November 7, 2025 • 26 mins
We sit down with the NYS Department of Health Commissioner James McDonald to discuss the state's hospice and palliative care system and why utilization is so low. POLITICO's Nick Reisman joins us to discuss the results of the NYC mayoral race.
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(00:00):
[THEME MUSIC]
(00:18):
>> WELCOME TO THIS WEEK'S
EDITION OF NEW YORK NOW.
I'M ELISE KLINE.
TUESDAY NIGHT, STATE ASSEMBLY
MEMBER ZOHRAN MAMDANI MADE
HISTORY BECOMING THE CITY'S
YOUNGEST MAYOR AND FIRST MUSLIM
AND FIRST SOUTH ASIAN MAYOR.
THE 34 YEAR OLD DEMOCRATIC
SOCIALIST AND MAYOR ELECT WON
THE RACE BY ABOUT 10 PERCENTAGE
POINTS AGAINST FORMER GOVERNOR
ANDREW CUOMO AND ABOUT 43
(00:38):
PERCENTAGE POINTS AGAINST
REPUBLICAN CANDIDATE CURTIS
SLIWA, ACCORDING TO THE NEW YORK
CITY BOARD OF ELECTIONS.
MAMADANI SAID IN HIS VICTORY
SPEECH, THIS WIN MARKS THE
TOPPLE OF A POLITICAL DYNASTY
AND THE DAWN OF A BETTER DAY FOR
HUMANITY.
MAMDANI'S WIN COMES AFTER HIS
GRASSROOTS CAMPAIGN SHOCKED THE
NATION WHEN HE WON THE
DEMOCRATIC NOMINATION IN JUNE,
BEATING CUOMO IN A POLITICAL
(00:59):
UPSET.
THIS YEAR'S NEW YORK CITY
MAYORAL RACE ALSO MAKES HISTORY
IN VOTER TURNOUT, OFFICIALLY
HITTING 2 MILLION VOTES, WHICH
IS THE FIRST TIME THIS HAS
HAPPENED SINCE 1969.
WE'RE GOING TO GET INTO THE
MAYORAL RACE, ELECTION NIGHT
RESULTS, AND WHAT A NEW MAYORAL
TERM WILL MEAN FOR THE STATE.
POLITICO'S NICK REISMAN JOINS US
IN THE STUDIO TO BREAK IT ALL
DOWN.
(01:21):
THANK YOU SO MUCH FOR JOINING US
TODAY, NICK.
>> GOOD TO BE HERE.
>> WELL, WE HAVE A LOT TO GET
INTO.
SO I WANT TO START WITH, CAN YOU
TELL ME A LITTLE BIT ABOUT, YOU
KNOW, YOUR THOUGHTS ON ELECTION
NIGHT RESULTS?
>> WELL, I WOULD SAY, FIRST OF
ALL, IT WAS NOT NECESSARILY THAT
BIG OF SURPRISE THAT ZOHRAN
MAMDANI IS THE NEXT MAYOR OF NEW
YORK CITY.
HE WAS THE DEMOCRATIC NOMINEE.
(01:42):
IT'S REALLY HARD TO LOSE AS THE
DEMOCRATIC NOMINEE IN NEW YORK
CITY AT THIS POINT, JUST GIVEN
THEIR HUGE ENROLLMENT ADVANTAGE.
MAMDANI HAS BECOME A NATIONAL,
IF NOT GLOBAL, POLITICAL
SUPERSTAR.
YOU KNOW, HE RAN ON THIS
AFFORDABILITY MESSAGE AT A TIME
WHEN THE DEMOCRATIC PARTY IS
(02:03):
OTHERWISE STRUGGLING WITH THIS
IDENTITY CRISIS AFTER DONALD
TRUMP WON LAST YEAR.
SO MAMDANI IS KIND OF OFFERING
DEMOCRATS THIS PATH FORWARD.
OBVIOUSLY, HIS CANDIDACY AND
NOMINATION HAS BADLY SPLIT
DEMOCRATS ACROSS THE COUNTRY AND
RIGHT HERE IN NEW YORK.
GOVERNOR HOCHUL ENDORSING HIM,
HER HANDPICKED STATE CHAIR JAY
(02:24):
JACOBS DECLINING TO ENDORSE HIM.
YOU HAVE MODERATE DEMOCRATS LIKE
TOM SUOZZI BREAKING FOR ANDREW
CUOMO OVER HIS OWN PARTY'S
NOMINEE.
SO THIS DID HIGHLIGHT THE
FISSURES WITHIN THE DEMOCRATIC
PARTY, BUT IT SHOULD NOT BE A
HUGE SURPRISE THAT ZOHRAN
MAMDANI IS GOING TO BE MAYOR OF
NEW YORK, JUST GIVEN THE BUILT
(02:44):
IN ADVANTAGES HE HAS, PLUS THE
POLITICAL STAR POWER THAT HE
BROUGHT TO AN ELECTION WHERE
TYPICALLY NOT A LOT OF VOTERS
TURNOUT IN A GENERAL ELECTION IN
NEW YORK CITY.
THIS HAD HUGE TURNOUT.
MORE THAN 2 MILLION VOTES WERE
CAST, AND THAT IS HIGHLY UNUSUAL
FOR A GENERAL ELECTION IN NEW
YORK CITY, WHERE THESE RACES ARE
USUALLY DECIDED IN THE PARTY
PRIMARY.
>> THAT'S RIGHT.
IT HIT OVER 2 MILLION VOTES, I
(03:06):
BELIEVE, AND THAT HASN'T
HAPPENED SINCE LIKE THE 1960S.
>> THAT'S RIGHT.
>> AND, YOU KNOW, MAMDANI DID
REALLY COME UP OVERNIGHT BECAUSE
HE WAS IN THE STATE ASSEMBLY.
NOT A LOT OF PEOPLE KNEW WHO HE
WAS.
>> HE WASN'T ON THE RADAR THIS
TIME LAST YEAR.
HE WAS POLLING AT AROUND LIKE
ZERO PERCENT OR SO.
SO THIS IS A RAPID ASSENT FOR
SOMEONE WHO ONLY RECENTLY,
(03:28):
RELATIVELY, GOT INTO ELECTED
OFFICE.
>> SO THAT GETS INTO MY NEXT
QUESTION HERE.
WHAT DO YOU THINK SEPARATES HIM
FROM OTHER POLITICAL LEADERS?
YOU KNOW, IN HIS VICTORY SPEECH,
HE HAD TALKED ABOUT HOW THIS IS
A DAWN OF A BETTER DAY FOR
POLITICS AND KIND OF THE TOPPLE
OF A POLITICAL DYNASTY.
>> WELL, IT'S CERTAINLY THE DAWN
OF A NEW DAY IN NEW YORK
POLITICS.
IT IS REALLY SIGNALING THE END
(03:49):
OF A PARTICULAR ERA, I THINK, IN
NEW YORK CITY POLITICS, AT
MINIMUM, POTENTIALLY NEW YORK
POLITICS OVERALL.
IT IS GOING TO BE A QUESTION,
HOW HE'S GOING TO GOVERN.
WE REALLY DON'T KNOW.
HE HAS ZERO EXECUTIVE
EXPERIENCE.
HE'S 34 YEARS OLD.
AGAIN, HE'S BEEN A BACKBENCH
MEMBER OF THE STATE ASSEMBLY FOR
ONLY THE LAST COUPLE OF YEARS.
(04:09):
SO WE REALLY DON'T KNOW WHAT
HE'S GOING TO BE LIKE IN OFFICE.
WE DID GET SOMETHING OF A
PREVIEW OF IT, I THINK, IN HIS
VICTORY SPEECH, WHICH WAS
PERHAPS A LITTLE BIT MORE
AGGRESSIVE THAN I THINK A LOT OF
PEOPLE WERE EXPECTING.
DURING THE GENERAL ELECTION, HE
WAS SEEMINGLY KIND OF MODERATING
SOME OF HIS VIEWS A LITTLE BIT
IN THE VICTORY SPEECH.
HE QUOTED EUGENE DEBS, WHO WAS
(04:30):
KIND OF THE FOUNDER OF THE
SOCIALIST MOVEMENT IN THE UNITED
STATES.
AND HE TOOK A RATHER FAR MORE
AGGRESSIVE POSTURE ON WHAT HE
WANTS TO GET DONE.
>> RIGHT. AND HE SEEMS LIKE HE'S
SORT OF COMING OUT THE GATE A
LITTLE BIT BECAUSE HE DID PUT
UP, I NOTICE HIS WEBSITE, A
TRANSITION PERIOD.
HE'S ALREADY SORT OF STARTED A
LITTLE BIT ON THAT MESSAGING.
(04:52):
SO HE SEEMS TO BE KIND OF AHEAD
OF IT.
BUT DO YOU THINK HE WILL HAVE
SUPPORT IN ALBANY WHEN, YOU
KNOW, BEING A NEW MAYORAL TERM,
HE DID HAVE ENDORSEMENTS FROM
SEVERAL POLITICAL LEADERS IN THE
DEMOCRATIC PARTY.
>> CERTAINLY HE'S GOING TO HAVE
SOME FRIENDS IN ALBANY,
ESPECIALLY, I WOULD SAY, IN THE
STATE SENATE, CERTAIN ALLIES IN
THE STATE ASSEMBLY.
BUT ALL EYES ARE GOING TO BE ON
(05:12):
GOVERNOR HOCHUL, WHO HAS THE
LION'S SHARE OF THE POWER WHEN
IT COMES TO SETTING THAT STATE
BUDGET.
THE GOVERNOR HAS SAID REPEATEDLY
THAT SHE DOES NOT WANT TO
INCREASE TAXES ON VERY RICH
PEOPLE AND CORPORATIONS IN NEW
YORK CITY.
SO THAT IS GOING TO BE THE
INITIAL TENSION POINT, I THINK,
BETWEEN ZOHRAN MAMDANI, HIS LEFT
LEANING SUPPORTERS, AND THE
(05:34):
GOVERNOR, AS SHE IS RUNNING FOR
RE ELECTION HERSELF.
NOW, THERE ARE OBVIOUSLY, THERE
ARE AREAS WHERE THEY AGREE, LIKE
UNIVERSAL CHILD CARE.
THAT IS AN END GOAL THAT THEY
BOTH SUPPORT.
IT'S INCREDIBLY EXPENSIVE.
IT'S GOING TO TAKE YEARS TO
IMPLEMENT.
I THINK IT'S SOMETHING LIKE $8
BILLION ON THE HIGH END.
THAT IS A LOT OF MONEY AS A
RECURRING EXPENSE FOR THE STATE.
AT THE SAME TIME, NEW YORK IS
(05:54):
ALSO FACING FEDERAL AID CUTS AND
REDUCTIONS.
SO THERE ARE A LOT OF DIFFERENT
AREAS WHERE THE GOVERNOR IS
GOING TO BE SQUEEZED HEADING
INTO NEXT YEAR.
>> SO LET'S TAKE A STEP BACK FOR
A SECOND.
HIS POLITICAL CAMPAIGN FOR
MAYOR, WHAT DO YOU THINK HIS
SUCCESSES WERE?
BECAUSE HE REALLY DID, YOU KNOW,
AS WE WERE TALKING ABOUT, COME
UP, YOU KNOW, OVERNIGHT AND
GAINED SO MUCH ATTENTION, REALLY
(06:15):
HELPED TURN OUT A LOT OF VOTERS
IN THIS RACE.
WHAT WERE HIS SUCCESSES?
AND DO YOU THINK THIS COULD BE
POTENTIALLY, YOU KNOW, A SEGUE
OR INSPIRATION FOR OTHER
DEMOCRATS AS THEY HEAD INTO
THEIR, YOU KNOW, MIDTERM
CAMPAIGNS?
>> WELL, IT WAS THAT KIND OF
RELENTLESS FOCUS ON
AFFORDABILITY.
THE COST OF LIVING IN A REALLY,
REALLY EXPENSIVE CITY REALLY
(06:35):
RESONATED FOR A LOT OF VOTERS.
THE RENT FREEZE PROPOSAL THAT HE
BACKED WAS SOMETHING THAT, WHILE
THERE'S A LOT OF QUESTIONS ABOUT
WHETHER THAT'S GOING TO HAVE ANY
SORT OF EFFECT, WHETHER HE CAN
ACTUALLY IMPLEMENT THAT, IT
CLEARLY DREW A LOT OF PEOPLE
TOWARD HIS CAUSE.
