google view entrance of tow pound
As a state-imposed deadline approaches for relocating a massive NYPD tow pound at Pier 76 in Manhattan, Mayor Bill de Blasio’s administration has requested the state waive fines that would be imposed if it fails to complete the task while the city continues to look at alternate sites for towing operations in the borough. The city may even have found a target Manhattan site owned by the state.
In the state budget this year, Governor Andrew Cuomo pushed through a provision that requires the NYPD to vacate its 250,000-square-foot tow pound at Pier 76 in Hell’s Kitchen and hand it over to the Hudson River Park Trust for redevelopment. The move has been in the works for more than two decades, having been first included in the Hudson River Park Act of 1998. The state gave the de Blasio administration a tough ultimatum. By the law passed in early April, if the city fails to move the tow pound by December 31, it will have to pay the Hudson River Park Trust a fine of $12 million, with an additional $3 million every month it occupies the space after February 1, 2021.
Mayor de Blasio and NYPD officials opposed the move, citing the city’s lengthy land use process. At a City Council hearing in late January, then-NYPD Chief of Transportation William Morris criticized the “unrealistic deadline” imposed by the state, noting that it would take far longer to find a suitable alternative in Manhattan. Last year alone, he said, the department towed 50,000 vehicles to the pound, a volume that can’t easily be handled by other locations.
“It literally would cause us to violate city law that requires a land use process for any such action to take place and that process by law takes more than a year to begin with,” de Blasio said of the proposal when testifying before the joint fiscal committees of the State Legislature in February. “This tow pound is basically the size of Union Square Park. Finding an alternative in and near Manhattan is a very complex undertaking.”
The city is now seeking a two-year waiver of those fines and fees and has offered to purchase or lease a State Department of Transportation parking lot at 621 West 45th Street that can accommodate the tow pound’s capacity. Deputy Mayor Vicki Been made the request in a letter dated October 29, sent to Erik Kulleseid, commissioner of the State Office of Parks, Recreation and Historic Preservation and to Basil Seggos, commissioner of the Department of Environmental Conservation and chair of the Hudson river Park Trust.
In the letter, as the mayor himself has noted previously, Been said the city can ill-afford millions of dollars in fines as it struggles to bring its budget under control because of the devastation caused by the coronavirus pandemic. “Already the City has had to make severe cuts to vital programs affecting NYC residents, the maintenance and improvement of other parks and critical infrastructure in the city, and the funding of nonprofits and the services they provide,” the letter reads. “Implementing a fine against the City would further shift resources away from such core programs at a time when they are most needed.”
A spokesperson for the state Department of Environmental Conservation declined to comment on the city’s request but provided an earlier September 17 letter sent by Seggos to Mayor de Blasio. In the letter, Seggos said he would ask the Hudson River Park Trust to open the pier as it could provide “extraordinary benefit” as a public space. But the letter also seemed intended as leverage against the administration.
“I’m sure we all agree at this time of economic pressure that it would be wholly unacceptable to the public to lose the benefit of the pier and to burden the City’s already stressed budget through noncompliance with state law at a time when the City is considering laying off personnel,” Seggos wrote. “Any site can be used as an NYPD parking lot, but only the pier can provide spectacular open space for the public.”
Despite the concerns about the fiscal cost that the city would have to bear, prominent elected officials also continue to push for the move of the tow pound. A spokesperson for City Council Speaker Corey Johnson, who represents the area, said he “supports moving the tow pound and creating more open public space in the area. He will continue working with the city and the state to make this happen as soon as possible."
State Senator Brad Hoylman, whose district includes the tow pound, also wants the city to meet the deadline. “The City has had over two decades to move the NYPD tow pound from Pier 76. New Yorkers deserve to have this pier in the Hudson River Park available for open space rather than used as a rent-free dumping ground for cars by the NYPD,” he said in a statement to Gotham Gazette. “I can’t speak to whether the Governor’s office is open to negotiating more time with the City, but I’d urge the City not to delay any further and find appropriate City- and NYPD-managed locations for the tow pound. We want a park, not a parking lot.”
