Chirlane McCray, leader of ThriveNYC (photo: Michael Appleton/Mayoral Photography Office)
First Lady Chirlane McCray’s signature mental health initiative ThriveNYC has faced withering criticism for spending hundreds of millions of dollars with few concrete results to show for it. But amid increasing scrutiny the de Blasio administration is seeking to put those concerns to rest as the Office of ThriveNYC for the first time releases detailed data tracking the outcomes of dozens of programs that have been launched under the Thrive banner.
It’s part of a reclamation project for McCray and her husband, Mayor Bill de Blasio, who have heralded ThriveNYC as a one-of-its-kind roadmap and national model, but struggled to show evidence of its effectiveness, particularly whether it was helping New Yorkers with serious mental illnesses. The mayor and first lady brought Susan Herman from the NYPD to the mayor’s office to establish better benchmarks, data-tracking, and standing for the program, and Herman is now showing the initial results of her work as executive director of ThriveNYC.
ThriveNYC’s proposed budget for the 2021 fiscal year, which begins July 1, is about $235.3 million, bringing its total spending to nearly $1 billion since the umbrella program was launched in 2015. Its programs include a mental health hotline, on-site mental health services at city schools, dedicated outreach teams for veterans, mental health screenings for younger adults at Department of Corrections facilities and for seniors at centers run by the Department for the Aging, to name a few.
Herman was named the director of Thrive a year ago, when it was formed into a standalone office under the mayoralty. In June of last year, the office released a list of about 100 metrics that it would be tracking to indicate program outcomes, the result of sustained criticism of the program by the mayor’s political opponents, budget watchdogs, City Council members, and others, which came after multiple media exposes and an embarrassing City Council oversight hearing.
When Herman took over, she set out to refine the program’s goals, culled down to four – strengthening crisis prevention and response, promoting mental health for the youngest New Yorkers, eliminating barriers to care, and reaching those with the greatest mental health needs.
While specific programs have been up and running for years – some have been refined, others expanded, and some cut back – they have so far only showed the city’s investments and inputs rather than outcomes. Last week, Comptroller Scott Stringer even added ThriveNYC to his “watch list” of city agencies, criticizing its profligate spending and lack of transparency.
The data released on Tuesday finally shows how much money is being spent on each program under ThriveNYC and the results of that spending. In an interview at the ThriveNYC office on Friday, Herman explained the new data and why it took so long to produce.
She said the office could only collect results once the programs had been implemented. “This was the undertaking that we went through very carefully last spring with all our partner agencies,” she said. “So some of them had to create new ways of collecting data and that takes time. Some of the effort is extremely time consuming.”
The data will be updated every quarter, with some indicators being updated semi-annually and annually, Herman said. The office also launched a new website to display the data and released a report showing its progress, including how many New Yorkers have received services between 2016 through June 2019, and highlighting how the program has achieved its four core goals.
Herman emphasized that the data release was not a scrambling response to the repeated criticism ThriveNYC has faced. “This is clearly a part of good government,” she said. “When you have a program, and you're ready to say this is how it's working. I think it will address many people's concerns but that's not why we're doing it. We’re doing it because it's part of what you do.”
She also noted that the comptroller may have jumped the gun when he claimed Thrive was not providing him with data he requested last week. Herman said Stringer requested detailed information on budgets, contracts and more, part of which includes the data released on Tuesday. “It’s a massive undertaking and he’ll get that shortly,” she said.
“I'm not really sure why he's added Thrive to the watch list,” she added. “I'm happy to talk to him about Thrive anytime he wants and I'm sure that some of this will satisfy some of his concerns. I don't think anybody can look at this data and not think that we are not only reaching a lot of people, but we're changing people's lives for the better.”
Stringer criticized the Thrive initiative’s failure to show line-by-line program expenditures and their results, which had been promised by the end of last year. “It should not take this long to produce metrics,” he said. “The current structure of Thrive can only be considered successful if it can prove its effectiveness.”
The new ThriveNYC progress report highlights some of those impacts. For instance, it shows that many people with serious mental illness are getting consistent help, something Herman also stressed in the interview. About 89% of clients treated by Intensive Mobile Treatment teams continue to receive treatment for more than a year, it says. According to other metrics, 90% of crime victims said they felt better after receiving services from the Crime Victim Assistance Program and 47% of seniors showed clinical improvement in depression symptoms after three months of treatment at a senior center.
The next stage, Herman said, will evaluate whether Thrive is having an impact at the larger population level by measuring whether New Yorkers with mental health needs get the treatment they require and whether fewer mental health needs turn into crises.
Herman also addressed questions about specific Thrive programs that have cropped up over time. The Mental Health Service Corps program, one of the most expensive aspects of Thrive, has been significantly scaled back after a disastrous launch and severe structural issues. “I would say it's been right-sized,” Herman said.