QUITE FRANKLY, ALSO, THE ANTI
(06:56):
ISRAEL POSTURE THAT HE HAS TAKEN
OVER THE YEARS IS SOMETHING THAT
I THINK ALSO RESONATED WITH SOME
PEOPLE WHO WERE CONCERNED WITH
THE WAR IN GAZA AND HOW ISRAEL
CONDUCTED THAT WAR.
NEVERTHELESS, YOU HAVE A
SIGNIFICANT NUMBER OF JEWISH
VOTERS IN NEW YORK CITY WHO WERE
ALARMED, QUITE FRANKLY, OF
(07:16):
ZOHRAN MAMDANI'S ANTI ISRAEL
STANCE, AND I THINK THAT DROVE A
LOT OF VOTES FOR ANDREW CUOMO IN
THE PRIMARY AS WELL AS IN THE
GENERAL ELECTION.
SO IT'S INTERESTING THAT WE'RE
SEEING NOW THIS SHIFT OF THE
DEMOCRATIC PARTY AND WE DON'T
WANT TO READ TOO MUCH INTO THIS,
RIGHT, BECAUSE THE DEMOCRATIC
PARTY NATIONALLY IS CONSIDERED A
(07:37):
LITTLE BIT MORE MODERATE.
WE SAW MODERATES GET ELECTED IN
VIRGINIA IN THE GOVERNOR'S RACE
THERE, AND EVEN ACROSS THE RIVER
IN NEW JERSEY WITH MIKIE
SHERRILL.
ALL OF THAT SAID, THIS APPEARS
TO BE SOME SORT OF ROADMAP.
I DON'T KNOW WHERE THAT ROAD
ULTIMATELY TAKES THE DEMOCRATIC
PARTY, BUT HE WAS ABLE TO
SUCCESSFULLY MESSAGE TO VOTERS:
(08:00):
HERE ARE THE THREE THINGS THAT I
STAND FOR.
IT WAS THE FAST AND FREE BUSES,
THE TAX HIKE, CHILDCARE, THE
RENT FREEZE.
THAT ALL KIND OF RESONATED WITH
THEM.
AND HE WAS ABLE TO TRANSLATE
INTO A MAJOR VICTORY.
>> I THINK SO, TOO.
HE KEPT IT REALLY SIMPLE WITH
JUST, I'M GOING TO FREEZE YOUR
RENT, I'M GOING TO MAKE BUSES
FASTER, REALLY LIKE SIMPLE
(08:21):
MESSAGING THAT I THINK PEOPLE
REALLY RESONATED WITH.
WHERE DO YOU THINK CUOMO WENT
WRONG WITH HIS CAMPAIGN
MESSAGING?
>>WELL, DURING THE PRIMARY, HE
PAINTED THIS VERY GLOOMY PICTURE
OF NEW YORK CITY AS BEING
OVERRUN BY CRIME.
HE SEEMED TO BE RUNNING A
CAMPAIGN THAT WAS PERHAPS BETTER
SUITED FOR FOUR YEARS AGO OR
(08:41):
MAYBE EVEN BETTER SUITED FOR THE
'80S AND '90S WHEN NEW YORK CITY
WAS BEING RIPPED APART BY THE
CRACK COCAINE EPIDEMIC, AND IT
WAS A MESSAGE THAT WAS NOT
REALLY BEST SUITED FOR 2025.
HE ONLY, KIND OF LATE IN THE
GAME, PICKED UP ON THE
AFFORDABILITY MESSAGE.
BY THAT POINT, IT WAS TOO
LITTLE, TOO LATE.
AND THEN IN THE FINAL WEEK OR SO
(09:04):
OF THE CAMPAIGN, HE APPEARED TO
BE LEANING INTO SOME OF THE
BIGOTED ATTACKS, QUITE FRANKLY,
ON ZOHRAN MAMDANI.
HE APPEARED TO AGREE, OR AT
LEAST HE DIDN'T INITIALLY
DISAGREE, WHEN A CONSERVATIVE
LEANING RADIO HOST HE WAS ON
WITH SUGGESTED THAT MAMDANI
(09:24):
WOULD HAVE CHEERED THE SEPTEMBER
11TH ATTACKS.
HIS CAMPAIGN POSTED AND THEN
LATER DELETED AN ARTIFICIALLY
INTELLIGENCE CREATED VIDEO THAT
PORTRAYED MAMDANI SUPPORTERS AS
BEING EITHER LIKE A BLACK PIMP
OR A DOMESTIC ABUSER.
I MEAN, STUFF THAT WAS REALLY
(09:46):
NASTY, QUITE FRANKLY.
AND ULTIMATELY, THAT VIDEO WAS
BLAMED ON AN UNNAMED STAFFER.
SURE. NEVERTHELESS, THIS KIND OF
FED INTO THE PERCEPTION THAT
CUOMO HAS EARNED OVER DECADES IN
NEW YORK POLITICS AS BEING VERY
AGGRESSIVE AND SHARP ELBOWED.
AND IT WAS JUST NOT SOMETHING
(10:07):
THAT WAS PERHAPS BEST SUITED FOR
THIS MOMENT IN NEW YORK
POLITICS.
NOW, HIS CAMPAIGN WILL SAY THAT
THEY, IN THE GENERAL ELECTION,
THEY PUT TOGETHER THIS COALITION
THAT WAS HIGHLY UNUSUAL OF
REPUBLICANS, MODERATE DEMOCRATS.
THEY TRIED TO MAKE INROADS WITH
THE SOUTH ASIAN COMMUNITIES,
WITH THE MUSLIM COMMUNITY BY
VISITING MOSQUES FOR THE FIRST
(10:27):
TIME.
IT CLEARLY, THOUGH, WAS NOT
ENOUGH.
HE GOT AN ENDORSEMENT FROM
PRESIDENT TRUMP AT THE VERY END.
THAT MAY HAVE ACTUALLY HELPED
HIM, I THINK.
WE SAW CURTIS SLIWA GET ABOUT 7
OR 8% OF THE VOTE.
HE HAD BEEN POLLING IN THE LOW
TEENS.
SO IT'S NOT UNLIKELY THAT CUOMO,
PERHAPS, WON PARTS OF
CONSERVATIVE AREAS LIKE STATEN
(10:48):
ISLAND IN NEW YORK CITY THAT HE
OTHERWISE WOULD NOT HAVE GOTTEN.
BUT ALSO, DONALD TRUMP IS HIGHLY
UNPOPULAR IN NEW YORK CITY,
HIGHLY UNPOPULAR.
AND THAT ALSO MAY HAVE HELPED
PUSH ZOHRAN MAMDANI SLIGHTLY
ABOVE 50% IN ORDER FOR HIM TO
CLAIM A MANDATE GOING INTO NEXT
YEAR.
>> AND SPEAKING OF, YOU KNOW,
DONALD TRUMP, WHAT DO YOU THINK
(11:08):
THIS NEXT MAYORAL TERM WILL
MEAN, NOT JUST FOR THE CITY AND
THE STATE, BUT ALSO THE NATION?
>> WE'RE REALLY GOING TO BE
WATCHING CLOSELY WHAT THE
PRESIDENT AND WHAT THE WHITE
HOUSE DO OVER THE NEXT COUPLE OF
MONTHS.
YOU KNOW, DONALD TRUMP HAS
ALREADY SUGGESTED THAT HE'S
GOING TO BE CUTTING FEDERAL AID
TO NEW YORK CITY AS A RESULT OF
MAMDANI'S ELECTION.
THE PRESIDENT HASN'T RULED OUT
(11:28):
SENDING IN THE NATIONAL GUARD TO
PATROL NEW YORK CITY STREETS.
SO THE PERSON THAT I THINK
EVERYONE'S GOING TO BE WATCHING
ONCE AGAIN IS GOVERNOR HOCHUL,
HOW IS SHE GOING TO BE DEALING
WITH THE MERCURIAL PRESIDENT
THAT SHE ACTUALLY HAS KIND OF A
GOOD WORKING RELATIONSHIP WITH
OVER THE LAST YEAR AND HOW IS
SHE GOING TO CONVINCE HIM, YOU
DO NOT NEED TO TRY TO TAKE OVER
(11:50):
NEW YORK CITY AS A RESULT OF A
DEMOCRATIC SOCIALIST BEING
ELECTED MAYOR BECAUSE THE NYPD
HAS THIS, THE STATE OF NEW YORK
HAS THIS, AND SHE'LL TRY TO BE
THIS BULWARK AGAINST TRUMP'S
EFFORT TO PUT HIS THUMB ON THE
SCALE IN NEW YORK CITY.
WELL, THANK YOU SO MUCH FOR
SITTING DOWN WITH US, NICK.
UNFORTUNATELY, THAT'S ALL THE
TIME WE HAVE FOR TODAY.
(12:10):
>> THANKS.
>> AND WE WERE SPEAKING WITH
NICK REISMAN FROM POLITICO.
AND FOR MORE INFORMATION AND
RESOURCES, YOU CAN VISIT OUR
WEBSITE.
AGAIN, THAT'S AT NYNOW.ORG.
NOW TURNING TO ANOTHER IMPORTANT
TOPIC.
THE STATE'S HOSPICE UTILIZATION
RATE HAS RETAINED THE LOWEST
RANKING ACROSS THE COUNTRY FOR
ABOUT 10 YEARS.
(12:31):
WE SAT DOWN WITH NEW YORK STATE
DEPARTMENT OF HEALTH
COMMISSIONER JAMES MCDONALD TO
TALK ABOUT THE STATE'S HOSPICE
AND PALLATIVE CARE SYSTEM, THE
CONTRIBUTING FACTORS TO ITS LOW
UTILIZATION RATE, AND WHAT THE
STATE IS DOING TO IMPROVE.
HERE'S THAT CONVERSATION.
THANK YOU SO MUCH FOR JOINING US
TODAY, COMMISSIONER.
>> IT'S GREAT TO BE HERE.
THANK YOU.
>> CAN YOU TELL US ABOUT NEW
(12:52):
YORK STATE'S APPROACH TO
ADDRESSING HOSPICE CARE, AND
WHAT DOES THAT ENTAIL?
>> YEAH, YOU KNOW, IT'S
INTERESTING.
LAST YEAR, WE STARTED THE
DEPARTMENT AT THE CENTER FOR
PALLIATIVE CARE AND HOSPICE
CARE.
YOU KNOW, IT WAS REFLECTING ONE
OF THE GOVERNOR'S PRIORITIES.
WHEN YOU THINK ABOUT THESE
CONCEPTS, THOUGH, I DON'T THINK
MOST PEOPLE UNDERSTAND WHAT
HOSPICE IS AND WHAT PALLIATIVE
CARE IS.
(13:12):
AND HOSPICE IS REALLY TO HELP
YOU WITH THE END OF LIFE
JOURNEY.
IT'S REALLY FOR SOMEONE WHO'S IN
THE LAST SIX MONTHS OF LIFE, BUT
AN EXPERIENCED, PASSIONATE
HEALTH CARE PROVIDER TO HELP YOU
WITH THAT END OF LIFE JOURNEY.
WHEN YOU THINK OF PALLIATIVE
CARE, THAT'S REALLY JUST TO HELP
YOU BE COMFORTABLE, BUT IT MAY
NOT BE CONNECTED TO AN END OF
LIFE JOURNEY.
SO THEY'RE A LITTLE BIT
DIFFERENT.
BUT THIS IS SOMETHING WE'RE
SPENDING A LOT MORE ATTENTION ON
(13:33):
IN THE NEW YORK STATE DEPARTMENT
HEALTH, IN PARTICULAR IN THE
LAST YEAR, TRYING TO REALLY MAKE
IT MORE AWARE TO PEOPLE WHAT IT
IS AND HOW IT CAN HELP PEOPLE.
>> AND NEW YORK, AS I'M SURE YOU
KNOW, IS RANKED 50TH AMONG
COMPARED TO OTHER STATES ACROSS
THE COUNTRY IN TERMS OF HOSPICE
UTILIZATION.
WHAT DO YOU THINK IS
CONTRIBUTING TO THIS?
>> YEAH, WE ARE LAST IN THE
(13:54):
COUNTRY WHEN IT COMES TO HOSPICE
UTILIZATION, AND THAT CONCERNS
ME.
NOW, PART OF WHAT I THINK
CONTRIBUTES TO IT IS, I DON'T
THINK PEOPLE GENERALLY KNOW WHAT
HOSPICE IS.
I DON'T THINK THEY KNOW IT'S
AVAILABLE TO THEM THAT IS
COVERED BY MEDICAID, MEDICARE,
AND PRIVATE INSURANCE.
