COUNCIL OF THE CITY OF PHILADELPHIA2 COMMITTEE ON PUBLIC HEALTH AND3 HUMAN SERVICES4 5 6 Room 400, City Hall7 Philadelphia, Pennsylvania Tuesday, November 16, 20108 1:45 p.m. 9 10 PRESENT: COUNCILWOMAN DONNA REED MILLER11 COUNCIL PRESIDENT ANNA C. VERNA COUNCILMAN DARRELL CLARKE12 COUNCILMAN W. WILSON GOODE, JR. COUNCILMAN JAMES KENNEY13 14 BILL 100489 - An Ordinance authorizing the15 City of Philadelphia to organize an authority to be known as The Philadelphia Health Center16 Authority... 17 BILL 100634 - An Ordinance amending Section 9-622 of The Philadelphia Code, entitled18 "Cigarettes and Tobacco Products," by revising the acceptable forms of identification...19 20 - - -21 22 23 24 25 2 1
Hi. Good2 afternoon. The Committee on Public3 Health is now in session. We have a4 quorum. I am Councilwoman Donna Reed5 Miller. Councilwoman Tasco is out sick,6 I believe, today. And to my right we7 have Councilman Wilson Goode. To my8 left, Councilman Jim Kenney and Council9 President Anna Verna.10 Can the Clerk read the title of11 the first bill.12 (Off-the-record discussion.)13
So will14 the Clerk read the title of both bills.15 Thank you.16
Bill No. 100489, an17 ordinance authorizing the City of18 Philadelphia to organize an authority to19 be known as The Philadelphia Health20 Center Authority, pursuant to the21 provisions of the Municipality22 Authorities Act, Title 53, Pennsylvania23 Consolidated Statute Section 5601, under24 certain terms and conditions.25 3 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 Bill No. 100634, an ordinance2 authorizing Section 9-622 of The3 Philadelphia Code, entitled "Cigarettes4 and Tobacco Products," by revising the5 acceptable forms of identification; and6 by increasing the penalties for7 violations; all under certain terms and8 conditions.9
Thank10 you.11 We have a couple of panels, and12 for Bill No. 100489, the first panel is13 Dr. Donald Schwarz, Cathy Scott, Natalie14 Levkovich. Will you please come up to15 the witness table and state your name and16 any other identifying information. Make17 sure you pull the mike close to you so we18 can hear you, and proceed with your19 testimony.20 (Witnesses approached witness21 table.)22
You can23 proceed in the order in which I called.24 Thank you.25 4 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
Good afternoon,2 Councilwoman Reed Miller, members of the3 Committee on Public Health and Human4 Services. I am Donald Schwarz, the5 Health Commissioner. 15 You have heard me state on many16 occasions that our City's eight17 ambulatory health centers provide more18 than 350,000 visits to almost 91,00019 people throughout Philadelphia. About20 half of our patients do not have health21 insurance. 1 prenatal care, care for those with HIV2 and AIDS, and traditional public health3 services like immunizations, treatment4 for sexually transmitted diseases,5 treatments for tuberculosis. 9 Our busiest health center10 remains Health Center No. 10 at 223011 Cottman Avenue in the Northeast. The12 center alone averages about 60,00013 patient visits each year. It also has a14 disproportionately long wait for new15 patient visits, as we've talked about16 here before, in excess of 250 days. As I17 have told this Committee and the18 Committee of the Whole during the Health19 Department's budget hearings, we've tried20 very hard to find ways either to increase21 the service that we offer or to reduce22 the demand at Health Center No. 10 in23 order to reduce waiting times. 1 because of budget issues that have2 resulted in funds intended to increase3 capacity at Health Center No. 10 being4 lost, and second because there are no5 other federally qualified health centers6 in the Health Center 10 area. 2 billion in18 new funds to create new federally19 qualified health centers. As you know,20 the City's own health centers are what21 are called federally qualified look-alike22 health centers. 1 center and we are not eligible for new2 dollars to build new centers that are3 look-alikes. The reason that we have4 look-alike centers is that our current5 centers are fiscally responsible to the6 City's General Fund, and the Department7 is responsible for staff selection and8 hiring. Each has a community board, but9 the boards do not have fiscal or10 personnel responsibility. 15 The purpose of Bill 100489 is16 to create a new administrative structure17 that sits outside of City government that18 is fiscally responsible and could oversee19 community boards and fully federally20 qualified health centers in neighborhoods21 with high need, like the Northeast. 3 At the same time, such an entity would be4 more appealing to private and foundation5 funders, whose support would be needed6 for the capital required to create a new7 health center. 18 We have no plan to do that, but if it19 were ever considered, this would, of20 course, require extensive consultation21 with Council. 9 Thank you for allowing me to10 present testimony on this important11 issue. 13
Thank14 you. We'll hear from everyone before we15 have questions.16
My name is Judy17 Hoover from District Council 47. I'm18 here for Cathy Scott, who was unable to19 come today, and we have several questions20 about the Health Center Authority bill.21 Several people have given us different22 ideas of what it was about. One person23 said -- staff people have said they24 didn't know. Other people said that it25 10 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 was to get money for the federal health2 centers. Another person said it was --3 Mr. Schwarz, I believe, told Cathy Scott4 that it was for the purpose of building5 just one center in the Northeast because6 of the amount of people that are being7 served by the Northeast Health District8 10. And what we are looking for is clear9 information, and if it is for only one10 center, we would like the ordinance to be11 amended to show that it's only for one12 center, but if it's a legal vehicle to13 eventually put all centers under that14 Health Center Authority, we'd like some15 union input on this and we would like to16 know why we weren't given input in the17 first place and how it will affect our18 union members and will our sustainability19 clause in our contract cover their union20 membership. There's a lot to be said21 there. If there's a chance that any of22 the health centers would be replaced by a23 center that would go under the Health24 Center Authority, as Mr. Schwarz said25 11 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 there's no plan to do that now, but that2 doesn't mean that there won't be any in3 the future and this is supposed to be the4 legal vehicle to do that.5 We'd like to know what section6 of the new Healthcare Act they're7 referring to when it says that 2.28 billion funds would be available and how9 Philadelphia would be able to acquire any10 of that portion of that Act. I know the11 federal Healthcare Center Act right now12 for federal health centers for new13 start-ups, that you're allowed to get14 money under the laws at presently, states15 is the cap is $650,000. So if it isn't16 much more than $650,000, how will the17 City of Philadelphia fund the rest of the18 new health center and the staff, et19 cetera? Six hundred and fifty thousand20 dollars is certainly not enough to fund a21 new health center.22 And we just want to know what23 the plans are. Is it for one center? Is24 it for all centers? Is it only for --25 12 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 will only federal health centers be under2 this Authority? Will eventually the3 look-alikes be under the Authority, too?4 What exactly is the long-term plan and5 how is it going to be funded?6
