please proceed thank you just um Ms. Saleta we did um submit slides last week and they've been
updated and that's the and I sent those this morning so those are the slides you'll be seeing
this morning thank you you're welcome um so Ms. Garland can you
Thank you.
You're welcome.
So, Ms. Garland, can you tell the board the company you work for?
I work for Resources for Human Development under the Healthcare Division, which is Family Practice and Counseling Network.
And how long have you worked there?
I've been with the organization for five years.
And what is your position?
And my position is Center Director for the Family Health and Birthing Center Project.
Anne, can you explain briefly your educational background?
Sure. Through the College of Public Health, Temple University, I've been on a tenure as a
public health professional. I'm in a non-profit sector, being an advocate and champion of medically
underserved communities through program development, policy and procedural development
to ensure excellence in service delivery, operational oversight of departments and
teams while being responsible to uphold quality improvement mandates of federal and state agencies
such as JCO, NCQA, and HRSA. And can you explain what your responsibilities and duties are
with the Resources for Human Development
and Family Planning Consulting Network?
So leading community engagement strategies,
promoting services and partnerships for the network,
marketing and program oversight
of the Birth Center Project,
serving as center director right now currently
for the Annex West Health Center,
providing operational oversight
and clinical support across work lines.
Again, program development, grant writing, and program implementation.
And what is your experience with women's health and health issues?
And so aside from being a Black woman, lived experience, and being a mother,
providing clinical support for our prenatal program at FPCN.
Thank you.
And with that, I would like to qualify Ms. Garland as an expert in her field.
Thank you.
anyone else miss garland oh i'm going to proceed with miss garland if that's okay okay
okay miss garland the proposed birthing center is to be located in an existing tenant space at
6100 woodland avenue correct correct and can you tell the board what is a birthing center
so a birth center is defined per let's see
is defined as, and let me see, here we go, a facility that's not part of a hospital,
which provides maternal care to childbearing families, not requiring hospitalization.
It provides a home-wide care for maternity care, including prenatal care, labor delivery,
postpartum care services for medically uncomplicated pregnancies. And this is per
the pa department of health chapter 501 birth center general provision excuse me this is sharon
seleta and i apologize for interrupting again but before we get too far into this testimony
are if you're making the argument that this is also in the that the variance request is an
alternative that you believe that the permit should have been issued by right as an accessory
use to the existing center so if you are making that argument the board really can't rule on it
unless the law department participates so the alternatives are you can they can vote strictly
on the variance request today or we can schedule a resumption hearing where you would be able to
present all the information going to your argument that it is part of that it is not a hospital
and the law department would have an opportunity to respond.
We would like to proceed today, Ms. Saleta, on the variance request.
Okay, thank you.
Please proceed.
So, Ms. Garland, what other licenses or permits, local or state,
may be required to operate the birthing center in Philadelphia?
you? So through the American Association of Birth Centers, which is an organization that provides
clinical oversight for birth centers, we obtain a certification. We also obtain a licensure from
the PA Department of Health. It's a rigorous licensure process, not only for the facility
and the structural concept, but also for the clinical protocols of the birth center
operations as well. Thank you. So why is a birthing center being proposed at this location in Philadelphia?
Thank you. So why is a birthing center being proposed at this location in Philadelphia?
Because here in Philadelphia, maternal mortality is poor, despite the highest expenditures for birth.
Also in the U.S., but in Philadelphia specifically, specifically for Black women, outcomes are poor.
and we want to do our part to combat what's called a maternal mortality crisis here in Philadelphia.
There's been a groundswell of connections and conversations and initiatives across
birth workers, hospitalists, and civic leaders as well. And so we know that vulnerable communities
could use a service like this to ensure and promote wellness and well-being and vitality
for families across Philadelphia. Can you do me a favor, Ms. Garland, and just move down to where
some of those statistics are? Thank you. And will this proposed health center and a proposed
accessory birthing center be for women only? Yes. And does a patient of the birthing center
have to be a patient of the health center? Yes. Will the birthing center be in the same area
location as the proposed health center? Yes, it will be co-located. Okay. Are there, is there
anything on this slide where you have these statistics that you haven't addressed for the
board? Yes. So just in terms of comparison to hospitals at a birth center, birth usually costs
anywhere from around $2,200 as compared to within a hospital at $10,000. Birth center concept,
it applies low-tech, high-touch, whereas in a hospital, it's high-tech and low-touch.
