COUNCIL OF THE CITY OF PHILADELPHIA PUBLIC HEARING COMMITTEE OF THE WHOLE FY '05 OPERATING BUDGET - - - - Room 400, City Hall Philadelphia, Pennsylvania Wednesday, April 21, 2004 10:00 a.m. - - - - BILL 040255 - An Ordinance adopting the Operating Budget for Fiscal Year 2005. PRESENT: COUNCIL PRESIDENT VERNA, Chair COUNCILWOMAN JANNIE BLACKWELL COUNCILMAN DARRELL CLARKE COUNCILMAN W. WILSON GOODE COUNCILWOMAN JOAN KRAJEWSKI COUNCILWOMAN DONNA REED MILLER COUNCILMAN MICHAEL NUTTER COUNCILMAN BRIAN O'NEILL COUNCILMAN JUAN RAMOS COUNCILWOMAN BLONDELL REYNOLDS BROWN COUNCILWOMAN MARIAN TASCO - - - - V A R A L L O Incorporated Litigation Support Services Eleven Penn Center 1835 Market Street, Suite 600 Philadelphia, Pennsylvania 19103 215.561.2220 215.567.2670 I N D E X BILL 040255 JOHN DOMZALSKI, Health Commissioner ROB DUBOW, Budget Director......... 118 BRENDA SHELTON DUNSTON............. 151 MICHALE COVONE, Health Dept........ 163 ALBA MARTINEZ, Commissioner, DHS... 179 CHERYL RANSOM, DHS................. 186 ELLEN STEIKER, DHS................. 190 DAVID FAIR, DHS.................... 193 JOHN ZANIER, DHS................... 210 ANNMARIE AMBROSE................... 225 ROBERT HESS, OESS.................. 238 RICHARD SHAEFFER,OESS.............. 300 CAROL TRACY, OESS.................. 318 JOAN SCHLOTTERBECK, Commissioner, Public Property................ 333 JAMES MULLER, Fleet Management..... 345 BOB FOX, Fleet Management.......... 349 3 04/21/04 - WHOLE - BILL 040255
Good morning, everyone. This is the continued public hearing of the Committee of the Whole regarding Bill No. 040255. The first department to be testify will be the Health Department. Good morning. COMMISSIONER DOMZALSKI: Good morning, President Verna.
Welcome. Please identify yourself for the record and proceed with your testimony. COMMISSIONER DOMZALSKI: Good morning, President Verna and Members of Council. I'm John Domzalski, Health Commissioner. I appreciate the opportunity to present the Health Department's budget request for Fiscal Year 2005. I'm joined at the table by Carmen Lemmo who is the Director of Finance and Administration for the Department of Public Health. And, President Verna, with your permission, I would like to introduce two of my senior staff Deputy Commissioner Carmen 4 04/21/04 - WHOLE - BILL 040255 Paris who is behind me to my left. An=d Deputy Commissioner Paris oversees a wide variety of programs and services in our department. Next to her is newly promoted Assistant Health Commissioner, Joseph Cronaur who comes out of the advocacy community, had been heading up our AIDS Activities Coordinating office and has a long and extensive history in coordinating community-based organization work. Not able to be with us is Dr. Joanne Godley who is the Medical Director for the Department of Public Health. As such, she's the Chief Medical Officer for the Department, and of particular note to Philadelphia is Dr. Godley led the process by which Philadelphia became one of the few -- one of the seven cities in the nation to receive a Steps grant which is a substantial amount of money for prevention services at the community level in Philadelphia. Dr. Godley worked with Gwen Foster in a wide variety of voluntary and non-profit health agencies and advocacy groups in the community to do that. 5 04/21/04 - WHOLE - BILL 040255 So thank you very much for that indulgence.
Thank you, Commissioner. 5 million in the Grants Fund, of which 105 million is in the General Fund and 70 million is in the Grants Fund. 5 million comes from City to tax supported funds. The Department's budget will support 1,017 positions, 761 in the General Fund and 256 in the Grants Fund. This represents a reduction of 10 General Fund positions. The staff reductions will be taken in administrative areas that do not affect services. I am pleased to report that the Department's recommended budget for FY '05 maintains key performance and service indicators comparable to those of FY '04. During FY '04, the Department undertook major 6 04/21/04 - WHOLE - BILL 040255 initiatives aimed at improving and protecting the health of the community and incorporating a neighborhood perspective on citywide health status indicators. We will continue these initiatives in FY '05. The Health Department administers a wide range of essential public health services for Philadelphians. These include primary care at eight neighborhood health centers, monitoring and control of communicable diseases, operating a specialty clinic for the treatment of sexually transmitted diseases and coordination, funding, and oversight of HIV/AIDS programs. The department coordinates, funds, monitors child health services, including infant mortality reduction, prenatal and family planning services, childhood lead poisoning control and prevention. We're responsible for a range of environmental protection services, including monitoring of pollutants and enforcement of local, state, and federal environmental regulations as well as the regulation of the local retail food 7 04/21/04 - WHOLE - BILL 040255 industry. In addition, the Department maintains oversight of the Philadelphia Nursing Home and monitors the healthcare delivered in Riverview Home. The Health Department is also prepared to respond to threatened or actual bioterrorism events and is a partner with the Police and Fire Departments and the Office of Emergency Management in the City's overall emergency response structure. 2 million in emergency preparedness funding under the new Homeland Security Act. In keeping with Mayor Street's focus on the transformation of our neighborhoods, we have organized our data so that health status indicators so that the overall health of the City can be understood from the perspective of its neighborhoods. These neighborhood level data aided by the mapping technology and use by Philadelphia Safe and Sound continue to be used strategically and deploy and redeploy resources to areas of greatest need. These data range from immunization and lead 8 04/21/04 - WHOLE - BILL 040255 poisoning incidents to the occurrence of communicable diseases and chronic diseases such as diabetes and heart disease. The Mayor's vision is that while we focus on neighborhoods, we do not turn our backs on the businesses that are so important to the economic health of the City. Accordingly, in our regulatory activity, we're making our procedures and processes more understandable and user friendly while not compromising the public health objective of our regulations. I will now highlight some of our major accomplishments and challenges: Lead poisoning control and prevention in children. A new public health offensive against childhood lead poisoning began in April 2002 and will continue in FY '05. Thanks to the vision of the Mayor, the effort of Philadelphia Congressional Delegation, particularly Congressman Chaka Fattah, and the advocacy community, in particular Philadelphia Coalition for Children in Youth, PCCY, and the credibility of our 9 04/21/04 - WHOLE - BILL 040255 re-engineered lead effort, the funding anticipated in last year's hearing has been acquired.
Philadelphia's signature approach to intervening in cases of childhood lead poisoning, the Lead Abatement Strike Team, or LAST, continues to actively address all new cases and to not allow any new cases to become part of a backlog, while at the same time continuing to reduce the backlog which stood at 1,400 properties in April 2002. The map on the screen depicts what the backlog looked like in April of 2002. Not only was the growth of the backlog stopped, the backlog itself has been reduced to 573 properties, with a further reduction anticipated to 250 in 2005. That map shows the reduction to the backlog now standing at 573. The unprecedented close collaboration of eight City units in the government and the Lead Court combine to make the Philadelphia approach unique among programs across the nation in both structure and effectiveness. We've also secured funding to begin to take childhood lead poisoning to 10 04/21/04 - WHOLE - BILL 040255 the next level, which is primary prevention. In this regard, working with Philadelphia Citizens for Children and Youth, the National Nursing Centers and others, more than 900 new and expectant mothers have been visited so far in FY '04 by a nurse or trained outreach worker. The target for FY '04 is 1400 families. Clients receive a lead education presentation and their homes are evaluated visually with dust wipe samples, and those found potentially dangerous by a certified risk assessor are offered lead hazard reduction through a grant from the United States Conference of Mayors. In FY '04, 50 potentially dangerous homes occupied by new or expectant mothers have been identified and have had lead hazards reduced through this program. In FY '04, the Department plans to strengthen its partnership with the medical assistance managed care organizations to provide increased lead education to new mothers, increased lead screening of their infants and increased inspection of their housing units for lead 11 04/21/04 - WHOLE - BILL 040255 hazards. Infant mortality. Infant mortality is the measure of the number babies who die before one year of age per thousand live births. 4 in 2001, which is 9 the latest year for which data are available, 10 a decrease of about 25 percent. However, this 11 decline does not reflect the significant 12 disparities that remain among individual 13 Philadelphia neighborhoods. The map on the 14 screen depicts the infant mortality across the 15 City, with those areas in red posting the 16 highest infant mortality, often times as much as double the citywide rate. The Department addresses infant mortality through targeted programs. In addition to two federally funded Healthy Start programs, the division administers a wide range of home visiting, outreach and community education programs funded through Maternal and Child Health Title V Programs. For the coming fiscal year, we have redesigned these programs 12 04/21/04 - WHOLE - BILL 040255 in order to better reflect best practices as defined by the literature and national maternal and child health experts. This restructuring will provide us with increased control over individual programs, including and enhanced capacity to measure outcomes and to focus our efforts in neighborhoods that have the highest infant mortality. Childhood immunization. Philadelphia and other large cities in the nation have experienced decreases in the rates of childhood immunizations, due in part to the introduction of additional inoculation requirements, but only in part. In response to our determining that the citywide immunization rate had fallen from a high of 83 percent in 1998 to 70 percent in 2002, the Department set a goal to raise the citywide rate to 90 percent by FY '06. I am pleased to report that the latest national survey identifies that we have stopped the decline in immunization rates and, in fact, had begun a turnaround such that current survey results show that our levels risen to 80 percent.
13 04/21/04 - WHOLE - BILL 040255 That is the map we started with, President Verna, in 2002 that shows the immunization rates. The red areas are the areas that have been as low as 30 and 40 percent in those neighborhoods. The new map shows that because of strategic development and our outreach deployment in those areas, we've turned that around, eliminated the red area and indeed, according to the survey, begun to stop the decline and increase the immunization rates citywide. Chlamydia and gonorrhea. Like the rest of the nation, we are in the midst of an epidemic of sexually transmitted diseases among our adolescence 15 to 19 years of age. Unlike the rest of the nation, we've developed an aggressive approach to meeting this epidemic head on. That's a picture of the epidemic in the City of Philadelphia. The latest data confirmed that there are 9,000 cases of gonorrhea and chlamydia in this age group. With the courageous collaboration of the Philadelphia School District, we mounted an aggressive and nationally unprecedented 14 04/21/04 - WHOLE - BILL 040255 response in FY '03 which involved the provision of STD education in all public high schools, including offering voluntary testing on-site and follow-up confidential counseling and treatment. In the 2002-2003 school year, 30,000 students attended educational presentations with 19,600 children receiving voluntary testing. 8 percent of those cases were treated. So far in 2003-2004 school year, 15,000 students have fattened educational presentations with 9,400 availing themselves of voluntary testing. And I can tell you we've identified again 519 new cases previously undiagnosed asymptomatic cases of chlamydia and gonorrhea in this age group. The uniqueness of this undertaking, collaboration with the School District and the aggressive case finding, resulted in national recognition of this program as a model for other cities to consider. HIV/AIDS. While the number of new 15 04/21/04 - WHOLE - BILL 040255 and existing AIDS cases reports filed with the department in FY '03 remained relatively stable with a slight decrease from 1,160 in FY '02 to 1,126 in FY '03, the number of actual new diagnosis of AIDS has continued to drop with the advent of effective treatment from 958 of new cases in FY '02 to 888 new cases in FY '03. AIDS continues to disproportionately impact minority communities, with 78 percent of persons living with AIDS being of color. The Department has engage in a variety of activities to address these disparities. This past summer, the Department put out the competitive bid of the entire HIV prevention system targeting the highest risk neighborhoods with interventions that address the highest risk behaviors. Community-based organizations competed for the approximately $6 million available, and as a result, new interventions were established by mostly minority-controlled organizations in neighborhoods most impacted by HIV. This included making available free HIV testing at more than 50 sites across the City where 16 04/21/04 - WHOLE - BILL 040255 35,360 HIV tests were conducted during Calendar Year 2003. Additionally, the Department continues to fund community-based providers 6 through the Ryan White Minority AIDS 7 Initiative. This initiative, also 8 neighborhood-focussed, centers around the 9 Storefront Project with it's three walk-in 10 safe spaces providing services in Germantown, 11 West Philadelphia, and Kensington. The 12 storefronts are street-level, open-access 13 service sites providing a safe space geared to 14 walk-in traffic. They link people with HIV to 15 primary medical care, testing and counseling, 16 case management, substance abuse treatment, 17 prevention programs and other needed services. 18 During the past year, we served 1,587 19 high-risk people and people living with HIV through the storefront initiative, about half of which are women and children. The Department continues to operate and structure its animal control services.
And this is focused on responding to those issues that stray animals present in the City, 17 04/21/04 - WHOLE - BILL 040255 of which we have an overabundance. A variety of animals make wonderful pets and can enhance family and individual quality of life and well-being. However, when such pets are not cared for and managed responsibly, the result can be detrimental to the public health and safety. Accordingly, a new and more aggressive public awareness licensing and license law enforcement campaign will occur this spring and summer and into 2005. The Department of Public Health has a number of challenges: Insurance coverage for health center patients. It's well understood that the medical care and the services ancillary to its service delivery are among the most complex and expensive of the services needed by a community. The Department's eight full-service health centers depicted on the screen are the medical care providers to 100,000 Philadelphia children and adults who make about 320,000 patient visits a year. No 25 Philadelphian is denied care in our health 18 04/21/04 - WHOLE - BILL 040255 centers. Our ongoing challenge is to secure the cooperation of all of our patients in accessing available health insurance for which they may qualify. In FY '02, a full 64 percent of our patients were without insurance. A number of studies, including a recent study by the Institute of Medicine have shown that people without health insurance have worse health status than people with insurance. Yet many of the uninsured in our centers were insurable, including the children. Working to get insurance for those who are eligible, we reduced the number of uninsured visits to 60 percent in FY '03, and our projection for FY '04 is to reduce the number to 55 percent. Our goal for FY '05 is to reduce that number still further to 50 percent. While we will turn no one away, we must have the cooperation of everyone in making application for insurance for which they may be eligible. Prescription drugs. The debate as to how to make this essential element of medical treatment affordable wages across the 19 04/21/04 - WHOLE - BILL 040255 political spectrum and among those who rely on life-sustaining prescription medication. In counterpoint in this volatile situation is the Department of Public Health's Pharmacy Program which provides prescription drugs to all health center patients without charge and at a level without equal anywhere in the City and perhaps the nation. Our health center pharmacies will fill an astounding 546,000 prescriptions in FY '04. While most of these are for longstanding health center patients, we see with increasing frequency persons being referred from other health systems for this benefit. The volume imposed on health center pharmacy results in long lines in each health center every day and delays that have been as long as eight days in getting a prescription filled. Clearly, we need to do better. And better will require a much different approach if we are to provide reasonably efficient, safe, affordable pharmacy services. Possible options, including accessing the existing pharmacy network in the City, continued emphasis on insurable persons becoming 20 04/21/04 - WHOLE - BILL 040255 insured, and close structure of scrutiny of a potential structure of co-pays for prescription drugs designed and implemented so that the cost of improved services can be affordable while assuring that persons in our system are not deprived of life-sustaining medication because of inability to pay. Health system changes. In the past 10 years, we have seen closures of 8 hospitals in this City, and this past December, the announced closure of the Medical College of Pennsylvania. In the intervening months, there is evidence that we have not seen the last of significant changes in the private and voluntary health systems in the City.
These changes have healthcare, legal, city planning and economic applications, and we need a mechanism within City government to assess, understand, and respond to these changes. That's our health centers, City health centers. These are the non-City health centers in the City. And third slide will so the combination. At first there were eight city health centers and precious little else. 21 04/21/04 - WHOLE - BILL 040255 And now we have 17 non-City health centers. And when we put them together, we've got something like 27 health centers. And the question is that we're all out there serving essentially the same population. The big question is, is it a system? And that's something that we've got to explore very closely and carefully as we go forward in this new fiscal year. Adjustment of fees for license services. The fees for many of the Department's services in certain City licenses and permits have not changed since 1993, and the Department has been absorbing increasing costs of providing these services which have increased percent during this period. In 18 the coming days, the Department plans to 19 introduce to Council amendments to the Health 20 and Air Management Codes to adjust these fees 21 to cover the cost of providing these services. 22 Universal healthcare. This past 23 November, the electorate approved a change in 24 the City Charter placing responsibility on the 25 Health Commissioner to develop a plan for 22 04/21/04 - WHOLE - BILL 040255 universal healthcare for all Philadelphians. This is a significant responsibility in relation to a subject that is the focus of much debate across the country and at every level of government. In this context, we have begun this work. Management. The Department has had the excellent service of a large number of highly skilled and effective management and technical staff. Many of these individuals have retired and will be retiring in the months ahead. Our plans are in place to manage these changes through a variety of organizational and structural changes. Principal among these are our new management structure for our health center system involving the use of a new health center manager series and the deployment of regional managers to oversee multiple health centers and the physical and managerial consolidation of the major laboratories that are operated by the Department. When I was here last year, President Verna, we talked about the some of the changes 23 04/21/04 - WHOLE - BILL 040255 that we needed to make in management. And one of the things that we were grappling with was making our health centers more accessible by telephone to the public. And the big area that we were facing was the virtual inaccessibility of our appointment desk for people calling in to make appointments in the health center. It was so bad in terms of access to that appointment desk that people would abandon the phone use completely and essentially walk to the health center to transact business as opposed to using the phone. We got together with the Department of Public Property, Joe James in particular, and Carmen Paris and a number of people on my staff got together and scoped out a system where we might have a centralized call system for our health centers. And I can tell you, President Verna, that this year we've been able to get all eight health centers on a centralized call system. And that's a picture of our very excellent public service people who are receiving calls from the general public for appointments in all of our health 24 04/21/04 - WHOLE - BILL 040255 centers. Essentially, when you're calling, for example, a health center at Broad and Morris, that phone is ringing here in City Hall with the appointment book up on the screen for that individual; and the individual can actually make, reschedule, change or cancel an appointment. A tremendous change. We're beginning to monitor the impact of that. We have one of our health center directors, Mr.
John McGill, who's got the operating responsibility for this. I'm told that Mr. McGill has taken to walking around the health center and when he sees people standing in line to make appointments, he bets them a cup of coffee that they can pick up the phone and make an appointment quicker or change an appointment quicker than they can by standing in that line. And what I'm told is he's losing very few cups of coffee these days. So that's an example, President Verna, of some of the management changes. In conclusion, the Department of Public Health is moving forward and meeting longstanding and developing public health 25 04/21/04 - WHOLE - BILL 040255 challenges in new ways. We are meeting the budget challenges by bringing sound management principles together with creative program initiatives to preserve and improve the delivery of essential public health services to the people of Philadelphia. Thank you, President Verna, for the opportunity to present this testimony.
Thank you, Commissioner. I have a couple questions, but before I do ask them, I certainly want to compliment and applaud you and your staff for doing an absolutely fantastic job. Thank you so much. COMMISSIONER DOMZALSKI: Thank you, President Verna.
Commissioner, on of your testimony, you mention that your Department has organized data on health status indicators so that the overall health of the City can be understood from the perspective of the health of its neighborhoods. This data is aided by mapping technology in use by the Philadelphia Safe and 04/21/04 - WHOLE - BILL 040255 Sound and is used to strategically deploy or re-deploy to resources to areas of greatest need. Can you tell us how this data is used and what resources have been re-deployed? COMMISSIONER DOMZALSKI: Yes President Verna. I think our immunization strategy was a good example of that. We have traditionally looked at citywide indicators of how we're doing from an immunization perspective. What I asked staff to do is not to talk about the City, don't ignore the averages but tell me what it looks like in the neighborhoods, what does the immunization rate look like in the neighborhoods. And when we did that, we found that even though our overall City rate was at a dismally low 76 percent, that turned out to be good news because there were neighborhoods where it was below 50 percent. So what we did was take our outreach teams and have them reduce work in the neighborhoods where the immunization rates were very high to the neighborhoods where the immunization rates were very low. And by 27 04/21/04 - WHOLE - BILL 040255 focussing the outreach and moving those resources from areas where we already accomplished our mission but if we didn't look at it from a neighborhood perspective, we wouldn't have known that and moving them into the areas, such as zip code 26, to improve the rates there.
Is Safe and Sound still involved? And if so, are they under contract, and for what amount? COMMISSIONER DOMZALSKI: Safe and Sound does a number of programs very effectively particularly with our beacon and schools and after school programs. We support some services under contract with Safe and Sound, particularly some of our disease prevention services. We also partner with them, President Verna, around the report card. And I will tell you that what got my attention on this whole business of chlamydia and gonorrhea was when we began doing the children's report card and showing that the STD indicators for our children were so poor, we were at the lowest level, Level 5, and that 28 04/21/04 - WHOLE - BILL 040255 focus, that was a challenge. I will tell you we in public health didn't want to see that. But we decided, you know, the data were accurate, it's displayed there and what we're going to do is organize our resources to begin to battle that epidemic. So we worked with Philadelphia Safe and Sound on a number of fronts, particularly around children services and after school and beacon school programs.
So they are under contract. And can you tell me for what amount? COMMISSIONER DOMZALSKI: We are contracting in the Health Department, our largest contractor we have with them -- this is not the only contract that we have from City agencies, but from the Health Department it's a little over 500,000 that we fund particularly for tobacco prevention and cessation programs. Mr. Lemmo tells me it's 578,000.
Thank you. Lead paint removal has been an area of great concern to Councilmembers, as you 29 04/21/04 - WHOLE - BILL 040255 know. And over the last few years, we have modified your budget in order to decrease the backlog. When do you anticipate the backlog will be eliminated? COMMISSIONER DOMZALSKI: We anticipate that the backlog will have been reduced from 1400 -- it's any 570-something now. We expect that by the end of Fiscal Year '05 for the backlog to be at 250 and probably by the middle of '06 for it to be eliminated completely.
That's great. Commissioner, how long does one have to wait for an appointment to see a physician at our health centers. COMMISSIONER DOMZALSKI: Well, it depends on the service, President Verna. One of our performance measures is a number of appointments that are available in three weeks. What our focus is, I think we're looking at somewhere around 76 percent of the appointments being available in three weeks. That's of all the appointments. When you 30 04/21/04 - WHOLE - BILL 040255 break that down, you see a number of differences. In our prenatal program, that might be three weeks, maybe four. Family planning might be two weeks. When we look at adults, for adults for just a routine visit, that ranges from health centers from -- I have appointments available today at Health Center 5. However, at Health Center up in the far 10 Northeast that might be a three-month wait up there for adults who do not have an urgent medical program. If there's an urgent medical program, it's an entirely different story. On the other hand, for children, we can get children in in a couple days across the system, so we have ample capacity for children. The adult piece does concern me quite a bit. One of the things that we're going to do is we're going to enhance that system that I had on the screen there about our operators taking central call. And each, we're able to access right now the appointment books for each health center. What I want to do is be able to look at a program where we're 31 04/21/04 - WHOLE - BILL 040255 able to display the whole system in front of an operator so that each operator can input into the system and make changes immediately so that if a patient does call from the Northeast and says, "My God, it's 70 days until you get an appointment." We can say, "Well, if you don't mind traveling a little bit, we can get you an appointment tomorrow or even this afternoon at Health Center 5 at 20th and Berks." Right now, the system, it's a little cumbersome to do that, but that's what we're doing. The other piece of it is, we have to look at how -- patients are telling us how they want to use the health centers. And we're telling them how we want them to use it. And they're winning. We might as well just figure out how best to accommodate this service and see whether or not there's ways in which we can adjust some of our initial appointments and how we bring people in for that first contact.
Do you 32 04/21/04 - WHOLE - BILL 040255 have any indication at all as to how many patients we've seen at the health centers in the last year, for instance? COMMISSIONER DOMZALSKI: How many people were served?
Yes. COMMISSIONER DOMZALSKI: Well, we serve 100,000 individuals, and they will make approximately 320,000 visits in a year.
Commissioner, in your testimony, I see that our health center pharmacies will fill an astounding 546 prescriptions in FY '04. Councilwoman Tasco and I introduced a resolution which has not been scheduled as yet and it resulted from what we saw on 60 Minutes on two different occasions. And that was that many of the cities and states are now having their prescriptions filled in Canada for their city employees. Can you tell me how much it cost to fill 546 prescriptions? And what do you think of the possibility or the idea of pursuing the issue of having prescriptions filled in 33 04/21/04 - WHOLE - BILL 040255 Canada? COMMISSIONER DOMZALSKI: In answer to the first question, President Verna, I will tell you, the price of medications, just the drug itself, runs probably somewhere just under $8 million a year. Then we have the price of pharmacists and then support 9 staff, and that's probably another 2, 2 and a 10 half million dollars on top of that. So we're 11 talking about a 10 or 11 million dollar issue 12 here with pharmacies. 13 Now, the pricing of all of this is 14 complicated. If you could bear with me just a 15 little bit, I can parse that out for you 16 somewhat. We enjoy -- because of the kind of health service delivery system we are, we enjoy the ability to purchase drugs at a very reduced cost. It's called the 340-B Program. It's under the Public Health Service Act. And it permits a very aggressive price discount to be made to programs that serve impoverished indigent communities such as our health centers. To understand the value of that, we have to talk about what's called AWP, which is 34 04/21/04 - WHOLE - BILL 040255 Average Wholesale Price of drug. That's a benchmark by which all prescription plans are based. For example, maybe the City employees program there's some discount from AWP. AWP is an average. And often times what the chain or the pharmacy will charge the prescription plan will be the following: They'll charge you for the drug at AWP minus a percentage plus a filling fee. Well, the difference between what AWP is and what pharmacies typically acquire the drug at is percent. There's about a 17 14 percent margin there. 15 We purchase drugs at a much more 16 attractive rate than that. Our price under 17 340-B pricing is approximately 56 or 57 percent below AWP. And so there's that part of it. In terms of the Canadian drugs, the Canadian system, I understand there's somewhere between a 30 percent price advantage and maybe a 50 percent.
Fifty. COMMISSIONER DOMZALSKI: Other 35 04/21/04 - WHOLE - BILL 040255 cities -- Sarah Haecker on my staff has done some research on this and identified that states of Minnesota, for example, and Wisconsin have posted on their web site pharmacies in Canada that they think are safe and places from which pharmaceuticals could be purchased at a discount price. I just heard the former FDA Commissioner David Kessler this week talk about the fact that it's against the law to do is that, that there are no safety standards to guarantee the safety of drugs purchased outside of the United States. Well, we're finding that the difference in all of this is really the price, not the pill. Because when you look at some of the manufacturer, for example, some of our major drugs like Lipitor a large portion of the drug Lipitor that comes into the United States is manufactured in Ireland.
And some of them are manufactured in Canada. COMMISSIONER DOMZALSKI: The whole business with the Medicare prescription drug 36 04/21/04 - WHOLE - BILL 040255 plan, you can see the ads on television, nobody understands it because it's so complex. On the other hand, the centers for Medicaid services CNS has now posting on its web site information about what -- in fact, I think they're even breaking it down to the pharmacy level so you could access their web site and say, Look, if I'm on drug X on a regular basis, they would give you the pharmacies in your surrounding area and the prices at which that drug is being sold. So there's a lot of activity here around this issue of drug pricing and the pharmaceutical delivery system.
Well, according to some information that we received, there are a number of cities and states that are sending their prescriptions to Canada. And the cities are really saving millions of dollars as a result of that. And according to what we saw, the drugs are safe because, as you say, most of them are produced outside of the States. Commissioner, I'll just ask one last 37 04/21/04 - WHOLE - BILL 040255 question because I know that Councilwoman Tasco has been waiting very patiently. For the last couple of years, it has been said that the healthcare center at Broad and Lombard would possibly be sold because the building is so inadequate. What is the status of that? COMMISSIONER DOMZALSKI: The health center at Broad and Lombard, we call it -- it's our health administration building. There's really three major functions in the building. The health center is on the first floor, the administrative offices for a number for our programs disease control on the second. And public health laboratory is on the third floor. That building sits on property that does not belong to the City. A good chuck of it --
It does not belong to the City? COMMISSIONER DOMZALSKI: Does not. We lease it --
It's 38 04/21/04 - WHOLE - BILL 040255 privately owned? COMMISSIONER DOMZALSKI: Yes. It comes to us by way of the Johnson estate that we lease this for on an annual basis. And our current lease with the Johnson estate expires in 2007 or 2008. When that lease expires -- right now I think we're paying $4,000 a year for that land. When that lease expires, we would expect that we would be paying market rates for that land. In addition to that, that building has just been a plague in terms of its maintenance, in terms of being able to work in there. We need to outfit our laboratory much better so that we can do bioterrorism kinds of work, but we cannot invest more money in the laboratory in that building. It will not support it. So our plan is to move out of there, one, the building doesn't work; two, we're going to los3 the lease on the site; and three, we probably are going to be able to better serve all of our public health functions and we're going to make sure we don't inconvenience the public in any new place that we move. 39 04/21/04 - WHOLE - BILL 040255
Either '07 or '08, President Verna. I'll confirm that for you.
Commissioner, thank you very much. The Chair recognizes Councilwoman Tasco.
Thank you. Is that the what John G. Johnson estate? COMMISSIONER DOMZALSKI: I'm sorry, ma'am.
What estate is that, the John G. Johnson? COMMISSIONER DOMZALSKI: All I know is the first Johnson. I don't know if it's -- I think there's an art collection.
John G. Johnson. COMMISSIONER DOMZALSKI: Yeah, you're right.
Thank you. I have a number of questions for 40 04/21/04 - WHOLE - BILL 040255 you, Commissioner, and I just like to begin with your statement in the testimony about the decrease in General Fund positions, but I'm 5 somewhat confused. On of the budget 6 book we have, it appears that there was an 7 increase of 37 employees? 8 COMMISSIONER DOMZALSKI: I think 9 what we're looking at is -- there are two 10 figures in terms of the number of employees. There is the budgeted figure for FY '04 and then there's the increment run which we run in November. So there's the increment run in November of '03. For example, the budgeted positions in the General Fund for '04 are 771. The increment run is 695. So what we planned to do, though, is to fill up to number of positions there -- 66 positions in FY '05. We show that as an increase of 66 positions, but it's not compared to what's budgeted, it's compared to what was in filled in November of '03. It's an awkward accounting way to show these numbers. The bottom line is that we'll end up with a net decrease of 10 positions across the department. 41 04/21/04 - WHOLE - BILL 040255
Explain that to me again. COMMISSIONER DOMZALSKI: When we show our budget in the General Fund, we show how many positions that we had budgeted for FY '04 when we began this fiscal year, which is 771. The increment date of November -- the City does, the accounting people take a snapshot. We never have all positions filled that we anticipate filling for a variety of reasons; people leave, we're slow in filling the positions for a variety of reasons, people are hard to get. So what we do is take a snapshot in November about how many of those 771 positions did you actually fill, Commissioner, you actually have filled at this time. And this November, it was 695 in the General Fund. And what we planned for in '05 then is to fill 761 positions, which looks like an increase of 66 positions compared to the '03 increment run, but it us is an actual decrease of 10 positions from the budgeted number. I will tell you, this makes sense 42 04/21/04 - WHOLE - BILL 040255 to --
No one. No 7 one. I don't understand it. I'm looking on where it says list of positions, General Fund, and you have a lot of positions in the Grant Fund. I'm looking on of the budget book. COMMISSIONER DOMZALSKI: The 37 positions, Councilwoman?
Yes. COMMISSIONER DOMZALSKI: That's compared, again, to the increment run in November. We're actually showing a 37 position increase because that's the number of positions that are vacant, that were vacant as of November. So we don't want to let that go, we want to fill those positions right up to what we're budgeted for, because these impact the health centers and we want to be very careful with that.
You had 423 43 04/21/04 - WHOLE - BILL 040255 budgeted in '04. I'm looking on . COMMISSIONER DOMZALSKI: Yes, ma'am.