Good afternoon.7 Thank you for this opportunity to testify8 today regarding the creation of The9 Philadelphia Health Center Authority. I10 am Natalie Levkovich, Executive Director11 of the Health Federation of Philadelphia.12 The Health Federation is a consortium of13 community health centers in the14 Philadelphia region, including non-profit15 federally qualified health centers and16 the City health centers. The17 Philadelphia Department of Public Health18 was a founding member of the Health19 Federation when it was originally20 established in 1983 and has been a21 continuous member and partner.22 The City health centers play a23 critical role in assuring access to care24 for Philadelphia's most vulnerable25 13 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 residents. At its eight health centers,2 the City serves 91,000 patients, or3 approximately one-third of the 270,0004 total patients who currently receive5 primary care through community health6 centers in Philadelphia. We can7 anticipate that need for and use of8 health center services will increase9 dramatically by 2014, when federal10 healthcare reform is fully implemented.11 As previously uninsured individuals gain12 coverage, they will seek access to the13 healthcare system for non-emergency care.14 In many neighborhoods, community health15 centers are the most accessible and16 attractive option for care. The National17 Association of Community Health Centers18 projects that the number of health center19 patients will double nationwide by 2014,20 making it essential that as a city we21 aggressively plan for growth.22 Right now, even before we feel23 the effects of healthcare reform, there24 is a critical need for additional access25 14 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 to care in Northeast Philadelphia, which2 was a need that was not anticipated when3 our current network of safety net4 providers was established. Regrettably,5 City funding is insufficient to simply6 build and operate a new health center to7 relieve the growing pressure on8 Healthcare Center No. 10. We also9 understand the limitations the Health10 Department faces regarding its ability to11 raise private or gain access to federal12 funds to expand health center services.13 The proposed Health Center Authority14 would be one answer to this dilemma.15 Today, the acute need is for a16 health center in the Northeast. In the17 future, however, as populations of18 low-income, publicly insured and19 uninsured residents shift and more of20 these individuals enter the healthcare21 system, there may be additional need to22 develop new or relocate existing health23 center services. A review of demographic24 data clearly indicates that low-income25 15 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 populations are migrating to previously2 middle-class communities, and3 higher-income residents are moving into4 previously poor neighborhoods. While5 these shifts occur gradually over time,6 we do not have a current mechanism to be7 proactive in redistributing resources8 accordingly. The creation of a public9 authority that can raise funds and target10 those funds to where the unmet needs are11 greatest will ensure the City's ability12 to plan and implement service expansion13 as indicated by population health needs.14 Therefore, I support passage of15 Bill No. 100489 and commend you for16 considering this strategic approach to17 solving a serious public health18 challenge.19 Thank you.20
Thank21 you.22 Dr. Schwarz, you heard some of23 the questions that District Council 47,24 correct --25 16 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
-- the3 representative from Cathy Scott asked?4 And maybe we could just start there, with5 answering some of those questions.6
9 So I want to make sure that I10 have the questions. One was a question11 about is it one center only, and I have12 to say that my current vision about need13 in the City is that there is one14 neighborhood in particular right now15 where we have a particularly acute need16 as measured by waiting times. So as you17 know, waiting times are long at all of18 our health centers, but they are very19 disproportionately long at Health Center20 10. And what we know from population21 data is that the population of people who22 are uninsured is growing rather quickly23 in the Northeast. 1 If need in the future would suggest that2 more centers are needed and we can't find3 anyone willing to do it, there may be4 another center in the future. 10 We haven't had a new health11 center in Philadelphia under the City's12 auspice in a long time, and the general13 reason for that is the leap that is14 needed for raising capital. I have tried15 to do so, and I'm acutely aware of the16 limitations that we have as a city for17 raising capital for a new health center18 operated by the City. 20 So is my own intention to open21 a whole fleet of health centers? 1 heard was how we would fund such a health2 center. Private funding of some sort3 would be required. I don't anticipate4 given the state's budget and I don't5 anticipate given the federal budget that6 there's going to be a lot of easy access7 to capital, large capital, and I think8 it's going to have to come from the9 private sector. 13 So in terms of funding, the14 construction, the construction would need15 to be funded with private money. 1 piece of the Act has it, but I'm happy to2 send the citation to you and I'm happy to3 send the citation to Cathy so you can4 read it. And there are -- I can tell5 you, The Health Resources and Services6 Administration now has out its second, I7 believe it is, request for proposals8 using that funding and it specifically9 references the money that was set aside10 through the Health Reform Act. 13 And the third thing I heard was14 concern that we would move all of our15 existing City health centers into the16 Authority. The biggest check I have to17 say on that is the amount of subsidy that18 the City currently provides, and that19 comes through the budget, which Council20 reviews and votes on. No health center21 could feasibly, existing health center,22 could feasibly be moved under any23 structure without Council's approval24 because of the budget process. 1 should be some level of assurance, that2 we would be back in this room again to3 have a conversation about how those funds4 would be moved from a General Fund to5 another area, and there's no way around6 that. 10 I don't at the moment11 anticipate that this would happen. I12 will say the one incentive, which I've13 talked with this Council about in my14 budget hearings, is could we draw down15 dollars for federally qualified health16 centers, and the reason we have not been17 able to is, as outlined in my testimony,18 we don't have boards for our health19 centers that have fiscal responsibility20 and personnel responsibility. 1 it. 5 So is there a reason to think6 about it? I think there's a reason to7 think about it. 9 There isn't. 13 We could only apply for those14 dollars so long as the federal government15 had them to give for new centers. 2 billion provides some opportunity,17 but according to the lawyers and18 consultants who we've talked to over the19 past three years since I've been asked by20 this Council and asked myself about this,21 we would only be able to do one center at22 a time. So if we wanted to move a center23 into the Authority, we could talk about24 it. 1 it. We could look at the financials2 together. We can talk to the union about3 what we do in terms of the labor force4 and guarantees and other things, and all5 of those things would be necessary, but6 the amount of money to do it is7 relatively small for one of our existing8 health centers. 12
What13 would be the advantage of -- I mean, I14 know why you want to do the one center.15
Because17 of the need. But what would be the18 advantage of or would there be an19 advantage of all making the existing20 health centers federally qualified?21
So one at a time,22 probably one per year over eight years,23 if we ever wanted to do it, could be24 moved, if we had boards and everybody25 23 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 agreed to it and we had labor and2 everything else agreeing. And to do3 that, we would get about -- Natalie4 Levkovich knows better than I do -- about5 $600,000 for operations.6
Up to $600,0008 and $130,000 in capital, about. So less9 than a million dollars. Our supplement10 for a health center now is on average11 about 3.2 million, going as high for some12 health centers as over 5 million. So it13 would help, and particularly when we were14 in the midst of the worst of our budget15 difficulties, we certainly thought about16 it. The timing is very difficult. It17 can't happen quickly because of the18 availability of federal dollars and the19 issue of doing it one at a time.20
Would21 this be a freestanding health center?22 For example, you said that -- or someone23 said that one-third of uninsured folks go24 to City health centers.25 24 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
It's between a2 quarter and a third, and I don't know3 freestanding. I think -- we've not4 looked for a facility, but presumably it5 could be freestanding or it could be6 associated with another City structure.7
And the8 other two-thirds are going or, whatever,9 three-quarters, two-thirds or10 three-quarters, are going to community11 health centers such as like Covenant12 House or we have one on Hunting Park13 Avenue, I think that's run by Greater14 Philadelphia Health Action --15
Would20 those -- if you get the funds for a new21 health center, would the employees there22 be freestanding, non-civil service?23 Would they be unionized? And what role24 does the union play in any of this in25 25 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 terms of your discussions now and in the2 future?3
