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Patients, Substance Use Treatment Providers Say New State Rule Causes Confusion and Risk

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Governor Hochul at an addiction-prevention event (photo: governor's office)

A new state regulation on access to medication-assisted treatment for those with substance use disorders is causing confusion and threatening patients’ recovery, providers say as they call on Governor Kathy Hochul to use her executive authority to immediately fix the problem.

On October 1, the state Department of Health began implementing a new statewide formulary that outlines coverage parameters for Medicaid patients receiving medication-assisted treatment (MAT). The new rule was meant to provide consistency across the state in access to MAT drugs like suboxone and buprenorphine, which are clinically-proven treatments for people with substance use disorders. But providers say there is a crucial flaw with the formulary: that it continues to require prior authorization for pharmacies to dole out certain drugs and places limits on their dosage.

Ahead of the October 1 deadline when the new rule became effective, providers warned that it would create a two-tier treatment system. New York no longer requires prior authorization for MAT drugs for people on commercial insurance after then-Governor Andrew Cuomo signed a law repealing it at the end of 2019. But, at the same time, he vetoed a bill that would have done the same for Medicaid patients. Effectively, wealthier New Yorkers have easier access while low-income New Yorkers, many of them Black and Hispanic, struggling with the same conditions face a greater administrative hurdle.

[Read: Amid Rising Overdose Deaths, Hochul Urged to End Two-Tiered Addiction Treatment System in New York]

After the rule went into effect, treatment providers say they have seen their warnings become reality. In interviews, providers said the state failed to adequately inform patients or pharmacies of the rule change and that several of their patients faced trouble receiving their prescriptions. “Why would we do this when there's the pandemic and the epidemic both occurring at the same time?” said Dr. Justine Waldman, CEO of REACH Medical, an Ithaca-based harm reduction provider. “This was an easy fix.”

As Waldman pointed out, MAT drugs -- which block the effects of opioids and help prevent overdoses, hospitalizations and death -- can only be given out the day a prescription is written and, if a pharmacy lacks the correct drug or prior authorization, patients face the risk of having their treatment interrupted. “Everything that I feared is happening,” she said.

“It's being touted as something that's beneficial for our patients but all it's done is to destabilize patients who have been further destabilized by COVID and have less access to care to begin with,” she added. “And now here we are again at Ground Zero and it's just really disappointing.”

Providers and advocates have for years been calling for executive action to immediately repeal the need for prior authorization for Medicaid patients on MAT. Their calls have become all the more urgent as overdoses spiked nationally last year. Between March 2020 and March 2021, according to provisional CDC data, New York saw an estimated 5,437 overdose deaths, a number that could possibly increase once data is official, and a 32% increase from the prior year.

Advocates see some hope under Governor Hochul, who has spoken of her own family’s experience with the opioid crisis and who recently signed a package of legislation aimed at tackling the opioid epidemic. The new laws decriminalized possession of opioid antagonists such as naloxone that can prevent overdoses, decriminalized possession and sale of hypodermic needles and syringes, and established a MAT program for incarcerated individuals in state and local correctional facilities, among other measures.

“When the State of New York has the ability to take steps that can just minimize the stress that people are going through to make it easier on them and their families, to let them know that there should not be stigma associated with seeking medication assisted treatment or any other variation that you need to get yourself in order, we have to send a message,” Hochul said at the bill signing. “We are there with you.”

Last month, a spokesperson for Hochul said her office was “reviewing the legislation and will have more to say on this soon.​” Hochul’s office did not respond to a request for comment for this story.

But her administration did. A spokesperson for the state Department of Health said the new formulary expanded coverage compared to previous regulations. “Prior to October 1, 2021, when the New York State Department of Health implemented the statewide formulary for Medication Assisted Treatment (MAT) products, the Medicaid Managed Care (MMC) and Medicaid Fee for Service (FFS) Program plans covered only 64% of MAT products on their formularies as compared to the statewide formulary, which covers 100% of FDA approved products,” said Jeffrey Hammond, the spokesperson, in an email. “As a result of the change, all seven million Medicaid members now follow a single formulary, where preferred products and coverage parameters are consistent across the Medicaid Program, as opposed to a system where every managed care plan establishes their own formulary and coverage for these drugs.  The Department will continue to work with providers to make sure that Medicaid members’ treatment is not disrupted as a result of this expanded coverage.”

Hammond noted that in instances where prior authorization is required for a non-preferred product, it must be processed within 24 hours and if the preferred medication is out of stock or unavailable, pharmacies can provide a five-day emergency supply to patients. The Health Department also requires MMC insurance plans to issue overrides to pharmacies, allowing them to issue non-preferred drugs without prior authorization if a preferred drug is out of stock. 

In practice, providers say, those rules aren’t clear to pharmacies and are an unnecessary level of red tape that doesn’t apply to those on commercial insurance.

Dr. Sonia Lopez, a medical provider in the Bronx, said that receiving prior authorization can take a day or more, precious time for a person in MAT treatment, and that there seems to be a lack of coordination between pharmacies and insurance companies. “They seem to have this bureaucracy about, ‘This is how prior authorization is done,’” she said in a phone interview, as she described a patient’s hours-long ordeal to try to get a prescription filled after the new formulary took effect. “My patient can't afford that.” Even a temporary disruption with MAT could force patients to seek drugs on the street, she noted, which could also possibly be laced with Fentanyl and lead to deadly overdoses.

“I feel like people don't understand the patient, that the patient is not the first priority in this system,” she said. “There’s all this bureaucratic craziness and the patient falls through the cracks.”

Louis Jones nearly became one of those patients. Jones is a syringe exchange outreach worker with VOCAL-NY, a nonprofit advocacy and service group, and is also in a MAT program to recover from years of heroin use. Jones was transferring between medical providers when the formulary kicked in, and was unable to get his prescription filled because he lacked the prior authorization for it. “I took the suboxone that I had and I was cutting it,” he said, having to stretch his existing prescription for three days before getting a new one. “I wasn’t sure about this pharmacy getting it delivered, the prior authorization coming through.”

“It was very uncomfortable. My anxiety level was very...There was some depression, you know, there was withdrawals,” he said.

Jones emphasized the dangers of disruption to patients like him on MAT. “Continuity of care is critical to anybody in this process of any kind of medicated assisted therapy or treatment,” he said.

“Who knows how many people might have died or gotten an accidental overdose,” he added. “It caused some chaos, some confusion. I don’t believe that's their intention but I believe that's what came out of it. That's how I felt.”

“It's basically a fairness issue...but I think it's also a major public health issue,” said Allegra Schorr, president of the Coalition of Medication-Assisted Treatment Providers and Advocates (COMPA). Schorr said the added red tape of the formulary may also discourage doctors from treating Medicaid patients and instead only treat people on commercial insurance. “It's like segregating the system and the gap is gonna just keep getting wider and wider and wider,” she said. “When a state makes decisions like that, the repercussions, it's like a cascading effect.”

“It's just pennywise and pound foolish,” she added.

by Samar Khurshid, senior reporter, Gotham Gazette

Read more by this writer.

Manhattan District Attorney Candidates Bragg and Kenniff Debate Resumes and Visions

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Manhattan DA candidates Alvin Bragg, left, & Thomas Kenniff

The two candidates running for Manhattan District Attorney in the imminent fall election met recently for a spirited televised debate, with issues ranging from the bail system to gun violence and each aspirant’s record of public service.

Democratic nominee Alvin Bragg, a former prosecutor and top deputy New York Attorney General, and Republican nominee Thomas Kenniff, a former military judge and criminal defense attorney, sparred over their resumes and visions for the office in a debate hosted by Manhattan Neighborhood Network and moderated by Gotham Gazette’s Ben Max. [Watch the full 30-minute debate here.]

As he’s done throughout the campaign, which included his win in a crowded and competitive primary, Bragg talked of both his personal and professional experience and positioned himself as a reformer who will also ensure public safety. Kenniff, who did not have to face any primary opponent and is fighting the uphill battle in a very Democratic-leaning borough, stressed first and foremost taking on crime more aggressively and sought to paint Bragg as a threat to public safety.

As the top state-level prosecutor in Manhattan and a local and national leader on criminal justice issues given the high-profile nature of the position, the district attorney has enormous sway over issues of law and order, prosecution and punishment, freedom and incarceration, and policy-making with a focus on improving public safety. The DA leads a large office of attorneys, investigators, and other staff with a budget well over $100 million and has jurisdiction over aspects of Wall Street, City Hall, major portions of the subway system, and much more.

In his opening statement, Kenniff emphasized his background as an army veteran and a defense attorney who served in Iraq and in the Javits Center in New York City during the COVID-19 pandemic. He professed his anger at what he called misguided criminal justice policies that he said have led to an increase in violent crimes and a decrease in quality of life for city residents. He also attacked Bragg, particularly over Bragg’s positions on bail reform. 

“Having spent the majority of my career defending the rights of the accused, I understand fairness, but I also know that Manhattan needs a district attorney that will keep us safe,” Kenniff said.

