Yeah. I was just saying how does Philadelphia's youth access these programs and what are the partnerships necessary to maximize their access? I'm asking this question in light of gun violence prevention.
Okay. Actually 4/15/24 - WHOLE - BILL 240179, ETC. the Hospital Violence Interruption Program and the Community Violence Interruption Coalition have been around for some years. I don't have the exact date, but I could call up one of my directors to sort of give me the exact date when they were started with the Department. As far as their access to -- for youth to be able to access them, we work with our partners. A lot of the individuals who are with CBI and HVIP are actually on the ground.
Okay. That's fine. I wanted to recognize the critical role DBH plays.
Just for the record, my directors came and reminded me, we also have the Youth Health Corps, which is another route for --
Yes. To access 4/15/24 - WHOLE - BILL 240179, ETC. that work or to access prevention services.
Got it. Thank you very much. So the Public Health Department plays a major role in providing a safety net for Philadelphians who otherwise can't access basic healthcare. An ounce of prevention is worth a pound of cure.
We know regular access to primary care is key to keeping folks healthy and preventing medical emergencies that can devastate families, both medically and financially. From your budget testimony, we know that there are plans to expand critical services to the City's health centers, especially for mental health and substance use disorders. You have also named that service delivery has been negatively impacted by staffing shortages. What, in your estimation, are 4/15/24 - WHOLE - BILL 240179, ETC. causing the actual staffing shortages and how can we help address this issue?
Councilmember, I'm sorry. I'm having a problem getting the last part of what you were saying.
What's causing the staffing shortages and how can we help address this particular issue?
Okay. In large, a lot of the staffing shortages in the Health Department or the Ambulatory Health Services, that division, is in competition with a lot of different players across the City for critical staff. It's important for the Health Department to remain competitive. We work with our partners in HR to recruit, OHR as well as the Health Department HR, but I'm going to also bring up -- well, Dr. Palak Raval-Nelson can speak to some 4/15/24 - WHOLE - BILL 240179, ETC. of that, also the Director of Ambulatory Health Services who can expand on that, if you'd like. Doctor.
Sure. Thank you, Dr. Franklin. So one of my responsibilities, I'm also over our Health HR division for the Health Department. What we did with the Office of Human Resources centrally is, we looked at bands of salaries. So we looked at what are the comparable salaries that nurses receive, that medical assistants receive, that medical clerks receive, and did a comparison with our current job specifications with Civil Service, because those salaries had not been raised in years and years and years. When we did that assessment and did the comparison, we realized that we needed to go ahead and raise salaries. We also realized that we needed to create specifications. A lot of the feeder series because of the pandemic for 4/15/24 - WHOLE - BILL 240179, ETC. entry-level clerical positions have been the service rep list. A service rep is not as qualified to address with a rodent issue as they would be to deal with a medical chart, so we created -- we worked with our Ambulatory Health Services, our OHR, and our Health HR to create a medical clerk job spec and a senior medical clerk job spec. We also reached out to the unions. District Council 33 Local 488 represents those folks, so we made sure they were on board and okay with us and the language of this job specifications. I'm happy to report those jobs, they were finally approved through the Ad Board and they're being announced for filling of those vacancies. So those are the things we've been doing.
Thank you very, very much. Are mental health and substance use services available at all City health centers right now? 4/15/24 - WHOLE - BILL 240179, ETC.
To my knowledge, yes. We have a mental health counselor at all the City health centers.
Fabulous. I know DBH is busy building out two new health centers in Northeast Philly. Will mental health and substance use services be offered at those new facilities as well?
Mental health services will be offered there as well or behavioral health services.
But not full behavioral health services, because they are not necessarily behavioral health clinics, but we do have behavioral health counselors at each of the health centers.
Okay. Thank you. I'll come back around. Thank you.
4/15/24 - WHOLE - BILL 240179, ETC. Thank you. The Chair recognizes Rue Landau.
It's all good. First questions are for DBHIDS. Thank you, Dr. Bowen. Congratulations on your move.
