Robert Doar, commissioner of the city Human Resources Administration, testifies Tuesday on proposed cuts in programs for people with HIV/AIDS.
Valida Henry sat over a bowl of plain pasta in the cafeteria of Bailey-Holt House, a supportive AIDS housing residence she has called home for the past four years.
Henry, who contracted HIV 10 years ago, has lived longer than she ever anticipated -- in part thanks to services from both the city and the 44-unit facility long settled on Christopher Street.
"A lot of these places were set up for us to come and die," said Henry, who is 62 and legally blind. "The people with HIV and AIDS are living longer than they anticipated, and now they have to rethink the medical [care] and rethink the budget. And rather than rethink it, they want to cut it."
Henry is referring to the Bloomberg administration's executive budget proposal, which includes a $75 million cut to the city's Human Resources Administration, the agency which oversees social services for those living with HIV and AIDS. That cut will sever 248 caseworkers from the HIV/AIDS Services Administration to save the city about $4.2 million in fiscal year 2011 and $8.5 million the year after.
The city argues the reduction of caseworkers will not only save money, but also reduce service redundancies. Meanwhile advocates and those living with HIV and AIDS contend it will not only drive up caseloads, but also violate city law.
"Who is going to represent [us], if we only have one to 100," Henry asked, looking toward two fellow Bailey-Holt House residents beside her. "How will we be taken care of?"
To cut back on costs, the city has proposed to include contracted caseworkers from outside groups, such as Bailey-Holt House, in calculating its client to caseworker ratio. City law requires one caseworker for every 34 cases for individuals and one caseworker for every 25 families. According to one HRA official, the administration has 850 caseworkers serving about 31,000 clients -- or one for every 36 clients and above the legal threshold.
The administration would not disclose how many caseworkers it contracted with in community based organizations and nonprofit groups. It did say both the city's caseworkers and its contractors do the same job and eliminating some of those positions would save taxpayers cash.
"We have reached a point in this difficult economy in which it is no longer tenable to have two case managers assigned to one case when both their salaries are paid for in whole or in part with scarce public resources," said Human Resources Commissioner Robert Doar yesterday at City Hall. "We are acknowledging the important role played by the long-standing contracted supportive housing programs and including their case management staff in the HASA staff ratios."
The administration will also hire 18 liaisons and two supervisors to work with caseworkers in contracted social service organizations to help streamline the process.
From the get go, advocates have argued contracted caseworkers and city caseworkers do not do the same job and should not be counted toward the ratio requirement. Advocates say the city's caseworkers focus on fundamentals, such as making sure those living with HIV and AIDS get housing and welfare. At a contracted social service agency, like Bailey-Holt House, staff focuses on mental health and social support.
"They might as well count farmers in Poland," said Armen Merijan, a senior staff attorney at Housing Works, another social service organization that deals with the HIV and AIDS population. "It's so preposterous that it's insulting to anyone's intelligence. The law says it has to be staff at the agency."
When Gotham Gazette asked Human Resources Administration staff for a response to Merijan's claim, they did not return phone calls or emails.
For now, some council members appear to be siding with advocates.
"You're going to tell me that every one of the HASA case managers is equipped with psycho-social case management and [can] deal with health issues and able to manage clients?" asked Councilmember Domenic Recchia, the chair of the council's Finance Committee, at a hearing at City Hall Tuesday.
"Without question," responded one administration official.
"So, you're going to tell me all these years you wasted taxpayers' money by contracting case managers?" Recchia boomed, his voice reverberating throughout the packed council chamber.
Administration officials said "robust case management" was needed at the beginning. Now, the commissioner countered, the administration has to "properly scale" its workforce.
Regardless of the cut's legality, those caring for or living with HIV and AIDS fear they reduction in caseworkers will have other consequences.
Raul Plasencia, the director of supportive housing services of Bailey House, predicted an increase in homelessness if the caseworker cuts go through. Clients at Bailey-Holt House all have HIV or AIDS and have been homeless, incarcerated or suffer from drug addiction. If it takes longer to get them into supportive housing should caseloads increase, they will have nowhere to turn to but the streets.
Above Plasencia's office, Henry was attempting to enjoy her lunch -- one of three meals Bailey-Holt House gives her gratis every day. Instead of focusing on her pasta, she was focused on the city budget.
"You've cut the pools, the parks, HIV, AIDS," said Henry. "Just have to go along humbly with what they say. ... If they can do that now, what else can the government do?"
Moments later, a caseworker from the Human Resources Administration walked through the door of Bailey-Holt House. She was there to see her client.
Nancy Smith, a 68-year-old Manhattan resident, was being abused emotionally and financially by her 23-year-old grandson, who she had raised.
