with the Mandatory Inclusionary Housing and Zoning for Quality and Affordability proposals, two citywide zoning amendments that lay the groundwork for the neighborhood rezonings that are set to go from East New York to Flushing, corridors in the Bronx and on Staten Island, East Harlem, and beyond.

The de Blasio administration has reiterated its commitment to the process. "The city is currently having very productive conversations with Council Member Espinal on the East New York rezoning plan," said Austin Finan, a spokesperson for the mayor, in a statement. "Since the beginning of the East New York planning process, we have been and remain committed to ensuring that the final proposal to be voted on by the City Council meets the affordable housing and community infrastructure needs of East New York residents."

Espinal will meet with city officials on Monday to hammer out the details of the East New York plan. On the Council side of the table, he'll be joined by Council Member Donovan Richards, chair of the Subcommittee on Zoning and Franchises, and Council Member David Greenfield, chair of the land use committee. Also expected to participate are the Council's land use director, Raju Mann, and the chief of staff to Council Speaker Melissa Mark-Viverito, Ramon Martinez.

According to a source with knowledge of the discussions around the rezoning, key sticking points include not only ensuring deeper levels of affordability in new housing, but also extending affordability for about 1,000 current residents whose rent-regulated apartments are nearing expiration of their terms; details of the city's commitment to a Workforce1 job training center; and progress around adding school seats and day-care slots - two areas of need in the administration's final environmental impact assessment of the rezoning plan.

"We have an opportunity to show that we are attacking inequality head on in East New York and the administration needs to take this issue seriously as we negotiate the first rezoning under MIH and ZQA," said Council Member Richards in a statement. "The lack of progress thus far on these negotiations is deeply concerning and we need to see legitimate movement soon to ensure that the needs of the community and Council Member Espinal are met."

All the stakeholders -- Espinal, his colleagues, community leaders, housing advocates, de Blasio administration officials, real estate developers, and others -- recognize that these rezoning negotiations will set the tone for the next fourteen and determine the future of housing and development in the city for decades to come.

"What I'm doing in East New York is the reason I ran for office," Espinal said. "It's an opportunity to create the strongest affordable housing plan in the city and set a precedent for how the rest of the city approaches rezoning." He has received strong support from his colleagues who, he said, "feel that whatever deal I'm able to reach with the administration, they can work off of when their neighborhoods are up for rezoning."

Council Member Peter Koo from Queens is likely to be next in the hot-seat as the Flushing West rezoning proposal moves through the ULURP process.

"We're certainly watching what happens in East New York closely," Koo said in an email, "but the Flushing West rezoning proposal is significantly different. Our rezoning area is on the waterfront which limits depth, and the LaGuardia flight path limits height. Flushing also has serious infrastructure needs that a large-scale rezoning of this nature would need to address. So we're watching East New York to see how the city responds to the community because Flushing also has a long list of needs."

Housing advocates also recognize the immense pressure that Espinal is facing, although different groups have taken varied approaches to respond.

"The guy's in a difficult spot," said Jonathan Furlong, zoning technical assistance coordinator, Association for Neighborhood and Housing Development. "What he decides in East New York has vast and far reaching implications for the Bronx, East Harlem, Flushing, Upper Manhattan."

ANHD has provided technical assistance to the Coalition for Community Advancement, a collaborative effort by housing advocates to address issues of rezoning across the city, communicating with administration officials, elected representatives, and residents. Members have met with Espinal numerous times to air their concerns and will also be meeting with Council Speaker Mark-Viverito.

The CCA has called for a scaling back of the East New York plan and has proposed its own alternative community plan. Besides more affordability for current residents, they want manufacturing sites removed from the plan to protect manufacturing jobs, a $15-million small homes preservation fund, the preservation of the Arlington Village development as affordable housing, and mechanisms to set aside space for community facilities.