And you so a budgeted number positions of 423 in '05. COMMISSIONER DOMZALSKI: Yes.
And the difference from -- let's go back. You had actual positions in '03 of 400. You budgeted 423 in '04. And I don't know what increment run is in November of 356. Is that the number of positions you had? COMMISSIONER DOMZALSKI: Yes, ma'am.
Now so how many positions do you have now? COMMISSIONER DOMZALSKI: We have 386.
And you anticipate filling 423? COMMISSIONER DOMZALSKI: Yes, ma'am.
So you budgeted for them doesn't mean that you're going to fill them, right? 44 04/21/04 - WHOLE - BILL 040255 COMMISSIONER DOMZALSKI: Our intention is to fill them.
Are these all new positions? COMMISSIONER DOMZALSKI: They're not new, no. They're a variety. Some of them are very important clerical positions. Some of them are nursing positions. Some of them are pharmacy positions. There are a variety.
Of the clerical positions, are they all civil service? COMMISSIONER DOMZALSKI: Yes, ma'am.
Would some of them come from other departments in the City? COMMISSIONER DOMZALSKI: No. 17
So they would be advertised and the test would be given and there would be no transfers from other departments? COMMISSIONER DOMZALSKI: People could. I mean, they could access the list. I don't know most of these open competitive. The promotions I guess would be in the department. But I think others would be open 45 04/21/04 - WHOLE - BILL 040255 competitive.
Could you tell me how then -- COMMISSIONER DOMZALSKI: Especially the entry level ones. They could come from other departments. But they'd have to get on the Civil Service list.
So then could you explain to me how do you account for General Fund reduction of 10 people? COMMISSIONER DOMZALSKI: How we're doing that?
Yes. COMMISSIONER DOMZALSKI: Yes, ma'am. We have three positions from facilities management. We are going to centralize the facility maintenance under Public Property, so we'll be giving up three positions there. There's a couple of clerical positions and there are a couple of administrative positions. For example, I have an administrative officer in environmental protection. Actually, it's a contract administrator that won't be filled. So it's 46 04/21/04 - WHOLE - BILL 040255 across the department, but it's at levels that will not --
Will they be Grants Fund or General Fund? COMMISSIONER DOMZALSKI: General Fund.
So you support in the various grant programs you have General Fund dollars supporting staff? COMMISSIONER DOMZALSKI: Yes.
In the grants program portion of the budget, you have General Fund money? COMMISSIONER DOMZALSKI: No, just grants.
So environmental protection, is that General Fund? COMMISSIONER DOMZALSKI: It's a combination of General Fund and Grant.
And so any individual coming out of the program that's funded with grant money would be the employee that is funded by the General Fund? 47 04/21/04 - WHOLE - BILL 040255 COMMISSIONER DOMZALSKI: No. Our reduction would be in General Fund positions but not in the Grant Fund.
All right. Thank you. I'm still not clear. On of your testimony, you stated that the health department has begun the work of drafting a plan for universal healthcare. I'd like for you to describe what work has begun and what is your timetable and plan for the completion of this Charter mandate. COMMISSIONER DOMZALSKI: Let me tell you, Councilwoman Tasco, that if I had gotten -- and I'll just be candid with you. If I had gotten an opportunity to volunteer or not volunteer to do this, I don't think I would have volunteered to do this. The Charter has been made the responsibility of the Health Commissioner to develop a plan for universal healthcare, something that nobody else has been able to do nationally or at the state level. Having said that, my colleagues and I in the Department have decided this might be 48 04/21/04 - WHOLE - BILL 040255 just an excellent opportunity to begin to pull this community together that's got things to say about and understand about healthcare and its access. And we've had an initial meeting. I will say it was a good meeting, but it wasn't a good meeting. It was a good meeting because we had probably different segments 9 of the community in there ranging from people 10 from the Philadelphia Unemployment Project to 11 organized labor to health insurance and people 12 in the middle of the spectrum there. And we 13 had people said at the end of that meeting 14 that this is the first time a conversation 15 like this has ever taken place in this City about an issue such as health insurance. Indeed, one of the insurers said that, "If you had ask me to come to the meeting like this three years ago, I would have said no. And if I did come, I would have said there's no place for me at this table." That person said that, "Yes, there is. I understand it now. Health is a community affair and we've got to pull our information together and identify what things we can do." 49 04/21/04 - WHOLE - BILL 040255 We cannot as Philadelphians change federal policy. Hopefully, what's going to have when we have presidential, you know, politics in the election everyone's got a healthcare plan. Maybe that's going to help us. The State's got a lot of leeway in this in terms of how they fund services. There are things we are do. There are things we can do. We can look at our health systems here as we displayed up there in terms of our 27 health centers. But we can also look at how we're being impacted by national trends across the board. When Carol Rogers and I looked at the number of uninsured, uninsured in Philadelphia, we were astounded to learn we have 136,000 uninsured people. And what was even more astounded than that, in the two years that elapsed from the time the first study was taken on that until these data became available, 20,000 more uninsured were added to the rolls. And the tragedy of that is 80 percent of the uninsured are employed, people who are employed who cannot access 50 04/21/04 - WHOLE - BILL 040255 health insurance. Either they don't get it from their employer anymore or they get less of it from their employer and they are required then to pay more into it as a co-pay. So we've got to take all these pieces together and say, "Look, what is the picture in Philadelphia?" And don't forget, there are increasing numbers of individuals who are not only insured but our system says you will never get insurance.
I understand and we all understand the difficulty in doing this. I think the intent -- and I can't speak for Councilman Cohen -- was to have Philadelphia begin to think about what we can do that could possibly serve as a model to stimulate national thinking. I mean, from small little acorns do big trees grow. And looking at developing a plan that, certainly, we can influence federal policy if it's done the right way. But I guess my question is, is your dialog ongoing and have you developed an outline for an action plan or a process for 51 04/21/04 - WHOLE - BILL 040255 how you meet the Charter mandate? COMMISSIONER DOMZALSKI: We have. We've engaged someone to help us lead that to begin to staff that, to pull the data together to begin to pull meetings together. We envision in this actually bringing in Councilmembers to this. We had a meeting last week with Councilman Cohen to talk about this. We also envision have meetings at the neighborhood level in the communities to see how they're impacted, get a perspective there that we wouldn't have just looking at it from our advantage point. So we're going to pull all these pieces together, including most of the people who came into Council and testified in favor of this because everyone has got something to say about this. I believe two things: One, all healthcare is personal. And two, health definitely is a community affair.
Councilwoman, you can finish you line of questioning on this. Councilman Ramos has been waiting, so we could always come back to 52 04/21/04 - WHOLE - BILL 040255 you.
I just want ask you, you said you pulled someone in to help you do that. Who is that? COMMISSIONER DOMZALSKI: Dr. David Grande (ph).
What is his background and experience? Is he an employee of the Health Department? COMMISSIONER DOMZALSKI: No, he's not. Dr. Grande has worked at the policy level in Washington on healthcare issues and health policy issues. He's familiar with that area. Importantly, he's also a practicing internist, so he understands patient care from the delivery point and also is able to bring some resources together from -- he's associated with the Woodrow Wilson School of Public Policy at Princeton. Is able to bring some of those resources together.
How was he selected? COMMISSIONER DOMZALSKI: Actually, through a process, I think it was suggested to 53 04/21/04 - WHOLE - BILL 040255 me from somewhere in the advocacy community, we brought a couple of people together to talk about does this make sense for us to go in this way. I'm talking about people outside the Health Department. We had some questions about what was his background and preparation. We shared his resume. We talked about it. And when we came out of it, we decided we've got to get going on this. Dr. Grande appears very competent. He's got the right background and experience. We think we need to be get moving, and I think that that's a good approach and so that's the way we're going.
Thank you. The Chair recognizes Councilman Ramos.
Thank you, Madam Chair. Good morning, Commissioner. COMMISSIONER DOMZALSKI: Good morning, Councilman
I want to thank 54 04/21/04 - WHOLE - BILL 040255 you for being one of many department head and agencies and boards that reached out to me. I'm the newest member of City Council. And that has helped me understand your needs and your concerns, especially within the deficit that this City faces, this government faces at this time. No health centers are closing, is that true? COMMISSIONER DOMZALSKI: Absolutely not.
The health centers have always been known to be free healthcare centers, and I'm glad that since I was a child they were there for especially people in neighborhoods, especially the poor. Is there any anything that's going to change in the services that provide that moves it from free to some kind of cost to the public? COMMISSIONER DOMZALSKI: Most centers of our type do have a fee schedule.
Is that new? COMMISSIONER DOMZALSKI: Well, we're not contemplating a fee schedule at this 55 04/21/04 - WHOLE - BILL 040255 moment. We've been advised that we ought to think about that because there are people who -- first of all, we will never want to have anyone not to receive care because of a cost factor or inability to pay. We don't want to have that barrier in the health centers. So we've not taken that advice to introduce a sliding fee schedule for the uninsured. We haven't closed the books yet on understanding whether or not a service such as our pharmacy program whether it's possible to create a fee structure that would enable us to obtain some revenue but also keep the service available for those who just don't have any resources. We haven't finished that analysis yet, and that's one --
So there is a chance that because of the deficit, correct me if I'm wrong, that some of the services that you're providing at the healthcare centers, there's going to be fee required? COMMISSIONER DOMZALSKI: That's not on the table at this point. My budget is not balanced on any fee schedule at this time. 56 04/21/04 - WHOLE - BILL 040255
If the event that you would, you know, because of the deficit that you would have to go in that direction, have you studied what kind of impact that would have on the population that you serve? Healthcare centers, as I stated, have been traditionally a place where people that are poor go to. And if so, will you notify -- I think you would need to notify the public in advance. I would like you to notify us through the office of the President of any of the changes that will have such a dramatic affect on the population that you have served so well over the years. COMMISSIONER DOMZALSKI: At this time, there is no plan to implement in fee schedule in the health centers. The FY '05 Health Department budget is not balanced in any way in anticipation of any fees chargeable to patients. So the services will continue to be available to patients on the same basis that they are today. Having said that, I have got over 50 percent of the people who come into the health centers without insurance, I 57 04/21/04 - WHOLE - BILL 040255 have got in some of the health centers I have got as many as 55 percent of the children, children who are without insurance. Now, Councilman, 98 percent of the children in this City are insurance eligible. We need to do a better job in our system of getting all children insured. So we're not going to charge people a fee; that's not in the cards. But we do need to double our efforts and get everyone's cooperation to help us get as many of the insurables in our health centers on insurance, just because it makes good public policy and good public health policy.
And I agree with you. I concur with you. I think that is wise. And thinking ahead, this is an area that we can probably do better and be able to get reimbursement or get insurance for people that are needy, especially our children. Last week, I presented a resolution 22 that was adopted here unanimously by this body and was commending you and the Health Department for your tenacious work that led to Pennsylvania's Health Secretary, Mr. Johnson, 58 04/21/04 - WHOLE - BILL 040255 temporarily allowing Philadelphia to use a code of assist that maintains an HIV patient's anonymity. And I talked about that last year as I ran for public office of how important this was to me and to people that needed to protect their anonymity. Can you talk to us a little bit about the program and the impact that this health department has made inside the State of Pennsylvania? Again, I congratulate you for being able to have Pennsylvania relieve us a system that I think was unfair to our HIV community. COMMISSIONER DOMZALSKI: Thank you, Councilman Ramos. It was very generous and I very much appreciate the action of Council in this regard. But I have to quickly say that this was a collaborative effort and without everyone's participation, none of it would have been possible. The leadership here began with the Mayor. The Mayor was absolutely four square in front of not having names based reporting. Joe Cronaur was very much part of this. Ronda Goldfein and the AIDS Law 59 04/21/04 - WHOLE - BILL 040255 Project. We have Kevin Konar in the Action AIDS, and Jane Schull, a member of our Board of Health. There are just so many people and people at the grassroots that came out and said, "We support you in this." And that's not to say it wasn't a difficult process with the prior Administration in Harrisburg; it was a difficult process, and some of my colleagues understand how difficult that was. The fact that we've got the Secretary of Health, Secretary Johnson, understanding the needs of the community here in Philadelphia and understanding the barrier that names based reporting will present for people accessing needed testing, that was the basis on which he granted the year's waiver. Having said all that, what we're going to have is we've begun to implement this, we began to implement this the 31st of March. It will involve -- what everybody agrees is, first of all, we know a lot about AIDS. We know almost nothing about HIV. So we have to understand something about HIV disease and where it is in the community. So 60 04/21/04 - WHOLE - BILL 040255 what we're going to do here in Philadelphia is we're going to have reporting done by a code-based identifier. The code will consist probably some combination of maybe the last four digits of a social security number and perhaps some part of a birth date and so on as the code gets structured. So that when those reports are made, the government is not getting access to a specific individual's identity.
Thank you for your efforts and all the other community groups that fought so hard for this system to become a fair system for HIV patients. Madam Chair, am I okay to continue?
We're not being timed because there aren't that many year.
The issue of undocumented immigrants going to your health centers, how big is that population? How have you seen it grown? And what rights do they have, particularly undocumented immigrants, what kind of services are they entitled to in 61 04/21/04 - WHOLE - BILL 040255 your health centers? COMMISSIONER DOMZALSKI: They're entitled, Councilman Ramos, to a full range of health services that every other person is. One of the hallmarks of this Administration is we've reached out to the diverse communities that make up this wonderful City. Indeed, last night, we were with the Mayor in the Cambodian community at 16th and Washington. The Cambodian community is 10,000 strong in this City. And under the leadership of the Managing Director last October, we took a tour, all the department heads, to six or eight culturally and ethnically defined communities in this City. We have seen in the health centers increasingly new Philadelphians, immigrant population turning to our health centers in great numbers. The health centers that are most dramatically impacted would be Health Center 6 where about 40 percent of the individuals who access care in that center require some sort of language assistance as we go through. And that's pretty much across the board. They're 62 04/21/04 - WHOLE - BILL 040255 just two health centers where language services aren't needed as much across the board, and that would be Health Center in 5 Strawberry Mansion. But by and large, just about every health center requires -- we have some 23 languages that we need to provide interpreter services. If you go back 20 years, perhaps what we were looking at might have been two or three languages. So it's increasing, we're glad that people are coming to Philadelphia, we welcome them, and we're very grateful that we're able to provide a whole range of services to all communities, including the new Philadelphians.
So I'm an undocumented worker walking into Health Clinic No. 6, there is every service that is provided to a citizen is also available to that undocumented person? COMMISSIONER DOMZALSKI: Yes.
And we are sure that they're being attended to? COMMISSIONER DOMZALSKI: Yes. 63 04/21/04 - WHOLE - BILL 040255
I haven't heard any reports. I commend you for that. I haven't gotten any complaints that they've been turned around, but I would think that this population is increasing, making your local health centers that much more crucial. Because given the health crisis in our country, health center seems to be our only place for the have-nots to go to. So I'm glad that we're doing -- Are you satisfied also with the language translators and people that work in your centers and having enough in these centers to be able to take care of this immigrant population that is getting sick but still haven't become proficient in English? Are you satisfied with -- and if you're not, I need for you to tell us that. COMMISSIONER DOMZALSKI: Let me answer the last question first. I'm not satisfied, not with the language. We've made a lot the strides in that. We do employ interpreters in our health center. We do access interpreter services through a variety 64 04/21/04 - WHOLE - BILL 040255 of organizations such as Nationality Services Center. We translate, we use the language line. But, Councilman, all of those are substitutes and very poor substitutes for being able to have someone who has a medical problem be able to communicate information as personal as about your health status through a third party, and sometimes not all that ably as well. So there are many things we need to do. We are making huge strides. I know the Managing Director's leadership on this has been extremely useful because what we're going to be doing is being able to access the citywide contract on interpreter services. So that may increase our ability to interact with the limited-English-speaking community in the City. So I think we have done a lot and we've increased our services over the years, but to say that we are at perfection at this point or where we absolutely need to be or where we can be, I think we still have work to do. In terms of your first question, coming in, yes, the full range of services would be available to you. The only think I 65 04/21/04 - WHOLE - BILL 040255 would say as a caveat is if you were bringing your child with you and your child was insurance eligible, such as a child being born in the United States, we would ask you to cooperate with us and help you get insurance for your child. And often times that's where the rub is. Because as hard as we try, we still ask those questions on the forms like, "where do you live, who lives with you, how much income do you have and proof of income." And all of those things begin to get very off-putting to people who are here under a variety of statuses in the United States.
Are you saying that when your staff starts to question the parent of a child who now is eligible for some assistance, they don't want you to give you the information? COMMISSIONER DOMZALSKI: It's a little difficult. What we need to do is make sure we get our message across that the only thing we're interested in is getting an application for insurance, that this information is not going to government 66 04/21/04 - WHOLE - BILL 040255 agencies, it's not going to John Ashcroft, it's not going anyplace other than to the people who make a decision about whether or not your child is eligible for insurance and get your child the insurance that the child is eligible for which opens up a whole range of additional services which are very important for people to not only come to the United States but to stay and be successful in our country and in our City.
I appreciate very much what you're doing, providing service to a poor immigrant community, and what I see is an increasing number of that community of people that are undocumented. That's an issue that the country and the federal government doesn't seem to be giving us any direction of what to do in this area, and it's a degree of consternation among Americans and also a degree of unfairness going on with new immigrants into our country. Am I okay, Madam Chair?
If you don't mind, we do have -- 67 04/21/04 - WHOLE - BILL 040255
Thank you, Madam Chair. Good morning, Health Department. COMMISSIONER DOMZALSKI: Good morning, Councilwoman. How are you?
Great. I have a couple questions pretty much around the issue of working uninsured and their need for healthcare. I believe a couple years ago we did talk about expanding the hours at the district health centers. What are the hours? Have they been expanded to evenings and/or Saturdays? COMMISSIONER DOMZALSKI: We do have expanded hours, Councilwoman. The normal workweek is 7:30, 8:00 to 5 or 5:30. All of our centers do have either an evening session or a Saturday session. And our Health Center at Broad and Lombard has two evening sessions, one on Monday evening and one on 68 04/21/04 - WHOLE - BILL 040255 Wednesday evening. That is something that's been a subject of some conversation in the past, several years in the department, because what we need to do is really look at our patient population and ask them what are right hours for you, for you to be able to access this service? Forever, we always provided services when it was convenient for us. So now we've got to get around to asking people, "What's convenient for you?" Because much has changed recently because since 1997, even people who are insured know or have some sort of assistance need to be in sort of educational program during the day or they're in jobs where they don't have the luxury of taking an afternoon or a whole day off to take their child for an immunization or to get well child checkup or even their hypertension checked for themselves. So I'm just very suspicious that our service structure in terms of the hours is adequate at this point. I just see, as we look over the months, that we look -- as we do 69 04/21/04 - WHOLE - BILL 040255 these patient surveys in the center, through some focus groups, and talk about what are the right hours. I' thinking we probably need more evening hours, but people may tell us, "Well, look, I'd rather not do the evening hours. Just give me a few more hours on Saturday when I can access it better. That's something that we're very much engaged with.
Okay. Because I do know that getting to doctors is important. And if the center is not assessable and open, then it does create a problem for people that need healthcare. What is the normal wait for prescription drugs? COMMISSIONER DOMZALSKI: I'm sorry, Councilwoman.
What is the normal waiting period to get a prescription filled? COMMISSIONER DOMZALSKI: The normal waiting period for a prescription in this City is probably a couple of hours. In our health center system it's a couple of days, at best. 70 04/21/04 - WHOLE - BILL 040255 And there have been times, Councilwoman -- and I think you and I have talked about this -- that wait has been as long as eight days and sometimes even longer in our health centers. That's why we've got to grapple with this pharmacy issue.
It does seem to me that the pharmacy setup is a real issue. I know in District Health Center No. 9, the space is an issue, which I think would impact the ability to effectively service people. I visited there, and prescription drugs were everywhere. They were everywhere, just stacked up on top of each other. COMMISSIONER DOMZALSKI: That's something that -- because you know what you're looking at, almost nobody else sees. We see the line outside the center. We see the patients who are in the line waiting to be told, "yes, come back in two days or four days." But when you look beyond there, some of the hardest working people in this government, Councilwoman, are the people who work behind those counters. The pharmacists 71 04/21/04 - WHOLE - BILL 040255 and those pharmacy technicians and the wide range of staff in our health centers, but when you look in there, the physical plant was never made for this volume. It looks like -- it's just is a jumble in there; you're right.
It's very small. And I know if you can't get organized, you can't really service people in an efficient manner. I'll talk to you later about what was discussed at the Germantown site just in terms of the ability to expand that would give them more space, and we can talk that at some other time. One thing I'd like to know, how does our infant mortality rates compare with other cities in the United States and nationally? COMMISSIONER DOMZALSKI: Well, it's similar to other large urban areas. And I'm kind of responding tentatively because there's a difference. It depends on where you look. And, unfortunately -- this is a part of a conversation I always have a lot of difficulty with. And we in Philadelphia count every 72 04/21/04 - WHOLE - BILL 040255 child that's born who dies as an infant death. That isn't the way infant mortality is calculated everywhere else. There's no 5 consistency. We looked at a place, for example, in one of the boroughs of the New York. 4. Well, I was astounded, because the population was very similar demographically to ours. One of the issues that comes up is that they don't issue a death certificate for very pre-term births. And so they've essentially calculated their way into a different infant mortality. I'm very reluctant to do that. What we need to do is focus on across the board getting our infant mortality rate -- see, if we had that map up there, Councilwoman, you're going to ask me -- and I think rightfully so -- is how come up in the Northeast and how come way, way up in the Northwest we've got an infant mortality rate of two or three, and in 73 04/21/04 - WHOLE - BILL 040255 parts of where I live in zip code 19144 and parts of Mantua in Councilwoman Tasco district, how come it's 15; twice, three times the percentage? And that's what we need to get at. And that's the issue we still have, babies being born too soon and too little. The other piece of this -- and I figured I'd try work this in, but there's something that gets me on the edge of my chair when I start looking at some of this stuff. It's not all that simple. There's a lot of different things that come together that impact infant mortality. And if you start teasing them out, you start to look at them. We know, for example, if we were to reduce smoking among pregnant women, we could reduce the infant mortality rate by as much as 30 percent. That's big. I had a meeting earlier this week when we were looking at tobacco sales to minors in this City. It's illegal to sell cigarettes to children in this City. It is illegal. We just looked at our enforcement, and two areas of the City that stand out. You 74 04/21/04 - WHOLE - BILL 040255 have 51 percent of the stores in North Philadelphia selling cigarettes to children. That doesn't happen in the far Northeast. It doesn't Chestnut Hill, it doesn't happen in Center City. That's the differences. And we've got to look at what our enforcement issues are there and we've got to bring this issue home to the people who are selling these cigarettes to kids. Kids can't afford a pack of cigarettes anymore. So these merchants will accommodate them because they'll open that pack up and they'll sell them two or three cigarettes at a time. We also know the impact of that because what happens is, particularly the women that we have in our smoking cessation programs, all of them -- almost 90 percent say they began when they were children to smoke. We've got to get our arms around that. I'm committing to support that effort and to be able to come in here and not wait until wait until next year but to be able to come within the next, say, 90 days, 6 months, to have a different turnaround on this 75 04/21/04 - WHOLE - BILL 040255 enforcement. We just met with Bob Sovibile and Dominic Verde about enforcement, ratcheting up this enforcement across the City.
We've also got to work with the State, because you take away a tobacco license, they can turn around and pick up another one because a tobacco license cost a grand total of $25 in this Commonwealth. It's a state issue. So we've got a lot of work to do across the board. And it's not about making life difficult for merchants; it's the law you shouldn't sell cigarettes and it's a good public health reason for not selling cigarettes to children.
Well, you know, there are stores out in neighborhoods that we all know of that will sell a loose cigarette. And I think part of what we have to do just as citizens is to report these stores. Once we report them, who do we report them to and how does L&I fit into this? COMMISSIONER DOMZALSKI: We have that number.
Before I came 76 04/21/04 - WHOLE - BILL 040255 to Council, there was a store a couple doors away from my office that was selling loss cigarettes and I just went over there and threatened to expose them.
It is L&I that we would report that complaint to. COMMISSIONER DOMZALSKI: Actually it's a 877 -- it's an 800 number.
You don't have to be so concern about the number. We're asking about the department. It's L&I. COMMISSIONER DOMZALSKI: Well, that could come into our tobacco enforcement. Certainly, it can get called into L&I, but we have a number in our department as well that --
Well, the Councilwoman's question is, who should she call? Should she call L&I or the Health Department? COMMISSIONER DOMZALSKI: Here is the number. It's 1-877-99-SMOKE.
That's part of what we can do when we're out meeting with 77 04/21/04 - WHOLE - BILL 040255 community groups, you know to educate the public and let people know, block captains know, et cetera, that this is what they need to do because we may want to let people know how smoking impacts infant mortality rate here in Philadelphia. What else are we doing? What groups are being funded to address the infant mortality issue in Philadelphia, particularly in zip code 19144 and also Councilwoman Tasco's zip code, 38 -- we share 38 -- that has the higher rates? COMMISSIONER DOMZALSKI: Well, what we're doing is we've created under our Title 5 Program in maternal, child and family health, a program called SAFE, S-A-F-E. It's an acronym for Services to Assist Families Excel. And this is focussing on children birth to 3 years of age. And what we've done is a RFP with this. In the Northwest area, we are re-doing that RFP. We were concerned that we didn't get enough bids, and we were concerned that the people who did bid on that, that they could have maybe didn't tell us everything 78 04/21/04 - WHOLE - BILL 040255 that they could have told us about all their services and so we might have missed an opportunity to do some business with them. So over the next 90 days that process will be completed, and we'll have a new or a continuation vendor in that area.
Okay. Commissioner, speaking of bids, I'd like to know -- and if you don't have it today, it's fine; we can get this information to the Chair. Of all the professional service contracts that the Health Department gives out, I'd like to get information on the number of minority firms that have received those contracts, the dollar amount of the total contracts, and the percentages of those contracts in terms of dollar amounts too of minority providers that have received contracts through the Health Department. COMMISSIONER DOMZALSKI: I can tell you this morning, Councilwoman, that in Fiscal Year '03, 23 percent of our contracts went to minorities. This year we're expecting that that will be 24 percent, and we expect that 79 04/21/04 - WHOLE - BILL 040255 our projection for FY '05 for is for that percent to go to 25. Now, the dollar amount I don't have, but I will get that to Council President right away.
Thank you. The Chair recognizes Councilwoman Brown.
Thank you, Madam President. Good morning. COMMISSIONER DOMZALSKI: Good morning, Councilwoman.
Let me speak to the issue of the MomMobile. Could you give me an update, if you will, on the MomMobile and what lies ahead for the MomMobile in the next fiscal year? Let's start there. COMMISSIONER DOMZALSKI: The update on the MomMobile is probably a little easier than the future. And I promised I would go into only as much detail as people wanted to 80 04/21/04 - WHOLE - BILL 040255 have.
I appreciate the detail. COMMISSIONER DOMZALSKI: Where we are at this point with the MomMobile services, in the far Northeast at Health Center 10, we do have them in Strawberry Mansion and we do have a Latino Mon-mobile that's operating.
Currently, how many? COMMISSIONER DOMZALSKI: How many MomMobiles? Somebody, before I'm finished, will give me that exact number. In terms of the way we're looking at services across the board, our issue with services around infant mortality is that we buy services that we think support our public health program objectives. It used to be that we would have organizations come to us and say, you know, "I've got a great program. I want you to fund it." It may not have had any 81 04/21/04 - WHOLE - BILL 040255 -- you know, we might not have thought, gee, that fits in service structure. It may or may not have. But in any event, we funded it. What we're doing is a lot differently than that. What we're doing is buying services that allow us to focus on the issue of infant mortality from the standpoint of getting women into prenatal care. And one of the issues there is the structured approach to how you are going to go and access women in the community who may need prenatal care. And that's a lot you different than taking care of women who are already in the system. There may be some overlap there, but it's a new structure in terms of the way we are buying services and the way we are evaluating proposals on how we go forward. I just happen to think that the concept of the MomMobile being community based and there is very good. The issue is, how many women do we actually identify and get into prenatal care. You know, one of the things we haven't talked about -- I just looked at a 82 04/21/04 - WHOLE - BILL 040255 figure in terms of prenatal care and women who need care. In the past year, we have had 373 births to women under the age of 15.
I'll hold my breath. Is that an increase or what? COMMISSIONER DOMZALSKI: That is a slight increase because I used to use a figure before of about something less than the 200s on that. That's a change. If we look at the figure of women under the age of 18, we're still looking at close to 3,000 births. So there are women out there we really do need to find ways in which we can interact with young women, get then involved, get them involved in prevention services, get them involved in a who variety of programs and services. So I'm not saying for a minute that the MomMobile and the concept isn't a valuable one. What I am saying is that what we need to do is look to see how that either as it now exists or how it can be modified can fit into our overall assault on infant mortality.
The principal 83 04/21/04 - WHOLE - BILL 040255 purpose of the MomMobile is to outreach and identify young ladies and women for prenatal services. So agree in principle that it's meeting its mission? COMMISSIONER DOMZALSKI: Absolutely. I agree that is an important mission.
Are there tools in place to track young ladies that come into the system by way of the MomMobile to further justify its purpose? COMMISSIONER DOMZALSKI: Yes, we do look at the number of women who are brought into care and were referred into services, number of contacts and that nature. We can supply that program data to you, Councilwoman.
So you would be able to say of the 378 women, an approximate number of those that were tapped or touched by the MomMobile? COMMISSIONER DOMZALSKI: Or not.
You can make that connect? COMMISSIONER DOMZALSKI: Yes.
Have you been 84 04/21/04 - WHOLE - BILL 040255 able to determine how many MomMobiles are currently within the Department? COMMISSIONER DOMZALSKI: We are funding all or in part four MomMobiles.
Currently funding four? And you say you now buy services from others who provide a similar service? COMMISSIONER DOMZALSKI: When we're looking at the whole business of infant mortality, we have several ways that we approach this in the City. These are new in compared to, for example, the service of the MomMobile. The MomMobile service is an important one. What we also do is we have the David Olds project --
You have the what? COMMISSIONER DOMZALSKI: David Olds.
Okay. COMMISSIONER DOMZALSKI: You know, it would be nice if infant mortality were straightforward that we could say, you know, this approach if we do X, we'll have Y result 85 04/21/04 - WHOLE - BILL 040255 and infant mortality go down. But it's a complex phenomenon. And what we need to do is learn an awful lot about why babies are dying before the first year of life. And some of those things we're learning through the David Olds Project, which is a very intensive program that's operating in West Philadelphia and it's for first-time mothers and we have -- the capacity of the system is 400, 400 women in the system under the David Olds. And what we do is look to see what interventions occur and what are successful in getting women into care. And also in that what's is called the conception phase, which is the period of time between the end of one pregnancy and the beginning of another and what impact these services have had with regard to that. So we're learning things from the David Olds Program.
Make the connect for me between the David Olds Project and MomMobile. COMMISSIONER DOMZALSKI: There's no 25 comparison. These are intensive -- the David 86 04/21/04 - WHOLE - BILL 040255 Olds program is nurse-based. We have one nurse that will have families. Nurses 4 receive very intensive specific training 5 according to protocols that have been 6 developed by Dr. Olds, and there's a very 7 stringent evaluation process in terms of the 8 educational piece. 9 A MomMobile, while not exclusively, 10 is an outreach service. And they also provide 11 a number of services inside our health centers 12 to women who are already in the our health 13 centers. So not to say that those services 14 aren't absolutely important, but it's a piece 15 that we need to evaluate in terms of where 16 we're going now with our assault on infant 17 mortality. 18 The other piece is something that we 19 just got started and our Division of Maternal 20 and Child and Family Health and our Medical 21 Director Dr. Godley heading this up called the 22 FIMR, F-I-M-R. It's called Fetal Infant 23 Mortality Review. This is sort of the area 24 where we're going to learn a lot more about 25 what happens in those first few days of life 87 04/21/04 - WHOLE - BILL 040255 that end before a year is up and the child dies. These are actually working with parents who have had a loss and accessing not only the social data, the demographic data, but also the clinical history, working with the hospitals. So we're going to learn an awful lot, and from that kind of learning --
Madam President is to give me the red bell in the minute. So is that to suggest then that FIMR is supplementing or complementing MomMobile services? COMMISSIONER DOMZALSKI: No. What it's going to do is it's going to give us information on which we might decide that we have some different programs that we may need to implement program either in the MomMobile mode or apart from that.
