4. School-Based Health Centers (SBHCs) and Connecting Adolescents to Comprehensive Health Care (CATCH)
Teen pregnancy rates across the five boroughs have declined significantly, thanks in part to new city initiatives that expand sexual health education, condom availability and counseling services for teens—with a particular focus on young adults living in low-income neighborhoods
In 2000, one out of every ten girls ages 15 to 19 in New York City was at risk of getting pregnant. Five years later, the teen pregnancy rate in New York was 21 percent higher than the national rate. With such alarming figures, the Bloomberg administration launched several citywide programs as part of its “Healthier New York” campaign. While some aspects of the program were controversial, the projects continued to expand between 2007 and 2012. These initiatives now include School-Based Health Centers (SBHCs), Connecting Adolescents to Comprehensive Healthcare (CATCH) programs, condom availability programs and mandatory sexual health curricula, all of which provide a range of reproductive health information and services. The latest addition to these programs launched this past March: an app called “Teens in NYC Protection+” that provides information on service locations and health data to any teen who is already or is thinking about becoming sexually active.
Reproductive health facilities targeted to teens are breaking down the taboos surrounding sex and sexual health, creating networks that allow teens in New York to get free educational material, testing services, and contraceptives. Students today have access to over 126 school-based health centers operating in 278 high schools across the five boroughs. All of these SBHCs provide access to health education and counseling, pregnancy testing services and STD screening in safe environments.
“The administration has really taken this issue on in a very positive way, and made significant inroads in reducing unintended pregnancies in teenagers,” says Joan Malin, CEO of Planned Parenthood-New York. “Teen pregnancy rates have come down close to 25 percent over the last few years. There’s still much more work to do, but my hope is that these kinds of programs will continue.”
A study comparing similarly situated schools showed that high schools with no pregnancy prevention programs had a 57 percent increase in pregnancy rates while those with SBHC programs had a decline of about 30 percent in pregnancy rates. Use of health services have been increasing, with a 27 and 40 percent rise in sophomores and seniors using SBHC services, respectively. This success led an increase in funding for the programs. Between 2007 and 2011, the Center for Economic Opportunity increased its funding for SBHCs from $40,000 to $1.35 million.
CATCH pilot programs began in early 2011 in five schools and have since expanded 40 high-risk schools. The programs provide birth control and Plan B pills to female students upon request. In the first year, 567 students received Plan B pills and 580 received birth control pills. In addition, students can now get a birth control injection once every three months to prevent unplanned pregnancies. “I think the program is great and I believe the policies put in place will help sustain the decline in adolescent pregnancy rates,” comments Dr. Angela Diaz, the program and research director at Mount Sinai Hospital’s Adolescent Health Center. “There are many young people, particularly the poor and uninsured, who don’t have access to care, and through these school-based clinics they have that. I think teenagers need to have the full range of methods available to them to avoid unintended pregnancies.”
The programs fit into a broader strategy to improve the lives of black and Latino teenagers, who have the highest pregnancy rates and the lowest declines over the past ten years. Malin praises the program for targeting poorer communities. “The program is thoughtful. It really works with the community. They’re working in concentrated areas of the South Bronx with providers to bring school-based clinics to schools, and there’s been a sustained effort that’s really beginning to show results,” she says.
While many parents argue that these programs are intrusive and can encourage sexual activity, the reality is that one in three New York City youth report they are currently sexual active. With 17,000 teen pregnancies still occurring in the city each year, the need for reproductive health services is overwhelming.
5. Child Support Management and Debt Reduction Programs
Instead of merely punishing “dead-beat dads” for failing to make child support payments, a new initiative helps non-custodial parents to find employment, reduce debt and pay child support leading to higher rates of compliance
Child support makes up roughly 40 percent of household income for single parents, underscoring how imperative it is for non-custodial parents to comply with their child support orders. But while single parents fundamentally depend on child support, many end up receiving little of what’s due to them because of two major barriers: fathers who are unemployed or who are overwhelmed by child support arrears. To address this problem, the city’s Office of Child Support Enforcement—a unit within the Human Resources Administration (HRA)—has implemented several programs to increase compliance rates. The goal is not only to reduce the debt owed by non-custodial parents and put more money in the pockets of single parents across the five boroughs, but also to increase that parent’s involvement in the child’s life.
