City of New York’s Cabinet for Older New Yorkers is a Model for Age-Inclusive Policy Design and Implementation

Abstract

The global population is aging with adults living longer and declining birth rates creating major implications for policy and infrastructure. The City of New York is cultivating an “Age-Inclusive” model that considers the needs of older adults today while laying the groundwork for tomorrow. Focused on cross-agency collaboration that approaches problem solving and design through the multi-dimensionality of every-day life, New York City Mayor Eric Adams introduced the Cabinet for Older New Yorkers (“Cabinet”) as a novel approach to imagining, designing and implementing policy, structural and systemic changes. Dozens of reforms have been developed and rolled out through the Cabinet, impacting the lives of thousands of New Yorkers across generations. The Cabinet is a model for policy design that can be replicated across cities and issue areas.

Keywords

Age-Inclusive aging policy Cabinet design

Introduction

The City of New York is designing and establishing policy for an “Age-Inclusive” city through a cross-discipline Cabinet for Older New Yorkers (“Cabinet”) (City of New York Cabinet for Older New Yorkers, 2024) that has cultivated innovation, collaborative design, and rapid implementation. This paper explores the Cabinet’s approach to policy formulation and implementation through structural design and illustrative examples. The Cabinet serves as a model for cities cultivating Age-Inclusive agendas and as a model for cross-agency discourse that can be applied across strategic priorities.

Background

We are in the throes of a “silver dawning!” People are living longer and birth rates are on the decline. In New York City, the older adult population surpassed school age children in 2010, and with every subsequent year the gap has been widening (NYC Aging 2023). Today, older adults account for nearly (20%) of New York City’s population, with school-age children numbering approximately (15%) (NYC Aging 2023). This trend is visible nationally and globally. By 2030, the World Health Organization (WHO) estimates that 16.67% of the population will be aged 60 years or older (World Health Organization 2022).

The current standard for addressing the global aging population is WHO’s “Age-friendly Cities and Communities.” Age-friendly has primarily centered on physical structures and cultivating accessibility for people 60 years and older. However, for cities to be ready for a silver future, it is critical to reconsider and reimagine the underlying architecture, networks and infrastructure that create the foundation for municipal readiness and sustainability (NYC Aging 2021).

In 2022, New York City Mayor Eric Adams introduced the New York City Cabinet for Older New Yorkers (City of New York Cabinet for Older New Yorkers, 2024) where city agency leadership comes together to collaborate on the vision, design and cultivation of an Age-Inclusive city. The Cabinet includes more than 20 New York City government agencies from transportation to health, small business services to youth services and public safety to housing—and sectors in between. The Department for the Aging (“NYC Aging”), which supports nearly 2 million older New Yorkers every year, is a participant in the Cabinet work and also responsible for Cabinet operations. Policymakers, researchers, service providers and administration leadership partner to develop, implement and secure an Age-Inclusive New York City through structural, legislative, and systemic solutions. Conversation and information sharing is paired with collective planning and action, as the Cabinet is motivated to “get stuff done” and break through agency silos to realize a cohesive vision.

The Cabinet has received national and international attention for its cross-discipline approach to Age-Inclusive policy design, innovation and impact (Coen 2023; Cullen 2023; Pisani 2023). Nationally, the U.S. Conference of Mayors adopted a resolution that “strongly supports that cities promote and adopt Age-Inclusive approaches to local policy, practices and programs . . .” (The United States Conference of Mayors 2023.)

Internationally, the City of Dublin, Ireland signed a pact with New York City to share best practices in Age-Inclusive policy and planning (Global Coalition on Aging 2023).

Results

With a solution-oriented outlook and shared vision, the Cabinet is driven by results and focused on meaningful and sustainable impact. The Cabinet rolled out an expansive set of policies, programs and accomplishments in the first sixteen months, all grounded in cultivating an Age-Inclusive city. Highlights include:

An elder abuse and elder justice referral training, designed by the New York City Police Department (NYPD) and NYC Aging that has reached nearly 20,300 NYPD personnel and connected more than 6,600 older New Yorkers with victim services and support.

Development of an anti-ageism resource guide for New York City public schools. Designed by the Department of Education with support from NYC Aging, the guide is customized and implemented by teachers. More than 1,500 high school students were engaged in the first year; empowered to be change agents in their communities.

Informed by research and community input, The NYC Department of Health, Health + Hospitals and NYC Aging created a training for healthcare and frontline professionals about free community-based resources for older New Yorkers and caregivers. More than 500 professionals have been trained with many more expected through a train-the-trainer model.