AND I DON'T THINK PEOPLE
UNDERSTAND, TOO, THAT HOSPICE
DOESN'T MEAN YOU'RE GIVING UP.
HOSPICE MEANS YOU'RE BEING
COMFORTABLE WITH SOMEONE TO HELP
(14:14):
THEM DURING THIS RATHER SACRED
JOURNEY.
YOU KNOW, ONE OF THE THINGS
ABOUT HOSPICE, TOO, IS IT ISN'T
JUST FOR THE END OF LIFE TIME.
THEY'RE THERE TO SUPPORT THE
FAMILY FOR A FULL YEAR AFTER
SOMEONE'S PASSED AWAY.
BECAUSE AS PEOPLE ARE GOING
THROUGH THE GRIEVING JOURNEY,
WHICH IS VERY PERSONAL, IT'S
NICE TO HAVE SOMEONE WHO CAN
HELP YOU WITH THAT.
DEAL WITH JUST SOME OF THE
LOGISTICS OF ALL THAT AND JUST
(14:36):
HELP YOU GET THROUGH THE
GRIEVING PROCESS AND GIVE YOU
THE SUPPORT YOU NEED.
>> AND I KNOW FOR THE FEW NEW
YORKERS WHO DO USE HOSPICE CARE,
THEIR STAYS ARE OFTEN PRETTY
SHORT, LIKE ABOUT ONE TO TWO
WEEKS.
AND A LOT OF EXPERTS SAY THAT
THIS REALLY ISN'T ENOUGH TIME
FOR PEOPLE TO GET THE FULL
BENEFIT OF HOSPICE EXPERIENCE.
(14:57):
WHY DO YOU THINK THAT, OF THE
FEW NEW YORKERS, LIKE, WHY ARE
PEOPLE'S STAYS SO SHORT?
>> YEAH, SO I THINK WHAT'S
HAPPENING IS PEOPLE ARE ENTERING
HOSPICE TOO LATE.
IN OTHER WORDS, THERE'S SORT OF
A RECOGNITION THAT WHAT HOSPICE
IS FOR IS FOR SOMEONE WHO HAS
SIX MONTHS OR LESS EXPECTED TO
LIVE.
WHEN YOU LOOK AT THE NATIONAL
AVERAGE, WHICH IS AROUND 75
DAYS, WHAT I THINK WHAT WE'RE
SEEING IS PEOPLE AREN'T AWARE OF
(15:18):
HOSPICE, SO THEY'RE NOT ENTERING
IT.
NOW, SOME OF IT IS HEALTH CARE
PROVIDERS COULD HELP PEOPLE
REFERRING YOU TO HOSPICE.
AND, QUITE FRANKLY, ENTERING THE
HOSPICE PHILOSOPHY BECAUSE
HOSPICE ISN'T A PLACE IT CAN BE
IN A HOSPITAL OR HOSPICE,
COMMUNITY HOSPICE PLACE, BUT
COULD BE AT YOUR HOME.
AND HOSPICE IS A PHILOSOPHY.
BUT ENTERING THE PHILOSOPHY IS
(15:39):
WHAT WE WANT PEOPLE TO
UNDERSTAND.
HOSPICE ISN'T ABOUT GIVING UP.
IT'S ABOUT HAVING AN
EXPERIENCED, COMPASSIONATE
HEALTH CARE PROFESSIONAL YOU
GUIDE YOU ON THIS PERSONAL
JOURNEY.
YOU KNOW, WHEN YOU THINK ABOUT
DYING, IT'S AN UNCOMFORTABLE
THING TO TALK ABOUT, BUT IT'S A
JOURNEY ALL OF US WILL TAKE.
BUT IT'S NICE TO HAVE AN
EXPERIENCED GUIDE TO HELP YOU BE
COMFORTABLE DURING THIS JOURNEY
(15:59):
SO YOU DON'T SUFFER
UNNECESSARILY.
AND MY EXPERIENCE WITH HOSPICE
HAS BEEN NOTHING BUT POSITIVE.
MOST PEOPLE, WHEN THEY
EXPERIENCE HOSPICE, YOU FIND,
LIKE, THESE ARE PEOPLE WHO KNOW
WHAT THEY'RE DOING, AND THEY
HELP YOU.
AND THEY HELP YOU DOING A VERY
DIFFICULT TIME IN LIFE.
>> AND IT'S INTERESTING.
YOU BROUGHT UP THE, YOU KNOW,
JUST AWARENESS, PEOPLE NOT
NECESSARILY BEING AWARE OF WHAT
(16:20):
HOSPICE IS, WHAT THEIR RESOURCES
ARE.
BUT DATA ALSO SHOWS THAT SOME OF
THE CONTRIBUTING FACTORS IS ALSO
JUST THE CULTURE IN A LOT OF
HOSPITALS OF, YOU KNOW, SOME
DOCTORS WANTING TO MAYBE BE A
LITTLE MORE AGGRESSIVE AND NOT
PRESENTING THE HOSPICE OPTION
UNTIL MAYBE, I GUESS, THE VERY
LAST RESORT.
IS THAT SOMETHING THAT YOUR
OFFICE IS AWARE OF?
LIKE, IS THAT PART OF IT, DO YOU
(16:40):
THINK?
>> YOU KNOW, I THINK IT CAN BE
PART OF IT, BUT I THINK IT'S
ALSO ONE OF THOSE THINGS WHERE,
YOU KNOW, HEALTHCARE PROVIDERS
ARE TRAINED DO IS LISTEN TO OUR
PATIENTS.
ONE OF THE THINGS I'VE NOTICED
AS I'VE NAVIGATED MY OWN CAREER,
I'M A PEDIATRICIAN TOO, BUT I
HAVE ENGAGED THIS END OF LIFE
JOURNEY WITH SEVERAL OF MY OWN
PATIENTS.
ONE OF THE THINGS YOU HAVE TO DO
AS A HEALTHCARE PROVIDER IS MAKE
SURE YOUR PATIENT FEELS LIKE
(17:01):
THEY ARE BEING LISTENED TO.
ONE OF THE THINGS WE AS
HEALTHCARE PROVIDERS DO IS
LISTEN, BUT ONE OF THE THINGS WE
WANT TO MAKE SURE WE DO IS WE'RE
NOT TRYING TO PUSH SOMETHING ON
SOMEONE.
WE'RE TRYING TO MAKE SURE PEOPLE
UNDERSTAND THE RESOURCE.
BUT ONE THING THAT HELPS US AS
HEALTHCARE PROVIDERS IS, ARE YOU
OPEN TO THIS IDEA?
BECAUSE AGAIN, HOSPICE IS A
PHILOSOPHY.
(17:21):
IT'S NOT NECESSARILY A PLACE.
AND REALLY WHAT WE WANT PEOPLE
TO BE OPEN TO IS THE IDEA OF
SOMEONE WHO'S AN EXPERIENCED,
COMPASSIONATE HEALTHCARE
PROFESSIONAL TO COMPASSIONATELY
ACCOMPANY YOU ALONG A JOURNEY TO
MAKE SURE YOU'RE COMFORTABLE
DURING THESE FINAL MONTHS.
AND I THINK ENTERING HOSPICE
SOONER THAN LATER ISN'T A BAD
(17:42):
IDEA FOR PEOPLE BECAUSE YOU GET
THE FULL BENEFIT OF IT.
>> AND DATA ALSO SHOWS THAT
THERE ARE SOME, YOU KNOW, RACIAL
DISPARITIES THAT KIND OF PLAY
INTO THIS ISSUE.
CAN YOU TELL ME WHAT THE STATE
IS DOING TO ADDRESS THIS?
>> YEAH, SOME OF THIS IS BASED
ON OUR CULTURE, YOU KNOW, AND
HOW WE ARE BROUGHT UP, TALKING
ABOUT THIS.
SO WE'RE TRYING TO DO IS MAKE
SURE THE PUBLIC UNDERSTANDS WHAT
HOSPICE IS, HOW IT'S AVAILABLE
TO PEOPLE, BUT ALSO WORKING WITH
(18:03):
COMMUNITY LEADERS TO TALK ABOUT
HOSPICE, YOU KNOW.
THERE'S CERTAIN TIMES WHERE YOU
WANT TO HEAR ABOUT SOMETHING
FROM PEOPLE YOU KNOW AND TRUST.
AND ONE OF THE THINGS WE JUST
HAVE TO ACKNOWLEDGE AS A PEOPLE
IS, TALKING ABOUT DEATH IS
UNCOMFORTABLE.
ALTHOUGH IT'S SOMETHING THAT'S
GOING TO HAPPEN TO ALL OF US,
WE'RE NOT USED TO DOING THIS AS
A CULTURE.
AND SO YOU HAVE TO CREATE THE
(18:24):
RIGHT SPACE AND TIME TO TALK
ABOUT THAT.
AND THIS IS PART OF WHY PEOPLE
NEED TO NOT JUST TALK ABOUT, BUT
BE PREPARED FOR IT BECAUSE IT'S
MORE THAN JUST HOSPICE, RIGHT?
IN OTHER WORDS, YOU NEED TO HAVE
A HEALTHCARE PROXY.
YOU NEED TO HAVE A LIVING WILL.
THESE ARE THINGS THAT ARE PART
OF AN ADVANCED DIRECTIVE, BUT
YOU NEED TO KNOW WHAT A MEDICAL
ORDER FOR LIFE SUSTAINING
TREATMENT IS.
IN OTHER WORDS, YOU AS A PERSON
GET A LOT OF CONTROL OVER WHAT
(18:45):
YOUR END OF LIFE EXPERIENCE
LOOKS LIKE.
AND THAT'S PART OF WHAT WE'RE
DOING IS TRYING TO HELP PEOPLE
UNDERSTAND WHAT ARE MY OPTIONS.
>> AND I WANT TO MOVE ON TO THE
NEXT PART OF THIS ISSUE, FOR
PROFIT HOSPICE CARE, WHICH I
WANT TO KNOW FROM YOU, WHAT DOES
THIS LOOK LIKE IN THE STATE?
>> YEAH, SO NEW YORK DOES ALLOW
FOR PROFIT RIGHT NOW.
AND RIGHT NOW, WHAT WE'VE SEEN
(19:06):
IN NEW YORK IS POSITIVE RESULTS.
NOW, WE ONLY HAVE 39 HOSPICES IN
NEW YORK STATE, ONLY TWO ARE FOR
PROFIT.
BUT WHAT WE'VE SEEN IN NEW YORK
HAS SO FAR BEEN POSITIVE.
OTHER STATES HAVE HAD DIFFERENT
EXPERIENCES.
AND I THINK IT REALLY GETS TO
THIS ISSUE OF, WHEN YOU THINK
ABOUT WHO ARE THE PEOPLE WHO
GENERALLY GO WORK WITH HOSPICE,
(19:27):
THEY'RE GENERALLY COMPASSIONATE,
KIND PEOPLE WHO REALLY LOOK AT
THIS AS MORE OF A MISSION THAN
AN OPPORTUNITY TO MAKE MONEY.
THIS IS WHAT I'VE NOTICED BY
PEOPLE WHO ACTUALLY WORK IN
HOSPICE.
>> AND I KNOW THAT THERE'S A
BILL TO BAN THIS PRACTICE, ONE
THAT WAS VETOED TWICE ALREADY,
BUT IT DID PASS AGAIN THIS YEAR
IN BOTH HOUSES AND WILL GO TO
(19:47):
THE GOVERNOR'S DESK.
I'M WONDERING, WHAT DO YOU THINK
ABOUT THIS ISSUE WHEN IT COMES
TO BANNING THIS KIND OF
PRACTICE?
AND DO YOU HOPE THE GOVERNOR
POTENTIALLY SIGNS THIS?
>> YEAH, SO WE CAN'T GET AHEAD
OF THE GOVERNOR ON SOMETHING
LIKE THIS, RIGHT?
LIKE, SHE HASN'T DECIDED ON A
BILL.
SHE HASN'T DECIDED YET.
SO I CAN'T COMMENT ON ANY
PENDING LEGISLATION.
WHAT I CAN SAY IS SHE'S A VERY
THOUGHTFUL, DELIBERATE
INDIVIDUAL WHO CARES DEEPLY
(20:08):
ABOUT PEOPLE.
I INTERACT WITH HER A LOT.
SHE GIVES THINGS A GREAT DEAL OF
THOUGHT.
SO WE'LL SEE WHERE IT GOES THIS
YEAR.
>> AND CAN YOU TELL ME IF THIS
WERE TO PASS, WHAT WOULD THAT
MEAN FOR THE STATE?
