Committee Hearing, March 8, 2006

COUNCIL OF THE CITY OF PHILADELPHIA COMMITTEE OF THE WHOLE - - - Room 400, City Hall Philadelphia, Pennsylvania Wednesday, March 8, 2006 10:25 a.m. - - - PRESENT: COUNCIL PRESIDENT ANNA C. VERNA COUNCILWOMAN JANNIE BLACKWELL COUNCILMAN DARRELL L. CLARKE COUNCILMAN W. WILSON GOODE, JR. COUNCILMAN JACK KELLY COUNCILWOMAN JOAN L. KRAJEWSKI COUNCILMAN MICHAEL A. NUTTER COUNCILMAN JUAN RAMOS COUNCILWOMAN BLONDELL REYNOLDS BROWN COUNCILMAN FRANK RIZZO COUNCILWOMAN MARIAN B. TASCO BILLS 060001, 060002, 060003, 060004, 060006, 060007, 060008, 060014, 060089 and 060090. RESOLUTIONS 060019, 060099, 060100 and 060119 - - - 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 2

Good morning, everyone. This is the continued public hearing of the Committee of the Whole. I would ask Mr. McPherson to please call our first witness. MR. McPHERSON: The Philadelphia Prisons.

Good morning. COMMISSIONER KING: Good morning, Madam President.

Nice seeing you. Please identify yourself for the record and proceed with your testimony. COMMISSIONER KING: Leon King, Commissioner of Prisons.

Thank you. COMMISSIONER KING: President Verna and members of City Council, I am Leon King, Commissioner of the Philadelphia Prison System. Thank you 3 3/8/06 - WHOLE - BILL 060001, ETC. for this opportunity to present testimony regarding our Fiscal '07 operating request. At the Prison System, our greatest challenge is to provide cost-effective services for the taxpayers of the City of Philadelphia, while providing a safe, secure and humane correctional environment that adequately detains persons accused or convicted of illegal acts. In FY06, we are meeting the challenge to provide these services to an inmate population that has averaged 8,410 for the fiscal year to date, beginning February 7, '06, and has exceeded 8,600 inmates at times during the months of September and October of 2005. The FY07 proposed operating budget assumes an inmate population of 8,500 inmates. million more than our FY06 estimated obligation level. The FY07 General Fund Class 100 request of $106,716,560 is 3/8/06 - WHOLE - BILL 060001, ETC. expected to fund 2,300 full-time positions. The General Fund Class 200 request of $81,973,591 provides for increased costs of inmate medical services and maintenance services for the Curran-Fromhold Correctional Facility and the Riverside Correctional Facility. The requested funding level for Classes 300 and 400 remains the same as the FY05 estimated obligation level, but is an increase of 890,000 over the FY06 appropriation. Inmate work payments, Class 500, remain the same as the previous year. Over the past several years, the Prison System has worked in partnership with numerous organizations, including the First Judicial District, the District Attorney's Office and other court-related agencies, to develop alternatives for sentencing people to prison. A variety of programs have been used to divert offenders from prison to treatment and lower inmate recidivism, 3/8/06 - WHOLE - BILL 060001, ETC. such as electronic monitoring, community service, drug treatment and the Forensic Intensive Recovery Program. For many convicted of minor crimes, providing alternatives to a prison sentence is preferable, since studies have documented that these alternatives can deter a participant's progression to more serious crimes. With the cost of housing one prisoner averaging $88 a day, diversion programs have the potential for substantial savings. The City has three initiatives that aggressively address the growth of the inmate population. First is an IT initiative that will enable us to identify specific demographics of the inmates incarcerated in the PPS. This will help us identify trends and groups of inmates that the PPS may target for release to control the population. Second, the Mayor's Office for the Reentry of Ex-Offenders addresses 3/8/06 - WHOLE - BILL 060001, ETC. challenges that offenders face when they are released and assist them in returning to their communities. This initiative is discussed further below in my testimony. The third initiative is the Goldkamp Study, which will take a comprehensive look at the inmate population and all the justice partners in Philadelphia and make recommendations to mitigate some of our population challenges. Delaware County: Late in 2005, the Philadelphia Prison System was informed that the contract with Delaware County to house inmates would not be renewed. The PPS was faced with the challenge of reintegrating 350 inmates held at Delaware County back into the PPS campus. We were successful in reacquiring the use of the Cambria Community Center, which now houses 200 inmates. The PPS continues to explore opportunities for new leased space to meet its ongoing needs. 3/8/06 - WHOLE - BILL 060001, ETC.

The Goldkamp Study: Faced with the realization that the City of Philadelphia cannot continue to add prison space to the PPS, we have contracted with Temple University, under the direction of John Goldkamp, to conduct a comprehensive study of the causes and remedies of the census growth. This study is examining all of the justice partners in Philadelphia and will yield recommendations on changes that can be made within the criminal justice community to relieve our population challenges. Staffing: With the loss of the Delaware County contract to house inmates, the PPS has proposed hiring more correctional officers. The FY07 budget assumes 1,757 correctional officers up from 1,639 in December of 2005. An analysis of overtime versus hiring has shown that the hiring of these additional officers is cost neutral to the City over the Five-Year Plan period. In exchange, 8 3/8/06 - WHOLE - BILL 060001, ETC. the PPS has pledged to reduce overtime by an equivalent amount over the cost of the new hires. The PPS has a proven record of reducing overtime when new staff are hired and by looking at every aspect of how we do business. Our CORESTAR Unit challenges our managers to justify statistical information concerning their divisions on a monthly basis in an effort to save money and be certain that we are doing business in the most effective way possible. This initiative will be partially funded with Class 200 savings achieved by the cancellation of the Delaware County contract. Contain the Cost of Medical Care: The Philadelphia Prison System needs to control the rising tide of inmate health costs. Medical costs for the PPS have increased at a 13 percent annual rate, from million in FY02 to 23 more than 50 million in FY06. The PPS 24 faces several challenges in its attempt to control the healthcare costs. The PPS 9 3/8/06 - WHOLE - BILL 060001, ETC. has experienced a growth in population of four to five percent over the last two years. We face an inmate population with significant medical and mental health issues at the time of admission. The Prison System has taken steps to control its costs. The Prisons Contract Unit has negotiated reduced hospital and physician rates for many hospitalizations that were based on standard terms such as Medicaid and Medicare instead of billed charges. We've added discharge coordinator services to the current mental health contract to more effectively link persons of severe mental illness with community-based services. The PPS, in conjunction with other justice partners, has vigorously pursued compassionate discharges for inmates with serious medical issues who have non-violent charges. We are exploring the use of an alternative pharmacy provider based on the Commonwealth of Pennsylvania 10 3/8/06 - WHOLE - BILL 060001, ETC. contracts, the Commonwealth's medical staffing contract, and hiring a firm to do utilization and claim management of outside hospital costs. The PPS has also partnered with MP Dugan Associates to develop a strategic plan for medical care at the PPS to ensure that we are using the best and most cost-effective practices in administering healthcare to the inmates. Invest in Programs That Reduce Recidivism and Aid in Reentry: Prisoners face numerous barriers to successful reintegration into the community, such as difficulties finding safe, affordable housing and steady jobs upon release from custody. When former prisoners are unable to successfully reintegrate, the likelihood of reverting to a life of crime is high. Communities pay the cost in terms of high public safety costs, victimization, reduced economic opportunity and quality of life problems. Successful prisoner reentry in the 11 3/8/06 - WHOLE - BILL 060001, ETC. community is critical to reducing the recidivism rate and ultimately reducing the prison population.

In response to the urgent need to stem the burgeoning growth of Philadelphia's Prison population, the Mayor created the Mayor's Office for the Reentry of Ex-Offenders, also known as MORE, to serve as a coordinating office for these diverse services and resources aimed at assisting ex-offenders in their attempts to successfully reintegrate into their communities. MORE will pursue this mission by convening an advisory council that will help to develop a City-wide agenda for reentry and will also advise the Administration in regards to reentry/reintegration concerns; identifying resources that can be employed in reentry endeavors; creating partnerships and synergies between existing agencies whose services impinge upon reintegrating ex-offenders; 12 3/8/06 - WHOLE - BILL 060001, ETC. fostering an atmosphere through education advocacy and action that highlights the need and value of successful ex-offender reintegration; and also by building a practical operating structure that will provide direct assistance to reintegrating ex-offenders. Recognizing that reducing inmate population and the prison budget will require a multi-faceted approach. The PPS has maintained and expanded a number of programs in an effort to reduce recidivism and improve reentry services and increase the chance of a successful reentry into the community. Through the Opportunities for Prevention and Treatment Interventions for Offenders Needing Support, OPTIONS, the PPS provides addiction treatment services, including evaluation, education and counseling, to inmates in intensive residential units called therapeutic communities and in moderate outpatient units. 13 3/8/06 - WHOLE - BILL 060001, ETC. OPTIONS serves as the first step in the continuum of care from prison to the community. Sentenced inmates participating in this program begin family therapy while still incarcerated. Upon completion of OPTIONS, PPS inmates can be paroled early or sentenced to participate in the Forensic Intensive Recovery Program, or FIR. Directed by the City's Department of Health, FIR is an early parole and re-parole program designed to provide community-based drug and alcohol treatment as an alternative to incarceration. The goals of the program are threefold: Reduce prison overcrowding, decrease recidivism and enhance community safety. The OPTIONS program began in 1973 -- that's an error there -- and encompasses more than 50 drug and alcohol programs that provide clinical evaluation, residential treatment and intensive outpatient treatment, along with a full spectrum of criminal justice and social services. 14 3/8/06 - WHOLE - BILL 060001, ETC. PLATO, Program Learning Through Alternative Teaching Options, is a computer-based education program that provides GED and adult basic education, post high school course work, literacy and English as a second language instruction, in addition to training in computer literacy, parenting, life and employability skills, substance abuse and health. The Jobs Project: The main focus of the Jobs Project is to aid in job training, job readiness and employment. A major goal of the program is to place ex-offenders who have successfully completed the Jobs Project in a job when they are released from prison and to provide them with case management and other services out of prison, through the assistance of reentry partners such as Impact Services and the Pennsylvania Prison Society. For those who complete the Jobs Project and are not able to be paroled and/or re-paroled, a 15 3/8/06 - WHOLE - BILL 060001, ETC. new initiative to have them placed in the work release program as part of reentry and transitional services is being coordinated with the assistance of Byron Cotter from the Public Defender Association.

All Jobs Project participants are expected to attend community meetings, participate in workshops on anger management, victim awareness, health issues and life skills training, enroll in OPTIONS or Fatherhood Initiative, as appropriate, and connect with a reentry partner. In January 2006, the Jobs Project joined with Aramark to establish a food service training program at the Curran-Fromhold Correction Facility. The inmates enrolled in this program will be assigned a reentry partner and will be offered job readiness and life skill workshops. More importantly, the reentry partners will work cooperatively with the Aramark Placement Center to secure 16 3/8/06 - WHOLE - BILL 060001, ETC. employment for inmates enrolled in this program. The WHYY Project: The WHYY Television Project will bring many hours of quality programming on education, vocational learning, life skills and employment skills directly to the inmates on their housing units, via the master TV system in place in all facilities. The Pennsylvania Horticultural Society/Prison Greenhouse Partnership: The Pennsylvania Horticultural Society in partnership with the Prisons, the Share Program and communities throughout the City of Philadelphia are sponsoring Philly Green. Providing training to PPS inmates and using the greenhouse, this program will involve the preparation of seedlings that will be used in community gardens throughout the City to grow produce. The produce grown will be donated to the Share Program. Share will distribute the produce to families in the communities who are in need. 17 3/8/06 - WHOLE - BILL 060001, ETC. The Inmate LAN: The inmate LAN, the Local Area Network, consists of a server with numerous or 350-plus computers linked to it. The server will hold software for computer-based educational and vocational programs that inmates can easily access throughout the Prison System. Examples of the software include PLATO; Careerscope that helps an individual determine what types of jobs he or she may have an aptitude for; Mavis Beacon, which helps an individual to learn how to type; and Microsoft Office. Additional software that will be beneficial for the inmate population will be placed on the server in the near future as funding becomes available. The law libraries at all of the PPS facilities are actually currently available on the inmate LAN. The Frankford Roundtable is a coalition of community-based organizations, faith-based organizations, criminal justice agencies, including the 18 3/8/06 - WHOLE - BILL 060001, ETC. Prison System, the Adult Probation and Parole Department and the Philadelphia Police Department, the business community and others, who are developing strategies to improve the transition to the community prospects for those who are currently incarcerated and sentenced, who give an address in the Frankford area, zip code 19124, and who are returning to that community upon completion of their court-imposed sentences. The PPS is supporting the Frankford Roundtable by providing a dedicated social worker who will serve as a full-time liaison with the Roundtable, identifying inmates from that area and working with PPS social workers in completing assignments for potential inmate participants in this reentry effort. This is a pilot project with potentially large ramifications. If the model shows positive results in reducing recidivism, PPS will work with other communities to introduce similar networks 19 3/8/06 - WHOLE - BILL 060001, ETC. of care to support the transition of their neighbors from jail to community. PPS partners with community-based organizations and individual volunteers to bring programs and fellowship inside the walls and recognizes the importance of educating and engaging the public in the work that we do.

The Office of Community Justice and Outreach raises the profile of corrections in Philadelphia by taking the message to neighborhood organizations, civic groups, schools and business organizations to help them understand who is in jail, why they are here, the important contributions that our staff makes to public safety and the ways that we can work together to help those inmates who are returning to our communities. Although the PPS has developed strong population management and cost control initiatives, these initiatives can only partially mitigate the demand 20 3/8/06 - WHOLE - BILL 060001, ETC. for prison capacity. All partners in the criminal justice system will need to do their part in order to prevent incarceration costs from continuing to expand beyond what the City's tax base can support. This concludes my testimony. I would be happy to answer any questions you may have.

Thank you very much. Commissioner, you mention in your testimony that the City has three initiatives that address the growth rate of the prison population. The first is an IT initiative that will enable you to identify demographics of inmates. This will identify trends in groups of inmates that may be targeted to be released to control the population. What are the demographics of the prisoners that would be targeted for release? COMMISSIONER KING: Well, until 21 3/8/06 - WHOLE - BILL 060001, ETC. we get the report, I can't tell you that specifically, but I can give you some examples that we've talked about. For example, with the study, a lot of it will be focused more on processes in the Court of Common Pleas. In other words, we believe that a lot of the reason for the rise in the population is not, if you look at the statistics, it's not because the crime rate is up in the City. It's not because there's been some drastic increase in the arrest rate or drastic increase in the amount of prisoners that actually reach the prison. For example, there have been changes in the law that require that -- well, have caused defendants in court to opt for jury trials as opposed to a bench trial or a guilty plea, depending on what their choice might be. So when we have more inmates opting for a jury trial, they stay incarcerated longer. If we see, for example -- they have something in the Court of Common 22 3/8/06 - WHOLE - BILL 060001, ETC. Pleas called section cases. I don't know -- they're the very serious cases that aren't homicides, and we've noticed that there's been a dip in the processing of those preliminarily from what we've been able to gather, and we know when processing time slows down in those types of cases, those people are more likely to stay longer in the prison. So that's a big part of what this study is going to look at. Another population, if you're going to talk about releasing them -- and, Madam President, I don't want you to, or Councilwoman Krajewski, too, I don't want you to get the impression that we're going to go around and after this study is done and say, Okay, take 200 people and put them on the street. It's really going to be a little more studied than that, a little more strategic than that. But we do have 1,500 people on our mental health caseload who have 23 3/8/06 - WHOLE - BILL 060001, ETC. mental health issues, and we have an initiative going aside from what Dr. Goldkamp is going on. I would like to target those people. And I think a lot of them -- and we've just now gotten it so that we have an information system that tells us who these people are. Before, all we knew is we had 1,500 people. Now we can tell you how many have serious mental illnesses, and we need to develop strategies to put them somewhere else other than jail. We're not going to release them to the community necessarily, but we do believe that a lot of these people we can either divert; in other words, because we are doing some training, the Department of Behavioral Health with the Police Department, to help them recognize people who have serious mental illness, because sometimes you can't tell. You don't know whether they're high, they're drunk or they have a serious mental illness. And we're trying to work with the Police 24 3/8/06 - WHOLE - BILL 060001, ETC. Department to divert people so they don't come to the jail, and then look at the ones that we have. Because we think there are ways to house them that is less than $88 a day, while at the same time provide services they need and protects the community at the same time. So I don't know if that answered your question.

Commissioner, can you tell me when the study is anticipated to be completed? COMMISSIONER KING: I know we were anticipating early FY03. We get preliminary reports --

FY03? COMMISSIONER KING: FY07. I'm sorry.

I was going to say, we're going backwards. COMMISSIONER KING: We're getting preliminary -- he meets with us every once in a while to let us know where he's going, but early FY07. So I 25 3/8/06 - WHOLE - BILL 060001, ETC. would anticipate August or September we should have the report.

Thank you. The second initiative is the Mayor's Office of Reentry of Ex-Offenders. Will you tell us what this office does and how it helps to control your population levels? COMMISSIONER KING: I would like to defer. I hope there's someone here from the Mayor's Office. Is there anybody here from MORE? (No response.) COMMISSIONER KING: I don't see them here, so I will attempt to speak on their behalf. But what MORE is supposed to be doing is taking over for prisoners when they're released. Our responsibility is inside the walls to prepare these inmates for release, and their responsibility is, once they're released, to assist them in finding jobs, 3/8/06 - WHOLE - BILL 060001, ETC. connecting them with healthcare, anything that they may need. And their mandate actually is more broad than just the Philadelphia Prison System. I know that their mandate also includes Philadelphia residents who are discharged from the State Department of Corrections, Philadelphia inmates who are discharged from the Federal Bureau of Prisons. And they would be taking care of those inmates that aren't already enrolled in the Jobs Projects or the Frankford Reentry Roundtable. I know that's their mandate generally. I can't comment specifically on what they're doing.

Ms. Reed, would you have any information on the Mayor's Office of Reentry?

Ms. Danzy will speak.

Great. Welcome, Ms. Danzy. 27 3/8/06 - WHOLE - BILL 060001, ETC.

Good morning.

Nice seeing you.

Julia Danzy, Director of Division of Social Services. The Mayor's Office of Reentry Services, which was created the past year, has as its specific purpose, as the Prison Commissioner said, to address the reentry issues of the prisoners who are coming from our city jail, as well as from the state jail system. They are working with business communities. They are working with other agencies to, one, look at how do they get jobs for this population; two, how do we make sure we connect them with any treatment services they were receiving while they were in prison, such as drug and alcohol treatment, mental health treatment, all of those pieces; and three is to help them really get better acclimated back into the community. One of the things that is on 28 3/8/06 - WHOLE - BILL 060001, ETC. design right now are what we call one-stop-shop programs, so that the point they're leaving the prisons, they come to a central point where they can find out about housing, where they can find out about treatment and where we can begin to work with them and get them coordinated in programs. What I would like, if Council is desirous, before our hearing is complete today, I can have Harriett Spencer, who is the Director of the program, and Nick Taliaferro is kind of the Executive Director of that program, to come and give you a more complete presentation today. They were to be here this morning. Obviously there was a mix-up and they're not here.