Bragg argued he has the ability to understand policy issues from a variety of angles, both personal and professional. He discussed his upbringing in Harlem, where he had guns pointed at him on six occasions, three of them by police, his education at Harvard Law School, and his dedication to the New York criminal justice system as an attorney in several different roles. Bragg noted his work as a federal prosecutor and chief deputy under the New York Attorney General, and mentioned having led a number of high-profile and complex cases, including related to armed robbery, public corruption by the former State Senate majority leader, and the Trump Foundation’s misuse of charitable assets. 

“All of these experiences, personal and professional, lead me to a vision that marries fairness and public safety. This is my life. This is my life’s work. As a result of it, I have been endorsed by the New York Times, by [former U.S. Attorney] Preet Bharara, and so many others,” Bragg said, with reference to the Times editorial board’s pivotal endorsement in the primary.

On running the large office of Manhattan District Attorney and the charges they would give to their many deputies as DA, the two candidates both indicated they would seek to shift the culture and priorities of the office.

Kenniff stressed the importance of rebuilding it given departures of staff and the need to abandon what he has deemed failed policies. He criticized what he characterized as “far left, progressive” policies that he says have hurt the office and the borough. Kenniff also denounced Bragg’s intention to rebrand a bureau to review wrongful convictions, calling it the “Free the Wrongfully Convicted Unit,” saying that it sends a negative message to those working in the DA’s office and beyond. While he supports overturning wrongful convictions, Kenniff indicated he believes it must be done without insulting longtime professionals who have done no wrong. 

Bragg countered, pointing out his experience leading a large office and talking about his extensive “Day 1 memo,” which Kenniff had criticized regarding the newly-named office. Bragg touted being the candidate who has laid out in detail what he would do if elected, and discussed leading the office by reshaping the criminal justice system so that it prioritizes what he called cases that really do harm while going up the food chain to the most harmful actors.

“I have walked the walk. I have done the work. I have been with loved ones who have had violent acts happen to them, and I have also walked with those who are fighting the civil rights fights. I have managed an office like this, and I am ready to serve on day one,” Bragg said. 

He would not prioritize the types of cases that led to the deaths of Eric Garner and George Floyd, he said, but stressed he would focus on drug and gun trafficking as well as sex crimes in order to improve public safety.

Kenniff highlighted his 15 years as a criminal defense attorney in Manhattan (where he lived until moving to Long Island) and discussed the wide range of clients he represented, including those who were indigent. He attacked Bragg’s career, including specific cases where he said Bragg had pursued harsh prosecution for powerless individuals.

“Take a look at the electronic filing system. Take a look at PACER [Public Access to Court Electronic Records]. See the type of people that Alvin Bragg was seeking decade-long, life sentences for as a federal prosecutor, including opposing a motion to vacate a life sentence against a non-violent drug trafficker who was found mentally unfit. That was one of his first published cases,” Kenniff said. 

Bragg continued to point to his varied career and personal experience, saying he is proud of his record. 

On the contentious issue of bail reform, Bragg argued for the recent reforms made by the state and said that they should be kept as-is after sweeping changes were passed two years ago and slightly rolled back last year. Bragg said that bail has been a wealth test that disproportionately hurts and incarcerates poor people and people of color, while it is meant to simply ensure a return to court for those not yet convicted of any crimes. He noted that Kenniff has regularly asked for bail reductions during his legal career.

In terms of additional policies, Bragg mentioned pretrial services or accommodation for people’s ability to return to court, and pointed to a recent op-ed he wrote on bail reform.

Kenniff vehemently criticized the recent bail reforms, which went into effect on January 1, 2020, and argued that such reform led to the massive increases in gun violence that plagued New York City throughout much of 2020 and into 2021, before some recent declines, and argued those results disproportionately hurt people of color. 

“We know when there is an increase in violent crime, disproportionately Black and brown people are going to pay the price for it,” Kenniff said. “So, the very people Alvin Bragg talks about how he walks with everyday, the policies that he and his progressive friends have championed are terrorizing them the most.”

It was one of several comments from Kenniff that Bragg took offense to.

Kenniff also criticized Bragg’s support for bail reform and said he and others had weakened the criminal justice system. 

“Ask people on the streets in Manhattan, in the neighborhoods that he is talking about, in every neighborhood, whether they are feeling safer post-January 1, 2020, or feeling that they are less safe,” Kenniff said.

When asked if there is statistical evidence that the people being released by the new bail policies significantly contributed to the increase in gun violence, Kenniff replied by discussing a single case in which an individual was released on a gun charge and went on to kill a 17-year-old young person of color, but did not cite any data.

Bragg noted that Kenniff did not provide any data, saying there isn’t any to support the argument that the bail reforms had led to the spike in shootings and murders. He called Kenniff’s arguments out of touch with the neighborhoods, such as Harlem, that the new bail reforms actually impact.

Bragg spoke about taking a nuanced approach to prosecuting gun crimes, citing certain instances of illegal possession where individuals should not be prosecuted.

“My dad had a gun when I was young. It was unlawful, but it was to protect our home. I had him turn it in when he was 65. He was not a public safety risk. My position [on gun prosecution] are nuanced. They are born out of real experiences, both in the courtroom and personal that marry fairness and public safety,” Bragg said. 

Kenniff said he would take a far harder line on gun prosecutions and also called for bringing back a disbanded NYPD plainclothes unit that was focused on illegal guns but had been the subject of civil rights complaints. Pointing out that Eric Adams, the Democratic nominee for New York City mayor, holds a similar position, Kenniff said he is arguing for common sense positions. 

When asked to present one question to each other, Kenniff asked Bragg about his reaction to the case Kenniff has previously mentioned: “I have brought up that case that was in the paper the other day with the individual who shot a 17-year-old boy and had been arrested a few days before on a gun possession charge, released on the sort of bail reform policies that you support. What would you say to the mother of that child?” 

Bragg answered that it wasn’t really a hypothetical for him, since he has talked to families whose loved ones were killed by gun violence. He spoke about his own experience, having guns pointed at him by police officers and others. “I understand the pain and I understand that the misguided policies you are talking about, like bringing back stop-and-frisk, is not going to address that,” Bragg said.

Bragg asked Kenniff how he could serve Manhattan’s interests when he is registered to vote and resides on Long Island. Kenniff said that he lived and voted in Manhattan in the past, and served on the front line of the Javits Center as a legal officer during the COVID-19 pandemic. “If I take this office, as I expect I will, I will obviously reestablish my residency in Manhattan,” Kenniff said.

In his closing statement, Bragg emphasized how his personal upbringing inspired his career in public services and how he would utilize his experiences as a federal prosecutor and criminal defense attorney to represent Manhattan. Kenniff addressed the need for improving public safety, noting his outsider background to politics and his focus on moving away from reforms he believes have made New Yorkers less safe.

[WATCH the full 30-minute debate between Manhattan District Attorney Candidates Alving Bragg and Thomas Kenniff]

by Tri Truong, Gotham Gazette

Read more by this writer.

WATCH: Get Ready to Vote on the 5 Ballot Questions

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Voters at the voting booth (photo: Michael Appleton/Mayoral Photography Office)

There are five yes or no questions on the 2021 general election ballot across New York, asking voters to approve or disapprove changes to the state constitution. All the items on the ballot have been passed by two successive classes of the State Legislature and now go to the voters. They includes measures related to legislative redistricting, voting, clean air and water, and more.

Four experts joined host Ben Max for a Manhattan Neighborhood Network discussion of the five ballot questions. They are Melody Lopez, Executive Director of New York Civic Engagement Table; Eric Friedman of the NYC Campaign Finance Board and NYC Votes; Pamela Stewart-Martinez of WE ACT for Environmental Justice; and Jeffrey M. Wice of the NY Census & Redistricting Institute at New York Law School. Watch:

Read more: WATCH: Get Ready to Vote on the 5 Ballot Questions

What to Watch for as Hochul's 45-Day Transition Period Ends

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Governor Kathy Hochul (photo: Darren McGee/Office of the Governor)

Governor Kathy Hochul's self-imposed transition period ends Friday. Hochul has already made a number of changes to the executive chamber and state policy -- but with the end of the 45-day interval she may reveal some key remaining personnel and policy decisions she has promised over the first weeks of her governorship.

Hochul, a Democrat, asked the public for patience to build her administration over the seven-week window amid an ongoing purge of officials implicated in the scandal-marred regime of her predecessor, Andrew Cuomo. As questions about her policies and initial commitments proliferated in the first weeks of her administration, the new governor said she would also take that time to evaluate many existing and forthcoming positions while making some notable appointments and policy decisions throughout. After that she would make additional decisions about which policies would stay and which would go in a number of previously outlined areas.

"I've asked for a 45-day period to be able to assemble my team, and I'm not going to be replacing people when they're in the middle of a pandemic on this day because I have so much to do to protect New Yorkers," Hochul said in an interview on MSNBC the morning after being sworn in. "I'll be taking an approach that's very different," she added, referring to Cuomo, who oversaw a "toxic work environment" and "culture of fear and intimidation," according to administration members cited in a report by the New York State Attorney General's office.

