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New York City Needs Supervised Injection Facilities


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First Lady McCray & Health Comm. Bassett (photo: Ed Reed/Mayoral Photography Office)


There is a hot topic trending in the debate over the war on drugs: should there be safe places for intravenous drug users to inject? A panel of experts from around the world convened a symposium in New York City to share their experiences and the panelists and their sponsor, VOCAL NY, called for such a facility in the city. They are completely correct.

There are an estimated 100 supervised injection facilities worldwide and advocates credit them with reducing both overdose deaths and the spread of infectious diseases (HIV and hepatitis C). These facilities offer clean needles, a sterile environment, and emergency services in the case of an overdose. They also provide education, counseling, access to treatment, and other services that might save users' lives.

Without such refuge, addicts resort to "whatever it takes" to get high and the resulting health problems resonate throughout society by way of the spread of infectious disease and the death of loved ones.

The rise in heroin, the primary drug used via injection, is well-documented and New York is no exception. Staten Island is the borough hardest hit by the heroin epidemic; 74 people there died of overdose in 2014. Many heroin users began by taking prescription painkillers that are chemically similar and after becoming addicted find that heroin is cheaper and easier to obtain.

Mayor de Blasio traveled to Staten Island in early December to announce measures addressing the heroin crisis there. He has made naloxone, an overdose antidote, available in pharmacies without a prescription and promised to increase the availability of substance abuse treatment by licensing more physicians to prescribe maintenance drugs that dull the cravings for heroin.

These are good steps. We still need supervised injection facilities.

Naloxone does not prevent overdoses which can occur from the improvised situations that users often find themselves in. Supervised facilities prevent overdoses by providing an environment that is cleaner and less chaotic than, say, a gas station restroom.

The spread of infectious disease through unsanitary conditions and instruments represents an even deadlier and widespread threat than overdose - infected users spread disease to unsuspecting loved ones, often through sexual intercourse.

One of the thorniest problems in combating illegal drugs is the fact that they are illegal and addicts, because they are punished, deplored, and shamed for their disease, live in the shadows, apart from mainstream society. Supervised facilities provide a place where they are not judged. Staff, often recovered addicts who understand their dire situation, can offer users a path out of their misery and provide education on infectious diseases and methods of prevention.

Supervised injection facilities are one example of the "harm reduction strategy" towards substance abuse. Needle exchanges are another example; they accept the fact that users will utilize infected needles if that is their only choice, but respect that users are intelligent and prefer clean needles if they are available. The immediate result of needle exchanges is fewer persons infected with HIV and Hepatitis C, thus the harm of addiction is reduced. New York City has 15 needle exchanges, but only one on Staten Island and, sad to say, no one is asking for more.

The harm reduction strategy is the polar opposite of the 50-year-long "war on drugs" which was lost long ago, though few will admit it. Throughout the world opinion is shifting towards decriminalizing all drugs. A recent draft United Nations report recommended decriminalizing drugs and Portugal did so about ten years ago with no discernible detriment to civil society.

A recent editorial in the Staten Island Advance excoriated the idea of safe places like supervised injection facilities, saying that they encourage more drug use - but they do not; they encourage safe drug use.

It is the plain fact that many thousands of people, without any encouragement, are seeking out heroin for any number of reasons. On Staten Island, and throughout New York City, it is time to tear down the walls that separate us, bring users in from the cold, and offer them whatever help we can.

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Christopher Beall works at a criminal justice nonprofit in the Bronx and is on Twitter @JailedintheUSA.

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Have an op-ed idea or submission for Gotham Gazette? E-mail editor Ben Max: This email address is being protected from spambots. You need JavaScript enabled to view it.

A Family-Centered Approach to Homelessness Policy


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Ralph da Costa Nunez, the author


The first two years of the de Blasio administration have been marked by a continued rise in the number of homeless children and adults, along with the resignation of both the deputy mayor for health and human services and the commissioner of the Department of Homeless Services. The Mayor's announcement of a comprehensive operational review of the city's homeless programs may be labeled by some as a sign of a system in crisis. However, the administration may actually be poised to seize this opportunity and radically overhaul the ineffective policies and practices of the past. The key question is: to what end?

Homeless children and their parents make up 70 percent of all the homeless individuals in the system. Tonight over 17,000 homeless parents with almost 24,000 children will call a shelter or a welfare hotel home. The sensational aspects of their problems routinely make headlines and overwhelm politicians, civic leaders, and taxpayers alike. It is time for those responsible for delivering the city's homeless services to face the facts about families—the majority of the city's homeless—who presently spend an average of 15 months living in shelter.

After serving 140,000 individuals over the past 30 years, most of whom were children, we at Homes for the Homeless have faced the facts. We've learned a thing or two about who homeless families are and what it takes to move them permanently into stable housing. The central lesson, contrary to popular belief, is that simply doling out government rental assistance or housing vouchers will not solve homelessness for most families. Our policymakers have to stop pretending that putting a roof over a family's head for a few months or even a year 'ends homelessness.' It doesn't. Over 60 percent of the families rehoused by the city have returned to shelter.

