Forged By AIDS, Storied NYC Residence Boosts Aging In Place

Driven by a mission of justice, Manhattan Plaza and Penn South create beloved communities that care for people at all stages of life.

nity college, and identify as gay. Then, with family tension mounting, it was time to leave. "I'm going to New York," he told his mother, Nita. "I'm going to be an actor." In New York, Pippin's blond hair and wholesome good looks landed him parts in commercials for Reese's Peanut Butter Cups and Stove Top Stuffing and, later, a role in the comedy film Simon with Alan Arkin and Madeline Kahn. But jobs were few, money was tight, and New York City was expensive. He spent his first two years couch-surfing. Then he learned about a huge new apartment complex called Manhattan Plaza that opened west of Times Square as a home for performing artists. He moved in some time after it opened in 1977, and it transformed his short life.
In the more than four decades since it opened, Manhattan Plaza has had a profound, if largely unrecognized, impact on the culture and history of New York. It ushered in the transformation of Manhattan's West Side. It provided an affordable home to thousands of actors, dancers, musicians, and stagehands, allowing them to live and work in New York. Over time, it became the home of countless performers from the famous-like Angela Lansbury, Dexter Gordon, Charles Mingus, Mickey Rourke, and Tennessee Williams-to lesser-known figures like the comedian Kenny Kramer and a drag performer named Ruby Rims. Pop singer Alicia Keys and actor Terrence Howard grew up there; Larry David honed his standup routine at Manhattan Plaza Talent Night and developed ideas for the Seinfeld show.
In the 1980s and 1990s Manhattan Plaza became the place where more people are believed to have died of AIDS than any other residence in the country. It also became a model for how a community can come together and care for its own. It has continued to do so as the building's population has aged, becoming a naturally occurring retirement community, or NORC.
A mile south lies a complex of ten high-rise buildings known as Penn South that is considered the country's first NORC. 1 Its 2,820 units were built with state and union financing to provide affordable cooperative housing.
When President John F. Kennedy cut the ribbon in the opening ceremony in 1962, one-bedroom apartments sold for $2,800. Two decades later, in 1985, a survey found that 70 percent of residents were over age sixty. 2 The next year Penn South Services for Seniors opened, and the community went from being a de facto NORC to one that embraced the term by creating services to meet the needs of older residents. This is the story of two very different urban developments, each born with a social mission, that have pioneered strategies to help older residents age in place and die at home. Now the coronavirus disease 2019 (COVID-19) pandemic is testing both communities in new ways, and residents, social workers, and staff are retooling their approaches as they provide mutual support and look after their most vulnerable. Experts believe that the NORC approach can provide community and care while also saving money by reducing hospital and nursing home usage. 3 What's needed now, they say, is the rigorous research that could document that belief.

Transforming Hell's Kitchen
Manhattan Plaza almost didn't happen. It was envisioned as a way to create market-rate, upper-middle-income housing and transform the Hell's Kitchen neighborhood west of Times Square, then the home base of an Irish gang known as the Westies and Manhattan's most visible group of drug dealers and transvestite prostitutes. 4,5 Politically wired developers Richard Ravitch, who later served as the state's appointed lieutenant governor, and Irving Fischer, who would build Trump Tower, hatched the project in the early 1970s. They gained control of the site, the entire square block between 9th and 10th Avenues and 42nd and 43rd Streets, and got the city to give them a $90 million mortgage through a state housing program. 6 The buildings were half-finished when the financing almost blew up in 1975, Fischer told me in a 2015 interview at his Westchester County home. The city, in financial crisis and nearing bankruptcy, kept falling behind on funding the mortgage, so his construction crew had to keep slowing down. At one point, work on the project stopped for almost a year. Meanwhile, it was becoming clear that the units wouldn't be marketable because rents and utilities would be too high for the area.