Departments like the Office of Child Support Enforcement are typically charged with going after “dead-beat dads” and implementing punitive measures, such as garnishing wages or suspending a driver’s license. While understandable, those enforcement measures lead to negative consequences for the child and present significant challenges to getting fathers to make child support payments.
“I’m trying to get somebody a job and as soon as he gets the job, he’s going to get hit with a child support payment that’s going to take most of his paycheck. That’s not really in anybody’s interest,” says Mindy Tarlow, who runs the Center for Employment Opportunities, which provides employment services for people returning from incarceration. “He owes child support and he must meet his legal obligations. But you want to do it in a way that makes sense for him and for it not to be a barrier to employment.”
OCSE rolled out a suite of programs to reconcile this conflict. The Debt Reduction Program assists parents who don’t have full-time custody of their children (so-called NCPs or non-custodial parents) and have high child support orders and massive arrears. The goal is to reduce their order to something more manageable and to help them bring down their child support debt. The program seeks to increase parent involvement, motivate parents to find employment and ultimately pay child support. Customer service walk-in centers allow NCPs to reduce their orders without having to go to court.
Since the program’s inception in 2009, 1,250 participants have had $13 million in debt reduced and orders reduced from an average of $320 a month to $39 a month for 167 non-custodial parents. Compliance rose from 41 percent to 51 percent for program participants.
“These programs should continue to receive support in the next administration because of the important role they play in connecting the NCPs to work and in helping strengthen families and improving outcomes for children,” adds Frances Pardus-Abbadessa, the executive deputy commissioner for HRA’s Office of Child Support Enforcement.
HRA’s Support Through Employment Program (STEP) helps non-custodial parents find work so that they can make child support payments. Tarlow applauds the program. “If this person gets a job, not only is he less likely to go to prison, he’s more likely to stay home and support his family, and he’s more likely to lead a healthier lifestyle,” says Tarlow. “So now instead of my tax dollars going to keep that person in prison, his tax dollars are going back into the community because he has a full time job.”
Non-custodial parents are generally referred to STEP by support magistrates. OCSE helps connect these out-of-work parents to jobs through HRA’s Back to Work Program. A quarter of the cases referred to STEP in 2011 and 2012 resulted in clients finding a job and making child support payments. Since 2008, the annual collection in child support payments for STEP cases has more than doubled. Collections rose from $15.3 million in 2008 to $24.1 million in 2010 and $33.3 million for the period of January to November 2012, and all of this is money that might not have been collected otherwise.
With the total amount of child support arrears hovering somewhere around $3.2 billion for more than 200,000 non-custodial parents, the city appears to be on the right track with enforcement models that not only seek to enforce compliance and recover much-needed child support payments targeted effort but also to engage non-custodial parents in employment and in their children’s lives.
6. Office of FInancial Empowerment
Opening up an important new front in the fight to reduce poverty, OFE provides an array of services that help low-income New Yorkers build assets, reduce debt and make smarter financial decisions
The Office of Financial Empowerment, launched in 2006 under the NYC Department of Consumer Affairs, was the first initiative to come out of CEO. It uses financial literacy, or what the city’s Office of Consumer Affairs has come to broadly term “financial empowerment,” as an important new tool to fight poverty. Although New York and the vast majority of other municipalities nationwide had never tried this path before, CEO recognized that empowering people to better manage their finances and decrease massive amounts of debt could prove effective in stemming poverty.
“Financial empowerment hadn’t really been looked at as a robust social policy solution to creating financial independence and economic mobility,” says Jeremy Reiss of Henry Street Settlement. “The field of financial counseling was fairly new, and I don’t think a lot of people at the time saw it as a way to work with low-income folks and help them move up the job ladder.”
Despite its relative newness, the effort has shown tremendous results. According to one study, the Office of Financial Empowerment helped clients reduce debt by a total of $1.3 million in 2010, $3.5 million in 2011 and $7 million in 2012. Every year, more people seek out the office’s services, with the number of counseling sessions going from 9,422 in 2010 to 10,296 in 2011 and 11,100 in 2012.