The city’s ideal proposed site is currently used for tour bus parking and a pedestrian bridge for the Intrepid Museum. The administration has said it will be willing to pay the fair market value for it. Over the years, the city has also reduced the footprint of the tow pound, requiring less space than in the past. Horse stables for a mounted NYPD unit were moved from the site in 2015 and the city is now in the middle of lease negotiations to move another 18,000-square-foot service shop from the premises, according to Been’s letter.
The city also identified Marshalling Yards, owned by the New York Convention Center Development Corporation, as an alternate site. According to Been’s letter, the Yards, between West 33rd and 34th Streets, will be redundant after the Javits Center expansion is completed in 2021, allowing the tow pound to be moved there.
Although the administration is considering two private properties as well, Been’s letter notes that “given the complexity of tow pound operations and procurement processes, conversations with private landlords often stall or move slowly.”
As the letter notes, the siting decisions were supported with a Capital Project Scope Development (CPSD) study, conducted by the firm Dattner Architects at a cost of $1 million. The study also examined whether booting illegally parked cars could be an alternative that would reduce the NYPD’s reliance on towing. The administration, however, concluded that it would be “frequently counterproductive” to do so. “Booting would significantly worsen the situation that the City is trying to address. Particularly in Manhattan, this creates an unsafe situation, as cars, pedestrians and bikers will be required to maneuver in and out of traffic,” the letter reads.
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by Samar Khurshid, senior reporter, Gotham Gazette
@samarkhurshid @GothamGazette
Covid testing (photo: Michael Appleton/Mayoral Photography Office)
City Council members and public health professionals gathered over Zoom late last week to discuss how the city can better support public hospitals so that they’re prepared for a potential second wave of COVID-19, which experts say could overlap with the annual flu season and recent case upticks indicate may be looming.
The public hearing — held by the Council’s Committee on Hospitals and billed as an oversight hearing “Examining the City's Support of NYC Hospitals During the COVID-19 Pandemic” — covered issues including the widely agreed upon underfunding of public hospitals, access to personal protective equipment, and improving equity.
Looking ahead, Council members said one key goal is to mitigate the disease’s disproportionate effects on working-class people and people of color, the very people who are disproportionately “essential workers” and who the city’s public hospital system, NYC Health + Hospitals, struggled to serve during the worst of the initial outbreak, especially in Brooklyn, the Bronx, and Queens.
The hearing, chaired by Council Member Carlina Rivera, a Manhattan Democrat, featured representatives from Mayor Bill de Blasio’s administration and from the public hospital system who defended the city’s record and said the city is ready for another surge of coronavirus cases. After city officials testified, advocates spoke on issues like funding for Health + Hospitals (H+H) and equity for marginalized people.
“This pandemic proves that our healthcare system is too disparate, not just in times of crisis but year-round,” Rivera said in her opening statement. “We are committed to ensuring that the path we build forward out of this pandemic is more equitable for all.”
Joined only by Council Members Mark Levine and Diana Ayala, Rivera asked about PPE access, transfers between hospitals, equity, and the city’s preparedness for a second wave, while officials signaled cautious optimism thanks to lessons learned from March and April. “We are better at caring for sick patients” now, said H+H President and CEO Mitchell Katz.
At the height of the pandemic, the public hospitals struggled to provide their employees with adequate PPE such as N95 masks, gloves, and gowns. Katz said the hospital system ordered PPE in January but “those shipments never arrived” because of a surge in demand worldwide. But NYC Emergency Management Commissioner Deanne Criswell said the city will be prepared this time around for whatever comes its way.
“Each hospital, even outside of the NYC Health + Hospital system and the independents, all have their own 90-day supply of PPE,” she said, “and then through our PPE Service Center we have an additional 90-day supply of PPE.” Criswell said the city also monitors state and federal PPE stockpiles.