What does the future hold for the MomMobile? If you currently have four -- and I hear from you four; I get different numbers from others. What's the status of the MomMobile going forward? 88 04/21/04 - WHOLE - BILL 040255 COMMISSIONER DOMZALSKI: I think the future depends on what the success rate is of the MomMobile in doing the outreach to get women into prenatal care early. What is the success of that? And the more successful that is, the more successful that is, the more secure the future of that mode of service delivery. We may still have things going around called the MomMobile, but we may be doing something a little bit differently.
So internally then you have a department or a practice or procedure that allows you and your staff to do a self-assessment on its success, correct?
Today, as we know it, there are four. And at what juncture do you see making a determination or at what point do you se yourself giving the Department an evaluation around the MomMobile to further determine its life in the future? COMMISSIONER DOMZALSKI: Well, that's what's going on right now, in terms of some of this. I think there may be some 89 04/21/04 - WHOLE - BILL 040255 MomMobile activity that is suggested for the Northwest part of the City in the area that we're now competing for the Safe Program. There may be some activity associated with that. What we'll be doing is looking at either those proposals and looking at what services are now being provided and actually looking at the success rate of the current activity in bringing pregnant women into prenatal care and keeping them in care.
Did you have a follow-up question, Councilwoman Tasco?
Way past it. So if you don't mind, Councilwoman, we'll have a second go-around.
The Chair recognizes Councilman Clarke. 90 04/21/04 - WHOLE - BILL 040255
Thank you, Madam President. Good morning. COMMISSIONER DOMZALSKI: Good morning.
Commissioner, a couple questions. Recently, as the part of the redistricting, I picked up a section of the City that has a substantial amount of industrial sites, some of them closed, over in Fishtown and Kensington. And as a result of that, I've had to attend numerous meetings to deal with certain environmental issues. The Absco site is one of them, the more notorious sites. I need to get some clarity on the lines of responsibility and jurisdiction as it relates to the municipal remediation unit, the state and the federal and who has jurisdiction, who dictates what strategies will be implemented to resolve some of these issues. The other question I have is about aggressive dogs as it relates to the City taking over the responsibility of the SPCA and 91 04/21/04 - WHOLE - BILL 040255 the reason why the SPCA got out of the dog business. But if you can talk to me about the environmental issues, the staffing levels on the City level, the ability to adequately respond to some of the concerns that are raised. COMMISSIONER DOMZALSKI: I will, Councilman. On the abandoned industrial sites, there are a number of agencies involved with that. The way we handle things in the Health Department is that typically we'll get a call from someone about a site, there's a leaking drum or whatever. We'll respond to that and do an evaluation. Frequently, what we'll need to do is pull in maybe an L&I unit from the commercial and industrial unit in L&I. Maybe there's a citation that belongs there. It may be the kind of product involved that's got federal regulations associated with it. For example, if there's asbestos involved, that may implicate the NESHAP (ph) regulations that are federal and come out of EPA. What we'll do is make sure we pull those 92 04/21/04 - WHOLE - BILL 040255 agencies in together and we may, in fact, not be the lead after that investigation goes forward. There may be a federal citation given to the company.
Are you saying that there could potentially be different regs associated with different types of environmental issues? COMMISSIONER DOMZALSKI: I am.
Does the municipal level have some whereas we may say that this particular company is in violation of an act on a municipal level but not necessarily on a federal level? COMMISSIONER DOMZALSKI: Right.
Why is that? Why would we have -- COMMISSIONER DOMZALSKI: We can do a lot under the Health Code. For example, we can declare something, based on fact and assessment, a public health issue and we can issue an order. The orders -- and we're looking at our whole order system at this point and the fines that are involved. Often 93 04/21/04 - WHOLE - BILL 040255 times at the municipal level, the fines are not sufficiently high enough to be an incentive to impact clean-up. At the federal or state level --
Cost of doing business basically for a person. COMMISSIONER DOMZALSKI: Precisely. That's different at the state level and it's sure different at the federal level. What we like to do -- and I know this is the approach you've taken particularly in one of those sites that you mentions, we want to problem resolved. We want the problem cleaned up. We want it made safe. We want it remediated. Sometimes when the remediation happens, sometimes we'll end up with a lot of the responsibility, particularly if there's reuse involved. We had one site in one part of the City, it was going to be reused as a fast food facility. And the previous use of the site was a dry cleaning operation in which dry cleaning fluid had seeped into the soil. That needed to be remediated. We needed to -- 94 04/21/04 - WHOLE - BILL 040255 under our federal delegation, we needed to oversee that and look at what kind of remediation the company was proposing, do an analysis in terms of personal and public health impact and then supervise that until it was completed. So it varies, but our role there, I think, is to, for example, work with whoever brings us the issue or one that we find on our own, to get it to the proper level of government to get the result that everybody wants, which is a remediation, and a permanent one, of the condition.
Is there a reason why -- you may not be able to answer this question at this time. Is there a reason why we don't have uniform codes as it relates to the violations? Recently, I know in the Building Code there was an Act, a Uniformity Act in the Building Code that we have uniform codes associated with certain levels of construction. And I would think that something as serious as the environmental 95 04/21/04 - WHOLE - BILL 040255 health of our citizens that we would get together and have sort of universal code, minimally at the state level but preferable at the level also to give us the broadest ability to make sure we remediate these problems. The other issue is, have we looked at possibly raising the cost of the fines? COMMISSIONER DOMZALSKI: There's a proposal that is being pulled together. We just contributed some information to the Managing Director about what current fine levels are, what penalties are, and what we think about those in terms of their usefulness. In all cases, I think we agree they ought to be raised. In terms of the uniformity of the Code, a lot of the stuff we get involved in has public health implications, really the resolution of that requires the enforcement of the Property Management Code, and that's usually L&I, so we'll work in conjunction with them. Rather than develop our own code about how a property maintain ought to be maintained or avoid a public health nuisance, that 96 04/21/04 - WHOLE - BILL 040255 usually the way the Property Management Code is structure, there's usually a solution within that code. So we use that as well as some parts of the Plumbing Code to address those issues. But we'd be happy to talk about some more of that.
You didn't really ask my question. I'm not suggesting that's your responsibility to pull all of the pertinent parties together, but it seems to make sense to me that you would want to have a uniform code to give you the ability to impact broadest way. And I don't know should the federal government be responsible for initiating that process. If there's some things on the federal level that you do not currently have in your Code and you have to get federal government involved, wouldn't it make more sense to simply adopt that particular code to give you the broadest ability to impact on environmental issues as opposed to having to bring the feds in? Why don't we just change our regs to reflect all of the various code violations as it relates 97 04/21/04 - WHOLE - BILL 040255 to environmental concerns? COMMISSIONER DOMZALSKI: I think that does make sense as long as we could get the same penalty level that would be. To the extent that penalty is going to be an incentive to getting the resolution we want.
Why don't we do that? I'm assuming that the penalty phase, that the money would go to the City as opposed to going to the Feds. COMMISSIONER DOMZALSKI: Who knows how that might come out, because when that bill comes over here to change those fees or those penalties, I think the maximum penalty we have is something like 300. I think the maximum federal thing can be something like 10,000 a day for every day of the violation. So it's huge. I don't know if there are municipal code legal aspects about that, about why we can't be that stringent, but we'd be happy to talk to you about that and work with you on that.
And not just the increase but also the ability to have 98 04/21/04 - WHOLE - BILL 040255 additional code enforcement issues on the table because if the federal level have certain code violations, I'm assuming that if they impose those code violations, that money goes to the Feds. Why don't we adopt those code violation so then the penalty and the fine would go to the municipality as opposed to going to the Feds? You understand where I'm going? COMMISSIONER DOMZALSKI: Right. And to some extent we've done that with some of the air management stuff. What we've done as part -- we have three laws that we enforce. We have the local air pollution control, the State Air Pollution Act and we have the Federal Clean Air Act. And in our plan, what we've done is incorporated those into our plan so we essentially do have a uniform code enforcement in that regard. I'm a little something reluctant to say that that would address something like the ABSCO issue.
I mention that in particular because I'm in the midst of it 99 04/21/04 - WHOLE - BILL 040255 and it's extremely frustrating when you have these different arms of government at a community meeting and you don't know who to hold responsible and different answers from different people. If we simply had the same code as the federal government, which I'm assuming is the broadest one out there, then we would have to have all of these other people involved. We can impact on that environmental problem ourselves. Before my time runs out, on the aggressive dog issue, in the hearings that we had a couple years ago, the SPCA essentially said they were getting out of the dog business primarily because of pitbulls and rottweilers, and they primarily felt that there were an entity that was being used to go out and get these dogs and put them to sleep because there was no likelihood of adoption or anything. And they asked us to impose essentially a ban on certain aggressive dogs. Now that the City has taken that responsibility, what is the position of the City? And I mention this because we've had 100 04/21/04 - WHOLE - BILL 040255 a recent spat of injuries, some to children, as a result of these aggressive dogs. What's our position on that now? COMMISSIONER DOMZALSKI: The way we got into this with the SPCA, the SPCA I think took the position that they ought to be banned, there ought to be dogs that ought to be banned, but I think in general -- and this is in general, that it's not so much the breed as the way the animal is handled and the way the animal is cared for and that there can be pitbulls that are very docile and very loving pets. Unfortunately, what we see are the situations where that is not the case and where there are injuries and sometimes the injuries are extraordinarily severe. I'll tell you at this point there are times when I see those injuries that I understand -- there ought to be some way to be able to predict this to be able to put controls over this. We do have -- but it's usually after the fact. It's usually after the fact where we can actually go to court an have a judge to declare an animal a vicious 101 04/21/04 - WHOLE - BILL 040255 dog. In order for that owner to retain that dog, a number of things have to be in place such as a huge fence and certain controls and all the rest of it. And we get the responsibility of going out and monitoring whether or not those protections are in place. And if they're not, the judge will amend the order and the dog will be put to sleep. So a way around about whether or not these breeds ought to be banned wholesale in the first place. There's a lot of discussion on both sides of that issue.
I actually think they need to be banned, frankly speaking. So you're suggesting that that short of that, if we can show just cause that a level of security can be imposed on individuals who have these dogs as pets or weapons or whatever you want to them, that's a possibility as it relates to the legal aspect of it? COMMISSIONER DOMZALSKI: Absolutely.
I live in a community where a lot of pitbulls -- and I hope nobody's waiting for me tonight when I 102 04/21/04 - WHOLE - BILL 040255 get home. But this is a serious issue. Unfortunately, a lot of people -- and I think the majority of people get these dogs, they use them as weapons or for purpose of fighting. And I just think that at some point we've got to take a stance on this. COMMISSIONER DOMZALSKI: Before we get to that second level, which some point we may need to get to, is that whoever is concerned, neighbors or whatever, give us a call, and what we'll do is send out an investigator to assess that situation. And we'll keep coming back just to see what's going in that neighborhood and we'll be able to issue a notice to the owner. And if we do see a serious situation where there is threatening behavior, if the owner doesn't comply with that, then we can take it to the next level which would be to court.
Thank you. The Chair recognizes Councilwoman Tasco. 103 04/21/04 - WHOLE - BILL 040255
Thank you. Commissioner, I want to follow-up on Councilwoman Donna Miller's request for information. You see all these people in the room today. Most of these people are here today because are concerned about the disparity in funding from the Health Department to community-based organizations. As I look through the budget and see some of the providers here, it seems to be that most of the providers are very large organizations and that the smaller neighborhood groups that in the past have always provided community outreach for whatever reason are not getting the level of funding. So I want to know in the information you provide, whether they are minority or small, how many community-based are receiving funding for service to the community and what is the dollar level. COMMISSIONER DOMZALSKI: Absolutely. We'll do that.
Because in the last couple of years, many of the groups have expressed concern about the lack to the 104 04/21/04 - WHOLE - BILL 040255 ability to access funds from the health Department. And when they submit their proposals, they're not given. And we've submitted proposals to you on behalf of organizations, and for some reason there is an excuse not to fund them. So we want to know what the process is. And in that line, I want to know who in the Health Department -- what is your policy of determining what programs will be developed, what programs will be funded? How do you determine what programs will be funded, where they will be funded and on what information do you base it? Is it just done by whatever department you have that goes out and gets a grants, or is there an internal process where you sit down and talk about policy? I want a short answer about policy and how we're going to provide services. Because we have in the Northwest -- I've constantly talked to you when this whole issues of infant mortality came out that the highest level in the newspaper reported was in the Ogontz section. I don't know yet -- and that was about three years ago we had public 105 04/21/04 - WHOLE - BILL 040255 hearing on the issue. I don't if your department has come up with anything to address the issue up there. I want to know how you plan to do that, if you plan to do that. And if it's not the way you operate, do the community groups decide, well, we need to do a program, let's go to the Health Department? Or the Health Department sees a need or a vacuum and says, there has to be something there? How do we do it? How do set the policy to address the health issues? COMMISSIONER DOMZALSKI: It is based on need.
Well, the need as established by your Department and by the need that we've established in the hearings on infant mortality, what are you doing about infant mortality in the Northwest? And if you're talking about cutting out the MomMobile in the northwest, what services do you get? You talk your Safe Program. There were two groups that responded to the RFP. You're saying you don't like the groups, 106 04/21/04 - WHOLE - BILL 040255 you're going to bid the RFP. I want to know why. COMMISSIONER DOMZALSKI: It's not that we don't like the group. There's a lot in your question, Councilwoman. I can tell you -- and we'd be happy to do a separate session on this. But just briefly, when we looked at what the need is, that's why we have maps that show that the infant mortality in your district higher than in some of the other districts. So we know there's a need there. Two, what should be done? And that question there is what should be done. Should what be done, should the service that's provided be determined that we need to interface better with teams, those kinds of things for a whole variety of pieces to that, we pretty much determined through our maternal infant care program the kinds of services that we think have the biggest probability of impacting in that neighborhood. Then the question is who can best provide them.
Who makes that decision? Who determines that need? Who is 107 04/21/04 - WHOLE - BILL 040255 at table? COMMISSIONER DOMZALSKI: At the table would be our Director of Division of Maternal and Child Health, Dr. Ingert that heads up our OB program, Dr. James. Depending on the issue, Dr. Godley might be involved and some of our social work staff as well to look and to say, okay, these look like the interventions that make sense for that particular issue in that particular neighborhood; who in the neighborhood is best able to provide those services. And what we want to do is drive those services down to the neighborhood level; absolutely in the neighborhood at the neighborhood level. And to do that, we want to have organizations help us who are comfortable who know how to interact with the community, know how to deliver culturally appropriate, competent services in the neighborhood to get the effect that our program individuals identify as having the highest probability of impacting on something as complex as infant mortality. And then we 108 04/21/04 - WHOLE - BILL 040255 make a decision to award it in the first place. Often times, the next step that happens is where we get into a lot of trouble, and that's because we've started to evaluate what is being produced in term of outcome. We used to measure, for example, immunization on how many times you knocked on the door. We're not interested in that anymore. We're interested in how many times you've brought a child in to get immunization. That's different than knocking on the door. I might have to knock on the door to do it, but we're interesting in measuring how many children you actually bring in who will end up being immunized. That's the outcome. And often times, what we have to do is to adjust our programs. And we never in any circumstance have a situation where there's a performance with a contractor, a contract agency, where we say, "You didn't do it; we're not going to contract with you anymore." We always tell --
We just went 109 04/21/04 - WHOLE - BILL 040255 through that with Maternity Care Coalition on the immunization, where they just took the money away from them. They were doing it in the Northwest. And I asked what basis did you take away that money and give it to somebody else or say that you were going to have someone else provide the service. I never got the answer. I never got documentation. Nobody could ever document why that money was taken from the Northwest. COMMISSIONER DOMZALSKI: Councilwoman, I was prepared to give it to you then, I'm prepared to give it to you now. And whenever we can get into talk, we'll sit down and go over it.
But who's doing the program? And you talk about the neighborhood and the sensitivity of the people in the neighborhood. And the group that I heard that got the program, I'm not sure that they're more connected to that community than the group that was doing it. COMMISSIONER DOMZALSKI: That's why 110 04/21/04 - WHOLE - BILL 040255 I'd like to share that information with you.
And no one told them that they weren't going to get the money. You just took the money and never told them they were going to take the money away from them. So I want to know who's making decisions. I want to know who made the decision on the Safe bid. Why if two providers -- I fussed with Maternity Health Coalition for years about expanding their program. They expanded to the Northwest. We don't have a lot of community groups up there that you may have in some other parts of the City. So when we get an organization that has a history who can -- and La Salle College has provided health services throughout. They have a health clinic over in Hillcreek, and you just snatched the program away from them. So you're not going to get anybody else up there to do the program because there are no 22 other community-based programs up there. I want to know who is making the decision and who's evaluating the success. COMMISSIONER DOMZALSKI: Well, on 111 04/21/04 - WHOLE - BILL 040255 the Safe piece, you see, I can give you this piece of information but it won't be responsive to the next piece of it. Who makes the decision on the Safe Program is a group of people that are some individuals from the Health Department, some individuals from some of the schools of nursing. I can give you that, but it takes a little bit of detail to go into that and that's why I think it's worth me sitting down as long as half hour and going over it.
We have some concern about who makes the decision in the Health Department and what basis they make those decisions. COMMISSIONER DOMZALSKI: I'd be happy to share that with you.
You don't want to talk about it right now, do you? So we'll talk it with the Maternity Health Coalition, because there's a problem there in the Health Department in terms of who makes the decisions for what community and what groups get the money and what groups don't get the money. 112 04/21/04 - WHOLE - BILL 040255 COMMISSIONER DOMZALSKI: I guess, Councilwoman, when it comes right down to it in terms of the final decision, I make it.
Well, then you're not making a very good decision. You're not making very good decisions. I'm told that the Coalition was told that they were not going to get the money for the Northwest for the MomMobile, but it's here in the budget. Now, are they going to get the same level of funding that they got this year? COMMISSIONER DOMZALSKI: I don't know. I don't know if they are going to get the same level of funding. The reason is that we're looking and we've competed all of the services for competitive bidding --
But you have no 19 one else doing services in the Northwest. You have no one else doing the services in the Northwest. You may have competing groups in West Philly. But if a group that has history wants to provide the service, who in the department decides they shouldn't do that? 113 04/21/04 - WHOLE - BILL 040255 All we want, bottom line, are some services for the people who are dying. Their babies are dying in the Ogontz section. For three years we've been talking about it, but there has been no action out of the Health Department to address the issue. COMMISSIONER DOMZALSKI: There has. Councilwoman, there's been action. We pick that area to institute the FIMR Program. I would really like an opportunity to sit down and talk about this in some detail. I think that when we do, we will have more information. And we still may have areas of legitimate disagreement, but I think we really need to share that information.
Let me go back to the health centers. Councilman Ramos asked you about a fee. How is the billing in the health centers for constituents who qualify for medical assistance and what do the centers do to ensure that the application process is completed? COMMISSIONER DOMZALSKI: What we've done is -- we used to refer people to the 114 04/21/04 - WHOLE - BILL 040255 county assistance office to make applications. We knew that wasn't working. So what we've done is put insurance counselors and social workers in all of our health centers to take applications right on the spot to help people understand what insurances they might be eligible for and to assist them with the application process as we go forward. And we don't wait to deliver care until the application approved. We deliver the care while the application is in process.
So what is the success rate of that process. COMMISSIONER DOMZALSKI: Well, when we started it, we had 64 percent of people coming to the health centers who were uninsured. We expect that this year that's going to be down to 55. It's down to 60 percent now. By the end of this fiscal year, we expect that that's down to be down to 55 percent. And by the end of the new fiscal year coming up, we expect that to be at 50 percent.
I've met with a 115 04/21/04 - WHOLE - BILL 040255 gentleman you know, Bob Brand, who the Council President and some of us in Council have met with him, look at this accessing system they have to retrieve -- you've got a client into the health center, and through this program they can go online and access not only Medicare services, but all other LIHEAP services, all other services that would help the City capture a lot of dollars, it would help PGW. You've got a client there, they qualify for services that -- not just health insurance, but other services that would help the City with its fiscal problems. What is your assessment of that? I know he messed with you. What do you think of that process? COMMISSIONER DOMZALSKI: Actually, not only did Bob come over and meet with me, but I was so intrigued with what he had to say that I asked him could I come to meet with him in his office and actually see that program in operation. And we spent a good afternoon one Friday afternoon there, and it was quite impressive. They do have an excellent 116 04/21/04 - WHOLE - BILL 040255 database. And for people in our health centers, we know that by and large our patients and perspective patients qualified for either medical assistance. They sometimes qualify for PACE, a prescription assistance program for the elderly. They sometimes qualify for CHIP, the Children's Health Insurance Program. So our challenge is to identify. Once we've identified that, we pretty much know that from our insurance counselors, is to get that application process started.
Well, what's wrong with his process? I mean, it's user friendly. You capture a lot of information. It would save the City a lot of money. And it's been implemented in a lot of offices. There's some state representatives that are going to put it in their offices that will help not just the City but also the client. Don't. You see it as a valuable asset to your department? 117 04/21/04 - WHOLE - BILL 040255 COMMISSIONER DOMZALSKI: Well, actually, I think where we had our most discussion was around PACE and how --
I'm talking about all services. They can access all services. Certainly, help you capture your medical assistance payment. You can tell them they qualify for CHIP. They can get LIHEAP services. They can qualify for all the services just by plugging in their name into a software program. What is so difficult about that? COMMISSIONER DOMZALSKI: Well, what's difficult about it is -- and it's not difficult, it's very easy. As you identify what the service is that the person qualifies for, the hard part is getting the application done and getting it through their approval process. So that doesn't mean what Bob has to offer isn't valuable. And I'd be happy to have Bob come in and talk to us again about some other issues or other services that he'd like us to know about. We did have a fairly lengthy discussion on PACE. 118 04/21/04 - WHOLE - BILL 040255
Is Rob Dubow in the room? I think he had met which of the gentleman you're -- I don't know that it's the same gentleman that you're referring to. Maybe Mr. Dubow could shed some light on this.
Rob Dubow, City's Budget Director. Yes, someone in my office did meet with Mr. Brand. And the next step for me was to actually talk to the Health Commissioner and get his impression on it. I haven't taken that step yet, but we did meet Mr. Brand.
What was your assessment in discussing it with Mr. Brand? Do you see it as a valuable service that could benefit the City?
It seemed on its surface that it was interesting. But, obviously, in any proposal, you need to understand the details. And that's why we wanted to circle back with the Health Department. 119 04/21/04 - WHOLE - BILL 040255
Well, when are you going to meet with the Health Department? Since we have such a massive deficit and we're getting ready to cut recreation centers, we're getting ready to cut out arts and culture. And there is a system that is used in other cities and counties to capture dollars, why we find it so difficult to think outside the box to move to accept something that's new and different that could be beneficial to us to capture money for this City?
I don't think we're resistant to it. We just want to understand it and make sure that we think it works. And if it's going to be something that would generate revenue for us, obviously we'd be interested in it.
We hope, Mr. Dubow, that you will move forward in doing that. Thank you very much. I'll come back.
The Chair recognizes Councilman Ramos. 120 04/21/04 - WHOLE - BILL 040255
Madam Chair, I yield to my colleague Blondell Reynolds Brown.
I thank my colleague. I assured him I would not abuse this opportunity. I'm going to ask one question, leave and come back, because I have several. A follow-up to Councilwoman Marian Tasco's question, who we have to remember chairs Health and Human Services and is intimately involved with this issue of indigenous professionals who care about providing a service in a world where they live. Pulling from my experience with the Youth Services Coordinating Office, there was a planning unit and an evaluation unit. And I had a chance to work in both. In the planning unit which was responsible for going out and sitting with those who were providing services to children and youth, we had a process where we had to sit down on the front end of the RFP and 121 04/21/04 - WHOLE - BILL 040255 provide an orientation session to help them understand what the criteria would be for a particular proposal that was about to let. Is that a standard operating procedure in the Health Department? COMMISSIONER DOMZALSKI: Absolutely.
So before a proposal is let, the world is informed that this opportunity is coming and invites them to -- let's them know what the criteria are and invites them to apply? COMMISSIONER DOMZALSKI: Yes. After they get the RFP, if there are any questions about it, there's an opportunity to raise those questions at that point.
You mentioned on the back end that ultimately a decision is rendered. For those organizations that do not meet the criteria as outlined, what happens? COMMISSIONER DOMZALSKI: It depends. We'll have a discussion with the organizations talking about why their proposal wasn't competitive. Sometimes it's an issue -- we do this fairly extensively around some of our 122 04/21/04 - WHOLE - BILL 040255 AIDS RFPs with community-based organizations where some of the issues have to do with having the need for technical assistance or payroll management and those kinds of things.
Does the Department provide technical assistance to those agencies that want to -- COMMISSIONER DOMZALSKI: Yes, we do. Because what we're trying to buy is not necessarily -- the highest and best use of that community organization's time is frequently never whether or not whether they can keep books accurately, but it's more how they get out and access the community. And so what we do is sure up and provide technical assistance on the bookkeeping end so we can avail ourselves and, more importantly, have the community avail itself of the special expertise of that organization.
What about on the program end? COMMISSIONER DOMZALSKI: Program end, sometimes maybe it's a misunderstanding. Maybe we can adjust it on that end. Often 123 04/21/04 - WHOLE - BILL 040255 times, it could be a situation where people are saying, you know, "We understand that goal. You asked for this, but we don't understand -- you know, you ask for X; why isn't Y if it accomplishes the same end just useful to that." Sometimes we can make an accommodation. Sometimes if we make a change in the standard, we have to say, "Wait a minute. If we are going to change and maybe we should change that standard or that requirement, but in fairness we need to let everybody now bid against the new standard." So we may have to go out to re-bid on it.
Is there any tracking of agencies? A practice at the Cultural Fund is that we actually track arts and cultural organizations who don't meet the muster to see how many times they apply. And the goal is to move them to a place so that they can take benefit of those dollars. So is there tracking of agencies that don't meet the muster one, two or three 124 04/21/04 - WHOLE - BILL 040255 consecutive years to really get a handle around and make sure they clearly understand what the criteria are? COMMISSIONER DOMZALSKI: Yes, Councilwoman. And sometimes what we do is actually ask those organizations like that to partner with another organization for a period of time until they can get their ses legs kind of thing and up and running on their own. Sometimes what we'll do is just provide technical assistance from a technical assistance agency, an accounting firm or whatever directly. But that's an ongoing process.
Could you provide that kind of information to the Chair so that those of us on City Council can look at that more closely to what has happened over the past few years, particularly around agencies that apply, don't get the opportunity, still care and are interested, apply again and for varying reasons don't meet the muster so that we can figure out what we in the body can do to help them who are 125 04/21/04 - WHOLE - BILL 040255 indigenous to the world where they want to provide services right in their world because they live and breathe it every day? COMMISSIONER DOMZALSKI: I agree. Absolutely. We'll provide that.
Thank you. I'll yield back to my colleague Councilman Juan Ramos.
Thank you, Madam Chair. Mr. Commissioner, one of the few compliments that I get as I've gotten older about my physical appearance -- compliments are very, very few, and I usually get them from my family. But one of them that I'm very proud of is they say to me that I got healthy teeth. And I like to tell them probably the main reason why I have healthy teeth is because as a child the Health Department would come and actually escort the kids from my elementary school to Health Clinic No. 6 which was right across the street from the school. 126 04/21/04 - WHOLE - BILL 040255 And I know that those services are not out there the way they were back then, but dental care for children is the blueprint for healthy teeth for us when we get old. And I know that that program has been, you know -- it's not where it was at. But I do know that you have started to do some innovative stuff with Temple University. I know that Temple's dental school, you opened up a program in at least one of our schools, I believe the Clemente School in North Philadelphia. Are you going to be doing more of this? I think that this is something that we can probably get institutions like Temple and others to be able to provide this type of service, particularly to our kids that cannot afford -- their parents cannot afford to dentists. Dental care is very expensive nowadays. COMMISSIONER DOMZALSKI: Councilman, we need to do that and do more of it. The Roberto Clemente School is just wonderful. I think we did that last summer, opened it up. You were there for the opening and Dr. Ivan Lugo and Dean of the dental school at Temple. 127 04/21/04 - WHOLE - BILL 040255 We got some funding from the State. We got some support from Temple Dental School. It was just wonderful, a wonderful program. And the whole key is the importance of dental care for children. The period of time in the Department that you refer to is our focus was exclusively on children. We had a director of dental medicine that required all our administrators to know what the DMF was across their health center population, and that was the ratio among decayed teeth, missing teeth and filled teeth. There was a certain level where you wanted to get dental health for children at a certain level and keep it there. So important an issue such as infant mortality as well because there's some information that dental infections are important with regard to poor outcomes if there's dental infections for women who are pregnant. So it's important across the board. I will tell you that when you look at the profile of our health centers at this point, we are seeing more adults now in the health centers than we have before. That's 128 04/21/04 - WHOLE - BILL 040255 not to say that dental care for adults is not important, but the critical nature -- dental carries among children are the number one reason for missed school in this country, just across the board. So it's an issue that's on the table of the American Public Health Association, the American Dental Association, and something we have to pay more attention to here in our system about just, you know, do we have children to get in those chairs and are we making sure we try to get them in for early care.
I didn't see any of it in your report or your diagram of how you spend your money in the various programs. Do you see yourself doing more of this? Is this a plan more of this? And if so, are you doing it through your contract employees? Is that the way -- I believe that's the way you did at Clemente, right? COMMISSIONER DOMZALSKI: Yes.
Do you have any plans to do more of this? COMMISSIONER DOMZALSKI: Yes. That 129 04/21/04 - WHOLE - BILL 040255 was from a particular funding stream. What we need to do is look for --
Do you have any money left in that funding stream? COMMISSIONER DOMZALSKI: No. It's all spent and going down rapidly. And what we're looking is looking to keep that program going.
I would like to work with you on this one particular issue to the extent that I can. My doors are open to you. Thank you, Mr. Commissioner. Thank you, Madam President.
Thank you. The Chair recognizes Councilman Rizzo.
Thank you, Madam Chair. Commissioner, first of all thank you for your Department's response to my needs are always first class and very effective and I appreciate that because it's such a very important issue to me personally. 130 04/21/04 - WHOLE - BILL 040255 You may have addressed this, and I apologize, I had to leave the Chambers for a few minutes. An area that I have a concern is eye care. I'm not sure what they do in the schools. I'm not sure what we do in the Health Department. But a child that has a vision problem, and you've all seen the commercials on TV how it can really have such a negative impact on their life, the ability to see, especially when nobody detects the fact that they are having difficulty seeing the blackboard or being able to read. What are we doing in the area of eye care, whether it's an examination and a referral or providing eyeglasses? What do we do to help monitor the vision of our young people, and for the same sake, our older folks also? COMMISSIONER DOMZALSKI: Vision care is very important. Part of our program in the health centers, children do get evaluated and eyeglasses are part of that. But here's where the issue is in terms of insurance. There's program called EPSDT, Early Periodic Screening and Testing Service Program. And under that 131 04/21/04 - WHOLE - BILL 040255 program, there's a requirement that vision screening be done. And in fact, eyeglasses, corrective lenses can be supplied under that program. So that's part of our health center operation. All children essentially who are in our system -- and there's an exception, but that might only be or percent at max. So virtually all children are insurable in some way in the centers, and so we're able to access care for children. I know Paul Vallas has been very concerned about eye care in the schools as well, and he's been trying to bring in the Medicaid managed care company to assist with that as well.
