OASAS’s Opioid Treatment Program Locations’ Concordance with Racist Redlining Maps

To see the presentation by Shawn Hill at the Rockefeller Institute of Government’s Developing Evidence-Based Drug Policy Conference (October 14, 2021) see:

https://docs.google.com/presentation/d/14DyAjBrGWu8a9EoEP25N3B9J8gCtzsJUV2lYPjJ9Jyc/edit?usp=sharing

or watch the recording of the presentation:

Redlining and Opioid Treatment Programs in New York City

The New York State addiction agency – OASAS – has licensed decades of opioid treatment programs (OTPs) throughout New York.

Examining the locations of the 69 OTPs in New York City, shows a non-random spatial pattern that can be compared to neighborhoods that were racially redlined in 1938. When the two geographies (separated by over 80 years) are overlaid, a shocking correspondence is immediately seen. 96% of OASAS licensed OTPs in New York City, are located in residential areas that had been redlined as “Definitely Declining” or “Hazardous”.

[The map, above, shows 1938 redlined New York City with dots indicating the location of 21st century opioid treatment programs]

This classic example of conscious and unconscious structural racism – locating OTPs under the guise of care while actually mirroring an 80 year-old map’s racist community designations – has had tremendously negative consequences for Harlem and East Harlem. The intense density of large methadone mega centers attracts a daily influx of drug dealers who feed and profit on the concentration of methadone patients. The dealers in turn attract (non-patient) users, who commute into Harlem and East Harlem in order to purchase. The inevitable outcome is that dealing increases, using increases, and overdoses increase – all of which are then used by OASAS to justify increasing the capacity of programs in fragile communities.

To see the full presentation of this cycle, see the video below – a presentation at Rockefeller Institute of Government at the Developing Evidence-Based Drug Policy Conference 2021.

https://fordham.hosted.panopto.com/Panopto/Pages/Viewer.aspx?id=b8f0dec0-2592-475d-8e8e-adc600cc2bd6

Over 75% of Patients in Harlem & East Harlem Opioid Treatment Programs are NOT Residents of Harlem

Homeless Shelter Census Numbers by Community District

Data from NYC DHS, pre-COVID-19.

Hover over a Community District to learn the Community District number and the total number of people in shelters, located in that Community District.

Unfair Share Per Capita

Last week The Greater Harlem Coalition published total homeless shelter resident totals by borough. This post raised a question, however, on whether or not the per capita distribution of homeless shelter residents would show a different pattern or not.

The answer is no. Staten Island, even on a per capita basis, does not even remotely pull its fair share in the homeless crisis.

Unfair Share

Recently, after years of struggle, The Greater Harlem Coalition was able to obtain data on homeless shelter populations at the community board level. The Department of Homeless Services has fought us for years, and resisted numerous FOIL requests, simply to protect the mayor and to justify the status quo where homeless sheters are eggregeously unfairly apportioned.

A quick look at the data below (from January 31, 2020) almost implies that New York has 4 boroughs.

Note how Staten Island has a virtually insignificant number of homeless shelter residents.

As many political observers have noted, Staten Island scares the bejeezus out of elected officials who are loathe to rile them up. (Recall that during the discussion regarding De Blasio’s plan to replace Rikers Jail with smaller, borough-based jails, Staten Island was somehow allowed to be the only borough that would not get a new jail.)

The powerful, conservative voting block/s on Staten Island, and the politicians on the Island and at City Hall who cater to them, shield that borough from pulling its fair share.

Research on Homeless Shelters

Given so much push back on placement of homeless shelters, the latest being on Upper West Side and West Harlem, we thought some facts and research material would be helpful.

There are about 60,000 individuals who do not have a permanent home in NYC. The majority of these are families who typically enter shelter when they can no longer afford to pay rent due to job loss or other hardship.

Times are tough. We encourage all districts to help take care of their own residents who fall into hard times. Unfortunately, “most homeless families are not sheltered in the communities they come from.” Currently, only about 50% of children are placed in shelters in areas where they have been going to school. In fact, there are 12 districts in NYC with no family shelters at all.

