Anderson, Lunneborg, Donaldson: State law needs a tweak this year so Lakeview Hospital project can proceed

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Stillwater’s Lakeview Hospital, Minnesota’s oldest, has been a cornerstone of care in the region since 1880. Caring for just a few patients at first, we’ve grown with our community over the years. And the need for our services continues to grow as the number of residents aged 65 and older in our area is expected to increase by 20% over the next five years.

Much of our current hospital campus dates to the late 1960s or earlier. We’ve known for some time that emerging needs for care would exceed the capacities of our current hospital campus. Last year, we began active planning to build a new hospital campus just a few miles from our current facility. Building a new hospital is an exciting opportunity, and we’re now engaging with our community to make sure our new facility will meet the needs of our area for years to come.

One key aspect of this engagement relates to a proposal now pending at the Minnesota State Legislature.

Sen. Karin Housley and Rep. Josiah Hill are chief authors of a bipartisan proposal (SF3674/HF3817) to make an important change to Minnesota’s Hospital Constructions Moratorium. The change would allow hospitals like ours to transfer up to 100 existing bed licenses to a new facility within five miles. Current law allows for the relocation of only up to 70 bed licenses for a replacement hospital.

The needs we hope to meet with the new Lakeview Hospital are a good case in point for why passage of this legislation matters now. With the physical limitations of our current campus, we can use only 68 of our 97 licensed beds. The new location allows us to maximize existing license capacity, but without this legislation we are limited to the 70-bed replacement limit in current law, and we would lose sorely needed bed license capacity for the east metro. That would be a tragedy for a growing community that needs more inpatient hospital beds now.

Lakeview Hospital is planning a new $400M Stillwater campus and wants your input

The benefits of this legislation extend beyond our hospital. As community hospitals close their doors here in Minnesota and across the nation, the demand for care at those remaining hospitals is increasing. The need to support community hospitals has never been more urgent. By enabling community hospitals like Lakeview to maximize use of existing licenses, we can keep care closer to home when possible and alleviate the pressure on larger tertiary hospitals providing higher-level, more specialized care for the region’s most acute patients.

We urge our community members, policymakers, and fellow health care providers to support the passing of this legislation. Doing so will help secure the future of Lakeview Hospital, as well as other hospitals like ours. It will also ensure the community continues to have access to exceptional health care services close to their homes.

Mike Anderson is chair of the Lakeview Hospital Community Board and retired director of HR Global Benefits, 3M. Brandi Lunneborg is president of Lakeview Hospital. Phil Donaldson, executive vice president and chief financial officer at Andersen Corporation, is chair of the HealthPartners Board of Directors and co-chair of Lakeview Hospital capital campaign.

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Exit Unknown: Where Do People Go After Leaving NYC Homeless Shelters?

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Amid a steep rise in people living in shelter, few are exiting the system, and even fewer are getting housing placements, a City Limits analysis of public data shows.

Adi Talwar

Starlite Harris lived in the shelter system for about a year in 2021 and 2022, staying in eight different facilities. She has since moved into her own apartment after securing a CityFHEPS voucher.

Starlite Harris lived in eight different New York City homeless shelters between 2021 and 2022, thanks to a series of transfers and health crises that required hospitalization.

“It’s more exhausting than it sounds,” Harris said.

Eventually, she received a rental voucher and found an apartment that accepted it in Williamsburg. But for many, this outcome remains out of reach.

Data on shelter exits released by the City of New York beginning last year highlights just how narrow the path out of shelter is, and how hard it is for homeless residents—particularly single adults—to find permanent housing.

Through nine months of Department of Homeless Services (DHS) exit data from May 2023 to January 2024, an average of 10 percent of households in shelter left the DHS system each month, and just 2.6 percent exited to permanent housing.

Over the 12 months ending last June, DHS shelter residents had spent more than a year on average in the system. That’s even after average stays decreased nearly 20 percent from the year prior for most households—a change Mayor Eric Adams’ administration attributed to increased housing placements and an influx of asylum seekers with shorter stays overall. 