She also drew a distinction between an existing Home Visits program for new parents that is run under Thrive, as opposed to the new one recently announced by McCray that City Hall said is not considered part of the Thrive umbrella, without explaining why. Thrive’s program is aimed at filling a gap for families living in shelters, while McCray’s announcement covers the expansion of a program currently run by the Health Department, Herman said.
“What some people are missing is that Thrive isn't the mental health care system. It's much, much bigger than Thrive,” she said. “The Thrive initiative was to identify particularly critical gaps, and try and fill them in innovative ways, to reach people who haven't been reached before, to serve particularly underserved neighborhoods, to serve people in new ways.”
***
by Samar Khurshid, senior reporter, Gotham Gazette
@samarkhurshid @GothamGazette
Council Members Dromm & Gibson with Speaker Johnson in between (photo: John McCarten/City Council)
The City Council held its first hearing on Mayor Bill de Blasio’s $95.3 billion preliminary budget on Monday, calling on the administration to find more agency efficiencies and savings and to fund the Council’s own priorities, while also asking for a contingency plan should potential state budget cuts and cost-shifts go through this year.
The mayor’s budget proposal this year increases spending by $2.5 billion over last year’s adopted budget, and reflects a $20 billion increase since he took office six years ago. Though the mayor did not include many new initiatives when he released his budget proposal in January, he has since announced several that could add hundreds of millions in spending.
This year’s budget is expected to be particularly challenging for the city as the administration faces $1.4 billion in cuts, cost-shifts, and unfunded mandates from the state, the highest in the last six years. Most of the potential cost-shifts stem from a proposed Medicaid overhaul that Governor Andrew Cuomo proposed in his executive budget, though state budget officials have argued that the mayor’s estimates are overblown and much is to be determined as the state’s Medicaid Redesign Team does its work and the governor and legislators negotiate the new state budget due by April 1. The next city budget is due by July 1.
Economic growth has also begun to slow and as the novel coronavirus roils the financial markets, it could threaten the city’s economy, particularly if it hurts tourism.
On Monday, City Council members and de Blasio administration officials seemed to acknowledge that they would not be able to beat back all of what Cuomo has outlined. “What we need to hear from the administration today is a plan,” said Council Speaker Corey Johnson to de Blasio budget director Melanie Hartzog. “We need the mayor to reassure us that if these shortfalls materialize, then the city is prepared to absorb them into our budget with minimal impact to crucial city services.”
But Hartzog, director of the Mayor’s Office of Management and Budget, said the city may have to make tough decisions. She reiterated at Monday’s hearing the de Blasio prediction that Cuomo’s Medicaid shifts would be “devastating,” particularly to NYC Health + Hospitals, the municipal health system. “We cannot absorb that level of cuts,” she said, noting that it would necessitate possible reductions in social services and after-school programs. “Unfortunately, everything is on the table,” she said.
Hartzog noted that the city has already spent roughly $3.8 million in repsonse to the coronavirus outbreak and while she could not be sure what the overall cost to the city might be, said that the city spent about $20 million on the Ebola scare of a few years ago, which might be a good initial benchmark to think about.
Council Member Daniel Dromm, who chairs the Council’s finance committee, said there are certain risks “that are inexplicably not addressed by the mayor’s preliminary budget even though they are predictable and necessary to continue to meet the needs and priorities of New York City.”
That includes underbudgetting certain costs. He noted, for instance, that the city has spent an average of 28% more than it budgets on overtime since 2015, but hasn’t taken steps to correct the gap. Projected spending on so-called Carter Cases, private school placements for students with special education needs, was also lower than should be expected, he pointed out – the Department of Education’s fiscal year 2021 budget includes $405.6 million for Carter Cases, he noted, which is about $134 million less than the budget for the current fiscal year. The budget also does not include a needed $64 million for pupil transportation and leaves out $75 million that the Board of Elections needed to implement early voting last year, he said.
As Dromm pointed out, the mayor in his State of the City speech announced several initiatives that would require more funding including the expansion of 3-K, a home visit program for new parents (expected to cost $43 million next fiscal year, an amount that wasn’t in the mayor’s preliminary budget), and ignored the City Council’s discretionary priorities, which cost about $450 million in the current fiscal year. The budget also does not provide funding for $215.7 million in one-time funding that the Council fought for last year, Dromm said.
On a promising note for the administration, Council Member Vanessa Gibson, who chairs the Council’s capital budget subcommittee, praised efforts to make the city’s capital budget process more transparent and to improve how funds are spent on capital projects over the course of the four-year, $85.5 billion capital commitment plan. She noted that the administration has started reporting on projects that are funded in the out-years after the plan, aligning more closely with the city’s ten-year capital strategy.