Ms. Danzy, or perhaps the Commissioner could answer, on , I notice that there is a million dollars appropriated for FY07 for reentry services for inmates. We're assuming that's a 29 3/8/06 - WHOLE - BILL 060001, ETC. contract? COMMISSIONER KING: No. I believe that is an appropriation for the Mayor's Office of Reentry Services.

Yes. He is correct. That is money that the Mayor in his budget address talked about the million that would be for reentry services. That is it.

But it's in Class 200 in the Prison's budget. Commissioner? COMMISSIONER KING: I would ask the Budget Director to come up and explain that. I don't know why it's in Class 100.

It's Class 200 in your budget. COMMISSIONER KING: The Budget Director indicates it's a placeholder. I don't know.

It's pardon me, sir? COMMISSIONER KING: A 30 3/8/06 - WHOLE - BILL 060001, ETC. placeholder.

Oh, a placeholder. What does a placeholder mean?

Dianne Reed, Budget Director. I think that the entire scope of services to be provided by the office has not quite been determined yet. I think contracting will be part of it, because there are several programs that are reentry programs that are funded now out of various budgets. This would not entirely go for Class 100. People are already on staff. So we will probably have to sort this out later.

People are already on staff where?

With the -- I don't exactly know where they are, Mr. Taliaferro and the other people that the Secretary of Social Services mentioned. So there may be just some reorganization on the Class 100 side and 31 3/8/06 - WHOLE - BILL 060001, ETC. that in fact most of this would go for Class 200 programs.

Can somebody explain?

The staffing for Reentry really has come from some of the other programs where we were already doing contracts with private providers for reentry services. We just sort of moved some of that staff over into Reentry. For instance, in MOCS, we were providing an area of funding for reentry services, and so what we've done is, we've reallocated that staff into the Reentry office. Prisons is also supporting some of the staffing for the Reentry office. Persons who were working on that within the prisons are now linked and involved in working in that office. And they are located at 990 Spring Garden, which is in the office with the Mayor's Office of Community Services.

But 32 3/8/06 - WHOLE - BILL 060001, ETC. how do you pay salaries out of Class 200?

Well, you can't.

That's not going to happen.

I would hope not.

No. 9

Gee, surprise. I think we'll need further explanation on this.

Yes, you will.

As I offered before, if you would like, I will have someone from the Reentry office, the Director, to come today and give you more detail, if you would like.

We'll notify you. Otherwise, I'd like it in writing.

All right.

Thanks. Commissioner, you mentioned in 33 3/8/06 - WHOLE - BILL 060001, ETC. your testimony that the proposed 2007 budget assumes an inmate population of 8,500. What is the overall inmate capacity of the Prison System? COMMISSIONER KING: It depends. You knew I was going to say that. If you take all of the facilities that we now have and you wanted to say, Okay, what were they originally designed to hold as far as inmates goes, it's around 6,000-something inmates. If you take into account all the areas that we've retrofitted to make it things that were other things before and now we have beds in them and we put toilets and showers, then you take the number up closer to 8,200. And then in situations where we have to triple-cell at the House of Corrections and we take our capacity up to that level, then you get to be around 8,565. And then after that, we have to be more creative. Last year, we had 8,704 inmates and we were triple-celling all over the 34 3/8/06 - WHOLE - BILL 060001, ETC. place and moving people around. So the prisons are full at different levels, but certainly 8,700, we've never been there before.

I know you're not going to be able to answer this question, but I'm going to ask it anyway. If you are not successful in controlling the inmate levels and the population increases by four percent, as indicated in the Five-Year Plan, how will you ever manage? We just open the gates and say, We just don't have room? COMMISSIONER KING: No, because I know Councilwoman Krajewski will be waiting around the corner for me if I do that. So I'm not going to do that. We have a lot of contingency plans that we're working on. We had to do this because we had Delaware County folks come back. So we had to add beds to the Detention Center in different areas. We have a proposal in hand that 35 3/8/06 - WHOLE - BILL 060001, ETC. I have to review for some community-based housing, and we're also searching the State of Pennsylvania and the State of New Jersey for leased space. I mean, those are the things that we have planned and those are really the only things that we have planned, and I think that's part of the reason we're very anxious to get this report back from Dr. Goldkamp, because there is no more space on State Road to build the prison. There's no more space. There's nowhere else to build anything. And I think even if there were space, there's now new FEMA regulations and earthquake regulations that wouldn't allow us to put anything near the river like that anyway. So that's part of the reason I think the Mayor has recognized you're building our way out of this. Building our way out of this is not the answer, but those are some of the things that we have that we're working on currently in case we don't reach the goal we've set. 36 3/8/06 - WHOLE - BILL 060001, ETC.

I believe Councilwoman Krajewski has a point of information.

Thank you. Commissioner, how many of the prisoners are with the state? COMMISSIONER KING: State prisoners that are serving time in the county? I was at a meeting the other day. Part of some of the information that was coming out of, I think, our information system that we're trying to set up, it looked like there were close to 300 people who were serving state sentences in the county.

They're at Curran? COMMISSIONER KING: They're at one of the facilities on State Road.

Shouldn't they be in the state institutions? COMMISSIONER KING: I would 37 3/8/06 - WHOLE - BILL 060001, ETC. argue, yes, that's where I'd like them.

Isn't it anything over like two years, they -- COMMISSIONER KING: Well, the way it works is, over two years is a state sentence, but county judges have the discretion if it's more than two and less than four to make them serve the state sentence in the county, and they usually do that a lot of times because they want the inmate to be near their family, et cetera, et cetera, or they're work release sentences where they're at 600 University Avenue and they're --

So in other words, they're not really paying too much attention to the state ones where they should be out of Curran and into other state facilities; is that true? COMMISSIONER KING: I mean, that's what we would like, but the judges have their reasons for doing that. And that probably will be one of the things 38 3/8/06 - WHOLE - BILL 060001, ETC. we'll be discussing with them. Remember when Judge Shapiro had control of everything, she had an order that said the judges in the City, you can't sentence people to county serving state sentences. They have to go upstate. Then when we settled the case --

That would solve some of the overcrowding, wouldn't it? COMMISSIONER KING: Yes, it would.

Are you doing anything about that, or is anyone? COMMISSIONER KING: Well, the number I just got yesterday, and it's going to be part of this roll-out of this report. We will be doing something about it.

I'd appreciate some information on that. COMMISSIONER KING: Okay.

Thank 39 3/8/06 - WHOLE - BILL 060001, ETC. you, Commissioner. COMMISSIONER KING: You're welcome.

Commissioner, with that being said, do you and perhaps the Administration meet on a periodic basis to discuss issues such as Councilwoman Krajewski is bringing to the table? COMMISSIONER KING: Well, actually, we have something called a Criminal Justice Coordinating Committee. We usually meet -- it's usually monthly, sometimes bi-monthly, and that is me, the other members of the Administration, Judge Fitzgerald, Judge Presenza. We meet on a monthly basis and we do discuss these issues. That number that I told you about the state inmates serving in the county, I just got yesterday. We will be having a meeting of that committee this week and I will make sure that I bring the issue up again. 40 3/8/06 - WHOLE - BILL 060001, ETC. They are very cooperative, the judiciary, when we bring things to their attention when they can do things. Judge Fitzgerald has been fantastic. Judge Presenza has been fantastic. They helped us with the Delaware County Bring-Back, and we had the Public Defender's Office put a massive -- a bunch of early patrol petitions, and they helped us shepherd that through the courts and we got some inmates discharged. So I'm sure they will be receptive, but Judge Fitzgerald and -- they're handicapped. As you know, all the judges are independently elected, so there's only so far you have to convince and cajole. You can't order them to do things.

Thank you very much, Commissioner. The Chair recognizes Councilman Goode.

Thank you, Madam President. 41 3/8/06 - WHOLE - BILL 060001, ETC. Good morning, Commissioner. COMMISSIONER KING: Good morning.

Thank you for your testimony. Let me thank you for your enlightened perspective. I think that this testimony and your service has been very different than previous Prison Commissioners, and I want to thank you for dispelling the myth. We actually don't lock anyone up and throw away the key, do we? COMMISSIONER KING: No. 15

We actually keep the key, we open the cells, we try to prepare them for reentry, and we try to reduce the rate of recidivism. COMMISSIONER KING: Yes.

Can you provide any new data on the recidivism rate? COMMISSIONER KING: Well, the last time we did the recidivism study, I think it indicated that the recidivism 42 3/8/06 - WHOLE - BILL 060001, ETC. rate was 54 percent or 56 percent. 56 percent. I like to remind people -- that means 56 percent of the population surveyed came back to prison within two years with a new parole violation or a new sentence. I'd like to point out to people that we also need to remember that also means that 44 percent of those people didn't come back. I'm waiting now. I've asked for a new recidivism report and I haven't gotten it back yet. I can have Deputy Commissioner Hammond come up and talk to you about some of the new things that we're doing with the Jobs Project and how that's working. One of our things that we wanted to do is be able to do a recidivism rate by program instead of the whole recidivism rate, because if you take everybody in the melting pot, there are some people who don't get intensive treatment. So we wanted to be able to project recidivism by program. So in 43 3/8/06 - WHOLE - BILL 060001, ETC. April, we should have the pilot project ready so we can start loading in people who go through OPTIONS, people who go through Jobs, people who go through the Culinary Arts Project so we can see how the programs are working and predict a little better the recidivism rates. And we're also going to do this with the Frankford Roundtable. That's one of the things that we're most proud of. There was a lot of -- there was some community concern in the last month or so about what that was doing. People thought we were going to take -- the statistics indicate that 800 inmates are discharged back into the Frankford community, and we're taking probably 19 of them and giving them intense 20 treatment, making sure that they are people from Frankford, they're not from South Philly and we're going to put them in Frankford, or wherever they may be from. They could be from North Philly. I don't know. I don't mean to pick on 44 3/8/06 - WHOLE - BILL 060001, ETC. any neighborhood. And we want to track that. And there was some issues with the community on that because they were concerned we were dumping inmates that wouldn't otherwise come back to the community there. And when we went out and explained it to them, they understood and people were nodding their heads. So I can only tell you -- that's a long answer, but I can only tell you that it was 56 percent the last time that we did it and I should have information shortly on whether it's gotten better or worse.

How recent is that data? COMMISSIONER KING: I think it was 2002 or 2003.

For those politicians who just like to talk tough on crime, can you tell us for the record what the biggest barriers to reducing that rate is? COMMISSIONER KING: The biggest 45 3/8/06 - WHOLE - BILL 060001, ETC. barriers to reducing the recidivism rate are treating people's addictions. That's the biggest problem. If you look at the statistics that we've seen preliminarily from this report and you look at the prison population, you don't see -- everyone talks about the homicide rate, and it has gone up recently, but when you look at the red line on the chart, which is drugs, I mean, it sort of goes like this and then in the late '80s and the early '90s, it goes like this, and then it comes down and then it goes up. And that is what's driving prison population. That is the biggest issue that we have to deal with when we talk about recidivism, is people's addictions. If you come into the receiving room at CFCF, they're all either drunk or high or in some in-between state when they come in. So that's the biggest thing. Jobs I would say is the second issue that we have to deal with in regard to recidivism, because we know that if 46 3/8/06 - WHOLE - BILL 060001, ETC. people have a job, they're more likely not to go back out and commit a crime. And it has to be a job, I would say, that -- we don't want to say, Okay, come to jail and when you're done, we'll educate you and you'll be Donald Trump. That's not the idea. But then on the other hand, if you give somebody a $5-an-hour job or a 6 -- I don't even know what the minimum wage is, but if you give them a $5-an-hour job and $6-an-hour job and they weigh it and they go, Okay, well, I was out doing what I was doing before -- I wouldn't work for -- I'd rather sit on the street than make $6 an hour. And then the final thing is housing, making sure they have a job and a place to stay and some mentoring and some support, because when they go back out, if they go back to Frankford -- for example, with the Frankford Roundtable, we're planning, I think it's, two or three mentors for each inmate. If they 47 3/8/06 - WHOLE - BILL 060001, ETC. go back out on the community and let's say they have a job or they have a house and they don't have anyone in their life who is saying, Stay on the straight and narrow, and they go back out and hang out with the people they were hanging out with before, all is lost, and they will recidivate. So those are the four things.

Lastly, Commissioner, in your view, are the reasons for recidivism similar to the reasons for increase in homicide rate and violence in the City? COMMISSIONER KING: I will say they're all interrelated. I mean, the other thing that you have to think about, there's just been an erosion of morals in the world and in the country. I mean, that's sort of part of it. And also poverty plays a role in it. People just don't have the same morals that they used to. There's poverty that contributes to everything. And they're related, I 48 3/8/06 - WHOLE - BILL 060001, ETC. think, yes.

Thank you, Commissioner. Thank you, Madam President.

You're welcome. The Chair recognizes Councilman Rizzo.

Thank you, Madam Chair. Commissioner, good morning. COMMISSIONER KING: Good morning.

I've been an observer of the Prison System for a lot of years and I think that you've really done a lot with the personnel. I think you brought a lot of leadership there, and I like what I see personally. COMMISSIONER KING: Thank you.

One of the issues that you know I'm interested in, and you used the word this morning, "reentry." I spoke with you this week 49 3/8/06 - WHOLE - BILL 060001, ETC. and you indicated something to me that's troubling, and I think you have a concern. And I don't want to use the word "disappointed," but I am, that for over a year now, I've been working with you and I've been working with the executives of Fairmount Park, and it's the work release program. It's sad to me to see 48 inmates sitting at the jail that have been processed for work release and there's no jobs for them. They sit there day after day after day. When we first started this conversation, I believe it was well over 100. Fortunately, you dwindled that down a bit. We had a sponsor that was willing to give the seed money for a program where people would go to work in Fairmount Park. And you know the Park is under a lot of distress, trees down, and we had it set up where it was going to be called a training program where these inmates eventually would have 50 3/8/06 - WHOLE - BILL 060001, ETC. opportunities to go to work for vegetation management companies, to go to work for companies that could use the skills that they learned working in the Park. And we thought the Park was a good place because it needed a lot of attention. I don't know whether it's political. I don't know whether it's just that we can't focus, but it's a shame when we've got 48 human beings that have gone through a process -- and for people that don't know, and correct me if I'm wrong, when you're processed for work release, that means you can jump on a bus in the morning, go to work and come back to the jail at night after you finish your day's work. Forty-eight human beings that had an opportunity to go to work every morning in Fairmount Park under minimum supervision, being able to replace fences, being able to do other work, learn how to use power equipment to clear walking paths where people can't 51 3/8/06 - WHOLE - BILL 060001, ETC. use because there's trees down. And for that program or that opportunity to be snubbed -- and I don't know where it's been snubbed, by Fairmount Park or wherever. You even had one of your people work with the labor unions, Will Rojas, and they came back and said they had no problem with that, that as long as it is training people for, the buzz word today, reentry. What better program that have 48 human beings that have been processed for work release to be paid. And I had a person that was willing to give you the seed money until the City budget and also matching funds became available. Our Park is in bad shape. What great opportunity to fix it up a bit and also train people for an opportunity for employment in the future. Commissioner, you're a pretty candid guy. What went wrong here? COMMISSIONER KING: Well, I think that the idea to use inmates to 52 3/8/06 - WHOLE - BILL 060001, ETC. give them some training, put them in Fairmount Park, help them maintain the trails and the trees is a fantastic idea. I thought it was a good idea when you brought it to me and I still think it's a good idea. I don't really know what happened to it. I know that it went to other places and it stayed there, but I can tell you that I know you brought it to the Managing Director's attention when he was here testifying. I told you last week that I'd be speaking to him about it. I actually have my meeting today at 5 o'clock with him or 4 o'clock to discuss all prison issues. So I will be bringing it up again. No one ever communicated to me. It was only communicated to me that we couldn't do that. It was never communicated to me why or who said it. And I do know it was prior to this Managing Director. So I think that we have a reasonably good chance of getting 53 3/8/06 - WHOLE - BILL 060001, ETC. it done. I mean, it's a situation where it's really a win-win, in a sense, for the prisons, because it's not -- we have this person who is going to contribute the money to pay the inmates.

And, Commissioner, beyond that, if this effort of mine fails, so be it, but maybe we can start to advertise to the public. Maybe the media would do a story. Forty-eight men -- I believe they're all men -- that have been processed for work release, that this program exists. I mean, there are a lot of good employers out there that aren't afraid to give somebody a shot, give somebody an opportunity. There's some people that might not want to participate, but there are. So I'm hoping that, again, I'd like to see this work, because the Park is dear to me, your system is dear to me, and if we could -- like you just said, it's a win-win, but if that doesn't work out, let's at least let the rest of the 54 3/8/06 - WHOLE - BILL 060001, ETC. business community know, because if someone needs a person, again, they can hop on a bus in the morning, show up for work and come back at night. You rarely have a person walk on you; is that correct? COMMISSIONER KING: Well, every once in a while, we have someone walk, but for the most part, no, we don't have that. They're there. They want to work. If anybody -- I'm just thinking this. If anyone in Council wants to come next Thursday, I think it's at 10:30, we're having an open house down at the Work Release Center to unveil our new resource center for job hunting and all that stuff for inmates. If you want to come, you're invited. But I agree with you, and I promise I'll get back to you after my meeting tonight.

Commissioner, again, we don't need to do it publicly, but I'd like you to ask the 55 3/8/06 - WHOLE - BILL 060001, ETC. question who said no and why. COMMISSIONER KING: Okay.

It sounds like I heard that before. Who did it, when. Or what was that expression? COMMISSIONER KING: I'll ask.

I'm curious what the rationale would be to not pursue a program that could be helpful. COMMISSIONER KING: Okay.

Thank you. Thank you, Madam President.

You're welcome. The Chair recognizes Councilman Kelly.

Right. Thank you, Madam Chair. Good morning, Commissioner. COMMISSIONER KING: Good morning.

Just on a personal note, I wanted to thank you and one of your aides, Greg Vrato, for 56 3/8/06 - WHOLE - BILL 060001, ETC. helping me and taking care of a problem for one of my constituents. COMMISSIONER KING: You're welcome.

I think really your very efficient and very professional manner is appreciated. In saying that, I just wanted to know, are you under any cap at present? I remember years ago there was a prison cap placed because of an agreement between Judge Shapiro and the Administration I believe with Mayor Goode. Has that cap been in existence since then or is it done away with? COMMISSIONER KING: No. 18 There's no cap on the prison population. I mean, there's no legal order in place that says you can only hold so many people. That has gone away. And, of course, that's interesting. When you look at the numbers of the prison population in the '80s, it was sort of going like this, and then Judge Shapiro 57 3/8/06 - WHOLE - BILL 060001, ETC. said no, you can only have so many, then the population went down, and then when she lifted it, it went back up.