Then federal Section 8 rent subsidies became available, and a fight broke out over who would move in. Low-income housing activists wanted to control the tenant pool, while real estate developers and Broadway producers opposed the subsidies, arguing that it would make the building a slum. The surprise solution was to make it a home for artists. Almost two-thirds of the 1,689 units would be reserved for performing artists,`and one-quarter would be split between low-income and elderly people already living in the neighborhood, with a final 10 percent for middle-class residents at market rates. For most units, residents would pay 25 percent of their income in rent (raised during the Reagan administration to 30 percent), and federal subsidies would cover the rest. 7 The building's developers feared that the neighborhood's violence and gritti- ness might dissuade qualified tenants. It didn't. Performers, dancers, and stagehands began moving in, and restaurants and markets opened to serve them. "All of a sudden 3,500 people moved in," said longtime resident Marisa Redanty. "Low income or not, they were working. They needed to buy food and to go to a drugstore." One of the first businesses to open was the West Bank Cafe. The early years were "crazy," said Steve Olsen, who still operates the cafe. Westies hung out at his bar and started fights. A busboy got stabbed in the stomach with a butter knife, and Olsen rushed him to the hospital. A gang member was thrown off the building's forty-second floor wrapped in a bed sheet, Olsen told me.
Playwright Lanie Robertson, then age forty, was living in Philadelphia and teaching at an art school while trying to find time to write. Once a week he'd come to New York to bring scripts to prospective agents. He read about Manhattan Plaza in a newspaper article and applied. The cheap rent enabled him to quit teaching. "It allowed me to come here and pursue my craft, as it did for many people in the performing arts," Robertson said. Forty-three years later, he still lives at Manhattan Plaza and has written more than thirty-five plays.
Comedian Kenny Kramer was visiting his mother in New Jersey after a weeklong gig opening for the Flying Burrito Brothers, when a New York Times article about Manhattan Plaza caught his eye. Two months later, in November 1977, he and his five-year-old daughter, Melanie, moved in. The atmosphere was electric, Kramer told me: "Musicians were playing on each other's demos. Playwrights were getting people to do readings. It was a great cross-pollination of artistic people." Early on, Kramer organized a talent night. He was given a list of fellow comedians, including his across-the-hall neighbor, Larry David. Kramer convinced David to perform at the event, and they became friends. David went on to create Seinfeld-including a character named Kramer.
Fischer, the developer, hired as the building's founding manager a gay Episcopal priest named Rodney Kirk, who had moved to New York in 1966 with his partner, a former college football player named Richard Hunnings. Kirk's first parish had been in tiny Newton, North Carolina, Hunnings told me.
Kirk treated the building like a parish, which meant getting to know every resident and creating a sense of community. The profile of the tenants made that easy. "A lot of people moving in were a bunch of hippies," remembered Aleta LaFargue, including many interracial families like her own. She was four months old when her parents moved in 1977 and still lives there today. With Kirk's support, the tenants formed child care co-ops, babysitting exchanges, food co-ops, and even a school.
For many who moved in, Manhattan Plaza amplified their sense of excitement at being working performers and living in the heart of the city: Here was a home for people who shared the same passions and dreams-and with rents they could afford. A place where there was almost always a gathering down the hall, where friends, fellow cast members, and lovers were close at hand. But the euphoria of those heady times soon gave way to something else: fear. Within a few years of Manhattan Plaza's opening, Hunnings recalled, "one guy had a mysterious disease, and nobody knew what it was." Other New Yorkers were also getting sick and dying. In June 1981 the Centers for Disease Control reported on the deaths of gay men with immune-system dysfunction. One year later the baffling disease had a name-AIDS-and Manhattan Plaza was at the epicenter.

'Our Friends Are Dying'
In September 1983 the phone rang in Marietta LaFargue's thirteenth-floor apartment to announce a visitor. When LaFargue opened the door, she was stunned to see a friend of thirteen years, Lionel Mitchell, a Black gay writer and theater critic, looking gaunt, filthy, and frightened. She gave him a bath, washed his clothes, and cooked him a meal. He died a month later at a city hospital, she wrote in a chapter of a book written in 1997 about AIDS. 8 For LaFargue's daughter, Aleta, then six years old, "Uncle Lionel" was the first of what she estimates to be forty men, all family friends, who died of AIDS over twelve years. All the others, beginning with "Uncle Kenny," who got sick a few months later, were residents of Manhattan Plaza. She told me she still remembers her anger at her mother for telling her that Kenny had AIDS, and thus making it a reality. She also remembers his seizures and the way paramedics acted when they learned he had AIDS. "They would drop everything and step back," she said, a reflection of the fear and ignorance of the time.