Okay. So I don't4 know the answer to that, chiefly because5 a new health center under an Authority6 would have to have a community board that7 would have decision-making authority over8 staffing and over the budget. So9 presumably there would be a conversation10 between that entity and either the City11 union, another union or no union,12 depending on what happens.13 There's a plus and a minus of14 having something outside government. The15 plus is, it could exist at all. The16 minus is, it has autonomy in a certain --17 to a certain extent, and that autonomy18 means there would have to be conversation19 at that time.20
Just24 briefly. To be federally qualified, is25 26 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 there just a requirement that there be a2 community board that's fiscally3 responsible or is there a requirement4 that there be a certain level of5 independence from government?6
That's a great7 question. So there are a lot of8 requirements. In order to be a9 look-alike, we meet many of them. So we10 do have community boards. The community11 boards meet the criteria that are set by12 the federal government in terms of13 membership, so representing the consumers14 and so forth, but decision-making15 authority over financing and personnel is16 a critical function for a board of a17 fully federally qualified health center.18 And your other question -- your19 question related to that is?20
What level21 of independence does there have to be22 from government?23
So there is an24 entity that exists in the body of25 27 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 federally qualified health center types2 where a public entity can be providing3 financial support, okay, but the4 decision-making on -- so the City could5 say or the Authority could say there's6 this much money in the budget available,7 but the board has the ability then to8 make decisions on its own use of those9 funds.10
So the City11 can invest in the Authority and the12 Authority can invest in the community --13
Health center,14 and the community board then makes15 decisions about procurement of paper and16 whatever else it will be.17
Thank21 you.22 What are the current hours of23 public health centers?24
They vary. In25 28 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 general, we are 8:00 or 9:00 in the2 morning until 5:00 at night, with one3 evening a week, and for, I want to say,4 two of them, but it may be one of them5 because we've cut back a little, there's6 a weekend, a Saturday.7
I8 happened to be out early one day -- and I9 think I told you this before -- on10 Chelten Avenue and I could not believe11 the number of people in line to go to12 Health Center 9 at like 6:00 a.m. It was13 unbelievable the number of people14 outside.15
That line exists16 at every one of our health centers every17 day. And the good news is, we serve18 those folks. The bad news is, I don't19 think the level of dignity that people20 have having to wait for us in the rain or21 the heat or anything else is what any one22 of us would want, but at least we're able23 to provide service, and the alternative24 in many cases is no service.25 29 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
That's2 right. And so that's why I was wondering3 about the hours, maybe expansion. I know4 that costs dollars.5
We, as you know,6 have tried now for our last three budgets7 to expand the hours in health centers,8 and every time we think we're there,9 someone finds that we need to cut our10 budget. So we've maintained what we11 have, and we're very pleased with that,12 and we've actually had some minimal13 levels of service-type expansion. So14 dental care, for instance, has been15 preserved and there was a plan to keep16 it. It's been able to be preserved. But17 we haven't been able to do the kind of18 service time expansion.19 In addition, for Health Center20 10, for instance, there would need to be21 investment in capital in order to expand22 space somewhat, and we haven't had that23 either.24
Okay.25 30 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 All right. Thank you. I want to thank2 you for your testimony.3
I just wanted to7 let you know that Cathy Scott will be8 giving her response in writing at a later9 time.10
She could11 just send it to the Chair. Thank you.12 That's it, I guess.13
You're on15 the next one, too? Okay. Let me just16 get to the next one.17 We will now hear testimony on18 Bill No. 100634. Our first panel will19 include Dr. Donald Schwarz, Raechelle20 Walker-Ellis. Raechelle. How do you say21 your name?22
Raechelle.23 (Witness approached witness24 table.)25 31 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
Thank you. Good5 afternoon, Councilwoman Reed Miller and6 members of the Committee and staff. 12 Curbing youth smoking is no13 doubt a nationwide challenge, but here in14 Philadelphia, the problem is particularly15 serious. Approximately half of16 Philadelphia high school students have17 smoked a cigarette at least once in their18 lives. Studies show that one-third to19 one-half of youth who try a cigarette20 even once will become daily smokers as21 adults. 6 Nearly 11 percent of7 Philadelphia high school students8 currently smoke, defined as having smoked9 one cigarette in the past 30 days. The10 rate is over 30 percent for white high11 school students in the City. 17 Sadly, it's no wonder that we18 have before us a serious youth smoking19 problem. You see, at the root of the20 issue of youth smoking is youth access to21 cigarettes. 23 Currently, over 4,300 tobacco retailers24 are licensed in Philadelphia. 8 Importantly, tobacco retailers9 are located where children spend most of10 their time during the day. More than11 three in four tobacco retailers in12 Philadelphia are located within 1,00013 feet, about two blocks, of a K-to-1214 school. 17 There is no more effective way18 of preventing a child from lighting up19 than to ensure that he can't get any type20 of tobacco product in the first place. S. cities. Local investigations4 conducted by trained, undercover youth5 reveal that one in five attempts to6 purchase cigarettes or cigars are7 successful. In recent years, illegal8 sales rates have been as high as 409 percent in certain parts of the City. 17 This is one month, and it includes a fair18 amount of tobacco products. This is a19 small number of kids employed through the20 Department to purchase in stores in21 Philadelphia. 2 Section 9-622 of The3 Philadelphia Code, as is currently4 written, allows a merchant who sells5 tobacco products illegally to a minor to6 pay $100 to admit the violation and waive7 appearance before a Municipal Court8 judge. It is $100 regardless of how many9 times a merchant has previously broken10 the law. A striking example of the11 current law's deficiency is a merchant12 who sold cigarettes illegally to youth13 seven times in a span of two years. This14 is only an undercover youth. This was,15 as mentioned, undercover, and we only16 found this retailer repeatedly through17 review of the Department's current18 violators. 14 The Department of Public15 Health, in coordination with Licenses and16 Inspections, has previously shut down17 businesses that repeatedly sold18 cigarettes to minors. This was19 accomplished through the City's powers to20 abate nuisance. 6 The state's youth sales law provides a7 powerful deterrent to selling illegally8 to minors. In Pittsburgh, the youth9 sales rate is zero percent. In10 Pittsburgh, people don't sell to kids. A11 first offense can bring a court-mandated12 fine of up to $500. 14 A third offense mandates a violation15 ranging from $1,000 to $3,000, and a16 fourth or subsequent offense mandates a17 fine of at least $3,000 and a maximum of18 $5,000. 1 law in Philadelphia would add up to 1,0002 cases per year in Municipal Court, making3 it costly and infeasible. Instead, Bill4 100634 strengthens the City's own tobacco5 youth sales law by increasing the penalty6 for a violation from $100 to $250. 9 This bill will help10 Philadelphia catch up to other11 jurisdictions in the state. 18 The Department recognizes that19 increased penalties alone will not bring20 down the high smoking rates among youth21 in Philadelphia. That is why we're22 moving on several different fronts to23 shield our children from these dangerous24 products. 1 objectives is the education of merchants,2 providing information and training about3 what the law is, its purpose and methods4 for checking identification and refusing5 sales to minors. 11 These educational interventions are being12 offered to every merchant that violates13 the law once.