According to NYC Test and Trace Corps Deputy Executive Editor Jackie Bray, some of this PPE can be manufactured in New York, but other equipment, like N95 masks, must be purchased from outside the state.
Katz also said that the city is unlikely to experience the same ventilator issue it faced in spring. “Intubation is not always the right answer,” he said; in fact, many patients do better with non-invasive ventilation, like devices that push air into the patient at high pressure.
Katz also shared takeaways about transferring patients between public hospitals, an important issue since during the height of the outbreak in the spring some intensive care units, especially in parts of Queens, were much more crowded than Manhattan ICUs. But there were some cases where hospital administrators wanted to transfer people between H + H hospitals but didn’t because they were unstable.
“You can’t put a patient into an ambulance to go to a less crowded hospital if you think they’re about to go into cardiac arrest,” Katz explained. If there’s a second wave, “we will stabilize patients and transfer them before we run out of space in our ICUs so that every hospital will still have available ICU beds.” This could help ensure that New Yorkers, especially people of color and working-class people who live in areas without many hospitals, can still access adequate care.
H+H has also changed the physical layout of its rooms, adding windows so that people can see each other without breathing each other’s air, putting video and sound monitors in every room so that nurses understand patients’ needs before they visit them, and expanding use of tablets for patients to communicate with loved ones, Katz said.
Something else the city hopes to do is send out health-related text message alerts in more languages. Notify NYC, the city’s emergency alert system, recently began sending text alerts to more than 31,000 New Yorkers in Spanish, but it hopes to expand. “One of our goals as we move forward is to work with our messaging platform and cell service providers to be able to issue these real-time alerts in additional languages,” Criswell said.
After officials spoke, advocates discussed issues of underfunding and inequality. H+H, which is run by the city but technically its own public benefit corporation, gets funding to treat uninsured patients from the state and city governments, and has faced what some call chronic underfunding. The pandemic has only added to the hospital system’s expenses, though significant federal aid has helped.
Elisabeth Benjamin, Vice President of Health Initiatives at the Community Service Society of New York, a nonprofit focused on the city’s most vulnerable residents, said historic underfunding is part of the reason the pandemic had a worse effect on people of color and people living in boroughs other than Manhattan. “New York State has made a series of policy decisions that have resulted in really unfair allocation of health-care resources, that have in fact exacerbated the disparities in the covid pandemic,” she said.
They include giving aid to bad actors among private hospitals that could’ve gone to public hospitals, Benjamin said. She pointed out that while hospitals in Manhattan have grown, hospital closures have negatively affected communities in the less wealthy boroughs and neighborhoods, including areas served by Elmhurst Hospital, which was overwhelmed during the worst of the first wave in New York and is situated near the sites of four closed hospitals. The Queens neighborhoods around Elmhurst Hospital, an H+H facility where mobile morgues stored increasing numbers of dead bodies this past spring, was one of the areas hardest hit by the pandemic.
Benjamin also criticized the city’s use of indigent care pool funding, which is funding from the government that’s meant to go to hospitals that serve poor people. “Every hospital gets a little bit of this funding, whether they serve poor people or not, whether they offer financial assistance or not, whether they sue their patients or not. That’s wrong,” Benjamin said. The state recently closed a loophole allowing hospitals to collect funding from the indigent care pool for bad debt even if that debt was from wealthy people, but Benjamin said that’s not good enough. “Maybe we should only then be spending the indigent care pool money on the hospitals that are about to go under first of all, but also that serve high-need communities and communities of color.” Coronavirus-spurred CARES Act funding from the federal government also went more to private than public hospitals, Benjamin said.
“I agree with you wholeheartedly,” Council Member Rivera told Benjamin.
The devastating coronavirus outbreak in the city led to and exposed a shortage of skilled medical staff and a lack of PPE. Judith Cutchin, a director of the New York State Nurses Association and director-at-large at Woodhull Hospital in Brooklyn, said that at the height of the pandemic, it was possible for one nurse to have to tend to “as many as eight patients at a time.” According to the New York Times, the situation was even worse than that in some places. “In the emergency room, where best practices call for a maximum of four patients per nurse, the ratio hit 23 to 1 at Queens Hospital Center and 15 to 1 at Jacobi Medical Center in the Bronx,” the Times reported.