Networks for community leadership, problem solving and intergenerational cooperation were established at ten New York City Housing Authority (NYCHA) communities through a partnership with NYC Department of Youth and Community Development and community based older adult centers. More than 100 residents participated in the first year.

Outreach and engagement programs were designed by NYC Office of Technology and Innovation, NYC Commission on Human Rights and Senior Community Service Employment Program to more effectively support older adults with resources, provide information about anti-discrimination rights and offer free tax preparation.

Joint workshops were developed and led by NYCHA and NYPD to increase safety and support for older adult NYCHA residents.

Expanded partnership between New York City Human Resources Administration and NYC Aging to reach new clients for public benefits (e.g., Supplemental Nutrition Assistance Program (SNAP) and Senior Citizen Rent Increase Exemption (SCRIE)) and Adult Protective Services).

Foundation for Success

Three key components create the foundation for the Cabinet’s success and ultimately drive meaningful results: (i) Broad Stakeholder Engagement, (ii) Facilitation and Project Management, and (iii) Structured Collaborative Design. Each of these areas is explored more deeply below in a roadmap for policy design and implementation through inter-agency and cross-discipline collaboration.

Broad Stakeholder Engagement

With life so multi-dimensional, it is important to spend time up front analyzing policy goals through an environmental scan to identify stakeholders whose input should be considered. Specifically, which sectors does your vision touch? Who are the leaders in those industries? Who will be champions of the work? Who may be naysayers? Who/what institution is part of the approval and implementation process? Who is at the center of impact? Will the policy disrupt existing practices and structures? This effort will illuminate who needs to be in the conversation to ensure thoroughly and thoughtfully designed policies, effective implementation strategies and buy-in for adoption and sustainability.

For the Cabinet, it was clear upfront that this Age-Inclusive initiative required engagement across New York City government agencies; it could not be the work of NYC Aging alone. All residents, including older New Yorkers, are touched and impacted by multiple aspects of City government—from transportation to health services, from housing to public safety and so on. To respond to the present and build a foundation for a future with more older adults than school age children, input from experts across sectors is imperative. Initially, the Cabinet launched with approximately 20 City agencies. Over time, enthusiasm for the work and Cabinet interagency engagement brought more agencies to the table, committed to collectively identifying solutions to challenges facing older New Yorkers. Today, there are about two dozen agencies working together to build an Age-Inclusive New York City.

With so many city agencies involved and ambitious goals, including legislative initiatives and policy reform, it is crucial to have accountable leadership and a strong connecting thread. In the Cabinet, that starts with deputy mayors, who report directly to the mayor, and to whom agency commissioners report. The City of New York’s First Deputy Mayor and five deputy mayors are briefed on the work of the Cabinet, are included in quarterly Cabinet meetings and are levers for internal advocacy and Cabinet engagement. They set the expectation that agency leadership attend meetings, actively engage in the work, and deliver results.

For change to be effective, responsive and meaningful, it is critical that the individuals and institutions that will be impacted are represented in the policy discourse and design. This can include agency leadership staff that will be charged with deploying the new set of practices and policies, the residents or other individuals who are the intended beneficiaries of change, as well as any organizations that may be impacted by reforms.

The New York City Cabinet for Older New Yorkers is focused on the agency end user, older adult residents and caregivers—today and in the future. Commissioners designate liaisons in their agencies to represent the voices of agency leadership and programs. Cabinet member agencies engage older adults and other frontline professionals for insight into gaps in services, challenges with aging in place in their communities and opportunities for New York City government to realize a truly Age-Inclusive city. All of these voices are front and center when designing and implementing new policies, services, and practices. These voices are also significant in assessing and refining initiatives when first launched. Stakeholder surveys, focus groups, interviews, and program assessments are important tools to evaluate impact.

New York City government, residents, and communities recognize the human-centered approach to design and the broad impact of Cabinet policies. One older adult who attended a feedback, walking session with the NYC Department of Transportation shared, “the room was filled with good feelings and deep appreciation for the strategies applied to enhance safety for pedestrians . . . touring the neighborhood and providing feedback, as community residents who walk these blocks and streets every day, help to inform how we can better navigate . . . and ensure . . . we remain safe . . .. The experience was memorable and rewarding.” (City of New York Mayor’s Office 2023).

