(MSCC) June 24, 2020 CHAIR (June 2, 2020 meeting):Sharon Jasprizza, Midtown South Community Council, MSCC POLICY COMMITTEES REPORT FOR JUNE 2, 2020, 8:30AM MEETING The prior 8:30am Policy Meeting was spent discussing isolation shelter policies and Medical Respite Beds Advocacy Plans status (see Addendum D). Cassie Dessalines, BronxWorks, gave the update. (Please see Addendum B for details) SPEAKER(S)  Michelle Mays, RN, New York Project Coordinator for Doctors Without Borders (DWB),  (MSF) discussed their outdoor shower program. She announced the Harlem location opening as of May 20th, 2020, and the opening of the midtown operation at the new location at 46th Street (between 10th and 11th Avenue). DWB is planning to stay till the end of June. DWB is speaking to different groups about continuing their operations. Jordan Otis & Harriet Holder from Midtown Community Court are holding several events to distribute PPE, food, clothing, hygiene products, and serving approximately 150 people per event. The remaining event: Event #4 Partnering with Doctors Without Borders Date & Time: June 19th (10am-2pm) Event Address: Midtown Community Court (Courtyard) & Hells Kitchen Dan Pinchinson offered his mobile health unit for these events. Harriet and Daniel connected during the meeting. Elise Levy, HCC, WSNA, advocates for stronger housing rights and spoke about the following:

• Supporting  #CancelRent for 25,000 New Yorkers
• Supports expansion tenant rights
• Joint training concept is being developed as an idea to support this expansion of tenant rights and to show how policy leads to homelessness
• Contact Elise for #CancelRent, show your support in social media, signs in windows etc.
• Targeting Gold Standard Bill (through equitable taxation) and redirecting federal funding

Kerry Moles, LMSW, Executive Director, Court Appointed Special Advocates of New York City (CASA-NYC) works with children who have been appointed by court order to foster care home Kerry’s focus is with children who are languishing in foster care, and with children who are aging out of the foster care without a system in place to be independent. Aging out is at 21 years of age. Kerry outlined the following facts and issues at the meeting:

• CASA-NYC supports parents to bring their child from foster care to safe housing
• CASA-NYC assists youth with housing, education and employment
• 25% of the foster care children are 15 and older
• Volunteers work as mentors and work with youth up to the age of 25. Foster care services fall away at this age
• In NY 650 people age out every year (21 years)
• It’s not legal to discharge people from foster homes to homeless situations; foster agencies are required to find housing
  • Often this housing is unstable, or doesn’t work out with relatives or friends after a few months
  • Often discharged to relatives but kicked out after a few months
• Nationally 40% of young people, who have been in foster homes, by 24-25 years of age become homeless. This figure came from a Midwest Study where people were followed after aging out of the foster system. NY does not carry out a longitudinal study
• 13% of people who have been in foster care and aged out have accessed the shelter system; this percentage depends on the shelter being able to identifying foster care history and also reporting it
• There is a system of supportive housing for people who have been in foster care, but here they age out of this system also
• It takes most a good decade to stabilize because of poor education, unstable employment and legal history
• Working with the Governor to sign executive order to stop aging out of foster care during COVID-19 to extend foster placement by a 90 day period
  • Betsy Kramer, Public Policy Attorney at Lawyers for Children, has added her letter to the Press packet advocating for Cuomo to sign the executive order
• The DORM project with CUNY provides dorms to kids who are aging out; however, CUNY is now expelling people because of the need for the rooms for other reasons
• NYCHA provides the most stable housing system for people who have been in foster care

MOBILE SHOWERS MSCC, Julia Chambers, Shower Power, Serafina Payne, CUCS, Jordan Otis, Lauren Curatolo, Midtown Community Court, are building a coalition to continue Mobile Showers Program, and we need at least 3,000 square feet. If you know of a space location in proximity to Midtown and if you are interested in supporting, please contact us john.mudd@usa.net, 917-520-3009. ANYTHING COVID-19 

• Jordan Feiner/ Laurie Hardjowirogo/ NYC Council’s Seniors Wellness Checks spoke about their program, its continuation beyond COVID, and expanding to people who are living in shelters
• Dan Pinchinson, Chelsea Ryan Clinic, gave his phone numbers for all health related issues. 844-692-4692, 212-484-5803. Dan outlined pathway for people testing positive to COVID-19, and also how to move people to isolation (see Addendum C). Dan outlined the Hotel Program for people testing positive
  • Thuy Pham, Chelsea Tenants Association, asked, how people call the hotel? Thuy also asked how people could access general support if they are homeless.