>> YEAH, SO INTERESTING, YOU
KNOW, IF WE'RE ALREADY LAST IN
THE COUNTRY WITH HOSPICE ACCESS,
AND WE DON'T HAVE THIS OPTION,
(20:29):
IT JUST CREATES A NEW CHALLENGE
FOR US.
AND I THINK THAT'S JUST ONE OF
THE THINGS WE'D HAVE TO ROLL
WITH THAT.
WE'RE THE DEPARTMENT OF HEALTH.
WE GENERALLY KNOW HOW TO SOLVE
PROBLEMS AND IMPROVE PEOPLE'S
LIVES.
SO IF IT COMES TO WHERE WE CAN'T
HAVE THEM, WE'LL FIGURE IT OUT.
BUT WE HAVE TO WAIT AND SEE WHAT
THE GOVERNOR'S GOING TO DO ON
THIS.
>> AND CAN WE TALK ABOUT NEXT,
YOU KNOW, WHAT IS THE STATE'S
PROGRESS ON THIS, AND, YOU KNOW,
INITIATIVES TO TRY AND BOOST THE
(20:50):
PROGRESS HERE?
I KNOW YOU KIND OF TOUCHED ON
THIS THAT THERE'S ONLY 39
FACILITIES.
I KNOW THAT'S ONE OF THE
CONTRIBUTING FACTORS DATA HAS
ALSO SHOWN IS THAT THERE JUST
AREN'T ENOUGH CARE FACILITIES
FOR PEOPLE TO GO TO.
>> YEAH. SO WE CREATED A CENTER
FOR A PALLIATIVE AND HOSPICE
CARE AT THE DEPARTMENT LAST
YEAR.
THAT'S SOMETHING WE DID.
THERE'S ALSO US LOOKING AT THE
CERTIFICATE OF NEED METHODOLOGY
(21:10):
SO WE CAN ACTUALLY HAVE MORE IN
NEW YORK STATE.
WE'RE ALSO DOING SOME PUBLIC
EDUCATION, RIGHT?
LIKE, WE'RE PARTICIPATING WITH,
YOU KNOW, THIS HAS HAPPENED TO
BE HOSPICE AND PALLIATIVE CARE
AWARENESS MONTH, RIGHT?
BUT WE'RE DOING PUBLIC
EDUCATION, AND THAT'S, SOME OF
THAT'S THROUGH TALKING TOO, BUT
SOME OF THAT'S THROUGH SOCIAL
MEDIA, SOME IT'S WORKING WITH
COMMUNITY PARTNERS.
SOME OF IT'S, YOU KNOW, DOING
THINGS LIKE SUPPORTING THIS
GOING YOUR OWN WAY FILM THAT'S
(21:32):
COMING OUT, YOU KNOW, AND PART
OF IT'S JUST WORKING WITH
PARTNERS AND WORKING WITH
HEALTHCARE PROVIDERS SO PEOPLE
UNDERSTAND WHAT HOSPICE IS.
IT'S AN OPTION, AND AN OPTION I
THINK PEOPLE SHOULD TRY TO STUDY
SERIOUSLY BECAUSE IT'S PROBABLY
ONE OF THOSE THINGS WHERE, IF
YOU KNOW YOU'VE GOT LESS THAN
SIX MONTHS TO LIVE, YOU WANT TO
AVAIL YOURSELF TO SOMETHING
THAT'S GOING TO MAKE YOU MORE
(21:52):
COMFORTABLE.
AND THIS IS SOMETHING, LIKE, I
DON'T KNOW WHAT THE JOURNEY IS
GOING TO LOOK LIKE FOR ME, BUT
AS I GET INTO THIS POINT IN MY
LIFE, I ANTICIPATE ENGAGING WITH
HOSPICE WHEN THE TIME COMES FOR
ME AND MY FAMILY.
>> CAN YOU TALK ABOUT, YOU'VE
MENTIONED THE CENTER FOR, YOU
KNOW, HOSPICE AND PALLIATIVE
CARE, LIKE, WHAT DOES THAT LOOK
LIKE IN THE STAGES OF WHERE IT
IS RIGHT NOW AND HOW COULD IT
BENEFIT NEW YORK?
>>YEAH, SO WHAT IT LOOKS LIKE
FOR US IS WE HAVE HIRED
(22:13):
PROFESSIONAL STAFF TO WORK IN
THIS.
SO WE NOW CAN INTERACT WITH 39
HOSPICES, YOU KNOW, MUCH MORE
REGULARLY.
IT LOOKS LIKE CREATING POLICY,
HELPING REVIEW THE CERTIFICATE
OF NEED METHODOLOGY, UPDATING
REGULATIONS.
AND WE'RE LOOKING AT WHAT ARE
THE STRATEGIES WE NEED TO DO TO
ENGAGE WITH COMMUNITY PARTNERS?
BECAUSE, REALLY, THAT'S HOW THIS
CHANGES, RIGHT?
AND THEN HOW DO WE ENGAGE WITH
(22:33):
HEALTHCARE PROVIDERS, RIGHT?
BECAUSE ONE OF THE THINGS WE
WANT TO ENSURE HEALTHCARE
PROVIDERS DO IS HAVE ALL THE
SKILLS THEY NEED TO MAKE SURE
THEY CAN TALK TO THEIR PATIENTS
ABOUT THIS.
>> AND THROUGH, YOU KNOW, MY
RESEARCH AND A LOT OF DATA THAT
ACCUMULATES, LOOKS LIKE THIS HAS
BEEN, YOU KNOW, RANKING FOR NEW
YORK HAS BEEN LAST FOR, TILL,
SINCE ABOUT, LIKE, 2014.
I'M WONDERING HOW LONG HAS THE
(22:54):
STATE BEEN, YOU KNOW, FIGHTING
THIS ISSUE AND WHAT PROGRESS HAS
BEEN MADE, LIKE, IN YOUR
OPINION, LIKE, SO FAR OVER THESE
YEARS.
>> YES, SO I CAN ONLY SPEAK TO
WHAT I'VE BEEN DOING SINCE
JANUARY OF '23 WHEN I TOOK OVER
AS COMMISSIONER, BUT THIS IS
PART OF WHY WE CREATED THE
CENTER FOR PALLIATIVE CARE AND
HOSPICE CARE.
BUT ONE OF THE THINGS WE'VE BEEN
DOING IS MAKING SURE PEOPLE
UNDERSTAND THE OTHER TOOLS THAT
ARE OUT THERE, RIGHT?
AN ADVANCED DIRECTIVE.
(23:15):
WHAT IS THAT, RIGHT?
IT'S A LIVING WILL PLUS A
HEALTHCARE PROXY, OTHER LEGAL
DOCUMENTS TO HELP MAKE SURE,
WHEN YOU'RE PASSING AWAY, YOUR
WISHES ARE CARRIED OUT.
ONE OF THE THINGS ABOUT A
HEALTHCARE PROXY IN PARTICULAR
THAT'S REALLY IMPORTANT IS YOU
WANT TO PICK SOMEONE WHO'S GOING
TO CARRY OUT YOUR WISHES.
OTHER THINGS WE'VE DONE IS
UPDATE THE MEDICAL ORDER FOR
LIFE SUSTAINING TREATMENT,
RIGHT?
(23:35):
ANOTHER TOOL THAT PEOPLE CAN
HAVE WHEN YOU'RE APPROACHING
TERMINAL ILLNESS, RIGHT?
BUT MAKING SURE PEOPLE
UNDERSTAND WHAT A MEDICAL ORDER
FOR LIFE SUSTAINING TREATMENT
IS.
IT'S WAY MORE THAN A DO NOT
RESCESTATE ORDER OR A DNR ORDER.
AND THIS IS IMPORTANT.
MY MOM, FOR EXAMPLE, WHO'S GOING
THROUGH HER OWN END OF
LIFEJOURNEY RIGHT NOW HAS AN
MEDICAL ORDER FOR LIFE
SUSTAINING TREATMENT THAT WE
HELPED CREATE FOR HER BECAUSE WE
(23:56):
KNOW WHAT HER WISHES WERE.
THIS IS ONE OF THE IMPORTANT
POINTS HERE, IS IT'S REALLY
IMPORTANT PEOPLE KNOW WHAT ARE
YOUR WISHES ARE WHEN THIS TIME
COMES.
BECAUSE YOU DON'T WANT TO GIVE
UP CONTROL OVER SOMETHING THAT'S
SO PERSONAL AND IMPORTANT TO
YOU.
>> AND A LEGISLATIVE SESSION IS
COMING UP HERE.
WE'RE ABOUT TO START BACK UP IN
JANUARY.
WHAT ARE YOUR GOALS HEADING INTO
(24:16):
THE NEXT SESSION IN TERMS OF
ADDRESSING THIS ISSUE?
>> YES, WE HAVE TO SEE WHAT THE
LEGISLATURE IS ON THIS ISSUE
HERE.
I THINK WE JUST NEED TO SEE
WHERE MEDICAL AID FOR DYING ENDS
UP AND WHERE THE FOR PROFIT
HOSPICE ENDS UP.
BUT WHAT WE LIKE, WHENEVER WE
DEAL WITH THE LEGISLATURE, IS
PARTNERSHIP.
WHAT I'M HOPING WE CAN GET IS
PARTNERSHIP ON MAKING SURE
LEGISLATORS ARE WORKING WITH
(24:36):
THEIR CONSTITUENTS TO MAKE SURE
THEIR CONSTITUENTS UNDERSTAND
WHAT HOSPICE IS.
THE DEPARTMENT OF HEALTH HAS
INFORMATION ON OUR WEBPAGE, BUT
REALLY MAYBE DEMYSTIFYING SOME
OF THE MYTHS ABOUT HOSPICE,
RIGHT?
LIKE IN OTHER WORDS, ONCE YOU
ENTER HOSPICE, YOU CAN REVOKE IT
IF IT'S NOT WORKING FOR YOU.
BUT HOSPICE IS COVERED BY
MEDICAID, BY MEDICARE, BY YOUR
HEALTH INSURANCE.
(24:57):
JUST GETTING SOME INFORMATION
OUT THERE.
AND HOSPICE ISN'T NECESSARILY A
PLACE.
IT'S A PHILOSOPHY.
>> AND AS YOU KNOW, THE STATE
BUDGET IS SUCH A BIG PART OF
LEGISLATIVE SESSION EVERY YEAR.
DO YOU HAVE ANY GOALS GOING INTO
THE BUDGET SEASON IN TERMS OF
WHAT YOU WOULD LIKE TO SEE FOR
WHAT COULD ADDRESS THIS ISSUE?
>>YEAH, IT'S REALLY HARD TO PLAN
FOR THIS BUDGET RIGHT NOW UNTIL
WE SEE THE FEDERAL GOVERNMENT
(25:18):
ACCOMPLISH THEIR BUDGET, WHICH
HAS BEEN A PROBLEM THIS YEAR,
MORE SO THAN PAST YEARS, I MIGHT
ADD.
BUT I THINK THEREIN LIES SORT OF
THE MYSTERY FOR THIS YEAR, IS WE
HAVE TO SEE WHAT THE FEDERAL
GOVERNMENT'S DOING.
RIGHT NOW, NEW YORK'S IN A
BETTER POSITION THAN WE WERE
EVEN A FEW MONTHS AGO.
HOPEFULLY THAT'LL ONLY IMPROVE.
>> WELL, UNFORTUNATELY, THAT'S
ALL THE TIME WE HAVE FOR TODAY,
BUT THANK YOU SO MUCH FOR
SITTING DOWN WITH US,
COMMISSIONER.
(25:38):
>> THANK YOU SO MUCH.
>> AND WE WERE SPEAKING WITH NEW
YORK STATE HEALTH DEPARTMENT
COMMISSIONER JAMES MCDONALD.
AND FOR MORE INFORMATION AND
RESOURCES ON THE STATE'S HOSPICE
CARE, YOU CAN VISIT OUR WEBSITE.
AGAIN, THAT'S AT NYNOW.ORG.
YOU CAN ALSO GO TO WMHT.ORG OR
THE FREE PBS APP AND FIND OUT
MORE ABOUT THE JOURNEY OF END OF
(26:00):
LIFE CARE FEATURED IN "GO YOUR
OWN WAY," A DOCUMENTARY NOW
AVAILABLE FOR STREAMING.
WELL, THAT DOES IT FOR THIS
WEEK'S EDITION OF NEW YORK NOW.
THANK YOU FOR TUNING IN, AND SEE
YOU NEXT WEEK.
