Sign up for “THE CITY Scoop,” our daily newsletter where we send you stories like this first thing in the morning.
On West 124th Street, Mount Sinai Hospital has been planning for more than a year to open a new health facility.
In some neighborhoods, the move might be cheered. But in Harlem, it’s been consistently shouted down.
That’s because neighbors of the planned facility see it as an extension of what the area already has too much of: services for vulnerable people.
In its current form, the Mt. Sinai outpatient clinic, set for a late-2021 opening, would include primary and specialty care as well as mental health treatment for children, teens and adults.
“This entire neighborhood has gotten inundated,” said Ila Gupta, who lives a block away from the planned facility with her husband, Hudson Roditi, and their 11-year-old daughter.
On the block Mt. Sinai is eyeing, there are multiple methadone clinics, a sliding-scale health center and at least two homeless shelters.
Some of those clients regularly spill onto the street, Gupta says. On Twitter, the couple documents what disturbs them: photos of human feces, empty methadone cups and videos of people nodding off on sidewalks, or injecting on their front patio.
“We have empathy for the people who are unwell,” she said. “But when a neighborhood gets as inundated as this, empathy starts disappearing, and that’s when it is oversaturation.”
Counting on Data
In their frustration, Gupta and Roditi joined a group called the Greater Harlem Coalition, which was founded last year to fight the Mount Sinai facility and bring attention to a concentration of social and health services members from East and Central Harlem view as a problem.
They have staged rallies, written letters and lobbied local elected officials. On Tuesday, the group took their message to the streets again, protesting in front of Manhattan Borough President Gale Brewer’s office as Mount Sinai representatives met with community members and Harlem political leaders.
The protesters’ message was clear: the neighborhood is already doing more than its fair share, and they shouldn’t have to shoulder more services.
“Fair share because we care!” the crowd shouted. Signs echoed the message: “Mount Sinai Stop Oversaturating Harlem” and “Enough is Enough.”
It’s a common argument made wherever and whenever New Yorkers feel they’re getting dumped on. But the Coalition isn’t relying on members’ feelings alone.
On a map of the density of mental health programs the group compiled from state and city health data, Harlem is shaded dark gray. Their analysis found Harlem has just 5% of New York City’s population but 15% of its mental health programs.
Data from the state’s Office of Alcoholism and Substance Abuse Services (OASAS) obtained by the coalition through a Freedom of Information Law request shows that while 6.9% of people in New York City OASAS-certified treatment programs for opioid addiction are Harlem residents, nearly a fifth (19.1%) of opioid treatment programs are located there.
Much of this data was compiled by Shawn Hill, a co-founder of the Coalition and a digital technology educator at Fordham. He brought his data visualization skills to the effort, and at Tuesday’s rally, underscored the importance of statistics to highlight the problem.
“Every time you feel overburdened, every time you feel that it’s too much — you are absolutely correct. And we have the data to back that up,” he told the crowd.
Feeble ‘Fair Share’ Rules
For all the group’s evidence, however, no mechanism exists for neighbors to stop or change the facility.
That’s because the project is “as of right,” meaning it will be built within existing land use rules, and is being run by a private entity, Mount Sinai. (A previous version of the plan called for approvals from the city’s Board of Standards and Appeals, but a newer design scrapped those elements and will no longer go before the board, a Mount Sinai official said.)
But even if it were a public facility, on public land, the “fair share” argument hardly has any teeth in New York, experts say.
In theory, the city is supposed to complete a fair share analysis for certain types of facilities and services, according to City Charter rules added in the early 1990s.
But those measures are “pretty useless,” said Eddie Bautista, executive director of the New York City Environmental Justice Alliance and a longtime organizer around fair share issues, particularly because the analysis is just that — a written report that has no consequences no matter what it finds.
“There’s no functioning way to enforce it,” he said. “There’s no cut-and-dry percentage level that triggers oversaturated [or] undersaturated.”
Councilmember Brad Lander (D-Brooklyn) has been trying for years to reform the way the city thinks about distributing services, including homeless shelters, firehouses and trash dumps, and in 2017 introduced legislation to make the fair share framework, well, fairer.
“Unfortunately, in the big picture … we have not made meaningful progress,” he told THE CITY Monday.
There have been some small wins, however. He points to the mayor’s homeless shelter revamp, which has brought shelters to neighborhoods that have previously had none. And a Council bill banning new waste transfer stations in neighborhoods that already handle at least 10% of the city’s trash became law last year.
But Lander wants to see fair share go far beyond those incremental steps.
“What you’d want is a proactive process that goes through all the different kinds of facilities, and defines — to our best effort — what fairness looks like,” he told THE CITY.
Addicts Must Go Elsewhere
Until that happens, the Coalition in Harlem is continuing to push — and their efforts have had an effect on West 124th Street.
At the Tuesday meeting where the group protested, Mount Sinai representatives presented changes to the proposed facility.
The hospital will now remove all substance abuse-related services from the clinic, including two previously planned rehabilitation and detox programs. That builds on a previous promise that no opioid treatments, including methadone, will be dispensed on the site.
“To ensure full community input, over the past year we’ve held more than 30 meetings with elected officials, community leaders, and providers, and participated in two public forums,” said Arthur A. Gianelli, president of Mount Sinai St. Luke’s Hospital, in a statement. “In response to community concerns, we’ve substantially modified the services being offered at West 124th Street.”
Taking those services out of the neighborhood in the middle of a drug overdose crisis — where East Harlem’s fatality rate is twice the city’s average — is concerning to Jasmine Budnella, drug policy coordinator at VOCAL-NY. But she says she can’t blame the residents for fighting to protect their blocks.
“I hear it all over the city from neighbors who say, ‘We don’t know what to do, but we don’t want somebody injecting on our stoop.’ I’ve heard it a million times,” she said. “It’s not right that people are being pitted against each other.”
To her, the solution comes in the form of “massive expansion” of supportive housing, universal access to treatment and finding a way to deal with people in crisis that doesn’t involve the NYPD — pointing to Public Advocate Jumaane Williams’ new proposal for an alternative to 911 as a good move.
In Harlem, Hill and his neighbors say the changes made by Mount Sinai are not enough — and he and his neighbors plan to keep fighting. To him, mental health patients, particularly young people, should not be drawn to a block where drugs are openly used and sold.
“I cannot imagine a worse block for a vulnerable population,” he said.
Want to republish this story? See our republication guidelines.