On the eve of this year’s 26th European Social Services Conference, Herminia Palacio, New York City deputy mayor for Health & Human Services, reveals the social services challenges and solutions in the USA’s biggest city.
Can you tell us what your role entails and its responsibilities?
I was appointed by Mayor Bill de Blasio in January 2016 as the New York City Deputy Mayor for Health and Human Services. As Deputy Mayor for Health and Human Services, I oversee eleven city agencies and mayoral offices with a total budget of $18.5 billion – nearly a quarter of the City’s budget. These agencies are focused on child welfare, homelessness, domestic violence, public benefits, and public health, as well as our city’s public hospital system. I’m working to coordinate transformation across the City’s public healthcare system, expand access to social services, and ensure that agencies serving the City’s most vulnerable populations are run compassionately, equitably, and effectively.
New York is the largest city in the US…what are the biggest social issues it faces?
Despite its overall prosperity, New York City continues to have both high rates of poverty and growing income inequality. As a result, low-income New Yorkers continue to struggle with the City’s high costs of living. Nearly half of the City’s population still lives in or near poverty, including a disproportionate number of African-American, Latino, and Asian New Yorkers. In addition, and as a result of these structural economic factors, there has been a 115% increase in the number of homeless individuals in the city’s shelters over the past two decades; from 24,000 in 1994 to 51,500 when de Blasio entered office in 2014.The homeless census is flat for the first time in a decade at 60,000 individuals. The face of homelessness has also changed: 70% of New York City’s homeless population is made up of families with children; more than one-third of these families include an adult who is employed.
How do you start to tackle these and what resources are available to you?
We have dedicated our entire city government to the fight against poverty and income inequality. In most American states, government agencies are run at the county level. However, New York City is an exception in that we directly run most of the systems that serve our residents – from our public hospital system to our public education system to social services and benefits. This unique role means that we can invest in policies and programs that have the greatest benefit for the greatest number of New Yorkers, especially the most vulnerable.
Being more specific, what are some of the programmes you have put in place to tackle some of the issues?
To meet the needs of a growing population at a time of rising housing costs, we’ve implemented the nation’s most ambitious affordable housing program, with the goal of creating or preserving 300,000 housing units by 2026. We are also working to keep more low-income New Yorkers in their homes by providing free legal assistance in housing court, which has decreased evictions by 27% since 2013. At the same time, we’re also transforming our homeless shelter system by working to place more families in shelters near their home neighbourhoods, and making a commitment to creating 90 new, high-quality shelters by 2022 as well as 15,000 units of supportive housing by 2030.
In 2014, New York City launched the largest and most ambitious expansion of pre-kindergarten of any city in United States history. Since 2014, the City has tripled the number of children in free, high-quality, full-day pre-kindergarten. Approximately 70,000 four-year-olds are currently enrolled.
We’re also investing in older students: In 2017, high school graduation rates were 74.3%, the highest on record for New York City. Together, these initiatives and others are building a pathway to success in college and careers for all New York City students.
What approaches do you take?
As a physician, I’ve learned that health doesn’t just happen in the doctor’s office – it happens at home, at school and in communities. My patients needed quality medical care, but they also needed social and financial supports to stay healthy. I approach my role of Deputy Mayor with that in mind – and I know that in order for New Yorkers to thrive, both health and social services resources must be integrated into health care in a meaningful way. I believe that sharing best practices and integrating services across all of the agencies I oversee builds stronger pathways to health and wellness, and is critical to improving the lives of New Yorkers.
How much value is put on social investment – as the mayor is keen to see social equality?
Mayor de Blasio is committed to making New York City more equitable and inclusive and ensuring that opportunity exists for all. In 2014, Mayor de Blasio released OneNYC, a comprehensive plan that established bold goals, set specific targets, and produced annual reviews to make this vision a reality. We’ve invested almost $2 billion additional funds into the City’s social services over the last four years, resulting in a total annual investment in $15.9 billion for social services citywide. These investments focus on many of the programs I mentioned above, and others – such as enhancing home delivery meals to senior citizens and providing increased street homelessness outreach. These new and enhanced investments have prioritized improving health outcomes for New Yorkers across the five boroughs and recognize that health equity is critical to making our city fairer.
How are you using technology to innovate your services?
New York City is using technology to improve service delivery models and to better connect residents to resources they need. For example, we’ve created several online platforms aimed at increasing access to public benefits, including a client portal and mobile app, which allow New Yorkers to identify if they are eligible for benefits, learn how to apply, and in some cases, apply online. We’ve also developed StreetSmart, a digital case management tool to support street homeless outreach, which allows outreach workers to better communicate with each other and better connect with City resources.
We’ve also developed ways for New Yorkers to confidentially engage in City services, creating a safe space for individuals to receive support. NYC HOPE is a web-based portal that connects New Yorkers to information, resources, and community-based organizations that can assist those who are experiencing domestic violence. We also know that individuals experiencing mental health issues are often unwilling to or afraid to seek treatment. NYC Well is a free, confidential mental health support vehicle that provides counselling services in over 200 languages 24/7 via phone, text or chat. These services and others are helping New Yorkers to get critical information and support, especially when they are at their most vulnerable.
Aside from your role as a speaker, what are you looking forward to from this conference?
I’m looking forward to the exchange of ideas and best practices between New York City and the international community. New York City is a global city – over 200 languages are spoken here, and over one-third of our residents are foreign born – which makes us uniquely positioned to act on the shared global challenges of our time. I’m excited to hear first hand about the challenges that other cities face, think about which best practices can be adopted, and allow other countries to learn about the vibrant tapestry of our city. Some of the world’s greatest developments have come from the exporting and importing of ideas, and I look forward to the opportunity to both learn and teach.