[THEME MUSIC] >> 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 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 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.

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.

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 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 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 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 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, 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 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.

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 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.

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 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 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 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 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 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 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 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 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: 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 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 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 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 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 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 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 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 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 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 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 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.

>> 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.

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 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.

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 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 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 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 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.

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 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 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 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 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 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 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.

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 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 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 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 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 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, 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 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 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, 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 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 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 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 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 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 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 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.

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?

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 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 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 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.

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 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.

>> 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 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 ] >> FUNDING FOR NEW YORK NOW IS PROVIDED BY WNET.