So you're asking for 3.2 million. Now, that's based on 8,500, a population of 8,500, and I want to go back to what the Council President has said. What happens if it does exceed that? COMMISSIONER KING: Well, if it does --

What is the growth rate, incidentally, of the last few years? Has that population been growing? COMMISSIONER KING: The growth rate is usually around three to four percent since I've been Commissioner, and before that, there was one year where it wasn't that, in Fiscal Year 2003. I don't remember if you all remember that. The population dipped to 7,100. We're pretty sure that was because of the method of policing in Operate Safe 58 3/8/06 - WHOLE - BILL 060001, ETC. Streets at the time where the focus wasn't on arresting people, but moving them and moving the behavior. So it's been three to four percent.

But what happens if it exceeds the 8,500? COMMISSIONER KING: If it were to exceed the 8,500, then we'd have to do some replanning and reallocating of resources.

It wouldn't be a matter of just releasing prisoners -- COMMISSIONER KING: No. 16

-- because of a monetary restraint? COMMISSIONER KING: No. 19 Sometimes I wish I had the authority to stop people from coming, but I don't.

Do you think you have enough money in your programs to deal with the drug addiction in the prisons? In other words, are you planning on expanding any of these 59 3/8/06 - WHOLE - BILL 060001, ETC. programs to deal with that? COMMISSIONER KING: Well, we're opening another OPTIONS unit, we intend to expand the Jobs Project, all within the budget that we have. I remember years ago Councilman Nutter always used to like to cross-examine or question my predecessor, Mr. Costello, about programs, and he would always bring up the fact 80 percent of the people have a drug and alcohol problem but you only have so many in treatment. There's really never going to be enough money to treat all those people. So you're never going to have a situation, especially when 60 percent of the people are only there two weeks or less. There's really no time to treat them. So there will never be enough money. If you all were going to appropriate all the money I would request so I could have social workers to everybody and programs for everybody, you'd have no libraries or rec centers or 60 3/8/06 - WHOLE - BILL 060001, ETC. anything else. So we have enough money based on the programs that we have now. We can expand them a little bit, and we do expect the Mayor's Office of Reentry Services and others to step up and help us. That's why the Frankford Roundtable is one of the things that we're trying to do. But we're really, in a way, lucky. I was just talking to somebody from the ACLU in Los Angeles. I think it's the largest county jail system, 20,000 inmates. They have no social workers there, no programming, no social workers, nothing. So we're sort of like a Cadillac in the corrections industry, I think. But in answer to your question, we have enough for the programs that we have and we do plan some expansion.

Has there been any discussion on outsourcing of any programs for the prison? And have you ever thought about, for instance, boot camps or something like that, which in 61 3/8/06 - WHOLE - BILL 060001, ETC. other states they do have for younger prisoners? COMMISSIONER KING: I thought of it, and every time we have a series of articles in the paper about people shooting each other, et cetera, I think of boot camps, but I have nowhere to put a boot camp, one; and, two, we have thought about those things, but, again, we don't have the space for a boot camp or anything like that. And, actually, the first part of your question slipped my mind. Could you ask me again? I'm sorry.

About the discussions on outsourcing programs. COMMISSIONER KING: Oh, outsourcing programs. We have a lot of good treatment staff on our team, and the things that they're doing we wouldn't want to outsource. We do have some contractors that come in and do some things. For example, at the female jail, we have something called the Cambria 62 3/8/06 - WHOLE - BILL 060001, ETC. Employment Project, and they come in and do treatment, and that's on a contract. We have JEVS, the Jewish Educational Vocational Service. They come in on a contract basis and they do programming. We're actually getting ready to rebid the CEP project, and we have some reentry partners that come in and help in the Jobs Project. So we do do that a little bit.

Has there been any interest in relocating prisons? Your location is a very, very prestigious location. It's right on the river, and I think Councilwoman Krajewski wouldn't mind to see it moved somewhere so she could develop it in different ways.

No 20 problem.

A casino or something like that would be nice to see on the river. COMMISSIONER KING: I have --

But you have 63 3/8/06 - WHOLE - BILL 060001, ETC. a problem with space as it is. You don't have enough room to expand that prison. I was just wondering. COMMISSIONER KING: No. I really haven't thought about that. I know that, practically speaking, that's just impractical. I mean, it took us, I think, from the time we first started planning the Riverside Correctional Facility, which is the last one we put up, to the time we actually opened the door and put an inmate, that was like ten years. So if we're going to relocate everybody, we have five major facilities, three satellites located most of them up on State Road, that would just take God knows how long and how much money. So I don't really think that that's something that we would ever do.

That's not going to happen, that's for sure. Okay. Thank you, Madam Chair. Thank you, Commissioner. 64 3/8/06 - WHOLE - BILL 060001, ETC.

You're welcome. The Chair recognizes Councilwoman Brown.

Thank you, Madam President. Madam President, Councilman Goode has a solution to Councilman Kelly's question regarding development on the river, and that would be to build a casino and hire the inmates. (Laughter.)

Certainly an out-of-the-box approach to solving that problem along the river. Good morning. COMMISSIONER KING: Good morning.

I read with interest the discussion in your report regarding the 32,000 inmates being released, and we know that many of them are likely to be parents. Will the Mayor's Office of Reentry be offering 65 3/8/06 - WHOLE - BILL 060001, ETC. counseling for prisoners? Will there be an alignment of existing services in DHS or within the Office of Social Services with the services that will be provided out of the Office of Reentry? COMMISSIONER KING: I do know we in the prisons for people who are in Jobs Project, OPTIONS, any of the internal programs, they get parenting counseling and all that stuff. So they get that inside the walls. We do have a partnership with the Department of Human Services, I believe, in relation to female inmates to provide parenting, and I do know from the discussions and some of the things I've seen from the Mayor's Office of Reentry that that's one of the areas that they want to focus on as well.

And I'm to understand that the leadership for the Office of Reentry will be coming before us at some point for more specific questions? COMMISSIONER KING: I would 66 3/8/06 - WHOLE - BILL 060001, ETC. imagine Ms. Danzy has called them, because they were supposed to be here.

Yes.

All right. Then I'll wait. I also read the investment in programs that we do for recidivism and aid reentry. Are you familiar with, have you had any action with yet a new entity called the Benefit Bank, which is a counseling-assisted program? COMMISSIONER KING: The Benefit Bank? I do believe that that issue has come up in relation to some of the planning that we're doing with medical services and discharge planning. That's my only experience with it. I know it was mentioned by the person we hired to do our strategic plan for discharge of inmates with medical problems or mental health problems. One of their issues is getting benefits.

Yes. It's like a one-stop-shop for all the types of 67 3/8/06 - WHOLE - BILL 060001, ETC. services that -- principally low income, but not only low income -- persons typically need instead of doing the run-around to several different entities, agencies, in several different places. They can come here and get food stamps, CHIP, medical benefits, childcare subsidy, the whole nine yards. You should know that I'll be calling for a briefing for the Benefit Bank and will be inviting all the members of Council, along with the leadership of the various social services and government to come here about it, because I think it's, some might say, smarter way to providing services to low-income persons, because they have so many hurdles they have to overcome. So they can make one stop and have access to all those types of needs. COMMISSIONER KING: Yes. I just heard it mentioned last week, and you have mentioned it again, so I'll make sure I look into that. 68 3/8/06 - WHOLE - BILL 060001, ETC.

All right, then. And then, finally, in recent years, there have always been questions from members of this body with regards to MBE, WBE participation, and given the big business that the Philadelphia Prison System is, just discuss and update or summarize for us where you were and what progress has been made with regards to MBE, WBE participation. COMMISSIONER KING: I'll ask Ms. Duzinski, our Contract Administrator, to come up and give you the specifics, but I do know that prisons exceeds the City's average in goals as far as MBEC participation goes, and that as I understand the way it's counted, because it's complicated the way they count it, U.S. Facilities is our contractor for maintenance at CFCF and RCF, and they are a minority-owned company, but they're not included in the count. So if you include them in the count, we well exceed the 69 3/8/06 - WHOLE - BILL 060001, ETC. City's expectations. This is Roseanne Duzinski, our Contract Administrator, who can give you some details.

Good morning and welcome.

Can you first tell us why the company just cited is not included in the count?

That has been rectified as of our last meeting with MBEC. There were some differences in the way certain companies could be counted because of the size of the companies, but I believe that that's been changed by MBEC now so that we can count a major organization.

Okay. Thank you.

Of the $62,878,085.74 that was available in this year's budget in Class 200 for for-profit companies -- we've subtracted not-for-profits because those amounts are 70 3/8/06 - WHOLE - BILL 060001, ETC. not counted by MBEC -- 11.9 percent went to primes, and that prime was U.S. Facilities, and that was approximately $7.5 million. An additional 14.1 percent, or $8.9 million, has gone to minority subcontractors. And then approximately $4.1 million, or just about 7 percent, has gone to female-owned businesses. That was our plan and --

Could I ask you to pause there?

Sure.

Share with us examples in both of those categories, examples of types of services.

Okay. In the minority-owned subcontractors, for example, our entire dental practice at the prisons under Prison Health Services is provided by an incredible minority-owned dentistry business from Baltimore, Maryland, Mumby and Simmons. They just do a phenomenal job. Our specialty services are from 71 3/8/06 - WHOLE - BILL 060001, ETC. a company called Eric Mitchell Associates. That's also a subcontractor to PHS. On the Aramark side, we have a number of subcontractors who provide uniforms, bags, different services of those types. When we get into the female-owned businesses, what we have was, we have a company called Milray, and Milray provides the bulk of food services to Aramark. Excuse me. Also on the minority sides, we have a company named Struthers, and Struthers for Aramark provides all of the food service at House of Correction. So these are real partnerships that are actually going to probably lead to the ability through these companies to become primes eventually.

That's progress.

Yes.

Just share with me a couple more examples of women. 72 3/8/06 - WHOLE - BILL 060001, ETC. You mentioned women.

Oh, sure. Examples of some of the female-owned companies, currently our pharmacy with PHS, the company that actually processes the pharmacy orders are women-owned companies. On our commissary side, the company that provides the uniforms, the company that's providing all of our trucking services is a female-owned company. I believe that some of our office supply providers are also female-owned companies.

What about landscaping?

Our landscaper under U.S. Facilities I believe is a minority-owned company, but I have to check that. They're the kind -- we do attempt to use as many local female and minority firms in our USF contract as possible.

How did you know I was headed there? 73 3/8/06 - WHOLE - BILL 060001, ETC.

Because I am passionate about this.

I appreciate that. Commissioner, in response to Councilman Goode's question about the number of barriers or factors that lead to recidivism, one of them was lack of jobs. Any discussion, conversation between any one of those MBE, WBEs; for example, landscaping, and how inmates being released from prison back to the real world can have an opportunity to have a J-O-B through, for example, a landscaping contractor? COMMISSIONER KING: No. That actually hadn't occurred to me, so I'm glad you brought it up. That's a good idea, one. Two, the only thing that we have going on with the contractors because it's a good concept, we do have it set up through Aramark that they have a culinary -- 74 3/8/06 - WHOLE - BILL 060001, ETC.

Training class? COMMISSIONER KING: Yes. They have a culinary arts program. And part of what we wanted from them, or I think what I insisted, was, You have a Job Placement Center. When our inmates are certified in food service, et cetera, they go down to the Food Center and I expect Aramark to hire them. So I think it's a good idea that had not occurred to me that we could do that with the other subcontractors.

I'm going to make notes and then next year we'll have the conversation again. COMMISSIONER KING: Okay.

Thank you for your testimony. COMMISSIONER KING: You're welcome.

Thank you, Madam Chair.

75 3/8/06 - WHOLE - BILL 060001, ETC. You're welcome. The Chair recognizes Councilwoman Blackwell.

Thank you, Madam President. I wanted to thank the Commissioner. I call often on so many issues, but we want to thank him for always being available and for servicing us in a very positive, professional way. Thank you. COMMISSIONER KING: You're welcome.

Thank you. The Chair recognizes Councilman Ramos.

Thank you, Madam President. I have the same expressions for our Commissioner for the job that he's doing. It must be one of the most difficult jobs in America, along with the Police and other services that we have to 76 3/8/06 - WHOLE - BILL 060001, ETC. provide our citizenry regardless of what their conditions are. There's a program at the prison where you have this big yard sale. You make things, furniture, and I've noticed that it's been cancelled a few times. You probably have had it since I honed in on going there and see what I could buy. Can I buy stuff from there, Madam President? Am I allowed to? Can I? I'd better find out whether I'm allowed to buy stuff from you. But I think it's a very good project, but it doesn't seem that -- what seems to be the problem with it, if there is? Because I think it's a very good opportunity to have some extra income for the system that is always in need of extra money. COMMISSIONER KING: That's our prison industry's shop. They sell used or things that people have used or gotten back.

Do you make 77 3/8/06 - WHOLE - BILL 060001, ETC. any new -- I believe you make new -- COMMISSIONER KING: Yeah. You can come up any time. We have a showroom. I think we just had an open house last week if you want to buy new stuff.

Such as? COMMISSIONER KING: Desks, chairs, anything you would need to outfit your office, we provide that. And I'm sure they can make customized things, too, if you have a drawing that you want us to do. So we're always open. You can always call my office if you have need of furniture. We do printing services, things of that nature. So that's always a thing. But as far as the yard sale goes, as I recall, and our Deputy Director of Legal Affairs can correct me if I'm incorrect, but I believe it was the Law Department who told us we couldn't have those yard sales anymore. 78 3/8/06 - WHOLE - BILL 060001, ETC.

What kind of revenue are you generating from the sale of furniture? That seems to be like the primary thing. And, if so, what else can you do -- I don't know much about it. A couple times it attracted me, but maybe this is something you should promote. COMMISSIONER KING: I'd be happy to promote it. I like promoting my department, but maybe Mr. Szymanski can talk about the finances at Philacor.

And a little bit more about the program, if you may.

Edward Szymanski, Fiscal Officer of Prisons. The Prison industry's fund is a separate entity from the General Fund. The revenue that's earned from that program is recycled, rolled over into the fund to purchase supplies and to pay for the inmate workers that are employed by the Prison industry's fund. It doesn't have any impact on the General Fund, though. 79 3/8/06 - WHOLE - BILL 060001, ETC. COMMISSIONER KING: How much money is there?

The amount of money that they recover from the, quote/unquote, yard sale, I'm not sure of the number. We would have to research that when we get back to the office.

I know that in the state penal system, there's industries that are money generating. Is this something that you would see as something you would want to build on? Although it doesn't affect your operating budget, is this something that is on your things that can help you with other costs incurred with our system? COMMISSIONER KING: I don't know what the monetary impact was, and whenever we can advertise prison industries or make a sale, that helps us with it. So I'd have to check in to see how much they made on prior occasions to see whether the yard sale is a big piece of what they do. But more important for 80 3/8/06 - WHOLE - BILL 060001, ETC. prison industries is what -- I would have to thank Council again. I think you did it last year. You passed a bill and I think the Mayor signed to expand the market that Philacor was able to sell things in. So things like that can help us. And what we're trying to do now is actually line people up for jobs when they leave. That really is what we've always done. You sort of like you go into Philacor, you have a job. It keeps you busy.

That's a very good point, because if you expand this business, that then we're very much focused on reentry programs, that if your inmate population is learning sales, is learning maybe -- or also fixing these furnishing or making new furnishing, that you're starting to provide these type of skills for a person that when he or she gets out can go into the market and find a job. 81 3/8/06 - WHOLE - BILL 060001, ETC. COMMISSIONER KING: Yes. So that's what we're trying to do. It's just that we have to be strategic about what we plan. And some of the things -- for example, we have a garment shop, where we're just moving the garment shop. And they make all of the inmate clothing at the Philadelphia Prisons. Last week they're moving. They're expanding. I said, Okay, before you get any more money, I want to hear what the reentry plan was. And then I was told, Well, there really aren't any sewing jobs or stitching jobs in the United States anymore. They're all in China or someplace else. So now the dilemma is what do we do with the garment shop, do we change it. But we're working on all those issues.

Okay. Anyone from the public can go to these sales, right? COMMISSIONER KING: No. That wouldn't -- we can't sell to the public. 82 3/8/06 - WHOLE - BILL 060001, ETC.

It's only City employees? COMMISSIONER KING: City employees, non-profit agencies that are contracted with the City and the School District and non-profit agencies.

Please pardon my ignorance. Why can you not sell it to the general public? COMMISSIONER KING: Well, it's a matter of there are federal statutes on the book that talk about the interstate commerce of goods made by inmates.

Okay. I saw two lawyers looking at me and the Council President nodding her head. Okay. Thank you so much, Commissioner. Keep up the good work, but let's see if we can do a little something in this area as well so when we have that population moving back into our communities, that there are some skills there that they've picked up and we continue to expand the industries within 83 3/8/06 - WHOLE - BILL 060001, ETC. the system. Thank you so much. COMMISSIONER KING: You're welcome.

Commissioner, before I recognize Councilman Rizzo -- and I don't want to lose my train of thought -- I know that at one time your institution was doing a lot of our stationery. Is the City still using -- COMMISSIONER KING: Yes.

Really? All departments? COMMISSIONER KING: I don't know if all departments are using us, but I know -- is it all departments that you know? Virtually all the departments are using us for that, yes.

And how about the other printing? Councilman Rizzo was just calling to my attention we have these beautiful citations that we give out on a Thursday to many very 84 3/8/06 - WHOLE - BILL 060001, ETC. worthwhile people, and they are rather costly. Have you seen one of them and do you think --

I gave him one, Ann. Madam President, I gave him one.

Sorry. Mea culpa. Do you think that your people would be able to do that? COMMISSIONER KING: I see no 13 reason why they can't, but I need to confirm that. It doesn't seem like it should be a problem. They print everything that you could imagine. I know they printed a lot of -- they printed ballots and all sorts of things for one of the elections. I mean, it's a full-service print shop.

They print ballots for elections? COMMISSIONER KING: They print forms, all sorts of things. Because I remember I went down there because I 85 3/8/06 - WHOLE - BILL 060001, ETC. needed some work done, and they said, No, Commissioner, you got to wait, we're doing work for the election that's coming up. So I can check into that and get back to you.

Okay. That sounds interesting to me. Councilwoman Brown.

I also wanted to seize the moment to commend the Commissioner on the progress that's been made with regards to putting, where appropriate and would be appropriate credentials, putting women in leadership within the Philadelphia Prison System. COMMISSIONER KING: Thank you very much.

I did not want that to go by since that was an extended discussion a year ago. COMMISSIONER KING: Thank you.

I wanted to also follow up on the questions 86 3/8/06 - WHOLE - BILL 060001, ETC. regarding the new reentry program. COMMISSIONER KING: Mr. Taliaferro is here from the Mayor's Office of Reentry, and he can, I guess, answer any of the questions that you had before.

Good. Good morning.

Good morning.

Madam Chair, I had a point of information that was on the other issue. You must have forgotten.

Oh, I'm sorry. Okay. See, when that happens, the light goes off.

Thank you.

Councilwoman Brown, do you mind?

Not at all.

Thank you.

87 3/8/06 - WHOLE - BILL 060001, ETC. Commissioner, I want to go back to the -- what's the formal name of the program? COMMISSIONER KING: The Jobs Project or the work release?