“This is unacceptable,” Cutchin said, later adding that when the hospitals did hire more workers or recruit them from other departments within the hospital, she was concerned by the last-minute nature of their training. “We are going into a next surge and we have to assure that people are properly trained,” Cutchin said. “Lives are at stake.”
Anthony Feliciano, Director of the Commission on the Public's Health System, a nonprofit that advocates for equal access to healthcare, said he thinks funding for public hospitals should come from the budget of the NYPD, echoing calls to “defund the police” in light of the Black Lives Matter movement that surged earlier this year after high-profile police killings of Black people in other parts of the country. “We need to ensure that the Board of Health declares racism as a public health crisis,” Feliciano said.
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by Lauren Hakimi, Gotham Gazette
@lauren_hakimi @GothamGazette
Supplies arrive at a hospital (photo: Michael Appleton/Mayoral Photography Office)
New York City is a "few weeks" away from securing a 90-day stockpile of medical personal protective equipment (PPE) and ventilators, according to Mayor Bill de Blasio’s administration, a project the mayor announced in April as part of a vow to be better prepared for a potential second wave of COVID-19 and other emergencies. But some elected officials and the New York nurses union are questioning the formula behind the 90-day supply benchmarks and whether the stockpile will be adequate for hospitals in the event the current uptick in cases and hospitalizations gains enough momentum to approach crisis levels.
De Blasio said the stockpile, known as the "NYC Strategic Reserve," would be ready by the end of the year and should be able to support public and private health-care facilities citywide for a three-month period based on the city's PPE usage at the height of the pandemic -- a time when hospitals were overrun and doctors, nurses, and support staff were forced to reuse disposable gear for days. According to the mayor’s office, the city is close to amassing thousands of ventilators and hundreds of millions of units of PPE, including 13.5 million N95 masks, 185 million nitrile gloves, gowns, face shields, and dozens of other categories of gear.
"We'll purchase what we need and create a stockpile so we will never be in a situation where we turn to those who are supposed to supply this and they say, sorry, we're all out," de Blasio said in April when he made the announcement.
"At the Mayor’s direction, we established a Medical PPE Service Center that could supply the New York City healthcare sector with peak volumes of PPE from the Spring for a full 90 days and meet any ventilation needs we might have," wrote Avery Cohen, a spokesperson for de Blasio, in an email at the end of October.
As part of the Strategic Reserve plan, de Blasio promised to acquire 4,000 ventilators, to be stored and regularly serviced until needed. "We are building up our City-owned ventilator fleet, in combination with resources at hospitals and ongoing support from the Strategic National Stockpile," wrote Cohen, who would not say whether 4,000 was still the goal, or if the maintenance program was underway.
The discussion has taken on more urgency in recent days with hospital admissions leaping upward and the seven-day positivity rate averaging over 2%. City Council Member Mark Levine, who chairs the Council’s health committee, says the figures mean the city is already experiencing a second wave. Governor Andrew Cuomo announced new statewide restrictions on Wednesday.
People on the ground in hospitals and elsewhere are skeptical that there will be enough PPE for a full resurgence of COVID-19 and, in terms of ventilators, city and state public health agencies have never before considered New York to be prepared for a serious pandemic influenza. Highest among the concerns is that the PPE burn rate at the peak of the pandemic should have been much higher, if supplies had been available, and that the city is calibrating to a time when hospital conditions were likened to war zones.
"At that time the way that we were using these supplies were [through] these contingency and crisis guidelines and, really, many places weren't even hitting the crisis guidelines," said Pat Kane, executive director of the New York State Nurses Association, which represents roughly 20,000 registered nurses in the five boroughs alone, of whom 8,500 work in the city's public hospital network.