"As part of the 45-day transition period, we are reviewing the matters raised by recent investigations and exploring all ways to ensure accountability and open, ethical governing that New Yorkers will trust,” said Hazel Crampton-Hays, the governor's press secretary, in a statement to Gotham Gazette.

Hochul has also spent her first 45 days moving ahead on urgent priorities, while taking time to stake out a path of reform that veers from the abuses of power that led to Cuomo's resignation. In her first major address, she vowed to return students safely to the classroom, boost vaccination rates, and expedite emergency relief to renters, landlords, and workers excluded from federal aid. She has advanced many of those through school mask mandates, preparations for booster shots, and hiring more staff to process rental assistance applications. She has imposed controversial vaccination mandates on workers in a number of industries and settings, several of which are being challenged in the courts.

"Your priorities are my priorities—and right now that means fighting the Delta variant," she said in her first address.

Now many stakeholders hope to see the substance of some of her other commitments to a more transparent and ethical government, the details of her sexual harassment policies, and the fate of Cuomo's longtime allies and aides who still hold positions of power in the administration.

One key matter relates to possible conflicts of interest around the governor’s husband, William Hochul, Jr., a senior executive at the gambling and concessions company Delaware North, which has millions of dollars in state contracts, and the husband of Karen Persichilli Keogh, the new Secretary to the Governor, who is a partner at the powerful Albany lobbying firm, Bolton-St. Johns. (The principal of that firm, Giorgio DeRosa, is the father of Melissa DeRosa, the last Secretary to the Governor under Cuomo.) Hochul has said she is soliciting outside experts to create an “ironclad policy” to avoid conflicts of interest, though none has been made public.

A spokesperson did not respond directly to Gotham Gazette questions about the status of the ethics policy.

One of Hochul’s first commitments was to get rid of any state official named in the Attorney General's investigation into Cuomo's sexual harassment, which led to his resignation. According to Crampton-Hays, that promise has been fulfilled. Several other members of Cuomo's inner circle appear to be staying on.

"We are retaining a number of public servants who have demonstrated a commitment to the Governor’s agenda, and we look forward to working with our top tier team to deliver results for New Yorkers," Crampton-Hays said in a statement this week.

In late September, Hochul announced the resignation of health commissioner Dr. Howard Zucker, a mainstay at Cuomo's daily pandemic press briefings last year who had come under fire for the state's handling of covid-positive nursing home residents, undercounting the covid death toll among nursing home residents, and under-reporting the overall statewide death toll. In his place, Hochul named Dr. Mary Bassett, a former New York City health commissioner, who has been widely lauded as a strong choice.

Around the same time, Hochul indicated another Cuomo stalwart, Budget Director Robert Mujica, would remain. 

"To date I am still evaluating positions, but he is working very hard with us to chart the future going forward, so I believe he’ll be with us for some time,” Politico reported her saying on September 24.

Since 2015, Mujica has been instrumental in Cuomo's dominance over the state budget, which he wielded to reward allies, exert pressure on adversaries, and push policy through the Legislature. Prior to that, Mujica worked for the Senate Republican conference, which Cuomo, a Democrat, had helped keep in power for a number of years.

"If I was governor I would not have kept Rob Mujica," said State Senator Liz Krueger, a Manhattan Democrat who chairs the Senate’s finance committee, in an interview with Gotham Gazette. "But I'm not governor," she added.

Mujica also holds a Cuomo-appointed spot on the MTA Board, a seat he was confirmed to only after the former governor pushed through a change to state law making Mujica eligible.

Observers have noted that to be successful, Hochul will need to retain cabinet and staff members with institutional knowledge even as she tries to break from the political culture cultivated by Cuomo and other Albany power-brokers.

"The strongest administrations tend to be those that, in terms of their personnel decision, have a balanced portfolio of people with varied experiences," said Bruce Gyory, a longtime political consultant at Manatt, Phelps & Phillips LLP. "Yes, they have fresh faces but they also have some experienced hands."

Keeping Mujica may be a strategic calculation by Hochul to ensure strong footing in her first -- and potentially only -- state budget presentation. That Executive Budget, due in January, will be part of what determines Hochul’s legacy and sets the tone for her performance in the June Democratic primary.

"The preparation, presentation, and negotiation of that first budget is always very key for any new administration, especially one that comes in like this one out of the trauma of a governor resigning," Gyory said.

Some in Cuomo's executive chamber left with him, including fixers like DeRosa, senior advisor Rich Azzopardi, and Department of Financial Services Superintendent Linda Lacewell, who was also an MTA Board appointee of Cuomo. Over the course of weeks, others left, announced their departures, or were replaced, like Director of State Operations Kelly Cummings, who was succeeded by Kathryn Garcia, the former New York City sanitation commissioner and recent mayoral candidate.

On Thursday, the Hochul administration announced the resignation of MTA board member Larry Schwartz, a one-time Secretary to the Governor and, more recently, voluntary "vaccine czar" who was named several times in the Attorney General's report. He will leave the board when a replacement is confirmed by the State Senate, which is not expected until January, when session resumes.

“Larry Schwartz will be resigning, effective when the Senate confirms his replacement, and the Governor is grateful for his public service,” Crampton-Hays said in a statement. “To ensure that the MTA Board is accountable to riders and represents the voices of New Yorkers, our administration will be soliciting input from advocates, impacted communities, and experts on candidates to fill the open seats on the board, and we look forward to working with the legislature to confirm those appointments at the next legislative session and deliver the modernization, reliability, and enhancements New Yorkers deserve.”

Other Cuomo administration officials set to depart include Michael Hein, commissioner of the Office of Temporary and Disability Assistance, sources told the New York Post last month. Hein was responsible for delivering $2.6 billion in federal rent relief, which the previous administration was criticized for not moving quickly enough. The governor's office confirmed Hein's resignation to City & State Thursday. Dr. Theodore Kastner, commissioner of the Office for People With Developmental Disabilities, Office of Addiction Services and Supports Commissioner Arlene González-Sánchez, and Licha Nyiendo, commissioner of the Division of Human Rights, will also step down, according to the Post.

Speculation remains over the fates of other Cuomo administration holdovers, especially those from his inner circle, like SUNY Chancellor Jim Malatras, who was previously Director of State Operations for Cuomo.

Beyond Personnel
Emergency orders were a hallmark of Cuomo's administration in his final 18 months as the pandemic invaded New York. On her first day in office, Hochul signed an executive order leaving remaining provisions in place for 45 days while her administration reviewed them.

"All Executive Orders issued by previous Governors which are currently in effect shall remain in full force and effect until October 8, 2021, unless otherwise revoked, superseded or modified," Hochul's first order states. During that time, her administration would assess whether "additional orders" should be removed or replaced.

"Today, I am directing an overhaul of State government's policies on sexual harassment and ethics, starting with requiring all training be done live, instead of allowing people to click their way through a class," Hochul said on her first day as governor, taking a jab at Cuomo whose training was completed online.

She also said she “will sign an executive order” mandating every state employee undergo ethics training, "which, shockingly, is not required across the board."

That hasn't happened yet. According to a spokesperson, it is part of the 45-day review before new executive actions are taken. That commitment hasn't stopped Hochul from making other changes, like extending pandemic-era exemptions to in-person government meetings under the state's Open Meetings Law.

Hochul also promised to direct state agencies "to review their compliance with state transparency laws, and provide a public report on their findings." She said her counsel was working on devising a system to fulfill requests under the state Freedom of Information law "as fast as possible." FOIL requests have been plagued by delays for years leading to a hefty backlog, something Cuomo has been accused of personally interfering in.

A month later, her office issued a memo to agency heads giving them until October 20 to present a plan for better transparency and FOIL compliance.

Transparency advocates and journalists have been pushing Hochul to release the sum of the state's Covid-19 data, which they say could include over 100 data sets and are subject to FOIL. In response to a Gotham Gazette inquiry for a prior story on that data transparency, a spokesperson said Hochul would take executive action to create a more open government following the 45-day review.

Many lawmakers have expressed the feeling that Hochul's early commitments and willingness to collaborate is a sign that she is invested in a more accountable and collegial government. "Speaking as a legislator, I've had more contacts from her administration on more issues in her first 45 days than I had with the Cuomo administration in his 11 years," Krueger said.

Watchers are also waiting to see the conflicts of interest policy Hochul promised surrounding the work of her husband at Delaware North. That has become more pressing with the revelation by the Associated Press that Hochul is involved in negotiations to subsidize a new stadium for the Buffalo Bills, for which Delaware North is the concessions vendor (and whose Buffalo tenancy Hochul, a native of the state's second largest city, has said is important to her personally). The deal could cost the state up to $1.1 billion, according to the Bills’ proposal.

"That document should be made public so that everybody can take a look at it and know what the rules of the road are," said Krueger, who commended Hochul's acknowledgement that such a policy was required.