They are occurring in14 person, on site, at businesses within 3015 days of the violation. 1 citations to violators. Youth2 investigators currently assist the3 Department in identifying merchants that4 sell to minors. Previously when a5 merchant sold illegally to a youth6 investigator, a citation was issued by7 mail and would sometimes arrive several8 weeks after the date of inspection. The9 Department has since made changes and is10 now beginning to implement a system11 whereby code violation notices will be12 issued in person within 48 hours after13 the date of inspection. 19 In sum, the Department is20 tackling the youth smoking problem on21 various fronts, but we simply cannot22 ignore the reality that many merchants23 see the current $100 violation amount to24 be the cost of doing business. 2 Merchants that sell to minors profit3 enormously from this illegal activity and4 endanger the lives of our youth. 8 And as previously mentioned, most9 violators break the law repeatedly. 14 Thank you for allowing me to15 testify on this important issue. 17
Thank18 you. Again, we'll wait until both people19 testify.20
Good21 afternoon, Councilwoman Reed Miller and22 members of the Public Health and Human23 Services Committee of City Council. 3 The Youth Commission serves as a voice4 between Philadelphia youth and City5 government. 11 As a young girl growing up in12 North Philadelphia, I was raised in a13 family of cigarette smokers. Both mother14 and grandmother, who were my primary15 caregivers, and two of my uncles were16 smokers. As cigarette smokers and17 individuals addicted to tobacco, my18 family members would smoke inside of our19 house, during family gatherings, inside20 of cars and anywhere else that they felt21 the urge, without concern for who was22 around or how the harmful smoke would23 affect them. 2 Shamefully, I can even recall trips that3 I have made on behalf of a family member4 to pick up cigarettes from the corner5 store. These transactions were ones that6 were made all too easily, because all I7 had to do was remind the merchant that8 the cigarettes were for a family member9 and the merchant would oblige. So with10 no real fear of significant consequences,11 community merchants frequently sold12 tobacco products to me as an underage13 minor. S. cities. 1 of youth who purchase their own2 cigarettes. Recent studies show that3 one-third to one-half of youth who try a4 cigarette even once will become daily5 smokers as adults. It is no secret that6 tobacco has negative health effects on7 the human body. People who engage in8 smoking have an increased risk of lung9 cancer and other smoking-related cancers,10 reduced lung function, heart disease,11 stroke and lung disease. And more deaths12 are caused each year by tobacco use than13 deaths from HIV, illegal drug use,14 alcohol use, motor vehicle injuries,15 suicides and murders combined. 1 tobacco products. In a city where one in2 three youth smokers buy their cigarettes3 themselves and 75 percent of tobacco4 retailers are located within two blocks5 of a school, it is evident that youth's6 accessibility to tobacco products is7 significantly high. 12 Currently, merchants who are13 caught selling tobacco products to14 underage minors face a meager fine of15 just $100. This fine is too small to16 serve as a penalty for something that is17 not just unethical, but facilitates the18 process of young people engaging in risky19 health behaviors. 1 for these tobacco retailer and thus is2 not much of a deterrent for illegally3 selling tobacco to youth. So how can we4 really expect merchants to not want to5 make a profit off of selling tobacco6 products to minors when the legal7 implications are not harsh enough to8 discourage anyone? Clearly, there needs9 to be stronger fines and legal10 consequences for merchants who sell11 tobacco products to minors. And with12 that said, we, the Youth Commission,13 respectfully ask that you support Council14 Bill No. 18
Thank19 you. Thank you both.20 Young people -- what is that21 Newports in the green and white box?22
They seem24 to like those or is that a special pack25 47 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 or something?2
Okay. I5 have a question. Is the legal age 18 or6 21? Underage means 18 or 21? Is it the7 same for alcohol as tobacco?8
Eighteen,10 okay. And what part of the City had 4011 percent of the merchants selling more to12 minors than any other part?13
Okay.15 Since I'm the only Committee member here,16 I don't have any other questions. We're17 just going to move on to the next panel.18
Thank21 you.22 The second panel will include23 Sterlen Barr, Dr. Lawrence Robinson,24 Denise Salerno, Robert Simmons, Lisa25 48 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 Ulmer and Sara Kinsman. We only have2 three seats, but we can share. Please3 come up to the witness table.4 (Witnesses approached witness5 table.)6
I know7 that Sterlen Barr has to leave early, so8 we'll have him go first.9 Pull the microphone up close10 enough so we can hear you and identify11 yourself for the record and proceed with12 your testimony.13
My name is Sterlen18 Barr. I'm a health educator and19 prevention specialist with Rapping About20 Prevention, Incorporated.21 As a health educator, I've22 worked in tobacco control for the past 1923 years. Over 18 years have been with the24 Health Promotion Council of Southeastern25 49 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 Pennsylvania. While there, I was2 actively involved in the initial passing3 of the bill that would restrict youth4 access to tobacco in Pennsylvania with5 Senator Allyson Schwartz in 1995. A lot6 of progress has been made since the7 passing of the bill, but we still have a8 long way to go before we can have a9 smoke-free society.10 I found that merchants are more11 likely to obey the law if it has a strong12 enforcement component. Therefore,13 increasing the fines for stores that14 break the law and sell tobacco products15 to minors or to youth would truly make a16 difference in our neighborhoods. Since17 most adults started smoking as preteens,18 it is vitally important for us to make19 penalties stronger for people that break20 the law and sell tobacco products to our21 youth.22 Tobacco use is the number one23 preventable cause of death in the United24 States, and I believe that if we can stop25 50 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 the sale, we can prevent the addiction.2 I strongly urge City Council to3 pass legislation that would increase4 fines to merchants that break the law and5 sell tobacco products to minors. I also6 believe that if we had stronger laws and7 stiffer penalties, I may still have my8 dad and my grandmother, who both died9 from lung cancer as a result of smoking.10 Thank you.11
Thank12 you.13 Hi. How you doing?14 Dr. Robinson, you want to go next?15
Okay. Good16 afternoon, Councilwoman. 2 Statistics demonstrate that one3 in three youth smokers in Philadelphia4 buy cigarettes themselves. A recent5 citywide investigation reveals that6 approximately 20 percent of tobacco7 merchants in the City sell cigarettes8 illegally to youth. 12 You are well aware that without13 Bill 100634 merchants simply pay $100 for14 each violation, whether it's the first,15 third or seventh time that they have16 broken the law. S. cities. S. S. 20 A child can't smoke cigarettes21 if they can't get access to it, and so22 that's why it's very important to prevent23 access. 3 Approximately 50 percent of4 Philadelphia high school students have5 smoked at least one cigarette in their6 lifetime, and studies show that one-third7 to one-half of youth who try a cigarette8 even once will become daily smokers as9 adults. The penalties for merchants that10 sell to minors is way too low, and a $10011 violation is really just a slap on the12 wrist and there should be an increase,13 whether it's the first time, the third14 time or the seventh time. 17 And, finally, law-abiding18 merchants are at a competitive19 disadvantage. So people who really20 follow the law and don't sell the21 cigarettes because the fine is so low,22 it's not even an incentive for them. 1 endanger the lives of our youth, and2 others that comply with the law are, in3 effect, penalized. 6