On Sunday, the coalition held a rally outside City Hall to tell the Council to vote against the rezoning plan unless these proposals are embraced. The group said Sunday night that about 120 people rallied, including community members, State Senator Martin Dilan and Assembly Member Latrice Walker.

Furlong commended Espinal for being firm with the administration, but faulted him for not being more vocal on specific proposals. "It's tough to get a read on him," he said of the Council member.

New York Communities for Change, a grassroots advocacy group, has been more critical. NYCC released a report titled "Educating Espinal: How to Deepen Affordability for Thousands of Apartments in East New York and Protect Low-Income Residents" in which they directly called on Espinal to fight for more affordability in the plan.

"The Council member has not yet come out in support of a growing cry in the community for deeper affordability for low-income families," said Jonathan Westin, NYCC executive director. The group, which claims about 1,000 members, has two demands: 50 percent of units in new developments affordable for families making about 40 percent of the $77,000 annual area median income (AMI), and union jobs for workers in any new construction along upzoned areas. AMI is a federally-calculated number for all of New York City and surrounding counties. The area median income in East New York is significantly lower - about $35,000 per year for a family of four, about the same as 40% of AMI.

"We're pushing that if that's not part of the plan, he should vote "no,"" said Westin. "He should not vote against the interests of his constituents."

Asked recently about the East New York rezoning and the pushback it has received, Mayor de Blasio said that development and gentrification are taking place all over the city and that the city must take action to harness it. On WNYC's The Brian Lehrer Show, the mayor said on March 18 that "the worst thing in the world is to do nothing about" gentrification. "And bluntly," he said, "that was the broad approach of the previous administration and I point to neighborhoods like Bushwick and Bed-Stuy as classic examples where there was no rezoning" to offer developers more in exchange for community benefits.

Saying that there needs to be "a coherent governmental response" to gentrification and displacement, de Blasio said that "rezonings are absolutely necessary to create that affordability...if we don't do it, you'll see displacement with no countervailing action by the government." The mayor indicated that the East New York plan will include many affordable units for both lower- and middle-income residents.

It is negotiations on the plan that will yield the full details of what that government response is, in East New York and elsewhere.

On Thursday, New York Communities for Change led a rally in East New York, blocking traffic along Atlantic Avenue to draw attention to their demands. "Along Atlantic Avenue is where lots of developers have bought property and stand to make a windfall of profits from the rezoning," said Westin. "We need to ensure that with the increase in density that they get from the rezoning, there are deep affordability standards and real job standards for workers building these buildings."

Espinal was blunt about NYCC's efforts. "I don't need any educating," he said of their report. "I was born and raised there. I know exactly the struggles my constituents are going through."

Insisting that he prefers a "pragmatic approach," Espinal said he wants a holistic plan that covers all constituents and their needs, and that the administration has been receptive.

"To be fair, they've been listening," Espinal said. "But the time to listen is over. It's time to take action."

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by Samar Khurshid, City government reporter, Gotham Gazette
     

Read more by this writer.

Note: this article has been updated with details of the Sunday rally.

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With Clock Ticking, East New York Negotiations to Heat Up Mon, 04 Apr 2016 00:52:30 +0000
In New De Blasio Heath Care Plan, Limited Coverage for Undocumented Immigrants http://www.gothamgazette.com/?id=5965:in-new-de-blasio-heath-care-plan-limited-coverage-for-undocumented-immigrants http://www.gothamgazette.com/?id=5965:in-new-de-blasio-heath-care-plan-limited-coverage-for-undocumented-immigrants bdb mmv idnyc alatriste

Mayor de Blasio holds his IDNYC (photo: William Alatriste)


According to a recent report from Mayor Bill de Blasio's office, there are 345,507 undocumented immigrants in New York City who do not have health insurance. The Mayor's Task Force on Immigrant Health Care Access seeks to provide coverage next year to 1,000 of those individuals.

A new plan from the de Blasio administration, called Direct Access, is intended to expand health care to New Yorkers who do not have it and diminish the mounting number of undocumented immigrants without insurance. Direct Access is lauded by Task Force members, whose work led to the plan, but has critics and immigrants wondering if it is enough.