Regarding single homeless adults, “Research shows that, compared to homeless families, homeless single adults have much higher rates of serious mental illness, addiction disorders, and other severe health problems.” These adults should be placed in small settings fairly distributed in areas where the individual used to reside, and with adequate social services to support them. 

Times are tough. Let’s all help each other while keeping fair share and equity in mind. We need to strike a delicate balance for the sake of our beloved NYC. click here to see a list of homeless shelters and methadone clinics in Harlem

See these 2 links for more info and our quotes: https://www.coalitionforthehomeless.org/basic-facts-about-homelessness-new-york-city/
https://www.icphusa.org/wp-content/uploads/2019/07/Shelter-DynamicsFinal07819.pdf

The graphic is plotted based on Shelter Score Card data: “https://fordham.carto.com/u/shill18/builder/8f51c8fb-6910-48d3-ae9d-35ffadfed443/embed”

SHELTER AND HOMELESS STATISTICS and building plan

  • 2021: Shelters purchased by the city to end reliance on cluster sites (CityLimits)
  • 2017: Mayor’s building plan for shelters (goodnewsnetwork)
  • 2016-2019: NYC: In 12 years, NYC homeless population surged 40% from 2011. The City counted almost 4000 people sleeping on the street and there is a 50-60,000 homeless population. Mayor launched turn the tide campaign to set up 130 shelters in the city – (Daily Mail Online, nydailynews.com, Curbed NY)

BACKGROUND INFORMATION ON nimby’s attepts TO PUSH BACK ON PLACEMENT OF HOMELESS SHELTERS

  • 2021 Jan: West Harlem pushes back on homeless shelter on 145th st. (Patch)
  • 2020 Dec: NYC Districts pushes back on housing affordable housing planned by Mayor – (nytimes.com)
  • 2020 Dec: NYC Upper West Side: The residents in Upper West Side Lucerne homeless shelter filed a law suit on decision to relocate them – (nydailynews.com)
  • 2020 Nov: NYC Downtown: Downtown residents filed a law suit against movement of homeless shelter to downtown hotel – (nydailynews.com)
  • 2019 Nov: NYC Ozone Park: 500 residents pushed back on new homeless shelter. 1 man went on hunger strike! – (citylimits.org)
  • 2018 Jul: NYC Midtown: Billionaires Row group sues city over homeless shelter plan – (Nydailynews.com, Fox News)
  • 2016: Central Harlem at 136th Street pushed back on another homeless shelter (Medium.com)

advocacy for safety issues in adult only shelters in nyc and harlem

  • 2012: NYC Harlem: Wards Island Homeless population of 1000 has one bus M35 and the only drop off point is… 125 street and Lexington. The City Limits claimed many of these men are ex convicts and sex offenders – (citylimits.org)
  • 2019 Sept: NYC Harlem Wards Island: Wards Island Homeless Shelter managed by Andrew Cuomo’s sister gets new 4 year renewal worth 45 million despite 22 code citation- (THE CITY)
  • 2019 Dec: Description of the medical challenges faced by residents in homeless shelters in New York City – (The New York Medical Journal)
  • 2017: 44 year old man stabbed to death in Central Harlem’s shelter by BRC (CBS news)
  • 2016: To mask the unsafe conditions in shelters, the city redefined how incidents are tracked in the system (NY Daily News)
  • 2016: 62 year old man stabbed to death in East Harlem’s shelter boulevard for single homeless men with mental issues (NBC)

Disappointing New Data

We are sad to report that new FOIL data indicates that number of patients traveling into Harlem to obtain methadone treatment continues to rise over the last 2 years.

For your background, below is the density map of methadone facilities in NYC.

And below is the overall capacity of methadone dispensing approved by NY State OASAS (Office of Addiction Services and Support)

Stop Mt. Sinai’s CARES program from moving at risk youth to a location rife with drug-trading activities. Stop this madness!

Despite tremendous push back from community members, Mount Sinai has announced it will relocate the 60 or so at-risk youth, ages 13-21, in its CARES program from their current Morningside Heights location to their new facility at 160 W 124th Street in Central Harlem as part of a “restructuring” effort. 

We appreciate such schools to help these vulnerable children, however, what is very concerning is that this new location, is a well-known drug nexus!!