Good afternoon,11 Councilmember Reed Miller. My name is12 Denise Salerno and I've been a practicing13 pediatrician here in Philadelphia for the14 last 17 years. I'm also a Professor of15 Pediatrics at Temple University School of16 Medicine, where I'm actively involved in17 educating our future doctors. Today,18 though, I am here as a representative of19 the Pennsylvania Chapter of the American20 Academy of Pediatrics. As you may know,21 it is an organization that represents22 over 2,200 pediatricians in the State of23 Pennsylvania. 9 Surgeon General have identified numerous10 harmful effects of tobacco. 16 I'm here today to tell you that no one is17 more susceptible to that harm than18 children. Their developing respiratory19 systems are extremely vulnerable to20 tobacco smoke. 1 Nearly 40 percent of the2 pediatric population is exposed to3 second-hand smoke. "12 It is a public health priority13 to keep the air that we all breathe, and14 especially that of infants and children,15 smoke free. Yet, as hard as we work to16 make sure this occurs, others continue to17 target our youth as the next generation18 of smokers. 21 More than one-third of them will go on to22 become daily smokers. 2 It's hard to believe, as many3 have said, that Philadelphia has the4 highest rate of youth smoking in the5 United States large cities. How can that6 be? 13 100634. For those of you that are14 parents in the room and for all of us15 that remember our teen years, what was16 the first rule to keep our children out17 of trouble? 19 Yet, that is exactly what we are doing20 here in Philadelphia. One in three of21 our youth smokers buy their cigarettes22 themselves and we make it so easy for23 them. 1 availability and accessibility. Local2 investigations reveal that one in five3 merchants sell tobacco products illegally4 to minors and that 75 percent of tobacco5 retailers in this city are located within6 two blocks of a school. 9 Councilmember Tasco's bill is a10 huge opportunity to deter tobacco sales11 to youth by escalating the penalty. The12 current fine of $100 for a merchant's13 first, third or whatever repeat violation14 they have for selling to minors is15 obviously too low, not to mention it is16 substantially less than the escalating17 penalties for repeat offenses mandated by18 the Pennsylvania statute. Many other19 states and other cities have first20 offense fines of $250 or more, a minimum21 of $500 for a second violation and a22 $1,500 and 90-day suspension of tobacco23 sales for a third violation. 1 Philadelphia in line with some of those2 standards. 5 An estimated 80 to 90 percent6 of adults began smoking during7 adolescence. Several factors likely8 contribute to this addiction, including9 environmental, psychological and10 biological influences. The American11 Academy of Pediatrics strongly recommends12 that provision of tobacco products to13 youth by adults should be made illegal,14 with significant consequences for15 non-compliance. 20 The message is clear. All21 Philadelphia merchants must stop selling22 tobacco to minors. 1 be polluting the air that their own new2 babies will breathe. As Arlene King, a3 CMO of health in Canada, once said,4 "Complacency is our enemy. 10
Thank11 you.12 Robert Simmons, is he here?13 (No response.)14
Lisa15 Ulmer and Sara Kinsman.16 (Witnesses approached witness17 table.)18
Hi. Pull19 the mike and identify yourself for the20 record and proceed with your testimony.21
I'm Sara Kinsman.22 Should I go second?23 Do you want to go first?24
Hi. I'm Lisa25 62 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 Ulmer.2
Thank you very4 much, Councilwoman, for the opportunity5 to testify today in support of the City6 Council Bill 100634. 11 During that time, Louisiana went from12 being the state with the highest retailer13 violation rate in 1997 to one of only14 three states in the country that have15 been below ten percent retailer violation16 rate sales to youth for at least a17 decade. 1 part of our strategy in Louisiana, is2 associated with these decreases in3 retailer violation rate. So some of the4 key provisions of the youth access law5 are graduated fine structure for both6 owners and for the clerks who sell to7 youth. A license will be revoked when an8 outlet is selling to youth. There is9 required seller training and an acquiring10 of a tobacco retailer card that must be11 done within 180 days of new employment12 for any employees that start at an13 outlet. That card will be revoked and14 the clerk not able to sell for repeat15 violations. 20 The enforcement is done by the21 Alcohol and Tobacco Control officers, who22 also do the enforcement for alcohol23 sales. 5 There are a minimum of 4,8006 inspections -- excuse me; 4,8007 inspections each year. Both retail8 owners and clerks may be cited for youth9 tobacco access violations. 16 Fines are assessed on a17 graduated scale. They start at $50 for a18 first offense, $100 for a second offense,19 $250 for a third offense and $400 for a20 fourth and subsequent offenses. 2 We have used these results in3 order to target our enforcement and our4 merchant education strategies to areas of5 high risk. So all of our outlets are6 investigated during a current year and7 then the high-risk outlets are visited8 again with enforcement strategies and9 merchant education strategies more than10 one time during a year. What we have11 found is that this targeted strategy has12 been very helpful, as no one area of the13 state is a repeat violator. 1 Louisiana, I believe that City Council2 Bill 100634 will be a critical step in3 preventing tobacco sales to minors in4 Philadelphia. 10
13 I'm Sara Kinsman. Good afternoon,14 Councilwoman Reed Miller. Thank you so15 much for the opportunity to testify16 regarding my concerns related to nicotine17 addiction and smoking among adolescents18 in Philadelphia. 5 There are several ways to6 comprehend the significant risk posed by7 cigarette smoking. One in five deaths in8 this country results from cigarette9 smoking. More deaths are caused each10 year by tobacco use than by all deaths11 from HIV, illegal drug use, alcohol use,12 motor vehicle injuries, suicides and13 murders combined. 17 With current patterns of18 smoking in the United States, 5 million19 (sic) Americans who are alive today will20 die prematurely from smoking-related21 illnesses. S. mainly results3 from a behavior that starts in the teen4 years. 6 Between 80 to 90 percent of7 adult smokers started smoking when they8 were younger than 18 years of age. This9 should not surprise us. Nicotine is the10 primary addictive component in11 cigarettes. 4 million children17 younger than 18 years start smoking. 6 percent of21 students smoke cigarettes. Approximately22 50 percent of these students say that23 they would like to quit. 1 As a pediatrician who2 specializes in caring for teenagers, I am3 worried that I cannot fully protect teens4 I care for from nicotine addiction. In5 the office, I try to reduce smoking6 initiation among my patients. First, I7 try to limit young adolescents' access to8 cigarettes. I counsel families about to9 not smoke at home or smoke at all. I10 encourage parents to quit. I support11 young teens' negative attitudes towards12 smoking and remind teens about all the13 negative health effects and getting14 really, really bad breath. smoking cessation for teenagers. So I follow best practice guidelines that5 work with adults and I ask about smoking6 behavior, give advice to quit, offer7 several ways to quit, and over and over8 and over again remind teens how much9 better they would feel if they stopped10 smoking. The challenge is that once an11 adolescent is addicted to tobacco, they12 have a lifelong problem to deal with that13 is not easily remedied. 20 I hope these thoughts are21 helpful. 23
Thank24 you.25 71 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 Okay. That's it for that2 panel. I have a couple questions.3 Dr. Robinson, what book did you4 say that you put together or pamphlet or5 brochure? You can stay there.6
You can actually7 find it on the web. The textbook is8 available. It's the Smoking Cessation9 Guideline, Clinical Guideline of the U.S.10 Public Health Service. If you Google it,11 you'll find it and you can load it down12 to full text.13
Actually, it's16 done in several parts. There's one part17 that's done for clinicians, there's18 another part that's done for consumers,19 and there is another part that's done for20 managed care organizations, and there is21 a section that's done for youth. So it's22 in several different parts, and you can23 find the monograms online.24