Prison industry. COMMISSIONER KING: Philacor.

Well, I remember a time where that industry supported many of the operating departments. I'll give you an example. When we had a significant snowstorm, the Police Department could not find tire chains, and they were breaking quickly. The Police Department brought barrels of chains to the jail, to the prison, and the inmates repaired them and got those tire chains back. I believe when we had the mounted unit, the dry cleaning shop was taking care of many of the horse blankets and pads at one time. I really believe that there's enough work before we need to go out -- 88 3/8/06 - WHOLE - BILL 060001, ETC. and it wouldn't be a bad idea if we could get around it somehow, but I think there's so many opportunities to support Fleet Management in certain areas. There's vehicles that need to be detailed. There's police cars that haven't had a detail for years, they're so raggedy. We could probably even set up an operation to do that. Because let me tell you, if there was a profession that's in demand, it's that one, a person to go to work for an automobile dealership and be able to expertly detail a vehicle. I mean, that's just an example, not that that could ever happen, but it could. I think that we in the government and the operating departments, really some day you need to brief us, more so the operating departments, like Fleet Management and the Police Department and those areas, because I think they could keep you as busy as could be up there with -- again, we talk about reentry. 89 3/8/06 - WHOLE - BILL 060001, ETC. What an opportunity to develop a trade, and I know that's what it's all about for when they leave there. COMMISSIONER KING: I agree with you, and I don't know the extent of whether we're still doing that. I know we provide barricades for the Police Department. So whenever you see those blue and yellow barricades around, they're made at the prisons. But we do need to relook at that again.

That's great. Thank you, Madam Chair. Thanks, Councilwoman Brown.

You're welcome.

The Chair recognizes Councilwoman Brown.

Sure. So can you provide for us a summary of the reentry program, how and if services that you'll be offering will be aligned with other existing services 90 3/8/06 - WHOLE - BILL 060001, ETC. within the Department of Human Services or the Department of Social Services? And, finally, are you aware of Benefit Bank, which is a one-stop-shop, principally for low-income persons but for sure folks who are returning to society who need a bevy of support services and instead of going to several different systems, they can go to one place and have access to a range of services that they need?

Thank you, Councilwoman. Actually, you're speaking my language on that. I'm not only aware of the Benefit Bank, I've just been installed as one of their Board members. We've been working with them for several years on the faith-based side of things. What we intend to do with the reentry program is to find a way upon the release of an ex-offender, to find a way for them to have access to all services needed for their successful reintegration. A person gets out of 91 3/8/06 - WHOLE - BILL 060001, ETC. prison. They may not have ID. You can't get a bank account without ID. You can't get a job if you don't have certain other accoutrements. So in one place, we're going to put a one-stop-center. One will be in North Philadelphia. Then we'll open a second one in Frankford. And the idea being there to provide every salient and useful service for their being made whole, getting their ID in order. The Benefit Bank will be a part of that process. They'll be able to go in there, find out what benefits they are eligible for so that they can get those entitlement programs that will accrue to them practically immediately, as you already know. The reentry program is designed to dovetail with what is being done by the prisons now. Whereas the prison is preparing them with certain programs, once they leave those gates, most guys who get out and most women who get out 92 3/8/06 - WHOLE - BILL 060001, ETC. don't want to go back to continue the program there. Our job is to make sure that there is an apples-to-apples program on the outside utilizing the services of certain volunteer organizations, particularly the faith community, who will be providing the same services on the outside. Councilman Rizzo just made mention of the fact of car detailing and so forth. One of our contractees at this present moment is a car detail shop that trains ex-offenders on how to do the work. And here's the best part about it: They have a 100 percent employment rate. Everyone who comes through their program has gotten a job thus far. We're utilizing them. We're trying to figure out how to expand their services.

In your absence, I shared with the Prison Commissioner there also may be an opportunity to explore with landscaping contractors and recently released 93 3/8/06 - WHOLE - BILL 060001, ETC. individuals, and take them through a training program where they can ultimately be considered to be hired with a landscaping contractor who is doing business with the Philadelphia Prison System. So to Councilman Rizzo's point, there are a number of potential opportunities in industries where folks who are leaving prisons can have access.

Just if I might respond to that by adding to it. Jobs like that, landscaping jobs, automobile repair jobs, these are jobs that are very -- how shall we say? They're plentiful, they're accessible and they're functional. You can get people into them. There are other jobs also that are helpful, but then we have to concern ourselves with certain union issues. But the landscaping job was one that we hadn't thought of. I imagine having grown up in Philadelphia, I don't think a whole lot about cutting grass, 94 3/8/06 - WHOLE - BILL 060001, ETC. but I'd like to take that back to our committee and discover how we can expand our services to include it.

Sure. Well, it's new and needed, and I wish you much success.

Thank you, Councilwoman. I appreciate it.

Thank you, Madam President.

You're welcome. Are there any other questions from members of the Committee? (No response.)

Seeing none, I thank you. COMMISSIONER KING: Thank you, Madam President.

Your testimony has been very informative. We thank you. COMMISSIONER KING: You're welcome. 95 3/8/06 - WHOLE - BILL 060001, ETC.

Thank you so much. The next department to testify will be the Health Department. Good morning. Please identify yourself for the record and proceed with your testimony. COMMISSIONER PARIS: Good morning, President Verna and members of Council. I am Carmen I. Paris, newly appointed interim Health Commissioner. Thank you for the opportunity to present the Department of Public Health operating budget request for Fiscal Year 2007. The FY07 Department of Public Health budget request totals $191,623,635. Of this total, $112,119,379 is in the General Fund and 79,504,256 is in the Grants Fund. 6 million in the Grants Fund. 6 million total budget, 96 3/8/06 - WHOLE - BILL 060001, ETC. million, comes from City tax-supported funds. The Department's budget will support 973 full-time positions, 698 in the General Fund and 275 in the Grants Funds. The 698 General Fund positions for FY07 represent an increase of 44 positions over the 654 General Fund positions that were filled in December of 2005. This is an increase of 12 positions over the number of General Fund 13 budgeted positions in the FY06 adopted 14 budget. That includes a restoration of 15 funding for 17 custodial positions due to 16 the termination of the warehouse 17 centralization initiative and a gain of 18 one new position in the Medical Examiner's Office. All Councilmembers are very knowledgeable regarding the Department of Public Health services, but we would like to note that we have performed these services within the boundaries of the FY06 budget and we have been able to 97 3/8/06 - WHOLE - BILL 060001, ETC. achieve the key goals we have set. I will highlight some of those. Biological terrorism and emergent diseases remain persistent public health threats everywhere. The Department continues to improve its capabilities for identifying public health emergencies and acts of biological terrorism through disease surveillance and communication, and our plans to manage mass illness and/or casualties in the City. In particular, in FY06, the Department completed activities on the federally mandated City's Readiness Initiative, which required planning for distribution of oral antibiotics or vaccinations to the entire Philadelphia population within 48 hours of a large-scale public health emergency. The Department has developed a written plan for implementing the mass medication distribution and has conducted two large-scale field exercises to evaluate and practice the plan. 98 3/8/06 - WHOLE - BILL 060001, ETC. In addition, a pandemic influenza plan has been developed to augment the overall Public Health Emergency Response Plan. Training of Department staff in the Incident Command System and the National Incident Management System, as well as in other aspects of Philadelphia's Public Health Emergency Preparedness Plan, took place in FY06 and will continue through FY07. The FY07 budget includes $3 million in the Grants Fund for emergency preparedness. As a result of the November 2003 voters' mandate, the Department has worked toward the goal of creating a realistic and practical plan to provide quality healthcare services to every Philadelphian. To help us assess the full universe of problems with the current healthcare system, we commissioned an analysis from the Woodrow Wilson School of Public Policy of Princeton University and sought the 99 3/8/06 - WHOLE - BILL 060001, ETC. participation of a variety of stakeholders in a series of information-gathering sessions. In May 2005, the Department released Decent Health Care for All in Philadelphia: Local Leadership & Action. The principle recommendation of the report is the establishment of a Health Leadership Partnership to assist public and private sector leaders to develop strategic plans and better coordinate health services in Philadelphia. The FY07 budget includes $150,000 for the creation and establishment of the Health Leadership Partnership.

The Department continues to work to increase childhood immunization rates across the City. In 1993, barely 40 percent of Philadelphia's two-year-old children were adequately immunized. Through a variety of improvements in assuring access to vaccines for all Philadelphia children, including working with community-based organizations to 100 3/8/06 - WHOLE - BILL 060001, ETC. outreach into communities with low immunization rates, the Department was able to bring the rate up to 81 percent in 2003. In recognition of this work, the Philadelphia Department of Public Health has recently been named to receive an award from the Centers for Disease Control and Prevention, CDC, as one of the urban areas with the most improved vaccination coverage for children. 7 million in the Grants Fund for childhood immunization. The Department is focusing on primary prevention, outreach to new mothers, and education on the hazards of lead in homes to prevent new babies from becoming lead poisoned. Thus far in FY06, we have provided primary prevention services to more than 1,200 new mothers with a special emphasis on immigrant and refugee populations. We have conducted lead hazard reduction work in 125 homes in which new mothers reside with their 101 3/8/06 - WHOLE - BILL 060001, ETC. children. The Lead Abatement Strike Team, LAST, successfully continues to secure collaboration among health, housing, regulatory, enforcement, and child welfare agencies to combat childhood lead poisoning. The backlog of 1,400 units with unabated lead hazards identified in 2002 has been reduced by three-quarters to 364 housing units in 2005. None of the units remaining is occupied by children, and no new housing units have been added to the backlog since 2002. 3 percent of the children screened in Calendar Year 2005. Philadelphia's effectiveness in 102 3/8/06 - WHOLE - BILL 060001, ETC. childhood lead poisoning prevention is a national model, and the Department has been successful in attracting federal and state funding to support its efforts. 5 in the Grants Fund for childhood lead poisoning prevention. For the past several years, the Department's West Nile Virus Prevention Program has consisted of intensive mosquito surveillance and control activities. In 2005, human cases of 15 West Nile Virus, including two deaths, 16 were reported in Pennsylvania. In 17 contrast, 2005 is the first year since 18 the early phases of the West Nile Virus 19 outbreak in which no human cases of the 20 virus were reported in Philadelphia. The 21 FY07 budget includes grant funding of 22 $350,000 for the West Nile Virus 23 Prevention Program. 24 In 2005, the Department's Air 25 Management Services concluded five years 103 3/8/06 - WHOLE - BILL 060001, ETC. of enforcement negotiations with a large industrial facility in the City, resulting in a signed Consent Agreement that will require the company to undertake projects to reduce air pollutants by more than 1,000 tons, resulting in cleaner air for Philadelphians. Infant mortality is the measure of the number of babies who die before one year of age per thousand live births. 5 deaths per 1,000 live births in 2004, this information just confirmed, the latest year for which the data is available. This is a decrease of 33 percent. Despite the overall improvement, there are significant racial disparities that remain among individual Philadelphia neighborhoods. For the period 2002 through 2004, rates ranged 104 3/8/06 - WHOLE - BILL 060001, ETC. from a low of five in some predominantly white neighborhoods to a high of nearly in some predominantly African-American 5 neighborhoods. DPH has a number of 6 infant death review processes in place 7 that furnish data related to the 8 circumstances of death that we are using 9 to improve Department maternal and infant 10 health policy. 11 DPH has implemented two new 12 strategies to address infant mortality. 13 The first is an expansion of the newborn 14 home visiting initiative.

Our goal is to 15 ensure that every new mother in 16 Philadelphia, particularly in high-risk areas, has the benefits of an early intervention home visit. We are working toward a coordinated system with managed care plans and home health agencies to provide in-home nursing visits to all Philadelphia mothers and their newborns, regardless of insurance status. Newborn home visiting will provide opportunities for comprehensive 105 3/8/06 - WHOLE - BILL 060001, ETC. education about immunizations and sleep position, as well as the importance of reducing home hazards and lead risks. The second strategy is to continue to communicate the risks of bed sharing and unsafe infant sleep positions. We are collaborating with the Department of Human Services to launch a public information campaign to educate families about these risks through medical providers and through our outreach agencies. The number of newly diagnosed AIDS cases has continued to drop, from 1,160 in Fiscal Year '02 to 758 in Fiscal Year '05. However, AIDS continues to affect minority communities disproportionately. 7,334, 78 percent, of the 9,340 persons currently living with AIDS in Philadelphia are people of color. DPH continues to expand its outreach activities to address this disparity, including the development of a program specifically designed to engage 106 3/8/06 - WHOLE - BILL 060001, ETC. African-American youth in HIV/AIDS education activities and testing. The Department supports a network of HIV/AIDS specialized treatment and care providers throughout the City, which includes the Department's health centers. The network offers medical care, medications, case management and a range of support services to enable consumers to overcome barriers to care. 3 million in the Grants Fund. After an extensive national search, the Philadelphia Animal Care and Control Association, PACCA, hired a permanent full-time Executive Director in April 2005. PACCA has also restructured its Board of Directors, which is now comprised entirely of persons in the field of veterinary medicine and community stakeholders, all of whom have a strong and vested interest in the mission of helping Philadelphia become a 107 3/8/06 - WHOLE - BILL 060001, ETC. "no-kill" city. PACCA has already made significant progress, improving its animals "saved rate" to 58 percent in January 2006, up from 38 percent in January 2005. 35 million budget in FY06, which will become a permanent part of the budget in FY07 and future years. 7 million. The Department has created a structure to address chronic disease prevention as a public health program. The Chronic Disease Prevention Program pulls together the activities and initiatives of Steps to a Healthier Philadelphia and the Tobacco Control Unit. Steps to a Healthier Philadelphia targets asthma, diabetes and obesity, and funds intervention activities that promote disease, self-management, healthy behaviors in 108 3/8/06 - WHOLE - BILL 060001, ETC. individuals and healthy environments through a variety of intervention activities offered at community centers, workplaces and schools. These services are provided through contracts with 7 community-based providers. 8 Tobacco control activities 9 include coordination of tobacco cessation 10 and community awareness programs, as well 11 as a variety of counter-marketing, youth 12 access prevention, and enforcement 13 activities that are provided through 14 contracts with 18 community-based service 15 providers. The main goals of the tobacco 16 control activities are to reduce the rate 17 of smoking among Philadelphia adults from the 2004 rate of 26 percent to 12 percent by the year 2010, and to reduce the rate of smoking among the very difficult to reach population of ninth through twelfth graders from the 2003 rate of 14 percent to less than 12 percent by 2010. In 2005, Episcopal Hospital, the parent company of Episcopal Long-Term 109 3/8/06 - WHOLE - BILL 060001, ETC.

Care, ELTC, announced it was leaving the business of long-term care and gave the City notice that ELTC would not renew its contract to operate the Philadelphia Nursing Home at the end of its contract on June 30, 2005. ELTC had operated PNH since January 1994. In response to this decision, the City solicited interest from long-term care providers to either contract with the City for the operation of PNH or to take over the PNH nursing home license from the City. The latter option would have involved a transfer of the license from the City to the new provider and a sublease of the facility. The City leases the PNH site from the Commonwealth. At the end of this process, the City decided to contract with Fairmount Long-Term Care, FLTC, to operate the facility on the City's behalf. Fairmount Long-Term Care is a newly formed non-profit whose management team and 110 3/8/06 - WHOLE - BILL 060001, ETC. Board were drawn from ELTC. As of the end of February 2006, the facility had an in-house census of 410, with PNH residents in hospitals, 6 for a total census of 435. The facility 7 continues to operate within budget, while 8 providing quality care for its residents. 5 million. 12 Our health centers continue to 13 provide essential medical care and public 14 health services to a large number of 15 residents. In FY05, the health centers 16 served approximately 100,000 individuals 17 who made 338,000 patient visits. A major 18 focus continues to be assisting 19 insurance-eligible health center patients 20 to become insured. Since FY03, this 21 initiative has increased the number of 22 health center insured visits from 36 23 percent to 49 percent, despite the 24 continued challenge of serving increasing 25 numbers of residents who are uninsured. 111 3/8/06 - WHOLE - BILL 060001, ETC. During the first quarter of FY06, 79 percent of new patients using the services of the health centers were uninsured. 6 million budget for FY07 comes from state and federal sources of funding. Our initial analysis of the Governor's proposed state budget is that level funding is expected in most areas, and increased funding is possible for the Children's Health Insurance Program, CHIP, and Adult Basic coverage for uninsured adults. The preliminary FY07 federal budget prepared by the President could have the effect of reducing funding for Department disease control, immunization, HIV/AIDS and air pollution control programs. We will monitor these developments closely over the next few months. Thank you for the opportunity to present testimony today, and I will be happy to answer questions at this time. 112 3/8/06 - WHOLE - BILL 060001, ETC.

Thank you. Welcome and congratulations on your elevation. COMMISSIONER PARIS: Thank you. Thank you, President Verna.

Do you believe that PACCA is being given the necessary resources to carry out their mission and provide adequate levels of service? COMMISSIONER PARIS: PACCA is one of the divisions that we are -- one of the contracts that we're very, very well aware of the fact that more support is needed. To this effect, in Fiscal Year '06, in addition to the $2.35 that were assigned to it, we added $304,000, and we are now securing this money permanently. We think that, of course, more money, more resources could be placed into this agency, and what we have done in the Department to support their mission and their goals is to provide 113 3/8/06 - WHOLE - BILL 060001, ETC. them with in-kind services. We have provided them with the phone system. They use our phone system. They don't pay rent. They share space with one of our programs. We also take care of their utilities, and also we provide in-kind assistance through personnel. For example, our Office of Facilities Management have been the one providing for all the care of the facility, sustaining the facility. We have done electrical general repairs, HVAC repairs in the facility, and we've also provided technical support for the information systems.

I know that Councilman Kelly will have further questions on that, so I will continue on with my line of questioning. Can you bring us up to date on the Nursing Home? I believe you indicated who is managing it. Can you tell us the terms of their contract and what, if any, exposure does the City 114 3/8/06 - WHOLE - BILL 060001, ETC. have? COMMISSIONER PARIS: This is a yearly contract. We are very pleased with the fact that they have and continue to -- they have been providing excellent service, and they are within the budget. The risk for the City will be, if any, if there is a deficit at the end of the year. Right now we are paying approximately --

I'm sorry. I'm sorry. You're going to have to repeat that. If at the end of the year? COMMISSIONER PARIS: Yes. If at the end of the year there's a deficit, we will then subtract the management fee, which is anywhere between $700,000 and $800,000. Then whatever the difference is between the deficit and the management fee will be the responsibility of the City.

Okay. You mentioned that the City's health 115 3/8/06 - WHOLE - BILL 060001, ETC. centers have 338,000 patient visits in FY05. How many visits do you anticipate to have in FY06 and FY07, and can you tell us what is the average waiting time for a visit? COMMISSIONER PARIS: Yes, ma'am. Our visits for FY05 were 338,000, and we expect pretty much level for FY06-'07. Potentially a decrease, but not a significant decrease. Our projection right now is 330,000 visits for FY06.