John Kaehny, head of the good government group Reinvent Albany, has called for Hochul to get independent verification from the state Attorney General and Comptroller of her disclosure and recusal process.

"That would lend tremendously to the credibility, because otherwise it's just her or Delaware North saying, 'Trust us,'" he said. "That's policing yourself and policing yourself doesn't work so well."

by Ethan Geringer-Sameth, reporter, Gotham Gazette

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Housing Group Offers Roadmap for Full NYCHA Funding

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NYCHA's Eastchester Garden Houses (photo: Michael Appleton/Mayoral Photography Office)

For decades, government officials, advocates, and residents have debated the best path forward for New York City public housing while conditions have deteriorated and the price tag for urgent capital repairs and operational costs has boomed.

The New York City Housing Authority (NYCHA) faces an estimated capital need of $40 billion to address mold, lead paint, broken boilers and elevators, and a host of other needs critical to stable and safe housing for more than 400,000 tenants. There is also an ongoing operating deficit exacerbated by the pandemic and the authority has been placed under the watch of a federal monitor.

A number of solutions have been suggested or launched but there has been only piecemeal follow-through from government officials and limited collaboration among city, state, and federal entities to solve the public housing crisis.

Some -- like Mayor Bill de Blasio and his likely successor, Brooklyn Borough President Eric Adams -- have embraced roadmaps that include privatizing public housing management at some developments and selling air rights while pushing for a variety of additional funding sources, including more state and federal aid. Others have rejected proposals that alter the management of NYCHA or allow new housing on NYCHA land in favor of full federal funding, which has been anemic for decades.

In his American Jobs Plan, a $2 trillion infrastructure bill, President Joe Biden has included $40 billion to restore public housing nationwide with much of it likely to go to NYCHA, the nation's largest public housing system. A counter proposal in Congress would double that funding to $80 billion, with half going to NYCHA -- enough to meet its capital needs. While Senate Majority Leader Chuck Schumer, the senior senator from New York, promised in a recent op-ed in City & State "to use all of my power as majority leader" to pass the congressional plan, its fate remains uncertain.

Now, a new report from Community Preservation Corporation (CPC), a nonprofit affordable housing financing company, seeks to cut through some of the noise and offer a concrete roadmap to finally secure the funding that NYCHA and its residents need. The CPC white paper being released Tuesday, October 5, argues that officials at all levels of government will need to use multiple tools to solve NYCHA's myriad problems -- even if the federal package does include $40 billion for New York City's public housing.

The company, led by Rafael Cestero, former commissioner of the New York City Department of Housing Preservation and Development (HPD) under Mayor Michael Bloomberg, is pushing for the city, state, and federal governments to pursue a three-part solution in line with de Blasio's 2020 roadmap.

It includes converting 62,000 NYCHA units to private management (while remaining under NYCHA ownership), an idea that has received mixed reviews from tenant advocates and elected officials, and which CPC is currently a part of in 16 NYCHA properties in Manhattan; establishing a so-called "Public Housing Preservation Trust" at the state level to leverage funding for the remaining 110,000 units; and receiving a one-time federal infusion to address major capital needs.

For the plan to work, Community Preservation Corporation argues the city and state will each need to allocate an additional $1.5 billion annually for the "comprehensive modernization of whole developments." The nonprofit is urging the next mayoral administration, due into office January 1, to move aggressively on the programs and to work with the state to advance legislation to establish the public housing trust.

"What we tried to get across is we should stop making a false choice between doing the first way, the second way, or the third way," Cestero told Gotham Gazette. "The reality is that NYCHA is important enough, and the problems big enough, that we should do all three things."

While the $40 billion for capital repairs has become the marquee figure used by NYCHA leadership, the de Blasio administration, and others, CPC believes the needs are far greater.

Its assessment, previewed by Gotham Gazette, reasons that the authority needs closer to $48 billion in capital funding to address both the collapsing infrastructure and increasingly urgent environmental resilience updates. And none of that addresses NYCHA's operating cost deficit.

CPC estimates the city and federal governments' subsidies for operating costs were $45 million below expectations in 2020, including $34 million in city assistance below budget. Rent collection from NYCHA tenants, intended to make up roughly a third of the authority's operating budget, has been declining since 2016, according to CPC, and has gotten worse during the pandemic. The city's Independent Budget Office has reported rent collection was $64 million under budget by the end of 2020.

Unsurprisingly, CPC's recommendations have the support of NYCHA Chair Greg Russ, who helped author the de Blasio administration's "A Blueprint for Change," which includes many of the components in the new CPC white paper.

“NYCHA agrees with and supports the recommendations made by the Community Preservation Corporation, including receiving capital funding from the City and State to make comprehensive modernizations to our developments; passing the Public Housing Preservation Trust legislation and having HUD allocate 12,000 Tenant Protection Vouchers; and receiving funding through an infrastructure package while establishing a distribution formula that works for NYCHA," Russ wrote in a Monday statement to Gotham Gazette. "This is an exciting time for NYCHA and we look forward to working with residents to transform and improve public housing.”

Budget watchdogs like Citizens Budget Commission, which has been pushing for better management of NYCHA's finances and aggressive steps to bring in new revenue, say the most important action is action itself. "Without dramatic changes within 10 years nearly 90 percent of NYCHA’s housing units could be at risk of deteriorating past the point at which it is cost-effective to repair — a crisis from which NYCHA and the City might well not be able to recover," reads a 2018 Citizens Budget Commission report. There has been limited action in the years since.

The most controversial component of the plans from NYCHA, CPC, and others who favor it is Rental Assistance Demonstration (RAD), which allows public housing authorities to enter into new public-private partnerships wherein private companies like CPC manage public housing developments using federal Section 8 subsidies.

In New York City's version of the plan, developments are still owned by NYCHA, which preserves requirements that rent not exceed 30% of tenants' incomes. According to Erin Burns-Maine, CPC's vice president of policy, RAD developments are still subject to requirements under a 2019 agreement with the U.S. Department of Housing and Urban Development (HUD). That same agreement, in response to a series of crises and scandals at the housing authority, including around lead paint, also established a federal monitor for NYCHA.

Some tenant groups have opposed RAD out of fear that private management companies would pursue evictions more vigorously and displace residents, calling it a clear step toward more full privatization of public housing. Opposition groups like Fight for NYCHA have organized protests against the de Blasio administration and Adams' campaign for their support of RAD, which have garnered some attention in the media and among some elected officials. If he becomes the next mayor, Adams has promised free legal services for tenants going through the RAD conversion process. Throughout the campaign Adams has stressed the importance of communication with tenants and said that in developments where he has seen RAD implemented the tenants have liked it.

According to Cestero, the current congressional proposal of $40 billion for NYCHA appears to come with the requirement that the authority use Section 9 subsidies, rather than Section 8, foreclosing the possibility of public-private partnerships under RAD. "That is just, in our opinion, a huge mistake," he said.

Under CPC's recommendations and NYCHA's Blueprint, a majority or repairs and operating costs should be covered by the Public Housing Preservation Trust, which if passed by state lawmakers would allow two-thirds of NYCHA units to transfer to a wholly public entity that can use more valuable federal Tenant Protection Vouchers. The vouchers would open the possibility for NYCHA "to leverage debt, deploy capital funds more quickly, and cut through a number of procurement challenges," according to the white paper. CPC is calling on Washington to allocate 12,000 vouchers to New York City and fund a study of the model.

While widely supported, legislation for the public housing trust has been met with delays. In June, the bill's sponsors, ​​State Senator Brian Kavanagh and Assemblymember Steven Cymbrowitz, said they were holding the proposal until the 2022 legislative session for "further conversation, outreach, and negotiation."

"The public housing trust shouldn't be controversial except it hasn't moved yet...and frankly should be the easiest thing because it is a fully public entity," Cestero said.

To raise additional revenue, CPC also advocates for the sale of NYCHA air rights, in line with the de Blasio Blueprint, as well as infill development -- the leasing of underutilized NYCHA land for private development.

by Ethan Geringer-Sameth, reporter, Gotham Gazette

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'There's Absolutely More Need': Catalina Cruz on Aid for Immigrant New Yorkers, the Assembly Cuomo Investigation & More

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Assemblymember Cruz, middle, with Governor Hochul (photo: @CatalinaCruzNY)

“My neighbors speak more than 150 languages. We have folks from all over the world who call this beautiful community their home. They are small business owners, they are first responders, they are frontline workers, we also have Elmhurst hospital. It’s just a beautiful, beautiful community that I am extremely proud to represent,” said Assemblymember Catalina Cruz, a Democrat who represents the 39th Assembly district, made up of Corona, Elmhurst, and Jackson Heights in Queens.

Appearing on a recent episode of the Max Politics podcast from Gotham Gazette, Cruz discussed the many ways she is working to help immigrant communities, at times especially undocumented immigrants, the Assembly judiciary committee’s investigation of former Governor Andrew Cuomo, and more.