Truly solving homelessness will require we move from an emergency response to a triage response.

There are essentially three types of homeless families: (1) those parents over 25 who have work, tenancy, and life experience; (2) those parents under 25 who want to complete their education, start a work life, and get help with parenting; and (3) those parents who are first and foremost confronting severe challenges such as domestic violence, child welfare and neglect, substance abuse, and mental health issues. For the past 30 years, every administration's policies to combat family homelessness have been based on a 'one size fits all' rehousing strategy. The untainted truth is that homeless families are not all alike, their challenges and opportunities are not the same.

Anyone who has worked on the front lines in family shelters will tell you that the current system does not work and never will.

Providing housing to families not prepared to obtain, maintain, and retain their housing or their job results in repeated returns to the shelter system, which is both disruptive to the family and costly to the taxpayer.

The entire shelter system must be triaged into a network of specialized facilities that meet the needs of the three types of homeless families: (1) short-stay shelters to rapidly rehouse families who have work and tenancy experience and the highest probability of a successful transition; (2) intermediate-stay sites would provide mandatory literacy and job training to improve job readiness and retention, as well as job placement; and (3) highly specialized facilities would be equipped to tackle the severe chronic social issues plaguing the most vulnerable homeless families who find themselves homeless over and over again.

The efficiencies to be gained by such a reorganization would be enormous: the demand for shelter, the length of stay in shelter, the rate of return to shelter, and the cost of shelter would all decline.

So while the truth about homeless families is a bit more complicated than one would like, reorganizing the existing system to meet their actual needs is ground in common sense. Redirecting a misguided system requires strong political will and bold leadership. The time for a new and sensible approach is here.

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Ralph da Costa Nunez is president and CEO of Homes for the Homeless, a social services provider that serves about 430 homeless families each night in the Bronx and Queens. Ralph is also president and CEO of the Institute for Children, Poverty, and Homelessness, a nonprofit that studies the impact of public policies on homeless families, particularly children.

New York History: Legislative Scandals Often Lead to Meager Reform


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Silver, Skelos, Cuomo (l-r) (photo via The Governor's Office on flickr)


An outraged governor
The Governor expressed outrage at the corruption in Albany, calling it "disreputable and indecent," he said: "I am convinced that the time has come when this must stop. The people are aroused. They will stand for nothing less than honesty and fair dealing in the public service. Rip the cover off. Let in the light.... For years, votes have been bought and sold at the Capitol. Send one of the bribe takers properly branded through the State, so that he may be scorned by all honest men and it will have an inestimable effect for good and wholesome things in the service of the State and the people."

Gov. Andrew Cuomo, reacting to the criminal convictions of Sheldon Silver and Dean Skelos? No. Actually, it was Gov. Charles Evans Hughes in April 1910. He was reacting to the forced resignation of Senate Majority Leader Jotham P. Allds after it was revealed Allds had taken a bribe years earlier to sidetrack a bill when he was a member of the Assembly.

Corruption in the New York legislature is not new. In our history, it has often existed side by side with legislative accomplishments. In the wake of major scandals, history suggests, legislative reform is often tepid.

Previous top leaders tainted
Assembly Speaker S. Frederick Nixon (1899-1905) regularly demanded bribes to advance or kill legislation, but evidence of his corruption did not emerge until years later (and after his death). Senate Majority Leader Arthur Wicks (1949-1953) resigned his leadership position after news reports revealed he had made frequent visits to a labor leader imprisoned in Sing Sing prison for extortion. Assembly Speakers Perry Duryea (1969-1974) and Stanley Steingut (1975-1978) were indicted for alleged criminal acts but their cases were dismissed before trial. Speaker Melvin Miller (1987-1991) was convicted of cheating legal clients. The charges were unrelated to his work in the Assembly but conviction meant expulsion. He was sentenced to community service. Two years later, the conviction was reversed on appeal. Senate Majority Leader Joseph Bruno (1994-2008) resigned from the Senate before being indicted on federal corruption charges in 2009. He was convicted on some of the charges, the conviction was overturned on appeal, prosecutors re-tried him, and he was acquitted after a second trial.

Major reform unlikely
The Silver and Skelos convictions and other recent convictions of a number of state legislators have brought a chorus of demands for tighter ethics rules, campaign finance reform, banning outside income, and other possibilities. Major reform may be unlikely. After high-visibility scandals and convictions for lawbreaking, there are often demands for reforms that will curb corruption.

Reform suggestions all merit consideration and discussion. Hopefully at least some will be enacted. But history suggests that decisive reforms may be unlikely, for several reasons:

*The legislature asserts that it has reformed and will police itself. Often after a scandal, there is a change at the top, a proclamation by new leaders that corruption will not be tolerated, some modifications of the rules, but no wholesale changes. The new leaders in the Assembly and the Senate already made some changes earlier this year. Assembly Speaker Carl Heastie, commenting on the Silver conviction, noted that "accountability and transparency are of the utmost importance...It is our hope that in time, the new measures we have recently put in place to strengthen ethics compliance will have a positive impact. This includes the creation of the Assembly Office of Ethics and Compliance, enactment of more stringent disclosure requirements, enhancements to the per diem reimbursement policy, new limitations on the use of campaign funds, and access to greater resources for the Joint Commission on Public Ethics (JCOPE)."