Facilitation and Project Management

While broad representation is significant for effective policy design, tactical leadership is key to managing many voices, channeling ideas into action plans and moving plans to implementation. In other words, there must be a strong facilitator, with authority and respect, along with disciplined, centralized project management. The facilitator ensures that meetings have an agenda and goals. They manage conversations to stay on track, support project planning to identify milestones that are feasible and goals that can be realized. Without a respectful, yet disciplined, facilitator there are too many cooks in the kitchen and all looking to have the stand-out dish!

Effective project management is key for a range of reasons. For a large-scale policy initiative to get off the ground, early “wins” and accomplishments encourage sustained focus and create buzz for broader engagement. Designing a plan that includes these opportunities can significantly impact the likelihood of a successful and lasting campaign. Many times policy reforms must align with other citywide calendars. For example, budget negotiations, legislative agendas and sessions, election campaigns, public relations strategies, even seasons and holidays. Developing a project plan, with milestones and measurable data, is an exercise in thoughtful deliberation and intentionality. This effort can create greater clarity of purpose, appreciation for timeliness, understanding of impact, accountability and ownership.

In the case of the Cabinet, NYC Aging serves as facilitator and project manager. Since all conversation and work is grounded in an Age-Inclusive New York City with older adults and caregivers as primary beneficiaries, it is natural that Cabinet operations can effectively be assumed by this agency. Moreover, while NYC Aging has a mission dedicated to supporting older adults and caregivers, the vision for the Cabinet is to enlist other agencies in this work and instill a broader sense of ownership and accountability in the goal to advance an Age-Inclusive city. With NYC Aging focuses on establishing and managing an operations framework, the agency provides space for colleagues at other agencies to step into leadership roles in service to older New Yorkers.

As facilitator and project manager, NYC Aging is at the epicenter of all Cabinet activities and nurtures its growth and momentum. In this role, it is in the best position to also serve as Chief Communications Officer. While each participating agency promotes the work of their teams, NYC Aging shares and amplifies the work of the collective body. NYC Aging maintains the Cabinet website, provides regular updates to city leadership and leads advocacy for resources and broad implementation. This wider publicity often circles back as a motivator for agency-specific engagement.

Structured Collaborative Design

There are two structural underpinnings that have proven effective to the Cabinet’s cross-agency policy development, design, and implementation. First, is a clear vision for the work that begins with a definition of Age-Inclusive. Grounding conversation in precise goals and a vision prepares the room for discourse and keeps the interaction on track. Additionally, the Cabinet has been fortunate that aging is a topic that everyone can relate to—we are all living longer and many of us are caring for older loved ones. Our lived experiences create a natural entry point for discussion and a space where everyone feels like they can contribute. Otherwise, establishing connectivity and relatability can be achieved through storytelling.

Second, it is important to establish a reliable and clear structure for the actual work that offers space to imagine and innovate, as well as design and implement. There are three levels of conversation and engagement within the Cabinet. Each level builds on the work of the prior one and participants enter each with an understanding of their purpose and goal. Let’s break it down.

Quarterly cabinet meetings, attended by city leadership, provide a forum for discussing big picture opportunities for focus. For example, at the immediate onset of the Cabinet’s first convening, a space was created for agency commissioners to share personal stories of recent experiences with older adult loved ones. One by one, each commissioner and the Deputy Mayor for Health and Human Services presented a conflict, a bottleneck, or general confusion around caring for an aging parent. This conversation sparked a key area of Age-Inclusive focus, namely caregiving. While NYC Aging offers caregiving services and support, it became clear that caregiving was an area of great unknown that was ripe for cross-agency education and engagement.

With topics in mind, agency liaisons (identified by commissioners) convene at monthly meetings to design opportunities for projects and policy, carrying forward the vision that was painted at preceding quarterly meetings. These liaison conversations are typically held in breakout groups with facilitation by NYC Aging and input from colleagues across agencies. For example, NYC Department of Health and Mental Hygiene and Health + Hospitals recognized a need for more information about available older adult services and supports in the community, and how best to share this information with frontline professionals to facilitate more effective referrals. Through the liaison meetings, the two agencies identified an opportunity to collaborate on education and trainings for frontline health workers who most often work with older adults and caregivers.

Once initiatives are formulated, they move to execution phase through regular planning meetings and correspondence that are facilitated by NYC Aging and grounded in project plans with milestones and key deliverables. The regular meetings allow teams to be nimble and responsive to what they are experiencing on the ground, maintain motivation for ongoing movement, stay on track and build camaraderie around a shared vision.