Black women are three and four times more likely to die giving birth. And here in Philadelphia,
again, maternal mortality amongst national cities in the U.S. is at 73%, and infant mortality is 8.3
out of 1,000 births. Ms. Garland, how will the birthing center be laid out and laid out in relation
to the health center we're proposing? Right. So here's a floor plan of the birthing center,
And so it's going to be co-located with the Women's Health Center.
And so you can see up at the top here, this is the Women's Health Center space.
It will consist of eight exam rooms, consultation rooms, to be able to provide those clinical services for women across the lifespan, prenatal care services, postnatal care services.
um and down here in this area here is the actual birth center so there is a separate and designated
uh entrance to either of the spaces here is where the women's center entrance is and over here is
where the birthing center entrance is and the birthing center will consist of three birthing
suites and they'd be um fitted with uh birthing tubs they're made again to provide a home-like
feel, and so there'll be linens and beds, again, to promote a more home-like setting
in these spaces. Also, there's going to be a family room here that can provide
a pantry for cooking and a waiting area for family members as they're waiting for their
bundle of joy to arrive. Okay, will any patient be permitted to enter the birthing center, or is
there some admittance requirement to enter the birthing center? Generally speaking, unless you're
having a birth or perhaps attending a child centering class or a lactation meeting with
lactation consultant, no one would be permitted into the birthing center unless a scheduled
visit was to occur. Generally, the women's health center would provide services Monday through
Friday from 9 to 5. Okay and how big approximately is the birthing center? So the birthing center is
approximately 3,000 square feet, maybe 4,000 square feet. I apologize. I think the entire
structure is of just about 9,000. So about 4,000 square feet. Okay and can you just tell us what
the follow-up services are for the patient post-delivery? Sure. For patients, both mom and
baby, there'll be an assessment done, again, by clinical midwives, and those are advanced
practical nurses that specialize in childbirths and, again, prenatal care.
that specialize in childbirths, and again, prenatal care, antenatal care, postpartum services.
So there'll be assessment of mom and baby, there'll also be screenings to, you know,
assess for, you know, violence, to assess for post-traumatic, postpartum depression,
and then, you know, birth weights and overall wellness of mom and baby post-birth.
Okay. And what is the protocol for post-delivery, for example, for sanitizing and cleaning the
birthing room and equipment? So generally speaking, for something like that, we would
contract with a vendor. We do this for each of our health centers right now where any medical waste
is picked up and removed from the premises immediately. And so especially now given COVID,
we've enhanced our services to ensure that spaces are sanitized and
to eradicate any infectious disease. And there's a, do you have a private
waste haul or mine for this birthing center and health center? Yes.
and there are parking accommodations nearby for the birthing center yes this space uh it has its
own um parking lot um you show the um kind of the uh schematic of the uh woodland village plaza so
this kind of it has it's it's it's how do i say it's it's adjacent to the other um businesses
within that corridor. And it, it's great because it has its own kind of entryway. It's kind of,
it's private, it's, it's set, you know, off to the side. And so, you know, it allows for folks
to specifically use the birthing center and allow for specialized parking in that particular space.
Okay, and Ms. Garland, can you explain what the security measures are that are in place
or proposed for inside or outside the tenant space building if a patient needs to leave
the birthing center for the hospital or needs to leave the birthing center after hours?
Right.
So security, we do provide security nine to five.
We call them security advocates.
And so they provide security for the space.
They're not armed.
And so that's from nine to five.
Now, in the case of a birth that occurs outside of that window, we will have an on-call team.
The security advocate will also be a part of that team to ensure safety into the space during off hours.
There are also going to be key card entry ways where staff is going to have access to each of the spaces.
There will be security cameras throughout the space as well.
And the parking lot will be well lit for any evening or overnight visits.
Okay. And can you just briefly explain how a patient may learn about the birthing center?