"Shortly after the pandemic hit, the CDC changed a lot of its positions on what the proper equipment was. They changed their guidance based on supply," Kane told Gotham Gazette.
"When there is a crisis in the supply chain...that's OK to do, but when that becomes the ceiling and the norm it's a problem," she added.
In the spring, nurses in hospitals were being asked by administrators to reuse the same N95 mask for five days or more, keeping them in paper bags and, when they got damaged, mending them with staples and rubber turnequits, Kane told Gotham Gazette. Hospital staff -- including non-clinical personnel -- at times resorted to other makeshift methods, like wearing plastic garbage bags as a protective layer.
"We are still using conservation methods for N95s in many places. We're still not using N95s the way we were before covid," Kane said, when nurses were able to follow "proper infection control."
"They don't have all the PPEs they deserve," de Blasio said at an April 3 press briefing, acknowledging the emergency measures strayed from traditional guidance. "We've been now for weeks and weeks on a crisis footing and the CDC recognizes this, that there's one standard, if you will, for peacetime, there's another standard for wartime and we have to make tough, tough choices and get by with less in wartime.”
City Council Member Ben Kallos, a Manhattan Democrat who chairs the Council’s contracts committee, said he has been seeking information on the peak PPE burn rate and the formula behind the city's stockpile figures without success, most recently at an oversight hearing in October. The mayor's office did not respond to a separate Gotham Gazette inquiry for the same information.
"The administration still hasn't shared how they came to this number and whether or not these numbers are accurate," Kallos said in a phone interview.
"We do know from common sense, common knowledge, anecdotes, and testimony at the hearing, that the numbers of PPE that we need are deflated because of people being instructed or choosing to recycle PPE that they shouldn't," he said, adding, "I am incredibly fearful that this 90-day stockpile is not the right number."
Kane said she is optimistic that any resurgence of the virus would not be as bad as in the spring because of the increase in testing, mask-wearing, and overall awareness of the virus. "I think it's great that the city put out some information, but it all comes down to: how are we going to be using the equipment," Kane said. Experts are exploring reusable alternatives to disposable PPE, like elastomeric masks -- a kind of gasmask-style face covering with removable filters -- which they say are safer and cheaper over longer periods of time, and are urging public health officials to consider.
"The good news from the hearing is that the administration said they were open to buying these elastomeric masks, but we have not heard from the city and whether they are going to add them," Kallos said.
Months after the first peak in COVID-19 cases and deaths in New York, the state is again seeing a rise in cases, hospitalization, and deaths. On Monday the mayor called a second wave "dangerously close" as the city's slate of COVID-19 indicators reached their highest point since spring, approaching or surpassing thresholds set by public health officials that indicate when action is needed. Since August, several coronavirus hotspots have emerged that the city and state have taken action to try to supress, including more testing, pushing mask use, cracking down on gatherings, and closing down schools and non-essential businesses.
It's unclear exactly what a second wave will look like but de Blasio is now saying he views the combination of a "sustained" 3% positivity rate of the tested population, a seven-day average of new reported daily cases above 550, and daily hospitalizations over 200 as constituting a resurgence of the virus. On Tuesday, the seven-day average positivity rate was 2.3% and covid hospital admissions in the city increased from 71 to 92. New reported cases surged to 795, per the mayor’s Tuesday report, alarming public health officials. The mayor has said the entire school system will move to all-remote learning if the seven-day rolling positivity average hits 3%.
These are still far from the levels the city saw in March, April, and May, but the recent memory of how quickly things can escalate has raised serious concerns in the city, which has lost over 24,000 residents to COVID-19, approximately 1 in every 350 New Yorkers.
The city's Department of Health and Mental Hygiene (DOHMH) said it has 37 million Level 3 isolation gowns, 54 million 3-ply surgical masks, 900,000 goggles, and 6 million face shields, on top of the N95 masks and gloves. Without more information on the city's peak data and modeling it is hard to gauge exactly what these numbers mean relative to a potential second wave of mass hospitalizations. Spokespeople for the department did not provide a full list of the items in the Strategic Reserve or respond to questions about stockpiling other non-PPE surgical and medical supplies -- things like intubation drugs, sedatives, and IV extension tubing -- that hospitals burned through at high levels this spring.