Are you coordinated in any way? I mean, I have no clue what they do at the School District. I'm not sure whether there is screening for the students. I'm not sure what the screening process is. But let me just give you a scenario. A mom brings the child. You find that there's a condition, their vision is not good. Will eventually 132 04/21/04 - WHOLE - BILL 040255 that child be examined and, if needed, will that child have glasses? COMMISSIONER DOMZALSKI: If it's detected -- you're talking about the child's problem being detected in the school?
No -- COMMISSIONER DOMZALSKI: The child will be screened.
And will have glasses eventually. COMMISSIONER DOMZALSKI: Yes. Yes. The hesitancy is whether or not we've got the EPSDT Program up and operating in terms of the coverage for that child. So we'll do everything necessary to be able to hook that child up with glasses.
If I person didn't qualify for insurance, they would leave the center with a problem? I think you know where I'm going here. Would there ever been a situation where we would knowing let a child out of that center after a few weeks of knowledge that that person had a vision problem and they 133 04/21/04 - WHOLE - BILL 040255 wanted glasses and they wouldn't get them? COMMISSIONER DOMZALSKI: No, they should not be. We should be working with a variety either through the EPSDT Program or through the managed care company to be able to get lenses for that child.
What if one of our folder folks comes in or maybe not so old and they have a cataract or some issue like that, how do we deal with that? COMMISSIONER DOMZALSKI: I think we'd probably deal with that around whatever provisions involved in Medicare. I do know for our residents who are in our Riverview Home, we have a relationship with the Pennsylvania College of Optometry where they actually provide services onsite and provide lenses.
I think it might be -- and I know that you're on top of the game over there. But I think it wouldn't be a bad idea to sit down with the School District and maybe get together. We're talking about this reaching out to each other. I think 134 04/21/04 - WHOLE - BILL 040255 there might be a little bit of disconnect. I don't want to be specific in what the School District does and what you do. I think it might be worth having a conversation. Not you personally, one of your staff to see -- COMMISSIONER DOMZALSKI: I'll be happy to do that.
Because I did hear that it was very difficult for some of our young people to get some help vision issues. COMMISSIONER DOMZALSKI: Well, I think I'd like to talk to you about that in a little more detail. And I'll also be very happy to reach to the School District on that issue.
Thank you. The Chair recognizes Councilwoman Tasco.
Thank you very much. 135 04/21/04 - WHOLE - BILL 040255 Commissioner, in looking through the budget book and the number of providers that you have, I notice there are two providers that receive a large amount of funding from the Health Department. I'd like to know who they are, what services they provide, who they provide those services to, and how do they provide those services. One is Philadelphia Mental Healthcare Corporation, and the other one is Philadelphia Health Management Corporation. COMMISSIONER DOMZALSKI: These are agencies that we contract with to help us provide services, to get the services done that we need that are a little bit outside of our regular systems in the Department. Picking up on Philadelphia Health Management, we probably have somewhere around contracts with Philadelphia Health 21 Management Corporation. And they provide a 22 range of services that go from providing technical support to some of our community-based organizations to actually providing the business office support for our 136 04/21/04 - WHOLE - BILL 040255 animal control program. So it's a wide rage of services that they provide. On the behavioral health side, there's also a number of services, direct services and service agencies that are funded through those mechanisms.
Now, is this a bid contract or is this just a professional service contract that you grant to them without a bid? COMMISSIONER DOMZALSKI: Usually it's not bid.
How about the Philadelphia Mental Healthcare Corporation, who are they and what do they provide? COMMISSIONER DOMZALSKI: This is a somewhat similar -- and I have to say somewhat similar in that Philadelphia Health Management Corporation provides a very broad range of services, including doing a community database and a household survey and the rest of it around the physical health aspects of service delivery in the City. The Philadelphia Mental Health, PMHCC kind of grew up around the 137 04/21/04 - WHOLE - BILL 040255 behavioral health system, and they provide not the same but a similar array of services that I think Mike Covone could talk about in better detail than I can when he comes up.
Well, under the Philadelphia Health Management Corporation, are there other agencies in the City who could do those same services? And why do you not put it out for bid? COMMISSIONER DOMZALSKI: These are professional services contracts so we're not bound by Charter to do it. If there's an agency where -- often times we just don't have other agencies that are competing in the same area of service as --
But you've not put a contract out for any service that they might be able to perform that you give them a no-bid contract for. You don't put that service out for bid for any other organization that may be able to provide that service. COMMISSIONER DOMZALSKI: Well, there are other organizations that we've begun to use. In the beginning, Philadelphia Health 138 04/21/04 - WHOLE - BILL 040255 Management Corporation just had the services that were needed and they had them most readily available. They're not that exclusive anymore. We also do business with other organizations such as the Health Federation for comparable services but not on the same scale sometimes as PHMC.
Who do these large organizations do business with? Who is their constituency? Do they have staff to perform these services that they provide to you, or do they subcontract out the services to other entities for the Health Department? You give them money for technical services for community organizations. Do they have in-house staff to perform the technical services or do they contract that out? And if they do, who are they contracting out to? COMMISSIONER DOMZALSKI: Sometimes it's both. With, for example, with the Health Federation, we employ a lot of our benefits counselors that are located in the health centers through the Health Federation. They 139 04/21/04 - WHOLE - BILL 040255 become Health Federation employees and they're detailed to do our work in the Health Department.
I'm talking about these two organizations that provide programatic service to the community. I don't remember all of the services that they provide, but some of the services they provide -- it's about $2 million worth of stuff I see, plus more. Do they have in-house staff to provide all the services that they contract Department of Health, or do they subcontract that? If they do, I'd like to know who the subcontractors are and I'd like to know the neighborhoods that they're doing the work in. COMMISSIONER DOMZALSKI: We can supply that.
And I'd also like to know some of the services they are providing, are there other groups in this City who can perform the same work. I mean, we're back to where we had the disparity issue around the minority MBE program in the City and the lack of minority 140 04/21/04 - WHOLE - BILL 040255 participation. When the majority of the clients in the City tend to be minority, then who are the minority contracts and service and program providers that are reaching out and serving them? Is it just large providers who have no connection to the community? These community-based programs that could do the work and they could get a no-bid contract too. You could give them a professional services contract. But when it comes to them, it seems that they've got to bid and they've got to compete. They've got to compete against each other. They have to fight for crumbs while millions of dollars are going to larger providers and they don't have to compete. They can just get a professional service contract. COMMISSIONER DOMZALSKI: Some of our contracts -- and I know these are not the ones you're talking about -- with large hospitals, we do contracting with them.
I'm not talking about hospitals. I'm talking about Philadelphia Health Management Corporation. 141 04/21/04 - WHOLE - BILL 040255 I'm talking about the Philadelphia Mental Health Corporation and some of the others in this book that are getting large numbers of health dollars. Hospitals we contract with because that's what we're supposed to do. We don't have a public health hospital so that's what we're supposed to do. I want to know who are they doing business with. I want to know diversity of their contracts and how they're given out. And I want to know why can't some of the contracts that they have can't be given out on a professional services basis to some of the community-based organizations that provide those same service. COMMISSIONER DOMZALSKI: We'll be happy to supply the information. Also, I'm going to say that in the Department we do have percent looking to go 21 to 25 percent. 22
Listen, I don't 23 24 or 25, I want as much as you can do. Don't 24 say, "Well, we're doing percent; that ought 25 to be good enough." 142 04/21/04 - WHOLE - BILL 040255 It's not good enough. We want it expanded to provide to those community groups who are struggling day-to-day to keep their organizations going, who get pennies from the Health Department while other providers get millions. The dollar value has to be -- there has to be some accountability for the parity of dollars that are spent with the groups who struggle with people every day in the community. COMMISSIONER DOMZALSKI: We agree.
I want to talk to you about the tobacco program you have. I see you have about $2.5 million for the tobacco program? COMMISSIONER DOMZALSKI: Yes.
Do you have a program in place for that yet? COMMISSIONER DOMZALSKI: Yes, we do.
Who's running that program? COMMISSIONER DOMZALSKI: It's a variety of organizations. Greater Philadelphia Urban Affairs Coalition has a 143 04/21/04 - WHOLE - BILL 040255 contract with that. Branch Associates is in a contract for tobacco. We contract with Teach do our enforcement. We contract with Philadelphia Safe and Sound to do prevention and cessation activity. And probably a list of maybe some or 30 organizations through 8 which we provide service and I'd be happy to 9 provide you with that list as well, 10 Councilwoman. 11
I'd like that 12 list to, too. 13 You talked earlier about the 14 enforcement by L&I on merchants who are 15 selling cigarettes. How forceful were you 16 with the L&I Department in terms of -- how 17 strong was your advocacy to them that it's 18 important that they enforce that law not to 19 children. Because we get calls all the time 20 and we get calls about the same store doing 21 it. So what is the real force to make them 22 stop? 23 COMMISSIONER DOMZALSKI: L&I is 24 really on board with this. They've been a 25 tremendous partner. I think what got me 144 04/21/04 - WHOLE - BILL 040255 exercised at that meeting was look just how many sales are going to children in communities that are impacted by so many other negative health status indicators, and we clearly need to focus on that. L&I is right on board. In fact, it was L&I that took the unprecedented step of not only putting in a $10,000 fine a year half ago, but actually supporting and causing the court of Common Pleas to have a business close; not taking away its license, they closed the business. So they've been partners in this. We need to keep pushing on our end too to make it all come together and to get this ratcheted back up to where it was a couple of years ago.
One other question. There's so many here. What has the Health Department done to address the OB/GYN crisis? COMMISSIONER DOMZALSKI: We continue to work with every one of the OB providers that are in the City. We get provided OB services by a number of health systems. All 145 04/21/04 - WHOLE - BILL 040255 of them have difficulty around the uninsured and are having very, very great difficulty with supplying services to uninsured individuals. We've worked with them. We've met with several of the systems. Later this month or earlier this month we're going to having all of the OB providers in to talk about where they see our services going and what needs to be done to make sure that they continue to be available in the health centers. We did have one system that wanted to pull out of our health centers. We had advance notice of that, talked to them. That health system did not pull out. They're back in those centers. So it's a matter of serious concern to me. That's very much on my front burner that's going to stay there as long as this remains in crisis.
Well, would these women qualify for medical assistance? COMMISSIONER DOMZALSKI: Yes. There's an issue that's now being addressed by 146 04/21/04 - WHOLE - BILL 040255 the Department of Public Welfare that's not an easy one. For women who are uninsurable who are pregnant -- say, they're immigrant women. There's no coverage for them under the present system. We provide some coverage for that out of some funds that we have called the Maternity Services Program. We're working with the State and others are working to look at a way to look at the CHIP regulation -- and this is controversial -- to see whether or not when a woman becomes pregnant whether or not her prenatal services might be covered in relation to the yet unborn child, covered under the CHIP program. That is being aggressively looked at and considered by the State Department of Welfare. The reason it's controversial is because the issue of declaring the fetus as a person.
That's a whole other issue. On of the budget detail, 200,00 is identified to be determined provider for a new federal grant for postpartum women's health services. 147 04/21/04 - WHOLE - BILL 040255 Who has been selected for these services? If a provider has been selected, what is the timeline and selection process for a provider? COMMISSIONER DOMZALSKI: This is new money that we've gotten for Fiscal Year '05. We haven't selected a vendor yet.
How are you going to select them? COMMISSIONER DOMZALSKI: We'll look at maybe existing providers, we'll look at organizations that we continue to do business with to see whether or not we can get these services that are going to be specified that have not been specified yet. We want to have an open process. We want to have people who are working in the community, working with our programs. We don't want to be aloof in any of our services. So we're going to work very hard to have community-based, culturally competent services.
When you're preparing a proposal for funding, do you list in the proposal the possible organizations who 148 04/21/04 - WHOLE - BILL 040255 could do the work? You have in mind who could perform the service that you're applying for the grant? COMMISSIONER DOMZALSKI: We don't name organizations.
No, but do you have some idea who might be able to provide the service? You don't just apply for the money and say, "Let's get it and then we'll figure out who can do it." COMMISSIONER DOMZALSKI: Well, we know what the services are and we know that there are several ways that we might go about doing that. For postpartum services, we'd probably want some nursing services for home visiting, maybe some lay home visiting serves. The question would be, do we hire those individuals ourselves as City employees and deploy them or does it make more sense to associate with and collaborate with an existing program, whether it's LaSalle or whether it's Maternity Care Coalition or some other provider. 149 04/21/04 - WHOLE - BILL 040255
So the program begins July 1st. When do you put out the RFP or when do you determine who gets the money? COMMISSIONER DOMZALSKI: That will be in process the next couple of weeks.
On the budget detail, $136,656 is allocated to be determined providers for HIV/AIDS prevention and care services. What is the selection process and time line for the selection of these providers? Also, what the ethnic makeup of the City's HIV and AIDS population -- which you don't have the answer; you said that. And which percentage of the City's HIV and AIDS providers are MWBEs? COMMISSIONER DOMZALSKI: What are we looking at, Councilwoman?
Yes. Down at the bottom you have, "To be determined, $136,000 prevention services and care 150 04/21/04 - WHOLE - BILL 040255 services." It's item 250, second from the last. COMMISSIONER DOMZALSKI: Councilwoman, to get you a complete answer on this, I'd like to get back to you on that.
Okay. What are the steps for a healthier US program and how will the million dollars designated to be -- how will you designate the providers? How will you spend the million dollars and who will be providers. COMMISSIONER DOMZALSKI: The Steps program is -- I think you may have some detail on that. There are three pillars, it's obesity, asthma, physical activity. What we did was look at a number -- probably about 50 individuals representing maybe that many organizations participated in this grant process. And the proposals have been an RFP-type of process, came back and a number of individuals having gone through that process and were selected. There's some, I think, additional Procurement going on. Steps -- is Brenda here? 151 04/21/04 - WHOLE - BILL 040255 Brenda Shelton Dunston is our program manager on this. Brenda, state your name for the record.
I'm Brenda Shelton Dunston, I'm the Project Director, Footsteps to a Healthier Philadelphia.
How will the million dollars designated for the program be determined? How will it be spent and who will be the providers?
The one point, for year one -- it is a five-year program. And for year one there was 1.5 million received. And primarily during year one, which is occurring right now, it is a planning year. However, we do have involved on the planning process neighborhood representatives, individuals who represent the neighborhoods that this program will be addressing --
There are 15 intervention areas that include a population 152 04/21/04 - WHOLE - BILL 040255 of just under 500,00 within north, southwest, south and Center City. These are individuals who have a -- we are basically addressing the morbidity and mortality and attempting to reduce morbidity and mortality as it relates impacted by obesity, diabetes, and asthma. And so these intervention areas are -- that's basically how it was determined that this project is funded by Health and Human Services, the Centers for Disease Control. And I mentioned for year one the 1.5, however, it's funded for a five-year period and during that five-year period there will be approximately 9.15. We are looking right now at program years two through five. And there will, in fact, be some programs within those areas that are community-based organizations that links will be established and they will, in fact, receive funds to support and address the reduction of the incidence of diabetes, asthma, and obesity in those communities. But there is a strong neighborhood component and a neighborhood coalition as well as a 153 04/21/04 - WHOLE - BILL 040255 faith-based coalition to ensure that.
What will be the process for selecting the providers?
Let me just -- are you going to do an RFP? Are you going to do professional services? RFP is you put it out and people have to bid on the program, they've got to compete. Or you can just say, "There's a group, North Philadelphia, West Philadelphia, let's give it to them," without any bid into it. How are we going to spend $10 million?
What the group is looking at is really trying to make it an inclusive process, one that makes sure that those individuals in community-based organizations in those areas who have an interest and skills in providing those services are in fact aware of the availability of the funds and that they have an opportunity 154 04/21/04 - WHOLE - BILL 040255 to submit proposals to be involved in those funds. The other piece is that in instances where there is a need for an organization to, I guess, have a stronger foundation for administrative or foundation to ensure that they can in fact operate those services provide those services and it be a community-based organization for that. Technical assistance will be provided to help sure them up so that that can be done. And if necessary -- I've seen other situations. We're going to explore all options so that we can do that, that technical assistance and consulting could possibly be provided to some of those community-based organizations to ensure that they have the infrastructure to operate and sustain the operation of them.
Will the technical assistance come from the Health Department? Are you going to contract with someone to do the technical assistance?
I am not sure. We're 155 04/21/04 - WHOLE - BILL 040255 going to explore all options. Now, this is program year two through five. And I am not sure whether it will actually be provided through the Health Department or an external organization.
Have you talked to the Councilmembers whose districts these programs will operate?
We will be doing that. This is the planning year and we do have plans for sharing that information and getting input from them as well.
Well, since the Councilmembers and maybe even the State Representatives know the community groups in their district, it would be helpful to have them involved in the planning process.
Thank you. COMMISSIONER DOMZALSKI: It's an important point and we need to do that.
I guess you can see where I'm going, Mr. Commissioner, in my line of questioning because I had a very 156 04/21/04 - WHOLE - BILL 040255 frustrating meeting yesterday with some member staff of your Department around an issue in my district. And when I see large organizations that continue to get funded year after year without having to bid, it is very unfair, I think. And when you have community based organizations that struggle along year after year trying to provide services to the community that get into a situation where they have to compete against agencies that are set up new to provide services to meet the criteria of a new program, it gets to be a little much. And then when you have community organizations come to say, "We are not treated fairly," and then when we speak to the Health Department -- you agree and you are concerned, but nothing changes. We want to know what's going to change and how are we going to look at funding these community-based programs? I want them to get some professional service contracts. Because if you give our professional services contracts to solve these community groups, then they don't have to get 157 04/21/04 - WHOLE - BILL 040255 into this competing against each other. All you've got to do is look at the City. If the people who are making the decision about the funding knows the community and they have the information which they base their determination where they have the program, you know, it's all subjective from the Health Department. "Well, we like this group, we'll give to this group over here. And we'll make this group over here bid and we'll make this group over there compete." And that's what's happening in the Health Department. And there's an unrest, not only with me, but other elected officials in this City about how the money is distributed in the community for services to the community. And when you have a City as diverse as Philadelphia and you have very few groups from the minority community with any level of support from the Health Department and you look at these two large groups will millions of dollar and all you do is say, "Let me just pick up the phone and give them a contract." That's just real easy. They just do 158 04/21/04 - WHOLE - BILL 040255 that, and it's all insidious. It's just not fair; it's not fair. So before we pass the budget, we're going to have to figure out what we do about that. We'll have to do something about that. And it can't continue to go on because its continuous over and over again and there is a disparity. I guess maybe that's what City operates disparity, but it's not fair. COMMISSIONER DOMZALSKI: I understand the perception, Councilwoman. I think a first step in that would be to open up the process, come in and talk to you, show you the process that we're going through --
I just want you to give them some of those professional services contracts. If you've got a training contract, don't call the Philadelphia Health. I don't have anything against them. I think they're fine people. But there are a lot of people who do training in this City. They're people I know who do training. They don't get any contracts. It's just like what's been in the paper lately. The same group gets the 159 04/21/04 - WHOLE - BILL 040255 same money. It's not expanded to be inclusive of the rest community. It's same little network who know the people who work in the Health Department and they work them to help them expand their businesses and they get the contracts. It's what it is. It's not a secret in the community how it's done. I could ask a lot more questions. If you want to break, I will. COMMISSIONER DOMZALSKI: We certainly want to clear up that information for you, Councilwoman. I'll be happy to do that.
Thank you. While the Commissioner is here, Councilwoman, since it's just me and thee, do you have any questions regarding CBH?
Commissioner, you do not have to read your testimony. It will be given to the stenographer. It will be transcribed in full. We do have it, and I'm sure the Councilwoman will be asking her questions from your 160 04/21/04 - WHOLE - BILL 040255 testimony. And I have a couple too.
It goes back to the secondhand smoke. What is your outreach and communication strategy for dealing with secondhand smoke in the City? Is that part of your responsibility with the tobacco money. COMMISSIONER DOMZALSKI: Yes. It's part of the education effort that we do. We have regulations that we enforce with regard to separate sections in public eating and drinking establishments. They have to provide a smoke-free area. So we support those efforts. Secondhand smoke is very definitely a problem. There's no smoking in public buildings. The airport will be going smoke-free next week, I think. So these are all important pieces of our educational process.
Do you have any money in this budget for communicating and educating people about secondhand smoke and about the whole issue of tobacco? COMMISSIONER DOMZALSKI: Yes, Councilwoman, we do. 161 04/21/04 - WHOLE - BILL 040255
What is it? COMMISSIONER DOMZALSKI: I don't know the specific dollar figure, but it's a fairly reasonable portion of the 3.4 million that we have. I've been having some conversations about how we're spending that communication money. Some of it is regarding advertising. Some of it is whether or not we can use community groups to get the message out. Some of it has to do whether we can use community newspapers to reach folks.
Have you made that determination yet? COMMISSIONER DOMZALSKI: Not yet. The only determination we've made is what we're now doing is not inclusive enough.
Well, that's the buzz word today. How do you plan to make it inclusive? COMMISSIONER DOMZALSKI: By looking at what we're doing, looking at who else is out there that we can have that kind of a relationship with and to have the contract 162 04/21/04 - WHOLE - BILL 040255 done.
Is it a professional services contract? COMMISSIONER DOMZALSKI: They're all professional services contracts.
So you can make the determination without doing a bid. So who have you got on the list to give this contract to? COMMISSIONER DOMZALSKI: Well, I mean, some of the places where we do this education is through the media such as we'll be doing stuff on public transportation, we'll be doing some targeted advertising in community newspapers, those kinds of things.
Well, I'd like I have a conversation with you about that before you leave. COMMISSIONER DOMZALSKI: I would love to.
Councilwoman, can we go to CBH? I just have a 163 04/21/04 - WHOLE - BILL 040255 couple questions too. COMMISSIONER DOMZALSKI: Is the Health Commissioner dismissed.
As far as I'm concerned. COMMISSIONER DOMZALSKI: Thank you.
Thank you so much, Commissioner. We don't have to read the testimony from CBH. As I said, a copy of it has been given to the stenographer and it will be transcribed in full. (Testimony attached.)
Can you tell me how many members are in the CBH program?
Sure. There are approximately 370,000 Medicaid recipients for a part of the Health Choices program that's operated by Community Behavioral Health.
What are the various category levels of care and the associated per member per month payment?
The categories of 164 04/21/04 - WHOLE - BILL 040255 service, Councilwoman --
Excuse me, sir. Those leaving, do so quietly, please. We're still trying to conduct business. Thank you. Please proceed.
The categories of service include psychiatric inpatient which is hospital-based inpatient care, not hospital, drug and alcohol care, residential rehabilitative services, there are residential treatment facilities for children requiring out-of-home placement, as well as traditional outpatient services both on the mental health and drug and alcohol side and a variety of ancillary supports, including case management services, resource coordination.
How about the associated member per month payment?
I don't have the exact figure with me. I believe it's somewhere in the neighborhood of, on a blended average, $120 per member per month. That varies by 165 04/21/04 - WHOLE - BILL 040255 category of aid. There are approximately six categories of aid, and each one has a different per member per month, and that represents a blended may.
Thank you. I think we're so eager to move forward that I neglected to ask you to identify yourself for the record.
We know who you are, but I don't think the stenographer did. Have the per member per month rates been set for FY '05?
For FY '05, let me just clarify one point. The Health Choices Program operates on a calendar year, so the per member per month have been set for the current year that began January 1st. The negotiations for the next year will occur during the summer.
Do you have any outstanding rate issues with the State? And if so, what are they? 166 04/21/04 - WHOLE - BILL 040255
At this point in time, what we're identifying for the Commonwealth are things that we believe may impact next year. For example, we're undertaking a strategic planning initiative with the group of stakeholders from the behavioral health system. Part of that effort, we believe, identify areas where we will need to expand services in the future. And what we're looking at identifying are those areas where we think that may indeed impact on the rate.
Thank you. The Chair recognizes Councilwoman Tasco. Do you have any questions?
I don't have a lot of questions, just a couple. Would you just explain to me now the new status of CBH in going from an outside agency to -- explain that process.
If I can first clarify that back in October, the Mayor signed an Executive Order creating the Office of Behavioral Health and Mental Retardation Services. So there are three components 167 04/21/04 - WHOLE - BILL 040255 Office of Behavioral Health, and that's the City Office of Mental Health, the City Coordinating Office of Drug and Alcohol and Community Behavioral Health who is our managed care entity for the Health Choices Program. So those three groups which used to be part of -- two of them used to be part of the Health Department, and one a 501C3, as you're aware, CBH are now part of a separate department. CBH is not City Civil Service at this point in time, it's just part of that, as well as our Office of Mental Retardation Services. With this budget represents really the first break from the Health Department. In previous years, we testified in conjunction with Commissioner Domzalski as part of Health.
So the community Behavioral Health will remain a 501C3?
Will the Office of Mental Health come under that, or will it just managed in the Managing Director's Office? 168 04/21/04 - WHOLE - BILL 040255
We're partners in that as part of Behavioral Health. We will remain City offices, the Office of Mental Health, and the Coordinating Office of Drug and Alcohol; both will remain City Civil Service offices.
Yesterday we were talking about the mental retardation side, correct.
Part of the reason mental retardation services was kept is because as the Mental Health Mental Retardation Act was established back in the '60s, it was an Act that had both those 169 04/21/04 - WHOLE - BILL 040255 services together. And basically the infrastructures of the office are supporting both mental health, drug and alcohol, and our mental retardation programs. And when the Mayor was considering the issue of an Executive Order, one of the things we didn't want to do was have to break out and create duplicative administrative structures to separate out mental retardation as a separate department. So our finance offices, our IS offices support both sides.
The Managing Director actually is chairing a search as we speak. And there's a search going on for the director for that office
It's going to be real confusing. Now, here you have a budget of 170 04/21/04 - WHOLE - BILL 040255 $500 million. Now, is that combined budget of Mental Health, CBH, and mental retardation?
That 500 million represents the Health Choices, the CBH of the program. The testimony will give you the breakdown of the various components. About 272 million or percent of that is for 9 mental retardation services and approximately 10 $809 million are for the behavioral health 11 component, which includes CBH, CODAP and the 12 Office of Mental Health. 13
Okay. I'll ask 14 you the same questions I hammered on with the 15 Health Department. 16 How many of the 100,000 17 Philadelphians who you serve in the Office of 18 Behavioral Health are -- what is the ethnic 19 makeup of that population? 20
I actually have that 21 here for you. Approximately 56 percent are 22 African-American, 22 percent Hispanic, 23 percent Asian, and the balance are Caucasian. 24
According to 25 of the budget detail, your office to 171 1 04/21/04 - WHOLE - BILL 040255 provide contracts worth $593 million. What portion of these providers will be MWBEs and what is the dollar amount of the contract these providers will receive of the amount?
Similar to the Health Department, we can update and provide you with that information. I believe last year when that information was requested, it was somewhere in the neighborhood to 11 percent. But we'll give you an update and 12 we'll attempt to provide you with the growth 13 over the last couple years as well. 14
Just for the 19 record, we had an in-depth discussion about 20 this yesterday, we talked about the support 21 coordination systems for individuals with 22 mental retardation. As you know, we really 23 had a serious discussion about the selection 24 process. 25 Would you go on record and tell me 172 04/21/04 - WHOLE - BILL 040255 how that selection process worked? Because we raised some issues about using new organizations versus organizations who had experience in running programs.
And this, as we discussed yesterday, fortunately or unfortunately, was a process that we went through a formal RFP on. We began discussions about reconfiguring the MR service, case management system almost three years ago at this point in time. Spent about a year prior to the issuance of an RFP, meeting with families and consumers and provider of network around the changes that are required as a result of -- some major changes that were going on with our funder at the state and federal governments and the requirements that on the mental retardation side, services had to be provided by providers that were quote/unquote conflict-free. And what was meant by that is that provider could also not be a direct provider of mental retardation services. We issued a RFP on July 1, 2003. We 173 04/21/04 - WHOLE - BILL 040255 had organizations that responded to that RFP in September. The RFP was reviewed and six agencies were selected to go to the second level which was a formal interview process that began in December and continued through February. That interview process consisted of a group of two parents, a consumer, a provider representative, a member of the Mayor's MHMR advisory board and three representatives of the Office of Mental Retardation. In mid-March, the four entities were selected for this particular service and really are using this point in time as a transition point in time. The new services will take effect July 1st, but they're working with the current network of providers to transition records, to transition information.
And the one organization that you know I was very concerned about was Warren E. Smith.
I want Warren E. Smith to be like Philadelphia Health Management Corporation. Why can't they just 174 04/21/04 - WHOLE - BILL 040255 get some --
Warren E. Smith, as I said yesterday, I think has and continues to provide valuable services to the City. Between the various components of the behavioral health system, they receive in excess of $20 million. The vast majority of that comes through Community Behavioral Health, but over the course of the last year, that organization was one the first organizations selected to do one of the new school-based behavioral health programs, was the only organization selected to expand that in the second year of that particular initiative and also as an organization that was, over the course of the last year, identified as one of our targeted case management pilots. There's only four that we have in the City for behavioral health services, and they were selected as one of the four. As I said yesterday, they're an organization who does do good work. This was not meant -- they're not being selected for 175 04/21/04 - WHOLE - BILL 040255 the mental retardation was not meant as a criticism of the organization.
Just to go on record, our concern was, one, the selection process and the internal process for selection. We question that in that there were staff people who made those selections and we had some concerns about that. And in the future, the selection process should be, even from the initial point, should be much more community-based inclusive.
And I think we hear that concern. That's something we'll certainly take in consideration as we do future RFPs. One of the thing I did want to comment on that is the selection process, that two-layer selection process that we discussed yesterday where staff reviewed the first wave and the larger group of stakeholders reviewed the second, was articulated in the RFP. So that was not a surprise to any of the bidders how that was going to be --
Well, that may 176 04/21/04 - WHOLE - BILL 040255 be true, but also we looked at the two organizations who received the services were spinoffs from other organizations that already existed. And we have some concern about how they would gear up the programs in communities that they did not serve and do not serve. How would they serve those communities? I jut want to put on the record. We still have open dialog about what we do with that process. We haven't ended that. I thank you, Madam President, that's all the questions I have.
Thank you. Mr. Covone, you indicated that the Managing Director presently has a search he's conducting for the director this department. Can you tell me what the qualifications are?
I believe they're looking for someone who has broad-based knowledge of both behavioral health and mental retardation reserve who has operated in large systems and in an urban environment over the years, has background both from a programmatic and financial operating end of that. And 177 04/21/04 - WHOLE - BILL 040255 there is a job description that I believe is finalized and available if you would like that.
Is there another organization like CBH in any other City in the country that you know of?
CBH is probably one of a kind. This was an initiative that actually received the Innovations in American Government Award a couple years back because of the approach we took with behavioral health. And really the intent behind the establishment of CBH is that any savings that existed through the initiative, unlike other states and other counties in Pennsylvania is not going to the for-profit managed care entities but is available for reinvestment in the system.
What did you say the qualifications were? The person had to work in an organization like CBH?
They would 178 04/21/04 - WHOLE - BILL 040255 have to have some knowledge of the programs.
Thank you. Thank you very much. Nice seeing you. The Committee will stand in recess for a half hour. Thank you. (Recess.)