Okay.25 72 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 One of the things that we have to discuss2 too with this bill are acceptable forms3 of ID, and I would think -- I can't4 remember what the school ID looks like,5 but I don't think date of birth is put on6 there. I know the picture is normally on7 a school ID.8 So if anybody, whether you've9 testified or not, think about it. I10 think we maybe need to change the school11 ID to put a date of birth or something on12 there, I guess. Because teenagers don't13 normally have an ID that has their date14 of birth on it. Normally I don't15 think -- it's just their name and their16 picture.17
Councilwoman,18 there's one other issue also, and maybe19 someone else will bring it up, but one of20 the major issues on why youth can buy21 cigarettes is because they sell the22 cigarettes outside of the package. They23 sell what they call loosies.24
I know.25 73 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
Because very few2 youth can afford to spend $6 for a pack3 of cigarettes, but they can spend 504 cents for a single cigarette.5
I know.6 I used to work near -- before I became a7 Councilmember, I worked on Germantown8 Avenue and I worked near a store that9 sold doughnuts and cigarettes and sodas10 and things, and at first, he didn't, but11 then he started selling loosies. And I12 went over and told him about the ATF and13 that we were going to report him, so he14 stopped. But he put up a sign, because15 he actually said that if he didn't sell16 them, then the kids would harass him and17 threaten him and all those other things.18 So he wanted to take the stigma above him19 and he put up a sign. And I don't know20 whether he had any trouble or not, but we21 couldn't stand there and police him all22 the time, but we did threaten to turn him23 in. And he stopped, told me he stopped24 selling them. I don't think he did. I25 74 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 think he did, because we used to send2 kids in there to see too and he didn't3 sell it to them. So I'm not really sure.4 But I think the education part5 that you did in Louisiana is probably6 really good, because we have all kinds of7 merchants here and I don't know8 whether -- all races, people from other9 countries. I don't know what the age10 requirements or if there are any legal11 limitations in some of the other12 countries that now -- of those folks that13 now reside here. I don't know. So14 people come here, they don't know whether15 you're taking it serious or whether16 you're taking it lightly, and I think the17 education of retailers is an important18 key.19
I really21 do, so they'll know. Because I know I've22 gone in stores and I've seen -- they used23 to sell these little glass vials, these24 little glass things with little teeny25 75 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 flowers in them, and people were saying2 they were drug paraphernalia. And I've3 said to a couple of them, like why are4 you selling that? Do you know what5 that's used for? And, of course, they6 know, but they tell you they don't know.7 Oh, no. I say, Well, you shouldn't sell8 that. And I know that a couple of them9 have actually taken them out, or if10 they're selling them, they're not like11 right up front anymore, because I think12 sometimes you just have to -- more13 citizens have to get involved in saying14 things when they see behaviors in their15 community. I really believe in that,16 when they see behaviors in their17 community that's not very positive. We18 have to open up our mouths and say19 something.20 Okay. Let me just see if I21 have any other questions.22 Other than the acceptable form23 of ID, because that's really what we need24 to do, is to get some type of ID. Maybe25 76 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 not for elementary or middle but for high2 school students, because when we talk3 about -- the bill also states -- the bill4 also has a passage in here that we would5 amend The Philadelphia Code, entitled6 "Cigarettes and Tobacco Products," by7 revising the acceptable forms of8 identification; and by increasing the9 penalties for violations. So we do need10 to look at what the current form of ID is11 if we're going to do a revision and make12 some suggestions.13 Yes, ma'am.14
Just a point of15 clarification or recommendation. A16 number of jurisdictions will use the17 state IDs only, either a driver's license18 or the state ID that is given out by the19 Department of Motor Vehicles, and people20 will turn the license in a vertical way21 when the youth is younger than 18 and22 then turn it horizontal way when the23 youth is older than 18, just as an24 additional aid to retailers about the age25 77 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 of the youth.2
Right. I3 don't know whether young people here in4 Philadelphia or Pennsylvania can get a5 state ID. I don't really know the answer6 to that. I actually thought -- you can?7
Oh, okay.9 Well, that's good, then. That takes up10 the -- I think the state ID is a good11 thing to have whether you're young or12 older, particularly if you don't have a13 driver's license. But many 16-year-olds14 have a driver's license, too.15
Okay.17 Thank you. Thank you very much for your18 testimony.19 Nick Maiale. Is Nick here? I20 don't see him. Nick Maiale, Deborah21 Brown, Valerie Pracilio and Lauren22 Gemberling and RaeNa Johnson.23 (Witnesses approached witness24 table.)25 78 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
Hi. Good2 afternoon. Just state your name for the3 record. Make sure your mike is up close4 enough so we can hear you and proceed5 with your testimony.6
My name is7 Nicholas Maiale. I've had a store for 368 years. I still have it. And I'm here9 today because I was asked to testify on10 raising the fines on selling cigarettes11 to kids. And I get kids in my store12 every day coming in for cigarettes, and I13 face that problem every day. The only14 way I think we can stop this is to15 stiffen the laws. The laws are very16 minor. A hundred dollars is a joke, I17 think. But, you know, raising it a18 little bit is a start.19 I got stores in my neighborhood20 that sell all kind of stuff. You got21 rolling papers, blunts, turtles. Some22 people sell baby turtles on their23 counter. And I know this ain't the24 issue, but if we can just raise it where25 79 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 it's a nice stiff penalty, then maybe the2 second time and the third time take their3 license from them, you know.4 That's about it, you know.5 That's all I could say.6
Yes. Good12 afternoon, Councilwoman. My name is13 Deborah Brown and I am the CEO for the14 American Lung Association of the15 Mid-Atlantic. Our Association supports16 Councilwoman Marian Tasco's Bill No.17 100634 recently introduced to increase18 penalties for merchants that sell tobacco19 to minors.20 While many merchants obey the21 current law and refuse to sell deadly22 tobacco products to our children, there23 are others who choose to break the law24 and should pay the price. Philadelphia25 80 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 has one of the highest rates of youth2 smoking among large U.S. cities. Almost3 11 percent of teens and 30 percent of4 Caucasian teens have smoked once in the5 past 30 days. Our Association believes6 easy access to cigarettes, cigars and7 other tobacco products are a key factor8 in this rate.9 As mentioned, the American10 Academy of Pediatrics have called tobacco11 use a pediatric disease. The vast12 majority of smokers start as children,13 become addicted, and far too many die14 prematurely from lung cancer, emphysema,15 heart disease or scores of other16 tobacco-caused illnesses. All these17 deaths can be prevented.18 The majority of the youth in19 Philadelphia buy cigarettes on their own,20 meaning merchants choose to ignore the21 current law and sell to them. Local22 checks on tobacco retailers reveal that23 one in five merchants sell tobacco24 products illegally to minors. Many of25 81 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 the retailers are within a short distance2 of our schools and community centers, and3 this is wrong.4 Tobacco retailers who must5 sell -- who sell to minors must face6 strict, graduated financial penalties and7 a loss of license. Without Bill No.8 