While New York public health officials have not historically considered stockpiling ventilators a viable option in a severe pandemic, representatives from the mayor's office expressed confidence that the city's ventilator reserves are enough to handle a second wave.
The city's "Pandemic Influenza Preparedness Response Plan," crafted by the DOHMH in 2006 under Mayor Michael Bloomberg, projected a citywide shortfall of between roughly 2,000 and 9,500 ventilators in the case of pandemic on the scale of 1918. The Department recommended a pilot program with a small number of ventilators because of the "large endeavor" of purchasing and storing the machines. The plan served as the basis for future estimates and was cited in a July report on hospital preparedness from City Comptroller Scott Stringer, which states the city later stockpiled a few hundred but "understandably" sold them when they became too expensive to maintain.
In April, de Blasio and the city's Economic Development Corporation (EDC) announced a partnership with local manufacturers to design and build 3,000 bridge ventilators -- a less powerful version of a full-service ventilator, designed for more minor cases -- though it is unclear if these are part of the 4,000 promised in the Strategic Reserve or if they would be going directly to hospitals. "The City produced 3,000 bridge ventilators to support local hospitals and to shore up the New York City Strategic Reserve, a stockpile of medical devices that will be ready for any future crisis," wrote Shavone Williams, an EDC spokesperson, in an email echoing the language of the mayor's original pledge.
Pre-coronavirus pandemic state guidelines appear to view ventilator stockpiling as a lost cause. In protocols developed by a task force chaired by Health Commissioner Howard Zucker in 2015, a question-and-answer supplement says stockpiling ventilators for a “severe pandemic” is futile: "Even if New York State purchases additional ventilators, the demand would quickly outpace supply in a severe pandemic."
At the time, the state had a stockpile of 1,750 ventilators on top of roughly 7,000 in use in hospitals. In response to questions about the state's current stockpiling, Jonah Bruno, a Health Department spokesperson, wrote, "We do not comment on our stockpiled supplies."
He did note there are "multiple warehouse sites located strategically throughout the state" with PPE and other medical supplies, which the state distributes through the Division of Homeland Security and Emergency Services.
In July, Governor Andrew Cuomo issued emergency regulations mandating all healthcare facilities maintain their own 90-day PPE supply and nursing homes, a 60-day supply. Cuomo, through his executive powers, laid the framework for the state to coordinate resources among all public and private hospitals statewide. At the time he announced the public-private partnership on March 31, he said the state would take the lead in "coordinating State-City stockpiles and individual hospital stockpiles." It's not clear exactly what is in the state's stockpiles and how they were used.
According to the Health Department, the state's supply goals are based on the average daily PPE burn rate between April 19 and 27.
"PPE supply numbers understandably fluctuate as facilities have regular need of the equipment, in addition to continuing to use it in their responses to localized COVID-19 outbreaks, while also preparing for a second wave," Bruno wrote in a separate email. "Recognizing that there continues to be supply chain challenges, the Department, in its role as regulator, continues to work with all facilities to achieve sufficient PPE and will track that process through our continued communication and daily HERDS reporting,” he wrote, referring to the Health Electronic Response Data System, the state's database of hospital capacity and resources.
Cohen, the de Blasio spokesperson, said the mayor's office has "worked with the [city] Health Department to set allocations for each and every provider in the city based on usage data from the Spring peak and scientific modeling, making sure that providers servicing vulnerable populations and neighborhoods in need are prioritized."
The Greater New York Hospital Association, a network of over 160 institutions in the region, did not provide an update on supplies in its facilities after multiple Gotham Gazette inquiries.
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by Ethan Geringer-Sameth, reporter, Gotham Gazette
@GeringerSameth @GothamGazette