NYC Council meetings, chaptered and linked by time.
Created by Uzair Qadir
Inspired by Vikram Oberoi's City Meetings
New York City Council
Executive Budget Hearings - Mental Health and Substance Use
Read summaries and jump into the video at the segment start.
Council staff opens the hearing, welcoming attendees to the Executive Budget Hearing for the Committees on Finance, Health, Mental Health, and Hospitals. Attendees are asked to silence electronics and not approach the dais.
Chair Linda Lee opens the FY27 Executive Budget Hearing, introducing the DOHMH Public Health portion. She outlines the proposed $1.59B public health budget, noting increases for disease outbreak resilience, mobile food vending, TB management, and sexual health clinics, while flagging concerns about federal funding uncertainty and staffing shortfalls.
Chair Lynn Schulman delivers her opening statement, highlighting the $2.64B DOHMH executive budget and key priorities including Healthy NYC, Medicaid disruptions from essential plan changes, Legionnaires' disease response, TB prevention, mpox, and animal welfare. She thanks finance and committee staff.
Chair Lee makes announcements about the upcoming public testimony hearing on June 10th at 9:30 AM. Committee counsel Brian Sarfo swears in Commissioner Dr. Alistair Martin and Deputy Commissioner Anderson.
Commissioner Martin testifies on the DOHMH executive budget, framing public health as an affordability issue. He discusses federal cuts to Medicaid, the department's three priorities—core services, affordability, and making public health visible—and highlights investments in perinatal mental health, asthma, and peer workers.
Commissioner Martin details the Board of Health resolution responding to looming Medicaid cuts and the launch of a $500K campaign to promote free health insurance enrollment services. He notes over 5 million New Yorkers are enrolled in low or no-cost insurance plans.
Commissioner Martin highlights DOHMH's direct services including the Citywide Doula Initiative, Nurse Family Partnership, and newborn home visiting programs. He shares stories of individual New Yorkers served and notes zero pregnancy-related deaths among doula program participants.
Commissioner Martin discusses the $20M childhood asthma investment in the Bronx, funded by MTA congestion pricing revenue. He also covers the Health and Affordability Corps, mobile food vending, Groceries to Go, and Article 6 state matching fund restoration.
Commissioner Martin discusses school-based health centers serving 143,000 students and the state budget's permanent Medicaid carve-out. He addresses federal funding comprising ~20% of DOHMH's budget, mostly for emergency preparedness and infectious disease control, and expresses cautious optimism about the year ahead.
Chair Lee asks about the chief savings officer review process. Deputy Commissioner Aaron Anderson details savings items including Legionella re-estimate, Zadroga re-estimate, early intervention re-evaluation, and space savings, all achieved without service impacts.
Chair Lee asks about consulting and IT contract reevaluations. Anderson explains they looked exhaustively but found little left to cut after prior years of pegs and budget cuts. Lee then asks about the elimination of 76 long-term vacant positions across DOHMH.
Anderson confirms the 76 eliminated positions were long-term vacancies spread across the agency, vacant for upwards of two years. Lee asks how responsibilities will be absorbed and whether any eliminated positions were connected to emergency preparedness or federally funded programs; Anderson says generally no.
Commissioner Martin discusses recruitment strategies including social media, community outreach, and partnerships with Workforce One. Lee asks about partnering with CUNY and workforce development programs, and Martin confirms discussions with Commissioner Minaya's Workforce One Healthcare Career Center.
Lee asks about conversations with OMB for items not in the executive plan. Martin says they have what they need for core services but will continue working with OMB and Council. Anderson confirms daily conversations with OMB about evolving needs.
Lee asks about DOHMH's state budget priorities. Martin highlights Article 6 restoration as a major win and thanks the Council for advocacy. Anderson confirms it's a huge deal for the city and agency.
Lee asks about the impact of $706M for hospitals, $480M for nursing homes, and $80M for FQHCs in the state budget. Martin highlights the school-based health center carve-out as a major benefit, and Anderson notes the city supports 34 of 139 sites with $9M annually.
Lee asks about additional capital needs and new school-based health centers. Martin discusses the program serving 140,000 students across 139 sites, emphasizing its importance for families concerned about immigration status. Anderson notes the carve-out will stabilize resources for city-supported sites.