The Direct Access program will launch in the Spring of 2016 as a year-long pilot, coordinating access for 1,000 uninsured, undocumented immigrant New Yorkers, while accomplishing other goals. The launch is intended to be a preliminary step to collect data to design a larger citywide model. The estimated cost of the pilot is $6 million, paid for by a mix of public and private funds.

Dr. Ramin Asgary, professor of population health at the NYU School of Medicine, is skeptical. “The thinking is right, but it is nothing and close to a joke,” he said of the plan and its affect on the overall population of uninsured undocumented New Yorkers. “On paper they can say we are doing something, but it is a drop in a bucket in the ocean.”

Nancy Berlinger of the Hastings Center for Bioethics and Public Policy defended the number. “You don’t want to launch a citywide program and then realize you don’t have enough doctors, social workers, and nurses,” she said. “You make a commitment to people when you promise ‘direct access.’” The Hastings Center co-released a report on immigrant health care access with the New York Immigration Coalition (NYIC) in March with recommendations for the mayor’s office.

Uninsured undocumented immigrants in New York City have a handful of insurance options, but all come with hurdles in an increasingly complex health system.

For instance, the Affordable Care Act, aka Obamacare, is not an option. The healthcare legislation from 2009 shut out undocumented immigrants, and made them ineligible for federal Medicaid. As a result of few options, 64 percent of undocumented immigrants in New York City go uninsured.

In emergencies, older immigrants use safety net health insurance at some hospitals. The New York City Health and Hospitals Corporation (HHC) and community health centers are the primary safety-net providers that care for uninsured New Yorkers.

However, some undocumented people find the cost of care prohibitive, and have major gaps in referrals to specialists for chronic conditions, according to the Hastings Center and NYIC report. Community centers and hospitals do not have access to the same specialists, so health providers often find themselves at a loss for where they can send their patients in situations of chronic conditions like diabetes and arthritis.

Young people are the select few with the opportunity to apply for help through Medicaid, but only on a state level, and only after applying for the protected status of Deferred Action for Childhood Arrivals (DACA). While the program’s participants are not eligible for the Affordable Care Act at the national level, five states, including New York, offer health insurance to low-income youth granted DACA.

Direct Access, Mayor de Blasio’s plan, aims to address four issues for the undocumented uninsured: language barriers; coordination shortfalls between health centers and hospitals; lack of education of healthcare options; and the mountain of high-priced services.

The mayor’s task force brought together 25 agencies and nonprofits beginning in June of 2014. The plan, released in early October, estimated the large number of undocumented immigrants who are uninsured, a higher figure than the previous estimate of 250,000 in Beringer’s 2015 report. The NYC Center for Economic Opportunity's Poverty Research Unit worked with the task force to develop a model to estimate the number of uninsured undocumented immigrants in New York City based on information contained in the Census Bureau's American Community Survey data.

Young Adults Struggle through a Two-Step Process
Applying for DACA is no easy task.

The initial deferred action application requires applicants to prove their age; that they arrived to the U.S. before their 16th birthday; have continuously resided in the US since 2007; were physically present on June 15, 2012 - the date of the president's announcement; are currently in educational programs (school, vocational training, etc.) or graduated from high school/have a GED; and haven't been convicted of a felony, significant misdemeanor, or more than three misdemeanors.

Many of the above are difficult for people who did not keep records, don't have a bank account, cannot speak English, or were not enrolled in school. Limited DACA enrollment keeps undocumented youth from accessing Medicaid, and creates more need for a program like de Blasio’s Direct Access.

Cesar Andrade is a 23-year-old deferred action holder interested in becoming a physician in order to address the very problem he endured— lack of access to vital services for undocumented immigrants. Andrade was insured through the Children's Health Insurance Program, which expired when he was 19. He was uninsured between the ages of 19 and 22, while he was attending CUNY’s Macaulay Honors College.