“Sixty percent of our neighbors were born in another country and 40% of them have no voting power,” Cruz said regarding the large number of residents of her district who are undocumented or otherwise not full citizens of the United States and unable to vote locally. “That’s because they are permanent residents, undocumented, they have DACA or asylum. Some sort of non-citizenship status that definitely, unfortunately, relegates them to a second class of ‘citizens,’ if you will, when it comes time to have their needs heard.”

Therefore, Cruz says, it’s especially important for local representatives like herself to work on behalf of those constituents and ensure that all levels of government are paying attention to their needs — and making a point to note that many are indeed taxpayers even as they are ineligible for many forms of government aid.

Not only has COVID-19 devastated many communities in New York City, particularly low-income communities of color like those Cruz represents, but Hurricane Ida also just poured historic rains on them, creating another example of how hard it is to be undocumented in a tragedy.

“A day or two after Ida hit, we were trying to figure out how to get our neighbors the government resources, that means the FEMA money, as soon as possible,” Cruz said.

As state government entities, from the administration of Governor Kathy Hochul as well as Cruz’s office and others, screened constituents and tried to help them apply for FEMA funds, they found that roughly half of those in need of help were undocumented and could not apply for FEMA help, Cruz said. She told podcast host Ben Max of Gotham Gazette that she then asked the governor for a fund to help the undocumented individuals of New York who could not apply for FEMA funds and quickly between the state and the city they created a $27 million fund that just launched through the state’s Office for New Americans.

Cruz, who is chair of the Assembly’s Task Force on New Americans, has also been working with her staff and other colleagues in government to help constituents and others access the state’s $2.1 billion “Excluded Workers Fund,” which provides financial aid to undocumented New Yorkers who lost income due to COVID-19 but were left out of federal relief programs. Cruz said many eligible New Yorkers have still not applied and should before the fund runs out of money, or in order to help make the case that it needs to be replenished.

“There’s absolutely more need,” Cruz said on the podcast. “I’m committed, if the time comes and the fund runs out and we realize we need more money, I’m committed to fighting along with the [Excluded Workers Fund] Coalition in the same way that we did before, because people need it to survive.

Cruz also explained that she is working toward a package of efforts coming out of her work as the chair of the New Americans Task Force, which will include new legislative and budget priorities.

[LISTEN: Max Politics Podcast: Assemblymember Catalina Cruz on Pro-Immigrant Policies, the Cuomo Investigation, & More]

Asked about two pieces of legislation she’s sponsored — getting Hochul to sign her Nourish New York Act and both houses of the Legislature to pass the Clean Slate Act — Cruz stressed their importance and expressed optimism.

“Nourish New York was born out of the food desert and food insecurity issues that we saw get exacerbated during covid,” Cruz said. “My office alone, we provided 250,000 meals in a six-month period because we closed our office and turned it into a food pantry because there was no other place where people could get food at one point.”

Working with the Cuomo administration, legislators and other partners helped set up Nourish New York as a pandemic food program connecting upstate farmers with food pantries and food banks across the state, with the state paying the farmers for their goods in order to both utilize that product and feed needy people. While it was a one-time deal with the Cuomo Administration, Cruz and her colleagues passed legislation to ensure its survival and now need Hochul to sign it into law.

The Clean Slate Act would remove publicly available criminal records for misdemeanor crimes and most felonies after people have completed their sentences and parole. For example, someone with a “clean slate” would not have their criminal history available for a landlord to check and then illegally discriminate against them in determining their housing options. 

“It gives people in my community a real second chance at life,” Cruz explained. “You’ve come out of jail, you’ve paid your dues, a certain amount of time will pass, depending on the type of crime, and during that time you are basically showing that you are a good, contributing member of our community. You’re able to show that you are moving forward. Then, after that, your record will disappear.”

Cruz and her colleague believe that Clean Slate can help reduce recidivism rates by removing barriers to employment, housing, and other things for those who have criminal records but have paid their dues.

Cruz also discussed the Assembly Judiciary Committee’s impeachment investigation of now-former Governor Andrew Cuomo. While his resignation led Assembly Speaker Carl Heastie to call off the impeachment proceedings but for referrals and a report, some were disappointed with his decision and many are eager to see the findings, however incomplete.

“I don’t have a date yet but I suspect we are not looking to extend this beyond a couple of weeks, maybe a month or two,” said Cruz, who is an attorney and sits on the judiciary committee. “Because I think people want to know, people want to hear what’s in that evidence, what was in that report.”

Asked about the report, Cruz confirmed that it would include significant information beyond issues related to the former governor’s pattern of sexual harassment that was outlined in the report issued by Attorney General Letitia James, which led to additional calls for resignation, impeachment, and prosecution, and to Cuomo’s decision to resign. Those issues include the governor’s use of government resources on his covid book memoir, Cuomo’s nursing home covid scandal, and more.

Cruz also took a moment to address how Cuomo and his allies have been pushing back against the attorney general and Assembly.

“The governor’s implying that this has all been some kind of political attack on him and his character,” Cruz said. “That this is some kind of war against him and his character. It’s not. This is a war against corruption in Albany. This is a war against corruption in government. This is a war against sexual harassment of staff.”

[Listen to the full conversation: Max Politics Podcast: Assemblymember Catalina Cruz on Pro-Immigrant Policies, the Cuomo Investigation, & More]

by Georgia Dodd, Gotham Gazette

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Max Politics Podcast: Assemblymember Catalina Cruz on Pro-Immigrant Policies & More

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Assemblymember Catalina Cruz, center (photo: @CatalinaCruzNY)

September 29, 2021 - Max Politics Podcast: Assemblymember Catalina Cruz on Aid for Immigrant New Yorkers & More

Assemblymember Catalina Cruz, a Queens Democrat, joined the show to discuss two state programs to help undocumented immigrants, other work she's doing as chair of the Assembly's Task Force on New Americans, the Assembly judiciary committee's investigation of former Governor Andrew Cuomo, and more.

Listen to the conversation and let us know what you think, on Twitter @TweetBenMax. You can listen to the show through the embedded audio below or download the episode wherever you get your podcasts at Max Politics.

Read more: Max Politics Podcast: Assemblymember Catalina Cruz on Pro-Immigrant Policies & More

Amid Rising Overdose Deaths, Hochul Urged to End Two-Tiered Addiction Treatment System in New York

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Then-Gov. Cuomo signs legislation (photo: Darren McGee/Office of Governor Andrew M. Cuomo)

In the aftermath of the highest number of overdose deaths recorded in New York State in a single year, advocates and substance use treatment providers are calling on Governor Kathy Hochul to sign what they call a crucial piece of legislation to reverse the trend. Without the new governor’s signature, they say, the state’s recently-established two-tiered substance use treatment system, with greater barriers to access for lower-income New Yorkers, will continue and cause more harm.

Medication-assisted treatment (MAT) is a proven tool for helping people who suffer from substance use disorders. It prevents overdoses, emergency room visits and hospitalizations, and ultimately saves lives. But, until recently, New York State required that insurers provide prior authorization to doctors before they can prescribe MAT drugs, like buprenorphine and methadone, to patients.

At the end of 2019, then-Governor Andrew Cuomo signed a bill that removed prior authorization for commercial insurers, expanding access to the life-saving drugs. But with the same pen, he vetoed another bill that would have removed that regulation for Medicaid, which the lowest income, mostly Black, Latino, and Asian New Yorkers rely on. The governor’s decisions effectively created two separate systems, removing obstacles for commercial insurance patients while keeping them in place for Medicaid enrollees.

This Friday, October 1, the state health department is also poised to institute a new statewide formulary for MAT drugs, taking a one-size-fits-all approach to a far more complicated issue.

“When it comes to anything in healthcare, one size does not fit all patients and their medical provider should have a right to decide what treatment works best for them,” said Senator Pete Harckham, who sponsored both bills to remove prior authorization.

After Cuomo’s veto, the state Legislature passed the Medicaid-related bill again this year with overwhelming bipartisan support, as part of an overdose prevention package. Lawmakers, advocates, and treatment providers are optimistic as they urge Governor Hochul to sign the bill into law that Cuomo previously vetoed.

Cuomo’s rationale for vetoing the bill was that it would increase state Medicaid spending. But as advocates point out, that argument was flawed and ignores the cost in human lives from preventing access to MAT drugs. A 2019 report by RTI International for the Legal Action Center, a nonprofit legal services and advocacy group, found that removing prior authorization would save almost 600 lives every year in New York, create cost savings for Medicaid of nearly $52 million annually, and reduce inpatient admissions and emergency department visits by 42%.

Dr. Justine Waldman, CEO of REACH Medical, a harm reduction provider based in Ithaca, said patients on medication-assisted treatment would benefit from a variety of medications rather than a single drug that may be allowed under the state’s new policy. “Given that it's a medication that keeps people alive, we really need to have that flexibility to find the medication that works for them,” she said.