So as the City is expected to move people experiencing homelessness with substance use disorder into treatment, I want to know more about the resources that currently exist and how we plan to expand them to meet the needs. I've asked a lot of people these questions. No one can answer it, from non-profits to people on the ground, and all signs point to DBHIDS. So if it's okay with you all, 4/15/24 - WHOLE - BILL 240179, ETC. I'm going to ask --
Not only can we, but we have. So we increased by 200 beds in the system for residential rehab. We just completed that 200 in 2023, so at the end of 2023. We increased our IOP programs, four new programs, that can serve 30 people each. We increased our MORS team --
Can I pause you for a second, because I don't know what the --
No. I don't know what the baseline is for the increase. So I'm going to rattle off my questions and would love to get the answers. We can slowly go back to them, but the first is, how many people in Philadelphia are in need of inpatient and 4/15/24 - WHOLE - BILL 240179, ETC. outpatient treatment services and what are their needs? Is it drug treatment, mental health care, wound care, all three? How many beds are currently available? How many exist and how many are available, free and available, and has the City done a comprehensive bed utilization study? What are the requirements for the available beds? For example, are there barriers to entry if the person is actively using drugs? Can they smoke cigarettes? Are there barriers to wound care? If they cannot be actively using drugs to come into a facility, how much time do they have to wait through withdrawal before being assigned a bed? What resources will be available to them during that withdrawal period? If there are not enough beds available, where are people being placed currently? If you expect an increase in patients coming into treatment, what 4/15/24 - WHOLE - BILL 240179, ETC. facilities will be utilized? What's the current plan to address the gap between the number of people who may be receiving treatment in the coming weeks and the long-term efforts to increase capacity? What services are provided in these facilities? Mental health care, wound care? How long do patients typically stay in inpatient treatment and what is the stay length based on? Is there any follow-up upon discharge? How do you ensure follow-up? What housing is connected to treatment and for how long are housing supports available? And then, finally, how are people assigned to outpatient slots? What are services -- what other services are provided with outpatient, like mental health care, healthcare assistance with benefits? How do the outpatient clinics keep track of their consumers to ensure they come back? Thank you.
So you want to know 4/15/24 - WHOLE - BILL 240179, ETC. about the entire system. That's good. That's okay.
The entire system. And I appreciate the increase in 200 beds, but I don't know the baseline.
Okay. So we have -- so first I'm going to talk to you about substance beds, because that has been the focus and -- first of all, we have capacity in our bed base system, just so that I say that, right? Some of that is because we've built it in anticipation of increases, but we do have capacity. The number of beds in our substance system is 1,874. On any given day, there are vacancies. I even know today's. There are 109 beds available today in our substance system. That can change hour to hour, right? We are -- we do have a treatment access website on CBH's website. We have a place where it gets 4/15/24 - WHOLE - BILL 240179, ETC. upgraded like three times a week, but we are building a bed registry to make that a much more dynamic, active system. As far as outpatient and flow from inpatient to outpatient, so that's all tracked as part of state responsibility, our responsibility to the state. So we know that whether people are -- what percentage of people like make it from like an inpatient to outpatient. We put things in place to try to make that as effective as possible. These are all different types of warm handoffs you're talking about really as you flow through the continuum, and we make connections between different parts of the system. For example, I know that like Amanda David and Andy Devos, who is in here -- hello, Andy -- have been working very closely in anticipation of needing to have faster flow from one part of the system to the other in the event that more people are going to be coming into 4/15/24 - WHOLE - BILL 240179, ETC. the system, working between the CRCs, which are the entry points, Crisis Response Center entry points, and the substance programs, the residential bed programs, to make sure that they're communicating with each other as well as possible so there's no delays in getting people into the treatment service. So one of the problems is that you do not want any delay in there or any barriers. There isn't a barrier to coming into -- tobacco is not a barrier. We removed that a couple years ago. There's no barrier. I'm getting good help here. As far as, yes, individuals are matched with an outpatient treatment provider before they leave the service. So those connections are made. Whether it's mental health or substance use, those connections are made beforehand. I think it's really important when you think about treatment -- let's talk about substance, because that's been 4/15/24 - WHOLE - BILL 240179, ETC. a lot of the focus of this -- that you don't just think about bed base, because levels of care are based on medical necessity and you need to be able to use this very robust system of IOP, or intensive outpatient treatment, that's what IOP is, or outpatient treatment even if you are, let's say, connected in a shelter. You heard some challenges, mental health challenges. We have housing specifically for people with substance, transitional, we have safe havens, we have recovery houses. Some are more low barrier, because you're talking about, well, what if they come in and they're not ready. Well, there's still access for folks. The connection, though, to outpatient treatment is really, really important. We have built some programs just this year also because of the intense need and because we take accountability, we take accountability 4/15/24 - WHOLE - BILL 240179, ETC. for the fact that it's still really not okay in Kensington. It's not. And it's not okay for the people that live there, and what we need to do is help people to come off the street. We've been doing that, always been doing that. What we did was, we added things that broke down the barriers. Wounds became a significant barrier to getting into rehab. We initiated the first ever licensed wound care van in the Commonwealth. We now have two of them out there, and they can clear someone so they can get into treatment quickly off the street.