People end up “stuck” in shelter, Harris said: “I just don’t feel like anyone should be in a place like that for more than a year.”

Among those who do exit shelter, where they go is often a mystery: an “exit unknown” as it’s tagged in DHS’ data system, accounting for over half, or 55 percent, of households who left shelter during nine months City Limits analyzed. 

This group—which includes most single adults leaving shelter and about a quarter of families with children—is more likely to stay homeless than find housing, advocates say.

About 38 percent of exiting families with children secured permanent housing with a rental voucher, City Limits found, compared to just 9 percent of single adults. 

“The limited data provided by the administration illustrates how the shelter system is perpetuating the cycle of homelessness, rather than interrupting it,” said Councilmember Shahana Hanif, a sponsor of Local Law 79 that made this data available, in a statement to City Limits.

Amid a homelessness crisis where a record 150,000 people stayed in shelter in December 2023, according to City Limits’ estimates, data on exits highlights a system with an inadequate release valve. 

And even as the shelter population declines modestly, it remains largely unclear whether those exiting actually find housing, move to a shelter operated by another city agency, or end up doubled up, on the street or, eventually, back in DHS’s care. 

Advocates for the homeless are calling for more detailed data, and say additional support is needed for clients who move in, out of, and around the system.

Many entrants, few exits

How did we get here? For one thing, there simply isn’t enough affordable housing to go around.

Over the last several years, the number of households entering DHS shelters has far outpaced the number of people leaving shelter for housing, even as housing placements have increased—up 17 percent in Fiscal Year 2023, according to the Adams administration, and 16 percent in the first seven months of Fiscal Year 2024, through January. 

At a city budget hearing on May 6, Department of Social Services (DSS) Commissioner Molly Park touted this progress, which she attributed in part to new rental voucher policies, like reduced paperwork and statewide applicability for City Family Homelessness and Eviction Prevention Supplement, or CityFHEPS, vouchers. 

But Park also acknowledged the supply shortage. “It’s hard to find housing,” she said. 

The gap between entrances and exits has also grown with the arrival of tens of thousands of new immigrants to the city since 2022, more than 30,000 of whom were living in DHS shelters as of March. 

For a closer look at how New Yorkers are exiting shelter, City Limits examined exit data from DHS shelters only, where roughly two in three shelter residents live. The data does not include exits from specialized DHS programs like safe havens or stabilization beds. 

The city does not report data on exits for all New York City shelters, like the Humanitarian Emergency Response and Relief Centers (HERRCs) where additional tens of thousands of recently-arrived migrants are staying.

Accessing a housing voucher is the most common route from shelter to permanent housing—58 percent of exits to permanent homes were by way of vouchers in the period City Limits examined, primarily CityFHEPS, the city’s rental subsidy program. 

DHS says it is on pace to move 12,000 shelter households into apartments using CityFHEPS vouchers this fiscal year, up 20 percent from the year ending last June. In 2023, the Adams administration eliminated a policy that had required households to be in shelter for at least 90 days before becoming CityFHEPS-eligible.  

But City Hall has so far refused to implement a suite of laws that would eliminate the vouchers’ work requirements and broaden income eligibility, among other reforms. 

Discrimination against voucher holders is also a persistent issue. “There’s just a lack of affordable housing and landlords and brokers that are willing to accept these subsidies,” said Jina Park, senior vice president of families with children services at HELP USA. 

Measuring the unknown

In 2022, the City Council passed legislation requiring various agencies to overhaul how they report data on unhoused New Yorkers, including—with new granularity—how many exited shelter each month, by what means, and where they went. The data is published on a delay in a PDF on the city’s website that is overwritten monthly. 

Most households exiting shelters aren’t getting a voucher, or a placement in a supportive or public housing unit. Some who leave report staying with family and friends, finding housing on the private market without a voucher, or entering medical care. 