“I always had to be cautious,” Cesar explained, “If you play soccer and tear your ACL, that’s a lot of physical therapy. Once I got insurance, there was a sense of relief. I got glasses and got treatment for an autoimmune disorder.”

In the meantime, CUNY was able to offer him clinic check-ups, which cost $20 each. Cesar became insured last year through Medicaid after DACA made him eligible.

Deferred action applications are seven-page forms, and must be mailed to the U.S. Citizenship and Immigration Services along with a $465 fee. Cesar said it was straightforward if you know English, but what gets most people, other than any language barrier, is the evidence one must submit.

Claudia Calhoon, director of health advocacy at the New York Immigration Coalition said, “The take home is really that given how tough it is for you and me to understand, you can imagine how this is for an immigrant with low-English proficiency, who may be new to navigating the U.S. healthcare system.”

As DACA enrollment continues, the number of enrollees in Medicaid will increase. According to the New York State Statistical Handbook, the average monthly number of Medicaid beneficiaries in New York has increased, with approximately 424,740 new enrollees in 2013. Sixty-three percent of the recipients lived in New York City. An unspecified number were new DACA holders and thus undocumented immigrants.

Kinsey Dinan, acting deputy commissioner of the city’s Human Resources Administration’s Office of Evaluation and Research said in an email, “We do not have the ability to specifically identify DACA clients in our Medicaid data.”

An unknown number of DACA recipients are accessing an already existing healthcare option. One of the plans for the Direct Access program is to educate uninsured immigrants on the options they may have if they have a protected status like DACA.  

Harvard Professor Roberto Gonzales is working on an initiative, the National UnDACAmented Research Project, which is a study to assess the effects DACA access has among undocumented young adults.

Gonzales and the American Immigration Council published a report in 2014 that announces preliminary findings where over 21 percent of survey participants obtained health care since receiving the benefit. Although the number of applicants to health insurance is low, he thinks there are reasonable explanations for this.

“The more likely option is that some DACA beneficiaries are acquiring health care coverage through work and college. Our survey was carried out in late 2013, 16 months after the initiation of deferred action. I suspect that since then more of our respondents have acquired health insurance.”

Still, Medicaid for deferred action recipients only addresses a small percentage of the 345,000 uninsured immigrants in New York City.

Can Community Health Centers and HHC serve the rest of the population?
Community health centers do not ask for documentation for patient treatment, so undocumented immigrants often go to these centers for emergency procedures. Over 400,000 of the New York City Health and Hospitals Corporation’s 1.4 million annual patients are uninsured.

For those earning up to 400 percent of the federal poverty level, these patients are offered a sliding scale for HHC health care services, including prescription drugs. However, patients and taxpayers often fall under tremendous financial burdens from copayments and subsidized care.

“If they are undocumented and don’t have financial resources, they aren't going to be able to pay the bill. The government will have to pay the bill. It is a cost effective perspective that is idiotic not to address,” said Dr. Asgary, of NYU Medical.

Asgary also mentioned that most undocumented immigrants do not have preventative care options that accompany being insured. “Imagine if someone has diabetes or heart problems, and doesn’t see a doctor in ten years. If they have kidney failure or an emergency, society has to pay for dialysis or surgery. One single night in a CCU in a public hospital will cost [taxpayers] $6,000. Five nights in a hospital will cost 20-30K, and they will need follow-up care. Forget just being a decent human being. There are a lot of costs on the line.”

An official statement from the city Department of Health and Mental Hygiene mentioned the expansion of current safety net services as outlined in the task force plan.

“The Direct Access program will build on New York City’s strong safety-net health care system. It will help make our safety net system more coordinated, will focus on prevention and primary care by providing “primary care homes” and will improve coordination of care while still preserving federal and state funds,” a representative from DOHMH wrote.