[ THEME MUSIC ]
(26:42):
>> FUNDING FOR NEW YORK NOW IS
PROVIDED BY WNET.
[THEME MUSIC]
(00:18):
>> WELCOME TO THIS WEEK'S
EDITION OF NEW YORK NOW.
I'M ELISE KLINE.
TUESDAY NIGHT, STATE ASSEMBLY
MEMBER ZOHRAN MAMDANI MADE
HISTORY BECOMING THE CITY'S
YOUNGEST MAYOR AND FIRST MUSLIM
AND FIRST SOUTH ASIAN MAYOR.
THE 34 YEAR OLD DEMOCRATIC
SOCIALIST AND MAYOR ELECT WON
THE RACE BY ABOUT 10 PERCENTAGE
POINTS AGAINST FORMER GOVERNOR
ANDREW CUOMO AND ABOUT 43
(00:38):
PERCENTAGE POINTS AGAINST
REPUBLICAN CANDIDATE CURTIS
SLIWA, ACCORDING TO THE NEW YORK
CITY BOARD OF ELECTIONS.
MAMADANI SAID IN HIS VICTORY
SPEECH, THIS WIN MARKS THE
TOPPLE OF A POLITICAL DYNASTY
AND THE DAWN OF A BETTER DAY FOR
HUMANITY.
MAMDANI'S WIN COMES AFTER HIS
GRASSROOTS CAMPAIGN SHOCKED THE
NATION WHEN HE WON THE
DEMOCRATIC NOMINATION IN JUNE,
BEATING CUOMO IN A POLITICAL
(00:59):
UPSET.
THIS YEAR'S NEW YORK CITY
MAYORAL RACE ALSO MAKES HISTORY
IN VOTER TURNOUT, OFFICIALLY
HITTING 2 MILLION VOTES, WHICH
IS THE FIRST TIME THIS HAS
HAPPENED SINCE 1969.
WE'RE GOING TO GET INTO THE
MAYORAL RACE, ELECTION NIGHT
RESULTS, AND WHAT A NEW MAYORAL
TERM WILL MEAN FOR THE STATE.
POLITICO'S NICK REISMAN JOINS US
IN THE STUDIO TO BREAK IT ALL
DOWN.
(01:21):
THANK YOU SO MUCH FOR JOINING US
TODAY, NICK.
>> GOOD TO BE HERE.
>> WELL, WE HAVE A LOT TO GET
INTO.
SO I WANT TO START WITH, CAN YOU
TELL ME A LITTLE BIT ABOUT, YOU
KNOW, YOUR THOUGHTS ON ELECTION
NIGHT RESULTS?
>> WELL, I WOULD SAY, FIRST OF
ALL, IT WAS NOT NECESSARILY THAT
BIG OF SURPRISE THAT ZOHRAN
MAMDANI IS THE NEXT MAYOR OF NEW
YORK CITY.
HE WAS THE DEMOCRATIC NOMINEE.
(01:42):
IT'S REALLY HARD TO LOSE AS THE
DEMOCRATIC NOMINEE IN NEW YORK
CITY AT THIS POINT, JUST GIVEN
THEIR HUGE ENROLLMENT ADVANTAGE.
MAMDANI HAS BECOME A NATIONAL,
IF NOT GLOBAL, POLITICAL
SUPERSTAR.
YOU KNOW, HE RAN ON THIS
AFFORDABILITY MESSAGE AT A TIME
WHEN THE DEMOCRATIC PARTY IS
(02:03):
OTHERWISE STRUGGLING WITH THIS
IDENTITY CRISIS AFTER DONALD
TRUMP WON LAST YEAR.
SO MAMDANI IS KIND OF OFFERING
DEMOCRATS THIS PATH FORWARD.
OBVIOUSLY, HIS CANDIDACY AND
NOMINATION HAS BADLY SPLIT
DEMOCRATS ACROSS THE COUNTRY AND
RIGHT HERE IN NEW YORK.
GOVERNOR HOCHUL ENDORSING HIM,
HER HANDPICKED STATE CHAIR JAY
(02:24):
JACOBS DECLINING TO ENDORSE HIM.
YOU HAVE MODERATE DEMOCRATS LIKE
TOM SUOZZI BREAKING FOR ANDREW
CUOMO OVER HIS OWN PARTY'S
NOMINEE.
SO THIS DID HIGHLIGHT THE
FISSURES WITHIN THE DEMOCRATIC
PARTY, BUT IT SHOULD NOT BE A
HUGE SURPRISE THAT ZOHRAN
MAMDANI IS GOING TO BE MAYOR OF
NEW YORK, JUST GIVEN THE BUILT
(02:44):
IN ADVANTAGES HE HAS, PLUS THE
POLITICAL STAR POWER THAT HE
BROUGHT TO AN ELECTION WHERE
TYPICALLY NOT A LOT OF VOTERS
TURNOUT IN A GENERAL ELECTION IN
NEW YORK CITY.
THIS HAD HUGE TURNOUT.
MORE THAN 2 MILLION VOTES WERE
CAST, AND THAT IS HIGHLY UNUSUAL
FOR A GENERAL ELECTION IN NEW
YORK CITY, WHERE THESE RACES ARE
USUALLY DECIDED IN THE PARTY
PRIMARY.
>> THAT'S RIGHT.
IT HIT OVER 2 MILLION VOTES, I
(03:06):
BELIEVE, AND THAT HASN'T
HAPPENED SINCE LIKE THE 1960S.
>> THAT'S RIGHT.
>> AND, YOU KNOW, MAMDANI DID
REALLY COME UP OVERNIGHT BECAUSE
HE WAS IN THE STATE ASSEMBLY.
NOT A LOT OF PEOPLE KNEW WHO HE
WAS.
>> HE WASN'T ON THE RADAR THIS
TIME LAST YEAR.
HE WAS POLLING AT AROUND LIKE
ZERO PERCENT OR SO.
SO THIS IS A RAPID ASSENT FOR
SOMEONE WHO ONLY RECENTLY,
(03:28):
RELATIVELY, GOT INTO ELECTED
OFFICE.
>> SO THAT GETS INTO MY NEXT
QUESTION HERE.
WHAT DO YOU THINK SEPARATES HIM
FROM OTHER POLITICAL LEADERS?
YOU KNOW, IN HIS VICTORY SPEECH,
HE HAD TALKED ABOUT HOW THIS IS
A DAWN OF A BETTER DAY FOR
POLITICS AND KIND OF THE TOPPLE
OF A POLITICAL DYNASTY.
>> WELL, IT'S CERTAINLY THE DAWN
OF A NEW DAY IN NEW YORK
POLITICS.
IT IS REALLY SIGNALING THE END
(03:49):
OF A PARTICULAR ERA, I THINK, IN
NEW YORK CITY POLITICS, AT
MINIMUM, POTENTIALLY NEW YORK
POLITICS OVERALL.
IT IS GOING TO BE A QUESTION,
HOW HE'S GOING TO GOVERN.
WE REALLY DON'T KNOW.
HE HAS ZERO EXECUTIVE
EXPERIENCE.
HE'S 34 YEARS OLD.
AGAIN, HE'S BEEN A BACKBENCH
MEMBER OF THE STATE ASSEMBLY FOR
ONLY THE LAST COUPLE OF YEARS.
(04:09):
SO WE REALLY DON'T KNOW WHAT
HE'S GOING TO BE LIKE IN OFFICE.
WE DID GET SOMETHING OF A
PREVIEW OF IT, I THINK, IN HIS
VICTORY SPEECH, WHICH WAS
PERHAPS A LITTLE BIT MORE
AGGRESSIVE THAN I THINK A LOT OF
PEOPLE WERE EXPECTING.
DURING THE GENERAL ELECTION, HE
WAS SEEMINGLY KIND OF MODERATING
SOME OF HIS VIEWS A LITTLE BIT
IN THE VICTORY SPEECH.
HE QUOTED EUGENE DEBS, WHO WAS
(04:30):
KIND OF THE FOUNDER OF THE
SOCIALIST MOVEMENT IN THE UNITED
STATES.
AND HE TOOK A RATHER FAR MORE
AGGRESSIVE POSTURE ON WHAT HE
WANTS TO GET DONE.
>> RIGHT. AND HE SEEMS LIKE HE'S
SORT OF COMING OUT THE GATE A
LITTLE BIT BECAUSE HE DID PUT
UP, I NOTICE HIS WEBSITE, A
TRANSITION PERIOD.
HE'S ALREADY SORT OF STARTED A
LITTLE BIT ON THAT MESSAGING.
(04:52):
SO HE SEEMS TO BE KIND OF AHEAD
OF IT.
BUT DO YOU THINK HE WILL HAVE
SUPPORT IN ALBANY WHEN, YOU
KNOW, BEING A NEW MAYORAL TERM,
HE DID HAVE ENDORSEMENTS FROM
SEVERAL POLITICAL LEADERS IN THE
DEMOCRATIC PARTY.
>> CERTAINLY HE'S GOING TO HAVE
SOME FRIENDS IN ALBANY,
ESPECIALLY, I WOULD SAY, IN THE
STATE SENATE, CERTAIN ALLIES IN
THE STATE ASSEMBLY.
BUT ALL EYES ARE GOING TO BE ON
(05:12):
GOVERNOR HOCHUL, WHO HAS THE
LION'S SHARE OF THE POWER WHEN
IT COMES TO SETTING THAT STATE
BUDGET.
THE GOVERNOR HAS SAID REPEATEDLY
THAT SHE DOES NOT WANT TO
INCREASE TAXES ON VERY RICH
PEOPLE AND CORPORATIONS IN NEW
YORK CITY.
SO THAT IS GOING TO BE THE
INITIAL TENSION POINT, I THINK,
BETWEEN ZOHRAN MAMDANI, HIS LEFT
LEANING SUPPORTERS, AND THE
(05:34):
GOVERNOR, AS SHE IS RUNNING FOR
RE ELECTION HERSELF.
NOW, THERE ARE OBVIOUSLY, THERE
ARE AREAS WHERE THEY AGREE, LIKE
UNIVERSAL CHILD CARE.
THAT IS AN END GOAL THAT THEY
BOTH SUPPORT.
IT'S INCREDIBLY EXPENSIVE.
IT'S GOING TO TAKE YEARS TO
IMPLEMENT.
I THINK IT'S SOMETHING LIKE $8
BILLION ON THE HIGH END.
THAT IS A LOT OF MONEY AS A
RECURRING EXPENSE FOR THE STATE.
AT THE SAME TIME, NEW YORK IS
(05:54):
ALSO FACING FEDERAL AID CUTS AND
REDUCTIONS.
SO THERE ARE A LOT OF DIFFERENT
AREAS WHERE THE GOVERNOR IS
GOING TO BE SQUEEZED HEADING
INTO NEXT YEAR.
>> SO LET'S TAKE A STEP BACK FOR
A SECOND.
HIS POLITICAL CAMPAIGN FOR
MAYOR, WHAT DO YOU THINK HIS
SUCCESSES WERE?
BECAUSE HE REALLY DID, YOU KNOW,
AS WE WERE TALKING ABOUT, COME
UP, YOU KNOW, OVERNIGHT AND
GAINED SO MUCH ATTENTION, REALLY
(06:15):
HELPED TURN OUT A LOT OF VOTERS
IN THIS RACE.
WHAT WERE HIS SUCCESSES?
AND DO YOU THINK THIS COULD BE
POTENTIALLY, YOU KNOW, A SEGUE
OR INSPIRATION FOR OTHER
DEMOCRATS AS THEY HEAD INTO
THEIR, YOU KNOW, MIDTERM
CAMPAIGNS?
>> WELL, IT WAS THAT KIND OF
RELENTLESS FOCUS ON
AFFORDABILITY.
THE COST OF LIVING IN A REALLY,
REALLY EXPENSIVE CITY REALLY
(06:35):
RESONATED FOR A LOT OF VOTERS.
THE RENT FREEZE PROPOSAL THAT HE
BACKED WAS SOMETHING THAT, WHILE
THERE'S A LOT OF QUESTIONS ABOUT
WHETHER THAT'S GOING TO HAVE ANY
SORT OF EFFECT, WHETHER HE CAN
ACTUALLY IMPLEMENT THAT, IT
CLEARLY DREW A LOT OF PEOPLE
TOWARD HIS CAUSE.
QUITE FRANKLY, ALSO, THE ANTI
(06:56):
ISRAEL POSTURE THAT HE HAS TAKEN
OVER THE YEARS IS SOMETHING THAT
I THINK ALSO RESONATED WITH SOME
PEOPLE WHO WERE CONCERNED WITH
THE WAR IN GAZA AND HOW ISRAEL
CONDUCTED THAT WAR.