And what is the average waiting time for a visit? COMMISSIONER PARIS: That is a complicated question, President. It depends on what appointment you're referring to. It depends if it's an adult visit or a pediatric visit. And it also has to do with which of the sites are we talking about. There is a larger demand in some of our -- much larger demand in some of our health centers than 116 3/8/06 - WHOLE - BILL 060001, ETC. others. On average, we have in some centers a waiting period for initial visit for adults for two months and, in general, for pediatrics for one week.

I do know that at some of the centers last year we were told that their waiting period was much longer than others. When you say two months for adults, is that the average? COMMISSIONER PARIS: That will be the average for an initial visit, ma'am. What that means is, if a person calls and says, I want to see a doctor for the first time in one of your health centers, we will let them know that there is an average wait of two months. That doesn't mean that if the person is ill or if the person makes any kind of request because he's not feeling well or the children is not well, we will then follow that with explaining what the walk-in policy in the centers are, which is 117 3/8/06 - WHOLE - BILL 060001, ETC. anybody that is ill can come in at any given day without an appointment and after being triaged by a nurse, they will see a physician.

Is this a new policy? COMMISSIONER PARIS: No, ma'am. This policy has been in effect forever.

My memory serves me that I believe it was the center at Broad and Lombard, it was testified to last year that the waiting period was so long and people who were quite ill could not get an appointment and they were told to go to another center somewhere in the Northeast where the demand was not quite as large as what we had downtown. So again I'm going to ask. The average waiting time for someone, say, at Broad and Lombard, and I'd like you to compare that to what the waiting period would be for one up in the Northeast. COMMISSIONER PARIS: I am a 118 3/8/06 - WHOLE - BILL 060001, ETC. little confused about the question, ma'am, because on Broad and Lombard what we have is the sexually transmitted diseases clinic.

I know. COMMISSIONER PARIS: And that is a walk-in -- there's no appointment given for receiving treatment on that clinic. That clinic is 100 percent run on a walk-in basis.

I'm going to have to look at the notes of testimony, because I recall that very, very distinctly. COMMISSIONER PARIS: Yes.

Well, where is the one in South Philadelphia that -- COMMISSIONER PARIS: There's one on Broad and --

Tasker? COMMISSIONER PARIS: Broad and 119 3/8/06 - WHOLE - BILL 060001, ETC. Tasker, ma'am.

Tasker, Morris. What's the waiting period there? COMMISSIONER PARIS: In that center as of March 1st was three months for our initial visit.

Supposing you have to go back, how long do you wait for a second visit? COMMISSIONER PARIS: It depends on the physician, ma'am, and the treatment. Our physicians have the authority that when they see you, if your condition calls for you to come back in two weeks, an appointment will be given to you in two weeks. What we have done is, we have given them the authority to be able to add on to their schedule as they see fit.

I know you said it's a three-month wait for the first visit, and you said that if I am ill and I went to the center, I would 120 3/8/06 - WHOLE - BILL 060001, ETC. be checked by a nurse? COMMISSIONER PARIS: Yes, ma'am.

Just walking in? COMMISSIONER PARIS: Yes, ma'am. You will walk in. You will sign in in the log. You will be called. You will be triaged by a nurse, and then depending upon the conclusion of the examination by the nurse, you will be seen by a physician.

That very day? COMMISSIONER PARIS: Yes, ma'am.

That very day? COMMISSIONER PARIS: Yes, ma'am.

This is much different testimony than I recall having heard in the past, to be very honest with you. However, I'm delighted 121 3/8/06 - WHOLE - BILL 060001, ETC. to hear that one can be checked on the same day and at least be diagnosed. Councilwoman Brown, your light was on, but I think it went off. Did you want to be recognized?

Thank you, Madam President. I mistouched it. My questions are actually for the next testifier, Julia Danzy. Thank you.

Okay. Councilman Ramos.

Thank you, Madam President. Ms. Paris, congratulations as well. COMMISSIONER PARIS: Thank you, sir.

I would probably need to have Dr. Mirchandani join you as well, because my line of questioning is more focused in on the Medical Examiner's Office. Is he here? I saw him earlier. There he is. Back in December, I introduced 122 3/8/06 - WHOLE - BILL 060001, ETC. a resolution calling for hearings in the Committee of Public Health and Human Services chaired by Councilwoman Marian Tasco to conduct hearings to investigate the policies and procedures of the City Medical Examiner's Office with regards to identifying missing persons. This came about particularly, one, because of my involvement in the issue after the young girl Latoiya Figueroa was missing, was found slain, but also that a missing girl by the name of Niecey Jefferson had been reported to have been found in the Medical Examiner's Office after two years. So we asked for the pathologist at the City Medical Examiner's Office -- a pathologist at the Medical Examiner's Office read a story in the Philadelphia Inquirer about Niecey Jefferson after her family attended the Missing Persons Conference on November 5th of last year, and information from this article 25 reminded this person that works in the 123 3/8/06 - WHOLE - BILL 060001, ETC. Medical Examiner's Office that he had a body there that was there for about two years, came from the general area of where this young lady was last seen. We went on to hold public hearings on January the 5th concerning this very issue. During that hearing, we had a very good exchange on the involvement of the Medical Examiner's Office with the Police when it comes to missing persons and why this particular young lady who had disappeared two years earlier had been at the morgue all this time. A Mr. Quain of the Medical Examiner's Office testified that the Medical Examiner's Office as a remedy and as a way to improve on how you handle these cases, stated that the Medical Examiner's Office and the Missing Persons Unit of the Police Department would be meeting on a weekly basis. This was on January the 5th. Can you tell me, Ms. Paris or 124 3/8/06 - WHOLE - BILL 060001, ETC. Dr. Mirchandani, if these two departments are still meeting weekly, and what has been the nature of their discussions? COMMISSIONER PARIS: Yes. The departments are meeting weekly ever since the hearings were held. They are sharing information pertaining to the new cases, and we are even revisiting those cases that have been in file for quite some time.

So these meetings, they're structured meetings? COMMISSIONER PARIS: They're structured to happen, yes, sir.

To happen or they're happening? COMMISSIONER PARIS: They're happening since January.

Dr. Mirchandani also testified at our hearings on January the 5th that his office had an advisory committee and that this committee had experts in the field of missing persons, but no one from our 125 3/8/06 - WHOLE - BILL 060001, ETC. communities of the City or family members of missing persons are on this committee, and, Dr. Mirchandani, as you remember, you indicated that you welcomed this idea. I just wanted to know if this issue has been addressed. Have you expanded the people, the number of people, to also include on that committee families of missing loved ones? COMMISSIONER PARIS: We --

Excuse me. I believe you're asking the doctor the question; are you not?

Yes. The doctor can answer. COMMISSIONER PARIS: I'm sorry.

Doctor, please identify yourself for the record.

My name is Haresh Mirchandani, Medical Examiner of the City of Philadelphia. Good morning.

Good morning. The stenographer cannot hear 126 3/8/06 - WHOLE - BILL 060001, ETC. you properly. Would you please spell your last name?

My first name is Haresh, H-A-R-E-S-H. Last name, Mirchandani, M-I-R-C-H-A-N-D-A-N-I.

Thank you.

Medical Examiner for the City of Philadelphia. We have met with the Medical Examiner Advisory Committee. We have a meeting every quarterly. Every three months we have meetings, and we have not -- we brought the problem to the Medical Examiner Advisory Committee, which consists of the Chairman of the Department of Pathology at the Drexel University.

Doctor, you're going to have to speak into the microphone, please.

And we did meet with them, and we are going to -- we are still looking for the candidates for 127 3/8/06 - WHOLE - BILL 060001, ETC. who have expertise in missing person. And I think the expert of the missing person are the people from Police Department, and we are meeting with them anyway on a regular basis.

What you committed to do was to add someone from the community that either had had an experience with a missing loved one or people in the community that were involved in this type of human anguish type of problem. Have you added that type of person to your Advisory Committee?

No, we have not. We have not had that, no. 18

Okay. I believe I stated at that hearing that if you were to give me a call, I can probably recommend you 20, and if you call the President of City Council, she probably has another 20. If you reach out to us, we will be able to recommend you some people, especially that we have 128 3/8/06 - WHOLE - BILL 060001, ETC. families now that have had missing loved ones just recently. Latoya Byrd, who had been missing for almost a year, showed up in Newark. There was a big story about her. It was because of the type of attention that the public gave to their missing loved ones that this now has become an issue of a lot of interest and throughout the City. So I would suggest that you reach out to -- you're welcome to reach out to me, and I'm quite sure that the Chairwoman of this Committee as well, that there are people that are willing to be part of this Advisory Committee.

I will certainly do that, Councilman. I'll do that, absolutely. I think you'd be of help to us. As to suggesting names of these people, they would be included on the Advisory Committee meetings.

And the transcript will also tell me that two of the families that were here that 129 3/8/06 - WHOLE - BILL 060001, ETC. testified, families of missing loved ones, volunteered to join the Advisory Committee on that day. So time has gone by, and I think that if you had two people here that testified and two different families that testified on their experience of missing loved ones, one of them was this one particular case, I find it kind of -- I don't know why you didn't call them up or got them here and tell them, Why don't you join my Advisory Committee. Get someone on that Advisory Committee, please.

Okay.

A Mr. Quain also testified at that hearing that he had been working for the Medical Examiner's Office for 17 years. Is he here?

Yes, he's here.

Yes. There you go. And that his office had -- and 130 3/8/06 - WHOLE - BILL 060001, ETC. you stated that your office was understaffed, and that in your budget, there is -- I asked if there was any request for staffing in your budget, because you did state that you were understaffed. Have you included a request for additional staffing in your department?

Should I state my name and title for the --

Please.

David Quain. That's Q-U-A-I-N, and I am the Forensic Services Manager for the Medical Examiner's Office. Yes. We have asked for two additional investigators.

Are they in the budget? COMMISSIONER PARIS: Currently we have eight investigators and nine technicians, Councilman Ramos, and we understand that we need to have at least 131 3/8/06 - WHOLE - BILL 060001, ETC. investigators and 12 technicians to really be able to address the volume of work. And what we're doing is, we will be asking in target budget for five new additional positions to fulfill the vacancies, any addition to bring in support.

10 Excuse me, Councilman. I'm sorry. I 11 don't mean to interrupt. 12 But I don't understand what you mean by "target budget," and why wouldn't you be asking for it now? COMMISSIONER PARIS: The request for additional staffing came in late and we were not able to include it in this fiscal year budget on time. That's why we are going to wait until this is revisited again during target budget, which happens in the end of May, beginning of June. Then we will request the additional positions that we need for this office.

Was January 132 3/8/06 - WHOLE - BILL 060001, ETC. the 5th too late to make that request of this year? COMMISSIONER PARIS: Yes, it was.

What was the deadline to receive the request? COMMISSIONER PARIS: Our budget was due in December.

I know this was not on your clock, Ms. Paris, because your clock only started ticking the other day. I think yesterday, right? COMMISSIONER PARIS: Yes.

Mr. Quain, did you make this request to higher-ups or Dr. Mirchandani about the necessity of these two -- you referred to them as investigators?

Yeah. The title is Forensic Investigator.

When did you make that request?

Staffing has been an issue at the Medical Examiner's Office 133 3/8/06 - WHOLE - BILL 060001, ETC. for some time and it's hard for me to recall exactly when this request was made. Certainly after the hearing.

Was it made right after you testified here on January the 5th?

It was made after. I'm not sure exactly when after. I think Carmen Paris was away and so upon her return.

How important was this issue to the Medical Examiner's Office and to the Health Department? I have now my good friend Dr. Mirchandani saying that he couldn't find a volunteer or he still hasn't gotten a volunteer, he hasn't gotten a person for his Advisory Committee, and now a request that you've made a number of times to get two more investigators has not happened, after everything that has occurred in the area and all the publicity, all the facts that have come forward in this Chamber and in the media 134 3/8/06 - WHOLE - BILL 060001, ETC. about a problem over there in the Medical Examiner's Office when it comes to identifying missing persons that are in the morgue, one of them for two years.

Hiring is not that simple a solution.

I understand that, but if you tell me in a hearing that that's always been a problem, you emphasized that on January the 5th, the request to hire two people -- and the Commissioner just talked about hiring five people -- it gives the impression that although the public is saying that this is a very important issue, it doesn't seem like you're at the same level of the public's concern about this issue. This is a perception you're giving. COMMISSIONER PARIS: If I may, Councilman Ramos, since the hearings in January, we have as a result of the issues that were brought to our attention from this Council, we have done some 135 3/8/06 - WHOLE - BILL 060001, ETC. significant changes and improvements in the way we do business at the Medical Examiner's Office. One of the problems that we have is that we have vacancies, because one of the seasoned experienced Forensic Investigators has now been given the responsibility of solely working with missing persons for identified bodies in the morgue. So even though we still have had some vacancies, this issue is of such importance that we moved one of our most experienced workers to address this issue. And this is the person that is responsible to continue and carry on the formalized weekly meetings that we have with the Forensic Investigators and the representatives from the Police Department Missing Persons and also with the Special Victims Unit. We have formalized a procedure for submitting the reports, so that we now have demographic information 136 3/8/06 - WHOLE - BILL 060001, ETC. available. We have been in contact -- and, actually, I am very excited because we have successfully been able to submit three names to the University of North Texas DNA Collection Center project so that we can go at a national level to expose this information and hopefully be able to link these missing individuals with their loved ones. In addition to that, we have arranged for an agreement with the FBI for the acceptance of our specimens to be entered into the national database, and we have established a website link in the Medical Examiner's page to a current list of UHR missing to the -- and identify human remains. So that now the public can access information directly. When you open the Health Department website page, sir, you have a link that will connect you --

I'm familiar with it. COMMISSIONER PARIS: -- to the 137 3/8/06 - WHOLE - BILL 060001, ETC. MEO that will connect you immediately to the list of unidentified human remains.

If Mr. Quain and others have for the last years 6 stated that they're understaffed and then 7 we see all these things happen around the 8 Medical Examiner's Office, particularly 9 last year, then I would probably, if I 10 was in your shoes, if I was in the shoes 11 of the -- although I don't qualify to be 12 Health Commissioner by no stretch of the 13 imagination, but I would have included 14 already something in this budget by now, 15 because chances are that because of your 16 understaffing and these other things that 17 are very good things that you just mentioned and very important that we bring the Medical Examiner's Office up to speed on what's out there and be connected to it so we don't have a Niecey Jefferson case happen. Again, shortly after that case, a case of a gentleman who had been missing for a number of months, a gentleman from Juniata, Bobby 138 3/8/06 - WHOLE - BILL 060001, ETC. Borschell, his body also was found in the Medical Examiner's Office, that you would include and know that this is something that the public thinks is very, very important, and that you have people in City Council that are willing to fight for you and say if we need it, let's go see how much is it going to cost and let's get the money to address this problem. Can you give us a quick overview of some of the changes? You just mentioned some of them, Ms. Paris, but some of the changes, if not Dr. Mirchandani, some of the changes the Health Department and Medical Examiner's Office have done in regards to communications between city, state and federal agencies regarding missing persons. You mentioned Texas, because Texas seems to be one of the areas where they're leading in this area of missing persons identification. Are you doing anything with the 139 3/8/06 - WHOLE - BILL 060001, ETC. state? You mentioned what you're doing with the City. Are you doing anything with the State of Pennsylvania, Mr. Quain?

Yeah. In August of 2005, there was the President's DNA initiative, and basically it was -- this is a national problem and there are about 40,000 unidentifieds in the country. So my plan was to model our efforts the way that the FBI suggested in this initiative. So what we do is, and so far, for the three that are unidentified for 2005, is, we have sent specimens for DNA typing. Once that typing is done, we can forward that to State Police. We could have that for the City as well. But this is a service that University of North Texas is -- they're receiving grant money from the FBI from the Department of Justice. So it doesn't cost us anything. In addition to the specimen, they do DNA typing on anyone who has a 140 3/8/06 - WHOLE - BILL 060001, ETC. missing loved one. So they can -- they accept it from people who have someone who is missing. So the idea is, on a national level, you'd be able to make a connection. Just keeping in mind even if we sent it to the State Police, Philadelphia being so close in proximity to New Jersey or Delaware, it's not out of the realm of possibility that somebody is from any other state. So the plan was to make it on a national level so that we'd be able to be more successful.

Thank you, Mr. Quain. One of the problems, Mr. Mirchandani, one of the troubling things that I found came out of the hearings on January the 5th was that there's an individual that has been identified as Mr. Hall. This is a matter of public record. This is not for me to make any judgment on him, on his qualities, but his name came up a number of times during the hearings. It was 141 3/8/06 - WHOLE - BILL 060001, ETC. that Mr. Hall who works for the Medical Examiner's Office made some disparaging remarks to a Ms. Orlanda Smith who testified in those, and that testimony is available to you because it's public record. She was a person that found the children who found the body of Niecey Jefferson. She related the comments that were made by Mr. Hall that were very, very offensive, bad taste. I read it as very bad taste, and everyone in the hearings that day were very taken aback by the remarks that were made by a Mr. Hall in the Medical Examiner's Office. Have you talked to Mr. Hall about that, anyone talk to him since January the 5th about questions about his professionalism, his language, the content of his language in dealing with people? We always have to remember that regardless of the circumstances around a disappearance or in a lot of cases 142 3/8/06 - WHOLE - BILL 060001, ETC. ultimate death, this is still somebody that people in the family, they still love him and it means a lot, their baby and their loved one. It means a lot to them. And to call the Medical Examiner's Office and to have someone talk and say the things that were said here in public testimony to a person who is broken-hearted and not sleeping for two years trying to find their daughter was very, very appalling.

Yes, sir. As a matter of fact, the day of the hearing, when I returned back to the office, Mr. Hall was there. And I, too, was upset at the remarks that were made, and I spoke to him immediately about that and told him that it was totally inappropriate, and he was disciplined for that. The discipline consisted of a written reprimand, as well as he was due for a promotion and he was not promoted.

We also stated at that hearing -- I don't know if 143 3/8/06 - WHOLE - BILL 060001, ETC. it was Councilwoman Miller, but that if you have someone saying things they shouldn't be saying to a person who is searching for a missing loved one, that training -- I mean, you said you're going to do training. I know that was something else that the Medical Examiner said that he would do. Has he been sent to be retrained?

Yes, sir. We are -- and not just for him, for the entire staff, obviously, but we're looking into dignity training, sensitivity training, things of that nature. And also, I should say that monitoring all the employees. I am spending more time monitoring their behavior. We meet with families in person as well as over the phone. So that's the other side of it.

Okay. Tomorrow I'll be introducing a resolution 24 urging the Pennsylvania House of Representatives to pass Bill No. 1462 144 3/8/06 - WHOLE - BILL 060001, ETC. that basically would require local officials such as the Police Department, the Medical Examiner's Office to share DNA samples of missing persons with the State Police for the latest in DNA analysis, and I hope that -- I was just in touch with the sponsor of the bill, Representative Gabig from Cumberland County, and he's very much interested in getting this bill passed. So I will introduce that bill 13 that -- I'm sorry. I will introduce this resolution tomorrow, and I'll look forward to my colleagues supporting this resolution and see if we can get this passed. It is going to be upon you. I will follow it, but it's upon you to do some follow-up now. It's like follow-up to getting someone on that Advisory Committee, follow-up on this. I suspect that you will be in support of this, right?

