Gotham Gazette

The Place for New York Policy and politics

Opinion

Opinion

Coverage Denied No Longer: Expanding Eating Disorder Treatment in New York


niley ro am

Assemblymember Nily Rozic, the author


“An eating disorder? I wish I had one of those — I could stand to lose a few pounds.”

Every year, clients, advocates, and professionals visit the New York State Capitol to meet with legislators. When discussing their eating disorder experiences and pushing for legislation to ensure proper insurance coverage, too often they are met with that response and others like it.

These kinds of insensitive quips reveal how little many people know about the danger and severity of eating disorders.

No one intentionally jokes about wanting a life-threatening illness. And the truth that too few people understand is that eating disorders are life-threatening mental illnesses. Not a choice; the disorder is a means of coping and can be attributed to a collection of biological, psychological, social, and genetic factors.

Anorexia and bulimia nervosa are the most common disorders but they are not the only ones. Others recognized by the American Psychiatric Association in the Diagnostic and Statistical Manual include Binge Eating Disorder, Avoidant Restrictive Food Intake Disorder, Other Specified Feeding or Eating Disorder, Pica, and Rumination Disorder. All of these disorders are serious and require medical attention.

People who struggle with an eating disorder are doing precisely that — they are struggling. Part of that pain and stigma comes from their symptoms not being understood as dangerous or serious. Often, symptoms are not taken seriously and they must convince not only their loved ones that they are sick but also insurance providers that approve treatment and coverage.

There remains a troubling gap in insurance coverage. Through Timothy’s Law, eating disorders are ensured coverage but only anorexia and bulimia nervosa are named. Insurance providers use this grey area as reasoning to deny coverage of the other eating disorders.

The story is common: Too many people are turned away due to lack of coverage. Too many people lose their chance of a full recovery because they didn’t meet strict weight requirements to classify as anorexic or didn’t throw up often enough each day to be considered bulimic. Not only is it hard to be approved for coverage, it’s even harder to find a comprehensive care center close to home — there are only three across New York.

It is time that law reflects the most current version of known eating disorders. New York can change the story. Earlier this year, I introduced the Eating Disorders Act (A1619/S3101) that would ensure coverage is provided to all people struggling with eating disorders by codifying all the currently recognized disorders.

The time for awareness is now. The time for change is now.

***
New York State Assemblymember Nily Rozic represents parts of Queens. On Twitter @nily.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.

Remembering the Value of the Public Advocate as We Choose the Next One


Tish James Public Advocate election

Tish James' inauguration (photo: Mayor's Office)


On Tuesday, Feb. 26, New York City voters will head to the polls to elect the next Public Advocate, a position vacated in January when the previous officeholder, Letitia James, was sworn in as State Attorney General.

New York is the only city in the country that has an elected city-wide Public Advocate, a unique position charged with helping individual residents and addressing broader city service problems. We’re better off for it.  

Unfortunately, 30 years after the position was created, too few understand the role of the Public Advocate. And, as New Yorkers head to the polls to vote, there is a simultaneous push to eliminate the office, a move that is misguided and irresponsible.

I served as New York City’s second Public Advocate, from 2001 through 2009. With a budget of around $3 million (that’s about 0.03% of the total city budget) we investigated complaints about city services, proposed solutions, introduced legislation, and held the rest of city government’s feet to the fire to improve services.

We were successful. So were the other four individuals who served in the position.

How?

Sometimes it starts with a single complaint. A family living in a homeless shelter called my office about problems getting food stamps. This led to an investigation uncovering a string of problems both with the food stamp application process and the offices of the Human Resources Administration, the New York City agency responsible for helping people access public benefits.

Other times, the office hears from groups of people, like parents of students who called my office to complain about being backlogged in the special education evaluation process.

In both these cases, and many others, we were able to force the city to fix the service problems. Letitia James did the same for tenants, children in foster care, children with disabilities, and others.

The fact of the matter is, the office has a three-decade-long track record of helping people in the city.

In the face of the facts, a City Council member has introduced a misguided bill to eliminate the office. Those who have sought to shutter the office have two basic criticisms: they claim the office is a stepping stone to higher office and that the role is filled by others. The first is true, but misses the point. The second is 100 percent wrong.

First, every office, aside from the office of the President of the United States, is a potential stepping stone. If the person who holds a term-limited position (all city-wide offices have term limits) does his or her job well, we should want that person to run for higher office and let the voters decide.

Second, there is no other elected official with a city-wide perch who can see service problem patterns from Bensonhurst, Brooklyn to Baychester, The Bronx, connect the dots, and use the power of the bully pulpit and the law (via legislation) to get the problems fixed.

But, after my eight years in the Public Advocate’s office, I realize the office isn’t perfect. Instead of re-debating whether the office should exist, we should talk about strengthening it.