Lee asks about DOHMH's collaboration with HRA/DSS on benefit enrollment. Martin describes the interagency task force with Commissioner Dalton and efforts to leverage place-based work to enroll people in SNAP, WIC, and other programs at DOHMH facilities.
Lee asks about resource navigators and HR1 impacts. Martin details 30 community health workers and 10 specialized insurance enrollers totaling $4.6M, plus plans to leverage volunteers who can satisfy Medicaid work requirements while gaining healthcare career experience.
Lee asks about the $20M investment in perinatal and early childhood mental health. Martin explains the NFPX expansion broadening eligibility and surging resources for perinatal mental health. Deputy Commissioner Lydia Leniak details expanded eligibility criteria and increased clinic capacity.
Lee asks whether early childhood mental health services are through Article 31s or community-based models. Leniak confirms it's through existing clinic contracts. Lee asks about age range; Leniak says perinatal and early childhood and will follow up on exact ages.
Chair Schulman asks about the $17.6M disease outbreak resilience investment replacing expiring ELC and COVID-19 grants. Martin says the investment is sufficient, allowing deployment of disease investigation specialists and shoring up technology platforms, with no expected service disruptions.
Schulman asks about other federal funding concerns. Martin describes the general climate of concern, recalling when ~$100M was cut and later restored through court injunction, and emphasizes the importance of city government stabilizing funding.
Schulman asks about the $8.9M Bronx Asthma Program and new Bronx Asthma Center. Martin explains the funding targets community-based interventions and school case management, not a new physical space, building on the existing Tremont Neighborhood Health Action Center.
Dr. McNatt details coordination through the NICAN asthma network with FQHCs, CBOs, and faith-based organizations. The funding supports technical assistance to primary care practices in the South Bronx, creating an ecosystem across schools, primary care sites, homes, and the action center.
Dr. McNatt explains the evaluation approach tracking ED visits and hospitalizations, with population-level impact analysis comparing served neighborhoods to other Bronx areas, and assessment of leveraging a local health information exchange for pre-post analysis.
Deputy Commissioner Leniak explains the expansion to 15 additional Bronx schools selected based on K-8 grade level, on-site health staff, poorly controlled asthma populations, and location in MTA-identified environmental justice communities.
Leniak states the current program serves 2,200 children in 14 schools; the expansion aims to reach 750 additional children, with about 6,000 people reached through training and community education. Services include medication administration, distribution, and self-management education.
Leniak explains the current medication administration form process is entirely manual. The initiative will build the form into the citywide immunization registry, allowing seamless digital delivery to the Office of School Health and improving medication access timelines.
Leniak confirms schools will receive additional asthma case managers and social workers. On data privacy, she explains the portal will be built into the existing secure, HIPAA-compliant citywide immunization registry system.
Martin confirms DOHMH will publish reports on program outcomes including asthma rates, hospitalizations, and school days missed. Dr. McNatt describes air quality monitoring showing congestion pricing tolling is not changing vehicle exhaust in environmental justice neighborhoods, with ongoing evaluation.
Schulman asks about DOT sensor collaboration. McNatt confirms close work with DOT and MTA on utilizing their data. Anderson confirms 9 positions in FY26 and 26 positions beginning FY27 for the asthma initiative.
Martin lists key positions including program directors, asthma capacity building manager, evaluation manager, community engagement coordinators, and a data analyst. The goal is to bring staff on before the 2027 school year begins.
Schulman asks about the $4M for rapid STI testing at Chelsea, Fort Greene, Morrisania, and Corona clinics. Martin describes the sexual health clinics as safety net of safety nets, with a new Quickie Express clinic opening in Morrisania and renovations at Morrisania and Corona.
Schulman raises the Crown Heights Clinic. Martin says getting it back online is a top priority but depends on funding and staff, and notes the Fort Greene Clinic is open nearby as an interim option.
Dr. Bronson shares data showing most reported STIs decreased or remained stable in 2024, but HIV diagnoses increased for the fourth consecutive year with persistent disparities—86% of new HIV diagnoses were Black or Latino, and syphilis rates among Black women were nine times higher than white women.
Dr. Bronson reports 282 people ages 50+ newly diagnosed with HIV in 2024, an 18% increase. He details the SHARP program for clinical provider training, Be Into Health program, Ryan White outpatient services, and housing assistance for older adults with HIV.
