Letter to Mayor Adams Re: Urgent Need to Submit Final Commissioning Report and Expedite Activation of Outposted Therapeutic Housing Units

The Honorable Eric Adams
Mayor
City Hall
New York, NY 10007

RE: Urgent Need to Submit Final Commissioning Report and Expedite Activation of Outposted Therapeutic Housing Units

Dear Mayor Adams,

I am writing to urge your administration to immediately submit the Final Commissioning Report for the Bellevue Outposted Therapeutic Housing Unit (OTxHU) to the New York State Commission of Correction (SCOC). This is a critical and overdue administrative step needed to move the unit toward full operation. Once submitted, your team should also advocate for an expedited review and approval process by the SCOC so that patient transfers and clinical care can begin at Bellevue without further delay.

The OTxHUs at Bellevue and Woodhull were first announced by the de Blasio administration in November 2019 as part of the broader initiative to close Rikers Island by developing secure, therapeutic facilities for people in custody with serious medical and behavioral health needs. At that time, the target completion dates were Spring 2023 for Bellevue, 2024 for Woodhull, and 2025 for North Central Bronx (NCB). Now, more than five years later, all three units remain offline.

The Bellevue OTxHU represents a vital investment in the City’s commitment to providing safe, humane, and clinically appropriate care to individuals in custody. Its delayed activation, resulting from operational concerns raised by the Department of Correction, has significantly hindered progress. Correctional Health Services (CHS) has worked diligently and in good faith to resolve those concerns and ensure that the unit meets both clinical and security requirements. The failure to submit the Final Commissioning Report is now the primary obstacle.

We acknowledge that DOC is facing serious challenges, including a growing jail population and operational disruptions caused in part by the February 2025 wildcat strikes by state correctional officers. These strikes spread across dozens of facilities and led to lockdowns, delayed transfers, and the temporary suspension of state prison intake, all of which increased pressure on City jails. These challenges only heighten the urgency of activating all OTxHUs as soon as possible.

According to The City, the Bellevue Outposted Therapeutic Housing Unit has been mostly complete since January 2025, yet remains unopened. The project’s cost has surged from $130 million to $241 million, nearly double its original budget, amounting to more than $2 million per bed. Despite Bellevue’s completion in January 2025 and a total cost of $241 million, DOC has not formally submitted its required staffing plan to the New York State Commission of Correction. The staffing plan, which outlines how DOC will deploy correction officers, supervisors, clinical staff, and emergency response teams, is a separate and necessary component for the Commission to certify the facility as operational. Without this plan, the Final Commissioning Report cannot be approved, even if the facility is physically ready.

While DOC’s uniformed headcount has declined in recent years, the claimed shortfall of more than 200 officers raises significant concerns. We believe the facility could be safely opened with far fewer staff than DOC has indicated. Bringing the Bellevue unit online would not add pressure to existing operations, but would help relieve it by transferring individuals who require specialized care out of Rikers and into an appropriate medical setting. The absence of a public staffing analysis or post plan prevents independent evaluation of DOC’s claim and remains a key barrier to moving forward.

Like Bellevue, the units at North Central Bronx and Woodhull have experienced significant delays and design revisions, including modifications requested by DOC and SCOC such as attack-resistant walls and additional security measures. These repeated delays undermine the health-first mission of the OTxHUs and directly impede progress toward meeting the City’s legal obligation to close Rikers Island. People in custody who were promised care remain in environments that worsen their conditions and increase the risk of deterioration.

To ensure the City’s Outposted Treatment Housing Units are brought online as soon as possible, we urge your administration to immediately submit its required Final Commissioning Report to SCOC and advocate for its swift approval. Additionally, to better understand the timeline and barriers to opening the additional housing units, I request that you provide my office with the following information:

1. A monthly progress report from your Administration on the development of all OTxHU sites until each facility is fully operational and accepting patients, to be delivered by the first working day of each month. These reports should include:
   1. Initial report: Define the component design, construction, and administrative requirements of each site’s development and give summary updates on the work that has been completed to date. Each sub-category should include an estimate of the percentage of work completed and the anticipated completion date.
   2. Subsequent reports: Explain what progress was made since the transmission of the prior report, as well as revised completion dates where applicable.
   3. All reports: A status update on the design and planning process for the OTxHU sites at North Central Bronx and Woodhull Hospitals, including any revisions requested by DOC and the New York State Commission of Correction (such as attack-proof walls, additional locks on doors, or other modifications) and the current target timelines for finalizing these designs and initiating construction or retrofitting work.
2. DOC’s plan for staffing the Bellevue OTxHU and coordinating timely patient transfers once the facility is approved.
3. If applicable, the specific internal steps and approvals required to begin patient transfers to the Bellevue, Woodhull, and NCB OTxHUs (such as security protocols, custody staffing assignments, and emergency response planning).

While we recognize recent administrative progress, meaningful progress requires that patients actually begin receiving care. The Administration must treat this effort with the urgency it demands. We request that you notify the Comptroller’s Office immediately upon any formal updates regarding Bellevue’s progress with SCOC approval. Beginning September 1, 2025 we ask that your office fulfill the data and progress reporting requests outlined above on a monthly basis. Please acknowledge receipt of this letter by August 1, 2025 and provide a formal response to these requests no later than August 12, 2025.

Thank you for your time and consideration.

Sincerely,

Brad Lander
New York City Comptroller