But overall, the city doesn’t know where the majority of people go when they leave the system: 56 percent of household exits were categorized “unknown” in reports published from May 2023 through March 2024, with data lags varying based on household composition. 

Single adults exited unknown 64 percent of the time during this 11-month period, far more often than families with children, who exited unknown 25 percent of the time. 

In written responses to City Limits’ questions, a DSS spokesperson emphasized that the agency has different approaches for single adults versus families with children. 

In particular, they seek to maintain lower barriers to entry for service-resistant single adults who may cycle in and out of shelter as staffers work to build trust, which may account for a high number of unknown exits in that population.

At the May 6 budget hearing, Park of DSS described adults in shelter as a more “transitory” population that tends to “come and go” from shelter and is not required to report where they are, in part out of respect for privacy. 

“If we placed somebody in permanent housing, particularly if it’s a subsidized permanent housing that we’re paying for, we do track that, and we know where they are,” she said. “But for people that make their own arrangements, that’s not data that we track on a regular basis.”

Those who exit “unknown” might double up with friends and family, switch to another shelter that DHS does not track, leave the city entirely, or end up on the street. But the gaps in the data make it hard to say for certain.

“There is a sizable number of people you just can’t really say. That remains an issue,” said Ashwin Parulkar, associate vice president of research at HELP USA who has been researching exits and movement within New York City shelters.

Shelter providers input data on clients who enter and exit in a city-run database, DHS CARES. But it was designed prior to passage of the Council law requiring more detailed data breakdowns and misses too much, Parulkar says, including movement within the system and more specific reasons for why people exit unknown. “The system is behind the mandate,” he said.

The responsibility of following up with and assisting clients after they exit shelter often falls to overtaxed shelter staff, who are trying to manage other cases and help place people in housing. 

“In addition to the work that they’re required to do, there’s a need to continuously follow up with these clients. It’s just sort of too much,” said HELP USA’s Park.

Migrants in shelter who either take the city up on its offer for a plane or bus ticket out of town, or—in the case of single adults and families without children—leave because of a shelter eviction notice, are included in the exit data as “other,” according to DSS, among other known exits that don’t fit in the listed categories.

The most common exit for families with children in City Limits’ review period was a housing voucher, accounting for about a third of those who left. But among families with children, unknown exits spiked in the latter half of 2023.

Experts say that rise can be attributed in part to the fact that many newly arrived migrants—over 29,000 of whom were living in DHS shelters as part of families with children as of March—must navigate obtaining asylum-seeking status and finding on-the-books work to be eligible for city housing programs.

“They’re in a really bad spot,” said Seth Frazier, supervising social worker at the Urban Justice Center’s Safety Net Project.

High mobility

Households only need to spend a certain number of weeks outside of a DHS shelter to be deemed “exited”—two months for single adults and one month for families—making it difficult to track how many people end up returning to shelter after those time frames.

But Parulkar of HELP USA believes those who exit unknown are more likely to bounce between shelters, the street, or other temporary housing situations. They may leave out of frustration, or because they find a given shelter too harsh of an environment. Missing curfew or otherwise failing to return to shelter can also mean losing a placement. (DSS emphasized that filling vacancies is important to maintain capacity and meet right to shelter requirements.)

Housing specialists, or staff that help shelter residents apply for housing, can also be hard to get in touch with, advocates say. “[Shelter residents] don’t feel like they’re getting the help they need for housing and so they just get up and leave,” said Safety Net Project’s Frazier.

Shuffling between shelters within the DHS system, as Harris did, can make consistent communication more difficult. 

“One of [the shelters] didn’t help me at all. And the other one just gave me paperwork and said you have to do it on your own, and they didn’t have a specialist,” she recalled. “And then when [the housing specialist] came in, she was right back out because she broke her foot or something. So it made it very difficult.”