As you see in our data map above, CARES’s current neighborhood has little drug-trading activity. The new location is rife with drug-trading activity — as indicated by the density of drug-related arrests — partly driven by its proximity to 3 methadone clinics as well as a safe-injection site (aka needle exchange site) maintained by Harlem United.

According to Mount Sinai, students in the CARES program are youths with “early run-ins with the police… and/or legal problems…” and “severe emotional problems and school truancy.” Common sense would dictate that these students needs to be placed as far away from drug dealers as possible. 

Who in their right mind would think placing these at-risk youths in this drug nexus is a good idea? 

Mount Sinai seems to be more concerned about about their bottom line than about the students’ welfare. To read more about our grievances with Mount Sinai, see here.

How can you help?

Tell Mount Sinai to STOP THE MOVE! These particularly vulnerable teenagers will encounter the open street drug dealing and usage on a daily basis.

For the sake of these children, tell Richard A. Friedman and James S. Tisch the co-chairmen of Mount Sinai’s Board of Trustee to STOP THE MOVE!!! Mr. Friedman is the Chairman of Merchant Banking at Goldman Sachs and Mr. Tisch is the CEO of Loews Corporation, which oversees the Loews Hotel chain. These large companies don’t like seeing negative press.

To help this cause, we recommend you to set up a twitter account and write something on the twitter accounts of Goldman Sachs and Loews Hotel. On their new posts, you can either leave a remark or quote tweet the post to your followers to raise awareness. Many of their millions of followers, including people from the media, will see your remarks.

Looking Back at Our Jan 14 2021 Town Hall

In Jan 14 2021, over 200 attendees turned out on Zoom to listen to updates on crucial quality of life concerns in Harlem, as well as Greater Harlem Coalition’s accomplishments in 2020, and our strategy for 2021. Thank you all of you for showing up in such powerful numbers.

Not surprisingly, emotions in the meeting ran high as  we listened to Mount Sinai obfuscate and filibuster, especially around the issue of their patients loitering after receiving treatment at Mount Sinai’s 132 W 125 Street and 103 E 125 Street methadone facilities. As a reminder, 40% of Harlem’s methadone dispensing capabilities come from Mount Sinai|Beth Israel.

With over 200 questions for Mount Sinai in the chat, the audience showed Mount Sinai that Harlem and East Harlem are watching, and that we are concerned about the community impact of their new Mount Sinai Ambulatory Care Center at 158 W 124th Street, which notably includes the  CARES program.  GHC members are also demanding  that Mount Sinai address and reduce the unacceptable impact that the methadone programs on 125th Street have on residents, our children, and local businesses.

Updates on the 158 West 124th Street Facility and CARES program from Mount Sinai

In spite of Mount Sinai’s less than forthright engagement with the community, It’s important to note that that we learned of one significant win:

Mount Sinai changed their minds about putting addiction services in their new 124th Street building. 

While this does not square with their insistence that CARES (a program for high school students with behavioral health and substance abuse issues) will also be located in this new facility, we are celebrating Mount Sinai’s reversal after two and a half years of protesting and organizing.  Although, this is not the complete abandonment we want, it is a victory to be celebrated nonetheless!

Although Mount Sanai has not completely abandoned the new 124th Street facility, as we wish them to, this is a victory to be celebrated, nonetheless!

Updates on Existing Facilities on 132 W 125 Street and 103 E 125 Street

As for the issue of loitering in the 2 large existing facilities, Mount Sinai informed us that they have contracted a new , more reputable security firm and will staff their new building with retired NYPD sergeants.  Mount Sinai will also be installing additional security measures  inside the buildings, such as metal detectors and security cameras. 

To our surprise, Mount Sinai pointedly noted that they are only responsible for security inside their building. We wonder: if Mount Sinai believes that such intensive security measures are required to protect their own personnel from their patients, where does this leave the local businesses and residents who live and work near these facilities? 

If Mount Sinai believes they are not responsible for mitigating their negative impact in the vicinity, who is protecting the local population??? 