A workplan offers a tool to organize the many components of a multi-dimensional campaign. In the case of the education and training program, there was a clear sequence of events that was required to roll out the program. First, robust stakeholder sessions and surveys were necessary to drill down on the specific referral needs and pressure points for frontline staff supporting older adults and their caregivers. Only with this insight in hand could the team begin to design the training. Training development includes curriculum content, delivery approach and feedback for refinement—all three elements needed to be included in the workplan and allocated appropriate amounts of time. The curriculum benefitted from reviews by agency staff and external stakeholders. The delivery approach was established as in-person trainings; however, the method quickly proved unsustainable from a resource perspective and limited the breadth of delivery. With this information, the team decided that broad implementation would be more effective and sustainable through an online webinar format. Developing a digital curriculum required input from content experts, along with technology and educational advisors. Much of this was in the workplan, but the regular touchpoints provided the opportunity to continuously revise activities within the larger milestone goals of the Cabinet.

There are regular periods of intentional reflection. The first part is during subcommittee meetings to discuss the status of initiatives focusing on particular areas, such as health, housing, or intergenerational work. Following stand-alone subcommittee meetings, liaison meetings unite Cabinet member agencies as a whole on the staff level in advance of quarterly cabinet meetings that also include agency heads and mayoral administration leadership. At the full Cabinet quarterly meetings, teams leading initiatives publicly share successes and challenges for feedback and insight. In the case of the frontline education and training, the team learned that the lengthy evaluation survey was often skipped by participants or partially completed. The team, coming together to consider updates, zeroed in on exactly what feedback was important and designed a short-two question evaluation tool that was really all they needed.

Conclusion

The City of New York’s Cabinet for Older New Yorkers is an effective approach for imagining, designing and implementing Age-Inclusive policies and practices. The Cabinet is also a model for municipal cross-collaboration across issue areas. In New York City, for example, the Cabinet model is now a vehicle for cross-collaboration in support of tenant protections.

All too often city agencies operate in silos, each with a unilateral focus on their individual areas of expertise and agency goals. This disconnected, parallel approach to planning and policy creates gaps in services and redundant and inefficient bureaucracy whereby multiple agencies may be serving the same client, but not coordinating around that client. Bringing agencies together in a regular conversation creates the opportunity to penetrate agency lines, impact client services and develop holistic solutions through group problem solving. It also creates important opportunities to consider how different, but related work, can more effectively coalesce to better serve residents and maximize resources. Whether an organization employs 300,000 people or 300 people, department lines often stifle discourse and collaboration. Scheduled conversations create scheduled opportunities.

No matter the size of a city, most municipalities are challenged by limited resources, leveraging existing programs and budgets to include citywide priorities is a smart, effective and efficient way to broadly reach residents. Both the Cabinet and many of its solutions are budget-neutral. In New York City, the NYPD has a budget allocation for community liaisons in every precinct. These liaisons are tasked with providing information and support for residents. Through the Cabinet’s cross-collaboration, the NYPD identified the opportunity to augment community liaison trainings with information for older adults, forge partnerships with public housing complexes that are home to many older adults and share data to better serve older adult crime victims. These collaborations offer access to new clients and additional benefits to clients that NYPD, Aging and the New York City Housing Authority are already serving. Since the inception of the data sharing collaboration, more than 6,600 older adult crime victims have been referred and outreached for services—additional impact without additional dollars.

Often policy and programmatic design grab the attention, only to be stymied upon implementation. Convening stakeholders across a city provides the opportunity to consider design and implementation from a holistic perspective. In developing intergenerational programming hosted through community based organizations located in NYCHA buildings, the lead agency—Department for Youth and Community Development—worked with NYC Aging to identify and address challenges for participants and find common ground. While older adults had more flexibility during the day, high school students were in classes. The agencies worked together to choose ideal days and times for successful programming. Many cities may identify with another common implementation challenge—engineers know how to build infrastructure, but human services agencies understand how it is used. Collective problem solving and design, which also includes residents, is beneficial across civic priorities and magnifies impact for clients and communities.

The City of New York’s Cabinet for Older New Yorkers is a successful and replicable approach to cultivating Age-Inclusive cities, which is more critical than ever with the shift in national and global age-demographics. More broadly, the Cabinet serves as a model for civic collaboration and innovation, establishing more comprehensive client services and maximizing limited financial and staffing resources. The Cabinet is a framework that can be applied across cities of all sizes and a range of strategic priorities.