Over the course of three hours, Council members questioned the administration on a myriad of issues including homelessness spending, nonprofit contracting, and funding for senior services, cultural affairs, public housing, overdose prevention, special education, and more.
Johnson was particularly focused on the city’s spending on homelessness. He cited the recent release of the Council’s comprehensive strategy to end the homelessness crisis, asking why the de Blasio administration could not act to increase the value of rental vouchers to fair market rates to help people stay in their homes and out of shelter and whether the city’s massive increase in shelter spending was money being spent in the right ways.
Hartzog said the administration agrees with the goal but could not act on its own. “We can’t without risking losing state and federal funding,” she said. She also pushed back on Johnson’s suggestion that a single deputy mayor oversee housing and homelessness.
Though the city faces major threats to its budget, the mayor did not institute a Program to Eliminate the Gap (PEG), which he did last year to mandate targeted savings at specific agencies. Budget watchdogs have long said the administration needs to find more actual agency efficiencies rather than savings through re-estimates in spending and accruals (not hiring for positions that are budgeted). Johnson questioned whether the mayor was planning a PEG as he looks toward his April executive budget plan. “Can’t rule it out at this point,” Hartzog replied.
Following the administration’s testimony, the Council heard from Comptroller Scott Stringer and experts from the Independent Budget Office, a city-funded fiscal watchdog. Stringer released his analysis of the mayor’s preliminary budget last week, and called for the administration to increase the ratio of reserves to total annual spending – the budget cushion – to 15%. The cushion was 11% in the current fiscal year, which Stringer has repeatedly said would be insufficient in the event of a recession. Stringer also highlighted his recent addition of the office of ThriveNYC to his "agency watch list," which already included the city's department of education, correction, and homeless services, and fielded questions on the subject. He explained that the mental health care office led by First Lady Chirlane McCray has not provided a detailed, transparent budget and has not shown sufficient indication that its spending, roughly $200 million per year, is producing results.
Over the next month, the Council will continue to delve into the budget, examining spending plans at agency-specific hearings. After the Council presents its response to the mayor, he will issue his executive budget, which will be the subject of another round of hearings before the final budget is agreed to in closed-door negotiations.
***
by Samar Khurshid, senior reporter, Gotham Gazette
@samarkhurshid @GothamGazette
De Blasio and the City Council talk budget (photo: William Alatriste/City Council)
The New York City Council will on Monday begin its public examination of Mayor Bill de Blasio’s $95.3 billion preliminary budget proposal for the 2021 fiscal year, which begins July 1. As in previous budget cycles, the Council and budget watchdogs are pushing the mayor to find more savings in city operations and sock away more money for fiscal emergencies.
First with Monday’s overall discussion of de Blasio’s budget plans -- both the $95.3 billion annual operating budget and the $85.5 billion four-year capital commitment plan -- then weeks of committee hearings with testimony from city department heads, the Council will examine the mayor’s programs and spending. Council Finance Chair Danny Dromm will lead all the hearings, at first in partnership with Speaker Corey Johnson, then with committee chairs as the Council digs into the individual departments.
The mayor himself has been cautious in increasing planned spending for next year but the budget has nonetheless increased by more than $20 billion since he first took office, raising red flags about whether the city can maintain its largesse in the event of an economic recession that is, at this point, widely anticipated.
When the mayor released his budget proposal in January, spending was outlined to rise by $2.5 billion compared to last year’s adopted budget. Most of the increase stemmed from now-unavoidable costs – $1.6 billion from labor contracts and benefits, $256 million from state mandates on education spending, $270 million to pay debts on city borrowing, and $175 million to implement recent state-approved criminal justice reforms.
There was no funding for new initiatives, and the mayor attributed his fiscal restraint to uncertainty emanating from a $6.1 billion state budget gap that could potentially lead to Medicaid cost-shifts onto the city. (Since releasing his preliminary budget de Blasio has announced some initiatives that will cost money, like home visits for new parents, estimates for which may be outlined in coming Council budget hearings or when the mayor puts forth his executive budget plan in April.)
[Read: Warning of State Threats, De Blasio Presents $95.3 Billion Preliminary Budget for 2021 Fiscal Year]
In his February budget testimony before the state Legislature in Albany, de Blasio said the cumulative effect of Medicaid cost-shifts, unfunded mandates, and reduction in expected aid to the city could be as much as $1.4 billion if Governor Andrew Cuomo’s proposed executive budget is approved. The Cuomo administration has disagreed with that projection but is nonetheless proposing major potential changes to the city’s financial picture.
[Read: In Albany, De Blasio Enlists Legislators' Help to Fight Cuomo Budget Proposals]
As is the case every year, the Mayor’s Office of Management and Budget tends to be conservative in its revenue forecasts, and budgets accordingly – by November, when the budget is modified nearly half way through the fiscal year, more spending is added.