Marietta went to Kirk, the manager. "Our friends are dying, we have to take care of them," she told him. Kirk was already hearing from other tenants with AIDS. Their conversation led to the formation of the Manhattan Plaza AIDS Project, a groundbreaking mutual-aid effort that assigned care partners to every person who got sick and deployed volunteers to deliver meals and get people to doctors. Kirk also arranged for Gay Men's Health Crisis, a pioneering AIDS organization, to conduct a training for the building's maintenance staff and residents about the disease and how it worked.
"Rodney got down on his hands and knees to scrub a sick tenant's floor to show there was no danger to the support staff," Marietta LaFargue remembered.
She became a care partner and frequently brought Aleta along on her visits. "The basic premise of the AIDS project was every sick guy had a care partner," Aleta told me. "As a care partner, you did everything for them. You'd show up every day, bring them meals, take them to hospital visits. I did that alongside my mother." One of the toughest aspects could be dealing with family members. "We had to make calls to families and tell them, 'Your son is gay and dying of AIDS,'" Hunnings recalled.
In 1987 Nick Pippin made a version of that call himself. 9 He told his mother, Nita Pippins, that he was sick, scared, and often left alone by his boyfriend. The elder Pippins, a retired nurse, traveled to New York and began staying in his apartment to care for him. "My family wouldn't come here to see my son, they were so afraid," she told me when I visited her in 2015. "They said, 'You'll die.' I said, 'Well, then he and I will die together.'" They shared the apartment for three years as Nick's health slowly failed. Despite his weakness, he founded the People with AIDS Theater Workshop and directed from a wheelchair. "I saw all these guys sitting around doing nothing, getting sicker, concentrating on death," Pippin told a reporter for the New York Daily News in 1988. 10 "I hated to waste the years we had left without chronicling the experience." As he got sicker, Pippin asked a friend, Carter Inskeep, to manage the troupe and improve the play, AIDS Alive. Inskeep asked Robertson, the playwright, to sharpen the script, and he booked the troupe into schools, hospitals, and cabarets.
Nita, meanwhile, began working with the Manhattan Plaza AIDS Project, look-ing after other young men in the building and giving them injections when they needed them. She also became a surrogate mother.
"I talked to one guy, and he said, 'All I want is to see my mother before I die.' I said, 'OK, let's see what we can do.' I called her, and she said, 'I didn't tell him to get AIDS. He went around and got AIDS, and I'm not coming.' Bang, she hung up the phone. I went and I held his hand. I said, 'She said she can't come.' He waited about two or three minutes. He said, 'Would you try her one more time?'" Nita called again, and she still refused. "I told her a head of mess before she hung up. I said, 'You've got a wonderful son. He's ill and he wants to see you and you're a terrible mother. I hope you have an awful life.' I went back and held his hand. I said, 'Son, she's not coming.' He squeezed my hand, and he didn't say anything for a few minutes. He died with me holding his hand." Working with the theater workshop "kept Nick going and gave purpose to his life," said Irwin Kroot, a longtime friend of both Nick and Nita. Still, Nick succumbed to his illness in 1990. Shortly thereafter, Kirk called Nita and asked if she wanted to stay. She did, and he made the arrangements. She would live in apartment 33B for the next thirty years.
The Manhattan Plaza AIDS Project continued, sustained by fundraisers, donations, and the time of hundreds of volunteers. From a social work office called the Stay Well Center and, later, a separate space, project staff members coordinated care, mostly from building volunteers. In the first nine months of 1993, volunteers provided more than 12,000 hours of service, Marietta LaFargue wrote in her book chapter. 9 By then, she wrote, 250 Manhattan Plaza residents had died of AIDS. That number would grow to approximately 400, according to Hunnings, until, finally, in 1996, new drug combinations started turning AIDS from a death sentence to a manageable chronic condition.