Yes. Absolutely. 145 3/8/06 - WHOLE - BILL 060001, ETC.

Then you need to follow up on it, and you want to make sure that the Medical Examiner's Office is staffed to handle the workload, and if you don't tell us that you need it, then we can't help you.

Yes, sir.

And there are circumstances -- and I know you have an option to redress the issue by June, right? Was it June you mentioned? COMMISSIONER PARIS: The end of May, beginning of June.

Okay. Thank you, Madam Chair, for letting me --

Point of information, Madam Chair.

You're welcome. Point of information. Councilman Rizzo.

I don't want to lose my turn. I know when I push this 146 3/8/06 - WHOLE - BILL 060001, ETC. button --

You can push it.

Thank you. It's really troubling to hear Councilman Ramos for all these months concerned about this particular issue. Could you explain to me, when you have a person -- when you have a body -- forgive me for not all the terminology here -- that's in your facility for months and months, what does the Police Department do about it? Obviously when a body turns up, it normally, you would think, be a Police issue. It sounds like the burden is on you to figure this out. Where does the Police Department fit into this thing?

The Police Department does the initial processing of the scene. If a death is determined to be a homicide, then it's a criminal matter and there's follow-up by the Police Department. Often times if a 147 3/8/06 - WHOLE - BILL 060001, ETC. situation is, whether it's a drug death or a natural death, the burden of identifying the person and locating the family is on the Medical Examiner's Office.

So have you ever had a situation where there has been a -- maybe not homicide, but let's say someone comes with physical injuries to your facility. What's the proper terminology for your facility? The morgue?

Medical Examiner's Office.

If a person comes there that doesn't have a gun shot, or just say that they've been beaten, is that your responsibility or is that a police case? Maybe that's part of our problem here, that the Police Department is getting out of the loop on some things that they should be more involved in. I mean, how often do you have a person that comes in that's clearly just 148 3/8/06 - WHOLE - BILL 060001, ETC. natural death, you don't know who they are and the Police aren't involved?

So far this year we've had almost 40 unidentifieds that have been identified. We don't have anyone currently who is unidentified for this calendar year. Some of those are homicides. Most of them are not homicides. We have the body and we have the information about the deceased. So the responsibility has been with the Medical Examiner's Office to use that information to identify the deceased and track down the family.

I remember an issue a few years ago where I received communications from some very poor people that claimed they couldn't afford to have that member of their family buried. What do we do now with the person that -- I hate to use the word they're unclaimed, or nobody steps forward. Maybe that's a better word. What do you do with the 149 3/8/06 - WHOLE - BILL 060001, ETC. corpse now?

On cases where the family is indigent and can't afford any type of cremation or burial, the City does do a cremation, and the family is entitled to the ashes. There is a time period of probably two months before it can happen, but it's what we have in place. And they are usually happy to get the ashes back, and, like I say, there's no expense to them for that.

At this present time, there isn't a situation where we have someone being kept at the morgue for months and months and months waiting for someone to pick them up? I mean, what's the longest you keep a body there? This is difficult to discuss, but I'm trying my best.

We have a period of time of 90 days. When we have a deceased and we don't have family, it gives us an opportunity to try everything we can to locate relatives and it also gives -- 150 3/8/06 - WHOLE - BILL 060001, ETC. there's a period of time for relatives to come forward. And then after three months, we would do a creation even if we didn't -- even if we weren't able to find family. There are a number of elderly people in this City who live alone who have, for all intents and purposes, outlived their family, and we will still try to find any distant relative, notify them of the death, but eventually after three months, we will do a cremation. If we have family right away or less than three months and the family is notified but they're either financially unable or unwilling to assume any responsibility, then at that time we would immediately arrange for a City cremation on their authority.

Thank you. I'm pleased to hear that. That's good.

Thank you, Councilman. Councilwoman Reynolds Brown. 151 3/8/06 - WHOLE - BILL 060001, ETC.

Thank you, Madam Chair. I was mistaken. I've just learned that the questions I have for Ms. Danzy were actually in your testimony, so I'll propose them to you and then you decide as leadership. First, on the child immunization, 40 percent in two-year-olds in 1993 and now 81 percent in 2003, which for sure is a remarkable gain. What factors do you believe have contributed to the progress, number one, and do you have current figures for 2004 and 2005, and then what strategy do you have in place to ultimately break the 90 percent barrier? COMMISSIONER PARIS: The significant increase was based on collaborations between the Department of Health and community-based organizations that were actually in the community doing outreach work. What we have done was, we collaborated with them, trained their 152 3/8/06 - WHOLE - BILL 060001, ETC. staff so that in addition to what every kind of support they were providing already to the Department, they will now start looking for the children that have not been immunized as of yet. And we concentrated our resources in those specific areas where there was a significant low percentage of children immunized.

CBOs such as what, such as who? When you say you partnership with community-based organizations, cite a few examples. I'm curious to know, is the mission of those organizations health related, or what? COMMISSIONER PARIS: They have been giving me the names of two of the organizations. One of them is the Council of Spanish Speaking Organizations, Concilio, who is in North Philadelphia, and the other one is Scan, who does --

Scan? COMMISSIONER PARIS: Yes. Both 153 3/8/06 - WHOLE - BILL 060001, ETC. agencies, which already had contracts with the Health Department to provide services.

I see. So right now it's two? COMMISSIONER PARIS: Yes.

So what might be the strategic plan to ultimately move that to 90 percent child immunization? COMMISSIONER PARIS: Well, among the many things that we are looking for, the implementation of Done By One, which is the program that in January '06 was put together to ensure timeliness of immunizations. So we added a brand new program. We have also launched a website, immunization registry, in February of 2006 that will allow the providers to receive up-to-date immunization information on every child in Philadelphia. So if you're taking your child to the doctor, now the doctor 154 3/8/06 - WHOLE - BILL 060001, ETC. will have updated information that will be able to let them know whether or not this child is up to date with their immunizations.

One continuous challenge in government is getting professionals to talk across lines, but also getting folks external to government connected to, for example, the service of child immunizations. So with that in mind, is there any connect with the new childcare alliance association, ABC, Alliance for Better Childcare? COMMISSIONER PARIS: Yes, ma'am. And I'm smiling because it is one of the projects that I have been personally working in the Department for. We have now convened a task force that includes the childcare organizations in the City, and we meet with them monthly to look at not only immunization rates but also childhood lead poisoning. And with them, we're working on improving not only how we access those licensed 155 3/8/06 - WHOLE - BILL 060001, ETC. providers but also the non-licensed providers. And we continuously come up with strategies that we implement. Some of the players that come in, not only are they childcare organizations but also we have agencies like PCCY is a member of our task force, as well as the state.

Very good. Any role for the School District? COMMISSIONER PARIS: Yes, ma'am. We actually have -- the educations are, Ms. Burnett attended our last meeting.

So they're at the table? COMMISSIONER PARIS: Yes, they are.

Let's move to the newborn home visiting initiative, which appears to be a terrific goal. I'm curious to know how you're going to pay for it and what strategy are you going to use to ensure, as you state in your 156 3/8/06 - WHOLE - BILL 060001, ETC. testimony, every new mother in Philadelphia will ultimately be able to benefit from this early intervention piece? COMMISSIONER PARIS: We're extremely excited about this initiative. We are working toward a system that includes the managed care organizations. So that as it is, through the mandate that the managed care organizations have, they are supposed to provide for a visit for every newborn. What we are doing is collaborating with them so that since they have that mandate anyway, why not allow us, the Health Department, to take the partners that we have in the community and make sure that that visit takes place. It's a win-win situation. So they will, instead of paying their own staff or people that certainly know how to access this population, instead of doing that, they will do it through people that are already in the community. 157 3/8/06 - WHOLE - BILL 060001, ETC. So this is something that we're really, really excited, because not only will we be able to talk to the mothers about immunizations, but also we'll be able to talk to the mothers about childhood lead poisoning. We are going to take it a step beyond and we're going to partner with the Philadelphia Fire Department and they're going to even train us on how to go in a property and look for different hazards.

Is that to suggest that managed care companies or is there some evidence to suggest that managed care companies are currently not doing that since they are mandated to provide these home visits? COMMISSIONER PARIS: I would not say that we have evidence that they're not doing it. What I'm saying is that because of their low rate in terms of success, they have not been doing it correctly. 158 3/8/06 - WHOLE - BILL 060001, ETC.

When you say you just started, what does that mean? A month ago? Six months ago? When? COMMISSIONER PARIS: Well, we have been meeting with them for quite some time, and right now we are almost ready to launch this effort.

We'll look forward to that. COMMISSIONER PARIS: Thank you, ma'am.

My final question, I believe, is around, are you aware of the Benefits Bank and what that is and what enormous potential it has for moms who are low-income status and the like? I mentioned the Benefit Bank with all the leadership of this Department because it also has as a part of its portfolio, I guess, state children's health insurance plan and medical benefits. Are you aware of that? 159 3/8/06 - WHOLE - BILL 060001, ETC. COMMISSIONER PARIS: I am personally not aware of it. I'm pretty sure probably the staff will be aware of that.

It's not a problem. For the record, you should know that I'll be calling for a briefing so that my colleagues can also hear about it, and we will extend an invitation to all of those in the social service leadership positions so that you're aware of it and what it can mean in terms of delivering better services to low-income families so that they don't have to jump around various systems to get what they need. COMMISSIONER PARIS: We will be more than happy. It will be our pleasure to participate, ma'am.

On of your testimony you talk about 78 percent of those living with AIDS in the City, of course, are people of color, and we know more and more that -- I've 160 3/8/06 - WHOLE - BILL 060001, ETC. learned that more and more of them are women of color. I'm pleased to see that the Health Department is taking a targeted, active approach in dealing with this. Describe for us more the HIV/AIDS education and testing program that's briefly discussed in your testimony. COMMISSIONER PARIS: I am going to defer to Assistant Commissioner Joe Cronauer to answer that question for you, ma'am.

Sure. ASSISTANT COMMISSIONER CRONAUER: Hi. I'm Joe Cronauer, Assistant Health Commissioner in the Philadelphia Department of Public Health. Our efforts around HIV prevention are primarily guided by what the federal government, the CDCs, calls a Community Planning Group made up of Philadelphians, more than half of whom already have HIV and know what that 161 3/8/06 - WHOLE - BILL 060001, ETC. experience is like, and they provide us not only with guidance around what interventions we should follow the CDC has found to be scientifically valid, but also what communities we particularly need to target. And primarily we follow the epidemic; that is, if we know the epidemic is primarily affecting people of color, we want to get ahead of that. We want to provide more -- we want to focus on that to a greater extent, to a greater percentage than the epidemic represents, because it's a trend and we want to get ahead of it. Same thing with women and particularly women of color. Our efforts are primarily through community-based organizations. HIV testing, for example, we provide over 30,000 HIV tests that the City pays for every year. They're provided through 50 sites across the entire City. They're virtually all community based. There's a mix between anonymous, if people don't want to give their names, or 162 3/8/06 - WHOLE - BILL 060001, ETC. confidential. And we're initiating new programs primarily with the help of Senator Hughes, who last year secured an additional million dollars to target HIV prevention activities primarily to African-American youth, and we're hopeful that he'll be able to secure that money in the coming year as well. And we're doing that in partnership with the School District and we're doing it with community-based organizations, particularly within his district, but also across the entire City.

Can you provide to the Chair a listing of who those organizations are? I'm curious to know where they're located. ASSISTANT COMMISSIONER CRONAUER: The organizations doing HIV testing?

Both, the organizations providing the testing as well as those where you're providing education-related information. 163 3/8/06 - WHOLE - BILL 060001, ETC. ASSISTANT COMMISSIONER CRONAUER: Absolutely.

Speak to activities that really are designed to target African-American women. ASSISTANT COMMISSIONER CRONAUER: The activities designed to target African-American women are -- there are two different venues. One is a community-based venue where organizations that are primarily organizations of color in communities like Germantown and in North Philadelphia and West Philadelphia, engages pretty much a peer-driven activity, but it's peers that are trained. So it would be women of color who are trained in the interventions. For example, curriculum that have been proven to be effective -- because we want to know what you're doing actually works. Conversations are great, but it has to be a conversation where we can really impart information and skill so that people can make more informed decisions. So we do 164 3/8/06 - WHOLE - BILL 060001, ETC. that training. We have training for all of the outreach workers that are community based. So they're trained and certified in the interventions that we know are effective, and they engage in those interventions in either a group setting or one-on-one called individual level intervention where they engage individuals on a one-on-one level and provide information and, where appropriate, help people develop plans for making safer decisions in the future. The second venue is around perinatal HIV transmission.

Around what? ASSISTANT COMMISSIONER CRONAUER: Perinatal HIV transmission.

Perinatal? ASSISTANT COMMISSIONER CRONAUER: Perinatal, which is the prevention of HIV from mother to newborn child. In that effort, we're now working with all of the delivery hospitals in the 165 3/8/06 - WHOLE - BILL 060001, ETC. City to make sure that rapid testing, which is a new technology introduced last year, is available to all women who present in a delivery room who have not been tested for HIV during their pregnancy during prenatal care. And, of course, it's optional, but our hope is that women who have been chosen to be tested will choose to be tested with a rapid test when they present for delivery, because if it turns out that they have HIV, we can provide interventions then during delivery to help reduce the rate of transmission from mother to child. So we're doing that, not only them but also targeting prenatal programs, because we'd rather catch women earlier as opposed to when they're presenting for delivery.

So then for sure you're tied into the newborn home visiting initiative? ASSISTANT COMMISSIONER CRONAUER: Absolutely. 166 3/8/06 - WHOLE - BILL 060001, ETC.

That was a test. Years ago there was a lot of criticism, some might say legitimate, that agencies providing services to HIV/AIDS patients were not talking to each other. What is the status of that today? ASSISTANT COMMISSIONER CRONAUER: The AIDS Activity Coordinating Office actually has monthly meetings with all of our providers, so that we're all in one room and we all have an opportunity to talk about what the issues are, how we can better work together. Then they have community-based meetings that happen on a regular basis. For example, around HIV testing, when we have to implement the new HIV rapid testing, which is our goal because people would rather know now as opposed to a week from now what the results are, the way we implement that is by having all of our HIV testing providers come in and meet 167 3/8/06 - WHOLE - BILL 060001, ETC. with us on a regular basis, work with us and work with each other to develop a plan on how to implement that which will meet their needs and will obviously meet the needs of Philadelphians. And we do that for all the variety of activities we have. For example, we do the same thing around HIV case management, where we have centralized coordination and regular meetings with all of our providers to make sure that they're overcoming that sort of silo mentality that can sometimes be there.

Very good. There aren't enough dollars for us to be silo anymore. ASSISTANT COMMISSIONER CRONAUER: Absolutely.

Finally, any linkage with recovery programs, and particularly recovery programs providing services to women and then women of color, since that's where the incident is going through the roof? 168 3/8/06 - WHOLE - BILL 060001, ETC. ASSISTANT COMMISSIONER CRONAUER: Absolutely. We have not only a lot of our HIV prevention interventions that are happening within drug and alcohol recovery programs such as One Day At a Time and Recovery King and a couple of other rather large programs where we do not only education but testing, CODAAP, and they'll be coming out next, has HIV testing and education that they provide in a range of recovery houses as well that they work with. And what we do in the Health Department is provide the training of certification and provide the resources for testing for all of those activities that happen as well. So we're connected with CODAAP to make sure that we have one system where everybody is educated to the same standard.

Okay. Well, thank you very much for your testimony. Thank you, Madam Chair. 169 3/8/06 - WHOLE - BILL 060001, ETC.

Thank you. Councilman Kelly, would you wait for Councilman Rizzo? His point of order took him out of his natural order. He's next and then you and then Councilwoman Tasco.

I'm sure he'll be brief.

That's correct. Always, since I'm going to compliment him.

Thank you.

Congratulations. My question is about PACCA. I really appreciate all the improvements, but I really believe that if it weren't for my colleague, Councilman Kelly, that the progress would have been a long time coming on making significant improvements. I'm trying to remember, and 170 3/8/06 - WHOLE - BILL 060001, ETC. maybe you can help me, I'm sure that you recollect this news story. I believe it was in a suburban community where a person's cat was at a facility and they left a message on the machine, they even left a note that they saw the cat through the window, and the cat was put down. That was really sad, I mean, to see that occur. And I'm positive as a result of that whoever manages that facility, before they would do something like that, in the morning they check -- I'm being very basic here, but if something like that could happen there, I would hope we learn by that experience that we do everything, look in a mailbox or check the voice mail or do whatever we have to do. Because to see that young girl cry the way she did at the loss of her pet, it was really sad. And I got some e-mails. My own mother was so upset by the fact that that little cat was killed, and just the reaction that happened. It made it look like this could only happen 171 3/8/06 - WHOLE - BILL 060001, ETC. on something that the government oversees. It would never happen in the private sector. But it just makes us look, government in itself, look bad. Did we learn anything from that or did we do anything to make sure that something like that couldn't happen? I know it's only a cat, but to somebody, that cat is maybe the only person they have in their life that they love, you know. COMMISSIONER PARIS: Yes. Actually, I can relate to that story because I have adopted two cats from the shelter. So I couldn't imagine what it would feel like to lose one of them. But one of the things that we have done so that corrections are in place and PACCA can move forward is the hiring of an Executive Director. We have hired a person that is very much qualified to run this facility. And what we have done is, in addition to continue to provide the support, all the income 172 3/8/06 - WHOLE - BILL 060001, ETC. support, we have made sure that we continue to meet with her so that whatever assistance she might need, whether it's in information systems, the phone systems, whatever it is that she might need to get from us, she will get it. I understand that she's done significant improvement, and not only in terms of the facility itself but also in the training of the staff, and I know that the staff now is much better prepared to deal with that kind of situation.

CBS 3, I think it's on Sunday morning or Saturday morning -- my days get mixed up -- I heard something that was so impressive. Carol Erickson loves animals, and the success rate that they have, I don't think they've ever had one animal that they have shown on television go unadopted. That's really impressive. We have a great -- I'm amazed 173 3/8/06 - WHOLE - BILL 060001, ETC. how many people watch our City TV channel, and I mentioned it many years ago, that it would be great if the Commissioner could have her own little TV show on our City channel to show the public the pets that we have there. We have this system. It's there. And I'm impressed. I thought I was the only one in the world that watched it, because I want to sometimes see what we do here. A lot of people do see that, and I would just recommend again -- I did suggest it in the past, and I don't know how far we've gone, but even if we did pictures of an animal and say, Adopt this animal. Because I know after hours they just run stuff about the Water Department, about the Streets Department, about the Health Department. That might be another opportunity to get the word out so we don't have to -- I know Councilman Kelly wants it to be a zero -- what's the proper language? COMMISSIONER PARIS: No kill. 174 3/8/06 - WHOLE - BILL 060001, ETC.

No kill.