Schulman asks about marketing services for older adults. Martin confirms meetings with DFTA Commissioner McKenzie. Bronson describes outreach through community partners, planning bodies, and advisory groups to ensure providers are aware of programming.
Councilmember Abreu asks about SNAP-Ed funding expiring in September 2026. Anderson explains it's $1.7M funding 17 staff, with the deadline extended through state conversations. Dr. McNatt notes the hardest-hit neighborhoods include South Bronx, East Harlem, and Central Brooklyn.
Abreu asks what populations and CBOs would be most impacted. McNatt describes food-related programming at action centers including Get the Good Stuff, Groceries to Go, Health Bucks, and More Veggies programs available regardless of SNAP status.
Councilmember Narcisse asks about cancer-related services and the Healthy NYC goal to reduce screenable cancer deaths by 20% by 2030. Martin describes hotspot mapping for targeted resource delivery and a recent advertising campaign on alcohol's impact on cancer risk.
Narcisse asks about vital records backlogs. Martin acknowledges the issue and says the backlog is top of mind, with efforts to shorten processing times. Narcisse also asks about the $12M peer workforce investment for substance use recovery.
Martin describes the $12M investment in peer specialists—individuals with lived recovery experience who help others start their journeys. He notes it will put 500 more peers across the city and is one of his proudest accomplishments in his first 90 days.
Narcisse asks about DOHMH's climate health budget and initiatives. Martin says climate change is a public health issue with a dedicated team in environmental health, woven throughout the agency. Anderson notes climate impacts are now built into the new needs review process with OMB.
Councilmember Wong asks about the 2,200 new supervisory licenses for street vendors starting July 1st and inspection capacity. Deputy Commissioner Corinne Schiff explains the rollout process and that food safety is DOHMH's focus while sanitation handles other vendor concerns.
Councilmember Cabán asks about PrEP/PEP access and gender-affirming care. Martin confirms all six sexual health clinics provide low-to-no-cost medications regardless of immigration status. On gender-affirming care, he describes the TGNCNB advisory committee and 20 CBOs funded through the Empowerment Fund.
Cabán asks about LGBTQ senior services. Martin says H&H clinics serve all ages and expresses eagerness to partner on targeted interventions for LGBTQ seniors, particularly through SAGE and similar organizations.
Chair Cabán (stepping in for Finance Chair) discusses the historical context of trans erasure, referencing Nazi Germany's targeting of LGBT organizations. She asks about the trans rights campaign budget and measurement of effectiveness.
Martin announces gender-affirming hormone therapy for adults will soon be offered at the Corona clinic. Cabán presses on youth care, noting few providers serve children under 13. Martin acknowledges the balance needed to avoid federal clawbacks while expanding services.
Anderson provides numbers: $2M for the TGNCNB Empowerment Fund across 20 CBOs, and $2.75M in FY26 council discretionary contracts across five vendors for trans-equity programming including primary, surgical, and mental health care.
Cabán notes the LGBTQIA+ caucus secured $13.25M last year and advocates want more. Martin acknowledges the gap between the mayor's campaign commitment and current exec budget, saying more is to come. Cabán also asks about mental health services for anti-trans violence impacts.
Councilmember Restler raises 465 vacant supportive housing units under DOHMH with no referral in process. Martin acknowledges the issue, noting a 5-6% vacancy rate across 13,300 units, and says some details will be addressed by the mental hygiene team later.
Restler emphasizes the urgency of vacant units with thousands sleeping on streets. He then asks about community health workers and the 233,000 people losing essential plan coverage, pressing on what insurance options exist and how navigators can help with Medicaid recertification.
Martin details the Board of Health resolution, the $500K enrollment campaign, and NYC Care as a safety net option. On Medicaid, he describes 26 new FTEs as a floor, with navigators, volunteers, and CBOs through Access Health building additional capacity.
Restler underscores that 9% of NYC residents will lose health insurance. Martin, as an ER doctor, anticipates increased volume and emphasizes the health department's role in helping ER docs by getting people insured. Restler appreciates the creativity in approaching the crisis.
Chair Schulman asks Speaker Menin's questions about the Office of Healthcare Accountability. Martin describes the price comparison tool launched in December, with 15,000 users, and the annual report due by August 1st per agreement with the Speaker.