'My Go-To Guy'
In the years that followed, AIDS-and activism-receded. Kirk retired in 1997 and died in 2001. Hunnings succeeded him as manager. The Stay Well Center was renamed the Rodney Kirk Center One year later the baffling disease had a name-AIDS-and Manhattan Plaza was at the epicenter. and shifted its focus to the growing number of elderly residents. In 2004 Related Companies, one of the largest real estate developers in the US, bought Manhattan Plaza, and residents feared it might be converted to market-rate housing. Redanty, then president of the tenants association, organized community meetings with Related representatives attended by hundreds of residents and local political leaders. Months of negotiations led to an agreement that maintained the essential nature of the building.
In 2011 the Actors Fund, a human services agency for current and retired actors, surveyed residents of the building and found that 46 percent were over age sixty. 11 By 2017, Hunnings said, that number had risen to 53 percent. The Actors Fund also took over the Rodney Kirk Center, which continues to offer exercise classes, financial workshops, health screenings, and hospital discharge planning.
The real beauty of Manhattan Plaza may lie in the richness of the social networks that have been forged over years. These networks offer emotional and logistical support and give people the confidence to know that if they need help, it will be there. It may come from social workers at the Kirk Center. It may come from a neighbor down the hall. Or it may come from longtime resident Peter Valentyne, a poet and former playwright who does chores and odd jobs for some of the building's frailer residents.
"In a typical day, I have two to three clients, and work two or three hours for each," Valentyne told me. "I do a lot of cleaning. I do organizing. Sometimes I take people shopping." He helps some people with hoarding tendencies, using the organizational skills he developed running thrift stores-and a deep well of kindness. "People seem to trust me," he said. He charges a modest hourly fee, around $30 an hour.
Valentyne's own eclectic apartment is decorated with mandalas and Oriental rugs. In a corner of the living room, a silver-gray cat named Clementyne lounges on a climbing structure. Clementyne was originally owned by a neighbor who developed terminal cancer and was desperate to find her a home. When Valentyne agreed to take the cat, the neighbor "felt she could go," Valentyne said. She returned home from the hospital and died days later.
In late February 2020, shortly before New York went into lockdown from COVID-19, Valentyne and I dropped by the apartment of Judith Delgado, a seventy-two-year-old actor who has lived in the building since 2008. A striking woman with high cheekbones and long dark hair, she was diagnosed five years ago with chronic obstructive pulmonary disease and now uses an oxygen tank. Valentyne began washing her clothes when she had trouble breathing in the hot, unventilated laundry room. He also pulled up her rugs to eliminate dust and reduce the risk of falling.
"Peter, he's my go-to guy," she told me. "Usually when he comes in to do laundry or clean, we sit, we talk about what's going on in our lives. I feel very safe knowing I can call Peter for help." Back at Valentyne's apartment, he pulled a key from a bunch that hung on a hook by his front door. We stopped at the apartment of another friend and client, a classical actor named Bob Hock. Valentyne packed some clothes, and we took a bus uptown to Amsterdam House, a rehab center in Morningside Heights where Hock was recovering from a fall.
At the rehab center, Hock told me he has lived with HIV since the nineties and is grateful to have spent the past thirty years at Manhattan Plaza. He said the Kirk Center has helped himlike arranging a few years ago for a podiatrist to come to his apartment-but Valentyne is his main support. When he fell recently and couldn't get up, he called Valentyne. "I live by myself, and there's nobody around," Hock said. "He's the one who helps me." The next day I made another visit to Amsterdam House to see Nita Pippins, who was recovering from a hip fracture and also suffered from Alzheimer's. She greeted me warmly but didn't recall me or our interview a few years before.