The Committee is back in session. The next department that we'll hear from is the Department of Human Services. We do have a copy of your written testimony which has been given to the stenographer. It will be transcribed in whole. I would ask that you please abbreviate your testimony. COMMISSIONER MARTINEZ: Good afternoon, President Verna and Members of City Council. It's an honor to be here once again. My name is Alba Martinez, I am the Commissioner of the Department of Human Services. And this afternoon, I am here to 179 04/21/04 - WHOLE - BILL 040255 present on behalf of our department our Fiscal Year '05 Operating Budget request and also to report briefly to Council the progress we have been achieving on successful outcomes for children. I'm also here prepared to share with you and discuss with you the challenges that remain for us and also to preview some of the plans that I believe will place Philadelphia's Department of Human Services on the cutting edge of service provision. 4 percent over our Department's Fiscal Year '04 estimated obligations. The Department has a budgeted position level in Fiscal Year '04 of 213 employees, of which 1,887 were filled as of December 2003. We are seeking a position level to be filled at 1,964 and the increase of 77 staff is detailed in the testimony, but I would like highlight that 33 of them are to investigate child abuse and neglect cases and 11 are to fill other social work vacancies. 180 04/21/04 - WHOLE - BILL 040255 We have been engaged since the year 2000 in a top to bottom effort to make a department more efficient, effective and accountable. Reform of a child welfare system, as we all know, is an ongoing work in progress. However, I want to highlight briefly some of the accomplishments that we have made, and I have to personally thank Council for its support throughout this reform period. We have increased our social work staff, including experience and master level professionals which has resulted in a reduction in staff case loads. We have created a staff training and development center that counts on the University of Pittsburgh, Temple University, and the University of Pennsylvania as formal partners. We have specialized our sex abuse investigations. We have expanded our investigation division by six unites to respond to a 17 percent increase in reports of abuse and neglect over the last three years. 181 04/21/04 - WHOLE - BILL 040255 We created a midnight to 8:00 in-office shift to respond to abuse and neglect. We redesigned and expanded our treatment foster care system which has resulted in a reduction in the dependence on institutional care for children with behavioral health problems. We've implemented performance-based contracting in foster care which is designed to increase permanency outcomes for children. We had a record number of adoptions last year, 654, and in the first year of performance-based contracting we have seen a 31 percent increase in permanencies over the prior two years. We've implemented permanent legal custody as a third permanency option for children in our care. We've created the Achieving Independence Center for aging out youth. These are just some examples of the many accomplishments that we have been able to achieve with the support of City Council. 182 04/21/04 - WHOLE - BILL 040255 For '05, our goals and initiatives include automating the entry of child abuse and or neglect reports, and this is going to help us document and track reports of abuse and neglect more timely and also assign cases much more quickly, which will, of course, minimize any risk that might be resulting from delays in the assignment of cases. We are eager to establish a parent support center focussed on family unification. There are 2,474 families with at least one child in placement as of December 31, 2003, for whom the Department was seeking reunification with their children.
And while we currently offer these array of services to support the return of children home, we recognize that parents often need additional support. So in collaboration with the Workforce Development System, we are going to develop a one-stop shop for parents to reduce the time that children are in placement, and that one-stop shop is going to include services like a gateway to mental health and drug treatment services, education and 183 04/21/04 - WHOLE - BILL 040255 training programs, benefits counseling, mentoring and peer mentoring for these parents and visitation, life skills, adult basic education and transportation assistance, among other supports. Another important reform the Department plans to fully implement is the transition from the existing way in which we are receiving legal representation to a team approach to legal representation. This means that attorneys will follow cases from beginning to end and there won't be a discontinuity in representation of children. We believe that this will add to the efforts to reduce the length of stay of children in placement. Lastly, we're working very aggressively to seek reimbursement for the Department's costs from, of course, any other source that can assist us in meeting our financial goals, and we are working on some substantial revenue initiatives, increase initiatives and we are tracking and following and advocating for those two specific pieces 184 04/21/04 - WHOLE - BILL 040255 of legislation which we can testify to in more detail. This concludes my truncated testimony, and I look forward to your questions and recommendations for the coming year.
Thank you very much. You mentioned about attorneys following the case from beginning to end. Are the attorneys within your -- are they in-house? COMMISSIONER MARTINEZ: They are attorneys that work within the City Solicitor's Office that are designated to the Department of Human Services.
How many attorneys assigned to your department? COMMISSIONER MARTINEZ: The exact number of attorneys is 34. We added 14 in the last year.
Commissioner, do you have any contracts with the fund for Philadelphia -- 185 04/21/04 - WHOLE - BILL 040255 COMMISSIONER MARTINEZ: Yes, we do.
-- in FY '04? You said yes. Can you tell me what's the amount and what are the funds used for? COMMISSIONER MARTINEZ: Yes. Allow me to look it up in our budget book, and I will also ask our contracts Deputy Commissioner Cheryl Ransom to join me at the table.
Are you also planning to contract with the fund for Philadelphia in FY '05? COMMISSIONER MARTINEZ: Yes.
Can you tell us what the amount in '04 is and what are the funds used for and also what is the amount for '05 and what services will be provided? COMMISSIONER MARTINEZ: Yes.
Cheryl Ransom, Deputy Commissioner for the Department of Human Services.
Good 186 04/21/04 - WHOLE - BILL 040255 afternoon.
Various projects. One is we have a CAPTA Project for special needs children.
We call it a CAPTA Project, C-A-P-T-A. It's support for children with special medical needs and equipment. The next is family preservation services in terms of planning family preservation activities for families. We have our communications campaign for the Department.
Our Communications Director, Ted Quali (ph). COMMISSIONER MARTINEZ: While it's called Communications, we have invested a 187 04/21/04 - WHOLE - BILL 040255 significant amount of time and effort in public education and outreach to the community. And that's really at the core of what we do in communications. In addition to public education and outreach on many different issues, which is partly the reason why we have a 17-person increase in reports of abuse and negative, we have also done tremendously aggressive outreach which has cost us money but has paid off in recruitment of staff for the Youth Study Center and the Department of Human Services social work team. And just to explain why this is needed, because it is a substantial amount of money, since in the last four years we have hired over 450 social workers for a net increase in the Department today of around 118. So the turnover is enormous. And the recruitment -- this is crisis nationally, the recruitment of social workers. So these are examples of the kinds of initiatives that we do through our communications campaign. And we have a Communications Director and we also then use different consultants in carrying out some of 188 04/21/04 - WHOLE - BILL 040255 those functions.
What are you planning to contract with the Fund for Philadelphia in FY '05, how much?
Would you explain your contract with Philadelphia Safe and Sound. COMMISSIONER MARTINEZ: Yes. I'm asking Deputy Managing Director Ellen Steiker to join me at the table for that question. But Safe and Sound is a provider for the department of after school and youth development initiative, and the department contracts with Safe and Sound to manage and oversee those many after school and youth development initiatives. In this current fiscal year, the Department provides them with approximately $25 million for those comprehensive programs throughout the City. And in Fiscal Year '05, 189 04/21/04 - WHOLE - BILL 040255 we are proposing to provide the same amount, and if we are successful in getting our increase, then we would increase that by an additional $10 million.
Let me ask. You also have summer programs that Safe and Sound administers. Are community recreation groups allowed to participate in running or applying or being a part of the programs that are in existence? COMMISSIONER MARTINEZ: Well, I will defer to Deputy Managing Director Syker for detail. I will report to you, President Verna, that I am aware that the Children's Investment Strategy does invest in the Recreation Department and that there are 63 recreation programs, at least that I am aware of, that receive support that comes from the Department through Safe and Sound. And in addition to that, the Mayor has committed and an additional $1.2 million --
I am led to believe -- and I don't mean to be cutting you short, but we are really pressed for time. 190 04/21/04 - WHOLE - BILL 040255 I understand that last year 40 recreational, I guess, different communities filed an application with Safe and Sound to be a part of a summer program or after school program, and not one of them were accepted. Was that portion of the money that would have gone to the community groups given to the Department of Recreation?
This is Ellen Steiker, Deputy Managing Director. As part of that RFP process, indeed, a number of groups, recreation advisory councils, and recreation departments sites applied. A decision was made to actually give the money directly to the Recreation Department where it could be optimized better, so that instead of having one site getting a lot of money and another site getting nothing, we have awarded or Safe and Sound awarded 1.2 million over three years to the Recreation Department, that's 400,000 a year and that started in FY '04. So FY '04, FY '05 and FY '06, and that's being used by the Commissioner to develop and enhance after school programming. 191 04/21/04 - WHOLE - BILL 040255
Would you please send me in writing the breakdown of how the Fund for Philadelphia operates their money and who they contract with and for what amount for both FY '04 and FY '05, please? COMMISSIONER MARTINEZ: Yes.
Thank you. The Chair recognizes Councilwoman Tasco.
Thank you very much. Good afternoon. Could you bring me up to date on the status of the Kinship Care Program? COMMISSIONER MARTINEZ: Well, the Kinship Care Program of the Department of Human Services has two components. One would be in the prevention side, the Kids and Kin Program that we support through Philadelphia Society for Services to children, and that has been growing and it's very successful. And I believe at this point -- and I will David Fair to join me to answer questions pertaining to that, but I believe our funding level with 192 04/21/04 - WHOLE - BILL 040255 them is $350,000 now. And when I became Commissioner, it was around 200,000. So we're investing more in that. In addition, on the foster care side, which is the other part of Kinship Care where relatives or friends actually become certified as foster parents, the number of kinship caregivers in foster care is growing dramatically. I mean, we continue to see a growth in that. And this year, we are seeing a dramatic move of kinship caregivers to permanency. We have close to 200 families that have now achieved permanency and are out of the foster care system, many of whom were kinship care providers. And that means that they will continue to receive a subsidy until the age of 18 of the child. So we're making progress. We prefer children to be with relatives caregivers instead of with strangers in foster care. And second of all, we prefer children to never to come into the system at all if we can avoid it. So we want to support that network of community services for families. 193 04/21/04 - WHOLE - BILL 040255
What's happening to the Grand Central Station site that was opened as a information site.
My name is David Fair, I'm Director of community based and prevention services for DHS. We're actually funding seven programs in addition to the Kids and Kin Program that the Commissioner mentioned targeting kinship caregivers, and Grand Central is one of those. We have continued to fund that. They are talking to us now about moving out of their Center City office building to a neighborhood site in South Philadelphia, and we are supporting the planning for that. That's probably our most essential component of our Kinship Care approach because it's the place where almost everybody starts. They're asking for information, they're asking for advice. Grand Central has helped a whole lot of Kinship caregivers through the Kinship foster care process, which can be very confusing and cumbersome for people. But mostly what they 194 04/21/04 - WHOLE - BILL 040255 do for us is help primarily older Kinship caregivers to connect to the network of social services that are available for them so that they don't need go through the formal foster care process; or if they do want to adopt the children, we help though process. Grand Central in Philadelphia is a society for services to children with the Kids and Kin Program, our largest providers in that area. We also have contracts with the 18th Street Development Corporation for a program called Raising Others Children. With the Center for Intergenerational Learning for a respite program for older caregivers called Family Friends. And that's targeting Kinship caregivers where the children have serious emotional disturbances and the adult needs respite periodically. And that's a peer respite program, so other Kinship caregivers who are in the same situation participate in that. We also have the Grandma's Kids Program which is a program that we've been expanding in the last two years which is a 195 04/21/04 - WHOLE - BILL 040255 tutoring literacy training program targeting the children of Kinship caregivers in what used to be the William Penn Cluster in North Philadelphia. And what we're trying to show there is that if we can target those kinds of supports to the Kinship families, that we can make more progress for those children than we do than just by having them go through the regular School District tutoring programs.
Grandma's Kids is also run by the Center for Intergenerational Learning.
I don't know exactly. I think there are about 70 kids who are in Grandma's Kids. That's one program and it's serving a particular neighborhood in North 196 04/21/04 - WHOLE - BILL 040255 Philadelphia. We started it at the time when the School District was organized by clusters. And that's about the extent of my knowledge.
Now, is Grand Central Station moving from -- they were downstairs, right?
They're currently at 1211 Chestnut Street. They want to move to a site that's actually right next door to Philadelphia Society for Services to Children since that's the primary social service agency that they actually refer families to, there is a certain cost effectiveness as well as just a smoothness of operation by having them together.
They always want more money, but other than that... I should say, we also support an annual local conference through Grand Central 197 04/21/04 - WHOLE - BILL 040255 to highlight Kinship issues and to advocate for the needs of Kinship caregivers. COMMISSIONER MARTINEZ: We are deeply, deeply committed to this issue. There are, the last time I looked at statistics, approximately 23,000 children being raised by relatives and family in the City of Philadelphia. These children do not belong in foster care. Clearly, the foster care system is not big enough to serve them. So the Department's whole reason for creating that community-base service network is to create real networks of support in communities that are there when people need them, not when it's too late or not after the fact. And so we are proud of those efforts and we're deeply committed to it.
And Raising Others Children, they are out of South Philadelphia, aren't they?
Yes, they are part of another organization called the 18th Street Community Development Corporation. There is some question about 18th Street's continuing 198 04/21/04 - WHOLE - BILL 040255 operation after the end of this fiscal year. If they decide to go out of business, then Raising Others Children Program will be transferred to either Grand Central or PSSC or one of the other programs. We've already started discussions with other kinship programs to make sure Raising Others Children doesn't suffer as a result of 18th Street's problems.
One of the things that I asked a lot of questions about to the Health Department and I want to talk to you about is how much of your direct services to children is contracted out and what is your bidding process and how contracts are given out and how many of them are no-bid contracts and what's the diversity in those people who operate those programs who are providers? COMMISSIONER MARTINEZ: Well, I will begin answering the question and, again, will ask Deputy Commissioner Ransom to join me at the table since she's our contracts and program evaluation deputy. The Department is really committed 199 04/21/04 - WHOLE - BILL 040255 to diversifying our provider base because it's the right thing to do, because it's the mandate of the Mayor and Council, and also because it results in a greater ability to deliver quality services, all for the right reasons. We have seen an increase -- I'll just give you one example. We have worked very aggressively to bring in a minority provider who does excellent work in Baltimore and District of Columbia to come and do treatment foster care in the City. And so we gave that provider a start-up grant, and they should be online with us, hopefully, next year. And refresh my memory about their name.
Progressive Life Center. COMMISSIONER MARTINEZ: Progressive Life Center. And in addition to that, the Department has grown in the prevention arena. A lot of the work that have done before that continues to be done, it's foster care and 200 04/21/04 - WHOLE - BILL 040255 institutional placements. And in the prevention arena, we have been very aggressive at diversifying. Unfortunately, the MBEC does not count that because a lot of that money gets the passed through intermediaries. So, for example, if we give a substantial amount of money PHMC then PHMC gets counted as a provider and not the subcontracts which usually the majority of the money goes. However, we are prepared to give you information today about the diversity in our prevention contracts. But first I would ask Cheryl to speak to the difference in accounting and what our numbers tell us.
Before you go to that question, one of the questions I raised earlier is why do you pass the money through PHMC and why don't you contract directly with these groups? COMMISSIONER MARTINEZ: Because the Department is so large, we are right now at close to $600 million and most of that money is in service contracts, $450 million. But 201 04/21/04 - WHOLE - BILL 040255 yet our staff infrastructure has not grown sufficiency. Frankly, Councilwoman, we wouldn't have the capacity to execute all of those contracts individually. So in order to be able to achieve the work and do it efficiently and do it responsibly and have sufficient accountability, we have to do it through an intermediary.
No, we use GPUAC as an intermediary, Greater Philadelphia Urban Affairs Coalition, and we use PMHCC as A intermediary as well.
Do you monitor who they contract with? If they are contracted with these programs, does the Department monitor the diversity of their contracts? COMMISSIONER MARTINEZ: Yes, we do. And in fact, we participate in the selection of providers. The providers are selected by the Department. We also use North City Congress as an intermediary for contracts. 202 04/21/04 - WHOLE - BILL 040255 It's partnership. When we talk about intermediary, we're not giving them the contract and then allowing them to do anything they want with the money. We are actively involved in the selection process, in setting standards, in setting expectations, and assuring that the providers are in the neighborhoods we need them to be, because our services are following the need. We look at data. We know that most of our client base is in lowest income neighborhoods in the City. We know that, so we've made every effort to, while having services equitably distributed according to need because abuse can happen anywhere, we are targeting the highest risk neighborhoods. We have to concentrate our resources, and we're doing it in those neighborhoods. And we know that those neighborhoods are often minority neighborhoods in the City. So, therefore, the logic follows that we need to have great representation. So I will differ to my staff, however, for the details of that which they will give you right now in terms of numbers 203 04/21/04 - WHOLE - BILL 040255 and specifics.
Cheryl Ransom, Deputy Commissioner for the Department of Human Services. The majority of our contracts are with non-profit providers. However, we participate with MBEC, but we're not able anymore to count the minority participation. They used to be able to get an affidavit and we could count their participation. And the requirement was to have over 51 percent minority or women on the board to serve minorities and to serve minorities in their communities. And we would really seek support to be able to go back to that because that's where the majority of our money is spent, with minority providers in minority communities.
I'm not sure about that. MBEC decided that they would no longer allow the affidavit process. You're not 204 04/21/04 - WHOLE - BILL 040255 permitted to certify a non-profit. According to MBEC rules, only for-profits may be certified.
Well, we've got a new director now. Let's see what he says.
Because our numbers were to percent. Now, it's like 2 11 percent because we can't count on non-profits, 12 and that's where a lot of our money is spent. 13
That's why the 14 community groups are very concerned because 15 they're not getting a dollar share as 16 providers anymore. So if there's no 17 monitoring and there's no way to hold these 18 people accountable, then the contracts go to 19 whoever. 20 COMMISSIONER MARTINEZ: Correct. 21 And also the City, both the Administration and 22 Council, not getting the credit for what we're 23 doing because non-profits are businesses. 24 They are organized businesses. DHS is the 25 largest operating department, and we put most 205 04/21/04 - WHOLE - BILL 040255 of our money on the street and services so that $450 million --
It seems to me that you have the contract with these organizations to subcontract out, you can require them to have a number to report to you how many of non-profits who the service providers, how many of them are disadvantaged or minorities. There's nothing to stop you from doing that.
The majority of our new services now, we issue requests for proposals. As part of that process, the MBEC requirements are attached and providers must adhere to them. So that's a standard requirement for all of our requests for proposals.
Well, if you do that now, will you see an increase in the number of minority providers through that process?
If we could count the non-profits because those are ones that are --
Who says you can't count the non-profits? 206 04/21/04 - WHOLE - BILL 040255
But you can do it. COMMISSIONER MARTINEZ: And we do. So our numbers show to of our 8 contractors are minority, overall. That's not 9 counting the intermediaries. The 10 intermediaries is over and above that. Our 11 direct contracts -- 12
Now because MBEC only 15 counts at this point in time for-profits, so 16 our minority participation with for-profits is 17 2 percent. When we were able to count 18 non-profits we were 15 to 20 percent and we've 19 even grown 20 to 25 at this point in time. 20 COMMISSIONER MARTINEZ: Also to 21 explain that, that 20 to 25 percent is our 22 accounting of what we consider minority 23 organizations according to what we know is 24 real, not the MBEC standards, 20 percent. 25 However, in the last four years, the 207 04/21/04 - WHOLE - BILL 040255 Department has grown by $180 million and a lot of that has been in the development of a prevention and community-based services network. Our community-based contracts since that time are 71 percent in minority organizations, and those are the ones that we count through PHMC and North City Congress and others. So 71 percent of those contracts are with minority community-based organizations.
Well, are there a number non-profits who are in the business here, minority non-profit organizations in the City? You said that there are only 2 percent for-profits.
The for-profits that have to have minority participation on their contracts.
How many for-profits do you have? Do you have a large community of for-profits? 208 04/21/04 - WHOLE - BILL 040255
But those who do exists only get 2 percent of the participation?
Are they subcontracted out through these larger organizations? COMMISSIONER MARTINEZ: No, those are contracted --
For example, on our MIS contracts, we required that some of their staff be minority employees. That was a way to get participation.
Yes, we actually had MBEC identify MIS businesses that were certified by minority and had our consultant providers go meet with them to talk about the kind of work we needed and actually received 209 04/21/04 - WHOLE - BILL 040255 resumes from them so that we could interview of those staff, those minority firms that were approved by MBEC. COMMISSIONER MARTINEZ: Councilwoman, just to clarify, the overwhelming majority of our contracts are directly contracted. We use intermediaries in limited purposes. So most of our contracts are direct contracts with providers.
Thank you. The Chair recognizes Councilman Kelly.
Good afternoon. Commissioner, I just want to know what percentage of funds in your budget is matching funds from the state or federal government? COMMISSIONER MARTINEZ: I'm going to ask our finance director to join me at the table to address your financial questions.
Good afternoon. I'm John Zanier, DHS Fiscal Director. Around 93 percent of the money for DHS comes from 210 04/21/04 - WHOLE - BILL 040255 federal and state and other sources.
Is that committed by the federal government? Are they federal grants? Is it state funding?
I just want to know if anything happens with the state or the federal government reducing the level of funding, what would you do to make up the difference, if there's any reduction at all proposed in in '04 or '05 or '06? COMMISSIONER MARTINEZ: First, Councilman, let me say that Philadelphia has the fifth largest child welfare system in the country. And we know nationally that child welfare systems are fragile and that if something goes terrible wrong that it can cost a CITY, a county, a state unspeakable amounts of money, as we're seeing in New Jersey. So our position and my position as Commissioner, and I position of the Mayor is that we must 211 04/21/04 - WHOLE - BILL 040255 receive all the funding that has been certified as due to us. So there is a certified number that the state has certified that relates back to our need, and it is our position that that money has to be provided, the state and federal share in that. In the last few years, our tradition has been, when we are not satisfied with the results of what the state has given, to file 11 an appeal and to proceed with litigation if we need to, and we intend to do that also. To date, I believe 60 counties --
Has that happened recently? COMMISSIONER MARTINEZ: Sixty counties in Pennsylvania have filed appeals against the decision or the recommendations of the Governor to the Legislature, and we are one of those counties. And so I guess what I'm saying is that we are taking the position that we will receive our full funding. So if we have a situation where we absolutely don't have everything we're asking for, then of course we would look first at expansion 212 04/21/04 - WHOLE - BILL 040255 dollars, the things we wanted to do to make our system better that we can't afford to do without. However, we're not conceding that at this point. And, of course, if things went beyond that, then at that point I believe it is the position of the Mayor that he will find the money for child welfare because that is not an area where he believes our City can compromise. Of course we do everything we could to be even more efficient and as efficient as possible. But at this point, we are fighting for our revenue.
The word I was looking for was certified, and you explained that. I just have another question that has to do with the foster care. Do you have any problems in finding qualified foster parents at any time? Do you have a waiting list? What is the procedure for that? COMMISSIONER MARTINEZ: Well, we have over 30 foster care agencies, 27 of them are most active partners, 27 of them are performance-based contracting foster care 213 04/21/04 - WHOLE - BILL 040255 agencies. It is the responsibility of those agencies -- and we fund them. Within their contract there's money for recruitment and outreach, but we also use our own communication dollars to do a lot of outreach for foster parents. In answer to your question, absolutely, there is always a need to be recruiting foster and adoptive parents. And anything that Council can do to help us in that is important because the more qualified, committed, loving foster parents and adoptive parents you have, the safer we keep our city's children. So you always want to have more foster parents than you need. You never want to be just at that moment because it's organizational nature people will cut corners. So, yes, there's always a need. And also, as a City we are moving more to permanency and moving more children to adoption and permanent legal custody. And that means that foster parents in the system will move out of the system and become just regular parents. So there's always a need to replenish that. And what we are doing is we're forging 214 04/21/04 - WHOLE - BILL 040255 partnership. We just formed a partnership with Freddie Mack Foundation to come into the City, and with Channel we're doing a lot of 5 recruitment for adoptive parents, Wednesday's 6 Child. We put a lot of ads in the paper, we 7 work with our providers in that. It's always 8 a need, always a concern and -- 9
I'm sure I have a 10 large screening process also. COMMISSIONER MARTINEZ: It's a regulated process and there are state regulations around who is qualified. And in addition to that each agency is responsible for doing a careful screening process. And lastly, what I wanted to also share with you is that this is an opportunity also, as we grow the foster parent pool, to reduce the number of children in institutions because we have almost a thousand children, perhaps a little more, of children in institutions. And if we can bring them into foster homes, then that would not only be a cost-efficient solution but better for children. 215 04/21/04 - WHOLE - BILL 040255
You're welcome. The Chair recognizes Councilwoman Brown.
Thank you, Madam President. Good afternoon. I would like to first follow-up on Council Lady Marian Tasco's questions regarding diversity amongst your direct service providers, and I need to make sure I heard it correctly in that at some point instituted the new policy where you no 17 longer certify non-profits. COMMISSIONER MARTINEZ: That is correct. And I'm asking Cheryl Ransom, Deputy Commissioner Ransom to assist in answering this question.
Good afternoon. Cheryl Ransom, Deputy Commissioner for DHS. I guess they stopped it about two years ago. DHS had contracts with a majority of 216 04/21/04 - WHOLE - BILL 040255 non-profits. They would allow the non-profits to receive affidavits rather than be certified. And the affidavit had to confirm three things. One is that their board had to be composed of 51 plus percent either women or minority. They had to serve a majority of minorities clients. And third, they would have to serve those minority clients in their communities. And many of our providers received the affidavits and we were able to count that participation. About two years ago, they stopped that. We advocate that it be reinstated.
That's important information for us to have at this juncture in MBEC's development. Absent that procedure, what impact has that had?
Well, we continue to advocate to have diversity in minority providers. The impact is that we are not able to count the participation. So if you looked at our record in MBEC, the reports that are done, you would also see 2 percent. And 217 04/21/04 - WHOLE - BILL 040255 that's because that 2 percent is with the for-profits.
I see. Of your direct service, 71 percent minority community-based organizations provide direct services. Is that accurate? Did I take that down correctly?
Is it possible for you to break down that further? Let me just tell you where I'm headed. When we know what's happening with African-American men and we know the value, connect to have African-American male role models participating in a leadership capacity with programs that are making a difference for African-American men or women, in that mix, I'd be curious to know how many of those direct service programs actually have an African-American man in leadership heading it up. So if you don't have that information today, if you could provide that to the Chair, because if we want to preach nurturing among 218 04/21/04 - WHOLE - BILL 040255 African-American men, young people need to see African-American men in leadership in those kinds of programs in their community to foster all of what that means. So I'd be curious to know what the yield of that is.
There is also the question regarding this intermediary organization. What's the name of it? Help me out. COMMISSIONER MARTINEZ: We use a number of intermediary organizations. North City Congress, Philadelphia Health management Corporation --
That one in particular. There's a commitment where you sit with regard to diversity. What type of, for lack of a better word, stick can you hold over the head of intermediaries to ensure that they are honoring your commitment to diversity? Do you have one? COMMISSIONER MARTINEZ: We 219 04/21/04 - WHOLE - BILL 040255 participate in the decision-making about who receives the subcontract.
Oh, you do? COMMISSIONER MARTINEZ: Yes, because these are initiatives that the Department sets up based on research and best practice and we know the targeted neighborhoods we want to go into and we have more expertise than almost anyone in this City collectively. I'm not speaking personally here. The Department of Human Services has more expertise than almost anyone in the City about who's doing social work in the City because of our history and the scale of our contracts. So we would know who we want, who we need, not particularly but in terms of the traits of a provider. So we dictate that and then the intermediary carries our dictate. They do not have that much discretion.
All right then. On the issue of recruitment, the direct question is, help me understand why you were budgeted for 2,013 positions in FY '04 yet about 1800 were filled and put that in the 220 04/21/04 - WHOLE - BILL 040255 context of the work you've been doing around recruitment and where you were when you came on board and where you are now. COMMISSIONER MARTINEZ: Well, Councilwoman, as you know, there is a hiring freeze in the City, and so the department is subject to that hiring freeze. However, the Administration has been very clear that we will not compromise on safety of children. And so the exception for that hiring freeze is the position of social worker and any position that is legally required, for example, social work supervisor, you need to have a ratio under state Rules, and also youth detention counselors. Those positions that are critical to health and safety are exempt. So as a result, the Department has taken full advantage of that exemption and we hire social workers and youth detention counselors aggressively. And we do have 120, or maybe more right now, more social workers than four years ago, but the point I made is we have hired almost 450 to get to that 118 increase. So it's just a lesson learned about the 221 04/21/04 - WHOLE - BILL 040255 incredible challenge to hire and retain social workers in you child welfare. It's incredibly hard.
Let me just say on a personal note, one of my forward jobs out of school was with Slaten Farms School when it was still servicing all girls. I lasted seven months because the burnout just came that quickly. So of the positions that you have, most of those employees are social workers and -- most of them, professional positions? COMMISSIONER MARTINEZ: The majority of our staff are in the social work profession or related. For example, we have approximately 40 program analysts, maybe between 40 and 50, and those program analysts do work related to social work. They do policy and planning and contract management and evaluation, and that's a promotional opportunity from social work. So that's really the overwhelming majority of the department. On the juvenile justice side, we 222 04/21/04 - WHOLE - BILL 040255 have a substantial number of employees, I believe around 300, in juvenile justice working in the Youth Study Center, which is a 24/7 facility. So that really constitutes the bulk of our employees.
Well, that's a perfect segue to my next line of questioning around Youth Study Center. Speak to some of the changes that have happened since you were last with us. And to the extent it's possible, knowing that there is still a lot of sensitive information around the new building site location possibly, give us some up-to-date on where you ever with that. COMMISSIONER MARTINEZ: Well, with the leadership of the Managing Director's Office and the Law Department, we are closer to an outcome on the issue of a site. The negotiations are very close to completion for a particular site in West Philadelphia, and we are hopeful that by the end of this week we will have some sort of resolution. 223 04/21/04 - WHOLE - BILL 040255
Any systemic changes you've made at the Youth Study Center under your leadership? COMMISSIONER MARTINEZ: Yes, many. Our population used to be on the average 150 children a day. And the average daily population now is approximately 105 or 100. And we have done that through managing our staff differently. We have reduced overtime by millions of dollars. The place is safer. It's actually now certified at a national level. We have state certification or national certification as a juvenile correctional facility. And certainly, the programmatic improvements are significant, and I believe that the physical improvement, a new facility, will allow us to do even better programming. We have a great school, great health services and great support services for children of families inside the Youth Study Center.
So acknowledging the fact that you're now able to redirect young people before they come through 224 04/21/04 - WHOLE - BILL 040255 those doors, is there adequate staffing for those professionals who are involved in the preventive or intervention, I should say, before they have to go through the juvenile justice system? Are you adequately staffed that way? Because my understand, based on some homework, that those dollars were actually -- the dollars for those staff was being handled by another revenue stream. Am I correct? COMMISSIONER MARTINEZ: Can you clarify?
I'll try. I did a tour with Judge Myrna Field, and I was struck by the decrease in number and there is some procedural program step that has to be taken before making a determination that that child should go through the criminal justice system. And what I learned in the discussion was, if we had more staff, then more young people could be redirected and not end up in a juvenile justice system. COMMISSIONER MARTINEZ: Well, I believe that when it has been brought to my 225 04/21/04 - WHOLE - BILL 040255 attention that there's a gap in staff that I have aggressively filling that gap. And I'm not sure that there's -- I mean, there's a lot of areas, as Mr. Fair mention, where we would love to have more so we can do that. That being said, I don't believe that we have any major gap in staffing right now in the Youth Study Center. However, we have Deputy Commissioner Ambrose from Juvenile Justice right here to help expand on this answer.
AnnMarie Ambrose from DHS, Deputy Commissioner for Juvenile Justice. Councilwoman Brown, I think you're referring to the diversion program that is actually run by David Fair's prevention division which prior to Alba's leadership there were about 150 kids that went through the juvenile justice system who were diverted through a process called the Informal Adjustment Section of the Juvenile Act. Because of the David's work and the court's commitment, we've now diverted 700 kids from the juvenile justice system directly into community-based programs. Those programs 226 04/21/04 - WHOLE - BILL 040255 include the Functional Family Therapy, lots of good community-based work so that those kids are not coming into the system in the first place and also they're not getting re-arrested. The overall recidivism rate for kids in juvenile justice returning from delinquent placement is around 30 percent. For the child who go through diversion programs in community-based the recidivism rate is about percent. So that program has 12 been very successful. It's not necessarily a staffing issue that I'm aware of, but David and the Court have done a tremendous job of increasing the number of kids who don't need to come into the juvenile justice, just need some services in the community and in the family that are going to prevent them from deeper re-entry. COMMISSIONER MARTINEZ: To clarify, I was speaking to direct DHS City of Philadelphia staff, and I think that that issue is one about additional resources for contracts to serve those children out in the community. And as I mentioned earlier, we 227 04/21/04 - WHOLE - BILL 040255 have over $450 million contracts with providers so that would be that issue. And in that sense, Councilwoman, absolutely, the more this City can invest in community-based services that are able to handle high-risk and high-end families, the less we would have to rely on institutions and foster care. And that is the system we are building. And, yes, if we had more, we could do more; but I will say that I am very proud of what we have been able to do in terms of building a community-based service prevention division that has almost $70 million today, but we will keep trying to expand on that.