Erica Strange outlined support for people showing symptoms of COVID and 311 was the number to call for support. Erica and Thuy were connecting to discuss further information for people needing support. Dan offered to make referrals to the isolation shelters. Josephine Ishmon: Students are falling behind because of COVID. IPads are given to students, but with no technology or academic support, Donation of headsets are needed. PTA raised $18,000 to buy gift boxes. Alexandra Urman MPH, Analyst, Genomic Revolution, ARK Investment, will discuss her proposal, Commercial Real Estate Industry to Minimize the Spread of Disease. CITY’S PROPOSED NEW RULE (ISP)  DHS ISP, Income Saving Program mandate for shelter residents: Please forward: ISP testimonials and additional savings option for the Objections and Suggestions to the ISP Rule PUBLIC CONCERNS: POLICE AND COMMUNITY

• Marni talked about the crowded sidewalks where people are now able to access bars and social distancing was a problem. Saturday nights were difficult in these areas
• David Achelis President, West 50s Neighborhood Association, regarding Blakely Hotel Homeless Shelter, 136 West 55th Street Bet. 6th & 7th Avenue, NYC 10019, being turned into a homeless shelter. They have two shelters on that block. He asks about Hospital style shelters. Link for the hotel https://www.blakelynewyork.com
• Lisa, wondering if you know what the situation is at the Watson Hotel on West 57th street? Is it a temporary men’s shelter? Received some messages from concerned residents about recent activity they’ve been seeing there, and that is the rumor.
• Notes of clustering spots for homeless outreach
  • Several individuals will congregate, seen mostly in the afternoons and weekends, on 9th Avenue, NE corner of 39th Street (restaurant)
  • 8th Avenue from 30th Street to 43rd Street. Heaviest on the weekends and near post office and 30th -34th Street)
  • 9th Avenue and SW corner of 40th Street
• Laurence Frommer, sent email with residents concerns:
  • George Sotelo, The homeless situation has reached a new level on 30th and Madison stretching to Park. yesterday,  was chased to my door by one of them while I was walking my dog. I’ve called 911. they come. they move for a few hours and then back the next morning. they’re becoming more aggressive
  • Ann Morgan, they been there for weeks now. They’re also on East 23rd between 1st and 2nd, 3rd & 33rd.

ANNOUNCEMENTS / CALLS TO ACTION

• Relish Caterers: Lenise Dazzel-Harris, Catering & Event Specialist; to discussed their food service and new efforts / How can we help move the services along?
• provide meals ad pantry bags at Relish Catering
• ability to provide 5000 meals and 6000 pantry bags per day. A Pantry bag feeds 3 people for 3 days
• GoFundMe campaign with MSCC to raise $12,000 to feed 300 people in the Bronx
• working with Susan Numeroff to proved food resources for those in need
• Shanon Luchs, LMSW, Program Director Harmonia, Services for the UnderServed
  • Harmonia Family Shelter is in need of board games, arts and crafts supplies, books or any other items that can assist us with maintaining our clients engaged to some extent during this Pandemic.
• Please support our  Go Fund me campaigns: Laundry for Kids and Street Sheets, Feed 300 Bronx families for 3 days and 3 nights. Laundry For Kids: raised $4,546.00, served 315 kids, raising funding goal to 8,000 to cover next year
• Street Sheets (Volunteers to vet contacts)
• CB4 is strategizing with community partners concerning dispenser issues / Allen Oster

ACTION LIST See accumulative actions(see Homeless and Housing Recap 5.5.20, Addendum A: Accumulative Action)

• What to add from today’s meeting
  • Spreadsheet of community concerns regarding people who are homeless
• John Mudd to reach out to Precinct and need to work with community boards
• Thuy Pham to Invite Gregory Edgar to meeting
• Nicholas Urban is aware of these locations and will send teams out starting day of this meeting

AOB

• The Homeless Crisis: The case for Change
  • Corey Johnson with Stephen Levin comprehensive homelessness; https://council.nyc.gov/data/homeless/
• Topic Suggests: 
  • Voucher: where are we and what are the next steps?
  • AirBnb effect on affordable housing market and homelessness
  • Transitioning for active society with COVID
• Speaker Suggestions:
  • Communilife, Rosa M. Gil, DSW Founder, President and CEO; Mount Sinai, Dr. Andy Coyle; Metroplus, hospital emergency supervisors; David Munson, Medical Director of Respite Programs at Boston Health Care for the Homeless; Human Rights Commissioner, Landlords…
• New Members: Thank you for joining, feel free to tell us about your needs or schedule a presentation for the group, and connect with anyone within this network
• Next Meeting: July 7, 2020 (The first Tuesday of every month)

HOW TO ZOOM

• Download the basic FREE app and become familiar with Zoom: https://zoom.us, create a FREE account.

