Gotham Gazette

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Opinion

A Change New York Must Make to Protect Safety Net Providers and Their Clients


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Health care professionals (photo: John McCarten/NY City Council)


Finalizing a budget can be chaotic in the best of times. This year, we hammered out the last details of the state’s $177 billion spending plan as the COVID-19 crisis was approaching its peak in New York State. 

It was in this context that the Legislature agreed to a little-noticed recommendation from the Governor’s Medicaid Redesign Team II (MRT II) that strips a critical federal benefit from health-care providers and patients in New York. Luckily, we have until April 1, 2021 to undo this mistake. I will be working non-stop over the next seven months to do just that, along with a coalition of advocates and Medicaid patients as part of the Protect the Safety Net campaign. 

The MRT II pushed through a provision in the budget that would “carve out” a pharmacy benefit from the state’s Medicaid managed-care program and shift payment to a fee-for-service reimbursement. The commission claimed its goal was to lower costs and increase transparency, but in reality this provision would devastate Ryan White Clinics, federally-qualified health centers, safety net hospitals, and other safety net providers in the 340B drug discount program. In Monroe County, for example, Trillium Health, Jordan Health, and the University of Rochester Medical Center all rely on 340B to provide essential services to families in our community. 

The federal 340B Drug Discount Program protects safety net providers from drug price increases and gives them access to pharmaceuticals at discount prices. This includes HIV/AIDS clinics that receive support under the Ryan White CARE Act as well as community health centers that have been on the frontlines of fighting COVID-19. 340B providers rely on this funding to operate food pantries, provide transportation assistance, STI screenings, mental health and wellness programs, and run harm reduction programs – services that are often grossly underfunded by the state.

If the carveout is not reversed, many patients across New York State will simply have nowhere to turn. These are not savings that should be made on the backs of those who can ill afford these cuts. 

The 340B Program is under constant threat from Big Pharma, which has tried to distort and undermine the program since it was established with broad, bipartisan support back in 1992. For the pharmaceutical industry, a discount program for Medicaid patients just means less profit. For short-sighted bureaucrats in Albany, it’s a chance for accounting gimmicks that allow them to claim “savings” that would actually harm the vulnerable New Yorkers they are supposed to be serving. 

The Medicaid commission chose the worst possible time to experiment with changes to New York State’s safety net. 340B providers care for patients in communities that have been hardest hit by the COVID-19 pandemic. If these providers are forced to eliminate services, more patients will be forced to go to hospital emergency rooms for care – swamping our hospital system and driving up costs while leading to poor health outcomes. 

This would also threaten the progress we’ve made in fighting the HIV/AIDS epidemic. Ryan White Clinics have built comprehensive models of health care and social services to address the diverse needs of their patients. This comprehensive model of care is only possible because of the clinics’ participation in the 340B program. 

In the weeks and months ahead, New Yorkers will be hearing a lot more about this issue. The New York chapter of Ryan White Clinics for 340B Access recently launched a campaign to Protect the Safety Net, led by advocates and Medicaid patients. We’re going to keep fighting until the state reverses course and restores this critical benefit for the most vulnerable New Yorkers.

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Assemblymember Harry Bronson represents Rochester and surrounding areas. On Twitter @HarryBBronson.

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How to Vote Biden-Harris and Protect Progressive Power in New York


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The Working Families Party's survival is on the ballot (photo: Kevin P. Coughlin/Governor's Office)


When we each ran for State Senate, the Democratic establishment supported our opponents — but the Working Families Party had our backs. That’s because for over 20 years, the WFP has stood up for working people’s champions running for the New York state Legislature and fought for true progressive power in Albany. So it’s no surprise that Governor Cuomo and the corporate Democratic establishment are now trying to take away the Working Families Party’s ballot line and weaken progressive power.

We can’t let that happen — that’s why we’re voting for Joe Biden and Kamala Harris on the Working Families Party ballot line, and you should too.

For decades, Albany was controlled by Republicans and corporate Democrats who worked hand in hand to empower themselves, rather than working people. The Working Families Party spent years campaigning to send working people’s champions to Albany — leaders like State Senator Gustavo Rivera in the Bronx, Assemblymember Yuh-Line Niou in Manhattan, and Assemblymember Diana Richardson in Brooklyn. And in a historic power shift in Albany in 2018, the WFP recruited, supported, and elected a slate of candidates who unseated the Independent Democratic Conference and their corporate allies — flipping the State Senate blue for the first time in eight years and kicking off the most progressive legislative session in New York history.

While establishment Democrats refused to endorse that slate of progressive champions — Jessica Ramos, Alessandra Biaggi, Robert Jackson, Rachel May, John Liu, Zellnor Myrie (and me, Julia Salazar) — the WFP was in the trenches. The WFP built campaign plans, recruited volunteers, and brought in the grassroots support and progressive muscle we needed to win.

Because of the Working Families Party, the State Senate was able to push through massive progressive wins in 2019 that had been bottlenecked by Republican control for years: from historic tenant protections and voter access laws to landmark climate legislation and driver’s licenses for undocumented immigrants. And that same year, the WFP invested heavily in Tiffany Cabán’s decarceral District Attorney campaign. This cycle, the WFP continued to back progressives like myself, Jabari Brisport, Marcela Mitaynes, Khaleel Anderson, and dozens more.

So it’s no surprise that Governor Cuomo and his corporate allies have been laser-focused on weakening the Working Families Party — the party that wrested control away from the Governor and his Republican allies and began to truly deliver for working people. During this year’s budget negotiations amid a pandemic, the Governor slipped in an eleventh-hour clause — requiring all political parties to meet the strictest ballot requirements in the nation to maintain their ballot line. Parties once needed 50,000 votes every four years to maintain their ballot line. Now, they need 130,000 votes or 2% of all votes — whichever is higher — at the top of the ticket and they need these votes every two years, starting now. The threshold and timing were clearly meant to hurt the WFP this year, during a presidential election with very high turnout.