We also created the first ever connection between the Level 4 ASAM, which is your most complex level of rehab, and they can take care of the wounds now there even if they went in for like hospital-level surgical necessity on the medical side, and they can now have their -- they can move into rehab even if they have an IV line still in or a PICC 4/15/24 - WHOLE - BILL 240179, ETC. line still in. That's not been done before, and that broke down so much stigma, I can't even tell you. But we have put in -- and the MORS team that I was mentioning before. Anything that gets people into the system -- we have capacity in the system. What we need is good flow into the system. We also just want to say one more thing, which is that we also have an overflow plan to be able to handle surge.
Thank you for that. I would want to submit these questions to get a couple more particulars, but the one question that wasn't answered is, what's the current need on the ground? So we have 1,874 beds with 109 available today at this moment. What's the need on the ground? If the need on the ground is 1,000 more people, we can't provide them beds.
Okay. So this brings me to the new publicly available data that's up, which shows you and shows 4/15/24 - WHOLE - BILL 240179, ETC. the public what is happening in Kensington in terms of who -- the numbers of people that Homeless Outreach is connecting with. Currently it's about 675 people. We know a fair amount about them. We know that percent of them 8 are chronically homeless by HUD's 9 definition, and we know that 61 percent 10 of them are newer to the area. 11 We know that we connect up and 12 can get certain percentages of them to 13 come in. If the question is what if they 14 all were brought in, right, would we be 15 able to manage that influx. That 16 depends -- so for now we have empty beds 17 and we have also slots, outpatient slots 18 available. So there is capacity in the 19 system, but that's why we have an 20 overflow plan. It's utilizing 21 out-of-network network to be able to expand, and we could expand also within the providers that we currently have. So there is capacity to expand further if we needed to, but it's also 4/15/24 - WHOLE - BILL 240179, ETC. really important to use the full continuum of care and to also recognize that there is a limit for how long they stay in one level. And so you have to really utilize the whole range of services that are available. I heard the dinging. I heard it.
Thank you. The Chair recognizes Councilmember Quetcy Lozada.
Thank you, Council President. First, let me say thank you to my partners at the Health Department for your willingness to participate in multiple community meetings to ensure that community residents were able to express their concerns or their support for the much-needed health centers in the 19124 zip code. I look forward to the 4/15/24 - WHOLE - BILL 240179, ETC. fact sheet, the information sheet being shared out with everyone who participated and those who didn't have an opportunity to come to any of the meetings, but we want to make sure that folks feel like their contributions were heard, valued, and respected, and I appreciate your willingness to do that. Thank you so much for that. Every time I hear from DBHIDS, I get severe anxiety, because what we say and what we are doing or what people are feeling on the ground to me are two different things. And we've had this conversation. I've met with you and your team multiple times. You know, I'm going to just start off with the beds conversation, right? We've talked about the need for beds. Dr. Bowen, you've said many times that we have enough beds. I'm still trying to figure out where are the beds and what are the beds and how are they classified and all of that. And we 4/15/24 - WHOLE - BILL 240179, ETC. talked -- I talked to you guys about the way we're doing things currently and how we have to find the ability to be able to go online like we do for a flight or for a car rental, for a hotel rental and find the beds, not just in Philadelphia but across the Commonwealth, right? Because we're getting people from everywhere. So we need to -- I really want us to take advantage of finding a system that will truly allow us to find a bed, because we have heard many times that when people are ready to go, they're ready to go. And so we should be able to put them into a bed. It doesn't matter if it's a treatment bed. It doesn't matter if it's a shelter bed, a DV bed. It doesn't matter. They're ready to go, and we need to get them in to a bed, stabilize them enough to be able to then move them to whatever bed is more appropriate, right? And so I had this conversation with you. I wanted to put it on the 4/15/24 - WHOLE - BILL 240179, ETC. record, because I want us to seriously do that. We have been talking about the same 700 to 1,000 people living unsheltered in Kensington for years. Yet we talk about we're responding to 50 percent of the need or we're responding to people and we're getting them into treatment. How? Who are the people? Who is counting? Is there really 700 to 1,000? Is there 500? Is there 3,000? Who are these people? Where are they coming from and who are the people we're putting into treatment? We have providers on the ground that we are funding that say they serve 30,000 people. Where are these numbers? Who is counting?
We've had this conversation, but I've never gotten numbers, real numbers, right? I've never gotten a solid answer. That's why I'm asking on the record. 4/15/24 - WHOLE - BILL 240179, ETC.