ADDENDUM A: ACCUMULATIVE ACTIONS A discussion is needed at our 8:30am Homeless and Housing Policy meeting to outline the studied and unstudied issues, and how best to progress them. Discussions should include team development for furthering planning, statistics, finance, procurement, and actions. ACTIONS Listed from more recent, to later items.

• Outreach and police monitoring for 8th Avenue around 34th and 35th Streets
• Communication with precinct
• Voucher: Additional information and discussion needed
• Daycare resources, discussion and development
• SOI: Speaker to discuss department’s policy and actions
• Comunilife: Establishing relationships with other homeless services, particularly Urban Pathways
• DHS’s General Welfare Committee held a hearing in September 2019 on medical respites; Erin Drinkwater suggests that we look at the testimony and transcripts of that hearing
• DHS is to provided information about institutional referrals & process for hospital discharges
• DHS with the Medical Director’s office are having ongoing conversations to find the nexus in which to operate among DHS, hospitals, and providers
• DHS is looking for ways to:
  • Reduce cyclical returns to emergency rooms
  • Transition people to medically appropriate shelters when needed
  • Source stable housing for people after discharge
  • Improve communication between the agency and the hospitals about people’s health status and expected discharge dates for timely transition to housing options
• Operating systems: CARES, Home, Street Smart needs more study
• Diversion Plan: The Committee thought it best to further seek further perspectives from enforcement (particularly from the Transit Dept. as they issue the summonses), courts, social services, and civilians (those who receive the summonses)
• Income Savings (ISP) Mandate: We’re waiting for your supportive or contrary comments (pro or con) and saving options for the Objections and Suggestions proposal
• Medical Respite Bed Facility: execute Advocacy Plan
• Non Medical Respite Bed Policy Recommendations:Cassie Dessalines (BronxWorks) and Reggie Miller (NYDIS/ESN) are preparing another draft to discuss with the principal respite bed providers
• Oversight
• Shelter Policies
• Social Workers embedded: School, Hospitals
• Affordable Housing / AirBnB / Deregulation
• Vouchers: The committee’s researching and taking testimonials.
• The committee wants to hear from independent landlords about barrier and reluctance to the voucher program
• Outreach / social workers embedded in the hospital emergency room (good), and to a much lesser degree during a patient’s respite period (not so good)
• Mapping medical pathways from recovery to stable housing
• Workshops development
• Hotel participation: Allen Oster, CB4 and MSCC, to organize a meeting with the hotel industry to discuss how they may participate
• Erica (CUCS)/MTS: follow up with outreach in the 8th Avenue (between 34th and 35th Street)
• Erik Botcher, NYC Councilman Corey Johnson’s office, suggests having a conversation between the person who was hampered by bureaucratic systems and DHS/HRA to troubleshoot and find where the breakdown occurred. Others with similar problems could be invited too (SUS’s client)
• Erin suggests watching for legislation and budgeting (that may not cover enough programs/assistance) to come from Albany: Liz Kruger’s Housing Stability bill, supporting increases of City and State voucher participation, and assistance for undocumented citizens (Federal provides only emergency assistance)

ADDENDUM B: POLICY COMMITTEE’S RECAP (Sub-committee of Homeless and Housing Committee) Policy COMMITTEE’S MEETING Recap When: June 2, 2020 Time: 8:30-9:30am TOPICS Today’s 8:30am Policy Meeting’s hour was spent discussing isolation shelter policies and Medical Respite Beds Advocacy Plan’s status. SHELTER, OUTREACH, AND CLIENT CARE POLICIES The committee discussed the following problems during the transition to isolation shelters in COIVD time

• Not enough planning
• People did not know what to do in special cases
• Cassie Dessalines, BronxWorks, said that the isolation shelters were opened before policy was clear, months later they are outlining one; policy seems to be slowly developing for a program that is quickly developing
  • Huge disparity between what should be a policy and what is happening
  • There are mistreatment issues within the isolation shelters
  • The permanent use of hotels as shelters may not be acceptable for some groups and community alliances
  • The cost of housing a person in a hotel shelter is excessive with an average $4-6,000 per month