DHS can transfer residents within its shelter network for a variety of reasons—if they need more intensive services, or if staff feel there are domestic violence, safety, or medical concerns—movement not reflected in the city’s exit data. A spokesperson for DSS said that transfers were particularly necessary for safety during the COVID-19 pandemic, and to manage shelter capacity during the migrant influx.

Harris was transferred on several occasions: when she returned to shelter from the hospital, when she got sick with an infectious disease, when she needed to move out of a traumatic situation, and when she needed to move to a facility that could better accommodate her medical needs.

While sometimes requested by residents, transfers can also be involuntary, and clients have limited recourse to challenge them and only 48 hours required notice. DSS emphasized that the city makes efforts to avoid interruption of services during transfers, for example by having caseworkers share some client information.

Still, moving shelters can be frustrating and time consuming. In addition to packing up one’s belongings, a person may have to fill out fresh paperwork and share personal information. (Even though single adults—unlike families with children—are spared repeating the full intake process.) 

Dinick Martinez moved shelters four times in two years before landing her current placement, a single room in a hotel shelter in Long Island City. “Just [moving to] a different shelter… you still have to do paperwork, 50 pages [of] paperwork,” Martinez told City Limits recently.

Adi Talwar

Dinick Martinez, pictured at Housing Works in Downtown Brooklyn, moved shelters four times in two years. Each move was a paperwork-filled process.

Towards a better system

More accurate and detailed exit data, and more support for street homeless New Yorkers, could help the city better understand mobility around the system and reduce shelter recidivism, experts say.

“It allows you to target the right type of service for the right subpopulation at the right time,” Parulkar said.

Borough-based offices within the city’s Homebase program are intended to help families avoid homelessness by accessing rental assistance and finding lawyers to fight eviction, among other resources. They also help tenants renew their rental subsidies, according to DSS.

But the volume of unknown shelter exits highlights the importance of improving support not just for those with apartments, but for hard-to-reach clients who leave shelter without a housing placement, advocates say. 

That could mean more street outreach. According to DSS’ Park, the Adams administration has doubled its outreach staff since taking office, to nearly 400. The city estimates that over 4,000 New Yorkers are street homeless as of January 2023. 

Advocates would also like to see more support for voucher holders while they are in shelter, as they hunt for apartments. As it stands, finding an apartment even with a voucher in hand can take tremendous persistence.

Harris, for example, was eventually able to secure a CityFHEPS voucher with the help of a housing specialist. But she didn’t get much help when it came to actually searching for an apartment to take her voucher.

Helping clients find housing is a specific skill set, said Jamie Powlovich, executive director at the Coalition for Homeless Youth. Funding for more staff to help with the housing search would help relieve overburdened shelter workers.

“Giving someone a piece of paper is a success, but it doesn’t always lead to the desired outcome because you need those wrap-around supports to ensure they can turn that piece of paper into a set of keys and actually move into an apartment,” she said.

After countless apartment viewings, calls, and follow-ups, Harris finally found her apartment in Williamsburg in February 2022.

“I got to the point where I got frustrated and I said, I’m not going to ask anybody [for help],” she recalled. “I’m just going to go out like I have a job everyday, and that’s what I did. I got up every day, got out and went purposely looking.”

Editing and additional reporting by Emma Whitford.

To reach the editor, email Emma@citylimits.org and Jeanmarie@citylimits.org.

Want to republish this story? Find City Limits’ reprint policy here.

Trump foe Cohen faces bruising cross-examination as top Republicans head to court with ex-president

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By MICHAEL R. SISAK, ERIC TUCKER, MICHELLE L. PRICE and COLLEEN LONG (Associated Press)

NEW YORK (AP) — Donald Trump’s fixer-turned-foe Michael Cohen awaits a bruising round of questioning from the former president’s lawyers on Tuesday after testimony that linked the celebrity client to all aspects of a hush money scheme that prosecutors say was aimed at stifling stories that threatened his 2016 campaign.