Schulman asks about the office's coordination with other agencies. Martin cites work with OLR on the NYCHA PPO plan and healthcare economists analyzing reimbursement rate negotiations between NYU Presbyterian and Emblem Health, though no final analysis is available yet.
Schulman asks about baselining the $10M Groceries to Go program. Martin calls it a huge program serving 4,200 people in 2025, with ongoing OMB conversations. Schulman also asks about TNR and spay-neuter services, to which Martin responds as a proud cat dad.
Schulman asks about the Brooklyn Animal Care Center renovation timeline. Martin says the Bronx shelter opens early 2027 and Brooklyn renovations are expected by late 2027.
Councilmember Narcisse asks about the $5M baseline for abortion access services. Martin describes the abortion access hub answering nearly 10,000 calls and referring 8,000 patients, with 25% of callers from outside NYC. Anderson details $1M for the hub and $4M for clinic medication abortion services.
Narcisse asks why medication abortion is only at four of six sexual health clinics. Martin says a fifth is being worked on, with challenges mostly around space and logistics. He also notes utilization trends including out-of-state callers.
Narcisse asks about maternal mortality disparities for Black and Latina women. Martin highlights the Citywide Doula Initiative with zero maternal deaths among participants, and notes mental health and substance use as leading causes of postpartum death.
Wong asks about the Queens Animal Care Center opening and Brooklyn animals being moved there, displacing Queens animals. Deputy Commissioner Schiff explains the alignment of projects and states no animals were euthanized due to the move. Wong urges better adoption promotion.
Chair Lee announces a quick break before the mental health portion of the hearing, targeting a 12:30 restart time.
Chair Lee opens the DOHMH Mental Hygiene portion of the FY27 Executive Budget Hearing, joined by Chair Cabán. She outlines the $923.1M mental health budget, noting increases for mobile treatment teams, clubhouses, the Office of Community Mental Health, and savings measures. Headcount was 24 below budgeted.
Chair Cabán delivers her opening statement, noting the $923.1M mental hygiene budget with 563 budgeted positions and 377 contracts. She highlights baseline funding cliffs for mobile treatment teams and clubhouses, and outlines focus areas including mobile treatment, opioid settlement funding, supportive housing, JISH, relay programs, and headcount.
Chair Lee announces the June 10th public testimony hearing. Committee counsel Brian Sarfo swears in Commissioner Martin, Deputy Commissioner Anderson, Deputy Commissioner Dr. Petit, Assistant Commissioner Knuckles, and Assistant Commissioner Dr. Lynn Walton.
Commissioner Martin testifies on the mental health budget, highlighting the $12M peer workforce investment, $20M perinatal mental health investment, and naloxone distribution. He emphasizes harm reduction, accessibility, and honoring every person's humanity across services.
Martin details the $12M opioid settlement fund investment for peer workforce development, aiming to employ 500 more peers over four years. He describes the peer model as honoring lived experience in recovery.
Martin discusses supportive housing, noting the 15 over 15 program has surpassed 13,000 units. He highlights the average length of stay of 7.6 years and the syringe redemption program collecting 1.7 million syringes in its first year, now baselined.
Martin describes the mental hygiene division's 600 employees and $900M operating budget. He highlights baseline funding solutions for mobile treatment teams (IMT and AOT), clubhouses, and notes federal funding is concentrated in disease control, not mental hygiene.
Martin details IMT teams serving over 1,000 people annually and AOT teams supporting over 2,000. He describes clubhouses as community strongholds with 13 sites across all five boroughs, where participants are members, not patients. He closes with a story about a public servant named Bev who called the work a calling.
Lee asks about state funding for mental health. Martin describes the state ACT program expansion and strong working relationships with OMH and OASAS. Lee asks about the dollar amount; Martin says they'll follow up.
Lee asks how often DOHMH assesses CBO program effectiveness. Martin and Anderson explain all CBOs are evaluated at least annually, with ongoing metric tracking. Lee asks whether any services would function better delivered in-house; Dr. Petit argues community-based providers are best for community-embedded services.
Lee asks about the $26M telepsychiatry contract with Somethings for teens, set to expire. Dr. Petit explains the TeenSpace program has had 45,000 registrations, and the contract will be extended while a new RFP is developed, hopefully before end of year.
Lee asks about the $2.2M contract renegotiation savings. Anderson confirms it's part of EO12 savings, with conversations ongoing across several vendors, and no service impacts expected. Lee asks about the $1.2M naloxone contract renegotiation; Anderson explains naloxone costs have decreased considerably.
