Opening doors

It was a “monumental achievement” resulting from a full ten years of effort, wrote Hamaspik Executive Director Meyer Wertheimer in his customary congratulatory in-house e-mail.

That’s how word came on Thursday, January 6 that NYSHA had passed its critical Article 16 pre-operating survey—opening a long-closed door for direly-needed community services for a direly needy community.

“Now, as we triumph on behalf of our precious consumers,” continued the Director, “we thank the best of the best of Hamaspik staff for their amazing work all the years.” He went on to laud Hamaspik of Rockland County Director of Operations Yoel Bernath, Hamaspik of Kings County Executive Director Joel Freund and Hamaspik of Kings County MSC Supervisor Shloime Reichman, now promoted to Hamaspik’s first-ever Clinic Director.

“Hamaspik didn’t need an Article 16,” Wertheimer tells the Gazette. “The community it serves needed it.”

According to Mr. Wertheimer, the absence of an Article 16 clinic in Williamsburg created “a gap in service,” causing the state to spend more to care for special-needs individuals instead of providing the clinic’s more economical offerings.

“It caused the state and the system to spend lots of money without reaching the goal expeditiously,” says Wertheimer. “In order to provide expedited service, you need to provide bilingual and culturally competent service, especially speech therapy. There was a big gap and there still is, which this will fill eventually.”

Special needs, special laws

An Article 16 clinic gets its moniker from Article 16 of the New York State Mental Hygiene Law, which authorizes the Commissioner of the Office for People With Developmental Disabilities, or OPWDD, to open clinics that exclusively service individuals with intellectual disabilities or developmental delays. (Other clinics operate under other state laws: general medical clinics under Article 28 of the Public Health Law and mental health clinics under Article 31 of the Mental Hygiene Law.)

Article 16s can serve their beneficiary communities with a variety of health and human services, including medical and dental treatment, psychological counseling and psychiatry, social work, and the trio of common therapies: occupational, physical and speech. The clinics can also provide nursing services and even dieting education.

Based on its stated community needs, NYSHA’s new Article 16 clinic has been approved for eight specific services: nursing, nutrition, occupational therapy, physical therapy, psychiatry, psychology, social work and speech therapy.

Asked for the difference between those services as rendered regularly or via Article 16, Reichman reiterates the clinics’ exclusive special-needs mission. Special-needs individuals need more attention, he explains. “This is why they created Article 16s.”

On home turf

Besides serving a distinct community of intellectually and developmentally disabled individuals right in their community, the new facility will become the first-ever Article 16 clinic in that community—the Orthodox Jewish neighborhood of Williamsburg, Brooklyn served faithfully by Hamaspik—according to current OPWDD data.

But besides that, the Article 16 clinic is authorized to serve that demographic in another way: by sending caregivers to consumers.

These “non-traditional services,” provided off-site after hours by the professional staff of an Article 16 clinic, are “the real difference” between Article 16 and standard services, continues Reichman. “We can send a therapist into someone’s home as long as it’s justified.”

Justification for Article 16-provided services, whether on or off site, springs from consumers’ diagnosed needs followed by approval by each clinic’s Medical Director.

Unique community, unique needs

“We had a huge list of people not getting services,” says Reichman. “Technically, it’s a waiting list.”

But it was that “waiting list” that was successfully parlayed into a state-sanctioned Certificate of Need—proving the needs of a distinct demographic within a distinct demographic, giving a reticent community access to services from a trusted public-services interface.

Interior construction and renovation at the Division Avenue center converted a spacious basement into state-of-the-art offices for the new clinic, offices and all, and the Article 16 shortly opened in early February.

A Medical Director in the form of Beth Israel ER physician Abraham Berger, M.D. was hired, and other staffers including a Treatment Coordinator and the licensed clinicians required for the provision of each offered service, were likewise brought on board.

Reichman describes the current operations: a waiting room stocked with culturally attuned reading materials, patients seeing same-gender clinicians per community values on alternating days, and caregivers largely conversant in consumers’ native Yiddish.

In due time, the clinic will also see action not just within its own doors but beyond those throughout the neighborhood, with trained therapists tending to special-needs tots in their living rooms and social workers supporting strained and struggling special-needs families in the comfort of their own homes.

“The need was always there,” says Reichman of his new command. “The most important thing is just to service the people who are not getting anything.”

Joel Freund, who is also the Executive Director of NYSHA, believes the community will be excited about it simply because the clinic will be the neighborhood’s first. “We’ll be able to offer all the therapies, evaluations and services that haven’t been available in our area,” Freund tells the Gazette. “They weren’t able to get it until now. Now they’ll be able to get it locally.”

In a community renowned for its self-supporting socioeconomic infrastructure, where homes, stores, schools and synagogues are all within walking distance of each other, another piece of the communal puzzle has just fallen into place.