John Mudd outlined two case confirming the mishandling the client and their property. Recommendations

• Leilani Irvin, DHS, may have the most current information about the policy and procedures
• Review, discuss, and make recommendation if there is a need
• Because of the high cost of housing within a hotel it would prudent to consider purchasing; inquire as to the purchasing and conversion Hotel and other property for permanent housing
• Contact social minded entrepreneurs who work in special development for the homeless
  • spizer@hudsoninc.com, aletastyers@gmail.com, Joycelyn Taylor <joycelyn@taylorfor2021.com>, Ali Urman <aurman@ark-invest.com>, GChung@lisc.org,

ADVOCATING FOR MEDICAL RESPITE BEDS It was noted during the committee that the following needs to be done:

• Comparing Financial Startup and Operational Models:
  • Boston McGinnis House
  • Stacey KirkPatrick facilities
  • Morovian House
  • Is Chelsea Ryan Clinic a good example and can they contribute to the cost analysis?

NYLAG: Follow with up on other models: statistics outlining success in other states RESPITE BEDS Reggie said, most respite beds are closed because of the difficulties of social distancing (laundry, disinfecting, hygiene, etc.). However, many of the beds on Staten Island remain open. ACTION / PLANNING LIST

• SOI: Organize speaker to discuss department’s policy and actions
• Request a speaker from the Human Rights Council
• Medical Respite/ DHS’s General Welfare Committee held a hearing in September 2019 on medical respites; Erin Drinkwater suggests that we look at the testimony and transcripts of that hearing
  • Need summary or transcript of the hearing for study
  • Acquiring transcripts

AOB John Mudd gave brief outline of the Doctor’s without Border’s Mobile Shower operation. Sharon Jasprizza talked about the expansion of the Wellness Checks to include the unstably housed. ADDENDUM C: COVID-19 HOTEL PROGRAM See below for notes on the webinar today. In short, registration is no longer required for use of Covid-19 Hotel program – just call 844-692-4692 (844-NYC-4NYC) and make the referral for isolation or quarantine, selecting the borough for services (1 for Manhattan). The patient should be called back within an hour. Expectation is that referring provider will continue to provide follow up services to the patient during their stay, as needed. See below for details. COVID Hotel Isolation/Quarantine Beds

• Tests, Traces, Take Care
  • Carlos Devia, Senior Clinical Quality Manager for DOHMH
    • Overview of Test and Trace Corps
      • This program will run hotel program
        • June 1^st – 20000 tests per day across 100 locations
        • June 1^st – 1000 tracers screen Hotel, food, Meds, informs on mental health and family violence
        • June 1^st 1200 hotel rooms, Nicole Jordan Martin in charge
        • Inability to self-isolate includes: cannot maintain 6 feet distance, do not have separate bathroom or cannot clean and disinfect after each use, shared kitchen that cannot clean touches surfaces after each use
        • Hampton Inn Times Square 851 8^th Ave
        • Aloft Hotel 100-15 Ditmars Boulevard
        • LaGuardia Plaza – not fast enough for the address

• COVID-19 Hotel Program by H&HC
  • Referral process: Call 844-692-4692 (844-NYC-4NYC)
  • NO REGISTRATION NECESSARY
  • No paper work or online forms
  • Contact center will call directly and screen patient and decide
  • H+HC will transport patient to room if needed
  • 3 meals/day
  • Children can be with parents
  • Wellness checks provided
  • Provides pajamas, wi-fi, TV
  • 24 hour nursing for emergencies (and ADLs?!)
  • Pharmacy services for regular meds, delivered to room

• Guests should bring:
  • Photo ID
  • 14-day supply of medications
  • No alcohol or recreational drugs
  • Items of necessity: clothes, shoes, toiletries, dentures, prostheses, personal electronic devices, small amount of cash or debit/credit card
  • Recent discharge paperwork/medication list

• Maintaining continuity of care:
  • PCP is expected to continue providing whatever care and follow up calls, or televisits or in-person visits
  • If patient has home care, coordinate with them to transfer to hotel
  • Patient’s PCP expected to coordinate in-home supportive services
  • PCP or referring clinician welcome to do a visit at hotel, please provide your own PPE
  • Guests receive guidance to call 911 if they have medical emergency