Lee asks about the $4M baseline for clubhouses, which addresses a funding cliff for existing DOHMH-funded clubhouses rather than smaller ones. Aaron confirms the total FY27 clubhouse budget is $30.7M. Lee advocates for smaller clubhouses funded by the Council.
Lee asks about the Office of Community Safety's role with clubhouses. Martin says there's no plan to shift current mental health services to OCS, though he's begun conversations with the OCS commissioner. Lee also asks about state youth clubhouses; Martin says DOHMH likely won't oversee them.
Lee asks about the $269.6M and 126 positions for OCS. Martin explains the Office of Community Mental Health is moving to OCS—$3.2M and 17 positions as of FY28—but no current mental health services will shift. Anderson confirms the numbers.
Lee asks about school-based mental health clinic budgets. Martin explains these are state-licensed and funded programs. Anderson confirms funding doesn't flow through DOHMH. Lee raises concerns about startup costs and Medicaid impacts; Martin says they'll follow up with the state.
Cabán presses on whether DOHMH has asked OMB to fund smaller clubhouses. Martin says conversations are ongoing. Dr. Petit reiterates the reprocurement was based on community feedback and national model standards, with positive quality-of-life and employment outcomes.
Cabán asks about the 15 state youth clubhouses and whether NYC will receive funding. Jamie Nichols explains these are OASIS clubhouses—nine exist in NYC and will be eligible to apply for expansion dollars, though it's a state investment.
Cabán asks what role the Office of Community Mental Health plays if it's just a coordinating agency moving to OCS. Martin clarifies DOHMH is the local governmental unit coordinating mental health activities by state law, and that's not changing. Cabán also raises the absence of harm reduction in OCS discussions.
Cabán asks about mobile treatment team wait lists. Jamie Nichols reports 600 waiting for IMT, 200 for FACT, 367 for ACT, and 87 for SP-SAC, with 80-90 people connected weekly. Cabán presses on resources needed to clear the wait list; Nichols discusses step-down resources.
Cabán asks about $4.5M for the STAPS pilot and $11M for IMT providers in FY26 that haven't been released. Anderson says the administration is continuing conversations with Council and defers to OMB. Cabán emphasizes funding is only useful if it gets out the door.
Cabán asks whether DOHMH would publish wait list data quarterly. Nichols expresses concern that visible wait lists might discourage referrals. Cabán pushes back, arguing organizations already know the wait lists exist and need the data for advocacy.
Cabán asks about a $1.7M outpatient competency restoration pilot for people at Rikers. Dr. Petit acknowledges the issue is significant and says while they haven't had conversations with OMH, he's eager to engage. Cabán shares a public defender example of someone languishing at Rikers.
Councilmember Wong asks about AOT petition data for NYC and Queens. Jamie Nichols says the state OMH has a dynamic dashboard with all petitions since inception, broken down by borough. Wong requests the data be sent to him.
Councilmember Restler revisits the 465 vacant supportive housing units. Jamie Nichols clarifies the most recent report shows 104 vacant with no referral, 523 with referral in process, and 376 offline—typically for repairs or sealed units after a tenant death.
Restler expresses frustration with DOHMH's limited assistance for constituents with severe mental health issues, citing a case of an individual screaming in a park for two years. Martin and Nichols acknowledge the frustration, noting HIPAA limits on sharing information but pledging to problem-solve with OCS.
Restler asks if Martin has met with the OCS deputy mayor. Martin confirms his deputy mayors have met and he corresponds with Commissioner Delaney-Breamsfield. Restler emphasizes the need for coordination between agencies and OCS.
Councilmember Aldebol asks about the reduction of 33 vacant positions in mental health. Anderson confirms these were long-term vacancies in back-office functions, spread across the division with no direct service impact. Martin discusses creative recruitment including social media and academic partnerships.
Cabán asks about the interagency working group targeting 5% supportive housing vacancy by end of 2026. Martin describes faster unsealing and reduced documentation burden. Nichols confirms three staff are dedicated and the city is on track to meet the 5% goal.
Cabán asks about evictions in supportive housing. Nichols reports 55 eviction-related discharges last fiscal year out of 12,800 units, with new data collection on filings starting in July. Cabán asks about the agency response process; Nichols explains the eviction prevention guidance issued to providers in April.