Councilwoman, do you mind holding on some of your questions for the second go around?
Thank you, Madam Chair. Good afternoon, Commissioner Martinez. Good to see you. 228 04/21/04 - WHOLE - BILL 040255 On September 16, 1997, before your stewardship of DHS, the police found the body of the 6-year-old child. She died of starvation up in Brewerytown section of Philadelphia. Her name was Charnay Wise. A state review of a DHS internal investigation found a serious lapses in which the agency had not followed its own policies for child safety. There were, according to the information that was provided, no times when no social workers were assigned to the family, that required risk assessments were not conducted, no record keeping during crucial periods of the child's life, and long-term family plans were not made, and that the case was arbitrarily closed. Again, I remind you, this is before your stewardship and back quite a few years in 1997. We fast forward to August of 2003 and the tragic death of 3-year-old Porsche Bennett. Similar circumstances but the same end result, the death of a young child. What practices are in place in your 229 04/21/04 - WHOLE - BILL 040255 stewardship, given the 1997 case and the Porsche Bennett case of last year? What practices are in place to make sure that this never happens again to the extent possible? COMMISSIONER MARTINEZ: Well, let me speak to the Porsche Bennett tragedy which deeply, deeply affected the Department. And since that point also, we have been working diligently to address some issues that were identified as a result of that. The situation in the Porsche Bennett tragedy is that the child was not born when we last served the family. The family was last served by the Department in the year 2000, and the mother was transient, she was in shelter and she left the shelter in 2000. After some time searching, the court allowed us to discharge the case because the family could not be located. Three years later, Porsche Bennett and her two sisters are living with her aunt and the boyfriend and they are being severely abused. They are not known to the Department at that point. Two days before her death, we 230 04/21/04 - WHOLE - BILL 040255 received a call to the hotline where there are allegations of abuse, but the caller does not know the names of the children. The allegations pretty serious, but we don't have the names of the children so we really can't trace back, which is a standard procedure. You always clear the case and find out if it's an active case or what we know. So a social worker went out the next day and could not get into the home. The day after when the social worker went out, the police was there and the child had died. So one of the issue that became clear to us that we needed to tackle was the policy that the Department follows with regard to locating missing families, because it is not uncommon that families who do not welcome services or who are transient try to avoid the Department's oversight and our social workers are not investigators. So in looking at our internal practices, we found that, number one, we could have a tighter policy but also that we did not have enough tools in place for our staff to look for families. 231 04/21/04 - WHOLE - BILL 040255 So right now, Councilman, we have established an electronic search unit where we have right now numerous databases that allow our social workers to immediately search in multiple places for or social workers when they can't track down a family. And since that was instituted -- it took us a long time and some money to do it. Since that was instituted, we have had approximately a hundred requests for help and over 80 of them have resulted in additional leads and information. In addition, we have contracted with a private investigator to help back out staff up when after they try they can't find a family. We've been consulting with the police, and they have given us guidance.
They're the ones, frankly, that recommended that hire a private investigator because they did not see themselves in the position of helping us go out and find families because of that limited resources. That was hope originally. In addition, we are tightening our 232 04/21/04 - WHOLE - BILL 040255 policy and we have added four more units to our intake department so that we can reduce the number of investigations that we give our workers so they can do a better job and spend more time doing it. In response to the questions about the 1997 case, since that time, the Department has really revolutionized many of its practices. For example, we have a visitation tracking system now that --
I'm sorry, Commissioner. What kind of system was that? COMMISSIONER MARTINEZ: A visitation tracking system. So the Department now electronically tracks any visit, any visit that we do for a child, and it also is a system that lets us know when a visit is due and it has not been made.
And that was in place before your tenure, and as a result of the 1997 -- COMMISSIONER MARTINEZ: That was part of the response of that 1997 tragedy. I would love to take the credit for it, however, 233 04/21/04 - WHOLE - BILL 040255 it was already underway in planning when I got there. But I will take the credit for it. So since I'm there, we have a new visitation tracking system. But we also have added a lot of staff. As I mentioned, we have 120 more social workers. And the fact of the matter is in child welfare, the higher your case loads, the more limited your ability to do a good job. It doesn't matter if you are a social worker. So lowering cases and increasing staff has been part of our building of quality system. We've added a staff training and development division to the Department to make sure that our staff are continuously trained. We have enforced strictly our evaluation procedures. When I got to DHS, 50 percent of evaluations of employees were not completed. Now, over 95 percent of evaluations are completed on our staff. We reward our staff for good performance and hold them accountable when their performance is substandard. We've enriched our provider 234 04/21/04 - WHOLE - BILL 040255 contracts so that they can help our staff do the work. One last thing, however. There's much more work to be done. And unfortunately, Councilman, children die of abuse and neglect nationally every year. Children die throughout Pennsylvania every year. And every death is a horrible tragedy but every death is also an opportunity to look at our system and continuously improve it. So the job of child welfare will never be done until no child dies of abuse and neglect.
Very good. Now, when you took office in 2000, you took a look at what was in place to prevent what is probably -- correct me if I'm wrong -- what your main mission is as head of DHS, and that's the protection of children that in some kind of way are under your custody. So you go into your job in the year 2000 and you see there has been some other things that have been put in place to try to prevent to the extent possible -- and I agree 235 04/21/04 - WHOLE - BILL 040255 with you that there is no way of making this a perfect system because of human frailties. But then this Porsche Bennett case occurs, and you're pained by it; I heard your pain during that time and you have then tightened your policies, you've gone into numerous databases, contracted investigators, more staff. At some point as we do our job, and sometimes I do this, I just put on the brakes and go back to what's my real job here, what's my principal responsibility? Do you do that occasionally and say, "Let me get away from this whole budget stuff here and let me double-check my system to make sure that the children under our custody in whatever way that happens are being protected and how do you do it? COMMISSIONER MARTINEZ: Well, child welfare systems are subject to annual inspections by the State. This a county-run but state-supervised system. So we have continuous reporting that we do to the State, not only financially but programatically. In addition to that, we are subject 236 04/21/04 - WHOLE - BILL 040255 to federal outcomes. And while we receive 93 percent of our funding from state and federal sources, that means that those sources expect something from us, just like City Council expects something from us and the Administration doing something from us. And Administration we are reviewed and I believe that's actually a good thing. Last year we had a child in Family Service Review by the government. It was a state review, however, because Philadelphia is so large we were 50 percent of the cases reviewed. Ad out of that review came a report about qualitative and quantitative performance. And they found that the Department does really well in safety compared to other systems but needs to do a better job around permanency. So that's why a lot of our work is around improving the number of children that achieve permanency meaning that they won't languish in foster care, will not grow up in foster care, and will not further injured by a system that does not give them a permanent answer regarding who their family is going to be until they reach 237 04/21/04 - WHOLE - BILL 040255 adulthood. That does not mean, however, that we turn our backs on the safety issue because safety is front and center what child welfare is about. I work in a system you have to have your eye on everything all the time. And what we have done build an incredible executive leadership team that works very, very hard and does everything they can to keep their eye on the present as they keep another eye on the future, because we are subject to federal penalties a few years down the road if we do not improve our permanency outcomes.
Not to mention the wrath of the public every time that we have the misfortune of having a tragedy occur. What I'm hearing is that you don't see it just as your responsibility, although you're primarily responsible, as stated you've stated, but you that have a team that you hold responsible within DHS to make sure they continue to stay focused on the principal mission of your Department.
We hold each other collectively responsible. 238 04/21/04 - WHOLE - BILL 040255
All right. Can you tell me the status of Riverview Home?
Good afternoon. Councilman, many of us will recall reading about the possible closing of Riverview Home in last year's five-year plan. Subsequent to that, we've had a lot --
Excuse me. Mr. Hess, you'll have to pull the microphone closer to you. You cannot be heard.
Subsequent to that, we've had a lot of internal discussion, a lot of discussion with a variety of stakeholders. And I think there's really two issues. First, this year's Five-Year Plan does not call for the closing of Riverview 239 04/21/04 - WHOLE - BILL 040255 Home. That's Number 1. Number 2, what we are doing at Riverview --
Correct. Where we are is where we describe here last year at Councilwoman Tasco's questioning which is that we do philosophically believe that the best placement for people who currently reside at Riverview would be high quality supportive living arrangements in the community. The problem with that is that those placements do not currently exist. And we do not have an expectation that they will exist certainly shortly in the short run. And therefore, Riverview Home continues to be a placement opportunity of last resort for poor folks in the City that are aging. 240 04/21/04 - WHOLE - BILL 040255 And so we think it's an incredibly valuable resource that needs to continue.
Now, that's not to say that we shouldn't continue to explore community-based options, and we will continue to do that.
What are the problems? You don't seem too optimistic at this point that you can place them in the community. Why? What were the obstacles?
Well, I guess the biggest obstacle is there's not available funding sources that allow you to do that development in a way that gets you to the scale that you need. In other words, for Riverview Home, we spend about 5 and a half million dollars a year. About $2 million of that we recover from fees from residents. That leaves you $3 million a year to place at the moment about 220 residents. And so the math just doesn't work. We're looking at other options, 241 04/21/04 - WHOLE - BILL 040255 we'll continue to do that. Philosophically, we would agree that Riverview looks like an institution in some ways. It is a facility of last resort. It is very important to us in the City and to the residents that live there. And so although we will continue to explore those community-based options, there is no 9 plan in the Five-Year Plan at this time to close Riverview.
Thank you. I want to just chime in on this issue because I've had this discussion with Mr. Hess and we've even had people on the other end who are interested in the Riverview facility. We've been associated with Riverview for a very long time, from the old days when we were feeding in the subway. And you get some seniors who needed help and even though many of them would rather to have been closer to the City and neighborhoods, they had 242 04/21/04 - WHOLE - BILL 040255 no place for them to go. And these were also some seniors who really didn't their income intact, so they had to have someplace to stay. And over the years, and Mr. Hess can correct me if I'm wrong and Commissioner Martinez, over the years we've had various people -- it served various uses for this aging population, but we haven't been able to pull closer in the neighborhoods for this reasons he described. So it gives us an option. You don't get many out there on the streets, but you always get some in addition to other people in neighborhoods who have to end of having someplace to go and who don't quite fit or have family or other places where they can go. So we've got to have some kind of facility like this even if it's not as modern and up-to-date as we like it in how we deal with senior care today. We've got to have some facility for seniors who need it. And so I've never gotten any complaints. We talk about it more in our level than -- I've never had anybody stays there complaining. We always talk about it ourselves and we talk about how 243 04/21/04 - WHOLE - BILL 040255 we care for seniors, what works best and what are modern methods. I've never had a person complain about it. And they have open house, as you know, every year and invite us. So thank you very much. Thank you, Madam President.
Thank you, Madam President. Good afternoon. COMMISSIONER MARTINEZ: Good afternoon.
How are you? COMMISSIONER MARTINEZ: Fine, thank you.
I have a couple questions. With your goal of children achieving permanency and you had a record number of 654 adoptions last year, I guess? COMMISSIONER MARTINEZ: Yes. 244 04/21/04 - WHOLE - BILL 040255
How many children are actually in need of being adopted? And are the older ones harder to place? That must have been very difficult. What were the numbers the year before last? COMMISSIONER MARTINEZ: I will need the assistance of my staff to give me the exact number of children going in the pipeline. I don't want to misspeak, but I will say that there is approximately 150 children in Philadelphia who need an adoptive resource. There can be 800 children at any one time moving through the process. The key for us is, obviously, to accelerate the process to achieve that adoption as quickly as possible, and that is what those numbers reflect. But I also want to point out our remarkable progress in that when I became Commissioner, there were approximately 300 children with no adoptive resources. That number conservatively is 150. It might be lower. It might be down to 100. So I would say that at any one time, Councilwoman, we need to find families for 150 children. The 245 04/21/04 - WHOLE - BILL 040255 demographics of those children is that they are older. Some might be teens, but I'm saying 7, 8, years old, children often who 5 are in sibling groups, and the reason why they 6 are at that stage and don't have an adoptive 7 resource is because perhaps they were living 8 with a relative who has now determined that 9 they can't keep them permanently or perhaps they were in a home that wasn't a permanent resource because we planned to reunify them with their family, however, that did not work out. The law and best practice now requires the Department to do concurrent planning. So a department that does the job right, I hope is ours most of the time, receives a child into placement and immediately places him in a home from which they can return but a home also that can become their permanent home. And that is called concurrent planning. The number exactly is 800 children who are freed for adoption which means they are eligible for adoption. 246 04/21/04 - WHOLE - BILL 040255 The other thing we've done this year which is really historic is that we now have third permanency option. Before we had reunification with a family, adoption or long-term foster care. Now we have permanent legal custody. That means that in cases where adoption is not possible because the child doesn't want to be adopted or because a grandmother doesn't want to terminate their child's parental rights, they can accept permanent legal custody. They're entitled to the same subsidies as an adoptive parent. They have the same legal rights over the child and authority, but the biological parents can maintain ties and connections which is really healthy in many cases and can have visitation. So we started this year and so far we have close 200 of these permanent legal custodies. And I will say that all my staff say all the social workers, all the lawyers, that one of most the beautiful things in child welfare is when those to say in child welfare when those families are created right at the bar of the court. And, of course, it's good 247 04/21/04 - WHOLE - BILL 040255 for us because we get out of the business of parenting children, which I don't think government should be in that business at all.
How long is the actual adoption process when you fast track it? COMMISSIONER MARTINEZ: Well, I believe that once a child gets freed for adoption, the process should not take longer than a year. That being said, though, to be very direct and candid, there is work to be done in our system to reduce delays. And part of our performance-based contracting methodology and contracting approach and part of our adding lawyers was to cut through unnecessary delays, delays in getting clearances, delays in getting petitions filed, delays in getting hearings. And Family Court has been really cooperative with us. They are holding special listings now for us when we have list some children that need to be adopted. This City making progress in the right direction. 248 04/21/04 - WHOLE - BILL 040255
Tell me when is the goal to open the Achieving Independence Center? COMMISSIONER MARTINEZ: It's open. I'm pleased to say that it is open. It's been open for a year. And the reports back are very, very favorable. We had a goal of enrolling 500 youth, and those youth are youth that have been in the foster care system or are in the foster care system at the age of 12 or older. Our goal was to enroll 500; we 13 enrolled close to 600. Those children are 14 receiving support from Temple University, 15 Community College, Planned Parenthood, and a 16 number of other providers right there and we're getting them placed in jobs, helping them get scholarships for school and helping them transition to adulthood. It's open extended hours, and it's at Seventh and Market Street in the Mellon Independence Building. And it's also a joint venture with the Workforce Development System, so there's very, very strong and education focus in that center. 249 04/21/04 - WHOLE - BILL 040255
That's really good, because I worry about the young people transiting from foster care to adulthood, particularly after I met with Wanda and she told me that many of those young people end up homeless or incarcerated. COMMISSIONER MARTINEZ: It's a huge, huge problem. We're collaborating with Rob Hess' department and with the Workforce Development system to see what we can do around housing, subsidized housing for those young people and also with the Philadelphia Housing authority, because it is very tragic that the children who have been with the City a long time in DHS would exit that system and end up in the street. We are not legally able to provide services to those children pass the age of 21, so at the age of they will be independent, 21 ready or not, and that's why we've created this Achieving Independence Center. But that's also why, Councilwoman, this focus on permanency is so important because if we build homes for those children before they're 16 and 250 04/21/04 - WHOLE - BILL 040255 17, then we wouldn't even face that situation.
That's correct. I had a young woman -- actually a young cousin of mine who came to live with me last year who had been foster care. When she came to live with me she was turning 18, 9 and we were trying to do a whole lot to help 10 figure out what we would do with her, get her 11 in Cheney and some other things. So I'm glad 12 to hear -- I don't think the center was open 13 then, but that would have been a good -- 14 actually, I think she may have off the rolls 15 for about a year, so I don't know whether she 16 could have gone to that center or not. 17 COMMISSIONER MARTINEZ: We are definitely committed to expanding our resources and programs for older youth. It's a very, very important population for the City to pay attention to. And the profile of children in placement is changing. We have older youth more and more and more, and we can't turn our back on that population. It's very 251 04/21/04 - WHOLE - BILL 040255 challenging to serve, but we have to confront that and so we've expanding that array. We've expanded our mother/baby programs, so that mothers who are teenagers don't have to be separated from their children if the only barrier is housing and economic. So we're expanding that with the help of Catholic Social Service.
When I was downstairs, I was actually listening to the testimony over the TV. And I believe Councilman Kelly may have asked a question regarding reimbursements. Did he ask that question? Do you remember if you were asked a question regarding state and federal reimbursements? COMMISSIONER MARTINEZ: Yes, Councilwoman.
I didn't quite catch the answer. Can you tell me -- can you answer again what would happen if the reimbursements that you anticipate don't happen? I'm little worried about whether the state and the federal government are going to 252 04/21/04 - WHOLE - BILL 040255 do adequate reimbursements. COMMISSIONER MARTINEZ: Well, we are worried, too. And I will restate the Department and Administrative's position on this matter. The State, under the law, provides for a needs-based planning process, and that process requires the Department to submit a plan to the State for the State Department of Public Welfare to certify our need in terms of dollars and then to allocate the appropriate level of federal, state, and city revenue. Those numbers have been certified, and we expect that the State will fill its commitment to this county and every other county regarding giving us what we need. We cannot compromise on what children need. And our position is that we will work with the State through appeal and communication and dialog to get the revenue that we need to do the job right. And if we don't receive what we need, then the Mayor is committed to continue fighting and also to make sure that children do not suffer, abused and neglected children do not suffer further because of bad 253 04/21/04 - WHOLE - BILL 040255 policy or political or financial decisions that are made at higher levels. So at this point, we're not prepared to concede that we have to cut back. But I did also mention that one area where we would obviously immediately look is in our desire to grow some programs. Obviously, that would be the first thing to be looked at, expansion.
I had someone from a community-based program mention that prevention funds, some of the programs dealing with prevention may be cut with youth, youth at risk, prevention programs for youth at risk. COMMISSIONER MARTINEZ: Well, we do not have any plans to cut our investment, to cut back our investment in programs for high-risk children. What you may have heard, Councilwoman, is that we do reprogram money. And I believe that in doing so, we are fulfilling the mandates of Council and the Administration that periodically we review is our money being spent efficiently. Not so 254 04/21/04 - WHOLE - BILL 040255 much that the agency is not doing a good job, but in the right kind of strategies. So periodically, we do issue new RFPs and we ask for providers to compete again because we changed the design of the program in order to meet the needs of today, not of yesterday. So we have issued a number of RFPs, including some for youth development programs and some for parenting programs. But we have not cut back on our commitment to high-risk youth.
Do you mind holding your other questions until the next go-around? Thank you. The Chair recognizes Councilman Rizzo.
Thank you, Madam Chair. Commissioner, your comments about adoption -- and I don't want you to misinterpret my question. I'm not a professional, I don't know a whole lot about 255 04/21/04 - WHOLE - BILL 040255 what you do. But I just have a basic question. When you talk about adoptions and other relationships where biological parents still have access to those children, is that good in all cases or are they exceptions where biological parents are not allowed to have a relationship? Because I just can imagine -- and I'm not sure what the ramification or the effect that has on young people, this bouncing back and forth. Could you describe how -- maybe it's politically correct to do that, but is it the right thing to be doing? COMMISSIONER MARTINEZ: Well, I think that that's a really important question. And I will say that it took me a while to learn the system, and I'm still learning it. In adoption, all legal rights terminated. It's as if the relationship never existed, and the adoptive family becomes the full legal family of the child, legally, on paper, a new birth certificate, the whole thing, and the biological family of origin has absolutely no 24 right and there's no right to sibling continuity. The adoptive parent determines 256 04/21/04 - WHOLE - BILL 040255 whether there can be some contact in the future or not. The government doesn't determine it, the court cannot determine it, no one can but that legal family. In permanent legal custody, the legal rights are not terminated, however, legal custody is in the hands of the new family. So while the biological parent may have visitation rights, it's not shared custody. The child does not go back and forth from one home to another, because we have ruled out when we apply permanent legal custody -- and I also want to say the Court makes that decision, it's an adversarial process where the Court makes a decision based on the evidence. We don't make that decision and implement it with court approval. But reunification has to be ruled out by law. In other word, a decision has to be made that child cannot return home. Adoption has to be ruled out by law, because adoption would be better than legal custody. And then legal custody becomes the third best option because of the next alternative is long-term foster 257 04/21/04 - WHOLE - BILL 040255 care where the child has no status of permanency.
Commissioner, at what point does the Court stay involved? I can't prove the statement that I'm about to make, but I have heard that in some of these relationships where the biological parents have access to the children, the parents with custody, for lack of a better word, the people that have custody of the child sometimes have days and days and days of problems associated with that contact that they have to deal with at after the fact. If are you observe that, do you have a way to go back to the court and say that this is not good for this child? Because I hear that this is a bit more common than we know, that it is very difficult sometimes because those visits create a lot of problems. And I don't know whether they're true or created just to avoid the visit. Could you comment on your experience with that. COMMISSIONER MARTINEZ: Yes. In 258 04/21/04 - WHOLE - BILL 040255 permanent legal custody, the biological parent does not a right to visitation, first of all. It's something that the Court can provide if it's in the best interest in the child. It's not a guarantee, and often in cases it's not given. The reason why adoption may be ruled out is simply because a child is over 14, doesn't want to be adopted or the grandmother doesn't want to terminate the child's parental rights, so visitation is just something that can be added if it's the right thing in that particular set of circumstances. Second of all, anticipating that, of course, change is the constant and relationships can change, we made arrangements when we set the system this system up with the Domestic Relations Court, and the Department working with the Domestic Relations Court to resource this function where if a custodian has permanent legal custody and wants to alter a visitation agreement, they can go straight to Domestic Relations Court, file a request for an amendment to the custody order, and they will have access to all of the 259 04/21/04 - WHOLE - BILL 040255 information. In other words, they can get the file, read the circumstances, and alter the order.
So you do monitor these types of situations, or are you out of it until you get a phone call? COMMISSIONER MARTINEZ: When permanency is achieved, the Department is available to support the family on a voluntary basis. However, if somebody calls us back and asks us for help, we will never turn them away. We will connect them to the services that they need. But the whole point of achieving permanency is that government gets out of the life of the family. However, it's not automatic. There's a process that is gone through and it's done with careful court approval.
My next question. Is foster -- and again, help me with the language here. Foster care, has that become a business? Are there people who do this for a business? 260 04/21/04 - WHOLE - BILL 040255 I had someone tell me a story about this one particular family that has -- and I don't know what the max is, five, six, seven. COMMISSIONER MARTINEZ: Six, by law.
And the neighbors refer to this as this lady's business. She does it because it's very lucrative. Is that so? Are there people who do this for a business? COMMISSIONER MARTINEZ: Well, of course, my position would be that it's very lucrative, but everybody else's position in the system is that it's not. It's really not a lucrative service, first of all. We do per diem per child. And the per diem at this point is $20.23 a day. And with this $20.23 a day, that family has to provide for the needs of that child. In addition, we give a per diem to the provider agency to provide case management and social services. And then more other, the Department has its own staff providing support and services. So it's not a lucrative business. I would say, Councilman, that I have 261 04/21/04 - WHOLE - BILL 040255 heard that too, and I'm sure -- it's a large system, I can't tell you that no there aren't people who wouldn't enter into this service for perhaps economic reasons, but I will tell you that in four years that I've been Commissioner, I have seen a huge amount of love and passion and commitment on the part of the people who do foster care. And I need to say that the Department of Human Services is a complex bureaucracy. It is not fun to deal with. On a good day it's not fun to deal with. So people have to really love this work to stay committed to being a foster parent for a long time. So I will tell you overwhelmingly that it's not a concern, but we also have mechanisms to audit and monitor foster parents. If we believe that a foster parent is not taking care of a child properly, that foster parent will lose that child immediately.
Could you provide to the Chair -- just a curiosity question -- how many of your foster parents are maxed out, that have six children? 262 04/21/04 - WHOLE - BILL 040255 COMMISSIONER MARTINEZ: That would be interesting data to look at. I'm not sure how quickly we can get it, but we will certainly work on getting that for you as quickly as possible.
Because, just to finish this conversation. I've been told there are certain families that always have six, it seems. When one goes on, bingo, another one. And that's why they refer to it as being a business. COMMISSIONER MARTINEZ: Well, Councilman, there are requirements about how much space there has to be per child and there are large families absolutely and there are people who want large families. I have met incredible people who have adopted six, seven, eight children. So some people have large families because they love large families, they come from large families. That may be possible, too. However, we will look for that information for you. I will tell you that --
Not that that 263 04/21/04 - WHOLE - BILL 040255 means anything negative. COMMISSIONER MARTINEZ: It's a good question. But I will tell you that while it is, of course, an imperfect system, there is a lot of love and passion and commitment that you see. And the other interesting point is that children that are adopted out of the child welfare system, 90 percent of them are adopted by their foster parents. So that's an interesting statistic also.
There was a lot of love in my family, but there were a lot of days that my father or mother wanted me to go out to adoption. (Laughter.)
Thank you. I just have a couple questions. Councilwoman Blondell Reynolds Brown asked you about what programs for men are 264 04/21/04 - WHOLE - BILL 040255 headed by men. I'd like to ask that question in a different way but will achieve the same end. What programs provide services to African-American men and who are the providers? COMMISSIONER MARTINEZ: Well, I will ask David Fair, Director of Community Based Prevention, to speak to programs that respond to need.
This is David Fair, I'm Director of Community Based Services at DHS. In terms of adult men, we have a limited number of programs. Starting in July we will be taking responsibility for the fatherhood initiative program at the Mayor's Office of Community Services so that we can better integrate it into our community-based parenting collaborative. And we have a few other programs, the Fathers Day Rally Committee, Men United for a Better Philadelphia is a major contract for us. But in the big picture, we have two big challenges in terms of targeting services specifically to African-American men. One is the difficulty 265 04/21/04 - WHOLE - BILL 040255 in targeting our resources that way within the regulations that we have to follow with our money, because most of the families that involved in the child welfare system is headed by women, and it's the women who are looking for the legal custody and it's not always directly available, a father who's even involved in the situation. The second problem is to be truthful is that there are very true community agencies that want to do this work. We put out our first parenting RFP about three years ago. We had $6 million available through that RFP. We funded 70 organizations, and two of them, 2 of the 300 or so applicants mentioned fathers as their target population even though our RFP emphasized that. I think there's the perception that that's a harder population to work with, especially men who are no longer connected to their children tend to have heavier burdens, they tend to have an incarceration history or a drug problem or a mental health issue or unemployment or whatever. I don't know whether that's true, 266 04/21/04 - WHOLE - BILL 040255 but that is the perception of what happens. This past year we did enter into a contract with an organization called "Menergy" to work with the batterers of women coming into the court system or the justice systems because of domestic violence. The majority of those men are also African-American men. That program has been very effective in helping to not only address the particular sort of counseling those men have, but also connecting them to a variety of social services. I think you're at the question of where men in our system work. I mean, how many African-American men are in leadership positions in our system, I think is really a fascinating one to me because even in our division the overwhelming majority of the organizations we work with are organizations that target lower income, primarily minority communities and are run by people who live in those communities, overwhelmingly it's women who are running those organizations and working in those organizations. We do have some programs like the 267 04/21/04 - WHOLE - BILL 040255 Imachi (ph) Project that we work with Reverend Good on where just yesterday he and I were meeting to talk about recruiting mentors for young men in the delinquent system, young African-American men in the delinquent system. And what we were talking about was how hard it is to recruit a mentor for that function when he's standing at the pulpit at the church and says, "I need mentors for kids who are in the delinquent system and I need men for that," it's very hard in that context to get men to step forward. But when we started jumping on the band wagon for his other recruitment efforts for mentors and made sure we had quality mentors in a pool, it was easier then to approach the men who were already volunteering to be mentors to connect with these kids. It is a very complicated issue, obviously, I could talk to you for hours for about it. COMMISSIONER MARTINEZ: And what I want to add is that this is an area where the Department is, obviously, investing resources. 268 04/21/04 - WHOLE - BILL 040255 But it is also, quite frankly, an area for improvement.
And when the federal government came in and did our child and family service review, they complimented us in some areas, but their purpose was also to tell us areas where we are weak, and one of things they told us is engaging fathers is an area where the Department has to do better in foster care side, because obviously children can return not to one parent or not to one family but to two. So I think it's clear that more needs to be done. This is a national problem, not a city problem. But in this City, we want to take leadership around it. We funded and hosted a fatherhood conference an engaging fathers conference last year that was really successful. And out of that came a couple of good initiatives. And one of them in one of our family service regions where we have approximately 200 workers, they're doing family trees when a child comes into care to force ourselves to find out who are these children's families up front, not just filling 269 04/21/04 - WHOLE - BILL 040255 out the record but really using a tool to do that. We've also talked to the Police Commissioner to add the lock and track system into our electronic search database. Because, unfortunately, a substantial number of children who come into care have parents who have addiction problems and who go in and out of prison or who may be hard to reach. Sometimes their families don't know where they are. So by having the lock and track system accessible to us, we would be able to work with the prison to look on a periodic basis for the parents. And when they're in prison, that's actually an opportunity to intervene and get them clean and sober and start engaging them. So there are some opportunities there and some ground to be covered. And I believe and I hope that it's a question that Council asks us about on a yearly basis to hold us accountable on making progress.
Well, I don't want to dredge up old history, but I do know a 270 04/21/04 - WHOLE - BILL 040255 couple of years ago there was an effort to do a program and Warren E. Smith had put the pieces in place to provide the service to the men and the contract was never awarded to them. COMMISSIONER MARTINEZ: Can you tell me what program that was? The Delinquent Day Treatment Program was for teens. And I do remember the case and I remember Warren E. Smith's complaints about the outcome of that RFP. And at that, Estelle Richman was the Director of Social Services, and I believe that their concerns were addressed by her but, frankly, Councilwoman, I don't remember the details of it, but I can look that up in answer to you. You'd like to know about it.
I just want to say that it's an organization, it's in the community, it provides mental health services, it provides community services. And wherever they turn to get a project from the City, whether it's DHS and they do exist or whether it's the Health Department, they get turned 271 04/21/04 - WHOLE - BILL 040255 down for every project. And it just boggles my mind that while it happens, but then you'll say, "We've got to find people to do the project," but there are people who do the projects but they never get funded. COMMISSIONER MARTINEZ: I understand your concern.
One other question. You provide funding to Safe and Sound for community-based programs? COMMISSIONER MARTINEZ: For after school and youth development programs.
Do they then contract out with providers for that service? COMMISSIONER MARTINEZ: Yes, they do.
Do you monitor who these groups are who provide the services, and what is the diversity among those groups? COMMISSIONER MARTINEZ: They actually have a sophisticated monitoring service in place. I believe that the technical assistance and oversight is with the 272 04/21/04 - WHOLE - BILL 040255 United Way and also with Philadelphia Health Management Corporation. They have two entities that assist them in the technical assistance and monitoring and training. But for more detail on that, I would defer to Deputy Managing Steiker since I frankly don't have more much more detail than that. But they do have evaluation systems in place.
Who do they contract what? Providers do they contract with to provide the service? You may want to give me later: Who are the providers of these after school programs? COMMISSIONER MARTINEZ: I will ensure that that information is made available, both on the contracting and evaluation aspect and the service delivery.