No kill. And I'm for that. So what more can we do than use that TV station to do that? COMMISSIONER PARIS: Absolutely, and we totally agree with it. To the fact that not too long ago we had a company here in the City that wanted to do some taping of public service announcements and so on, and we thought that this might be an excellent opportunity for PACCA to take advantage of it and get some of those PSAs recorded. And that information has been made available to the Executive Director, who is in the process of contacting the company so that they can produce this show that then can be shown in the cities.

That's good to hear, too, that that's going to be on the general media. COMMISSIONER PARIS: But also on our channel. 175 3/8/06 - WHOLE - BILL 060001, ETC.

I'm talking about our Department of Public Property's and the School District, we have three or four stations where I think in this area the more, the better. COMMISSIONER PARIS: Absolutely. And these different videos, productions, are going to be done in a way that they can be used in any televised program or channel.

My colleague said I'll do the commercials. No. 14 That's okay. I think it's a great improvement, and I thank you, because it was really troubling to see what we were struggling through there, and thanks for all the effort, and also to my colleague, Councilman Kelly, who really pushed hard from the bottom of his heart, by the way, to make this happen. COMMISSIONER PARIS: Yes. Thank you.

Thank you. 176 3/8/06 - WHOLE - BILL 060001, ETC.

Thank you, Councilman. Councilman Kelly.

Yes. Thank you, Madam Chair.

Certainly.

I just want to follow up on, of course, the same subject that we were just addressing. First of all, let me congratulate you on your appointment. I think it's very well earned, and I think that you and I are going to be working very closely on this subject, and that's PACCA. As you well know, about a year or so ago, there was some negative publicity throughout our local papers here, and from that, we were fortunate enough to have Councilwoman Tasco, who chaired the Health and Human Services Committee, to hold hearings immediately to resolve or at least to improve the 177 3/8/06 - WHOLE - BILL 060001, ETC. problems that PACCA was having. And I agree with you that we have now a Director who has really taken immediate action. I think that we have a turn-around. We're going in a new direction, and I want to see that continued. I think there's a lot of improvement that could be made, and I'll go into that in a minute. Presently their budget, their contract, for PACCA was 2.6 million, I believe. COMMISSIONER PARIS: 2.35 and we added another $304,000.

I believe you said 2.7 million. Is that for '07? COMMISSIONER PARIS: That will be -- actually, it will be 2.69 for '06 and we are asking that that becomes a permanent item in our budget. So that in years to come --

So it's almost 100,000 more than what it was? COMMISSIONER PARIS: 304,000. 178 3/8/06 - WHOLE - BILL 060001, ETC.

304? COMMISSIONER PARIS: Yes, sir.

Now, the salaries, I believe, and the personnel expenses come to about 2.3 million. Would that be correct? COMMISSIONER PARIS: The personnel expenses, they come up to 1.2, $1,271,000.

1.2? COMMISSIONER PARIS: Yes. Yes, sir.

And that leaves over a million or so for operational costs; is that true? COMMISSIONER PARIS: That's correct, sir.

See, what I want to get down to is that I think we should have improvements and probably additional funding for PACCA. I really do. Because presently there's probably, from what I gather, there's been reported 1,700 cases of dog bites, for instance. 179 3/8/06 - WHOLE - BILL 060001, ETC. And presently you have six trucks to handle animal control in the City. How many of them are actually being used? COMMISSIONER PARIS: To my understanding, all the vehicles have been used. They are contracted to be used for animal care, and that is the number -- what we have done is, we developed a scope of services for PACCA.

Is there anyone from PACCA here? COMMISSIONER PARIS: We usually don't --

I know it's a contract. COMMISSIONER PARIS: I don't think we have --

I know they're not part of it, but I just have a lot of questions on this. And maybe you can answer this one. The City Charter allows for an Animal Controls Fund? COMMISSIONER PARIS: Yes, sir.

And all 180 3/8/06 - WHOLE - BILL 060001, ETC. license fees collected by the City should be going to this fund. Do you know if that's being done or is this just going into the general revenue of the City? COMMISSIONER PARIS: That fund has been created. There is a fund, and we have right now -- we're starting to collect the monies from the licenses, and our plan is that we will -- anything in excess of the $60,000 that the City committed to put in place the licensing operation, that will go into the fund.

If there was an increase in licensing fees, that would go into this Animal Control Fund? COMMISSIONER PARIS: Yes, sir.

Anything like that? Okay. COMMISSIONER PARIS: Yes.

I don't know if people are familiar or people know about this, but about a year ago, there was about 25,000 animals euthanized every year in Philadelphia. We have made 181 3/8/06 - WHOLE - BILL 060001, ETC. improvements there. We've reduced the animals being killed, but we still have a long way to go, and as Councilman Rizzo has stated, my goal is, of course, to have a "no kill" policy in Philadelphia. It's going to take a lot of funding. It's going to take a lot of effort on a lot of people's parts to do this, and I'm sure that you're going to be part of it, because what we want to do is work with you and we're familiar with you and we want to ask you for any help you can give us in this endeavor. Right now what happens when an animal is euthanized? What happens to the body? COMMISSIONER PARIS: Well, the Streets Department takes care of that. Well, if it's an animal that is euthanized, we have an agreement where the Streets Department takes care of it and is in compliance with all the EPA regulations. EPA and Streets have communicated to confirm that, yes, we are 182 3/8/06 - WHOLE - BILL 060001, ETC. in compliance.

You're in compliance, but as far as you know, it's the Streets Department just picking up the animals? Do you have any idea what they do with it? COMMISSIONER PARIS: The Streets Department has a process by which they --

Well, what I would like to do is, shouldn't those animals be cremated? Wouldn't that be the proper way of -- COMMISSIONER PARIS: I apologize, sir. I don't know what the Streets Department does.

That's something I would like to know and how much would the cost -- I mean, would it be an additional cost for that? Does it pose a health risk when you're just taking those animals and throwing them in a landfill or whatever the Streets Department does with them? 183 3/8/06 - WHOLE - BILL 060001, ETC. COMMISSIONER PARIS: No. The Streets Department has a process in place that meets all the requirements and regulations of the EPA, of the Environmental Protection Agency. So they're regulated. So that they dispose of the animals that are euthanized in a way in which they are not a hazard to the environment or to anyone in the community.

Well, I'll follow up on that later, but it seems to me that the funding is -- this is a very low priority in the Health Department. I can understand why, with all the problems that we have today with AIDS and a lot of other things, but this is a problem that's been, I think, neglected and underfunded for many, many years, and to me, it's a quality of life issue. Some of the seniors that we have or people who just have a pet and that's it and it's part of their family, and I think this is very, very important to have the proper 184 3/8/06 - WHOLE - BILL 060001, ETC. animal care in this City. One of the things I would like to ask you if you would be recipient to is, if we received additional funding, for instance, for PACCA that would enable us to ask for grants from private sources, such as Maddie's Fund -- I'm sure you're familiar with it. New York City recently just received $10 million. This would be a great boom to us to get to be the first major city in this country to have a "no kill" policy for their animals in the City. If we were to be able to get sufficient funds from private sources, such as Maddie's Fund, I'm sure within five or six years we could be that city. This is one of the things that I'm going to be asking you to look into. I'm asking a lot of people if we were. And another thing it would do, I understand there's problems with people getting through to PACCA. Do you have any idea how many phone calls a month are 185 3/8/06 - WHOLE - BILL 060001, ETC. made to PACCA? COMMISSIONER PARIS: PACCA's phone calls are answered through the center call operation that we have here in City Hall. I don't have with me the numbers, sir, but I will certainly be more than happy through the President's office to get you that information on how many calls we receive monthly.

I may be wrong on this, but it's something like 10,000 a month. Now, I know they only have one or so operators in PACCA to handle those calls and I know no person could handle that many. And you're right, I think most of those calls are put through the City Hall switchboard, but that to me is not the way to go about it. If a person is calling and it's sort of an emergency or want to get some help immediately, going through the City Hall switchboard just doesn't do it. I think we would rather have operators from PACCA to give them the information that they 186 3/8/06 - WHOLE - BILL 060001, ETC. need immediately. COMMISSIONER PARIS: Sir, we have our own operators in this building. They don't go through the City Hall switchboard.

But how many do you have? COMMISSIONER PARIS: We have six of them that are just answering the calls for PACCA and the health centers.

Oh, okay. COMMISSIONER PARIS: They manage all the calls.

That's for how many health centers? COMMISSIONER PARIS: Eight health centers.

So you have six and they handle eight health centers in addition to PACCA? COMMISSIONER PARIS: That's correct.

Does PACCA have any operators themselves? 187 3/8/06 - WHOLE - BILL 060001, ETC. COMMISSIONER PARIS: Yes. They have one person there. Yes.

That's the problem. COMMISSIONER PARIS: What we have done is, we have provided, through the Department of Health, staff support to that one operator. It's another way for the Health Department to support PACCA's lack of support in that end.

I'm sorry. What was that again? COMMISSIONER PARIS: What I'm saying is that the reason why PACCA is where it is is because it allows the other Health Department staff to support that one person. When that person is busy, the other Health Department staff is able to assist with the PACCA calls.

That's provided that they're not busy with their calls. Because I'm sure the health centers get quite a load of calls, too, quite a number of calls. But, there 188 3/8/06 - WHOLE - BILL 060001, ETC. again, it could be a problem, an overall problem. But I just want to say at this point, I think there's a lot of things that we can do. One of the things that bothers me is that the facility itself, where it's located. I would think we would do a better service for the citizens of Philadelphia if that were moved to another area which would, I think, be better situated for people who want to adopt animals. That's very difficult to find. You can go by there 50 times and not even know where it is. I mean, it's just not prominent. It's just not in the right setting, in my opinion. But that's something that we can look at and we can work towards. I think that we can improve immensely on the adoption rate if that were placed in another section of the City. COMMISSIONER PARIS: I agree, sir. And if I may go back, I just found 189 3/8/06 - WHOLE - BILL 060001, ETC. my report on the average answer delay for PACCA is, the average answer delay is one minute.

Is that all? COMMISSIONER PARIS: Yes, sir.

Well, that's great. Okay. That's all I have at this time, Commissioner. And, again, I want to congratulate you on your appointment. COMMISSIONER PARIS: Thank you.

I think that you and I are going to see a lot of each other in the next two years. So I look forward to it. Thank you. Thank you, Madam Chair.

You're welcome. The Chair recognizes Councilwoman Tasco.

Thank you. Good afternoon and, again, congratulations to you on your 190 3/8/06 - WHOLE - BILL 060001, ETC. appointment. I hope you are planning to stay. I want to go back to the Health Department's services. What services are provided by the health centers? I'm sorry; health centers. If I'm a client who goes to a health center, what services can I get? COMMISSIONER PARIS: You get primary care services by an adult medicine physician or a pediatrician. We also have a pharmacy on site. We have a number of ancillary services like lab, laboratories, radiology. We also have family planning services, prenatal, GYN. We have dieticians on board. We also have social workers that provide any kind of social support to the patients that we serve.

President Verna asked about the waiting time at the health centers. Do you deploy staff to these health centers based on need or is there a one set plan that you have one of 191 3/8/06 - WHOLE - BILL 060001, ETC. everything at every center every day? Maybe the Northeast might not require the -- they don't have the same level of service need as, say, Broad and Lombard or Broad and Tasker. How do you determine how you deploy staff to these health centers? COMMISSIONER PARIS: We have a formula that I don't have with me that we use just to give us an idea based on the size of the center. And based on the size of the facility, based on how many exam rooms we have available and so on, we determine how many staff we deploy on each health center. No, we don't have them moving from one center to the other. We pretty much have them all stable where they are, and I think that is very critical, Councilwoman Tasco, because it is part of our mission to provide that continuity of care, and it is very important, because the patients do develop relationships with their nurses and their physicians 192 3/8/06 - WHOLE - BILL 060001, ETC. and so on. So we have a set number of clerks, nurses, physicians that staff each of the health centers.

So suppose you had a center that didn't have the volume of patients that you would have at Broad and Tasker. Would there be -- you don't like that question, do you? Could you probably deploy -- could you provide more staff at the center where you have the greater number of need and maybe cut down on -- no? The moment I started asking that question, I saw Yvonne in back of me. But I'm just trying to figure out how can we get the best service, not cutting out employees, but instead of having a dentist five days a week in an area where you don't need them five days a week, you take that dentist and use them in South Philadelphia with the other dentist or in North Philadelphia with the other dentist. You're not really cutting staff, but you're enhancing the services 193 3/8/06 - WHOLE - BILL 060001, ETC. where the greatest need might be. You don't have to answer that, because it might get you in trouble, but I just put that out there as a way to talk about how we cut down on the waiting time. If we're not going to have additional money to hire additional employees, which is probably what we should be doing, to have better service, because we have a large City -- (Applause.)

-- we have a large City with people who don't have health insurance, and our Charter gives us the mandate that we're to provide for the health and welfare of our citizens and we're not funding the health centers to the level that they need to be, we may have to look at another way or maybe we need to start looking at how we shift some priorities in some of the other areas of the budget and provide it to the Health Department to provide health coverage services to those families who 194 3/8/06 - WHOLE - BILL 060001, ETC. are working poor who don't have health insurance, who can't get examinations at a doctor's office or whatever, but need the health centers. So as you move towards being the new Health Commissioner, maybe you ought to think about asking for more money, looking at your departments. Because no one has come in here ever and advocated for additional staffing for the Health Department. We know you get the line that this is what you have to ask for, but part of the role of the Commissioner is to be the advocate for the people that you serve. So what we want is to hear what's really needed. Yeah, you get whatever the amount you want and that may cover what you're doing, but what is it that we need? Are people being served? I spoke this morning to a group about the disparity in healthcare. You talk about it in your testimony. Well, what is the City doing? You talk about 195 3/8/06 - WHOLE - BILL 060001, ETC. the -- I think David Cohen passed the initiative on universal healthcare so that we can come up with a plan for providing healthcare for those people who need it. So, Commissioner, you have a charge from me, and I'm sure maybe some other people on Council, to tell us what's really needed in the Health Department. I chair that committee. I don't hear from anybody that said we need anything. It's fine, business as usual. But I think we need to begin to think about what our needs are. So that's my speech for the day. But I won't have you answer that question. You can think about it with Ms. Sutton back there. The question I want to ask, Councilwoman Blondell Reynolds Brown asked about the newborn home visiting initiative. I need to have some clarity on how the Health Department is working with the -- you're working with the -- COMMISSIONER PARIS: Managed 196 3/8/06 - WHOLE - BILL 060001, ETC. care organizations.

Managed cares. Tell me how that's going to work. COMMISSIONER PARIS: Well, currently the state funds the managed care organizations to provide this visit to --

To every newborn? COMMISSIONER PARIS: That's correct, ma'am.

And the Health Department's role is to do what? COMMISSIONER PARIS: Well, the Health Department really does not play a role in that, because it is a business agreement between the state and the managed care organizations. So what we have done is, since we have realized that the managed care organizations have not been successful in doing that and we meet with them on a quarterly basis, in one of those meetings we discussed with them the possibility of the Department assuming a 197 3/8/06 - WHOLE - BILL 060001, ETC. more active role in that kind of a service, because we know that we can reach those women out in the community.

Who will you use to reach those women? I mean, how do you do that and they can't? If they're not doing it, how is the Health Department going to do it? COMMISSIONER PARIS: Well, we are going -- we already have a system relationship with many -- we contract with, I believe, almost every single home visiting nursing group in the City of Philadelphia for many other of our programs. We have contracts with them for the childhood lead poisoning program and other programs. So what we're going to do is, we're going to enhance what they're already doing successfully to add to that the information necessary for mothers to make sure that they are doing everything they can to raise their children correctly and in a healthy manner. 198 3/8/06 - WHOLE - BILL 060001, ETC.

But if the state has contracted with the HMOs to provide the service, they get paid for that? COMMISSIONER PARIS: Yes, ma'am.

Who is monitoring that from the state side? If they're not successful, why -- and I don't have any problems with trying to help, but what prevents them from fulfilling their obligation, since they're getting dollars for it? COMMISSIONER PARIS: We have set a number of -- and we have been meeting with the state to that effect also, because we understand that in order for this initiative to be successful, it's going to take more than just the managed care organizations and the state and the city. So we are talking about how best we can utilize and rechannel those resources to really make it a successful initiative. 199 3/8/06 - WHOLE - BILL 060001, ETC.

So how will you evaluate the success of this venture? COMMISSIONER PARIS: Well, now we have been able to receive information. We have established a system by which we receive information on every child that is born in the City of Philadelphia, and I think that with that information, we will make sure to track that every child has received that first home visit.

Okay. Thank you. Let me just talk a little bit about infant mortality. You said the Department of Public Health has a number of infant death review processes in place that furnish data related to the circumstances of death that we're using to improve Department maternal infant health policy. How are you gathering this data? During the hearings we had on infant mortality, we had the hospitals 200 3/8/06 - WHOLE - BILL 060001, ETC. come in and talk about the issue of the number of increases in the high rate of infant mortality in the African-American community. One, how are you collecting that data, and, two, what is the follow-up to the Council's hearing on the issue? I know you're just the Commissioner, but you were part of that administration. COMMISSIONER PARIS: I am asking the Director of Maternal, Child and Family Health to come and assist with me that question, ma'am.

I'm Kate Moss. I'm the Director for Maternal, Child and Family Health for the City Health Department. As to your question about the death review processes, my division now manages, I think we're up to, four death review processes, the newest of which is a real-time review of every infant death that occurs within the City of Philadelphia. We bring a 201 3/8/06 - WHOLE - BILL 060001, ETC. multi-disciplinary group together to take a look in enormous detail at every single death that comes through the Medical Examiner's Office. So any death related to asphyxia, any sudden unexplained infant death or any infant death that would be called SIDS, Sudden Infant Death Syndrome, we take a look at in great detail and then review it again to see what kinds of policy implications there might be. In fact, one of the reasons that we're moving ahead with this newborn home visiting program is that we've discovered that an awful lot of these deaths are related to parents who just didn't know how to provide appropriate care for their babies. Their babies died because they were face down on an inappropriate sleep surface. They were in a crib but with adult bedding, two or three mattresses, a couple of other kids. Just unsafe sleep arrangements in general, perhaps relating to a caregiver's incapacity, substance abuse, 202 3/8/06 - WHOLE - BILL 060001, ETC. exhaustion. So this is part of what led us in the direction of pushing for safe sleep education throughout our programs. So that's, I guess, one of the examples I can give you of how we're using the death review processes to change what we do.

What outreach do you have to expectant mothers to provide them with education prior to the child being born that would help you with that? Are there any programs in-house now?