Cabán asks about the $2M relay program cut eliminating phones and gift cards. Martin and Dr. Walton clarify the cut was to an enhancement that hadn't started—existing gift cards and follow-up practices continue. Cabán argues phones are critical for engagement and likely cheaper than sending staff to find people.
Cabán asks about JISH budget and units. Martin reports $10.4M in FY26 and $8.3M in FY27, with 120 operational units across Bronx, Brooklyn, and Manhattan. The goal is 350 units; Nichols explains the amended RFP raised rates, resulting in fewer units overall but higher per-unit funding.
Cabán asks about the JISH RFP for 190 units and Just Home project funding. Nichols confirms no funds were redirected—all available funds went to raising rates for existing and new units. Higher rates per unit explain the reduced unit count. No OCS role is planned for JISH.
Councilmember Brewer asks about child care center closures and reopening timelines. Martin acknowledges the balance between safety and family disruption, saying they're working to reduce wait times and improve parent communication.
Wong asks what the Office of Community Safety has done since its March 19th launch with $270M. Martin defers to OCS on specifics but notes the Be Heard program will be operated by that office. Wong criticizes the lack of a defined operational model.
Restler revisits supportive housing vacancies with updated April 30th data showing 486 units offline or with no referral. He presses on repair costs for 381 offline units; Nichols says costs are borne by landlords and providers, not visible to DOHMH. Restler pushes for solutions to bring units online.
Cabán asks how opioid settlement funds flow to DOHMH. Dr. Walton explains City Hall determines allocations in four-year increments, with every dollar out the door to 40+ organizations across all boroughs. A listening tour is being launched for community input on spending priorities.
Cabán asks about transitioning the syringe redemption pilot to permanent. Martin and Aaron confirm baseline funding has been secured. Cabán also asks about SAMHSA guidance eliminating federal funding for fentanyl test strips; Walton says providers are using DOHMH and state opioid settlement funds for test strips.
Councilmember Brooks-Powers asks about mental health services for formerly incarcerated individuals. Dr. Petit describes the Bureau of Justice Impacted Populations, health justice network, and co-response teams pairing clinicians with police officers for high-acuity calls.
Brooks-Powers asks about the $10M reduction in JISH funding and the February RFP for new supportive housing. Martin explains the reduction reflects anticipated underspending, not service cuts. Nichols describes the amended RFP raising rates and adding congregate options.
Chair Lee opens the final hearing of the day for NYC Health + Hospitals, joined by Chair Narcisse. She outlines the $1.75B H&H budget, noting increases for Medicaid cash flow, federal reimbursement, COVID-19 costs, correctional health, and savings measures. Headcount was 43,580.
Chair Narcisse delivers her opening statement, noting the $1.75B H&H budget and $2.9B capital plan. She outlines focus areas including Bridge to Home, correctional health, medical malpractice, the Maimonides merger, maternal health, headcount, Elmhurst ER renovation, and B-Heard.
Chair Lee announces the June 10th public testimony hearing and welcomes the Public Advocate. Committee counsel Brian Sarfo swears in CEO Dr. Mitch Katz, Senior Vice President Olberg, and Senior Vice President Dr. Yang.
Dr. Katz testifies on H&H's strong financial position with $784M cash balance, 22 days cash on hand, and $134M positive operating margin. He highlights $60M higher patient care revenue, $472M in financial initiatives, 10,800 nurses, and reduced registry usage. He warns of HR1 headwinds and operating losses in outer years.
Lee asks about the $14.1M savings from reducing temporary staffing. Katz confirms no service decrease, as successful hiring has eliminated temporary lines. Lee asks about physician overtime; Katz says successful physician hiring has decreased overtime dramatically.
Lee asks about revenue collection improvements. Katz explains the eight-year journey of learning to bill insurance effectively, improving documentation, prior authorization, and contract negotiations, resulting in annual increases above inflation.
Lee asks about contract savings and in-house versus external services. CFO Olberg explains they frequently renegotiate contracts with vendors, leveraging H&H's nearly $13B enterprise scale, and are targeting $100M in additional savings. AI is being explored for denials and efficiency.
Lee asks about federal funding risks and Medicaid eligibility changes. Katz uses a frog-in-boiling-water analogy, describing incremental changes designed to avoid a single moment of alarm. He emphasizes H&H will care for everyone regardless of insurance status and explores AI and care model efficiencies.