Any additional administrative hurdles can reduce participation in treatment programs, Waldman said, and without first reducing opioid use, the state cannot eliminate it. “If you make everything based on elimination of use completely, you’re not treating a disease process, you're treating sort of a moral process,” she said.

The need for greater action on the overdose crisis has also never been more urgent. In 2020, overdose deaths spiked nationally by about 30% to more than 93,000. In New York, the Cuomo administration cut funding to syringe exchange programs, forcing many providers to lay off staff and reduce services, exacerbating the crisis even further and leading to increases in overdoses and STD outbreaks, according to experts. According to the latest CDC data, New York reported 5,129 overdose deaths between February 2020 and February 2021, a  34.3% increase compared to the 3,817 overdose deaths in the same period from 2019 to 2020.

“The state of New York should be doing everything that it can to make sure that we're turning the tide,” said Jasmine Budnella, drug policy coordinator at VOCAL-NY, an advocacy and service group.

“We have a moment in New York to really chart a whole new path and there's never been a better moment to have true leadership at the state level to trickle down into interventions and solutions,” she added.

Budnella is among the advocates that spent months negotiating with the Cuomo administration to allow greater access to MAT drugs, particularly for those on Medicaid. But while the administration agreed to implement those demands through policy, the new formulary for medications does not achieve the goal. Instead of ensuring that all MAT drugs would be “preferred” and hence need no prior authorization, several drugs continue to require it as well as come with limits on dosage.

“[W]hat you had there was an indication that the Cuomo administration wasn't too worried about creating this two-tiered system and specifically not expanding access for the Medicaid population, which obviously is low-income communities of color,” said Christine Khaikin, senior health policy attorney at Legal Action Center.

Hochul, a Democrat with just over a month on the job as governor, has indicated an interest in more fully tackling the substance use and overdose crisis. In her first public address as governor, she spoke of her own personal experience, having lost her nephew to a fentanyl overdose in 2017, and said the issue would be a top priority.

“Too many of our families have had to face this specter of dealing with someone, and sometimes they lost someone they cared deeply about because of addiction,” she said on August 26, when she announced Senator Brian Benjamin as her lieutenant governor. “So to those families, I know the pain you're going through, and we're going to make sure that we do everything in our power to stop that,” she added.

“Combating the opioid epidemic is a top priority for Governor Hochul, having served as co-chair of the NYS Heroin and Opioid Task Force for years,” said Haley Viccaro, a spokesperson for the governor, in a statement to Gotham Gazette. “She was also personally impacted by the crisis, losing a nephew to addiction several years ago. Governor Hochul will continue to fight for protections for New Yorkers struggling with substance abuse in partnership with families and impacted groups. The Governor is reviewing the legislation and will have more to say on this soon.​”

Hochul’s comments have been encouraging to those who have worked on substance use legislation for years. “It is refreshing to have a governor that understands that pain and grief and frustration that the state of New York has gone through around the overdose crisis,” said Budnella from VOCAL-NY.

“I think she's been much more willing than her predecessor to take on some of these issues,” said Senator Harckham, a Hudson Valley Democrat who chairs the Committee on Alcoholism and Substance Abuse and has been open about his own struggles with substance use.

As Harckham noted, the state is also flush with federal relief funds to fight the overdose crisis and is expected to receive as much as $1.6 billion through the settlements of lawsuits against opioid manufacturers and distributors brought by State Attorney General Letitia James’ office.

“So we will be having new revenues coming into state coffers that will be targeted to addressing substance use disorder, and clearly medication-assisted treatment and equity in medication-assisted treatment needs to be at the top of the list,” Harckham said.

For providers, Hochul’s approach has the right focus on lives rather than cost. “This is a governor who's really going to pay attention to health equity and put health equity above the cost of it, and that makes me extremely hopeful that this is our governor,” said Waldman.

by Samar Khurshid, senior reporter, Gotham Gazette

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Advocates and Journalists Push Hochul to Release Troves of Covid Data

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Gov. Hochul (photo: Mike Groll/Office of Governor Kathy Hochul)

A coalition of advocacy groups is pushing Governor Kathy Hochul to release over 100 datasets related to the coronavirus pandemic in New York that they believe the state is keeping. The groups say that information can be used by scientists, journalists, and advocates to better understand the virus, its impact on public health, and the state's response.

In a letter to Hochul, the coalition identified 123 datasets it said should be made available "without delay," of which only 14 have been published on the state's open data portal in a way that is easy to read and analyze. Another 64 sets have been published across various portals and websites in formats, like graphs, that cannot be broken down into more granular detail.

There are believed to be 45 of the datasets completely hidden from public view, including data on outbreaks and death in long-term care facilities, where some of the worst devastation of the pandemic has taken place.

"Publishing COVID data in a tabular, downloadable, machine-readable format would help restore trust in state government and help researchers, journalists and the public to better understand the dire pandemic that has cost us loved ones and continues to upend everyday life," reads the letter, dated September 7 and signed by ten organizations “from across the political spectrum.” The advocates include good government groups like Reinvent Albany, Citizens Union, Common Cause NY, and the Empire Center, journalist associations like the New York News Publishers Association, national organizations like the National Freedom of Information Coalition, and civic data group BetaNYC.

The groups have been urging the state to release this information at least since March, when they sent a letter to then-Governor Andrew Cuomo, Senate Majority Leader Andrea Stewart-Cousins, and Assembly Speaker Carl Heastie.

On June 22, the Empire Center submitted requests for 62 of the datasets under the state's Freedom of Information Law (FOIL). By September 2, only five had been provided with another five fully or partially denied, according to a blog post by Bill Hammond, the Center's senior fellow for health policy who has been tracking the Cuomo administration nursing home scandal throughout the pandemic. The rest of the requests are pending, including 42 filed with the state Department of Health.

In the most recent letter, the groups argued all the data is subject to FOIL disclosure and should be published online. "We emphasize that this public health data is owned and paid for by the public and should be published as a matter of course," they wrote.

The missing data includes basic information on COVID-19 testing and fatalities as well as more detailed statistics that could be used to track the virus and its variants in critical settings. Many of the datasets are reported in open data format in other states and localities, including on New York City's COVID-19 portal.

Hochul has promised a new era of transparency and accountability in state government, including a reevaluation of what covid-related information is released publicly. A spokesperson for Hochul noted to Gotham Gazette that when she became governor on August 24, Hochul signed an executive order to review all existing executive orders through the 45-day transition period she allotted herself, at which time she will take new executive actions that will include efforts toward a more open, ethical government. That transition period ends October 8.

According to the groups, the state does not publish positive tests tracked by zip code, age, or race and ethnicity, nor does it publish a chronological account of fatalities by zip code -- information that could be used to track regional outbreaks and assess local responses.

The state also does not publish information on hospital capacity, including available COVID-19 beds, according to the coalition analysis. Nor does it publish records of the state's stockpile of PPE and medical equipment -- a major source of anxiety for hospital administrators and health workers, and critical information in the event of another serious outbreak.

The groups say the state has not released any information about the death of staff members working in long-term care facilities, nor infection data in those settings or a list of facilities with outbreaks.

Despite months of lagging inoculation rates and the ongoing prevalence of the highly contagious Delta strain, information on covid vaccines and the state's efforts, while published, is not available in open data format making it difficult to closely analyze. The same is true of deaths in nursing homes and assisted living facilities, as well as testing efforts in schools, according to the coalition. Infection and fatality data in other congregate facilities, like prisons and some group homes is not published at all, the groups say.

"Because the state has not made this data available it is possible that they are not collecting it at all," said Tom Speaker, a policy analyst at Reinvent Albany.

On her first day in office Hochul committed to improving government transparency and the state's FOIL responses. "A new era of transparency will be one of the hallmarks of my administration," she said. "I have instructed my counsel to come up with an expedited process to fulfill all FOIL requests as fast as possible—and post completed requests publicly online."

On September 20, the governor's office issued a memo to state agency heads directing them to review their information-sharing policies and submit a plan "detailing changes your agency will make to increase the transparency of your work." The plans, due October 20, must show how agencies will improve FOIL response times, including "by proactively posting frequently requested information or completed requests online."

The state's tight grip on COVID-19 data, particularly the total death toll and facility outbreaks, has been the subject of controversy. For months, the Cuomo administration had underreported the pandemic's total fatalities by excluding people who died at home, in prisons and other state-run facilities, and people suspected to have contracted the virus without confirmation by a positive test result. On her first day in office, Hochul acknowledged an additional 12,000 deaths -- which had previously been tracked by the CDC and academic institutions -- in the state's regular reporting.

Last week, Hochul announced the resignation of Health Commissioner Dr. Howard Zucker, whose department had kept the state's mortality figures and was dogged by criticism that it mishandled outbreaks in nursing homes and covered up the full covid death toll of nursing home residents.