You're welcome. Councilwoman Blondell Reynolds 273 04/21/04 - WHOLE - BILL 040255 Brown.
Thank you, Madam Chair. I would like to go back if we could, Commissioner, to the new information you provided to us with regard to MBEC. MBEC certifies only for-profits. If not today, can you provide for us an accounting of the dollars in terms of percentage across the board, what percentage of what you do are for-profits and what percentage are non-profits and then break that down in terms of dollars. COMMISSIONER MARTINEZ: Yes, we will.
And then for the for-profits, if you can provide the breakdown of minority, women, and disadvantaged-own businesses. COMMISSIONER MARTINEZ: We will.
Second question. Since MBEC only deals with for-profit dollars in contracting and procurement, what has been the level of 274 04/21/04 - WHOLE - BILL 040255 interface with your department and MBEC for the for-profit agencies. COMMISSIONER MARTINEZ: Because Deputy Commissioner Ransom interacts with MBEC most frequently, I'm asking her to assist in answering.
Cheryl Ransom, Deputy Commissioner for DHS. One thing we've done on all of our RFPs, we stipulate that the MBE participation is mandatory so that we can find what -- MBEC normally sets the ranges. They look at our RFPs and decide what the range should be. And we issue that range to the providers. We've also worked with them with our IT contracts to look at how they could get participation, and we've done that through their staff. And I said earlier that we also worked with MBEC. They identified minority firms in the IT business who were certified, and we went to those firms and explained the type of work we were doing, and they offered resumes to us. 275 04/21/04 - WHOLE - BILL 040255
And then MBEC has the responsibility to share with you what the numbers are in those areas, correct?
They give us a range to reach in terms of what our goals should be for the Department.
For the for-profit, do you know what those current numbers are?
They actually look at -- for example, if we're doing an RFP, they will review the RFP and determine what the range should be based on the type of program, who's going to be served and the funding level.
Okay. I'm trying to follow you. And so of the 2 percent, have they recently given you the number that speak to total number of minority, total number of women-owned? Have you received those numbers at all from MBEC?
DHS. We indicate who's certified. That's really where the number comes from. It's the actual number of contracts that you let and the total money spent on a for-profit who is certified. That's where the 2 percent comes from. That's not a number that has been given by MBEC, that's a number that we calculate based on certified for-profits that we can count the participation.
That's it for now. I'm still just trying to get a handle on not just DHS but all City departments where and how MBEC does what they are prescribed to do. Thank you for your testimony. Clarity. Did Councilman Juan Ramos pose the question regarding how you may have adjusted your system with regards to the loss of the little girl last year? Was that your question, Councilman Ramos?
Thank you very 277 04/21/04 - WHOLE - BILL 040255 much.
Thank you. And on that, let me just say in closing with regards to your performance measures, I did look hard and I found nothing which suggests to me that DHS does enormously important work, period, and you're to be commended for the work we knew you were doing when you first sat with us in January 2000 and how far that agency has come with regards to systemic change and not just tinkering with reform around the margins. So I congratulate you. COMMISSIONER MARTINEZ: Thank you. Our Department is grateful for your recognition. Thank you.
Are there further questions? I believe OESS, you're next. COMMISSIONER MARTINEZ: Thank you very much.
One moment, please. 278 04/21/04 - WHOLE - BILL 040255 Councilman Ramos.
Just one last question, Commissioner. Back in March, the City Council presented a resolution urging the Pennsylvania House of Representatives to oppose Representative Jerry Birmelin. It was a bill 9 which we considered discriminatory under City's Fair Practice Code which undermines the core value of the original bill to improve the Adoption Assistance Program as reported by the House Children and Youth Committee. It was a bill essentially that was trying to prevent non-traditional families or same-sex couples the right to adopt. And you gave a report about your adoption rate. Are we now making adoptions available to non-traditional families or same-sex couples? COMMISSIONER MARTINEZ: Yes. Philadelphia and the court system has been actually on the leading edge, along with other major cities in defining family as broadly as possible in the best interest of children. 279 04/21/04 - WHOLE - BILL 040255 And so it is a City that has been in a tradition of doing that and supporting same-sex couples or gay and lesbian individuals being foster or adoptive parents long before I became Commissioner. The amendments that Representative Birmelin proposed were withdrawn and the legislation moved forward as originally planned. However, this is an issue, as we all know, that is hot nationally and we have not heard of end of the debate.
Have any same-sex couples or gay or lesbian individuals applied or have adopted children in our system? COMMISSIONER MARTINEZ: While we do not track that particular aspect of our foster and adoptive parents identity, I know anecdotally that they have because they come up to me and say that they've adopted. The question is not asked about their sexual preference and that's perhaps what makes our system so progressive and so open-minded that what the system looks for is the qualifications and the background and the 280 04/21/04 - WHOLE - BILL 040255 ability of that individual and that family to provide a loving home for a child. So we don't keep those statistics but, yes, there is a history of it being done through the child welfare system.
A loving home is the gauge we should use. COMMISSIONER MARTINEZ: Thank you.
Good afternoon, Commissioner. Just curious about the issue Procurement opportunities even within non-profit contracts. In terms of your non-profit contracts, are there opportunities or cases where there is either subcontracting or materials that are borrowed under those non-profit contracts? COMMISSIONER MARTINEZ: Yes, there are opportunities. And I believe that the department has made a lot of effort and a lot of progress in getting our own providers, if I 281 04/21/04 - WHOLE - BILL 040255 understand the correctly, our own providers to use minority providers in their own operations. But I will ask Deputy Commissioner Ransom to assist in answering that.
Let me just advance the question then. So even within the non-profit contracts, there are opportunities to set goals for minority participation in terms of subcontracting opportunities and in terms of the purchasing of services?
Yes. We often recommend to our providers -- we have the MBEC book of certified vendors. They often approach us and ask us about the services, and we in turn give them information about the certified vendors.
So MBEC does not set goals for your non-profit contracts?
No. We had an arrangement with MBEC around affidavits and having the non-profits --
Can you explain to me, although they do not certify 282 04/21/04 - WHOLE - BILL 040255 non-profits for obvious reasons, why they still wouldn't be setting goals for non-profit contracts? COMMISSIONER MARTINEZ: Why they would not?
Yes. COMMISSIONER MARTINEZ: We believe that they should.
Can you request that they set goals for your non-profit contracts as well? As long as you're going to have subcontractors and you're purchasing services and there are still for-profit companies that are going to benefit from that non-profit contract, there's no reason why you can't meet as many goals and even exceed goals under non-profit contracts. COMMISSIONER MARTINEZ: Yes, Councilman. We have requested it and we will request it again. And I am aware that this is an issue that Council is going to be discussing with MBEC also, but we will definitely make that request. There's opportunities for the City to get recognition 283 04/21/04 - WHOLE - BILL 040255 and also opportunities to promote that principle and non-profit community because their business is just like any other business, they just happen to be tax exempt. In other way, they are a business.
Absolutely. Thank you, Commissioner. COMMISSIONER MARTINEZ: Thank you.
Thank you, Councilman. Are there further questions? (No response.)
Thank you again. Mr. Hess and OESS. Good afternoon. We thank you for your patience. Certainly, we do have your testimony. You can present any part of it or make reference to it if you would like. And we would like you to introduce the folks with you and make your comment.
Thank you, Madam Chair. To my right I have the Director of OESS, Letty Hinton; behind her, our Administrative 284 04/21/04 - WHOLE - BILL 040255 Services Director, Richard Shaeffer. And then the balance of the team is spread throughout the gallery and employees to assist as necessary. I would like to take this opportunity to thank you for being offer testimony today on behalf of the Office of Emergency Shelter and Services for Fiscal Year 2005, as well as to have an opportunity to discuss the challenges and opportunities that lie ahead. I will touch on just a couple of specific areas that I think are particularly important to share with Council this afternoon. First, I think it's important to state that in the area of demand for emergency shelter, the upward trend that I reported in last year's testimony has continued, unfortunately, into this fiscal year. The overall number of people staying in emergency shelter so far this year is on average 8 percent greater than last year and 15 percent more than two years ago. The month of April, we're currently running about 11 percent ahead 285 04/21/04 - WHOLE - BILL 040255 of last year in demand for emergency shelter. So this trend, which we view as a result of the long economic slump that communities across the country has experienced and although there have been some recent encouraging signs for the economy and the creation of jobs nationwide, we have not yet seen the trend extend to Philadelphia. Furthermore, homeless people living in our shelters are often excluded from realizing the benefits of a rising economy by being the last hired, first fired. Because of these combined factors, we do expect the higher demand for shelter will remain steady for the remainder of this fiscal year and in the next fiscal year. I think with that said, I think the testimony addresses a lot of the programatic improvements that we've been able to make over this past year. It does point out that we've made some great inroads on the Parkway with respect to being able to relocate some feeding operations indoors. And I'd like to publicly thank you, Councilwoman Blackwell, for your 286 04/21/04 - WHOLE - BILL 040255 leadership and support that assisted us in working with Chosen 300 and Reverend Brian Jenkins to be able effect that change, which we view as incredibly important. You know, it wasn't that long ago that there were several hundred folks at night standing in line out on the Parkway no matter what the weather in order to enjoy the good meal that Chosen 300 provided. Now those folks are able to go indoors, sit down with the kind of dignity and respect that we all deserve to be able to enjoy a meal and it's because of your leadership and the Mayor's and others that allowed us to make that happen. So I would like to publicly thank you for that. I'd also like to publicly recognize the great work being done by City employees, by our non-profit partners, by the Mayor's task force on the issue of chronic homelessness where we've now seen the street numbers drop from kind of a high watermark of 824 to 133, as counted by the Police Department and Center City Philadelphia just this past week. Still a lot of work to be 287 04/21/04 - WHOLE - BILL 040255 done. Still incredibly tragic for the 133 folks who still call our streets home, but we have made a lot of progress in this area, and it's been because of great leadership and partnership with members of this Council, the Administration, the non-profit community, and City workforce that's helped us immensely in this area. With that, Madam Chair, I'd be happy to entertain any questions you have.
Thank you very much. We would certainly like to thank you and your Department for all that you do as well. And if I did not respect you and like you, which I do, I'd still find a way to get along with you because this is my area. This is part of my mission and what I'm meant to do. In your testimony, you refer to about 2200 people at night on an average night. I know in past year we've had and 24 and 2700 people who are in shelter and 25 people who need shelter. 288 04/21/04 - WHOLE - BILL 040255 Will you still be able to absorb people above 2200 who could be on the street at any given time?
Madam Chair, the commitment of this Administration is to provide as many beds as necessary to meet the demand. We have been as high as about 2700 beds in the midst of this past winter, which I must say was incredibly difficult. So far this winter, we've had 72 Code Blue days and, hopefully, we've put the last one behind us, but who can tell. Last year, we set a record with 73 Code Blue days. So as you know, we have developed a system of sort of a just in time delivery system for beds to be able to expand to meet the need, and you have our commitment to continue to do that. And if that strains our budget as we go along, then, of course, I'm confident we'll be having those conversations.
Thank you. You mentioned outside feeding, and we are doing better. As you know, I'm always one of those people who believes we have to do 289 04/21/04 - WHOLE - BILL 040255 it one place or another. And as we push for people without lodging or the homeless to go inside, we just hope that those in Center City -- we know it's tough on some of the businesses who complain, but I hope that they will continue to understand that we've really come a long way and we're working very, very hard to certainly make sure that people are inside and that they're not outside. As you know, the Mayor made a commitment, I don't know, maybe about four years ago to end homelessness in 10 years. And I continue to hope that, while I'm still working, before I retire that we won't have any homeless people on the streets in this City and certainly not in this country, but here in this City because I do believe that we have the wherewithal, we have the capacity to take care of people. And that it's a moral commitment on the part of you, me, and every elected official in our City and every elected official in our country. People in America shouldn't have to sleep on streets. And I will say that as long as I see one person out 290 04/21/04 - WHOLE - BILL 040255 there because it's what we have to do.
Madam Chair, I absolutely share those views and absolutely believe with a firmest of commitment that Philadelphia is capable of becoming the first City in America to end the need for any of our citizens to sleep on our streets. We've made tremendous progress in this area so far, but the work is not yet done. I'm so encouraged, though, by the help and support of my fellow commissioners, John Domzalski, Alba Martinez, Mike Covone and others have been incredibly supportive as we've gone to them for additional resources to be able to provide those resources to those folks sleeping on our streets. It has been an incredible team effort with your office and others in the Administration and in the community that have really achieved phenomenal results, but we still have a long way to go to become that first City in America which I believe we can become that ends the need for any of its citizens to sleep on the streets.
Thank you. 291 04/21/04 - WHOLE - BILL 040255 What you might also remark about is the fact that your Department -- we do a lot more with case workers because we know that people need training. People can't go from shelters to self-sufficiency without training of various sorts, without job readiness, without case management to deal with whatever their situations are, and that you are working and that you've moved forward in that arena as well.
We are so fortunate to have the leadership of Letty Hinton as Director at OESS that is retooling business practices, creating systemic change in a way that we could have only envisioned a couple of years ago, being able to position ourselves to lower the case loads of our social workers, remove some of the administrative impediments and duties from our case workers so that they can really focus in on working with the clients and on the clients' needs to help them move back into the community and to be self-sufficient in the community with appropriate supports attached to them. We've 292 04/21/04 - WHOLE - BILL 040255 come so far under her leadership and that of her team. I'm also extraordinarily proud of the work that we're doing to implement the new HMIS system that will help us from a management perspective better track, better coordinate with the services of other departments and better serve the clients that come in our front door. So I believe that we are well positioned to continue to make those systemic changes necessary to better serve our clients moving forward.
Thank you. Thank you, Mr. Hess. Questions? Councilwoman Blondell Reynolds Brown.
Thank you, Madam Chair. First let me say thank you for the new initiate for little people on front end of their lives, the Bright Spaces Program at our shelters. It's a wonderful idea. And I'm 293 04/21/04 - WHOLE - BILL 040255 curious to know how many are up and running as we speak.
Thank you for that question, Councilwoman. We have at the moment six Bright Spaces that have opened and an additional planning eight planning to open in 2005. This is just an incredible program, as you point out. We're so fortunate to have the Bright Horizons Foundation and McNeal Pharmaceuticals that came to the table to be able to provide us the funding to enlighten the lives of women and children and men in shelter.
That was my next question. Who's paying for it? How did it come to be?
The way this worked is Bright Horizons Foundation came to us and said they would like to add a couple of these play spaces to our family shelters. And we said, "Oh, no, this is a tremendous opportunity. We shouldn't limit ourselves two shielders. We should be the forward city in America to have 294 04/21/04 - WHOLE - BILL 040255 Bright Spaces in all of our family facilities." They agreed. It was a little beyond the scope of what they could do internally, so they reached out to McNeal Pharmaceuticals who enthusiastically who embraced the idea and have been working closely with us to make this dream a reality for all of our children, the 900 now plus children that reside in our shelter system on any given night.
Because that was one of our questions too. How many children are currently in our homeless shelters?
Currently six and adding two more essentially for FY '05, correct?
Out of a total 295 04/21/04 - WHOLE - BILL 040255 of how many shelters?
It looks like we have -- the future projects beyond these include 5 four more facilities and so that would be 18 6 total family facilities. 7
And how many 8 shelters in total does the City have in 9 operation? 10
So that's 18 12 out of 29. Okay, so that is useful and 13 important and a new phenomenon for little 14 people on the front end of their life. Let's look to those on the back end of their lives who met bumps and they're looking for a second chance. Under professional services in your budget for FY '03 there are eight non-profits that are providing, I would imagine, education training services to individuals. And then in FY '04, there are three. In FY '05, there's one. And the reason why I'm troubled by that when I look at those numbers and stack that against your opening comments which were that 296 04/21/04 - WHOLE - BILL 040255 homelessness is going from to percent and we're 11 percent ahead in the demand for emergency shelters this year than we were last year, help me recon with the reality and where you're moving with regards to fewer programs, fewer educational and training programs.
This is an area where I 12 have to take you back a couple of years. 13 We're now in the fifth year of a six-year 14 cycle on employment training programs. OESS 15 historically was a system to try to provide all of its own services and, frankly, was inadequately funded to do so. And so employment training programs like clean and sober programs and mental health services, they tried to fund internal tot he agency and they weren't a sufficient capacity to be able to do that work effectively; effectively being meeting the demand within the system. So we had to reach out -- we recognized that had began to reach out to the mainstream systems, 297 04/21/04 - WHOLE - BILL 040255 if you will. For example, we could spend a couple hundred thousand dollars on drug and alcohol treatment. Well, CODAAP is a much bigger system and has much greater resources, so if we can tap into that system more effectively, then our clients would be better served. And so we have done that. On the employment training side, clearly there's two ways for folks to leave our shelter system and not come back. One is to have sufficient income to be able to afford market rate housing. Or two is to have some sort of housing subsidy. And so we try to work that on both ends. We have been blessed with a variety of good employment training providers. I think it was seven or eight to begin with. That funding came from HUD. It came from PWDC and came from a City match. The City overextended its match in the early years, the first three years. So we got into the second round of a three-year renewal and the final renewal. At that point, we had PWDC back out of the picture and so we were left 298 04/21/04 - WHOLE - BILL 040255 with HUD funding and some general funds.
Okay, pause there. Define "back out." Does that mean they were approached and they said no?
You approached the leadership at PWDC, Ernest Jones, to ask them to continue to offer their share of funding for training programs when PWDC is in the business of training programs; is that what I'm hearing?
A couple reasons. They have a threshold what they call success requirement -- and if I get any of this wrong, somebody speak up so we can get it exactly right for you -- of about 75 percent success rate is what they need.
I think this is '04. Our programs -- obviously, we have a challenging 299 04/21/04 - WHOLE - BILL 040255 clientele and our programs have historically not been achieve to level of success that PWDC asked us for.
My immediate reaction to that is PWDC is in the business of providing training across the board, including hard to reach or difficult to manage populations.
And that was our feeling as well. So what we recognized is we need to find other ways to be able to have our clients access mainstream employment programs that PWDC already funds and offers as opposed to long-term trying to fill that void with our own internal programs.
I cut you off. So as of FY '04, you no longer had the match with PWDC which is the reason why we only three here for FY '04?
I actually see three -- no, that's not true; it's four.
I think you're just 300 04/21/04 - WHOLE - BILL 040255 looking at General Funded programs. I think there may have been actually four. I'll ask Richard Shaeffer to check me on that.
Good afternoon. My name is Richard |Shaeffer, Administrative Services Director. In this fiscal year, if you want to count the Ready, Willing and Able Program, there are actually five funded programs.
How many of them are Philadelphia based? And I know that for myself that Ready, Willing and Able is not from out of the City, it may be New York because I clearly remember former Commissioner Estelle Richman telling us about that program and I know clearly of their value and their worth. So the other four are located where?
And so with the cutback in the funding, the total pot of funding, we 301 04/21/04 - WHOLE - BILL 040255 reduced the number from eight to four this current year. We're now approaching the final year of funding from HUD, which was the big piece that got this program started to begin with.
Okay, you'll have to help me understand that in terms of the actual dollars. You say "the big piece," I need to know what that means in terms of actual numbers.
HUD provides, I think, about $400,000 a year, and we have one year of HUD funding left. That will be for Fiscal Year '05. We have already met all of our match requirements for general funds for this cycle of funding. So we're not required to put any additional general funds into this employment and training pot for Fiscal Year '05, it will be strictly HUD funded.
So the Ready, Willing and Able which did not get axed is funded by whom?
Ready, Willing and Able is funded largely from general funds. It's 302 04/21/04 - WHOLE - BILL 040255 outside this program mix. Ready, Willing and Able was never funded from HUD.
There's one year left of HUD funding; that will go to support what?
That would fully support three of the four programs that remain.
Yes, ma'am. That's encouraging, stacking that against this 11 percent increase and the need for emergency shelter, but they're not listed in this document. So there's been some development since this paper was produced in today's hearing?
Councilwoman, if you look at , there's a grant information summary form. Even though it doesn't show the detail, that shows the funding that is set aside for the three remaining employment and training programs.
I need Councilman Nutter over here. You said ? 303 04/21/04 - WHOLE - BILL 040255
Councilwoman, about in the middle of the page in the second column from the right, it says "Fiscal Year 2005 obligation level," that's Column 6. If you follow that down about halfway, there's $493,352 under purchases of service line 200.
I'm going to be quite honest with you, I'm struggling with trying to find it in the book. But if you're telling me it's on --
I got it. So repeat what you said. For FY '05, I see $493,000.
Right. And that money will be used to fund three of the Philadelphia-based employment training programs for FY '05.
That will cover the three. Is one of them Ready, Willing and 304 04/21/04 - WHOLE - BILL 040255 Able?
So these three are for Philadelphia-based organizations?
Do providers provide a written -- so you're saying funding is driving this, not insufficient or ineffective program performance?
We have analysts that do regular monitoring. Each of the agencies we have contracts with also is required to provide us regular data on their program results.
So if you're going from eight to three, then it's ultimately the information retrieved from the program evaluations that move you to the lucky three that benefit from the remaining HUD dollars? 305 04/21/04 - WHOLE - BILL 040255
For the five that aren't lucky and continue to provide the service and deal with this issue of homelessness and getting folk where they need to be so they can become self-sufficient, what provisions are made for them in terms of awareness and letting them know criteria -- typically at the end, my experience is, a program evaluation -- let me not answer the question. What does OESS do when you make a determination that an agency is not meeting the criteria and therefore don't warrant consideration for continued funding?
And that's done how, written or a meeting or a conference call or what?
It could be any combination of those, depending upon the circumstances. In the case of a program where we were terminating funding, of course, that 306 04/21/04 - WHOLE - BILL 040255 would be in writing.
Final question. Given the high percentages of homelessness, knowing that PWDC is in the business of moving individuals to self-sufficiency, does OESS do anything to aid the agencies to move them to a place where they can meet the criteria to benefit from PWDC funding?
Councilwoman, we view this money that remains for employment and training as being simply a final year phase-out. We know that we will not be able to fund any of these programs beyond Fiscal Year 2005 because there will be no more HUD funding. And, therefore, we recognize that we need to be working very closely with PWDC. And we've already had a number of meetings and conversations to be able to get better access to all of the PWDC array of training programs for our clients. We also recognize that given PWDC's --
Yes. We also recognize 307 04/21/04 - WHOLE - BILL 040255 that five PWDC's wide array and large budget, they ought to be able to kind of spread our folks across their programs and not hurt any of the programs total numbers. In some ways, the way we have provided employment and training programs to date has been unfair to the providers because we've given the providers all complicated folks. And maybe the results would have been better had they had more of a mix of clients in those programs. Maybe at that point, the percentages would have been at the 75 percent or better and PWDC would be in a better position to be able to report to the State rather than viewing our programs as kind of holding them back.
In a very formal way? Because that's now on some ways killing these programs. The way you've just presented it, the fact that they did not meet their numbers now leads you to no longer fund 308 04/21/04 - WHOLE - BILL 040255 the programs.
Well, we would not be able to fund the programs beyond Fiscal Year '05 in any event because the federal funding will not be there for us.
So am I hearing that you're prepared to serve as a bridge or a negotiator with PWDC so that these agencies who can't get funding for the reasons you just stated can be fairly considered by PWDC?
Absolutely. In fact, Director Hinton and Richard Shaeffer had a meeting with PCDC just, I think, last week. I've talked Blackwell about giving us an entry to PWDC to have those discussions greater depth. We fully recognize that we need greater employment and training opportunities for all of our clients all of our clients. And we fully recognize that we're generally better off when our clients are treated within the mainstream systems as opposed to being singled out in a homeless system.
Sure. Well then I will look to the Chair 309 04/21/04 - WHOLE - BILL 040255 of the Committee on homelessness and housing for us stay close -- as a member of that Committee, Madam Chair, for us like a laser beam, stay in touch with this issue so that PWDC, A, recognizes agencies in our City in the business of providing services to this population and hear the observations and judgements shared by Mr. Hess so that do what they've been legislated to do.
Thank you, Councilwoman. And we also note that one of the providers is here OIC. We thank them for coming in. They have had contracts with OESS and they are reviewing that who area. We've talked with them Mr. Nelson and we're glad he and his team are here. Let me ask one final question that the President had. Is the 15 million in the Grants Revenue Fund, is that money secured? Is that speculative or is that secured money?
We've reflected in the budget, Madam Chair, an increase of 15 million 310 04/21/04 - WHOLE - BILL 040255 essentially in the Grants Fund. Of that, $5 million is new dollars, Act 148 dollars, through the DHS needs based budget to support women and children in shelter. So we are hopeful and encouraged by what we've heard so far with respect to how that will play out. But that 5 million does represent new investment from the State.
Thank you, Councilwoman. Mr. Nutter, would like to ask a question?
Mr. Hess, I think this came up during Capital; I believe you came up. I wanted to ask some questions with regard to shelter services related to domestic violence. So first I'll say if you've already gone over this topic --
I've not yet had the pleasure of doing that, Councilman. We have prepared a response to your questions with respect to the Capital Budget hearing and that is in the process of being submitted to the 311 04/21/04 - WHOLE - BILL 040255 Chair.
Okay. Well, one, that's very good because quite honestly I don't remember what the question was.
Well, we've got one heck of an operation going on here. (Laughter.)
But I think it was around the issue of how many shelter beds do we have for victims for domestic violence, how many do we believe we actually need, the issue of -- I don't want to secret but certainly confidential or there must be some other appropriate term, but the ability of people to when they're in a dangerous situation to go somewhere that is not a known place as opposed to some of the known places that we have. And I think I also asked about the City acquiring properties specifically for 312 04/21/04 - WHOLE - BILL 040255 the purpose of creating that kind of environment, whether known or unknown, given much of the property acquisition activity that we're already experiencing through the NTI program. Can you respond to some of that.
I can. We looked into this, and I've worked with Carol Tracey, the Co-Chair of the Mayor's Task Force on Domestic Violence. We currently have dedicated specifically to domestic victims at an undisclosed location 46 beds. We compared that to a couple of other cities. In New York City, for example, they have 832 beds. In Chicago, a City of 3 million or about twice our size, there's 211 beds. And in Boston, City of 600,000 there is 96 beds. And so I think it supports --
Yes. That is not to say, as I think we mentioned before, that this represents all the beds available to victims of domestic violence, but these are the undisclosed locations relatively secure beds. We fully believe that we need more. We are 313 04/21/04 - WHOLE - BILL 040255 unclear and unsure at this point how many more. I think it is safe to say we need to at least double that inventory.
You indicated at the last hearing that, I'm going to assume, you correct me if I'm wrong, that in the disclosed environment we had the capacity if we needed to to serve I believe you said somewhere between 50 and a hundred. Did you tell me that?
That was in the undisclosed. I was incorrect. The actual number is 46.
And in the disclosed, not that I want the locations, how many are there?
So that is not designated specifically for victims of domestic violence, that's for, I've became homeless, I need to go in the shelter system, I have a domestic violence situation, I had a fire, whatever circumstance happens, there are 1500.
With regard to general services, the 1500 or undisclosed 46 specifically for domestic violence, do we find at any point in time that we are over capacity?
For the undisclosed locations of 46. It is not unusual to have all of those beds filled. It is not unusual for them to try to, you know, squeeze in an extra person or two to accommodate a specific family or a specific situation.
How often would you say that happens? 315 04/21/04 - WHOLE - BILL 040255
We are currently working very closely with the Mayor's Task Force on Domestic Violence and Women Against Abuse in particular to identify a new location that we would be able to expand significantly the number of undisclosed beds available to the system at any given time.
And with the new location are you talking about getting rid of the 46 at whatever location that's at, or is it on top of the 46?
I think that would depend on the location. I think our forward goal needs to be to essentially double the number of available undisclosed beds and continue the work of the task force to complete the real needs assessment that needs to happen.
And you may have just said this and it got past me. Have we identified a location? 316 04/21/04 - WHOLE - BILL 040255
We have identified a potential location that we're going through kind of the feasibility piece on now
Would you be the right person also to talk about the hotline?
I can certainly tell you what limited knowledge I have about the hotline. I think Carol Tracy is here also if you have specific questions.
Again, I know I'm coming in fairly late in the course of today, so I don't want to you go over any material that's already been discussed.
Councilman Nutter, can you add to that line of question, because I also had some questions around that, where we are in the process of identifying a facility, just where you are? In addition to Councilman Nutter's questions, please address 317 04/21/04 - WHOLE - BILL 040255 that one as well.
I can tell you that we have identified this is a need, that we meet on a weekly basis with an internal group of commissioners and directors to kind of move the facility feasibility through a process that is ongoing, and that we are hopeful of finding a location that we can do some of this work with very soon.
Actually, to follow-up the Councilwoman, can you give us a sense of the timing on this? Are there some particular obstacles? Is there a financial issue? Is it in negotiation with the property owner? And are we looking for an acquisition or lease?
We're looking at both options. We are in negotiations at the moment. I think it would be premature for me to try to guess how long that will take, but I am encouraged by the team. Joan Schlotterbeck, the Commissioner of Public 318 04/21/04 - WHOLE - BILL 040255 Property has been intimately involved and very supportive of our facility's needs, and I am greatly encouraged by her direct involvement in this.
Okay. Before I get to the hotline issue, but this is tied into it, are there any estimates or relatively hard numbers on -- what would you estimate is the average number of daily victims of domestic violence in Philadelphia?
I'm Carol Tracy, I'm the Director of the Women's Law Project and Co-Chair of Mayor's Task Force on Domestic violence. Councilman Nutter, there are 115,000 segregated domestic violence calls that go into 911 each year, so the numbers are enormous. There are 14,000 petitions for protection.
When you use the terminology you used earlier, you're saying -- you used a specific term "segregated." Are you telling me that you mean to indicate they are separate calls? 319 04/21/04 - WHOLE - BILL 040255
The Police Department two years ago segregated domestic violence calls from other domestic disturbance calls. Previously, dog bites and domestic violence were in the same category. So now they can actually count the number of domestic violence calls that come in and they heighten the priority call for which they get. In the previous fiscal year, the first full year that it was in place, there were 115,000 domestic violence calls going to 911. More than half of them had been called to the address more than once.
More than half had had a previous call to the address?
I know this is not your area, but you've been on a couple different task forces in the past. We get about, what, a million calls to 911? Do you have any recollection what those numbers are? 320 04/21/04 - WHOLE - BILL 040255
There's no 5 question about that. So 115,000 calls. And what is your information in terms of what happens with the vast majority of people who call seeking assistance?
I believe that somewhere on the order of to 14,000 arrests are made. 12 And in the cases in which prosecution will occur, the District Attorney's Office and Women Against Abuse verifies this, more than half of the victims decline to prosecute.
The Mayor has provided or has suggested, I guess, to Council an increase of somewhere in the order of a million dollars, $300,000 of which will go to improving the hotline services. The hotlines 321 04/21/04 - WHOLE - BILL 040255 are run by four independent agencies as is the domestic violence shelter and they share one hotline -- they have four different numbers. They bounce the numbers from one to the other. They have indicated that they have an extreme need for more staffing and for more technological support to provide better, more efficient technology to provide this. So three will be at least four more staff people that will be handled by this and, hopefully, this will pay for both the technical assistance and the technology itself.
I'll kind of conclude with this. What kind of efforts should the City be making -- and I know a significant step is even the Mayor creating the task force. What kinds of efforts should we be taking to try to help curtail or reduce the amount of domestic violence directed at women and families?
I think we need more services for women and families. But we also, I think, are in desperate need of services for men who batter. There are very limited 322 04/21/04 - WHOLE - BILL 040255 services. Almost always those services, except some something that was mentioned earlier that the DHS is funding, an organization called Menergy, almost all of the services that are available to men who batter come from criminal justice proceedings. So it's an after-the-fact service. There is, for example, no hotline that someone might call who wants to change his behavior. So I think that that's one of the issues that's very much on the agenda of the task force. And quite frankly, part of our work in the task force is looking at best practices around the country. And much to my surprise, that practice doesn't exist anywhere. And I think part of our emphasis is not what has so generally been the emphasis in domestic violence cases of looking at why does she stay as much as why does he do it and what kinds of efforts should we be developing to intervene. Some of them are, of course, at the educational level in the school systems and some are with adult men who want help, some of whom I believe want help, some of whom do benefit from the services they get 323 04/21/04 - WHOLE - BILL 040255 even after they've been convicted of a crime but for whom there's very little available, here or anywhere else. It's actually a national disgrace.