Previously, there had been little acknowledgment that low assets, high debt and lack of basic financial knowledge contributed to the cycle of poverty. Although the city has long had an alphabet soup of anti-poverty programs, it had never embraced financial literacy education and counseling as part of these efforts. Although a number of non-profits focused on some aspects of financial literacy, such as teaching clients how to make a budget, OFE offered went a step further, providing one-on-one financial counseling and advising services. It went so far as to sit down with clients and call creditors to figure out a way to reduce debt and set up payment arrangements. OFE also rolled out a tax-credit campaign that offered education on what tax credits are available to New Yorkers. The program has netted New Yorkers over $16.5 million in tax credits over the last four years.
The success of the OFE has made New York City the epicenter of the financial empowerment movement around the country and has legitimized financial empowerment—literacy combined with the one-on-one financial counseling—as a viable anti-poverty tool. “There’s got to be a permanent office that’s about helping people build assets stabilize their finances and be on pathways to financial independence, security and stability,” says Cathie Mahon, the original executive director of OFE and currently the president and CEO of the National Federation of Community Development Credit Unions.
Among other initiatives, OFE launched the $aveNYC program, a tax-time savings incentives program for low-income families. Participants who put a certain amount of their tax refund into a savings account and leave it untouched for a year receive matching funds on a portion of their original deposit. Data suggests the program works. According to one study, 80 percent of New York City residents who tried it succeeded in saving for the full year. Moreover, participants were much less likely than non-participants to skip paying bills or to take out loans, and over 30 percent of participants continued to save in the years after participating in the demonstration. The $aveNYC program was so promising that it has been replicated as $aveUSA in three other cities across the country.
7. The NeighborhoodOpportunity Network
As a part of the NeON Initiative, the Dept. of Probation has transformed probation sites into neighborhood-based resource hubs, where probationers can learn about a wide variety of educational opportunities and social services and meet with mentors as they transition back into society
Traditionally, probation offices have been institutional and impersonal—they focus on enforcing compliance rather than helping probationers get access to the resources they need to stay out of trouble. A single trip to the New York City Department of Probation’s central office in lower Manhattan can eat up valuable hours of the day, cutting into school and work time. And, once there, the environment is hardly inspiring. With rows upon rows of hard-backed chairs and walls festooned with rules prohibiting a half-dozen different activities, including talking and eating, the atmosphere is forbidding, even somewhat humiliating.
In response to some of these problems the Department of Probation established NeON, a new community-based network for serving individuals in the city’s probation system. New Yorkers who are on probation now meet with their probation officers in a community setting, close to where they live, and also are provided with opportunities, resources and services. There are NeON offices in all five boroughs, and the staff share office space with community-based organizations that offer critical expertise, services and access to opportunities. Unlike the old waiting rooms, the new NeON “resource hubs” are outfitted with greeters, resource advisors and computers, and decorated humanely with brightly-colored walls, furniture and inspirational posters. “It’s a huge change,” says Jeremy Kohomban, president and CEO of The Children’s Village, an organization that provides a broad continuum of programs for families and children. “We should never go back to what it was.”
As part of the YMI initiative, some offices provide specialized services to young men between the ages of 16 and 24, providing them with mentoring, internships, educational advising and child-support services. While waiting, clients have access to computers to apply for jobs or search for other resources to smooth their re-entry. Flat-screen televisions air videos listing upcoming programs and events, along with tips on things like accessing benefits and finding work. Additionally, probationers outline individualized achievement plans to help guide them as they are transitioning back into society. This is a fundamental change from the typical probation experience.
“Many black and brown kids didn’t feel comfortable going to probation officers in the Financial District,” says Kohomban. “Now they are in the neighborhood where people come from. It makes it less threatening and allows [the Department of Probation staff] to get to know families. It makes it more accessible.”
“What I’ve seen with the NeONs is it actually changes the way probation officers think about people on probation,” says Glenn Martin, vice president of development and public affairs at The Fortune Society, a nonprofit that focuses on the successful reentry and reintegration of individuals with criminal histories. His organization has been co-located with one of the NeON sites for more than a year, so he has seen its effects up close. “When you walk into the facility you don’t know the difference between the two probation officers and our staff, because they are totally immersed with our staff and treat clients based on our culture. They’ve become very warm and very thoughtful in terms of the long-term impact on our clients lives.”
