BY DAVID WOODLOCK
Thanks to runaway costs, New York State’s Medicaid
program – and the millions of vulnerable
patients it serves – faces a $4 billion shortfall
and across-the-board cuts to help balance the state’s
But instead of reducing care for Medicaid patients,
we should invest in a whole person approach that
brings physical, behavioral and other kinds of services
under one roof so people with the most complex challenges
can truly get better.
At the East New York Health Hub, run by ICL and
Community Healthcare Network, we bring doctors,
psychiatrists, substance misuse counselors and social
workers to one place. The most vulnerable – and costly
– clients there are getting better, and we’re saving the
state money by reducing costly interventions such as
Oscar, a 60-year-old man who suffers from schizophrenia,
type II diabetes, hypertension, obesity and
worsening vision problem, is one example. Before
coming to the Hub,Oscar hadn’t seen a primary care
doctor in years, his diabetes was out of control, and
he simply wasn’t taking care of himself.
But after engaging with a mobile treatment team,
Oscar’s glucose readings dropped by half, he began
taking medication regularly and decreased his sugar
intake – all signs that point to improved health and less
costly care down the road.
At ICL, we’ve applied this whole person approach
across 100 programs serving more than 10,000 New
Yorkers, and it works: In 2018, we reduced client emergency
room visits by 57 percent and hospitalizations due
to mental illness by 62 percent.
At the Hub, we have on-site services and multidisciplinary
teams that travel to meet patients where
they are – homes, jobs, parks, cafes, shelters, literally
anywhere and more – to ensure people get the care
Our clients see their behavioral health counselor
frequently. This allows our staff to build trust with
individuals, who then are more likely to keep doctor’s
appointments and change health behaviors.
Our staff escort patients to appointments and often
when they stay for the duration of their visits to offer
support and reassurance. And when patients can’t get to
the Hub, we bring nurses with us to home visits. Access
to care is an empty promise without measures like these.
The lesson for policymakers is clear: Forget cuts that
would allow problems to worsen and costs to grow, and
invest in whole person care that improves outcomes and
David Woodlock is CEO of the Institute for Community
Digging inside report of
BY ANDREW BERMAN
A recent report issued on behalf of the NYC
Department of City Planning, the Manhattan
Borough President, and City Councilmember
Margaret Chin called for seeking opportunities to
create affordable housing in SoHo and NoHo, and
to increase density to do so.
That suggestion has recently been amplified by a
small but vocal group of activists who’ve made this
their No. 1 priority as zoning changes are being considered
for these lower Manhattan neighborhoods.
This may sound benign enough; there’s no denying
New York City in general and these increasingly
pricey neighborhoods in particular need affordable
housing, and one could easily be forgiven for thinking
that “increased density” means nothing more than
allowing smaller buildings to be replaced by larger
ones for this purpose.
In fact, what is actually being called for is something
far less innocuous, that would result in much
more super-luxury than affordable housing being
added, and in grossly out-of-scale development of
the sort currently prohibited in these neighborhoods.
And no one would benefit so much from these
proposed changes as the real estate developers
who would earn a tremendous windfall from these
The de Blasio administration has adopted a policy
whereby in order to get new affordable housing mandated
in a neighborhood, communities must accept
a massive ‘upzoning,’ meaning a change in rules to
allow much larger development than what is currently
Every New York City neighborhood has limits on
the size of new development defined by local zoning;
no matter the limits, though, those rules allow
substantial new construction to take place in every
neighborhood in New York City. But in order to get
affordable housing as a required part of the mix, the de
Blasio administration insists that existing zoning rules
be changed for that neighborhood to allow a doubling
or tripling of the allowable size of new development.
Only in those cases will they impose requirements
that 25-30% of new housing fit certain criteria for
But here’s the catch — the upzoning that’s attached
means that getting that small amount of affordable
housing also means getting 70-175% more market rate
housing than would otherwise be built along with it,
which in neighborhoods like SoHo and NoHo (and
many others in New York City) means super-luxury
housing. And it also means that new buildings will
be 2-3 times the size of those which have been going
up in the area.
This way, the real estate developers who will build
the housing (and who by no coincidence are also the
largest contributors to Mayor de Blasio’s campaigns)
The historic buildings of SoHo.
will actually make much more money than they would
otherwise on their properties, which is why they have
been largely supportive of this policy.
To use some real life examples, new construction in
SoHo includes 10 Sullivan Street (204 feet tall), The
James Hotel (258 feet tall), and The Mondrian SoHo
(311 feet tall) — all built under the existing size limits
for construction in the neighborhood. Upzoning advocates
are calling for allowing new construction two
and half times as large as what’s currently allowed.
Such changes are a real possibility, given the
confluence of real estate interests, city government
officials, and upzoning advocates using the false
premise of affordable housing as justification for
seeking this dramatic policy shift. If implemented,
it would result in a radical change in the character
of these historic neighborhoods — not only in terms
of oversized development, but introducing a flood of
new luxury housing under the guise of creating new
This is why communities across the city — from
Bushwick to Inwood to Sunset Park — are resisting
these upzoning proposals.
This approach is absolutely unnecessary. Even the
city’s existing policy would allow requirements for the
inclusion of affordable housing when non-residential
buildings are converted to housing, which is the source
of by far the majority of SoHo and NoHo’s housing.
And the city can and should end its practice of making
massive upzonings a requirement for affordable
If not, we’ll continue to be presented with this false
choice between maintaining neighborhood character
and building new affordable housing, and continue
to bear the burden of the false linkage between new
affordable housing and vastly increased and comparatively
much larger amounts of new super-luxury
housing as the price to pay for it.
Andrew Berman is the executive director of Village
Preservation, the Greenwich Village Society for
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