I think what will likely happen with the creation of hotline is we will begin to gather a lot more information than we have now and it will probably inform our service delivery system in a way that we can not even imagine yet. For example, I can certainly foresee a time before long where our emergency relocation services are dispatched to support from a service delivery standpoint women who are very difficult situations at that moment but maybe don't need police intervention yet. So I think there's a lot still to be done and learn from the collection of data as we move forward.
I could jump in here just for a second with a point of information? I would hope when you develop this hotline technology that you ask for every exemption possible because many times people 324 04/21/04 - WHOLE - BILL 040255 will call from a phone that is blocked, that you're able to capture through caller ID the location, the number that's being called from. Because today, unless you have a government exception, that information is not shared with normal customers. So I would hope that you'd have the ability to see a person like you just describe that are in immediate distress that we have a similar system -- and I'm on this technology committee now here in Council -- that you're able to capture all of the information from location that the person is calling from, the phone number, the address, et cetera, because if you don't have that exemption, you will be blocked from a person that has the phone line that is blocked or a pay phone or a cell phone or whatever the instrument may be. So I would hope you take a note and make sure that that happens, whatever technology you move towards.
Thank you, Councilman Nutter. 325 04/21/04 - WHOLE - BILL 040255
Sure. Lastly, Ms. Tracy, is the expectation in terms of the task force that there would be a report issued as a part of the work and the series of recommendations for action steps to be taken?
Yes. As we're moving along, action steps are being taken, but I would be more than happy to provide a report, an interim report, an ongoing report. I think that this is not an issue that we're going to be able to turn away from for sometime to come. So I think that it would be interim reports. And I am so appreciative of Council's interest in this because this year is really the first year that government has really paid attention to domestic violence. It has been on the shoulders of four small private agencies. So I think Police Commissioner Johnson and I would be very happy to provide a report, an interim report to Council at your desire. You tell me the appropriate committee.
Thank you. If 326 04/21/04 - WHOLE - BILL 040255 you could just forward it to the Chair or the Council President and then we'll get it. One last question. Are there any discussions with regard to the male side of the problem, which is basically where it starts, where the City might possibly sponsor workshops or kind of meetings for men to have these kinds of discussion either with a facilitator or some other person to come in? You know, guys are -- you know, we can be a little strange about a variety of things.
I don't know the answer to that. I can tell you that within our realm, OESS adult services, the answer is no. 16 We don't generally see the men, however. By the time folks get to us --
I understand. At that point, you actually don't want to see them.
If I could add to that, I think earlier the Department of Human Services was talking about they're working 327 04/21/04 - WHOLE - BILL 040255 more with some of the fatherhood initiative programs and Men United for a Better Philadelphia, and I very much would like to pull them into this discussion. I think there's probably a role for the faith-based community in dealing with the needs of men, making sure that they're held accountable for their behavior, but providing some intervention to help them stop.
It is unacceptable, and it's more than just a saying. There is no excuse. Sometimes you just need to walk away. Thank you very much. Thank you, Madam Chair.
Any other questions? The Chair recognizes Councilwoman Brown.
Thank you, Madam President. I read with interest, Mr. Hess, your new housing first initiatives on your testimony. Please share with us the 328 04/21/04 - WHOLE - BILL 040255 obstacles that homeless men, women, and children face in finding permanent housing solutions to their homelessness. Because we know that clearly income is an issue. But for those who ultimately develop a stream of income, are you finding that there's still a lack of affordable housing for them?
Councilwoman, thank you for that question. The short answer is yes. Our housing first programs, and I've asked Dr. McGuire, our Director of chronic homeless initiatives to join me at the table. Our housing first initiatives target two groups. These are both new federal streams that we're excited to have been awarded. In fact, we were 1 of 11 cities out of 100 applicants that were fortunate enough to receive this funding.
It is, and we're very proud of that. Thank you. And it targets two groups. The first group is there is a group that Penn has done research on that 10 percent of the people that are the homeless system at any time are 329 04/21/04 - WHOLE - BILL 040255 what they call chronically homeless. That is to say, they've been homeless for year or more or had four occasions of homelessness in the last two years. That group that's chronically homeless occupies about 50 percent of our resources because they're constantly in and out systems. So we try to target that group to get them out of our system once and for all and living in stable housing in the community with the appropriate support of services to free up dollars to be able to have better services for other populations. And so one of our housing first programs does that by identifying our long-term shelter stayers, which we now kind of have that wanted list, you know, this group has to go, and providing them that service by being able to move them into housing at a rate of five per month with intensive, what we call, act team supportive services. There is second group. I mentioned earlier that we've been, I think, ever so fortunate in this City to be able to reduce the number of people living on our streets 330 04/21/04 - WHOLE - BILL 040255 from a high of 824 do 133 in Center City last week based on police count. I don't personally believe, after talking to many of these folds on the streets and the outreach teams regularly as I do, that our current intervention strategies will work for this last hard core group.
They will not work. We have engaged these folks day in and day out; week in, month in, year in and year out. We need different tools, we need strategies. And so the housing first strategy that targets folks living on our streets is designed to do that. We have that wanted list, and we're moving under Dr. McGuire's leadership with great community partners, five chronically homeless individuals a month off of our City streets into permanent housing with intensive supportive service and with good results so far, and we're very proud of that.
I certain commend you for that and also for, again, 331 04/21/04 - WHOLE - BILL 040255 looking for alternative funding to take care of a need that the City's becoming increasingly difficult to -- though we have the responsibility, it's becoming increasingly difficult to manage and fund. So to reach to other funding sources makes all good sense.
My final statement is to say thank you for the support you offer to our holiday program that we do for children in the shelters.
It does bring probably one of the few moments during the year that reminds me of why I do this work that I do. And we thank you for your partnership in important children's initiative.
We certainly appreciate your good work in this area, Councilwoman, and would certainly welcome any additional initiatives that you may wish to undertake in this area.
I have plenty. 332 04/21/04 - WHOLE - BILL 040255 You may be sorry. I'm just going to put a pin in it and say thank you.
Thank you. Are there any other questions or comments from Members of the Committee? (No response.)
Seeing none, I thank you. Thank you very much. Public Property is next. Good afternoon and welcome. We do have your written testimony, a copy of which has been given to the stenographer. She will transcribe it and in whole. I would simply ask you to abbreviate your testimony. (Testimony attached.) COMMISSIONER SCHLOTTERBECK: Joan Schlotterbeck, acting Public Property Commissioner for the Department of Public Property. With me on my left is Deputy Commissioner Joseph James, Deputy for Communications. Also joining me are John 333 04/21/04 - WHOLE - BILL 040255 Hezins to his left, he's Deputy Commissioner for Real Estate and Administration. Actually, given the late hour today, I'd be just as willing to forego the entire testimony briefing and just go straight to questions, if you don't have any problems with that.
That would be fine with me. Everybody has a copy of the Commissioner's testimony. Just a few brief questions. In FY '04 you were budgeted for 236 positions. And if in FY '05 you are budgeted for 193 positions, that's a reduction of over percent. Could you explain why you're 17 being reduced by 43 positions? 18 COMMISSIONER SCHLOTTERBECK: Actually, the number is more like 23. The other positions are the 311 call center.
I'm sorry? COMMISSIONER SCHLOTTERBECK: It's actually a total of 23, and the other positions are the 311 call center. That will be an administrative transfer into our budget. 334 04/21/04 - WHOLE - BILL 040255
What are positions? What are the titles of those 4 positions mostly? 5 COMMISSIONER SCHLOTTERBECK: At this 6 point, it's a combination of a couple of very 7 top level positions in the Department that we 8 chose not to fill with DROP as well as trades. 9 I can get the details. I don't have them with 10 me. 11
SO you 12 feel that you will have no operational impact 13 on your department? 14 COMMISSIONER SCHLOTTERBECK: 15 Actually, we do anticipate some problems. But 16 we also anticipate having those specifically 17 with the trades dealt with by the 18 consolidation that we're analyzing for 19 city-wide consolidation of maintenance. 20
In FY '05, 21 you are requesting to transfer the SEPTA 22 operating subsidy to your budget. May I ask 23 why? COMMISSIONER SCHLOTTERBECK: Actually, I probably would like Rob Dubow to 335 04/21/04 - WHOLE - BILL 040255 answer that question.
I think he just left the room. COMMISSIONER SCHLOTTERBECK: I frankly don't know the answer at this point.
You are requesting approximately $94,000 for transit lobbyist. Would you explain why these services are needed and who is the lobbyist. COMMISSIONER SCHLOTTERBECK: I forget the exact name of the company. That is normally transit subsidy. However, because that was taken out of our budget in '04 we were paying for that directly out of operating funds. It's a federal lobbyist for transportation for the City.
On of your detail, you're requesting $643,000 for centralized custodial services. Would you please explain what these funds are for and how these services are currently being provided? COMMISSIONER SCHLOTTERBECK: That's an initiative that would entail transferring 336 04/21/04 - WHOLE - BILL 040255 and consolidating custodial services into the Department of Public Property. And departments affected would be Health Department, Recreation, Streets Department.
Most of all of the maintenance then would come under Public Property? COMMISSIONER SCHLOTTERBECK: Custodial maintenance.
They're going to be consolidated? COMMISSIONER SCHLOTTERBECK: Into Public Property. That's what we're analyzing we're analyzing at this point. We're not there for transfer. We don't dates set. But that's the intent, to analyze it and then begin the transfer.
Council President, you had a question for me when I was out of the room about the SEPTA subsidy and why it was moved back into Public Property?
We moved it out of Public Property last year because there were 337 04/21/04 - WHOLE - BILL 040255 specific concerns about the cuts that SEPTA had proposed last year, and then since they've have taken those cuts off the table, so we thought it was appropriate to move it back to Public Property where it had always been.
Okay. On of the detail, it reflects a reduction $1.6 million in your electrical accounts. How are you able to do this in a time of rising energy costs? COMMISSIONER SCHLOTTERBECK: It's an initiative that we've taken -- basically, we're working with the Municipal Energy Office, Managing Director's Office, and our intent is to produce a report which is a bench line that will identify facilities, particularly the largest facilities that are the biggest energy users. The intent is to continue to establish a baseline. "This is your energy use for the last two years. This is where we would like you to be. We would like you to reduce the overall cost by 5 percent," and we're going to give them basic common sense approaches. And the larger 338 04/21/04 - WHOLE - BILL 040255 buildings we're analyze the operations of their building automation systems.
When do you think that report will be completed? COMMISSIONER SCHLOTTERBECK: We are working on it, and the idea would be to have it in Commissioner's hands so they can begin this initiative effective July 1. We're working with Kent Miller from the Municipal Energy Office.
Very well. Thank you. The Chair recognizes Councilwoman Brown.
Madam President, I have been struggling trying to find my couple of questions for the Commissioner, and I have not found them, so let me just say congratulations on your new post and we wish you well. COMMISSIONER SCHLOTTERBECK: Thank you.
And well deserved. 339 04/21/04 - WHOLE - BILL 040255 COMMISSIONER SCHLOTTERBECK: Thank you. The Chair recognizes Councilman Rizzo.
Thanks, Madam Chair. Is Public Property responsible for actually paying the energy bills? COMMISSIONER SCHLOTTERBECK: Yes.
This is not a trick question. Do we pay our bills on time, gas, electric, PGW, et cetera? Tell us a little bit about how well we pay our bills. I'm hearing that sometimes it takes a long time to get paid. COMMISSIONER SCHLOTTERBECK: I would say that that's incorrect. We do pay them on time.
Tell me how we do that when we get the bill. COMMISSIONER SCHLOTTERBECK: Well, it depends on which utility.
Let's start with electric. Talk about cell phones. Talk about 340 04/21/04 - WHOLE - BILL 040255 PGW. COMMISSIONER SCHLOTTERBECK: I'll talk about PGW. PGW, PECO, we get the invoices in the middle of the month to the end of the month. We do some analysis. The Mayor's Municipal Energy Office also does analysis and then we process the payment. I would say they get them within the normal 10 days after that point. 11
We pay our bills 12 within 15 days? 13 COMMISSIONER SCHLOTTERBECK: About 14 15 days. 15
Well, I'll get back to the person that was critical of the way we pay our utility bills, and I'll get back to you if they don't agree with that. COMMISSIONER SCHLOTTERBECK: That's fine.
How about cell phones? COMMISSIONER SCHLOTTERBECK: I will ask Joe James to talk about that. I'm not necessarily versed in that. 341 04/21/04 - WHOLE - BILL 040255
Good afternoon, Councilman. Joseph James, Deputy Commissioner, Department of Public Property. The process by which we process our cell phone bill, it takes us about 30 days. The process is because when we get the bill 8 in, we get the bill in two forms. We get in both a CD format and we also get a paper bill. And we take the CD format and upload it into our call accounting system that we use to generate bills back to the departments. We also then go through the bill to make sure all the credits have been applied and we make sure that all charges that need redacted are redacted. And it takes about 30 days for us to go through that process and generate a payment.
That's a fair amount of time. But with us putting the heat on the utility companies about their collection process, I have gotten some information where we don't do the best. And now I'm go back and tell them that that is not accurate, that we pay our bills as promptly as 342 04/21/04 - WHOLE - BILL 040255 required. Thank you very much. I appreciate that. Thanks, Madam Chair.
You're welcome. The Chair recognizes Councilman Nutter.
Thank you, Madam Chair. Just very quickly. Is it my understanding based on recent very positive developments with regard to Memorial Hall and the Please Touch Museum proposal, is Public Property going to be responsible for the relocation of the Fairmount Park Commission? COMMISSIONER SCHLOTTERBECK: Yes.
How is that proceeding along? COMMISSIONER SCHLOTTERBECK: We're making great progress. We're moving them into One Parkway Building.
So it's just a straight move to One Parkway? When will that happen? 343 04/21/04 - WHOLE - BILL 040255 COMMISSIONER SCHLOTTERBECK: It's October we're projecting to have them moved in.
October of this year? COMMISSIONER SCHLOTTERBECK: Yes.
And what about the Accident Investigation Division of the Police Department? COMMISSIONER SCHLOTTERBECK: They are going to be relocated to 26th and Master Street, which is where traffic police vacated to go 501 Building.
What's the 501 Building? COMMISSIONER SCHLOTTERBECK: The navy yard.
So this is kind of a musical office situation here. So you're going to park out by October, that's what you expect. And does that also fit in with the Please Touch timetable in terms of when they need to do what they need to do? 344 04/21/04 - WHOLE - BILL 040255
Joan to the best of my knowledge, yes. We've been planning this for a long time so that we didn't have any delays on our end.
I'm glad to here that because not too long ago it seemed like the park people were desperately in search of a location and they were looking to go possibly with the new school out in West Philly, then one of the stables somewhere else, then they were going here, they were going there, so I never had a good sense that they had really kind of found a secure home. COMMISSIONER SCHLOTTERBECK: We did.
Is there anyone else that would like to ask questions?
I would like to thank you and all the City departments who helped out so well and did such a great job at our office after the fire. Thank you. COMMISSIONER SCHLOTTERBECK: Oh, you're welcome. 345 04/21/04 - WHOLE - BILL 040255
And certainly in this beautiful room, with exception of you-know-what. Any other questions or comments? (No response.)
Thank you all very much. Good luck to you, Joan. Fleet Management is next.
Good afternoon. Please identify yourself for the record.
James Muller, Fleet Manager for the City of Philadelphia. And to my left is Bob Fox our Administrative Services Director.
Fine. We have a copy of your written testimony. It has given to the stenographer. It will be transcribed in the whole. If you want to give us the summary, fine. If not, we can go right into questions because everybody does have a copy.
I'd like to go into questioning, please 346 04/21/04 - WHOLE - BILL 040255
That's wonderful. Thank you. We appreciate it. (Testimony attached.)
Let me just say that you mentioned in your testimony that have or will be implementing creative strategies to significantly cut costs. Would you tell us what these strategies are?
Madam Chair, the forward thing is our fleet reduction initiative will reduce the City's fleet size by 400 vehicles or 7.3 percent of the fleet. This will result in a cost avoidance of over $4.3 million, including 1.4 million for parts and fuel, 2.2 million in acquisitions, 164,898 for parking cost, and 617,184 for labor fees. One creative solution to help ease the burden of the loss of City vehicles is that the City awarded a contract to the Philly Car Share. It's a non-profit company that provides vehicles on an hourly basis. The vehicles are parked in lots throughout the City and employees can reserve them through the internet or by telephone. Additionally, 347 04/21/04 - WHOLE - BILL 040255 employees can utilize the personal auto program for transportation needs. This program provides a per mile reimbursement and is currently being utilized by 258 City employees with no increase to their insurance cost.
Are all employees aware of that? I guess they are. You're requesting $3,180,000 for vehicle acquisitions. What vehicles will you be purchasing?
Police cars, compactors, fire pumpers, some ladder trucks, sweepers, large dump trucks.
We had the Fire Department in here the other day, and I don't know where these fire trucks would go.
They said they're taking that equipment out of first line of service to bump it back to second line of services, and the second line of service equipment is going to be sold or retired. Why would we be buying more equipment?
Councilman, what I 348 04/21/04 - WHOLE - BILL 040255 believe is what we're going to do is the new equipment is going to update the older equipment and get it out of the fleet. We have some older fire equipment in our fleet presently. What usually happens is that there's a first line service and then a 200 series. What we're doing is putting newer equipment in our 100 series which is what's used every day, and 200 series is a backup.
I understand that and that makes lot a sense. What the Fire Commissioner, I thought, testified to, because we asked this question the other day, the 11 pieces of equipment that they're talking about taking out of service, 7 engines, 4 ladders, or vice versa, that that equipment is moving to what I guess you call the 200 series and the present equipment in the 200 is going to be sold. So what new equipment are you buying and what is it replacing since we've got 11 pieces that are now apparently front line service equipment that's moving to the second tier?
Well, as you know, fire 349 04/21/04 - WHOLE - BILL 040255 equipment, a ladder is like $600,000 for one ladder and a pumper is $350,000. So we're not going to buy a lot of them. We'll probably buy three or four.
Of the $3 million, can you tell us how much is going for the ladders and the engines, please, the Fire Department? Can you give us a breakdown, please?
Our plans are to for the first time after 28 years or so is to lease vehicles. We're going to take our budget which is $6 million and we're going to appropriate a certain amount of that, $820,000 of it so that we can purchase large ticket items, vehicles that cost over a hundred thousand dollars and have a useful life of over 10 years. That is going to allow us to buy close to $7 million worth of equipment.
I'm just being told that all the money is in Class 400. How do you do that for leasing? If you're leasing, Bob --
We've moved 820,000 into 350 04/21/04 - WHOLE - BILL 040255 Class 200.
We would still like to have a breakdown for the Fire Department, please, how many vehicles and what the cost of each would be.
Thank you, Madam Chair. I have one comment that I want to make is that you guys should be congratulated on the fact that you have done something that I've asked other utility companies and other municipalities, even in our Newark suburban area, that you've been able to lock into an unleaded fuel deal for a dollar a gallon. That's something that you apparently analyzed that very carefully and locked in where other people locked into a deal that the price changed on a monthly basis. And you're paying a dollar, where some other municipalities are paying $1,25, $1.30 gallon for unleaded fuel. Does that apply to diesel also? 351 04/21/04 - WHOLE - BILL 040255
Congratulations on that. That was a real good move. The other question I have is, what can you do -- I'm getting letters lately about our sanitation vehicles that pick up trash. I've talked to the Streets Department, and they gave me an answer that was, I think, satisfactory from the Streets Department, but I'd like to ask as it relates to Fleet Management. The truck comes down the street, it gets full. At some point they compress, they compact the truck. The next thing that happens, all of a sudden all of this water, sloppy, dirty, stinky water comes out of the truck and truck pulls away making this trail of water up the street. And apparently, it stains the street, it smells bad. The Streets Department came back and said there's a seal or something that becomes defective in the truck. And when the trucks sits out in the weather or whatever, how the water gets into truck, it really is starting 352 04/21/04 - WHOLE - BILL 040255 to make our neighborhoods look kind of messy when you see the trash being picked up with this trail of water. Is that accurate, what the Streets Department said about these defects in the vehicle?
Councilman Rizzo, there is a seal, a tailgate seal in the back. When the hopper closes there's a rubber seal that sometimes gets torn or ripped form foreign material when they empty the truck. And also, in the hopper itself, in the bottom of the hopper, there's a hopper plug. What I'll do is have our guys check and make sure. Sometimes we have to actually weld the plug in because the guys take them out.
How does all this water get into the truck? Is it when it rains the hopper fills up?
That and anything that's in a container when they put it in, any kind of liquids.
It's such a large 353 04/21/04 - WHOLE - BILL 040255 amount of water. I followed one of the trails where they compressed it for like two or three blocks and it was all garbage in the water. It was just not a nice situation to leave behind. Garbage is not nice, Councilwoman Tasco said. It's amazing just recently in the last couple months I've gotten numerous calls from people complaining about that. So if you could put some kind of a bulletin out maybe to keep an aye on that, that would be appreciated. Can't they empty these trucks from the liquid that's in them before they start their work?
When they come into your shop, if it's got 50, 60 gallons of water in it, what do they do, just leave it there?
Thanks. Great job you guys do. 354 04/21/04 - WHOLE - BILL 040255
Are there any other questions or comments from members of the Committee of the witnesses? (No response.)
Thank you for your patience and thank you for doing such a great job.
Councilman Nutter, did you have questions or comments of Fleet Management?
No, I did not. And I see that the historical commission is next and I guess they're last?
I have a question but it's not related to Fleet or the Historical Commission so I'll deal with it when this is over.
Okay. Historical Commission is next. Good afternoon, I'm sure you heard 355 04/21/04 - WHOLE - BILL 040255 me telling the previous witness that we have copies of your written testimony. It will be given to the stenographer and it will be transcribed in whole. You have a choice to either abbreviate or either sit there and allow us to ask any questions we'd like.
I will be very brief. With me is John Farnham of the staff of the Historic Commission. Dr. Tyler would normally be here. He's home recuperating from surgery.
I think he's feeling better, and we hope that he'll be back in a couple of weeks.
Wonderful. I didn't realize he was out sick again.
That's especially good news. This is an increase for the Commission. As we see it, it's an increase in -- I would ask our statement be corrected. It looks like in increase of 60,000 not 90,000. 356 04/21/04 - WHOLE - BILL 040255 We're very grateful to the Mayor and the Managing Director. This will allow us to have a new staff member. And with a new staff member, we will be able to address the current needs of the Commission, which are great. My understanding is the Commission has not had an increase in staff for over years. 9
Ten years, I'm told. So this will allow us to meet our current obligations. We'd be happy to answer any questions.
Does anyone have any questions of our witness? The Chair recognizes Councilwoman Blackwell.
Thank you, Madam President. As many of you know, we've been in the middle of some legislation and we've been meeting to try to resolve various issues. We do commend the Mayor also on giving them two 357 04/21/04 - WHOLE - BILL 040255 new staff members. But for the Council's information, we will be having a task force meeting. We've created a task force to deal with various issues that concern the Commissions, and we'll have our first breakfast meeting on May 24th, and then we will get back to the Council later. We intend on having a meeting in May, June and September. Am I correct, Mr. Scleroff?
We're trying to work it out so we can bring some suggestions to the Council after we've worked out so many of the fine points. So we do say thank you to them for coming and that we look forward to working closely with them.
We want everyone to know that we are working closely with Councilwoman Blackwell, her office, and two of the members of the Commission will be part of 358 04/21/04 - WHOLE - BILL 040255 the task force, so we're delighted.
This is in response to the legislation we introduced to kind of change a lot of the legislation, the laws regarding the setup of the Historic Commission. So we have met and have decided the best way to deal with its organization and what we should do. There have been many positive articles in the paper about me with regard to this issue, and so we decided that we would try to come up with three focussed meetings and then come back to the Council before we have a hearing. We've never had a hearing, but we wanted to work so much -- you know, the Historic Commission is all detail and no main point, so we wanted to have three task force meetings before we come back to the Council with a requested action or suggested action
Very good. Thank you. Any other questions or comments? 359 04/21/04 - WHOLE - BILL 040255 (No response.)
Thank you very much. Thank you. You've been very patient. Mr. Dubow, please don't leave. Councilman Nutter, do you want Mr. Dubow to remain? I have a feeling you have a couple questions.
Mr. Dubow, thank you for making yourself available. I just need to get some information regarding the City's budget. Now, what's the estimated deficit for FY '05?
You mean what the fund balances at the end of the year or what the operating deficit is during the year?
Well, the plan projects that it will end the year with a positive fund balance, roughly 13.6 million -- 360 04/21/04 - WHOLE - BILL 040255
Yes. Since the plan was submitted, however, we've loss million from 6 PGW for '05, which means unless we took 7 corrective actions we'd have a negative fund 8 balance of over $4 million. 9 The plan also projected that we 10 would end '04 with a $14.6 million fund 11 balance, so our operating deficit would be 12 roughly a million dollars. 13
So you're 14 expecting to basically roll over from '04 to 15 '05 $14 million? 16
That's correct. And if 17 we lose the scoop that would be another -- 18 depending of if it all went away that would be another five million.
Yes. And then the negative fund balance would be closer to 10 million.
All right. So let's go back through this. For the current 361 04/21/04 - WHOLE - BILL 040255 fiscal year, you anticipated ending the year with a positive fund balance of $14 million which you were going to roll into FY '05?
When you submitted the FY '05 budget, you anticipated having a positive fund balance of $13.6 million?
And based on the decision made within the past two weeks by the Mayor under certain circumstances, you agreed to forego million from PGW? 15
Leaving you a 17 negative fund balance of $4.6 million? 18
4.4. And then another proposed action is to take the $125 million from the Water Department Debt Reserve Fund for development, which means that you forego the interest payments on those funds often referred to as the scoop; is that correct? 362 04/21/04 - WHOLE - BILL 040255
And that decision cost the City how much money? What's the value of the scoop?
Two recent decisions made by the City Administration; is that correct?
Now, let me understand with regard to our tax strategy. A couple years ago the Mayor proposed to end the incremental cuts in the wage tax; is that correct?
And that was in January of 2002, expecting to keep the anticipating July 1, '03 cut that was already 363 04/21/04 - WHOLE - BILL 040255 in the approved Five-Year Plan but actually ending the cuts July 1, '04; is that correct?
And so the first impact of Bill 92 which established for the first time a five-year guaranteed schedule of the same incremental cuts that had always been proposed in the Five-Year Plan but were not guaranteed, the first impact of Bill 92 was in July of '04; is that correct?
What's the cost of the cut from July 1, 2003, into the present fiscal year? It's the current fiscal year.
I think roughly about 364 04/21/04 - WHOLE - BILL 040255 $30 million in years. But part of that is the impact of Bill 73.
Right. Now, 5 that was a different bill passed subsequent? 6
Was that bill 8 passed in '02 or was that bill passed in '03? 9
The Mayor let that bill 14 become law without his signature. 15
And that bill 19 was approved by this City Council unanimously; 20 is that your recollection? 21
Have you been to any other signing ceremonies for bills?
So in the budget that you've sent up for FY '05, is there a wage tax bill in that budget?
No, because the wage tax -- the wage bill that we had from last year carried forward.
Yes. I think. I don't think it was. 366 04/21/04 - WHOLE - BILL 040255
The FY '05 budget that you sent up to us is proposed to shift the date --
But in previous years, every budget would have a wage tax bill 11 because we would change the rates every year, right?
I read in the Five-Year Plan that the Administration appears to support wage tax reductions; is that right?
And if the Administration did not support continued wage tax reductions, you would send us a bill that would stop the reductions; is that right?
So the fact that you've not sent such a bill to City Council would indicate that the Administration 367 04/21/04 - WHOLE - BILL 040255 supports the continued wage tax cuts; is that correct?
And does the Five-Year Plan indicate what the impact is of those cuts on wage tax revenues to the City?
There's language in the plan that indicates, I think, the combined impact of both the wage tax and the business privilege tax reductions.
No, we're just talking about the wage tax. Council didn't really attack the business privilege tax. Why don't you go to in the Five-Year Plan?
Is it true that for every fiscal year in the plan FY '04, '05, '06 '07, '08 and 09 that the wage tax anticipated collections to City or revenues to the City grow every year notwithstanding the present schedule of proposed wage tax cuts?
Yes. It grows -- each 368 04/21/04 - WHOLE - BILL 040255 year it grows based on a combination of what we anticipate will happen with wages and earnings, what will happen with employment and then what the impact of the cut would be. So those are the three --
Since the wage tax cuts have stared under former Mayor Rendell, have there been any years where the wage tax revenues from one year to the next have been less than the previous year?
Haven't been years where it's been less than year before. There are been years where it was less than inflation but not when it was less than the year before.
So the number that we hear out in the general public, the $227 million deficit, what is that exactly?
That is the couple accumulated gap between our revenues and expenditures over time.
The fund balance really -- I mean, it's a rolling number. So it's not 369 04/21/04 - WHOLE - BILL 040255 from any particular start date.
Hold on one second. I mean, it's a hard question to answer because if the wage tax rates hadn't been cut since '95, we would have been taxing people at the higher rate, so that argument would say you would have more revenue. On the other hand, argument --
No, but your question what's the impact tax cuts on the deficit. And you'd need an econometric model to answer that question.
I guess what I'm ultimately trying to understand is --
What I'm saying is there's some loss revenue from the cut in the 370 04/21/04 - WHOLE - BILL 040255 rate, but we wouldn't be doing this if we didn't think that there was some positive impact on the economy, so there's a benefit in that we have more jobs and more wages than we would have without it.
Well, there have been a number of proposals to either reduce services, close facilities, reduce or eliminate funding to groups and organizations as a result of our difficult financial situation in the City. As a budget director, would you recommend that we end the incremental reductions in the wage tax in order to avoid the cuts in services or the closure of facilities or the ceasing of grants to groups and organizations or operating budgets?
No. That's why the Five-Year Plan which includes those proposals includes a continuance of their reduction in those rates.
Well, let me ask the question in a different way. Is it a viable strategy for the City in an effort to 371 04/21/04 - WHOLE - BILL 040255 prevent either closure of facilities, restrictions in grants, elimination of funding to groups and organizations and the like, is it a viable strategy from your perspective as a Budget Director to in the course of these budget hearings to cease the wage tax cuts that are already articulated or detailed in the Philadelphia Code as a result of Bill 92?
What we've said in the Plan is that the wage tax reductions are necessary to continue to kind of make Philadelphia more competitive because our tax rates are not competitive. And so we recommend continuing those reductions even though it means that there are in the short term lower revenues which means that we have to make painful choices which we've included in this Plan.
So lastly, if the Administration felt so strongly that continuing the wage tax cuts was detrimental to the City's ability to operate or function or provide a certain high level of services, the Administration would then send a bill up 372 04/21/04 - WHOLE - BILL 040255 to stop the wage tax cuts?
That's right. If we thought that continuing the wage tax cuts would jeopardize our service to such an extent that it would hurt our competitiveness more than lowering the wage tax rates, that's what we would have recommended?
Because you believe that cutting the wage tax is important to the future of this City?
You're welcome. Any other questions from members of the Committee? (No response.)
The Committee of the Whole will stand in recess until Wednesday, April 28th at 9:30. Thank you. (Council adjourned at 5:25 p.m.) - - - - 374 C E R T I F I C A T I O N I HEREBY CERTIFY that the foregoing proceedings of the Council of the City of Philadelphia of Wednesday, April 21, 2004, were reported fully and accurately by me, and that this is a correct transcript of the same. RE: COMMITTEE OF THE WHOLE _________________________ Lisa C. Bradley, RPR