• LOS
  • Isolating: after 10 days of onset of symptoms and absence of symptoms for 3 days and overall improvement in symptoms
  • Quarantine: 14 days or if home situation changes so that they can isolate at home
  • Any issues with referrals: Assistant VP Dr. Aaron Miller: aaron.miller@nychhc.org
  • Hotels are free
  • Patients will be contacted within an hour of referral
  • What if patient doesn’t have a phone? TBD maybe Ryan considers keeping patient on site and gives a direct call back to the center

I made two attempts to call into this line s a general line for H&HC Covid services. I was able to get through to the right place for the Covid Hotel Program within 5 minutes on my second attempt. They stated ancillary staff should be able to make these calls, but providers should be able to make the referral within a visit as well. Sara Sansone, MS, MPH, RN (she, her) Chronic Care Manager | Population Health P: 212.484.5860 M: 646-927-9609 F: 212.265.6565 Ryan-Chelsea Clinton Community Health Center ADDENDUM D: MEDICAL RESPITE ADVOCACY PLAN FOR NYC MEDICAL RESPITE BED ADVOCACY PLAN There is no question that we need medical respite beds in New York City. Many of our service providers will attest to this. People suffering homelessness are deprived of complete recovery alternatives after leaving an emergency room. People are mostly cared for by family or visiting nurses after returning home to ensure successful recovery. People who are homeless do hot have access to aftercare, and hospitals are reluctant to house people beyond their needed emergency care. As one Mount Sinai doctor said, we’re not a Holiday Inn. A medical respite bed facility can be a pipeline from the hospitals to health, medical, social, and other services, which can lead to housing opportunities.  This four-step plan is to encourage the development of medical respite beds in NYC. This is a plan in progress, not without flexibility, and is open to suggestions. Step #1 (Began November 2019) Mission: Describes our mission (the encouragement of medical respite beds) and suggests the following pathways to complete that mission:

• Encourage medical respite bed funding through the city budget
• Ask the city to fund a pilot project to study the financial and clinical outcomes
• Encourage the network of providers to develop medical respite beds

A press release describing the committee’s intentions, emphasizing the forthcoming presentations, and encouraging attendance could be prudent. Step #2 (March 2020) Information Gathering: This step requires a tremendous amount of information gathering affirming the necessity, sustainability, and capital to develop a respite bed facility. Fortunately there are successful examples and developers who are willing to guide this endeavor. The information gathering should include, but not be limited to:

• Statistics outlining success in other states
• Costs difference between emergency care and respite bed facilities
• Developmental and operational cost analysis
  • Daniel Muwamba, Deputy Chief Financial Officer, Boston Health Care for the Homeless Program is already working on financial details of the Barbara McInnes House and Stacey KirkPatrick facilities
• Short documentaries and testimonials speaking to medical respite needs
• Video and PowerPoint presentations affirming the medical respite beds necessity and benefits:
  • Andy Coyle, M.D., Assistant Professor of Medicine and Medical Education, Associate Program Director for Ambulatory Care, Internal Medicine Residency Program, Icahn School of Medicine at Mount Sinai, has shared a great deal of knowledge during a conference call and with his PowerPoint presentation, using data from March 2019, and he is willing to further support our endeavors:

I can pull updated data if there is an opportunity to speak to a group…I can also share more of our outcomes data for the respite as we have it.

• Comunilife’s Rosa Gil, DSW, President and CEO, has contracts with Monte, Bronx Lab and a few Medicaid Managed Care plans for medical respite bed care
• David Munson, Barbara McInnes House, has shared details of his operation and as with Dr. Coyle, is willing to support our endeavors
• BronxWorks, is partnering with One City Respite Program, to lower the cost of emergency room use, to provide longer care for persons without a residence, and to enable a pathway to better health and housing stability (an interim step towards medical respite beds?)
• Insurance Companies: Health First, United Healthcare, MetroPlus, Amida Care
• DHS, Outreach services, and NYDIS: How can medical respite beds benefit?

The video presentations should educate, speak to the need, and empower others to advocate for medical respite facilities. Step #3 (July, August 2020) Administrative, Proposal Development, and Marketing: This step collates the work from Steps 1 & 2, fills in the gaps, and tailors it to the needs of client and state for a finalized proposal to encourage the development of medical respite beds. This step serves the final presentation and marketing needs, and also encourages support and participation. Step #4 (September, October 2020) Advocating for Development: This is the culmination of discussions, meetings, research, discoveries, proposals and presentations to gather the support from nonprofits, city agencies, governing bodies, medical institutions, and humanitarian developers to realize the building of medical respite beds.