100634, merchants can simply pay the $1009 for each violation regardless of how many10 times they've broken the law. Compared11 to the profit made off of our youth,12 what's a few hundred dollars a year?13 Philadelphia -- a majority of14 Philadelphia's tobacco retailers cited15 for selling tobacco products illegally to16 minors continue to sell again and again.17 To help decrease illegal sales and18 prevent youth from smoking, Councilwoman19 Tasco's bill needs to be passed.20 Under the bill, the initial21 fine would increase from $100 to $250.22 If a merchant does not pay $250,23 Municipal Court could have the ability to24 assess a minimum fine of $300 and a25 82 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 maximum fine of 2,000. If a merchant2 sells to a minor three times in two3 years, the business could be shut down4 for 48 hours.5 It is time for all of us to get6 serious about sales to minors in the7 City. It is time for merchants who sell8 to minors to stop profiting from this9 illegal activity, and it is time to save10 lives. Each day we permit tobacco11 retailers to sell to our youth, it is an12 opportunity lost to save another13 Philadelphian, another family member,14 another loved one from the potentially15 deadly effects of tobacco. Please do the16 right thing and support Bill No. 100634.17 Thank you for the opportunity18 to comment.19
Proceed24 with your testimony, Ms. Pracilio.25 83 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
Good afternoon,2 Councilwoman. My name is Valerie3 Pracilio and today I am here to speak on4 behalf of the American Cancer Society. I5 am Chair of one of the Society's6 volunteer advocacy teams, as well as a7 healthcare professional interested in8 health policy at the local, state and9 national levels. I live, work and10 volunteer here in the City. 19 As we've heard throughout the20 afternoon, 90 percent of adults who smoke21 today began at or before age 19. All22 tobacco products, including cigarettes,23 cigars and smokeless tobacco, contain24 nicotine, which is highly addictive. 1 a result of this simple fact, the tobacco2 industry markets their products to kids3 in hope that they will get lifelong4 customers. 7 To continue to lure young8 customers, the tobacco industry is9 changing the look and smell of its10 products. In addition to the traditional11 forms of cigarettes, cigars and chew12 tobacco, new products are now available13 with brightly colored packaging, flavors14 and scented aromas, all designed to15 appeal to kids. As shown on the colorful16 poster of actual products that my17 colleague holds up, examples include18 grape-flavored cigars and cigarillos;19 mint, grape and citrus-flavored smokeless20 tobacco; watermelon-flavored rolling21 papers. 4 These products are no longer restricted5 to chew that is visible when placed6 inside the cheek. 9 These new smokeless products are not10 visible to a teacher or parent when11 placed inside the mouth. 14 Some would have us believe that15 because these products are smokeless,16 they may be less harmful. 1 cities. One very alarming statistic2 provided by the Department is that one in3 five merchants in the City sell tobacco4 products illegally to minors. 9 Clearly, Philadelphia's youth10 are endangered by illegal tobacco sales,11 and we support stricter penalties12 proposed in this bill. 17 The younger you are when you18 begin to use tobacco products, the more19 likely you are to be an adult tobacco20 user. S. 1 3,500 people under the age of 18 try2 their first cigarette and another 1,1003 become regular, daily smokers. About4 one-third of these youth will die5 prematurely from smoking-related6 illnesses. 4 From this information, I am5 sure you can see that the health and6 well-being of our city's young people are7 at stake. The tobacco industry is hard8 at work trying to make its product more9 alluring. We need the help of10 responsible merchants to combat this11 problem. 14 The Philadelphia Department of15 Public Health has rightly called our16 attention to this problem, and now we are17 asking for your action. Currently, the18 penalties for City merchants that sell to19 minors are too low. 5 This week on Thursday, November6 18th, the American Cancer Society will7 observe the 35th Anniversary of the Great8 American Smoke-Out. In the spirit of9 that event and toward a healthier10 Philadelphia, we ask your Committee to11 protect our kids and vote yes on Council12 Bill No. 15
Thank16 you. Thank you for testifying.17 Lauren Gemberling, and I know18 you're here, Robert Simmons.19 Hi. Good afternoon.20
Good21 afternoon. My name is Lauren Gemberling22 and I'm the Program Manager for Health23 Promotion Council. Commissioner Schwarz24 had mentioned us earlier. 5 The youth that's going to6 speak, she's a youth investigator or a7 surveyor. We're the team that's out on8 the streets enforcing these laws. 10 Basically what that means is, we have a11 team of youth and a team of adults. One12 youth will go into the store. The youth13 are not of age. So they are all either14 15, 16 or 17. They go into every store15 in the City that sells tobacco products16 and they ask for a tobacco product,17 whatever they feel comfortable with. So18 what you saw, that box, many times they19 ask for blunts or loosies. If they see20 loosies, they're encouraged to ask for21 loosies. Any type of cigarettes they22 feel comfortable for asking, they'll ask23 for them. 2 2008 our sales rate in3 Philadelphia hit an all-time low. So4 it's 20 percent. So you've heard a lot5 today about people saying one in five6 youth is sold to. Keep in mind that7 these are youth that they don't know. So8 think about what the actual sales rate9 is. 12 2009 our rate increased just13 slightly to 22 percent. 6 percent. And here's a pretty15 astounding statistic: This far in 2011,16 we're talking fiscal year, so from July17 1st, our sales rate is 33 percent. 20 So the box that Commissioner21 Schwarz just showed you was one month's22 worth of tobacco products that our youth23 have gathered. and that was from only three weeks. I have two little stats to5 discuss, little snapshots. We pulled6 some data from our youth surveys from7 November 2nd through November 10th. So8 we're talking eight days. Our sales rate9 was 49 percent. Traditionally in the10 City there were in fact specific areas or11 zones of the City where the sales rate12 was traditionally higher. That's all out13 the door. That no longer applies. We14 found that all aspects or all areas of15 the City are now selling at a higher than16 usual rate. 19 Also, we're finding that many20 chain stores are selling. Traditionally21 this does not happen. 1 stores or restaurants were selling. Now2 it's everybody, Rite Aid, CVS. 4 We discussed merchant5 education. I also oversee a bit of the6 City's merchant education program. So7 previously what we would do as part of8 our enforcement program, we'd sit down9 with merchants, invite them to some of10 our trainings. They'd receive a signed11 letter from Commissioner Schwarz saying12 you're highly encouraged to come to this13 meeting, we're going to talk about how to14 educate you best, how you learn about the15 laws and whatnot. 17 The sales rate did not decrease. So now18 what we have is a merchant education19 program. 21 They go out. 1 store, whatever time works for them, in a2 culturally and linguistically appropriate3 manner. 5 We're trying to address the reasons that6 they've told us previously that they7 sell. Many times they'll say, We don't8 know the law. And you discussed earlier9 we have a turnover, a lot of stores,10 people are coming in from other11 countries. Absolutely, we will give them12 the benefit of the doubt. Perhaps they13 don't know the law. 15 Many times we hear, We feel16 threatened. We'll discuss with them what17 to do when you feel threatened. 1 handing them an ID, so they may say, Let2 me see your ID. They'll take a look at3 it. 5 So we address all of these6 issues when we go out and do these7 merchant education sessions. 12 Up through last week -- so we13 started this merchant education program14 in June. Through last week, we had15 conducted 405 of these merchant education16 sessions. And keep in mind that these17 are to violators. 1 again. Here's an astounding statistic:2 Of the 405 merchant education sessions3 that we conducted, 184 of them sold to4 our youth again. That's 45 percent. 8 Forty-five percent.