The Plan
Launching in the Spring of 2016, the initial $6 million cost of the plan will be partially funded by the Robin Hood Foundation through the Mayor’s Fund to Advance New York City. The New York City Council has also committed $2.5 million toward related education and outreach efforts, including a recommended medical interpreter training program to address language barrier issues in immigrant health care access.

In a statement, the Mayor’s Office of Immigrant Affairs expanded on the details: “The Direct Access program will provide predictable costs, provide a primary care home, and increase coordination of care. By providing a defined network and package of health services, set eligibility criteria and predictable fees, we will be enhancing the existing system for the uninsured in our city.”

The hope is that the program will expand access to health care, and coordinate many independent efforts throughout the city, including the new Caring Neighborhoods initiative, recently announced by Mayor de Blasio. Caring Neighborhoods,  a new program led by HHC and the New York City Economic Development Corporation (EDC), will expand community health centers in all five boroughs, so that 100,000 new patients will be able to receive care. The City is dedicating $20 million over two years to cover costs for new health centers.

According to the de Blasio administration press release on Caring Neighborhoods, the initiative will complement the Direct Access plan for immigrant New Yorkers by expanding services at Federally Qualified Health Centers (FQHCs) in neighborhoods with high concentrations of immigrants.

There is also hope that the recently launched municipal identification card program, IDNYC, will play into removing the paperwork barrier for the undocumented. The Direct Access program will require a verification of identity and residency in New York. The program will allow use of IDNYC to verify both, and as a participant ID card that will expedite access to care.

Berlinger, of the Hastings Center, is hopeful that the plan will bring together private and public health providers who do not typically work together. “You have to figure out how they share information, how they work together, how they share patient info. Then you have to figure out what it is a better way to reach the population,” she explained.

Enough?
Not everyone is satisfied with the plan as it stands. The Task Force report shows that in the neighborhood of Flushing, 14-37 percent are uninsured non-citizens.

City Council Member Peter Koo, of Flushing, is aware of the high population of uninsured undocumented immigrants, and has held community meetings that promote the use of MetroPlus Health Plan, the insurance plan of the New York City Health and Hospitals Corporation.

A recent Monday afternoon meeting had 75 attendees. Koo’s Chief of Staff, Elaine Cheung, said, “In terms of the Mayor’s Task Force report, Councilman Koo believes that there will be a huge demand for these services and we would like to see the number of participants expanded, especially in an community such as Flushing.”

In Brooklyn, 14-37 percent residents in Sunset Park are also uninsured non-citizens. City Council Member Carlos Menchaca addressed the issue in a statement: “The inaccessibility of care for immigrant communities in our City continues to be of great concern for me, and for the City Council as a whole. In the Council, we’ve allocated millions of dollars in the last year alone to help bridge some of the information and access gaps that exist on this front.” The Caring Neighborhoods Initiative recently announced that two of the community health expansion sites would be in Sunset Park and Queens.

Asgary recommends the pilot target senior citizens. “I would target the elderly undocumented. In terms of cost saving, it should be directed toward elderly. They are equally neglected as children. This program moves in the right direction but needs to be expanded.”

The Direct Access plan is modeled after assessments of several other cities’ health plans for immigrants. The plan, with adjustments, is based on Los Angeles’ My Health LA, a no-cost program for low-income residents regardless of immigration status. It offers care through 164 community clinics, and incorporates a preventative health approach.

Of the estimated 400,000 remaining uninsured in Los Angeles County, 280,000 are being served through the plan.

***
by Sarah Betancourt for Gotham Gazette
@GothamGazette

Note: this article has been corrected to note that the Hastings estimate for undocumented uninsured New Yorkers is 250,000, not 150,000; to remove mention of use of passport for DACA age verification; and to clarify City Council funding toward relevant initiatives and rates of non-citizens who are uninsured in certain neighborhoods.

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In New De Blasio Heath Care Plan, Limited Coverage for Undocumented Immigrants Tue, 03 Nov 2015 03:26:57 +0000