How Freedomland Became A ‘Health Care’ Center

My parents were in their early 40s in 1969, the year we moved to the massive Co-op City housing development in the Bronx. My brother and I were preteens.

When it was completed a few years later, Co-op City had more than 15,000 apartments, most of them in high-rises scattered across 300 formerly swampy acres that had once been the Freedomland amusement park. Within a few years, the community’s schools and shopping centers appeared. Most of Co-op City’s occupants were working-class laborers and civil servants, drawn mostly from elsewhere in the borough. Direct and indirect subsidies made their new apartments affordable.

My brother and I both left for college within a decade. Our parents stayed until 1990, when they retired, departed for the suburbs of central New Jersey and rebuilt their lives around the activities of the local senior citizens’ center. But many of their peers stayed in Co-op City, and quite a few of the kids my brother and I grew up with ended up staying with their parents, or inheriting apartments when their parents died.

For thousands of people like my parents, Co-op City became a “naturally occurring retirement community,” also known as a NORC. The survivors of their generation who have stayed put, now advanced far into old age, have had the benefit of family, friends, familiar neighborhood institutions and a host of social services to sustain them. The phenomenon of this open-air retirement home that came into being quite by accident has been apparent for more than a decade. The New York Times wrote about it as far back as 2002. (1)

In New York, Medicaid pays for a lot of the services these people need. To the extent that Medicaid is a low-income health care program, this is not necessarily surprising. Yet what makes New York’s situation different is that Medicaid often covers even those services that don’t have much to do with health care as most people understand it. In literature about the “Health Homes” initiative, introduced in 2012, the state’s Medicaid administrators described the function of a “care manager,” an individual who coordinates those seeing to an individual’s medical, behavioral health and social service needs. The theory is that by making sure people can live independently in their own homes, Medicaid saves money on hospital costs, ambulance rides, repetitive doctor visits and, most of all, nursing home care.

The same thing is happening in the mental health arena. Several years ago, New York expanded Medicaid coverage to provide housing for individuals with mental illness. In addition to the Health Homes program, New York also offers “supportive” housing that combines subsidized housing with a host of services, including medical, but also legal, career and educational, among others. Keep people off the streets and make sure they take their meds and get regular meals, the theory goes, and you’ll ultimately save money on emergency room and other acute-care costs.

Brenda Rosen, the director of the organization Common Ground, which runs a supportive housing building called The Brook, told NPR, “You know, we as a society are paying for somebody to be on the streets.” (2) And the outgoing New York State commissioner of health published an article in December 2013 arguing that housing and support services are integral to health, so Medicaid should help support the costs.

The state may be on board, but the arguments in favor of these programs haven’t made much headway with the federal government, which normally shares Medicaid expenses with the states. The feds won’t pay for these housing services, on the grounds that housing is not health care. Bruce Vladeck, who formerly administered the federal Medicaid (and Medicare) programs, said, “Medicaid is supposed to be health insurance, and not every problem somebody has is a health care problem.” (2)

That’s true. Not all care that leads to better health is health care. Good nutrition, having the time and place to get a full night’s sleep, and access to clean air and water are all essential for health, but we do not expect health insurance to pay for these things. Providing housing to people who need it is what we used to call social work, and most people don’t view social workers as health care providers.

But it is easier to gain political support for providing health care – with its image of flashing ambulance lights and skilled professionals dressed in white – than for subsidized housing for the aging or the disabled, especially the mentally disabled. So it is easier for Gov. Andrew Cuomo’s administration to organize these services under the label of Medicaid Health Homes. They are not homes at all in any traditional sense. Care managers are typically not doctors or nurses, but they are trained in social services or health care administration. Health Homes is a potentially worthwhile initiative that comes with clever, voter-ready branding.

The approach itself is not nearly as novel as the marketing. We have known for decades that good community support, including safe housing and close supervision for people who need it, is a lot less expensive than parking people in hospitals, nursing homes and other institutions. As New York State Medicaid Director Jason Helgerson pointed out when arguing in favor

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5 Ways To Monetize Your Blog

A well-run blog can help you:

Improve SEO ranking (Google loves fresh content)
Drive traffic to your website (e.g. you can promote your fresh content on social media so you are not a one-trick pony)
Boost your expert status with high-value and relevant content (people pay more for experts)
BUT, if you don’t have a content marketing strategy to maximize the revenue-generating potential of your blog, you are just typing and hoping for the best.

Here are 5 easy ways you can start to use your blog posts to generate income for you right away:

1. Drive Traffic, Grow Your List

After you labor over a blog post, make sure you share it with the world! Sharing the link to your post will drive traffic to your website, and if your readers like what they see, they are likely to look around.

You can also use this as an opportunity to grow your list. At the end of each blog post, add your newsletter sign up form and ASK your readers to subscribe to your newsletter to get more of such great content. (Scroll all the way down to see this tip in action). If you use WordPress, there is a widget call “After Post” – you just have to set it up once and the sign up form will appear at the bottom of each blog post.

You probably have heard, “money is in the list” – building a loyal, high-quality list is one of the best ways to ensure consistent income and sure-fire launches.

2. Promote Your Evergreen Products/Programs/Services

If you have set a good foundation for your business, you would have your products, programs and services mapped to your sales funnel and showcase your expertise, which is created based on a business model that reflects your dream biz/life.

As your content should evolve around your expertise, it would not be a stretch at all to link a certain topic to your offerings.

Here is the formula: Targeted Traffic + Irresistible Offering = Juicy Payday

3. “Drip Content”: Launch a Product/Program/Service

When you write a series of blog posts on a specific topic leading up to a launch of a product, program or service that goes deep into that topic, you are dripping content to draw potential clients who are interested in that topic into your circle. You are positioning yourself as the expert in that area and you are also building up anticipation for unveiling something awesome. This tactic can increase the success of your launch.

4. Affiliate Marketing

If you are an affiliate of any product or program, you can write a blog post on that topic or a review on that particular product, with an affiliate link so your readers can purchase and you can be paid affiliate commission.

You should pay special care while selecting programs and products. They should be truly of value to your readers, as they are putting their trust in you.

5. Guest Blog + Affiliate Link

To take using affiliate link one step further, you can invite experts who share your target market but offer slightly different services to guest post on your blog. You can set up a guideline such that if they want to include a link to a specific product or program, they need to provide an affiliate link.

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