For Release Sunday, August 25, 2013
© 2013 Washington Post Writers Group
Prevention and invention are the magic words. Increasingly, imaginative cities are finding keys, with a fascinating cross-section identified in recent studies by two New York City institutions: the Center for an Urban Future and the New York University’s Robert F. Wagner School of Public Service.
They report that Camden, N.J., for example, has devised an inventive “hot-spotting” program to reduce the huge expenses and inefficiency of “super-utilizers” – patients afflicted by substance abuse or mental and chronic illnesses who make repeated visits that overcrowd hospital emergency rooms and drive up costs.
The Camden Coalition of Health Care Providers seeks out patients it initially encounters anywhere from emergency room gurneys to street corners to homeless shelters. Using outreach teams of social workers, medical assistants and nurse practitioners, it works to locate temporary shelter, government assistance and a permanent medical home for each of the super-utilizers. As their hospital visits drop dramatically, the prior pattern – with 13 percent of Camden’s emergency room patients consuming 80 percent of the costs – may well be on its way to resolution.
In Chicago public schools, foreign-born and low-income parents are being offered posts as teaching assistants in elementary classrooms – a route to workforce experience while they receive English language training and a modest stipend. Building new community connections, the immigrants and other challenged parents also become acquainted with – and can better support – their children’s school curriculum.
Another innovation opportunity: efficient housing. Across North America, as populations of the elderly rise, the approach once called “mother-in-law apartments” or “granny flats” offers a promising opportunity to keep aging parents close to their families in cities and smart suburbs.
The compact apartments mark a 180-degree turn from zoning codes of the post-World War suburban era that favored single-family homes and often made it literally illegal to recreate the intimate, mixed-use neighborhoods of earlier times.
Often, proposals to add extra units on home lots have often been opposed by neighbors who complain they’ll bring renters or undesirable people into communities. But increasingly, change is in the air. Seattle first piloted an “accessory dwelling unit” (ADU) policy in 1994 and now allows one- and two-family homes to build a separate, self-contained residential struspear, providing it’s no larger than 800 square feet and covers no more than 40 percent of the rear yard.
Vancouver has pushed even more aggressively, relaxing its building code to allow detached accessory dwelling units of up to 500 square feet, and has legalized basement conversions.
The Center for an Urban Future suggests that Brooklyn, Queens and the other New York City boroughs outside of crowded Manhattan have vast inventories of single-home lots and would be excellent terrain for ADUs. The units could help accommodate the city’s projected 600,000 additional residents by 2030. For New York’s expanded numbers of the elderly, the compact new housing units could provide a welcome substitute for nursing homes – letting elders transition to a “backyard cottage” beside their own or family member’s home where they can safely age in place.
The lesson is clear: Opportunities abound to think ahead and plan for more livable, humane and successful cities.
New York City, to its credit, has been at the forefront of advanced thinking under Mayor Michael Bloomberg’s leadership. He created, within his own office, a Center for Economic Opportunity (CEO), which has hatched more than 50 anti-poverty programs and initiatives. One major goal has been to give the working poor a variety of programs and supports to help them move up the economic ladder. Another is to create opportunities for youth who are out of school and unemployed.
A prime example of CEO programming: a set of initiatives to help thousands of low-income New Yorkers avoid debt and unscrupulous payday lenders by accessing simple and safe banking products, to lower their debts and even start to build savings.
Other CEO-launched programs have helped low-income people advance in their jobs, find jobs after imprisonment and graduate from community college while working or raising a family. The effectiveness of each program has been tested by random trials before the programs are transferred out of the mayor’s office to regular line departments.
The bottom line: New York City still has serious poverty levels – an issue in the current mayoral campaign. But critics among those running to succeed Bloomberg will find it a challenge to devise more ingenious sets of preventive and curative measures. And my bet is that the city’s systemized effort to discover, launch and then test new initiatives will start spreading across the United States – and potentially worldwide.
Neal Peirce’s e-mail is email@example.com.
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