Trump, the first former U.S. president to go on trial, was being joined in the Manhattan courtroom Tuesday by an entourage of Republican supporters including House Speaker Mike Johnson, second in the line of succession to the president. Johnson was traveling with Trump in his motorcade along with North Dakota Gov. Doug Burgum, Florida Reps. Byron Donalds and Cory Mills and his former GOP rival Vivek Ramaswamy. Burgum and Donalds are considered potential vice presidential contenders.

Their presence Tuesday as Cohen, the prosecution’s star witness, returns to the stand is a not-so-subtle show of support meant not just for Trump but also for voters tuning in from home and for the jurors who are deciding Trump’s fate.

On Monday, Cohen delivered matter-of-fact testimony that went to the heart of the former president’s trial.

“Everything required Mr. Trump’s sign-off,” Cohen said.

He placed Trump at the center of the hush money scheme, saying he had promised to reimburse money the lawyer had fronted for the payments and was constantly apprised of the behind-the-scenes efforts to bury stories feared to be harmful to the campaign.

“We need to stop this from getting out,” Cohen quoted Trump as telling him in reference to porn actor Stormy Daniels’ account of a sexual encounter with Trump a decade earlier. The then-candidate was especially anxious about how the story would affect his standing with female voters.

A similar episode occurred when Cohen alerted Trump that a Playboy model was alleging that she and Trump had an extramarital affair. “Make sure it doesn’t get released,” was Cohen’s message to Trump, the lawyer said. The woman, Karen McDougal, was paid $150,000 in an arrangement that was made after Trump received a “complete and total update on everything that transpired.”

“What I was doing, I was doing at the direction of and benefit of Mr. Trump,” Cohen testified.

Trump has pleaded not guilty and has denied both sexual encounters.

Cohen is by far the prosecution’s most important witness, and though his testimony lacked the electricity that defined Daniels’ turn on the stand, he nonetheless linked Trump directly to the payments and helped illuminate some of the drier evidence such as text messages and phone logs that jurors had already seen.

The testimony of a witness with such intimate knowledge of Trump’s activities could heighten the legal exposure of the presumptive Republican presidential nominee if jurors deem him sufficiently credible. But prosecutors’ reliance on a witness with such a checkered past — Cohen pleaded guilty to federal charges related to the payments — also carries sizable risks with a jury and could be a boon to Trump politically as he fundraises off his legal woes and paints the case as the product of a tainted criminal justice system.

The men, once so close that Cohen boasted that he would “take a bullet” for Trump, had no visible interaction inside the courtroom. The sedate atmosphere was a marked contrast from their last courtroom faceoff in October, when Trump walked out of the courtroom after his lawyer finished questioning Cohen during his civil fraud trial.

This time around, Trump sat at the defense table with his eyes closed for long stretches of testimony as Cohen recounted his decade-long career as a senior Trump Organization executive, doing work that by his own admission sometimes involved lying and bullying others on his boss’s behalf.

Trump’s lawyers will get their chance to begin questioning Cohen as early as Tuesday, where they’re expected to attack his credibility — he was disbarred, went to prison and separately pleaded guilty to lying about a Moscow real estate project on Trump’s behalf — and cast him as a vindictive, agenda-driven witness. The defense told jurors during opening statements that he’s an “admitted liar” with an “obsession to get President Trump.”

Prosecutors aim to blunt those attacks by acknowledging Cohen’s past crimes to jurors and by relying on other witnesses whose accounts, they hope, will buttress his testimony.

Jurors had previously heard from others about the tabloid industry practice of “catch-and-kill,” in which rights to a story are purchased so that it can then be quashed. But Cohen’s testimony is crucial to prosecutors because of his direct communication with the then-candidate about embarrassing stories he was scrambling to suppress.

Cohen also matters because the reimbursements he received from a $130,000 hush money payment to Daniels, which prosecutors say was meant to buy her silence in advance of the election, form the basis of 34 felony counts charging Trump with falsifying business records. Prosecutors say the reimbursements were logged, falsely, as legal expenses to conceal the payments’ true purpose.