The program is fairly new, but early data shows that the centers served about 492 probationers in 2012. One NeON participant we interviewed told us that his probation officer goes beyond simply making sure he is in compliance. “My P.O. always pushes me to do better for myself, you know, stay out of trouble. She pushes me to go to school,” he says. He’s currently attending Queensborough Community College and has completed one year of his three-year probation period with no mishaps or infractions. He says his probation officer connected him with other resources like the Justice Scholars program, which helps him with school projects and even provides weekly Metrocards so that he can make it to class. “Look what it’s done for me. It can work for other people too. I definitely think it’s something that should keep going, keeping people out of trouble, getting them back into school,” he says.
8. Close to Home
Housing juvenile offenders in New York City rather than upstate and providing them with rehabilitation services, reduces recidivism and allows these young offenders to retain important connections with their families and communities
In 2010, New York City juveniles made up over 80 percent of young adults in custody statewide. Thousands of juvenile offenders from the five boroughs were being housed hundreds of miles away from their families in upstate detention facilities, many of which were rampant with physical abuse and without sufficient mental health services.
In response to this dysfunctional juvenile justice system, Mayor Bloomberg proposed a new community based approach that would keep youthful offenders “close to home” and give the city flexibility to change levels of supervision and services based on the progress of the youths. “Keeping youth close to home and allowing them to maintain or establish ties with their families and communities, these programs will promote rehabilitation and long-term success for at-risk youth,” argued the administration in late 2010.
In 2012, Governor Andrew Cuomo signed legislation to make the mayor’s plan a reality. Titled “Close to Home,” it allows all but the most extreme juvenile offenders to transfer from juvenile facilities back to their own neighborhoods to be closer to family support and rehabilitation resources.
Close to Home uses a data-driven risk assessment indicator that channels youth into the appropriate placement and program based on their offenses, backgrounds and needs. Since 50 percent of the young people in the state’s juvenile justice facilities have been diagnosed with a mental illness, this tool will transform the juvenile justice system from a punitive model to one of rehabilitation. Once in facilities, youth will live in small-scale treatment homes where they do their own laundry, cook their own meals, attend counseling sessions and go to school. On weekends, their families can visit.
Putting juvenile offenders closer to their families and providing them with rehabilitative services represents a massive sea change from the primarily punitive detention and corrections system. “Family engagement and a family relationship is key to reducing recidivism,” says Jeremy Kohomban of The Children’s Village.
Prior to Close to Home, 81 percent of young men who served time in state run juvenile detention facilities were rearrested within three years, one of the highest recidivism rates in the nation. The detention centers were filled with kids who weren’t a serious risk and needed treatment instead of imprisonment. Too many kids left these facilities more damaged than when they entered, effectively trapping them in a revolving prison door.
At the same time, it was also costly to run facilities that had fewer youth inmates while still operating under the same budget with costs estimated at $140,000 per inhabitant. Many of the detention facilities were only 30 or 40 percent full while the city was still being charged to run the entire facility. It is believed that Close to Home, when fully implemented in 2015, will result in a combined annual state and local savings of approximately $12 million.
It is still too early to know just how successful Close to Home will be in decreasing recidivism rates among youth, but the program is showing promise. “The agencies that run these programs would generally say that it’s working really well for about 95 percent of the kids so far,” says James Purcell, CEO of the Council of Family and Child Caring Agencies.
“There is no doubt that the Close to Home Initiative (CTHI) represents an unprecedented opportunity to redirect our young people, who have strayed too far along the pipeline to prison, back on to a path to success,” testified Beth Powers, senior juvenile justice policy associate for Children’s Defense Fund – New York at a public hearing in April 2013. “Easier access to family and support in re-building fractured relationships, opportunities for community involvement, and the ability to earn educational credits that actually count towards a high school diploma are just a few of the critical components now afforded youth as a result of the CTHI.”
“When kids break the law we must aim to address their whole needs, including their familial and educational needs, and Close to Home embraces the importance of this concept,” adds Jennifer Jones-Austin of FPWA, who previously served as New York City’s Family Services Coordinator. “Though there have been implementation challenges, especially given that many of the youth involved in the program have challenges themselves, the program has real potential for positive and sustainable impact—and replication.”