*People tend to judge the legislature by its leadership and their own local legislators. Citizens tend to judge the legislature in part by what they read and hear about its leaders. The legal, ethical, and moral standards exhibited by legislative leaders often set the tone for how legislators approach their public responsibilities. For instance, under Oswald D. Heck, New York's longest-tenured Speaker (1937-1959), a modest man and a model of probity, scandals were rare and public confidence was high. So far, Speaker Heastie, and the new majority leader of the Senate, John Flanagan, who replaced Skelos when he relinquished his leadership position in May to face criminal charges, have been low-profile, un-confrontational, and seemingly worthy of respect and confidence.

Moreover, people often feel that the legislature as a whole is not trustworthy but they think positively about their own senator or Assembly member, whom they may know personally or at least have met. That also dilutes public pressure for drastic reform.

*Governors have limited power to clean up the legislature. There are lots of calls for Gov. Cuomo to step in and bring about legislative reform. Governors have great power to propose reforms, frame legislative proposals, and force action through insertion of initiatives in their budget proposals. But they have had limited success in combating legislative corruption. The framers of the New York's first constitution in 1777 included provisions on the document to keep the governor from interfering in legislative affairs. In his initial address to the legislature in 1777, New York's first governor, George Clinton, promised "carefully to avoid the invasion of those rights which the constitution has placed in other persons," meaning the legislature. The Assembly sent him an official response that "we are determined neither to encroach upon the privileges of others, nor suffer our own to be invaded."

That dividing wall still exists. Governor Cuomo tried to breach it in a sense with the Moreland Commission on Public Corruption, which he disbanded in April 2014 amid rumors his office was meddling in its work. The commission accomplished little and left the suspicion in its wake that the governor killed it because he himself may have something to hide.

Cuomo acknowledges the need for more reform. At a news conference on December 13, he revealed he will propose closing the "LLC Loophole" as part of his 2016 reform package. The loophole allows multiple limited liability corporations owned by the same person to donate to candidates, thereby skirting regulations that cap donations from individuals at certain amounts each election cycle. He may propose other reforms as well.

Will the governor succeed? He may. But history suggests most of his predecessors did not.

Governor's reform proposal scuttled
Charles Evans Hughes, a Republican, energetically fought corruption during his years as governor, 1907-1910, including pressuring the legislature to enact the Moreland Act, which he and several governors since then, including Andrew Cuomo, have used to investigate and confront corruption in government. Republicans controlled both houses of the legislature, shady leaders like Allds were influential, so many of Hughes' struggles were with leaders of his own party.

In May 1910, with public anger still smoldering over the Allds scandal, Hughes proposed a dramatic reform -- creation of a direct primary system which would undercut the power of political bosses and special interests by allowing voters to directly select candidates. The legislature had killed the proposal in 1909. Propelled by public anger over the Allds scandal, Hughes demanded passage.

The legislature stonewalled. They passed a weak reform bill which mostly left the status quo in tact. Hughes, enraged, vetoed the bill, called the legislature into special session and demanded passage of his primary bill. He enlisted the support of good-government advocates and former president (and governor) Theodore Roosevelt in the cause.

But the legislature dug in. George Cobb, who had replaced Allds as Senate majority leader, denounced the bill. Assembly Speaker James W. Wadsworth declared the legislature would not "swallow its convictions" by passing it. Legislators complained of "coercion" and "dictation" by the governor. The bill was defeated.

Chastened and weary of fighting corruption, Hughes left the governorship in the fall of 1910 to accept an appointment to the U.S. Supreme Court.

The people themselves may intervene
The story does not end there. Fed up with corruption, voters elected a Democratic governor and Democratic majorities to both houses of the legislature in the fall 1910 elections. The direct primary law was enacted in 1911. But two years later, a maverick, crusading Democratic governor, William Sulzer, accused the Democrat-controlled legislature of rampant corruption. The legislature turned the tables on him, impeached him for misuse of campaign funds, and removed him from office. Voters, again disillusioned by the spectacle of corruption in Albany, ousted the Democrats and elected a Republican governor and legislative majority in 1914.

New York resumed its usual history of mostly progressive government alongside shady politics.

Voters do not have an easy "throw the crooks out" option at the polls this time. But in the fall of 2017, they will vote on whether to hold a state constitutional convention. That could lead to fundamental reform.

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Dr. Bruce W. Dearstyne is the author of The Spirit of New York: Defining Events in the Empire State's History, published in 2015 by SUNY Press.

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Have an op-ed idea or submission for Gotham Gazette? E-mail editor Ben Max: This email address is being protected from spambots. You need JavaScript enabled to view it.



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