It’s clearer than ever why we must work to protect the Working Families Party’s ballot line: if not for the WFP, Democrats might be still battling with Republicans for control of the statehouse. Instead, GOP legislators are dropping like flies, corporate Democrats are on the defensive, and the Left is building real power in Albany. 

We will both be voting on the WFP line, because we cannot let Governor Cuomo and his fellow corporate Democrats weaken our progressive power in the middle of the political fight of our lives. New York is in the midst of a massive public health crisis, while suffering the effects of decades of austerity budgets and racist police brutality. We need to build working people’s power in Albany — and the WFP plays a key role in that fight.

Tens of thousands of our loved ones have died because of the state’s crumbling health-care system; millions are at risk of eviction; too many to count cannot afford to feed their families. Unemployment claims are climbing, and New York and Washington have left our undocumented brothers and sisters out to dry. If Governor Cuomo has his way, New York will continue cutting funding for hospitals, schools, and localities instead of asking the wealthy to pay more so we can all survive. We can’t afford a weakened Left right now. By voting for Biden and Harris as well as candidates like us on the WFP line, you can help protect the ballot line — and protect the multiracial, people-powered movement for justice that this moment demands.

For those of us who believe in a truly progressive agenda, voting for this year’s Democratic presidential ticket is not going to be easy; Biden and Harris are far from the working people’s champions that this moment deserves. But we also know that we can and must use our ballot to vote against Trump and to vote to strengthen progressive power in New York, by voting for Biden and Harris on the WFP line. To win, we need to keep progressive power growing in New York — so join us, and vote for Biden and Harris on the WFP line.

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State Senator Julia Salazar represents parts of Brooklyn in the 18th District and is running for reelection. Jabari Brisport is the Democratic and WFP nominee for Brooklyn’s 25th State Senate District. On Twitter @JuliaCarmel__ & @JabariBrisport.

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Saving Lives from Domestic Violence


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City Hall in purple (photo: Ed Reed/Mayoral Photography Office)


One survivor used the word “red” in telephone calls with her best friend when she and her children were in trouble. A family living with an abuser placed a photo in a window visible from the street – when the photo was not visible it meant they were in trouble. Another survivor signaled for help with a special knock on the wall shared with a next-door neighbor.

As a domestic violence survivor said in “When Staying Home Isn’t Safe,” one of my recent ThriveNYC podcast episodes, “If you can’t be strong, be brave. Go get help.” In her case, she left her partner after the smacks turned into punches. Survivors break through isolation in many ways, as the above anecdotes show.  

Domestic Violence Awareness Month is marked every October but COVID-19 has changed everything this year. There have been surges in suspected and reported domestic violence nationwide since the pandemic, with a 19% uptick in calls to New York’s domestic violence hotline since April compared to last year. A New England Journal of Medicine article called domestic violence during COVID-19 “a pandemic within a pandemic” because of a cascade of relationship stressors -- crowded housing, unemployment, illness, isolation, remote schooling and work.

In this moment of protests for racial equality and a higher profile for social justice movements, now is the time for all New Yorkers to become allies in the fight to end domestic violence, which touches 1 in 4 women and 1 in 10 men. Like so many social ills, domestic violence cuts across all demographic lines, exacerbated by factors like racism, homophobia, citizenship status, and poverty. 

We can all do much more than wear purple on October 22, a day historically dedicated to raising domestic violence awareness.  

Be an “upstander” not a bystander. Learn the signs of domestic violence and abuse by going to our NYC Hope website, and memorize and share the phone number of the domestic violence hotline: 1-800-621-HOPE (4673) to connect to services.  

The ThriveNYC helpline at 1-888-NYC-Well is also available 24/7 to talk, text, or chat with trained counselors in almost every language. It is a free and completely confidential place to talk about whatever is on your mind. The city’s Family Justice Centers (a one-stop shop for survivor services) closed temporarily because of the pandemic but services are available by telephone.

Still active is the city’s network of services and assistance for survivors: shelters, food delivery, legal assistance, reimbursement for tele-health mental health services. Links to those services are on the city’s domestic violence support page.

These strange, unprecedented few months have been a time to learn what we can do better. Survivors have told city officials that during the COVID-19 crisis they urgently need survivor-led spaces for peer-to-peer support. So for the first time ever, the city is supporting a series of public, virtual Survivor Town Halls in every borough, with two planned for Domestic Violence Awareness Month. One is on October 15 in Manhattan and one is October 28 in Brooklyn. 

Notably, the town halls are organized with grassroots organizations like the Voices of Women Organizing Project, the lead initiative of the Battered Women’s Resource Center.  

These 90-minute Zoom calls are an opportunity for networking, story-telling, and resource-sharing with fellow survivors and representatives of such key city agencies as the Administration for Children’s Services, the Department of Education, and the Department of Health and Mental Hygiene. Among topics to be discussed are financial survival, being undocumented, family court, mental health, and staying safe online.  

Cecile Noel, Commissioner of the Mayor’s Office to End Domestic and Gender-based Violence (ENDGBV), emphasizes that allies must listen to what survivors need and be respectful of their choices, which might include staying with the person who has abused them. 

There is always hope and there is always help. We need every New Yorker to join us in this battle for equality, dignity, and life. In a time of rampant uncertainty, isolation and fear, we are stronger by standing together. As the marches and social justice protests across the country have shown, we can share a different vision for how we treat one another, even in our own homes and our most intimate relationships.

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Chirlane McCray is First Lady of New York City. On Twitter @NYCFirstLady.

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