Footnotes

Acknowledgements

The authors acknowledge NYC Aging Commissioner Lorraine Cortés-Vázquez whose visionary leadership established the Cabinet for Older New Yorkers. Jennine Ventura, NYC Aging Assistant Commissioner for the Office of Interagency Collaboration and Innovation, manages the Cabinet for Older New Yorkers.

Author Note

The City of New York’s Cabinet for Older New Yorkers is a model of inter-agency and cross-discipline collaboration for Age-Inclusive policy innovation, design and implementation.

Data Availability Statement

Data sharing not applicable to this article as no datasets were generated or analyzed during the current study.

Declaration of Conflicting Interests

The author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Jennifer Geiling

Author Biographies

Jennifer Geiling is the President of 1digit, LLC (1digit.nyc), a management consulting firm specializing in strategic initiatives, operational transformation and government relations. 1digit collaborates with government agencies, nonprofits and the private sector to drive systemic change, maximize impact and strengthen organizations. Jennifer is a graduate of The University of California at Berkeley, received her law degree from George Washington University Law School and earned a Master’s in Public Administration at New York University’s Robert F. Wagner School of Public Service. She has held leadership roles in the nonprofit, philanthropy, private and public sectors. Jennifer is a recipient of the Frederick Hayes Prize for Innovative Contributions to Public Service.

Meghan Shineman has more than 15 years’ experience in the public, nonprofit, health and aging sectors. Meghan leads NYC Aging’s Research & Development Office, which coordinates research on demographic trends/analyses and program evaluation, as well as development of NYC Aging’s solicitations and innovative pilots, partnerships, and initiatives for the City’s older adults. Prior to NYC Aging, she worked as an independent consultant for ILC-France, and a policy analyst for both the United Hospital Fund as well as PHI (formerly Paraprofessional Healthcare Institute), both located in New York City. She has a Master of Public Administration, with a focus in Health Policy, from the NYU Wagner Graduate School of Public Service and her bachelor’s degrees in Sociology and Communications from Boston College

References

City of New York Cabinet for Older New Yorkers. 2024. https://www.nyc.gov/site/cabinetforoldernewyorkers/index.page.

City of New York’s Mayor’s Office. 2023. “Mayor Eric Adams Hosts Reception in Honor of Older Americans Month.” YouTube, May 5. https://www.youtube.com/watch?v=j3HMUYI2Ce0.

Coen

Susie

. 2023. “New York Rolls Out Anti-ageism in Schools to Tackle ‘Disney Villain’ Stereotypes.” The Telegraph, August 28. https://www.telegraph.co.uk/world-news/2023/08/28/new-york-anti-ageism-schools-disney-villain/.

Cullen

Paul

. 2023. “Home Care Conference Hears Calls for ‘Cabinet for Older Dubliners’ to Co-ordinate Services.” The Irish Times, October 13. https://www.irishtimes.com/health/2023/10/13/home-care-conference-hears-calls-for-cabinet-for-older-dubliners-to-co-ordinate-services/.

Global Coalition on Aging. 2023. “Healthy Aging in Practice: How Age-Friendly Cities and Communities Can Contribute to an Age-Friendly World.” https://agefriendlyireland.ie/wp-content/uploads/2023/06/GCOA-Healthy-Aging-in-Practice.pdf.

NYC Aging. 2021. “Building Community Care for an Age-Inclusive New York City.” https://www.nyc.gov/assets/dfta/downloads/pdf/publications/DFTACommunityCarePublicVisionFinal040221.pdf.

NYC Aging. 2023. “U.S. & NYC Older Adult Population Comparison 2023.” https://www.nyc.gov/assets/dfta/downloads/pdf/reports/Older-Adult-Snapshot%20Vertical-3-pager.pdf.

Pisani

Joseph

. 2023. “Goodbye ‘Senior,’ Hello ‘Older Adult.’ Teens Learn to Talk to Baby Boomers.” The Wall Street Journal, May 25. https://www.wsj.com/articles/anti-ageism-workplace-language-biggest-school-district-368db30f?st=siri8s83xxked7l&reflink=desktopwebshare_permalink.

The United States Conference of Mayors. 2023. “Promoting Age-Inclusive Cities to Support and Serve a Nation of All Ages.” https://www.usmayors.org/the-conference/resolutions/?category=a0F4N00000S4unqUAB&meeting=91st%20Annual%20Meeting.

10.

World Health Organization. 2022. “Ageing and Health.” https://www.who.int/news-room/fact-sheets/detail/ageing-and-health.