So we take pride in our networks and connections and collaborate collaborative partners.
So if it isn't through their insurance, it would be by way of referral.
We also will be embarking on a very rigorous marketing campaign.
We've garnered support from earth workers and civic leaders who are in this line of
work as well that understand, you know, the importance of this particular service line,
especially with the closure of Hahnemann Hospital and now having to give birth out of six sites as
opposed to the once seven. And so we look forward to be able to providing the service for women of
Philadelphia. Okay, thank you. Now, Ms. Garland, in your opinion, as a public health professional,
Will the grant of the variants have a negative impact on the public health, safety, and general welfare?
No, it would absolutely work to enhance community wellness.
Thank you.
And in your opinion, will the grant of the variants substantially or permanently impair the appropriate use or development of adjacent properties?
No, we feel that this would certainly be able to enhance the Woodland Village Plaza,
The Woodland Village Plaza, the space that we are talking about here, has been vacant for some time,
the space that we are talking about here has-
and again with this unique and new service line, coupled with our adjacent health annex clinic
that we'll be talking about a little bit later, we'll be able to again promote wellness for
families throughout Philadelphia. So in your opinion, the grant of the variance to allow
the birthing center will alter the essential character of the neighborhood? It won't alter
the character of the neighborhood. We look forward to enhancing where we are. We've been here in this
space, again, with our health annex clinic for about 15 years. We serve 24,000 patients across
Philadelphia at the health annex. We take pride in being a community stakeholder, and so we look
forward to community partnerships to help steer this project along the way and thank you and
finally uh miss garland in your opinion will denial of the variance create a hardship for
resources for human development and fpcn yes it will we've come so far this has been a five-year
conversation and a five-year journey for us and um granting this variance will absolutely
allow us to be able to provide this service to, again, to join in others who are working to combat
maternal mortality here in Philadelphia, specifically for women and families of color.
Thank you, Ms. Garland. With that, I'd like to have Rebecca Bixby.
Briefly, Ms. Quigley, not to be rude, we got support letters from, you know, the community.
so right okay thank you i would like to hear also from the council person if it's possible
okay great thank you um so miss bixby can you just um briefly give us some background your
educational background bixby can you uh please identify yourself for the record
Yes. Hi, Rebecca Bixby, R-E-B-E-C-C-A, last name B-I-X-B-Y.
Thank you. You swear to affirm to tell the truth, the whole truth for nothing but the truth?
Yes, I do.
Thank you.
So, Ms. Bixby, what is your position with RHD FPCN?
I'm the executive clinician and director of primary care for FPCN.
And can you explain your educational background?
I am a nurse practitioner. I received my master's degree from the University of Pennsylvania as
well as my bachelor's degree there. And can you explain briefly what your responsibilities and
duties are with RHD? I oversee the primary care department, which includes prenatal care.
I coordinate with our other departments across behavioral health, integrated behavioral health,
and dental care. And what is your experience with women's health and health issues?
I was a prenatal care coordinator and women's health nurse over 15 years ago and I have overseen
again primary care and prenatal care programs for the last 10 years. I gave birth in a birth
center five years ago and we have been working very closely with our midwives
and other colleagues and consultants on this project. Thank you. With that I would like to
qualify Ms. Bixby as an expert in her field. Thank you. Thank you. So, Ms. Bixby, can you
briefly explain the model on which the birthing center is based?
Yes. So, FPCN is very well positioned to open this birth center with the collaboration of an
experienced federally qualified health center with wraparound services that are community
located and community-specific, combined with our 14-year partnership with Penn Family Medicine
as our prenatal care provider, and the midwives who have been trained to attend births at the
University of Pennsylvania. These midwives will now be able to provide prenatal care
and attend births on site in a family-like atmosphere, a home-like setting for our patients
with wraparound services, including labor support with doulas.
So can you just tell the board who would be staffing the birthing center?
So there would be nurse practitioners who have an additional certification in nurse midwifery.
There would be nurses, medical assistants, and labor support in the form of fully trained doulas.
And for the postpartum, there would also be nursing support, lactation counselors, social workers, and behavioral health.
lactation counselors, social workers, and behavioral health counselors.