Lee asks about the $5M Mental Health Continuum program with DOE and DOHMH. Katz confirms discussions with OMB are ongoing and he feels hopeful, praising the model's teacher mentoring component. There are 16 clinics with no new openings planned.
Lee asks about the $3.3M transfer to OCS and whether other H&H programs will move. Katz says no current plans. On the Hospital-Based Violence Interruption Program, Katz describes programs at all hospitals and a recent all-H&H retreat for peer learning.
Narcisse asks about billing staffing increases. Katz confirms they hired up the billing department, then eliminated the contractor once staff were trained. Narcisse praises Katz's leadership turnaround at H&H.
Narcisse asks about essential plan eligibility loss impact. Olberg estimates 50-60,000 H&H patients affected, with disproportionate share hospital funding covering about 50% of uncompensated care costs. Katz emphasizes H&H will continue serving all patients regardless of insurance.
Narcisse questions whether 22 days cash on hand is sufficient. Katz explains H&H operates differently from private systems due to city and state support, and that in a worst-case scenario, services might need to be consolidated at fewer sites rather than cut entirely.
Narcisse asks about projected operating losses in FY28-30 from HR1. Olberg notes the state budget added over $1B for hospitals, and the five-year operating deficit is $350M. The average commercial rate enhancement generates about $2B, serving as the first line of defense.
Narcisse asks about the $5M emergency weather services budget for warming centers. Olberg confirms OMB will cover expenses, and Katz describes the innovative approach of using vans to find and bring people in from the cold. No separate funding for cooling centers, which are part of the city's overall response.
Narcisse asks about the Office of Healthcare Accountability. Katz says H&H provides cost data showing it often provides the same care at a third of the price. H&H has not been involved in NYU Presbyterian-Emblem Health reimbursement negotiations, which are handled by OLR.
Narcisse asks about the $30.9M asylum seeker budget with no FY27 funding. Katz explains the money is closeout costs for hotels and shelters now transitioned to DSS. All employees were absorbed into other jobs with no layoffs.
Narcisse asks about the $20.1M Bridge to Home program with three sites. Katz passionately describes the program's success—high retention, four people placed in permanent housing, zero neighbor complaints due to 24-hour staffing, and monthly injectable medications. The second site opens in Brooklyn in September.
Narcisse asks about the $13.1M SHOW program with three new units. Katz says they're not yet operational—funding opens with the July budget—and H&H is working with DHS and CBOs on locations. The program successfully reaches people who won't initially come to a hospital clinic.
Narcisse asks about correctional health contracts. Dr. Yang explains the primary affiliate is PAGNI for frontline providers, with two small contracts for dental and emergency medicine. Contracts are evaluated annually, and some have been terminated for performance issues.
Brooks-Powers asks about the Far Rockaway Trauma Center, noting the 40-minute travel time and $200M estimated capital cost. Katz strongly supports the project, citing the peninsula's geography and comparing coverage favorably to other boroughs. He confirms the $200M estimate is still accurate.
Cabán asks about gender-affirming care for children under 13. Katz commits to continuing care, noting H&H has no volume cap and has accommodated families from ended programs. He promises to look into care coordinator capacity and says H&H has not received a federal subpoena.
Cabán asks about B-Heard eligibility and structure. Katz clarifies H&H trains and hires social workers but doesn't run operations—currently FDNY does. He describes the staffing model problem of using two paramedics per call and supports adding peers to B-Heard teams.
Brewer asks about correctional health at Rikers. Dr. Yang reports a vacancy rate of about 8%, improved from prior years, and describes the outposted unit at Bellevue with 95 people currently housed. Brewer also asks about NYC Care enrollment, now at 130,000—10,000 higher than last year.
Brewer asks about bike crashes and e-bike accidents. Katz, as a manual bicycle rider, blames e-bikes and scooters for increased accidents due to speed, noting many wrist fractures at Bellevue. He emphasizes everyone needs to follow traffic laws.
Restler asks about B-Heard funding and coordination. Katz says the $6M goes to FDNY, not H&H, and the city hasn't decided on the ultimate operational home. He describes the staffing model as unsustainable and suggests the issue is staffing, not which department runs it.