In his teens, Andrew began drinking and using drugs, and stopped attending school. He would threaten his grandmother, saying, "I will break your heart open," and "I will destroy this house." He would vandalize her belongings and demand money to stop.
Jewish Association for Services for the Aged, received an order of protection. The Jewish Association for Services for the Aging also got her locks changed and secured a court order to have her grandson removed from the home. Staff helped Smith get involved in a support group. Today, she says she is at peace in her home and feels freer and safer than she has in years.
Nancy Smith is not alone.
According to the Jewish Association for Services for the Aged, its 715 elder abuse clients are just the tip of the iceberg. There are currently nine elder abuse programs in New York City that help approximately 1,200 persons each year. Initially funded under the Department for the Aging, these programs have been put on the chopping block for the last two budget cycles.
But in January and July of last year, the City Council restored $849,000 for all of the elder abuse programs in New York City. (The Jewish Association for Services for the Aged gets over $400,000 of that for its elder abuse programs serving Queens, Brooklyn and Manhattan.)
In his most recent budget proposal released in January, Mayor Michael Bloomberg proposed eliminating these programs entirely. The Council of Senior Centers and Services, which is leading the campaign against the cuts, and the Jewish Association for Services for the Aged are committed to not letting that happen.
According to the National Center on Elder Abuse, between 1 million and 2 million Americans 65 or older have been mistreated. Only one in 14 cases of elder abuse in domestic settings is reported, and only one in 25 cases of financial exploitation is reported. Elder abuse victims tend to be female, socially isolated, dependent on a caregiver, physically frail, and experiencing other family stressors. The abuser is most frequently a family member, perhaps a spouse or an adult child. He or she also may be a neighbor, friend or paid caregiver. Abusers tend to be unemployed, suffering from mental illness and/or chemical addiction, middle aged, dependent on the older adult, socially isolated and experiencing their own financial and/or legal problems.
The current economic climate will cause deep and painful funding cuts to key publicly funded services across the board. However, in contrast to other New York City programs, elder abuse programs are slated for elimination -- not just a budget cut. Eliminating even the existing bare bones level of funding for these programs will have a catastrophic impact on elder abuse victims. No other programs assist New York City's older adults with this specific targeted service and with the necessary professional expertise they need.
Elder abuse, if not addressed, may threaten the victim's life. It can induce poverty and so deprive them of needed care. This can lead to an even greater strain on public resources whether the victim remains in the community or is institutionalized.
Eliminating elder abuse services will place a greater burden on other public services, such as the police, hospitals and senior social services. Although adult protective services are available, not all elder abuse clients meet the eligibility criteria -- which include mental and/or physical disability. In fact, perhaps only 20 percent of the our current elder abuse services caseload would be eligible for these services.
Elder abuse programs work, providing vital safety measures, legal representation, support services and community wide education. Providing services for the most vulnerable population and keeping older adults safe from abuse is imperative from a human rights and a moral perspective.
In 2006, the New York City Elder Abuse Network was established. The 50-member coalition creates links and addresses service gaps among police, prosecutors, providers of direct elder abuse services, providers of supportive services and government agencies, medical providers, advocates and academic institutions. If the elder abuse funds are eliminated, this network will be difficult -- if not impossible -- to maintain.
What will happen to the 80 percent who are not eligible? Who will they turn to? Where will they get help? Will they call the police? As the majority of elder abuse is perpetrated by family members, many older adults do not want to involve the criminal justice system. If there are no elder abuse programs, where would the police refer them?
In New York City, the over 65 population is projected to increase by 45 percent by 2030 -- more than three times the increase of younger New Yorkers. Elder abuse will grow, especially in bad fiscal times when people are out of work and financially stressed. These programs conduct extensive outreach. Since the onset of the economic crisis, there has been an increase of almost 30 percent in the number of incoming elder abuse cases.
Will New York City let thousands of elder abuse victims down? There is no excuse to cut elder abuse programs -- ever.
Bobbie Sackman is director of public policy for the Council of Senior Centers and Services. Mara Schecter is Queens district director and director of Elder Abuse Programs for the Jewish Association for Services for the Aged.
More than 40 parents crowded the back room of Strong Place Day Care Center in Brooklyn. Their anger -- and fears -- were in stark contrast to the room's cheerful pink walls. Their calls of worry almost drowned out the laughter coming from a classroom down the hall.
"What are we going to do?" asked one parent from the back.
For now, staff members of Strong Place, where more than 50 kids attend city-subsidized day care from 8 a.m. to 6 p.m. year round, don't have answers.
"I will fight for you with my last breath," said Strong Place Day Care Director Lorraine Pennisi, who has run the center for two decades. "The mayor thinks, 'Day Care… Babysitting,'" Pennisi said, throwing her hands in the air.
"It's important for you to say there is no place like Strong Place," she added.