13 We also have a hotline in the14 City, 188-99-SMOKE is the hotline where15 people, community members, anybody out16 there can report a store that sells. 1
Good afternoon,2 Councilwoman. My name is RaeNa Johnson.3 I'm an 11th grade student at Strawberry4 Mansion High School in North5 Philadelphia. I've been a tobacco youth6 surveyor with Health Promotion Council of7 Southeastern Pennsylvania for two years.8 I named my testimony "Smoking Babies."9 Tobacco contains the most10 addictive drug, nicotine. Nicotine's11 textbook definition reads a colorless,12 oily water soluble, highly toxic, liquid13 alkaloid which is used as an insecticide.14 Five out of 4,000 chemicals that are15 found in tobacco are acetic acid,16 ammonia, arsenic, methane and methanol.17 Many of these chemicals are used in18 household cleaning products, jet fuel and19 poisons. This is what is going into the20 hands of our youth today.21 Because so many addictive22 smokers are introduced at a young age, it23 is important to censor the access to24 tobacco products. According to the25 98 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 United States Department of Health and2 Human Services, our beloved City of3 Philadelphia has the highest rate of4 regular smoking 9th to 12th graders.5 Nearly 11 percent of all teens and 306 percent of white teens have smoked in the7 past 30 days.8 In 2002, the United States9 Center for Disease Control recorded that10 80 percent of smokers began smoking11 before the age of 18, whereas 60 percent12 began smoking before the age of 14.13 These percentages have greatly increased14 for the past eight years.15 Many of these vendors benefit16 excessively from these sales, but despite17 the booming tobacco industry, our youth's18 health is in danger.19 In my experience as a tobacco20 youth surveyor, I received a numerous21 amount of sales. For the past two years22 that I worked as a tobacco youth23 surveyor, my rate of sales has increased24 approximately 40 percent. This past week25 99 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 I was conducting a survey. I was sold2 ten times out of 19 stores. That's over3 50 percent.4 Bill No. 100634, Section 9-6225 clearly states that tobacco is not to be6 sold to anyone under the age of 18.7 Penalties for merchants that sell to8 minors are too low. It's still breaking9 the law and $100 is not enough.10 I would like to also add that11 in my getting -- when I received my ID,12 they told me that you can receive an ID13 at the age of 11. So it is legal, the14 state ID. And my school ID has my date15 of birth on it. The merchants obviously16 do not care. They want the money.17 Me purchasing a $7 pack of18 cigarettes, they can count, so they can19 give me my change back. So they can20 subtract 1994 from 2010.21 (Applause.)22
Thank you. That23 was a great statement. 1 My name is Rob Simmons and I'm2 at Thomas Jefferson University in our3 School of Population Health and I direct4 our Public Health Program. , attributing10 to an estimated 443,000 premature deaths11 per year. 16 Smoking by youth has declined17 sharply during 1997 to 2003, but rates18 over the past seven years have remained19 stable throughout the country. 1 particularly among our youth, we can2 improve the public's health by lowering3 unnecessary disease and death rates due4 to smoking. National efforts to reduce5 youth tobacco use have been taking place6 across the country. 14 We have a major public health15 problem here in Philadelphia, as our16 tobacco use rates are one of the highest17 in the nation. 21 Approximately 35 percent of Philadelphia22 youth are reported to buy cigarettes23 illegally themselves. 3 On a personal note, during the4 1980s and 1990s, I was involved in the5 development and implementation of6 California's tobacco control and7 prevention program, the most8 comprehensive tobacco prevention and9 control program in the country. One of10 the many components of this11 internationally recognized public health12 program is the prevention of youth access13 to tobacco initiative, called Stop14 Tobacco Access to Kids Enforcement Act,15 or STAKE, that took effect in September16 of 1994. The penalties for merchants who17 illegally sell tobacco products to18 minors -- this is again in 1994, 16 years19 ago in California -- are $200 to $300 for20 the first offense, $600 to $900 for the21 second, $1,200 to $1,800 for the third22 and continues to double with subsequent23 offenses. 8 Our goal is to improve the health of our9 community. One of the ways to reduce is10 to reduce tobacco use. 15
Thank16 you.17 Did any of the store owners18 ever ask you for ID, RaeNa? It's RaeNa,19 right?20
And once24 you gave them ID, did they sell to you?25 105 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1
Okay. So4 I don't know the purpose of them asking5 then. I mean, they're going to sell6 anyway.7 I just want to state that I8 know that all Councilmembers are in9 support of this bill, and we want to10 thank everyone for coming in today to11 testify.12 Is there anyone else that wants13 to testify for or against this bill?14 (No response.)15
Let me16 ask my Council colleague here.17 Questions?18
Okay. So20 thank you. This concludes the hearing on21 Public Health. Thank you.22 (Pause.)23
Excuse24 me. Can we have a little quiet. We're25 106 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 still in session here.2 We are now going into our3 public -- the Committee on Public Health4 is now going into its public meeting.5 The Chair recognizes Councilman6 Goode.7
Thank you,8 Madam Chair. I move that Bill No. 1004899 be reported out of the Committee with a10 favorable recommendation and the rules of11 Council be suspended so as to permit12 first reading at our next Council13 session.14 (Duly seconded.)15
It has16 been properly moved and seconded that17 Bill No --18
-- 10048920 be reported out of this Committee with a21 favorable recommendation and the rules of22 Council be suspended.23 All in favor signify by saying24 aye.25 107 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 (Aye.)2
Okay.5 This bill has been properly moved -- all6 right.7 We have actually -- Council8 President Verna has appointed Councilman9 Clarke to this Committee to help us with10 our quorum and voting.11 COUNCILMAN CLARKE:12 Temporarily.13 COUNCILWOMAN MILLER:14 Temporarily to this Committee. Thank15 you. Thank you.16
Madam Chair,17 I move that Bill No. 100489 be reported18 out of the Committee with a favorable19 recommendation and the rules of Council20 be suspended so as to permit first21 reading at our next Council session.22 (Duly seconded.)23
Great.24 All in favor?25 108 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 (Aye.)2
It has3 been properly moved and seconded that4 Bill No. 100489 be reported out of this5 Committee with a favorable recommendation6 and the rules of Council be suspended.7 Councilman Goode.8
I move that9 Bill 100634 be reported out of the10 Committee with a favorable recommendation11 and the rules of Council be suspended so12 as to permit first reading at our next13 Council session.14 (Duly seconded.)15
It has16 been properly moved and seconded that17 Bill No --18
-- be20 reported out of this Committee with a21 favorable recommendation, that the rules22 of Council be suspended.23 All those in favor signify by24 saying aye.25 109 11/16/10 - PUBLIC HEALTH - BILL 100489, ETC.1 (Aye.)2
This bill6 has been properly moved and seconded and,7 furthermore, the rules of Council have8 been suspended so as to permit first9 reading at our next session.10 This concludes -- both bills,11 actually.12 This concludes this hearing.13 Thank you.14 (Committee on Public Health and15 Human Services concluded at 3:30 p.m.)16 - - -17 18 19 20 21 22 23 24 25 110 1 CERTIFICATE2 I HEREBY CERTIFY that the3 proceedings, evidence and objections are4 contained fully and accurately in the5 stenographic notes taken by me upon the6 foregoing matter on November 16, 2010, and7 that this is a true and correct transcript of8 same.9 10 11 12 13 --------------------14 MICHELE L. MURPHY15 RPR-Notary Public16 17 18 19 (The foregoing certification of this20 transcript does not apply to any reproduction21 of the same by any means, unless under the22 direct control and/or supervision of the23 certifying reporter.)24 25