She died three months later from complications of COVID-19. Hock followed her in death in June, also at Amsterdam House. Both had been able to remain living at Manhattan Plaza until shortly before they died.

A New Generation Of Activists
In 2016, more than thirty years after her mother helped start the Manhattan Plaza AIDS Project, Aleta LaFargue and a group of younger residents decided it was time to rejuvenate the building's tenants association. They ran for the board and won. In late February and early March 2020, as news emerged about another virus-this one ravaging China and Italy-they urged the staff of the building and the Kirk Center to get ready.
LaFargue and her fellow board members began recruiting volunteer floor captains-even before the city went into lockdown. They started a phone bank, called fellow residents, and created spreadsheets to record people's needs and phone numbers. When the stay-athome order came, the tenant leaders, building managers, and staff from the Kirk Center came together to coordinate services, including food deliveries and check-in calls to vulnerable residents.
Just as important were long-standing informal networks. Robertson, now eighty-four and in good health, said he'd been leaving the building every third or fourth day to shop for "actor friends and people I know who are holed up in the building." Though the numbers are hard to pin down, residents estimate that at least six residents died of COVID-19, including Jim Kelly, a longtime resident who served for years as director of Manhattan Plaza AIDS Project. Residents believe he contracted the virus caring for his next-door neighbor, who also died. In a tradition that has continued since the AIDS era, each death is marked by a flower and sign left in the building's lobby.

The Penn South Program For Seniors
While tenant leaders give the staff of Manhattan Plaza and the Rodney Kirk Center high marks for responding to the needs of elderly residents during the pandemic, the building's owners have The real beauty of Manhattan Plaza may lie in the richness of the social networks that have been forged over years.
declined repeated interview requests to discuss its history and role as a NORC. Penn South, on the other hand, proudly proclaims its NORC status.
Like Manhattan Plaza, Penn South was not originally designed with elderly people in mind. But by the mid-1980s many residents were old and needed assistance. The co-op board authorized a survey, which found that 70 percent of units had a resident over age sixty. 2 The findings led to the creation of the Penn South Program for Seniors in 1986. It became the prototype of a new type of NORC with a longer acronym: the NORC-SSP (for supportive services program). Anne Foerg, a social worker who now directs the program, wrote her senior thesis on Penn South as a student at New York University twenty years ago.
"The idea was to meet the needs across the entire spectrum of the older adults," Foerg told me. Now administered by JASA (Jewish Association Serving the Aging), the center employs eleven social workers, group services workers, and nurses and has a budget of $750,000.
Funding for the program comes largely from state and city grants; the Penn South co-op provides free office space and additional funds. JASA also operates a dozen other NORC services across four New York boroughs. Each is a partnership involving a social service program, a housing operator, and often a health care provider, said JASA's chief program officer, Amy Chalfy.
Penn South's nurses make house calls, run a blood pressure clinic, and monitor residents with chronic conditions. The social workers help residents obtain services and coordinate care when they go in and out of hospitals. But the program's work extends beyond health care. It also offers a dizzying array of classes and activities including indoor gardening, yoga, tai chi, and "intergenerational community conversations with Avenues High Schools Students." 12 Penn South resident Florence Cohen, who uses a cane, goes regularly to yoga, exercise, and dance classes. "I have a problem with balance, and they're very helpful health-wise," she said.
In August 2019 Cohen was one of seventeen Penn South residents who worked with students and faculty from the Program in Drama Therapy at New York University to stage a play. They chose Fiddler on the Roof, rehearsed for weeks, and performed it four times. Cohen played Yenta the matchmaker. The participants found it so satisfying that they formed a group called the Penn South Players to continue doing theater.
When the COVID-19 pandemic struck in March, JASA halted in-person services and classes at Penn South.Working from home, staff members scrambled to reach out to 1,000 clients, assess their needs, and create new systems to help. "It was all hands on deck," Foerg told me in a recent phone call.
Forty Penn South residents ranging in age from fourteen to late sixties stepped up to help, starting a grassroots volunteer organization, Neighbors Helping Neighbors. Coordinating with Foerg and her staff, they set up a system to do shopping, run errands, walk dogs, and take out the trash for fellow residents needing help.