To establish Trump’s intimate familiarity with the payments, Cohen told jurors under questioning that Trump had promised to reimburse him. The two men even discussed with Allen Weisselberg, a former Trump Organization chief financial officer, how the reimbursements would be paid as legal services over monthly installments, Cohen testified.

He said Trump even sought to delay finalizing the Daniels transaction until after Election Day so he wouldn’t have to pay her.

“Because,” Cohen testified, “after the election it wouldn’t matter” to Trump.

Cohen also gave jurors an insider account of his negotiations with David Pecker, the then-publisher of the National Enquirer, who was such a close Trump ally that Pecker told Cohen his publication maintained a “file drawer or a locked drawer” where files related to Trump were kept. That effort took on added urgency following the October 2016 disclosure of an “Access Hollywood” recording in which Trump was heard boasting about grabbing women sexually.

The Daniels payment was finalized several weeks after that revelation, but Monday’s testimony also centered on a deal earlier that fall with McDougal.

To lay the foundation that the deals were done with Trump’s endorsement, prosecutors elicited testimony from Cohen designed to show Trump as a hands-on manager. Acting on Trump’s behalf, Cohen said, he sometimes lied and bullied others, including reporters.

“When he would task you with something, he would then say, ‘Keep me informed. Let me know what’s going on,’” Cohen testified. He said that was especially true “if there was a matter that was troubling to him.”

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PWHL Minnesota beats Toronto 2-0 to extend playoff series

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There will be hockey on Wednesday night at Xcel Energy Center.

Minnesota stayed alive in the Professional Women’s Hockey League playoffs on Monday at Xcel with a 2-0 win over Toronto.

Toronto leads the best-of-five series 2-1. A Minnesota win on Wednesday would send the series back to Toronto for a deciding Game 5.

Minnesota goaltender Maddie Rooney, making her second straight start after a standout performance in Game 2, made 18 saves to earn the shutout.

After it was shut out in the first two games, Minnesota finally found some offense.

Maggie Flaherty scored Minnesota’s first goal of the postseason early in the second period to give the home team a 1-0 lead. Flaherty beat Toronto goaltender Kristen Campbell on a wrist shot from the top of the right-wing circle with Denisa Krizova providing a screen in front. Krizova followed with a goal of her own just over six minutes later.

The game featured tight checking from the opening faceoff.

Minnesota had the only two shots on goal through the first 10 minutes of play. Minnesota got the game’s first power play at 11:28 of the first period but came up empty despite some good pressure.

Minnesota got another opportunity at 14:26 of the period when Toronto’s Kali Flanagan was sent off for tripping. But Toronto ended up with the best scoring chance while short-handed, with Rooney making a left pad save on Blayre Turnbull from in tight.

Minnesota outshot Toronto 11-2 in a scoreless first period.

Flaherty’s goal, at 2:12 of the second period, came after an aggressive start to the period by Toronto. A rare miscue by Campbell helped give Minnesota a 2-0 lead at 8:39 of the period.

Campbell made an easy stop on a long shot but was unable to control the rebound. The puck was free at her skates when Krizova was there to poke it in.

Trailing 2-0 after two periods, Toronto got its first power play of the game at 4:04 of the third period. Rooney was called on to make one big stop late in the power play, with the crowd responding by chanting her last name.

Toronto went back on the power play at 15:04 when Sophia Kunin was sent off for tripping.

Minnesota killed off the penalty without much trouble.

Taylor Heise appeared to have added an empty-net goal at 18:09, but a whistle blew the play dead on a delayed offside.

Briefly

The PWHL will begin announcing its award winners on Tuesday with naming of the rookie of the year. The winner of the coach of the year award will be announced on Wednesday, followed by the forward of the year.

Defender of the year, goaltender of the year and the Billie Jean King Most Valuable Player will be announced next week.

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