Restler asks about Local Law 42 and prolonged placement in the contagious disease unit at Rikers. Dr. Yang explains the CDU is for medical isolation, and while CHS places patients for medical reasons, DOC may place others for non-medical reasons. Restler asks about the outposted unit timeline; Yang confirms 2029.
Brewer raises concerns about people with mental illness on the streets. Katz argues most upsetting behavior stems from drug addiction, not mental illness per se, and advocates for mandatory substance treatment after repeated low-level arrests as an alternative to Rikers or leaving people on the street.
Councilmember Won asks about the Elmhurst Extended Care Unit opened in December 2024. Olberg confirms the ECUs operate at a loss but provide longer-term savings through avoided future admissions. Won asks about FY27 funding and expansion beyond 20 beds; Olberg promises specific numbers.
Aldebol raises the issue of out-of-service pediatric X-ray and fluoroscopy rooms at Jacobi Hospital, leaving zero dedicated pediatric radiology rooms. Katz acknowledges equipment is past useful life and promises to follow up on the replacement plan, noting fluoroscopy has been partially replaced by CT scans.
Aldebol asks about the violence interruption program at Jacobi. Katz describes the Guns Down, Life Up program expansion to all hospitals including new programs at Bellevue and Woodhull, with no current plans to transfer to OCS but willingness to coordinate.
Restler asks about the financial impact of 783,000 New Yorkers losing health insurance. Katz says DSH dollars cover about 50% of uncompensated care, with the average commercial rate generating $2B as the first line of defense. Olberg confirms they've factored EP5 losses and 10-13% Medicaid disruption into their model.
Restler asks about Medicaid recertification preparation. Katz says H&H is increasing navigators and NYC will need to invest in large numbers of people to help with enrollment. He notes food stamp outcomes will predict health insurance outcomes.
Restler asks about NYC Care enrollment trends. Katz reports 10,000 more enrollees than last year, with anecdotal evidence some immigrants have left the program or the country due to federal climate. Restler emphasizes the need for primary and secondary care capacity.
Narcisse asks about correctional health insurance reimbursement—Yang confirms they're federally precluded. Narcisse asks about the CHS budget breakdown; Yang says they don't budget by medical versus mental health, with 95% for patient care and 84% of that for personnel.
Narcisse asks about incarcerated individuals served and common mental health issues. Yang reports a 15% increase in custody population from 6,000 to over 7,000, with schizophrenia and schizoaffective disorders most common among seriously mentally ill patients. Wait times are 24-72 hours depending on priority.
Narcisse asks about the Bellevue Outposted Therapeutic Unit opened in April. Yang reports 95 people currently housed at over 90% occupancy, with strong staff and patient responses. Katz notes cost savings from eliminated transport and encourages Council members to visit.
Narcisse asks about medical malpractice defense contracts. Katz confirms 17 firms contracted for specialized cases, with contracts lasting 5-6 years. The budget is $21.3M in FY26 and $21.4M in FY27, covering only legal fees not payouts. About half of cases settle before trial.
Narcisse asks about the Maimonides merger delay. Katz says it will go through eventually but requires an equity assessment before going to the state's PHPC committee. He notes $2.4B in state money is waiting and $9M per month in upper payment limit funds could flow once the merger completes.
Narcisse asks about maternal health services and the $513K baseline addition. Katz describes funding for two social workers, fetal heart monitoring, car seats, and portable cribs. He discusses joint mom-baby visits and the importance of postpartum support, with no caps on visit frequency.
Narcisse asks about nurse and physician headcount changes. Katz confirms 21 physician positions moved to affiliate payroll, not eliminated. Registered nurses increased by 223 across acute care hospitals. New residencies include psychiatry at Kings County and family practice at Metropolitan.
Narcisse asks about the Elmhurst ER renovation. Katz confirms the $2.6M project is currently in procurement with a March 2029 completion timeline. Narcisse, who works at Elmhurst ER, celebrates the expansion plans.
Narcisse asks about B-Heard team structure and dispatch. Katz reiterates that H&H trains social workers but FDNY handles operations and dispatch. He says the city is interested in expanding B-Heard to more calls but hasn't articulated the model. Specific criteria for call qualification are a fire department question.
Chair Narcisse and Chair Lee thank Dr. Katz and the H&H team. Narcisse expresses appreciation for Katz's leadership and optimism about NYC's future. The hearing is officially concluded.