Nearly 56,500 New Yorkers have died from the coronavirus since the pandemic began, according to the state Department of Health.

by Ethan Geringer-Sameth, reporter, Gotham Gazette

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‘Turning the Page on a Long Chapter’: Kathy Hochul's First Month as Governor of New York

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Gov. Hochul (photo: Mike Groll/Office of Governor Kathy Hochul)

Governor Kathy Hochul on Friday marked her first month in office, during which she has responded to several ongoing and new crises, barnstormed the state in public appearances, and sought to begin restoring confidence in state government after nearly three full terms of her disgraced predecessor’s leadership.

Hochul, a Democrat from Buffalo, continues to carve out the rot of Andrew Cuomo’s administration and build out the top echelons of her executive office as she works to put more distance between herself and the man with whom she twice shared the Democratic ticket. And she is laying the groundwork for her own legacy, already significant as the first woman to be governor of New York, with an eye toward winning a full term in next year’s election.

But there are near-term challenges and opportunities for Hochul, and it remains to be seen if she will live up to the many promises she has already made. In her first month in charge, Hochul has appeared to relish the opportunity and realize she has limited time to make her mark, at least in terms of addressing immediate crises and setting herself up to have more time to lead the state. A major piece of the equation will come in January with her first, and potentially only, Executive Budget.

Hochul has come across as determined and collegial, winning high praise from many and cautious praise from some. Others are taking a wait-and-see approach and some don’t trust anyone who was a major figure of the Cuomo administration — however distant Hochul and the former governor may have been, she did travel the state for more than seven years praising him and promoting his agenda as Cuomo’s lieutenant governor.

Hochul has echoed the need for culture change so many in New York politics and government have identified given Cuomo’s way of doing things, and she quickly made progress on several key issues, including getting more pandemic relief money out the door. But she also appeared to falter on Hurricane Ida, not giving the storm its due in terms of early warnings and emergency decisions as it inundated many parts of the downstate region and killed 16 New Yorkers. A review of the state’s preparations and response is ongoing, Hochul has said. 

In her first public address after being sworn in on August 24, Hochul promised a new era in state government, one marked by collaboration, transparency and accountability. She inherited multiple crises from Cuomo, who resigned under a cloud of scandal that included a series of sexual harassment victims, a culture of secrecy and bullying, allegations of misuse of state resources, and more. The Delta variant was surging, the reopening of schools was fast approaching, and the state was failing to quickly release federal relief funds for renters, landlords, and undocumented workers. The Cuomo administration also faced a federal investigation into the handling of covid in nursing homes, and the alleged subsequent cover up of nursing home resident deaths. 

“I've embraced and internalized the hopes and dreams of 20 million people who share the name 'New Yorkers.' And I want you to know, you are heard, and I'm ready to get to work as your governor to solve the big problems that this state faces,” Hochul said in her inaugural address on August 24.

In her first acts as governor, she directed the health department to issue a universal mask mandate for schools, launched a $1 million outreach campaign to jumpstart the state’s $2.7 billion rent relief program, and announced a series of ethics, transparency, and anti-sexual harassment reforms. She took steps to boost covid vaccination rates, made appointments needed to launch the recreational marijuana industry in New York, and batted away assertions from Cuomo and his camp that he had been railroaded out of office by politically-motivated individuals.

Hochul faced her first crises as two major climate events hit New York within ten days of her taking over. The first, Tropical Storm Henri, hit the day before her swearing in, dropping record-level rainfall on New York City, flooding streets and subways but doing limited damage. But that was followed by Hurricane Ida, which broke those records, wreaking the most havoc in Queens.

Hochul quickly met with local, state, and federal officials to determine the state’s response and preparations for future climate events, including visits to several especially hard-hit areas. She appeared publicly with Mayor Bill de Blasio – who spent years bearing the brunt of Cuomo’s vindictive and adversarial approach – to address the aftermath of the hurricane, further signalling a new cooperative dynamic between the two top executives.

She made national media appearances, met with storm victims, and appeared alongside New York Senators Chuck Schumer and Kirsten Gillibrand and President Joe Biden, whom she worked with to get quick federal emergency relief approval. Questions do remain, however, about how well both the mayor and the governor reacted to the impending storm.

“Since swearing-in just one month ago, Governor Hochul has hit the ground running to deliver results for New Yorkers,” said Hazel Crampton-Hays, a spokesperson for Hochul, in a statement. “Whether it’s accelerating getting pandemic relief money out the door to struggling New Yorkers, taking smart, science-based steps to slow the spread of the Delta variant, or changing the culture in Albany through higher ethical standards and more transparency, Governor Hochul has swiftly demonstrated her leadership, ability to get things done, and that she will continue to move New York forward.”

The relationship with the mayor was just one of many things that Hochul set out to repair in the wake of Cuomo’s departure. The former governor left the state Health Department in shambles, with a mass exodus of top officials and experts during the course of the pandemic. The state’s ethics watchdogs, long under Cuomo’s thumb, had all but ceded their duties. Authority over, and responsibility for, the state-run MTA varied on the whims of the governor, who took credit for its successes and deflected blame for its failures, prioritizing his own political image over the best way to ‘run a railroad.’

Hochul faced challenging decisions on all those fronts and more, including personnel. She’s toward the tail end of the 45-day review period she announced for making decisions around major appointments and nominations, some of which she has already made. She has pledged to revamp one state government ethics watchdog, JCOPE, with new appointments and less political interference.

This past week, she accepted the resignation of two more controversial Cuomo allies in powerful positions, New York State Inspector General Letizia Tagliafierro and Health Commissioner Dr. Howard Zucker, both of whom had been mired in scandal related to prioritizing Cuomo’s image over serving New Yorkers.

Hochul swiftly filled out some of her top ranks. She appointed Karen Persichilli Keogh as secretary to the governor, the chief executive’s top aide, and Elizabeth Fine as her counsel. She picked Manhattan State Senator Brian Benjamin to be her lieutenant governor, and made a number of other appointments and nominations, while also bringing some of her top staff from the lieutenant governor’s office with her.

“She’s put some terrific people in place who have hit the ground running. That’s important,” said Kathy Wylde, president and CEO of the Partnership for New York City, a business group.  

A number of top Cuomo loyalists do remain in their positions pending Hochul’s ongoing review. Larry Schwartz, once Cuomo’s secretary to the governor who became a volunteer “vaccine czar” last year and continues on as an MTA board member, has not resigned from the board, despite being implicated in the state attorney general’s report on Cuomo’s pattern of sexual harassment. State budget director Robert Mujica, the architect of Cuomo’s tightly controlled budgets over the last several years and also an MTA board member, has also kept his position so far.  

Hochul has been reviewing cabinet positions and meeting with elected officials, making a slew of announcements, including on renewable energy projects for Climate Week, and appearing at events like the Buffalo Bills season home opening game. She's been speaking at Syracuse University and Harlem churches, giving remarks at rallies with activists and labor unions, greeting national and international figures, and generally appearing to squeeze as much into every day as possible, sometimes tweeting about her late-night meals from Shake Shack or a neighborhood diner.

“I'm not sure when she's sleeping or how she's getting it all done, but she is,” Wylde said. “Within a few weeks, she really has made a formidable effort to respond to issues that were of great concern to New Yorkers and get them moving.”

In a September 16 appearance on MSNBC, as she assessed her own performance, Hochul pointed to the various crises she has had to handle, including the two climate emergencies. “Really most of that was in my first two weeks on the job, and I realized I do have the experience and confidence to handle it and that people in New York are willing to give me a chance,” she said. “This is turning the page on a long chapter and a lot of people, particularly in state government, are feeling liberated again.” 

“I'm excited about the potential to transform not just state government, but more importantly, people's image and perception of their state government,” she added. “I want them to trust their leaders once again, and I'm committed to making sure that that happens under my watch.”

Though Cuomo may have received an honorary Emmy award (later rescinded) for soothing a distressed public with his daily press briefings during the pandemic, his administration was marked more by obfuscation, opacity, and a war-like footing with most other entities, from the press to legislators. Hochul has said her administration will be the opposite and given early indications she’s following through, though there is much still to prove.

In at least some ways, she’s shown her style to be very different from Cuomo, including that “she doesn't make hour-long speeches,” Wylde noted. “She focuses on brevity, clarity, and I don't think there's a spin involved. For someone who had to quickly take charge. I think that she's been honest and clear in her communication and I don't get any sense of an attempt to manipulate public opinion.”

Wylde added, “It’s nice when women are in charge. Women are able to multitask, are pragmatic and just want to get stuff done.”

In a Siena College poll released September 14, Hochul was viewed favorably by 42% of New York voters and unfavorably by 17%; 41% said they either did not know her or did not know enough about her. A majority, 52% of voters, said she will be more collaborative than Cuomo, against 18% who disagreed; 74% of voters were excited about Hochul becoming the first female governor, against 16%.

Hochul clearly knows she needs to introduce herself to more New Yorkers and that she has a chance to make a good all-important first impression. She’s regularly taken pains in public appearances to discuss her background, noting repeatedly that she was a local government official for many years, mentioning her brief time in Congress, and discussing her humble roots. From reproductive rights to a clean environment, she has sought to connect with New Yorkers, offering that a number of issues are “personal to me” and offering biographical examples.