The City Council isn’t bound by those forecasts and has typically called for millions more in spending in every budget and has been largely successful in having its demands met. At the same time, for years now, the Council has called on the mayor to increase agency efficiencies to cut costs and to bolster reserve funds for a rainy day. This year promises to be no different.
"As we have done with previous budgets, the Council will fight for a responsible and fair city budget. We will continue to look for savings and push for reserves,” Council Speaker Johnson said, in a statement to Gotham Gazette. “We are also committed to securing a budget that works for all New Yorkers and includes our priorities such as sustainability, criminal justice, education, Fair Fares, transportation infrastructure, homelessness and affordable housing. Albany's budget gap has presented us with major challenges, but we will continue to advocate for all New York City residents by ensuring they don't lose critical services they depend on. The Council looks forward to working with the de Blasio Administration to achieve an equitable City budget.”
Johnson has already previewed that spending on homelessness will be among the Council’s budget priorities, whereby it is looking for increased city rental subsidies while reigning in other costs, something that has been an ongoing focus for budget watchdogs like Comptroller Scott Stringer, who is raising other repeated and new flags about de Blasio’s budget.
Stringer has also repeatedly beat the drum of fiscal discipline, pushing for a 15% “budget cushion” – the ratio of reserves to total operational spending. The cushion last year stood at about 11%. On Tuesday, Stringer presented his analysis of the preliminary budget, outlining his “agency watch list” and raising concern that the city is “spending more than we are taking in.”
Notably, Stringer added First Lady Chirlane McCray’s signature mental health initiative ThriveNYC to his watch list along with the city’s education, correction, and homelessness agencies, insisting that the program has been opaque about how its funding has been disbursed and has released few metrics to show it is working effectively. ThriveNYC is spending more than $200 million annually at this point on a variety of programs, often working in partnership with agencies like the NYPD and health department, but McCray and others have acknowledged its struggles with showing its successes through data.
Stringer pointed out that the city often spends more than is budgeted every year, and the increased spending is funded from expected surpluses before the end of the fiscal. Hence, the November budget modification. “One little warning sign is if we suddenly had a reversal of fortune, that would not leave us with much room to maneuver,” he said.
Unlike last year, the mayor did not institute a PEG (Program to Eliminate the Gap) which sets mandatory benchmarks for city agencies to identify savings that the mayor and his team then evaluate, but he did leave the option on the table. He has instead relied every year on a Citywide Savings Program, which asks agencies to find voluntary savings and efficiencies, but its results have been underwhelming to budget watchdogs. Stringer has been critical of the program, saying “we need a more rigorous review of agency spending. That’s how we will protect our most vulnerable communities. We simply have not done enough to root out inefficiencies, redundancies and waste. We have not done enough to prepare to weather a storm.”
Ana Champeny, director of city studies for Citizens Budget Commission, a nonprofit fiscal watchdog, echoed the concerns raised by Stringer and Johnson. “The Citywide Savings Programs, while they have been close to funding new needs, have continued to be small relative to city-funded spending, and they've also been particularly weak on efficiency savings,” she said in a phone interview. “While a third of the savings plan so far this year has been efficiency savings, that represents just 0.22% of city-funded spending. So in terms of the agencies really looking at their budgets and making reductions and improving efficiency and improving operations, we don't see enough of a focus on that.”
The administration has persistently touted a “historic” level of reserves, maintaining them at nearly $6 billion this year – $1 billion in the general fund, $250 million in the capital stabilization reserves, and $4.7 billion in the Retiree Health Benefits Trust fund.
But the CBC does not consider the RHBT fund a true reserve. “We feel that those deposits are being made against a very substantial liability on the city's books. And so we shouldn't be thinking of that as a pot of money which to use during a recession or some other contraction,” Champeny said.
There’s no doubt that economic growth is slowing. The city’s surplus revenue reduced from 2019 to 2020, which, as Stringer also pointed out, could be a worrying problem.
After the City Council concludes its month-long series of hearings on the preliminary budget, the Council will release its formal preliminary budget response and make clear its top priorities for budget negotiations, then the mayor will craft the next iteration of his spending plan, the executive budget, which will undergo another series of hearings, followed by both public and private jockeying before the final agreement is made behind closed doors. Amid all of it, the state budget is expected by its April 1 deadline for the new state fiscal year, results de Blasio will have to take into account in his executive budget plan released that month.
***
by Samar Khurshid, senior reporter, Gotham Gazette
@samarkhurshid @GothamGazette
Note - This article has been updated to note that Champeny said efficiency savings represent 0.22% of city-funded spending, not 2.2%.