BACKGROUND

Since September 11th, rebuilding and recovery discussions have focused almost exclusively on the physical rebuilding of the World Trade Center (WTC) site, on emergency services, and on management initiatives to retain businesses and jobs. Because New Yorkers who live, work and raise their children here have not had the opportunity to weigh-in on redirect the City’s priorities for urban revival or on issues that affect their everyday lives, on June 25th, 2002, Citizens’ Committee for Children of New York, Inc. (CCC) and the Children’s Defense Fund-NY (CDF-NY) sponsored a hearing enti- tled Lessons Learned from 9/11: Helping Children and Families. At the hearing, New Yorkers gave and heard testimony to better understand how the City’s non- profit, government and private sectors responded to the events of 9/11 and how the lessons learned from these experiences can be applied to improving the on-going organization and management of services needed by New York City children, youth and families. Most important, it provided an opportunity for New Yorkers to present community needs, personal concerns and per- spectives to policymakers so that these experiences are considered in public and private efforts to plan and rebuild New York City.

This hearing is part of a comprehensive community involvement and education initiative undertaken by CCC and CDF-NY, with support from the W.K. Kellogg Foundation, that seeks to understand the needs of New York City children, youth and families who rely on the City’s health and human services infrastructure. Recommendations for addressing their needs were suggested at the hearing, and will be fully addressed at a conference called Lessons Learned from 9/11: Helping Children and Families, One Year Later on September 27, 2002.

CHILDREN’S MENTAL HEALTH

Before September 11th, 9-13% of all children were estimated to have a mental illness that substantially impaired their functioning and 5-9% of children to have a mental illness that caused severe functional impair- ment. After September 11th, the prevalence of diagnosable mental health disorders in children in New York City climbed even higher. A survey commissioned by the New York City Board of Education estimated that 190,000 fourth through twelfth grade public school stu- dents in New York City had diagnosable trauma-related mental health problems six months after the attack on the World Trade Center and only one third of those meeting diagnostic criteria for Posttraumatic Stress Disorder had received any kind of mental health service.1 Although federal funding supported the provision of crisis counseling for affected New Yorkers, the avail- ability of longer-term mental health treatment services has not increased. Pre-existing gaps in the children’s services infrastructure including over-subscribed outpa- tient treatment clinics and a reliance on traditional approaches to care, block the road to recovery for thou- sands of New York City children.

DISASTER RELIEF MEDICAID

Prior to September 11th, 1.7 million people in New York City did not have health insurance, and about half of these people were eligible for some kind of publicly supported health insurance program. As a result of com- puter shutdowns after 9/11, the City instituted Disaster Relief Medicaid (DRM) which streamlined the tradition- ally lengthy Medicaid application process and allowed eligible individuals to receive immediate coverage at, or within a day of, the time of application. The response to this facilitated enrollment process was enormous, with 340,000 people enrolling into DRM in just four and a half months, about ten times the regular rate of enroll- ment. Many of the new enrollees who received health care were treated for conditions that were in advanced stages because they had gone without treatment for so long. Despite the benefits of this new enrollment system policymakers have not agreed to make it permanent.

CHILD CARE

The demand for quality, affordable child care far exceeded the supply prior to the events of September 11th, and in its aftermath, the need for child care continues to present a challenge for families who live, work and raise their children in New York City. Over 100,000 eligible children age 0-5 years are without child care opportunities and the need for care continues to grow. After September 11th, the City and State recognized that families needed emergency child care and began an initiative to provide it in an expedited way to 1,500 families so they could get back to work. The State expanded child care capacity and eligibility in the “Liberty Zone” – for those affected by 9/11 and statewide, allocated funds to provide child care to 9,400 more children. The City also added $24 million to its Fiscal Year 2003 budget for an additional 3,000 new child care opportunities for children. Despite this progress and the important recognition by policymakers that families need quality childcare in order to work, significant resources are still needed to ensure that all eligible families receive a child care sub- sidy. Additionally, 9/11 brought to light the importance of having qualified staff available to child care programs, in order to guide parents and young children through difficult financial and emotional periods.

AFTERSCHOOL AND YOUTH SERVICES

New York City’s 1,700 youth development programs are extremely important to the young people and fami- lies they serve. Because these community-based programs provide afterschool, leadership development and academic help to young people and are a trusted resource in the community, they became even more important during and after September 11th. A recent survey by the Partnership for After School Education (PASE) found that many youth programs became safe havens for young people, offering a place to creatively explore their emotions and reactions to the tragedy.2 Youth also identified several areas where they would like additional support and services, including cultural diver- sity and conflict resolution training, opportunities to give back to their communities through service and employment programs.

INCOME SUPPORT

The World Trade Center attack exacerbated the City’s recession, resulting in over 110,000 jobs lost, attribut- able directly to the event. The response to the financial impact of 9/11 included rapid and unprecedented levels of public and private support, characterized by flexibility to meet pressing needs. Emergency Cash Assistance and federally-funded Disaster Food Stamps became vital measures for stabilizing economically affected persons and families. Community-based organizations played a critical role in assisting families to access these benefits and in brokering relationships between relief agencies and affected communities. These efforts demonstrated that it is possible to distribute benefits in an expedited manner and in a respectful and supportive environment. However, most of these initiatives were temporary, and the City and federal governments have returned to traditional eligibility and enrollment processes that leave the needs of many poor New Yorkers unmet as they attempt to rebuild their lives in an ailing economy.

CONCLUSIONS

On June 25th New Yorkers who live, work and raise their children here came together to articulate the needs of children, youth, families and communities post 9/11, to weigh-in on policy choices and to interact with poli- cymakers. The hearing illuminated that New Yorkers’ needs increased dramatically after 9/11 and because of an outpouring of good intentions and support from gov- ernment and philanthropic organizations, help got to many, expeditiously. However, for too many others, limited or no access to child care, need for health and mental health services, income support and youth serv- ices continues, unabated. For many, a return to former methods of service delivery has left them without access to essential services. It is against this backdrop of need juxtaposed to experiences and lessons learned in the wake of disaster that New Yorkers urged government leaders and policymakers to continue initiatives put in place after 9/11, to help children, youth and families.