Strong Place, which is located across the street from the New York City Housing Authority's Gowanus Houses, is one of 16 day care centers overseen by the Administration for Children's Services that could close in July. More than 770 children and their families and 300 workers would be affected.
The closings are just a small part of the Bloomberg administration's plan to fill an approximately $4.9 billion budget hole. As part of the Administration for Children's Services attempt to pare down, it plans to close day care centers with disproportionally high rents compared to other facilities citywide. The administration, said city officials, also considered whether there were other day care alternatives nearby when deciding what centers to close.
As a result, many of the centers slated to close are in gentrified areas, like Cobble Hill, Carroll Gardens or DUMBO, and 11 of them are in Brooklyn. Of those, four are within two miles of Strong Place.
But parents and kids at Strong Place -- like the many others who attend these day care centers -- don't want an alternative center. They want Strong Place to stay open.
In Strong Place on Thursday, dozens of parents navigated between cubbies and artwork strung from the ceiling.
Several 3-year-olds sitting in miniature chairs tossed Legos back and forth along the miniature tables. Meanwhile, parents, who pay tuition on a sliding scale, lamented the potential closure, wondering what they would do next should Strong Place actually shut in July.
"It's very upsetting," said Sara Allen, whose daughter, Ruth, has attended Strong Place since early 2008. "I don't think it's fair for people that don't have much of an alternative. It's hard as it is," Allen added.
Strong Place is more than day care, said parents. It's the start to their children's education.
"They are like family," said Anna Marie Vitale, whose two children, Anthony and Gianna Aleo, attend Strong Place. As for the closing, "It's not going to happen," she added defiantly. "It can't happen. It's kids."
The city directly negotiates leases with landlords for 115 centers. Strong Place is one of them. In total, the Administration for Children's Services oversees 339 day care centers, the vast majority of which are contracted out to local nonprofits.
Administration officials say the leases at the centers slated for closure are too much to cover in this recession. By closing the 15 sites, according to budget documents, the city would save $9 million in the next fiscal year and $16.3 million every year thereafter.
In addition, the administration argues these children have other options.
"The 772 children enrolled in those 15 centers will be able to find seats in other quality neighborhood programs," Commissioner John B. Mattingly said in a prepared statement. "Our only other option was to cut slots and take away child care services for hundreds of children, which we wanted to avoid. The closures of these 15 centers will achieve significant costs savings with no loss of service for any child currently being served.”
According to the administration, the average occupancy cost, which includes rent, real estate taxes and utilities, at these 15 sites is $396,952. The average cost of centers citywide is $177,184. The administration also notes the cost per child at the facilities slated for closure is as high as $11,000, while the average for city leased centers is $5,000.
Funding for day care from the state and federal governments has not kept up with market rates, according to the Administration for Children's Services. Child care costs have increased 36 percent between 2000 and 2008, while the state and federal share of city costs has decreased from nearly 67 percent in 2004 to 54.6 percent in 2009.
But these arguments haven’t convinced anyone at Strong Place.
Walking past kids' paintings -- which included interpretations of Jackson Pollock's abstract style and renditions of Vincent Van Gogh's "Starry Night" -- Pennisi said every day care is different. But the curriculum here at Strong Place goes far beyond that of other day care centers, Pennisi said.
"I want to create thinkers," said Pennisi. "I want to create people that have a heart."
Some of the city's unions, including District Council 1707, who represents day care workers, and the Council of Supervisors and Administrators, as well as a number of the city politicians are taking up Strong Place's cause.
In an ornate second floor room in Brooklyn Borough Hall on Friday, State Sen. Velmanette Montgomery joined them.
"We cannot let our families go," said Montgomery. "We have abandoned our children."
Many of these officials claim the administration's logic for choosing these centers is flawed. They contend total enrollment is not at 772, but more than 1,000, according to unions. They also say some of these centers recently renovated. Closing their doors is a lost investment, the council says.
Meanwhile other officials said the proposal contradicted the Bloomberg administration's economic development strategy.
"How do they expect a parent to work if they don't have a safe environment for their children?" asked Councilmember Sara Gonzalez, who attended the meeting Friday.
Officials have floated several proposals to avert the day care cuts, including negotiating with landlords to lower rents. Or if that doesn't work, the Council of School Supervisors and Administrators suggests allowing day care centers to pay for half of the lease, while the city picks up the rest. Councilmember Letitia James said federal funding could also help keep the centers open.
The administration said it was talking to landlords in hopes of negotiating a decrease.
Strong Place too was coming up with contingency plans, though they weren't ready to discuss them. Staff and board members there don't think they will have to.
They aren't going anywhere.
"In my gut, I'm going to give it 100 percent," said Pennisi last week while on the center's roof, which boasts a play area and jungle gym for the kids. "I am not accustomed to failing."