Not government agencies, as OASAS has already stated that this is not their problem. Not the police, as they are overstretched and believe OASAS to be the root cause of the problem. This game of hot potato being played with our safety is extremely disturbing to say the least. We urge Governor Cuomo to address this issue.

Update on 160 W 124 Street Facility CARES Program for At-risk Youth

We are highly disappointed to hear that Mount Sinai insists on moving CARES from its Morningside Heights location at 1111 Amsterdam Avenue to 160 W 124th Street. CARES — Comprehensive Adolescent Rehabilitation and Education Services is Mount Sinai/St. Luke’s program for high school students ages 13 through 21 with mental health and/or substance abuse issues.  

CARES program current location

To be clear, Mount Sinai is moving at-risk youth to one of Manhattan’s most blatant open-air illegal drug marketplaces and half a block from one of NYC’s largest methadone treatment clinics. How is this a good idea???

Would Mount Sinai board members send their children to school in this location?  It is hard to see any pedagogical motive for this move.  Rather the relocation  appears to be soley for the benefit of the hospital’s profit maximization.

We will Not Stop Here

Many of you participated in the very active chat with more than 200 questions and comments for Mount Sinai.  A copy of this chat will be sent to the Mount Sinai participants to give them the opportunity to respond.

If you have any follow-up questions, feel free to reach out to Brad Beckstrom the public relations person who led the Mount Sinai presentation and let us know what response you get (or don’t) so we can encourage follow-up and accountability: brad.beckstrom@mssm.edu. For questions related to the CARES program, contact the program director: shilpa.taufique@mountsinai.org 

To see some sample of the > 200 questions and comments in the chat:

New Facility on 158 West 124 Street

  • Why was this location chosen?
  • Do you have a community advisory board/committee?
  • I am curious to hear how this facility was initially approved. Was it a city decision? What is Mt Sinai’s strategy for expansion in the community, and has it already been approved? Thank you.
  • What is the security plans for outside the building and surrounding areas?
  • Can you please speak to the ways in which you plan to make the facility culturally acceptable to this key community, while maintaining your security personnel on site
  • What assurance is there that medication assisted treatment (MAT) patients will not eventually be supported at this location?
  • What percentage of your patients are from areas outside of Harlem?
  • Can you tell us the breakdown as far as what percentage of patients will be HIV vs behavioral health care?
  • You say there will be no drug treatment, service for other concerns; the background history of these participants is DRUG USE; thereby some form of drug treatment will be carried out.

CARES program:

  • Are you not concerned that you are bringing vulnerable people who may have addiction issues into an already over-saturated drug clinic area, with so much illegal drug dealing?
  • St. Lukes/Columbia Univ area seems to get a different level of attention than Central Harlem

Existing Facilities on 132 W 125 Street and 103 E 125 Street

Quality of life

  • Do any of you panelists live on a street with three drug treatment centers?
  • If you are such a good neighbor, why are you over saturating our community when you could locate these substance clinics in upper east side?
  • The residents here are sick and tired of the dope addicts and drug dealers your enterprises have brought to our neighborhood. 123rd 124th streets on MXB.  We had to create a block association because of the influence of your dope clinics. I personally want you out of here but I am willing to listen….every single day they shooting a heroin on my block!! this doesn’t help my community
  • Dope addicts and drug dealers have overrun our neighborhood. I have been calling the police, taking pictures, putting my family’s lives in danger, walking through throngs of dope addicts for over two years mostly, but this has been going on for over a decade.

Security

  • I agree that [under the new plan,] you seem to have great security in your facilities, but the you’re causing serious problems for the rest of the neighborhood since your jurisdiction is only your property line.
  • Sounds like you have great security in your facilities, but the you’re causing serious problems for us. Because your facilities attract all these folks that become an easy target for drug dealers and since they cannot linger around your facility they end up in front of our cafe and wreck havoc. I spend all day every single day trying to move high out of their minds people, spitting, pissing, and throwing garbage all over the place. What do you say or do about that?
  • What will be the ratio of security staff to patients and how will the clinic prevent the clients from congregating in large groups on the block
  • How many blocks around your facility will your security firm cover? If you cannot cover more than your perimeter, then you must reduce methadone capacity in Harlem