As a statewide official for more than seven years with a busy schedule and the knowledge that she could become governor at any moment, Hochul was in some ways very much ready to hit the ground running. But in other ways Hochul has given indications of a fairly steep learning curve -- she’s correctly pointed out, sometimes to give herself cover, that she was not part of Cuomo’s inner circle. While she is particularly familiar, for example, with state economic development policy, which was central to the portfolio Cuomo assigned her, she has not been intimately involved with the MTA.

But Hochul has pledged to quickly get up to speed where necessary and repeatedly offered that she will listen to experts on the various issues, including those she plans to appoint. Her positive relationships with officials across the state have appeared to pay initial dividends. Her commitment to allow more local decision-making while giving state support to county, city, and town officials has been music to many ears.

“Kathy Hochul enters the job as a very different and distinct person...from Governor Cuomo,” said Christine Quinn, former speaker of the New York City Council and once a staunch Cuomo ally who is CEO of WIN, a nonprofit homeless shelter provider for women and children. “She has a commitment to transparency, a bottom-up government, a very much participatory government.”

Quinn praised Hochul’s first few weeks on the job and her response under crisis. “I think she's done a great job. She’s on the ground, connecting with people and marshalling all of the resources of the agencies of the state,” she said.

Though there may be significant exceptions, the central differences between Hochul and Cuomo may not be stances on the issues, but on management, style, and personality. Like her predecessor, Hochul is a moderate with progressive impulses, a “Biden Democrat,” as she recently told The New York Times, naming another moderate who has been moving left with the party.

Hochul has in some cases fulfilled the demands of activists where Cuomo showed intransigence. After nearly a dozen detainees died this year in the Rikers Island jail complex, including three this month, Hochul rushed to sign into law the Less is More Act. Approved by the state Legislature in June, the legislation restricts the detention of parolees on technical violations, and led to the immediate release of 191 detainees while paving the way for others to be let go or not re-incarcerated in the first place in the future. 

Meanwhile, Hochul has also been vocal about her opposition to the “defund the police” movement while also saying she is having conversations about the decriminalization of sex work.

She has said that while she may not support every project Cuomo put into motion, she also plans to go big on infrastructure, and she’s been clear about her readiness to work with business leaders as she seeks to revive the state’s economy.

“No matter the size of your business, I need you to survive because you're the identity of New York that people create jobs and opportunities,” she said at the Business Council's annual meeting on Friday. “You are who we are as New Yorkers. Your success means the success of this entire state. So count me in as an ally, someone who's going to be there for you, who will fight for you to make sure that we do not lose out to any competition, whether it's in the space of cannabis, where I believe there's thousands and thousands of jobs and new industries, to be created that were not even focused on.”

“Hochul’s been very self-assured and competent out of the gate,” said Neal Kwatra, founder of Metropolitan Public Strategies, a consultancy, in a phone interview. “She's been a very proactive governor in the first few weeks and months, and I think she's had a pretty steady hand. I would give her very good reviews in the early innings here.”

Kwatra said Hochul’s already shown a drastically different form of leadership “exemplified in her outreach to other elected officials, her embrace of sharing the spotlight if you will. That has been probably a concerted effort and strategic to show a clear break and I think it's been fairly successful so far...I think she's trying, and I think successfully showing, a different kind of governing approach and culture.”

“I think politically she's done an excellent job in her first month because she's establishing herself as a new ‘normal’ governor who's not engaged in histrionics and bluster and bullying and grandiose pronouncements,” said John Kaehny, executive director of Reinvent Albany, a nonprofit good government group, drawing a clear distinction between Hochul and Cuomo. 

“From a watchdog perspective, I wouldn't grade her as highly,” he said. “She set a very, very high bar for herself by saying that she wants to make ethics and transparency a high priority...That's great. But Cuomo also said that when he was running for governor. Not only did he say that, he published an entire detailed campaign book, a 100-page policy document on it.”

“She’s created an expectation around ethics reform and transparency but not yet been able to match her actions to her words,” Kaehny said, pointing out that Hochul’s incipient administration is already facing conflicts of interest questions. Hochul’s husband, William Hochul Jr., is general counsel and senior vice president at Delaware North, a Buffalo-based gambling and concessions company which has millions in state contracts. Her top aide, Karen Persichilli Keogh, is married to Mike Keogh, a partner at Bolton St. Johns, one of the top lobbying firms in the state. Delaware North was previously a client of the firm from 2019 till February 2021.

Delaware North, Kaehny noted, is the concessions vendor for the current Buffalo Bills stadium as the Hochul administration now negotiates the possibility of a new stadium. “The Hochul administration has kept complete secrecy around the negotiation and around the terms of the deal,” Kaehny said.  

The Bills have proposed a new $1.4 billion stadium, funded through a public-private partnership where the state could cover up to $1.1 billion of the cost. The report commissioned by the team has not been released to the public or reporters who have requested it through the state Freedom of Information law. 

On Wednesday, September 22, Hochul promised that a separate study was underway and would soon be completed and publicly released. “We are waiting for the results of a study that's been underway for a number of months now and I think that will come out in the next couple of weeks,” she said. “We're studying all the options."

The Buffalo native has also repeatedly stressed her emotional attachment to the Bills and has said she is working to make sure they stay put. “I'm a parent of a big family, I love all my teams, but the Bills are staying and I'm very excited about cementing their future in the next few months. Let's just get that done,” she said in her Business Council speech.

Well before those remarks, Reinvent Albany was among several good government groups that called on Hochul to institute a conflict avoidance plan and release it to the public. As questions were quickly raised when she took office, Hochul said in an August interview on CNN’s State of the Union that she had asked outside ethics experts to create an “ironclad policy” for her administration. “So no one will ever question that there's any involvement of my husband in anything pertaining to the state of New York,” she said.

No such policy has been made public as of yet.

Kaehny also criticized Hochul for appointing James Dering, a Cuomo ally, the acting chair of JCOPE just prior to a vote before the board on a matter directly relating to Cuomo. “That created a storm of unhappiness and rightly so,” he said. Asked by reporters, Hochul said JCOPE needed someone familiar at the helm and that she had no relationship with Dering herself. She also re-committed to an overhaul of the troubled ethics agency.

Kaehny said it’s hard for the public to give Hochul or her administration the benefit of the doubt after Cuomo “destroyed” the public trust in government. “Hochul inherited an extremely politicized executive branch where Cuomo spent ten years populating these agencies with loyalists, and that's a big challenge,” he said. “It's hard to just pretend that everything will be normal now. She has to earn the public's trust, and let's not forget the really fundamental fact is, she was lieutenant governor during all of his misdeeds and reign of terror and whatnot….She was in his administration. She represented their policies and programs.” 

New York Republicans, who’ve been focused on trying to win the 2022 governor’s race for several years as their main path back toward greater political relevance in the state, have quickly labeled Hochul as a continuation of the Cuomo regime. “Kathy Hochul is so desperate to avoid a Democrat primary, she's gone even further to the radical left than Andrew Cuomo,” said Nick Langworhty, chair of the New York State Republican Party, in a statement to Gotham Gazette. “She may be a nicer version of Cuomo but beware the wolf's in sheep's clothing as she poses an even greater threat to taxpayers and the safety of all New Yorkers.”

When Hochul took over from Cuomo, one of her priorities was to fix the mess his administration made in trying to hide data on the covid toll in nursing homes. Even as the federal investigation into that continues, she promised to be more open and to provide all the data that the Legislature and the media had been requesting for more than a year. 

Assemblymember Ron Kim, a Queens Democrat who battled the Cuomo administration on the nursing home issue, said he has seen no difference in Hochul’s response. “She has not even communicated, or acknowledged the problem in her first month, and that for me is a major problem,” he said. 

“All the families and the workers want to have an opportunity to present themselves and what they’ve gone through during this pandemic and start working together to try to fix a broken system. But she has not made an effort,” added Kim, who some believe is eyeing a run for statewide office, possibly lieutenant governor, in next year’s election. “In fact, she’s gone out of her way to avoid having tough conversations with me...This is something that’s really appalling.”

Hochul has taken some steps to address the nursing home scandal. Last month, she said on MSNBC’s Morning Joe that her administration would “continue working to identify principals involved in those decisions'' as she builds out her team. She also immediately ordered the release of health data that more accurately reflects the actual death rate from covid, including in nursing homes, and she accepted Zucker’s resignation. Much more is being asked of her on the issue, however.

“She’s good, if not even better, at identity politics,” said Kim. “...Beneath all the recent headlines and press conferences and announcements and pictures that we're seeing on social media, nothing has changed at all,” he said. “She’s going to the same power brokers that made Cuomo and she’s trying to cut the same deals that propped up Cuomo for many years. And that is a sign that she’s playing the same game, she’ll fall into the same traps....Every decision is about loyalty to her and garnering as much support for her reelection.”

by Samar Khurshid, senior reporter, Gotham Gazette

Read more by this writer.

Ben Max contributed to this story.

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