NEVERTHELESS, YOU HAVE A
SIGNIFICANT NUMBER OF JEWISH
VOTERS IN NEW YORK CITY WHO WERE
ALARMED, QUITE FRANKLY, OF
(07:16):
ZOHRAN MAMDANI'S ANTI ISRAEL
STANCE, AND I THINK THAT DROVE A
LOT OF VOTES FOR ANDREW CUOMO IN
THE PRIMARY AS WELL AS IN THE
GENERAL ELECTION.
SO IT'S INTERESTING THAT WE'RE
SEEING NOW THIS SHIFT OF THE
DEMOCRATIC PARTY AND WE DON'T
WANT TO READ TOO MUCH INTO THIS,
RIGHT, BECAUSE THE DEMOCRATIC
PARTY NATIONALLY IS CONSIDERED A
(07:37):
LITTLE BIT MORE MODERATE.
WE SAW MODERATES GET ELECTED IN
VIRGINIA IN THE GOVERNOR'S RACE
THERE, AND EVEN ACROSS THE RIVER
IN NEW JERSEY WITH MIKIE
SHERRILL.
ALL OF THAT SAID, THIS APPEARS
TO BE SOME SORT OF ROADMAP.
I DON'T KNOW WHERE THAT ROAD
ULTIMATELY TAKES THE DEMOCRATIC
PARTY, BUT HE WAS ABLE TO
SUCCESSFULLY MESSAGE TO VOTERS:
(08:00):
HERE ARE THE THREE THINGS THAT I
STAND FOR.
IT WAS THE FAST AND FREE BUSES,
THE TAX HIKE, CHILDCARE, THE
RENT FREEZE.
THAT ALL KIND OF RESONATED WITH
THEM.
AND HE WAS ABLE TO TRANSLATE
INTO A MAJOR VICTORY.
>> I THINK SO, TOO.
HE KEPT IT REALLY SIMPLE WITH
JUST, I'M GOING TO FREEZE YOUR
RENT, I'M GOING TO MAKE BUSES
FASTER, REALLY LIKE SIMPLE
(08:21):
MESSAGING THAT I THINK PEOPLE
REALLY RESONATED WITH.
WHERE DO YOU THINK CUOMO WENT
WRONG WITH HIS CAMPAIGN
MESSAGING?
>>WELL, DURING THE PRIMARY, HE
PAINTED THIS VERY GLOOMY PICTURE
OF NEW YORK CITY AS BEING
OVERRUN BY CRIME.
HE SEEMED TO BE RUNNING A
CAMPAIGN THAT WAS PERHAPS BETTER
SUITED FOR FOUR YEARS AGO OR
(08:41):
MAYBE EVEN BETTER SUITED FOR THE
'80S AND '90S WHEN NEW YORK CITY
WAS BEING RIPPED APART BY THE
CRACK COCAINE EPIDEMIC, AND IT
WAS A MESSAGE THAT WAS NOT
REALLY BEST SUITED FOR 2025.
HE ONLY, KIND OF LATE IN THE
GAME, PICKED UP ON THE
AFFORDABILITY MESSAGE.
BY THAT POINT, IT WAS TOO
LITTLE, TOO LATE.
AND THEN IN THE FINAL WEEK OR SO
(09:04):
OF THE CAMPAIGN, HE APPEARED TO
BE LEANING INTO SOME OF THE
BIGOTED ATTACKS, QUITE FRANKLY,
ON ZOHRAN MAMDANI.
HE APPEARED TO AGREE, OR AT
LEAST HE DIDN'T INITIALLY
DISAGREE, WHEN A CONSERVATIVE
LEANING RADIO HOST HE WAS ON
WITH SUGGESTED THAT MAMDANI
(09:24):
WOULD HAVE CHEERED THE SEPTEMBER
11TH ATTACKS.
HIS CAMPAIGN POSTED AND THEN
LATER DELETED AN ARTIFICIALLY
INTELLIGENCE CREATED VIDEO THAT
PORTRAYED MAMDANI SUPPORTERS AS
BEING EITHER LIKE A BLACK PIMP
OR A DOMESTIC ABUSER.
I MEAN, STUFF THAT WAS REALLY
(09:46):
NASTY, QUITE FRANKLY.
AND ULTIMATELY, THAT VIDEO WAS
BLAMED ON AN UNNAMED STAFFER.
SURE. NEVERTHELESS, THIS KIND OF
FED INTO THE PERCEPTION THAT
CUOMO HAS EARNED OVER DECADES IN
NEW YORK POLITICS AS BEING VERY
AGGRESSIVE AND SHARP ELBOWED.
AND IT WAS JUST NOT SOMETHING
(10:07):
THAT WAS PERHAPS BEST SUITED FOR
THIS MOMENT IN NEW YORK
POLITICS.
NOW, HIS CAMPAIGN WILL SAY THAT
THEY, IN THE GENERAL ELECTION,
THEY PUT TOGETHER THIS COALITION
THAT WAS HIGHLY UNUSUAL OF
REPUBLICANS, MODERATE DEMOCRATS.
THEY TRIED TO MAKE INROADS WITH
THE SOUTH ASIAN COMMUNITIES,
WITH THE MUSLIM COMMUNITY BY
VISITING MOSQUES FOR THE FIRST
(10:27):
TIME.
IT CLEARLY, THOUGH, WAS NOT
ENOUGH.
HE GOT AN ENDORSEMENT FROM
PRESIDENT TRUMP AT THE VERY END.
THAT MAY HAVE ACTUALLY HELPED
HIM, I THINK.
WE SAW CURTIS SLIWA GET ABOUT 7
OR 8% OF THE VOTE.
HE HAD BEEN POLLING IN THE LOW
TEENS.
SO IT'S NOT UNLIKELY THAT CUOMO,
PERHAPS, WON PARTS OF
CONSERVATIVE AREAS LIKE STATEN
(10:48):
ISLAND IN NEW YORK CITY THAT HE
OTHERWISE WOULD NOT HAVE GOTTEN.
BUT ALSO, DONALD TRUMP IS HIGHLY
UNPOPULAR IN NEW YORK CITY,
HIGHLY UNPOPULAR.
AND THAT ALSO MAY HAVE HELPED
PUSH ZOHRAN MAMDANI SLIGHTLY
ABOVE 50% IN ORDER FOR HIM TO
CLAIM A MANDATE GOING INTO NEXT
YEAR.
>> AND SPEAKING OF, YOU KNOW,
DONALD TRUMP, WHAT DO YOU THINK
(11:08):
THIS NEXT MAYORAL TERM WILL
MEAN, NOT JUST FOR THE CITY AND
THE STATE, BUT ALSO THE NATION?
>> WE'RE REALLY GOING TO BE
WATCHING CLOSELY WHAT THE
PRESIDENT AND WHAT THE WHITE
HOUSE DO OVER THE NEXT COUPLE OF
MONTHS.
YOU KNOW, DONALD TRUMP HAS
ALREADY SUGGESTED THAT HE'S
GOING TO BE CUTTING FEDERAL AID
TO NEW YORK CITY AS A RESULT OF
MAMDANI'S ELECTION.
THE PRESIDENT HASN'T RULED OUT
(11:28):
SENDING IN THE NATIONAL GUARD TO
PATROL NEW YORK CITY STREETS.
SO THE PERSON THAT I THINK
EVERYONE'S GOING TO BE WATCHING
ONCE AGAIN IS GOVERNOR HOCHUL,
HOW IS SHE GOING TO BE DEALING
WITH THE MERCURIAL PRESIDENT
THAT SHE ACTUALLY HAS KIND OF A
GOOD WORKING RELATIONSHIP WITH
OVER THE LAST YEAR AND HOW IS
SHE GOING TO CONVINCE HIM, YOU
DO NOT NEED TO TRY TO TAKE OVER
(11:50):
NEW YORK CITY AS A RESULT OF A
DEMOCRATIC SOCIALIST BEING
ELECTED MAYOR BECAUSE THE NYPD
HAS THIS, THE STATE OF NEW YORK
HAS THIS, AND SHE'LL TRY TO BE
THIS BULWARK AGAINST TRUMP'S
EFFORT TO PUT HIS THUMB ON THE
SCALE IN NEW YORK CITY.
WELL, THANK YOU SO MUCH FOR
SITTING DOWN WITH US, NICK.
UNFORTUNATELY, THAT'S ALL THE
TIME WE HAVE FOR TODAY.
(12:10):
>> THANKS.
>> AND WE WERE SPEAKING WITH
NICK REISMAN FROM POLITICO.
AND FOR MORE INFORMATION AND
RESOURCES, YOU CAN VISIT OUR
WEBSITE.
AGAIN, THAT'S AT NYNOW.ORG.
NOW TURNING TO ANOTHER IMPORTANT
TOPIC.
THE STATE'S HOSPICE UTILIZATION
RATE HAS RETAINED THE LOWEST
RANKING ACROSS THE COUNTRY FOR
ABOUT 10 YEARS.
(12:31):
WE SAT DOWN WITH NEW YORK STATE
DEPARTMENT OF HEALTH
COMMISSIONER JAMES MCDONALD TO
TALK ABOUT THE STATE'S HOSPICE
AND PALLATIVE CARE SYSTEM, THE
CONTRIBUTING FACTORS TO ITS LOW
UTILIZATION RATE, AND WHAT THE
STATE IS DOING TO IMPROVE.
HERE'S THAT CONVERSATION.
THANK YOU SO MUCH FOR JOINING US
TODAY, COMMISSIONER.
>> IT'S GREAT TO BE HERE.
THANK YOU.
>> CAN YOU TELL US ABOUT NEW
(12:52):
YORK STATE'S APPROACH TO
ADDRESSING HOSPICE CARE, AND
WHAT DOES THAT ENTAIL?
>> YEAH, YOU KNOW, IT'S
INTERESTING.
LAST YEAR, WE STARTED THE
DEPARTMENT AT THE CENTER FOR
PALLIATIVE CARE AND HOSPICE
CARE.
YOU KNOW, IT WAS REFLECTING ONE
OF THE GOVERNOR'S PRIORITIES.
WHEN YOU THINK ABOUT THESE
CONCEPTS, THOUGH, I DON'T THINK
MOST PEOPLE UNDERSTAND WHAT
HOSPICE IS AND WHAT PALLIATIVE
CARE IS.
(13:12):
AND HOSPICE IS REALLY TO HELP
YOU WITH THE END OF LIFE
JOURNEY.
IT'S REALLY FOR SOMEONE WHO'S IN
THE LAST SIX MONTHS OF LIFE, BUT
AN EXPERIENCED, PASSIONATE
HEALTH CARE PROVIDER TO HELP YOU
WITH THAT END OF LIFE JOURNEY.
WHEN YOU THINK OF PALLIATIVE
CARE, THAT'S REALLY JUST TO HELP
YOU BE COMFORTABLE, BUT IT MAY
NOT BE CONNECTED TO AN END OF
LIFE JOURNEY.
SO THEY'RE A LITTLE BIT
DIFFERENT.
BUT THIS IS SOMETHING WE'RE
SPENDING A LOT MORE ATTENTION ON
(13:33):
IN THE NEW YORK STATE DEPARTMENT
HEALTH, IN PARTICULAR IN THE
LAST YEAR, TRYING TO REALLY MAKE
IT MORE AWARE TO PEOPLE WHAT IT
IS AND HOW IT CAN HELP PEOPLE.
>> AND NEW YORK, AS I'M SURE YOU
KNOW, IS RANKED 50TH AMONG
COMPARED TO OTHER STATES ACROSS
THE COUNTRY IN TERMS OF HOSPICE
UTILIZATION.
WHAT DO YOU THINK IS
CONTRIBUTING TO THIS?
>> YEAH, WE ARE LAST IN THE
(13:54):
COUNTRY WHEN IT COMES TO HOSPICE
UTILIZATION, AND THAT CONCERNS
ME.
NOW, PART OF WHAT I THINK
CONTRIBUTES TO IT IS, I DON'T
THINK PEOPLE GENERALLY KNOW WHAT
HOSPICE IS.
I DON'T THINK THEY KNOW IT'S
AVAILABLE TO THEM THAT IS
COVERED BY MEDICAID, MEDICARE,
AND PRIVATE INSURANCE.
AND I DON'T THINK PEOPLE
UNDERSTAND, TOO, THAT HOSPICE
DOESN'T MEAN YOU'RE GIVING UP.