Nurses continued to help clients with chronic conditions and those with new acute problems, only now they were looking for ways to avoid sending people to emergency rooms, where they could be exposed to COVID-19.
As of early July, six clients had died of COVID-19, and another dozen had confirmed or suspected cases. "Given our population, we were bracing for a much tougher experience," Foerg said. "If a program like ours wasn't in place to coordinate volunteer services, I think we would have seen more impact. Without our nurses, we may have seen more people die at home." The pandemic tested in an unexpected way one of the key attributes of the NORC model: its flexibility. Residents may first get involved with NORC programs by going to a lecture series and later end up in the hospital, Chalfy said. "We help [a resident] recover, then maybe she comes back to the group program. Sometimes you need a nurse, sometimes you need a class." The key goal is to help people stay healthy and tied to their community as long as possible. "We don't want someone going to a nursing home because they don't have the right services," Chalfy said. "What can we do to make this a livable place for as long as possible, so each person feels safe and connected to community?" Limited research suggests that NORCs can do this. A 2010 study looked at NORC services in six apartment buildings in suburban Maryland and compared residents who chose to use health, social work, activity, and transportation services with residents who did not. 13 The residents were assessed before the services were offered and again two and a half years later. In the follow-up surveys, people who used the services said they'd become more satisfied with recreational activities and social life in the community and less depressed, while those who didn't said they were less satisfied and more depressed. The bottom line, according to the authors, was that the participants "were more likely to get out of the house, felt less isolated, and were happier since joining (the) activities." The study, however, was small and relied on self-reports. A more recent study, published in 2018 in Health Affairs, compared residents of six senior housing complexes managed by a nonprofit, Selfhelp Community Services, with a similar group of residents living in different buildings in the same Queens neighborhoods where no services were offered. 3 The researchers found that people living in the Selfhelp buildings ended up in the hospital 32 percent less often overall and 30 percent less often for conditions that can be addressed in outpatient care. Their hospital stays, on average, were one day shorter.
Carmen Matias and Hechter Ubarry may be the only people in the world to have lived in both Manhattan Plaza and Penn South. Matias was working as a television producer when she moved into Manhattan Plaza shortly after it opened in 1977. There, she met Ubarry, who was then performing in the Broadway cast of Man of La Mancha, and they got married. She loved the excitement and atmosphere at Manhattan Plaza. "It was like a college dorm," she said. "Everyone was in the same profession." They lived there for twenty-seven The key goal is to help people stay healthy and tied to their community as long as possible.
years and raised their daughter, Degan, in the building. At some point they'd put their names on the waiting list for Penn South, and in 2005 their name came up for the third and final time. On each previous occasion, Matias said, "I couldn't get Hechter to leave." In the end, the opportunity to be owners rather than renters and to leave something to Degan was compelling. Matias loves Penn South's "extraordinary sense of community," though she sometimes feels frustrated by a lack of diversity. She served six years on the board of the co-op and goes to classes and events regularly-now via Zoom.
She marvels at the support her more vulnerable neighbors receive from the senior program. "That's where I want to be if I need help," she said.
The staff and her neighbors "stepped up big time" during the COVID-19 pandemic, and she has joined in, delivering meals and running to buy hand sanitizer for a neighbor who ran out. "I feel really good when I'm able to help someone else," Matias said. "If you have passion and a reason to get up in the morning, you live longer." ▪ This article is part of a series on transforming health systems published with support from The Robert Wood Johnson Foundation. This is an open access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt, and build upon this work, for commercial use, provided the original work is properly cited. See https://creativecommons.org/ licenses/by/4.0/. Rob Waters (robwaters2@gmail.com) is an independent journalist in Oakland, California, who writes about health and science and has contributed to Kaiser Health News, STAT, Mother Jones, and Psychotherapy Networker, among other publications. The author is grateful for support for initial research and reporting from the Solutions Journalism Network, which supports rigorous reporting on responses to problems.