The office needs a guaranteed independent budget. Currently the office’s budget is decided at the whims of the Mayor and City Council, the very entities the Public Advocate is intended to scrutinize.  

Furthermore, while I was Public Advocate, we received around 12,000 calls a year about problems with city services. 311, the city hotline for information and complaints, receives tens of millions. The Public Advocate’s office should be linked with 311 to give it a broader view of the problems New Yorkers are experiencing and the trends that need to be brought to the attention of the administration.

As New Yorkers get ready to head to the polls to vote in the next Public Advocate, they should consider which of the 17 candidates would best fit the ombudsman role. And those in government should get to work to strengthen the office and better ensure city services work better.

***
Betsy Gotbaum, a former New York City Public Advocate, is Executive Director of Citizens Union, a government reform organization.

As Executive Director of Citizens Union Foundation, Gotbaum also serves as publisher of Gotham Gazette.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.

Note: Gotham Gazette is an independent publication of Citizens Union Foundation, sister organization of Citizens Union.

Time for the City to Pay Up


Justin Brannan

Justin Brannan, the author (photo: @JustinBrannan)


Talk is cheap. The city needs to pay up.

We have all been impacted by the important work of hundreds of human services providers across the city, many of which are deeply rooted in our communities. These vital non-profit organizations deliver services to New York City’s most vulnerable – the poor, the hungry, the homeless, our children, our grandparents. The clear and powerful impact of this sector makes it easy for politicians to praise the services these non-profits provide — but such talk is cheap if you don’t back it up with action.

The uncomfortable truth is that these crucial organizations are very much at risk and in direct harm at the hands of the same government agencies and elected officials who praise them. How so?

Human services contracts are registered late by city agencies 94% of the time, forcing organizations to make impossible decisions to bridge massive gaps in their funding. Ninety-four percent!

In fact, most city contracts with non-profit human services providers are registered months or even years after these non-profits begin providing the services they cover. While this money is being held up by a broken and opaque contracting system, critical support for children, the elderly, those experiencing homelessness, people with disabilities, those living with HIV and AIDS, immigrants, and individuals coping with substance abuse and mental health challenges are put in direct risk.

This is shocking and unacceptable.

A domestic violence shelter cannot close for months while the city gets its act together. Senior centers can’t stop serving daily meals because of a funding gap due to a late payment from the city. Instead, non-profits are forced to front money, taking on costly loans and lines of credit with high rates of interest that are never reimbursed by the city agencies that held up their money up in the first place.

I cannot believe this has somehow become the status quo. It must change.

There are real human and financial consequences if a non-profit doesn’t start its services on time. Not to mention the corresponding challenges for those who work providing these crucial services.

It is time for those responsible for this crisis to step up. Non-profits have borne the brunt of the city’s delays, putting the financial health of their organizations in jeopardy to ensure communities receive critical services. While no contract should ever force a provider to start delivering services before being paid, at the very least non-profits should not bear the cost! Those interest payments must be the responsibility of those at fault and should be paid, in full, by the city, a requirement that would provide a direct incentive to process contracts on time.

It is also important that there is clear public access to data about which city agencies have the longest delays and why contracts are being held up. This information is vital not only to promote accountability but also to seek the needed remedies to this failure.

Contracts and the procurement process may not be the sexiest topic in this city of headlines, but it has an exponentially reverberating effect on the city and how it functions. If we allow this to continue, these compounding late payments to the human services sector will only get worse and soon every neighborhood will suffer the consequences.

As chair of the City Council’s Committee on Contracts, I have heard dozens upon dozens of devastating stories about how organizations are impacted by these unnecessary barriers built around them by the city. Talk is cheap. Action is long overdue – we must act now to address this crisis.

***
City Council Member Justin Brannan represents parts of southern Brooklyn. On Twitter @JustinBrannan.

***
Have an op-ed idea or submission for Gotham Gazette? Email This email address is being protected from spambots. You need JavaScript enabled to view it.



Print Friendly and PDF

Editor's Choice


Gotham Gazette: New York Voters Approve $4.2 Billion Environmental Bond Act
New York Voters Approve $4.2 Billion Environmental Bond Act
Gotham Gazette: 
New York City Voters Approve Racial Justice Ballot Measures
New York City Voters Approve Racial Justice Ballot Measures
Gotham Gazette: 
Housing Development in New York City Slows to a Crawl as Officials Debate Tax Incentives
Housing Development in New York City Slows to a Crawl as Officials Debate Tax Incentives
Gotham Gazette: 
City Council Examines Low Voter Turnout, Moving Local Elections to Even Years City Council Examines Low Voter Turnout, Moving Local Elections to Even Years