HOSPICE MEANS YOU'RE BEING
COMFORTABLE WITH SOMEONE TO HELP
(14:14):
THEM DURING THIS RATHER SACRED
JOURNEY.
YOU KNOW, ONE OF THE THINGS
ABOUT HOSPICE, TOO, IS IT ISN'T
JUST FOR THE END OF LIFE TIME.
THEY'RE THERE TO SUPPORT THE
FAMILY FOR A FULL YEAR AFTER
SOMEONE'S PASSED AWAY.
BECAUSE AS PEOPLE ARE GOING
THROUGH THE GRIEVING JOURNEY,
WHICH IS VERY PERSONAL, IT'S
NICE TO HAVE SOMEONE WHO CAN
HELP YOU WITH THAT.
DEAL WITH JUST SOME OF THE
LOGISTICS OF ALL THAT AND JUST
(14:36):
HELP YOU GET THROUGH THE
GRIEVING PROCESS AND GIVE YOU
THE SUPPORT YOU NEED.
>> AND I KNOW FOR THE FEW NEW
YORKERS WHO DO USE HOSPICE CARE,
THEIR STAYS ARE OFTEN PRETTY
SHORT, LIKE ABOUT ONE TO TWO
WEEKS.
AND A LOT OF EXPERTS SAY THAT
THIS REALLY ISN'T ENOUGH TIME
FOR PEOPLE TO GET THE FULL
BENEFIT OF HOSPICE EXPERIENCE.
(14:57):
WHY DO YOU THINK THAT, OF THE
FEW NEW YORKERS, LIKE, WHY ARE
PEOPLE'S STAYS SO SHORT?
>> YEAH, SO I THINK WHAT'S
HAPPENING IS PEOPLE ARE ENTERING
HOSPICE TOO LATE.
IN OTHER WORDS, THERE'S SORT OF
A RECOGNITION THAT WHAT HOSPICE
IS FOR IS FOR SOMEONE WHO HAS
SIX MONTHS OR LESS EXPECTED TO
LIVE.
WHEN YOU LOOK AT THE NATIONAL
AVERAGE, WHICH IS AROUND 75
DAYS, WHAT I THINK WHAT WE'RE
SEEING IS PEOPLE AREN'T AWARE OF
(15:18):
HOSPICE, SO THEY'RE NOT ENTERING
IT.
NOW, SOME OF IT IS HEALTH CARE
PROVIDERS COULD HELP PEOPLE
REFERRING YOU TO HOSPICE.
AND, QUITE FRANKLY, ENTERING THE
HOSPICE PHILOSOPHY BECAUSE
HOSPICE ISN'T A PLACE IT CAN BE
IN A HOSPITAL OR HOSPICE,
COMMUNITY HOSPICE PLACE, BUT
COULD BE AT YOUR HOME.
AND HOSPICE IS A PHILOSOPHY.
BUT ENTERING THE PHILOSOPHY IS
(15:39):
WHAT WE WANT PEOPLE TO
UNDERSTAND.
HOSPICE ISN'T ABOUT GIVING UP.
IT'S ABOUT HAVING AN
EXPERIENCED, COMPASSIONATE
HEALTH CARE PROFESSIONAL YOU
GUIDE YOU ON THIS PERSONAL
JOURNEY.
YOU KNOW, WHEN YOU THINK ABOUT
DYING, IT'S AN UNCOMFORTABLE
THING TO TALK ABOUT, BUT IT'S A
JOURNEY ALL OF US WILL TAKE.
BUT IT'S NICE TO HAVE AN
EXPERIENCED GUIDE TO HELP YOU BE
COMFORTABLE DURING THIS JOURNEY
(15:59):
SO YOU DON'T SUFFER
UNNECESSARILY.
AND MY EXPERIENCE WITH HOSPICE
HAS BEEN NOTHING BUT POSITIVE.
MOST PEOPLE, WHEN THEY
EXPERIENCE HOSPICE, YOU FIND,
LIKE, THESE ARE PEOPLE WHO KNOW
WHAT THEY'RE DOING, AND THEY
HELP YOU.
AND THEY HELP YOU DOING A VERY
DIFFICULT TIME IN LIFE.
>> AND IT'S INTERESTING.
YOU BROUGHT UP THE, YOU KNOW,
JUST AWARENESS, PEOPLE NOT
NECESSARILY BEING AWARE OF WHAT
(16:20):
HOSPICE IS, WHAT THEIR RESOURCES
ARE.
BUT DATA ALSO SHOWS THAT SOME OF
THE CONTRIBUTING FACTORS IS ALSO
JUST THE CULTURE IN A LOT OF
HOSPITALS OF, YOU KNOW, SOME
DOCTORS WANTING TO MAYBE BE A
LITTLE MORE AGGRESSIVE AND NOT
PRESENTING THE HOSPICE OPTION
UNTIL MAYBE, I GUESS, THE VERY
LAST RESORT.
IS THAT SOMETHING THAT YOUR
OFFICE IS AWARE OF?
LIKE, IS THAT PART OF IT, DO YOU
(16:40):
THINK?
>> YOU KNOW, I THINK IT CAN BE
PART OF IT, BUT I THINK IT'S
ALSO ONE OF THOSE THINGS WHERE,
YOU KNOW, HEALTHCARE PROVIDERS
ARE TRAINED DO IS LISTEN TO OUR
PATIENTS.
ONE OF THE THINGS I'VE NOTICED
AS I'VE NAVIGATED MY OWN CAREER,
I'M A PEDIATRICIAN TOO, BUT I
HAVE ENGAGED THIS END OF LIFE
JOURNEY WITH SEVERAL OF MY OWN
PATIENTS.
ONE OF THE THINGS YOU HAVE TO DO
AS A HEALTHCARE PROVIDER IS MAKE
SURE YOUR PATIENT FEELS LIKE
(17:01):
THEY ARE BEING LISTENED TO.
ONE OF THE THINGS WE AS
HEALTHCARE PROVIDERS DO IS
LISTEN, BUT ONE OF THE THINGS WE
WANT TO MAKE SURE WE DO IS WE'RE
NOT TRYING TO PUSH SOMETHING ON
SOMEONE.
WE'RE TRYING TO MAKE SURE PEOPLE
UNDERSTAND THE RESOURCE.
BUT ONE THING THAT HELPS US AS
HEALTHCARE PROVIDERS IS, ARE YOU
OPEN TO THIS IDEA?
BECAUSE AGAIN, HOSPICE IS A
PHILOSOPHY.
(17:21):
IT'S NOT NECESSARILY A PLACE.
AND REALLY WHAT WE WANT PEOPLE
TO BE OPEN TO IS THE IDEA OF
SOMEONE WHO'S AN EXPERIENCED,
COMPASSIONATE HEALTHCARE
PROFESSIONAL TO COMPASSIONATELY
ACCOMPANY YOU ALONG A JOURNEY TO
MAKE SURE YOU'RE COMFORTABLE
DURING THESE FINAL MONTHS.
AND I THINK ENTERING HOSPICE
SOONER THAN LATER ISN'T A BAD
(17:42):
IDEA FOR PEOPLE BECAUSE YOU GET
THE FULL BENEFIT OF IT.
>> AND DATA ALSO SHOWS THAT
THERE ARE SOME, YOU KNOW, RACIAL
DISPARITIES THAT KIND OF PLAY
INTO THIS ISSUE.
CAN YOU TELL ME WHAT THE STATE
IS DOING TO ADDRESS THIS?
>> YEAH, SOME OF THIS IS BASED
ON OUR CULTURE, YOU KNOW, AND
HOW WE ARE BROUGHT UP, TALKING
ABOUT THIS.
SO WE'RE TRYING TO DO IS MAKE
SURE THE PUBLIC UNDERSTANDS WHAT
HOSPICE IS, HOW IT'S AVAILABLE
TO PEOPLE, BUT ALSO WORKING WITH
(18:03):
COMMUNITY LEADERS TO TALK ABOUT
HOSPICE, YOU KNOW.
THERE'S CERTAIN TIMES WHERE YOU
WANT TO HEAR ABOUT SOMETHING
FROM PEOPLE YOU KNOW AND TRUST.
AND ONE OF THE THINGS WE JUST
HAVE TO ACKNOWLEDGE AS A PEOPLE
IS, TALKING ABOUT DEATH IS
UNCOMFORTABLE.
ALTHOUGH IT'S SOMETHING THAT'S
GOING TO HAPPEN TO ALL OF US,
WE'RE NOT USED TO DOING THIS AS
A CULTURE.
AND SO YOU HAVE TO CREATE THE
(18:24):
RIGHT SPACE AND TIME TO TALK
ABOUT THAT.
AND THIS IS PART OF WHY PEOPLE
NEED TO NOT JUST TALK ABOUT, BUT
BE PREPARED FOR IT BECAUSE IT'S
MORE THAN JUST HOSPICE, RIGHT?
IN OTHER WORDS, YOU NEED TO HAVE
A HEALTHCARE PROXY.
YOU NEED TO HAVE A LIVING WILL.
THESE ARE THINGS THAT ARE PART
OF AN ADVANCED DIRECTIVE, BUT
YOU NEED TO KNOW WHAT A MEDICAL
ORDER FOR LIFE SUSTAINING
TREATMENT IS.
IN OTHER WORDS, YOU AS A PERSON
GET A LOT OF CONTROL OVER WHAT
(18:45):
YOUR END OF LIFE EXPERIENCE
LOOKS LIKE.
AND THAT'S PART OF WHAT WE'RE
DOING IS TRYING TO HELP PEOPLE
UNDERSTAND WHAT ARE MY OPTIONS.
>> AND I WANT TO MOVE ON TO THE
NEXT PART OF THIS ISSUE, FOR
PROFIT HOSPICE CARE, WHICH I
WANT TO KNOW FROM YOU, WHAT DOES
THIS LOOK LIKE IN THE STATE?
>> YEAH, SO NEW YORK DOES ALLOW
FOR PROFIT RIGHT NOW.
AND RIGHT NOW, WHAT WE'VE SEEN
(19:06):
IN NEW YORK IS POSITIVE RESULTS.
NOW, WE ONLY HAVE 39 HOSPICES IN
NEW YORK STATE, ONLY TWO ARE FOR
PROFIT.
BUT WHAT WE'VE SEEN IN NEW YORK
HAS SO FAR BEEN POSITIVE.
OTHER STATES HAVE HAD DIFFERENT
EXPERIENCES.
AND I THINK IT REALLY GETS TO
THIS ISSUE OF, WHEN YOU THINK
ABOUT WHO ARE THE PEOPLE WHO
GENERALLY GO WORK WITH HOSPICE,
(19:27):
THEY'RE GENERALLY COMPASSIONATE,
KIND PEOPLE WHO REALLY LOOK AT
THIS AS MORE OF A MISSION THAN
AN OPPORTUNITY TO MAKE MONEY.
THIS IS WHAT I'VE NOTICED BY
PEOPLE WHO ACTUALLY WORK IN
HOSPICE.
>> AND I KNOW THAT THERE'S A
BILL TO BAN THIS PRACTICE, ONE
THAT WAS VETOED TWICE ALREADY,
BUT IT DID PASS AGAIN THIS YEAR
IN BOTH HOUSES AND WILL GO TO
(19:47):
THE GOVERNOR'S DESK.
I'M WONDERING, WHAT DO YOU THINK
ABOUT THIS ISSUE WHEN IT COMES
TO BANNING THIS KIND OF
PRACTICE?
AND DO YOU HOPE THE GOVERNOR
POTENTIALLY SIGNS THIS?
>> YEAH, SO WE CAN'T GET AHEAD
OF THE GOVERNOR ON SOMETHING
LIKE THIS, RIGHT?
LIKE, SHE HASN'T DECIDED ON A
BILL.
SHE HASN'T DECIDED YET.
SO I CAN'T COMMENT ON ANY
PENDING LEGISLATION.
WHAT I CAN SAY IS SHE'S A VERY
THOUGHTFUL, DELIBERATE
INDIVIDUAL WHO CARES DEEPLY
(20:08):
ABOUT PEOPLE.
I INTERACT WITH HER A LOT.
SHE GIVES THINGS A GREAT DEAL OF
THOUGHT.
SO WE'LL SEE WHERE IT GOES THIS
YEAR.
>> AND CAN YOU TELL ME IF THIS
WERE TO PASS, WHAT WOULD THAT
MEAN FOR THE STATE?
