Good morning.

Welcome to the New York City Council hearing for the committee on hospitals, hospitals and disabilities.

Please sign.

If you wish to testify today, please fill on appearance card with the sergeant at arm.

Without further ado, cheers, we are ready to begin.

Good morning, everyone.

I'm Councilmember Shahana Haney, Chair of the Committee on Disabilities.

I'm a brown woman in my mid-30s, and my hair is tied up.

Today I'm wearing black glasses and a white button-down, and I'm seated behind a dais.

Welcome to this joint oversight hearing with the Committee on Disabilities, Health and Hospitals on Access to Reproductive Care for New Yorkers with Disabilities.

We are also hearing a package of legislation, which I will describe shortly.

Nearly one in six New Yorkers lives with a disability.

People with disabilities are sexually active at rates comparable to people without disabilities, and yet they are less likely to receive preventive reproductive health services and comprehensive sexual health education, and they experience higher rates of unintended pregnancy, pregnancy complications, and intimate partner violence during the perenatal period.

These are not differences in choices, they are differences in access.

The consequences are measurable and they are severe.

In a study of more than 223,000 deliveries across 19 hospitals nationwide, researchers at the National Institutes of Health found that compared with women without disabilities, women with disabilities were more than twice as likely to develop severe preeclempsia, more than six times as likely to experience thrombo embolism, and 11 times as likely to die.

Pregnancy should not carry those odds for any New Yorker because of a disability.

Some of the barriers behind those numbers are physical.

Nationally, only about 40% of medical offices have an accessible examination table and a wheelchair accessible weight scale.

When the equipment doesn't adjust, patients with mobility disabilities are examined in their wheelchairs or not fully examined at all.

Some of the barriers are about training.

In one survey, only about 17% of obstetrician gynecologists reported having received training on caring for patients with disabilities.

And in a separate survey of practicing physicians, only 41% felt confident they could provide the same quality of care to a patient with a disability as to a patient without one.

The city has taken real steps, and the agencies in this room deserve recognition for them.

The mayor's office for people with disabilities serves as the city's central disability compliance authority and has delivered health equity trainings to medical residents and convened health care leaders specifically on barriers facing women with disabilities.

New York City Health and Hospitals reports that 15 of its Gotham Health Clinics are fully ADA accessible.

Seven offer additional accommodations for patients who are blind, deaf, or hard of hearing, and its Morrisania site houses a fully accessible radiology suite, an $850,000 project built with city council capital funding.

The Department of Health and Mental Hygiene operates eight sexual health clinics, provides medication abortion at four of them, and provided abortion care to 1,253 patients in 2025.

A 24% increase over the prior year.

Its abortion access hub has served more than 12,000 people since November 2022, including callers from states where abortion is banned or restricted.

This work matters.

But now we must contend with federal Medicaid cuts, which are projected to eliminate coverage for an estimated 1.5 million New Yorkers and to cost roughly 34,000 hospital jobs statewide.

And the state controller has warned that the harm will be most acute at the safety net hospitals in New York City.

NYC Health and Hospitals is the nation's largest public health system and the primary safety net provider for low-income and Medicaid-dependent New Yorkers.

And New Yorkers with disabilities rely on that system disproportionately.

When the safety net is weakened, they are among the first to feel it.

There's also a federal deadline bearing down on the city's own facilities under a 2024 rule by August 9th, 2026, less than two months from today, state and local government entities that use examination tables and weight skills must have at least one accessible example of each that meets enforceable federal standards.

That deadline applies directly to city-operated health facilities, including health and hospitals and DOHMH's sexual health clinics.

And we cannot talk about reproductive access for people with disabilities without addressing the history of reproductive control exercised over them.

From a documented history of coerced sterilization to present day questions about guardianship, informed consent, and decision-making authority.

People with disabilities continue to experience higher rates of sterilization than people without.

So today we are asking straightforward questions.

With the August 9th federal deadline almost here, are the city's own health facilities equipped with accessible diagnostic equipment?

And where are the remaining gaps?

DOHMH, HH, and MOPD have acknowledged in their own accessibility planning barriers around inaccessible exam space, equipment, and communication.

Are these agencies coordinating to close them?

And on what timeline?

What disability-specific clinical training are providers in the city's reproductive and sexual health settings actually receiving and how is it being measured?

Are the sexual health clinics and the abortion access hub reaching New Yorkers with intellectual, developmental, sensory, and psychiatric disabilities?

As federal Medicaid cuts move through the safety net system, these New Yorkers depend on what is the city's plan to protect their access to reproductive and sexual health care.

We are also hearing legislation today, and we look forward to the administration's and the public's feedback on it.

Intro number 200, sponsored by Councilmember Jennifer Gutierrez in relation to creating resources for doulas.

Intro 211, sponsored by myself in relation to requiring the Department of Health and Mental Hygiene to provide information regarding fertility treatment, including insurance coverage of fertility treatment.

Intro 840, sponsored by Councilmember Kayla Santo Suoso in relation to requiring health insurance coverage for pre-implantation testing for city employees.

Intro 941, sponsored by Councilmember Linda Lee in relation to requiring the Department of Health and Mental Hygiene to develop and offer resources, clinical guidance and training on disability and accessibility in healthcare settings.

An intro 953, sponsored by Deputy Speaker, Dr.

Nantasha Williams, in relation to requiring the Department of Health and Mental Hygiene to make medication abortion available at no cost to a patient at all of its sexual health clinics.

We are also considering proposed resolution 89A, sponsored by Councilmember Gutierrez, calling on the New York State Assembly to pass A9175 and the governor to sign S2058 A9175 legislation to require each institution within the state university of New York and the City University of New York to have at least one vending machine making emergency contraception available for purchase.

Proposed Reso 108A, sponsored by Councilmember Frank Morano, calling on the New York State Legislature to pass and the governor to sign S5262A3051 legislation creating a refundable tax credit for up to three cycles of in vitro fertilization not covered by insurance.

And RESO 447, sponsored by Councilmember Santosuoso, calling on the New York State legislature to introduce and pass and the governor to sign legislation to ensure insurance companies cover the cost of pre-implementation genetic testing for Anuploys.