Yes, ma'am, there are. We have a Healthy Start program. We had had two essentially separate Healthy Start programs which in the last year we've combined into a single program that we now call Healthy Start Philadelphia, and it covers all the high-risk areas of the City, all those areas where the infant mortality rate is such that we're eligible to receive Healthy Start funds from the federal government, and at this point, we extend 203 3/8/06 - WHOLE - BILL 060001, ETC. from the northern boundary of the City -- we became aware that there were demographic changes which were leading to increased infant mortality in some areas of the City where we've just never seen it before. So we now have these services from the north border of the City, Cheltenham, Cedarbrook, that whole area, down through the north central section of the City, out into the West Philadelphia area, Southwest Philadelphia and South Philadelphia. Any area of the City where we have an infant mortality rate that will allow us to qualify for Healthy Start funding we now have Healthy Start services. The bulk of that activity is around identifying pregnant women early in their pregnancy, getting them into care. We're currently using those Healthy Start monies to do some very interesting things, like providing pregnancy education classes at our district health centers and child birth 204 3/8/06 - WHOLE - BILL 060001, ETC. education in the district health centers, breastfeeding support classes in the district health centers. One of the really important protective factors against Sudden Infant Death Syndrome is breastfeeding. We know we haven't done as nearly as good a job as we'd like in promoting breastfeeding, particularly within the African-American community, which is at highest risk for SIDS. And so through our Healthy Start program, we have some breastfeeding education support groups. We train lactation consultants, who are now in almost every one of our birth hospitals. We've been able to show that particularly high-risk populations, when exposed to a lactation consultant in the hospital, are much more likely to leave the hospital breastfeeding. Again, a very important protective factor in Sudden Infant Death.

Do you have enough staff?

We never have enough 205 3/8/06 - WHOLE - BILL 060001, ETC. staff. Do we have enough staff? Yes. I would say that for the programs, where we are, we contract with a number of community-based agencies, so that we have less need for staff centrally because we're working with some excellent community-based agencies who provide services throughout the City. We're never able to pay them as much as we would like, but, yes, I think we're doing a pretty good job at this point.

Okay. Thank you. One more question about the health centers. Is there a big waiting list for dental care for children and are there plans to expand dental personnel and support? COMMISSIONER PARIS: Again, ma'am, the wait varies from one center to another, with the average wait being approximately about a month for an appointment for dental, with the understanding that if there's a medical 206 3/8/06 - WHOLE - BILL 060001, ETC. emergency, they will walk in and they will be evaluated and referred to one of our partner hospitals for follow-up.

You have not answered my question and you didn't answer the President's question. Maybe we're not clear. COMMISSIONER PARIS: I apologize.

We know that there will be a longer waiting list in some areas than in other areas. COMMISSIONER PARIS: Yes.

But what are the waiting lists like in each of the districts? COMMISSIONER PARIS: If you call in for an appointment today, we will give you an appointment within 28 days for dental.

For dental? COMMISSIONER PARIS: Yes, ma'am. 207 3/8/06 - WHOLE - BILL 060001, ETC.

But if they have a toothache today, they can walk in and get it taken care of? COMMISSIONER PARIS: We will examine you, and if you have a severe problem, you will be referred to one of the hospitals that we have agreements with. Because we have limited service, limited dental services, in the health centers. We don't do complicated oral surgery. I mean, there's some things that we don't do at the health centers.

So what kind of services do they get at the health center, dental service? COMMISSIONER PARIS: Just routine dental care.

So if they go to a hospital for more extensive care, who pays for that? COMMISSIONER PARIS: The City does not pay for that care, ma'am.

Now, how are you on your billing for services for 208 3/8/06 - WHOLE - BILL 060001, ETC. people who don't have Medicare, and are you all billing for Medicare -- or Medicaid? I'm sorry. COMMISSIONER PARIS: Yes, we are. We are billing for both Medicare and Medicaid.

How is your rate of billing? One time it was kind of low and you weren't collecting the money. Are you up to date on your billing? COMMISSIONER PARIS: We have implemented a number of procedures so that we can increase the turn-around productivity of our staff, as well as the methods that we now use. We hired a woman that has extensive financial experience to spearhead that particular effort. Our staff had undergone training once again, and they're much, much accurate and expeditious in terms of how they are submitting the bills.

Councilwoman Brown talked about the 209 3/8/06 - WHOLE - BILL 060001, ETC. Benefits Bank, and I know we had an interview. I know the Benefits Bank was presented to the last Commissioner. Were you a part of that presentation? Are you familiar with the Benefits Bank? COMMISSIONER PARIS: No, ma'am, I'm not familiar, but it will be on my to-do list for tomorrow morning.

What happens, if I walk into a health center and you can access all of the services that I should get through this Benefits Bank. It's a wonderful program, but we couldn't seem to get the City interested. It has to be a coordinated effort with you and it should go through the Social Services Director so that you can have up-to-date information on what benefits a person qualifies for when they walk into your office, and it can be accessed through the computer. We did not get a positive reception when we presented that to the Health Department about two or three 210 3/8/06 - WHOLE - BILL 060001, ETC. years ago. But there is a cost to it also, but in the end, it may benefit you, as we talked to Ms. Danzy, that there may be a benefit to that. I have a couple more questions. I mean, some of them were asked, but I'm coming back in a different way. Last March when we had the budget hearings -- and, again, I know you were not here -- we talked about the million dollars that Senator Hughes -- and the gentleman who is from HIV might want to come forward. Thank you, Kate -- had given a million dollars to the Department of Health to provide HIV/AIDS prevention services for minority youth. Now, are you all still working on that $1 million?

Yeah. I have the record. Good afternoon. My name is John Cella. I'm the Director of the AIDS Activity Coordinating Office for the Philadelphia Health Department. 211 3/8/06 - WHOLE - BILL 060001, ETC.

Let me ask the question first.

Yes. Okay.

My question, in 2005, of these funds, over 924,000, or 92 percent, went to non-minority, non-community-based providers. In addition, 500,000 of these funds went to one agency to provide six testing events at a cost of $83,000 per event.

Those figures are not accurate. Let me say, first of all, that they're not figures that make any sense to me at all. When we first received, Councilwoman, these dollars from Senator Hughes, it was back in January of last year. We got them for six months. Now we have to stretch the million dollars for one year. It goes from July obviously on the state contract period. We implemented a series of historic very innovative relationships 212 3/8/06 - WHOLE - BILL 060001, ETC. with the Department of Human Services where we directed these funds to youth in foster homes, aging out of foster homes. We had a very innovative program with the School District for gay, lesbian, transgender youth. So we reached out and we did an RFP, a request for proposal. So we went through a codified process where anybody could apply. We ended up funding six agencies. I have a list here. I don't know them all right off the top of my head, but one of them is Bebashi, for instance, which is a minority organization. I can have the list for you right here. But we basically reached out and we reached out with our prevention activities, as Mr. Cronauer talked about before. These are scientifically based CDC activities. It's not whatever they wanted to do. But they were CDC-approved interventions directed at minority youth. So we have a number of programs out there through Senator Hughes' dollars 213 3/8/06 - WHOLE - BILL 060001, ETC. directed at minority youth being operated, for the most part, through minority agencies. I mean, it's Action AIDS. It's Bebashi. I have the list here. I have to like refer to it.

Why don't you just refer to it.

I'll refer to it. We also gave dollars for minority youth roundtable to the Office of HIV Planning. Let me get the list here. But, no, 500,000 was not given to one agency. I think you're referring to the Family Planning Council that got a sum of money through Senator Hughes' efforts for rapid testing and a series of youth-initiated events in the community. But it wasn't $500,000. Let me get the list, the state list here, for you.

Why don't you provide that information, because I think Councilwoman Brown asked for that information. So you can provide it to the Chair. 214 3/8/06 - WHOLE - BILL 060001, ETC.

Okay. COMMISSIONER PARIS: We will do that.

Well, when we spoke to the office last year regarding the issue, they responded that they received -- was that they were using existing providers in order to deliver the services quickly.

We went through an RFP process, an extensive RFP process, which not everyone necessarily wanted, but we had a process, we issued an RFP. It was disseminated widely throughout the City to many, many agencies beyond the traditional agencies, and we have a Resource Allocation Advisory Committee which is an independent non-conflicted review committee, not associated with AACO, that made the decisions. The Health Department, AACO, doesn't make the decisions. The recommendations are made to the Health Commissioner. But there was an RFP process. 215 3/8/06 - WHOLE - BILL 060001, ETC.

All right. Thank you very much.

You're welcome.

I think I have one last issue for you, Commissioner, and that is regarding the Mayor's Executive Order of 2005. Are you familiar with the Executive Order that the Mayor signed? There was an extensive Executive Order that the Mayor signed, because one of the concerns we've often had about the City is the involvement and participation of minorities in doing business with the City. And part of that RFP required that the departments deliver a compliance plan to MBEC that includes participation benchmarks for the coming fiscal year and proposed participation ranges for each contract to be awarded which ought to be approved by MBEC. To your knowledge, did your department comply with these requirements for this fiscal year, 2006, and will it do so for Fiscal Year '07? 216 3/8/06 - WHOLE - BILL 060001, ETC. COMMISSIONER PARIS: We have submitted the plan.

Can you tell us the results, and did you meet your benchmark goals? Did you first set benchmarks that you know of? Did you set goals? COMMISSIONER PARIS: Yes, we did, and we met those benchmarks. I don't have the specifics here, but I can tell you that in Fiscal Year '05, we have a participation of 28.93 percent of all the contracts were minority business contracts.

And what was your goal? Had you set a goal? COMMISSIONER PARIS: I will have to get that specific number to you through the President's office, but I know that our goal was not -- I remember being involved with it and receiving from MBEC a lot of support and positive feedback, because one of the things that the Health Department has is, we contract 217 3/8/06 - WHOLE - BILL 060001, ETC. with about 207 providers, and the majority of them are community-based organizations already. So the number of for-profit contracts that we have is a very, very small number. And I know that within that small number, we have a 28.93 percent of minority participation. We are very, very committed to increase that number, and what we have done is, we have taken it upon ourselves to put together training sessions for the vendors that we know are certifiable and for different reasons have not gone through the process. At this point, we even went on to identify a person in the Commissioner's office that works directly with the vendors and help them facilitate them to go through the whole MBEC process, because we are really committed to increase the numbers.

Okay. So could you after reading -- I know you're new -- reading the 2005 Executive Order 218 3/8/06 - WHOLE - BILL 060001, ETC. explain to us and submit that to the Chair how your department complied with the section that was required? COMMISSIONER PARIS: Yes, ma'am. We will do that.

Thank you. Thank you, Madam President.

You're welcome. Councilman, at the request of the stenographer, we're going to take a five-minute break. (Short recess.)

The Committee is now back in session, and the Chair recognizes Councilman Rizzo.

Thank you, Madam President. Yesterday we heard some cases that were a bit troubling in reference to infrastructure and the health centers. There are eight, correct? Could you tell me how we keep an eye on the physical plant? I mean, we talked earlier about 219 3/8/06 - WHOLE - BILL 060001, ETC. the services, et cetera. I have visited many, if not all eight, of the centers, and you can obviously see that they're used, they're well used. Do we have any concerns? Because we heard other operating departments, the Police Department, we got reports from Capital Programs. What's the condition of the physical properties and what is your concern about that, and how do you inspect or who do you have in your organization other than Public Property, I would assume, that takes care of them to keep an eye on the fact that they look like health centers? COMMISSIONER PARIS: We have made through the past eight years a considerable investment in each one of our health centers through capital projects. We have renovated the facilities. We have improved lighting. We now make use, much better use, of the limited space that we have there. Each one of the health centers had undergone a 220 3/8/06 - WHOLE - BILL 060001, ETC. makeover, a physical makeover, where it's more attractive and it's more pleasant for our patients. In addition to that, the renovations have included extensive improvement renovations for our heating and air conditioner systems. We've done the same thing for the electrical system and the plumbing system. We have new roofs almost in every health center. There was a time when we did not know if it was better to be inside or outside on a rainy day, and I'm happy to say that those days are behind us. So the facilities have improved. We've even included in some of the centers like Health Center 6 on 3rd and Girard where we have done all the sidewalks outside as well.

Commissioner, the only other concern, there was a media story recently about the disposal of materials from physicians offices, and I imagine you use a 221 3/8/06 - WHOLE - BILL 060001, ETC. tremendous amount of devices that you put in people's mouth, gauze, cotton. How do you handle the disposal of the materials that you use in the eight centers? I would think that's not handled through the Streets Department, normal pick-up, or is it isolated or is it handled by specialty companies? How do you deal with the materials that are used in the health process? COMMISSIONER PARIS: We have a contract with a company that specializes in waste management, and we bag all of this disposable material into a red bag that is then later on picked up at each of the health centers every afternoon by people that know how to handle this kind of trash or waste.

My last question for many years, and I think I've mellowed a bit, is the needle exchange program. Where are we? Does it still have the same presence it once had? Have we gotten to the point where we've moved 222 3/8/06 - WHOLE - BILL 060001, ETC. it away from schools and any controversial area? Could you give us the status of the needle exchange program? COMMISSIONER PARIS: It is my understanding that we continue to fund that program and that I know that there's been a lot of work between the communities where they are located and the providers to make sure that it includes a very, very clear agenda of staying away from any, not only schools but also playgrounds.

Commissioner, one of the concerns and just recently I've received again a communication from outside the City where syringes aren't readily available. Have we gotten to the point where we say no to people that we know, if we do know, that come from other areas? I have a mother that wrote to me that the source of her daughter's needles was our needle exchange program 223 3/8/06 - WHOLE - BILL 060001, ETC. from Camden County. Not a good situation if that is occurring. I understand the bigger picture, that we're helping a human being, but I would hope that we have a way of managing who and whether it becomes a business for someone to provide the needles. I mean, I assume a person could walk up that isn't involved in that kind of activity, exchange needles and go sell them on the -- how do we manage a program that's so -- I don't want to use the word "controversial," but could be so controversial? COMMISSIONER PARIS: Well, the program itself, I mean, it is an exchange. A person can just not walk out from the street and say, I want to pick up needles today. It's an exchange 20 program. We are in collaboration with the different providers to make sure that there is that kind of continuity where the same individuals are the ones that are benefiting from the --

So a person 224 3/8/06 - WHOLE - BILL 060001, ETC. could come from anywhere? If they had six needles in their hand, they can get six new ones? So if we have a visitor that's on vacation -- COMMISSIONER PARIS: The answer is yes, sir.

Policy-wise, do you agree with that? COMMISSIONER PARIS: In the picture of public health and how we serve the public and what our goal is, yes, because it will ensure that less people share a virus that could lead them to severe illness or death. So in the spectrum of public health, yes, sir.

Okay. I told you I've mellowed a lot on this. Thank you. Thank you, Madam Chair.

You're welcome. The Chair recognizes Councilman Nutter.

Thank you, 225 3/8/06 - WHOLE - BILL 060001, ETC. Madam Chair. Good afternoon, Commissioner Paris. I just have two issues that I'd like to raise with you. On of your testimony, you make reference to, under Chronic Disease Prevention Program, you make reference to Steps to a Healthier Philadelphia. That's a program, Steps to a Healthier Philadelphia? COMMISSIONER PARIS: Yes.

Is that a program within the Health Department? COMMISSIONER PARIS: Yes, sir, it is a program.

You make reference on the second paragraph to, This program targets asthma, diabetes and obesity. Could you provide us with a little more information about specifically the area of obesity in general and childhood obesity in particular? What kind of steps are we 226 3/8/06 - WHOLE - BILL 060001, ETC. taking in that area? COMMISSIONER PARIS: Through the Steps program, we fund a number of initiatives. We have done health planning where we had come up with strong recommendations on the interventions that we believe are going to be successful. We have currently, in terms of the management of the disease, which is part of the goal of the program, we have diabetes self-management education and we have contracts with a number of providers to do that, such as Thomas Jefferson, the Health Promotion Council and Congreso. We also have asthma self-management education programs that we fund through Steps, and we do that through Healthy Hoops, which is a very successful program that has been put together by Keystone Mercy. We have nutrition and physical activity programs that we do in several community sites, including churches and in schools as well. 227 3/8/06 - WHOLE - BILL 060001, ETC.

Okay. Could you provide us through the Chair any detailed information about where these programs function and operate, number of people served, and I'm particularly again interested in what steps we're taking to try to reduce childhood obesity, how extensive these programs are and what areas of the City in which they operate. COMMISSIONER PARIS: We certainly will do that, sir.

Thank you. My second question is from your testimony on , the Universal Health Care Initiative. Reference is made to the report released by the Department and then the principal recommendation is the establishment of a Health Leadership Partnership. Could you give me a little more detail? I mean, what exactly is that about? COMMISSIONER PARIS: The goal of this leadership partnership is to 228 3/8/06 - WHOLE - BILL 060001, ETC. develop the plan that will coordinate, that better coordinate, the health services in the City of Philadelphia. We have involved through this process many partners, private and public partners, to come in and put together the plan with us. What I'd like to do is, I would like to ask Carol Rogers from our office, who has been the person spearheading the services, to come and give you more details.

Carol Rogers, R-O-G-E-R-S, and I work in the Health Commissioner's Office. Essentially the findings of the report that was released by the Mayor in May of this past year was that in spite of the fact that many people that put this ballot on the initiative wanted to find universal insurance in the City, that that was not a capability for technical reasons related to health insurance itself. However, we did find 229 3/8/06 - WHOLE - BILL 060001, ETC. that we have to advocate both on the state and federal level for universal insurance. We did find that there are adequate resources spent in the City to provide decent healthcare to all, but that the resources were not put in a way that would enable people to have decent healthcare.

I'm sorry. I didn't completely understand that. I mean --

We found that there were enough resources spent in the City to provide decent healthcare for all. So that if you are very ill and end up in an emergency room, that you can get care, but that the services that you need to protect you from getting to that point are not available to people. So we -- excuse me. I'm quite short of breath here. We found that what we would like to do is to bring together a health 230 3/8/06 - WHOLE - BILL 060001, ETC. leadership partner. Excuse me.

Take your time.

To form a health leadership partnership, which will be composed of non-profit, all of the healthcare resources that exist in the City, to reallocate their healthcare resources that we could provide decent healthcare. We are in the process of establishing a work group to do that.

Just a couple questions in that regard. Do we know how many people in Philadelphia do not have health insurance?

We know that there are 60,000 more than there were a couple years ago. We know that there are close to, I believe it's -- we do know that. Wait. We know that of people polled, and it's somewhat an underrepresentation, that in 2004 there were 160,000 people without insurance.

160 -- 231 3/8/06 - WHOLE - BILL 060001, ETC.

That was a 60,000 increase over four years previous to that.

160,000?

Approximately that. It's a survey that's done every two years. It's based on a telephone survey, so clearly it doesn't represent all people that are living without healthcare.

So when we go back to what you said earlier, that there are enough resources in the City to provide coverage --

No. There are enough resources that are currently spent on healthcare. If you look at all of the expenses City-wide, including what's called uncompensated care in hospitals, that there is an adequate amount of money spent that would provide primary preventive care for everyone in the City. We know that, for example, if you go to a hospital emergency room and you need an 232 3/8/06 - WHOLE - BILL 060001, ETC. amputation, you will be admitted into the hospital, but that the care that you need to manage diabetes, for example, is not available to people.

I understand that, but at the same time, the hospitals are required by either state and/or federal law to see anyone under that circumstance that comes in. That doesn't mean they're going to get paid for it.

Correct.

If the person doesn't have health insurance.

Right. Right. But that our --