>> YEAH, SO INTERESTING, YOU
KNOW, IF WE'RE ALREADY LAST IN
THE COUNTRY WITH HOSPICE ACCESS,
AND WE DON'T HAVE THIS OPTION,
(20:29):
IT JUST CREATES A NEW CHALLENGE
FOR US.
AND I THINK THAT'S JUST ONE OF
THE THINGS WE'D HAVE TO ROLL
WITH THAT.
WE'RE THE DEPARTMENT OF HEALTH.
WE GENERALLY KNOW HOW TO SOLVE
PROBLEMS AND IMPROVE PEOPLE'S
LIVES.
SO IF IT COMES TO WHERE WE CAN'T
HAVE THEM, WE'LL FIGURE IT OUT.
BUT WE HAVE TO WAIT AND SEE WHAT
THE GOVERNOR'S GOING TO DO ON
THIS.
>> AND CAN WE TALK ABOUT NEXT,
YOU KNOW, WHAT IS THE STATE'S
PROGRESS ON THIS, AND, YOU KNOW,
INITIATIVES TO TRY AND BOOST THE
(20:50):
PROGRESS HERE?
I KNOW YOU KIND OF TOUCHED ON
THIS THAT THERE'S ONLY 39
FACILITIES.
I KNOW THAT'S ONE OF THE
CONTRIBUTING FACTORS DATA HAS
ALSO SHOWN IS THAT THERE JUST
AREN'T ENOUGH CARE FACILITIES
FOR PEOPLE TO GO TO.
>> YEAH. SO WE CREATED A CENTER
FOR A PALLIATIVE AND HOSPICE
CARE AT THE DEPARTMENT LAST
YEAR.
THAT'S SOMETHING WE DID.
THERE'S ALSO US LOOKING AT THE
CERTIFICATE OF NEED METHODOLOGY
(21:10):
SO WE CAN ACTUALLY HAVE MORE IN
NEW YORK STATE.
WE'RE ALSO DOING SOME PUBLIC
EDUCATION, RIGHT?
LIKE, WE'RE PARTICIPATING WITH,
YOU KNOW, THIS HAS HAPPENED TO
BE HOSPICE AND PALLIATIVE CARE
AWARENESS MONTH, RIGHT?
BUT WE'RE DOING PUBLIC
EDUCATION, AND THAT'S, SOME OF
THAT'S THROUGH TALKING TOO, BUT
SOME OF THAT'S THROUGH SOCIAL
MEDIA, SOME IT'S WORKING WITH
COMMUNITY PARTNERS.
SOME OF IT'S, YOU KNOW, DOING
THINGS LIKE SUPPORTING THIS
GOING YOUR OWN WAY FILM THAT'S
(21:32):
COMING OUT, YOU KNOW, AND PART
OF IT'S JUST WORKING WITH
PARTNERS AND WORKING WITH
HEALTHCARE PROVIDERS SO PEOPLE
UNDERSTAND WHAT HOSPICE IS.
IT'S AN OPTION, AND AN OPTION I
THINK PEOPLE SHOULD TRY TO STUDY
SERIOUSLY BECAUSE IT'S PROBABLY
ONE OF THOSE THINGS WHERE, IF
YOU KNOW YOU'VE GOT LESS THAN
SIX MONTHS TO LIVE, YOU WANT TO
AVAIL YOURSELF TO SOMETHING
THAT'S GOING TO MAKE YOU MORE
(21:52):
COMFORTABLE.
AND THIS IS SOMETHING, LIKE, I
DON'T KNOW WHAT THE JOURNEY IS
GOING TO LOOK LIKE FOR ME, BUT
AS I GET INTO THIS POINT IN MY
LIFE, I ANTICIPATE ENGAGING WITH
HOSPICE WHEN THE TIME COMES FOR
ME AND MY FAMILY.
>> CAN YOU TALK ABOUT, YOU'VE
MENTIONED THE CENTER FOR, YOU
KNOW, HOSPICE AND PALLIATIVE
CARE, LIKE, WHAT DOES THAT LOOK
LIKE IN THE STAGES OF WHERE IT
IS RIGHT NOW AND HOW COULD IT
BENEFIT NEW YORK?
>>YEAH, SO WHAT IT LOOKS LIKE
FOR US IS WE HAVE HIRED
(22:13):
PROFESSIONAL STAFF TO WORK IN
THIS.
SO WE NOW CAN INTERACT WITH 39
HOSPICES, YOU KNOW, MUCH MORE
REGULARLY.
IT LOOKS LIKE CREATING POLICY,
HELPING REVIEW THE CERTIFICATE
OF NEED METHODOLOGY, UPDATING
REGULATIONS.
AND WE'RE LOOKING AT WHAT ARE
THE STRATEGIES WE NEED TO DO TO
ENGAGE WITH COMMUNITY PARTNERS?
BECAUSE, REALLY, THAT'S HOW THIS
CHANGES, RIGHT?
AND THEN HOW DO WE ENGAGE WITH
(22:33):
HEALTHCARE PROVIDERS, RIGHT?
BECAUSE ONE OF THE THINGS WE
WANT TO ENSURE HEALTHCARE
PROVIDERS DO IS HAVE ALL THE
SKILLS THEY NEED TO MAKE SURE
THEY CAN TALK TO THEIR PATIENTS
ABOUT THIS.
>> AND THROUGH, YOU KNOW, MY
RESEARCH AND A LOT OF DATA THAT
ACCUMULATES, LOOKS LIKE THIS HAS
BEEN, YOU KNOW, RANKING FOR NEW
YORK HAS BEEN LAST FOR, TILL,
SINCE ABOUT, LIKE, 2014.
I'M WONDERING HOW LONG HAS THE
(22:54):
STATE BEEN, YOU KNOW, FIGHTING
THIS ISSUE AND WHAT PROGRESS HAS
BEEN MADE, LIKE, IN YOUR
OPINION, LIKE, SO FAR OVER THESE
YEARS.
>> YES, SO I CAN ONLY SPEAK TO
WHAT I'VE BEEN DOING SINCE
JANUARY OF '23 WHEN I TOOK OVER
AS COMMISSIONER, BUT THIS IS
PART OF WHY WE CREATED THE
CENTER FOR PALLIATIVE CARE AND
HOSPICE CARE.
BUT ONE OF THE THINGS WE'VE BEEN
DOING IS MAKING SURE PEOPLE
UNDERSTAND THE OTHER TOOLS THAT
ARE OUT THERE, RIGHT?
AN ADVANCED DIRECTIVE.
(23:15):
WHAT IS THAT, RIGHT?
IT'S A LIVING WILL PLUS A
HEALTHCARE PROXY, OTHER LEGAL
DOCUMENTS TO HELP MAKE SURE,
WHEN YOU'RE PASSING AWAY, YOUR
WISHES ARE CARRIED OUT.
ONE OF THE THINGS ABOUT A
HEALTHCARE PROXY IN PARTICULAR
THAT'S REALLY IMPORTANT IS YOU
WANT TO PICK SOMEONE WHO'S GOING
TO CARRY OUT YOUR WISHES.
OTHER THINGS WE'VE DONE IS
UPDATE THE MEDICAL ORDER FOR
LIFE SUSTAINING TREATMENT,
RIGHT?
(23:35):
ANOTHER TOOL THAT PEOPLE CAN
HAVE WHEN YOU'RE APPROACHING
TERMINAL ILLNESS, RIGHT?
BUT MAKING SURE PEOPLE
UNDERSTAND WHAT A MEDICAL ORDER
FOR LIFE SUSTAINING TREATMENT
IS.
IT'S WAY MORE THAN A DO NOT
RESCESTATE ORDER OR A DNR ORDER.
AND THIS IS IMPORTANT.
MY MOM, FOR EXAMPLE, WHO'S GOING
THROUGH HER OWN END OF
LIFEJOURNEY RIGHT NOW HAS AN
MEDICAL ORDER FOR LIFE
SUSTAINING TREATMENT THAT WE
HELPED CREATE FOR HER BECAUSE WE
(23:56):
KNOW WHAT HER WISHES WERE.
THIS IS ONE OF THE IMPORTANT
POINTS HERE, IS IT'S REALLY
IMPORTANT PEOPLE KNOW WHAT ARE
YOUR WISHES ARE WHEN THIS TIME
COMES.
BECAUSE YOU DON'T WANT TO GIVE
UP CONTROL OVER SOMETHING THAT'S
SO PERSONAL AND IMPORTANT TO
YOU.
>> AND A LEGISLATIVE SESSION IS
COMING UP HERE.
WE'RE ABOUT TO START BACK UP IN
JANUARY.
WHAT ARE YOUR GOALS HEADING INTO
(24:16):
THE NEXT SESSION IN TERMS OF
ADDRESSING THIS ISSUE?
>> YES, WE HAVE TO SEE WHAT THE
LEGISLATURE IS ON THIS ISSUE
HERE.
I THINK WE JUST NEED TO SEE
WHERE MEDICAL AID FOR DYING ENDS
UP AND WHERE THE FOR PROFIT
HOSPICE ENDS UP.
BUT WHAT WE LIKE, WHENEVER WE
DEAL WITH THE LEGISLATURE, IS
PARTNERSHIP.
WHAT I'M HOPING WE CAN GET IS
PARTNERSHIP ON MAKING SURE
LEGISLATORS ARE WORKING WITH
(24:36):
THEIR CONSTITUENTS TO MAKE SURE
THEIR CONSTITUENTS UNDERSTAND
WHAT HOSPICE IS.
THE DEPARTMENT OF HEALTH HAS
INFORMATION ON OUR WEBPAGE, BUT
REALLY MAYBE DEMYSTIFYING SOME
OF THE MYTHS ABOUT HOSPICE,
RIGHT?
LIKE IN OTHER WORDS, ONCE YOU
ENTER HOSPICE, YOU CAN REVOKE IT
IF IT'S NOT WORKING FOR YOU.
BUT HOSPICE IS COVERED BY
MEDICAID, BY MEDICARE, BY YOUR
HEALTH INSURANCE.
(24:57):
JUST GETTING SOME INFORMATION
OUT THERE.
AND HOSPICE ISN'T NECESSARILY A
PLACE.
IT'S A PHILOSOPHY.
>> AND AS YOU KNOW, THE STATE
BUDGET IS SUCH A BIG PART OF
LEGISLATIVE SESSION EVERY YEAR.
DO YOU HAVE ANY GOALS GOING INTO
THE BUDGET SEASON IN TERMS OF
WHAT YOU WOULD LIKE TO SEE FOR
WHAT COULD ADDRESS THIS ISSUE?
>>YEAH, IT'S REALLY HARD TO PLAN
FOR THIS BUDGET RIGHT NOW UNTIL
WE SEE THE FEDERAL GOVERNMENT
(25:18):
ACCOMPLISH THEIR BUDGET, WHICH
HAS BEEN A PROBLEM THIS YEAR,
MORE SO THAN PAST YEARS, I MIGHT
ADD.
BUT I THINK THEREIN LIES SORT OF
THE MYSTERY FOR THIS YEAR, IS WE
HAVE TO SEE WHAT THE FEDERAL
GOVERNMENT'S DOING.
RIGHT NOW, NEW YORK'S IN A
BETTER POSITION THAN WE WERE
EVEN A FEW MONTHS AGO.
HOPEFULLY THAT'LL ONLY IMPROVE.
>> WELL, UNFORTUNATELY, THAT'S
ALL THE TIME WE HAVE FOR TODAY,
BUT THANK YOU SO MUCH FOR
SITTING DOWN WITH US,
COMMISSIONER.
(25:38):
>> THANK YOU SO MUCH.
>> AND WE WERE SPEAKING WITH NEW
YORK STATE HEALTH DEPARTMENT
COMMISSIONER JAMES MCDONALD.
AND FOR MORE INFORMATION AND
RESOURCES ON THE STATE'S HOSPICE
CARE, YOU CAN VISIT OUR WEBSITE.
AGAIN, THAT'S AT NYNOW.ORG.
YOU CAN ALSO GO TO WMHT.ORG OR
THE FREE PBS APP AND FIND OUT
MORE ABOUT THE JOURNEY OF END OF
(26:00):
LIFE CARE FEATURED IN "GO YOUR
OWN WAY," A DOCUMENTARY NOW
AVAILABLE FOR STREAMING.
WELL, THAT DOES IT FOR THIS
WEEK'S EDITION OF NEW YORK NOW.
THANK YOU FOR TUNING IN, AND SEE
YOU NEXT WEEK.
[ THEME MUSIC ]
(26:42):
>> FUNDING FOR NEW YORK NOW IS
PROVIDED BY WNET.
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