Well, not only do I have a solid answer, it's now available to the public, right? So what you have asked for and what the community has also asked for, they want to see the numbers. They want to know who is out there, and we now can do that. And that was not an easy thing to build, let me just tell you. It's complicated. It's complex out there. It's not that easy to get the information that you're talking about. There's self-report, but that's not enough. So I'll tell you what we know now, and I want you to see it. It's DBHIDS.org/SDOH, and then you hit Outreach, and this data comes up. It's going to be updated monthly so that we can see. But we know some very interesting things right now that we didn't know before. So I definitely don't want you to be anxious. I want us to be very much on the same page here. 4/15/24 - WHOLE - BILL 240179, ETC.
-- and have been for the last to years, 7 and over the last eight years, it has 8 been an absolute disrespect and disregard 9 for community residents. 10 So I just say cautious, be very 11 cautious with choosing your words, 12 because my anxiety right now is at a 13 different level. 14
And so I want to be respectful, but I also want us to recognize that we have not done this community any -- we've done a huge disservice to this community. And so finding out that there are now systems in place that can collect this data, I want us to figure out how do we not collect -- not just collect the data, but how do we connect people to the services that they need and get them out of -- 4/15/24 - WHOLE - BILL 240179, ETC.
Yes. And we totally hear that. We hear that from you, we hear that from Council, we hear that from others as well. We also hear that from the community, and that has been the driver for us to put into place the things that we put in place. What we have put into place just this year is actually quite different, and knowing that, most of the people that we're counting -- and who is counting is DBHIDS Homeless Outreach are out there every day. It's our providers. It's the providers who are part of the outreach teams.
So tell me what your numbers are. What are your numbers? If we were to ask you today, how many people are living in the streets of Kensington?
So I would tell you -- and I assure you it's never an easy answer, so I'm going to give you the answer, because the truth is where the -- 4/15/24 - WHOLE - BILL 240179, ETC. even if it's complex, it's not simple. It's what has to be addressed, right? And all of those barriers and all of these things that we've built that we get all of this attention for across the state and across the country are things that were built specifically because of the concerns that you're raising. Like the wounds don't -- why can't they get into treatment even if they have wounds. Why can't the system take care of people and get them into recovery even if they have wounds. Why would smoking be a barrier. Why is there any barrier. We removed --
I can answer that. I can tell you that. We are in this position right now today because for the last eight years, we've been talking about safe injection sites and not prevention and recovery. That's why. Because --
Okay. I can talk to you about prevention and the 4/15/24 - WHOLE - BILL 240179, ETC. prevention that's going on in the schools, because we go upstream with this at the same time we attack it right where it is. We're also upstream like crazy with this, really, really high upstream with this in the schools. We have enhanced our prevention programs specifically in Kensington because of the challenges that the kids are facing. It's helping them to address substances, so when they're in the midst of this, how they can deal with it and also not go down that road, and also with the violence. So the things that we have been creating are not separate from what the concerns are on the ground, and we take that seriously, and we do feel accountable for everything that works and everything that doesn't work and any gaps that there are. So everything that I'm talking about is actually meant to fill the gaps that you're talking about. When we learn something like 4/15/24 - WHOLE - BILL 240179, ETC. more than half of the people out there in the street are not the same people, even being able to get data about what happened to the people that we brought in, you know, in 2018 and 2019, like was that effective, are they back out on the street again, do they just go in and come right back out. We're actually learning it's something different than that. We're actually learning that the majority of the people are coming in new. Are they coming in to shop? Are they coming in to socialize? So we need a different strategy for that group, which is now the majority of the people that we're encountering out there as opposed to the chronically homeless that we've been encountering, let's say, for quite some time, and they meet the definition for HUD's chronic homeless. Okay. So different strategies, but we have this data and we can show it. And we can say more too, where are they 4/15/24 - WHOLE - BILL 240179, ETC. from, how can we determine where they're from. They say they're Philadelphians. Are they Philadelphians?
So what you're telling me is that we now have new people there, which to me means that we've done absolutely nothing to prevent people from continuing to come into that footprint. Is that what we're saying? All of the strategies, all of the --
I don't think -- I think people can come into Kensington, yes, and I think that there is -- they can come into Kensington, but they're not coming -- they are mostly from Philadelphia. What I'm trying to say to you is that we are able to check whether they have ever -- whether they are CBH eligible; in other words, they have a Philadelphia address. They have had a Philadelphia address. They have a Philadelphia address. If in fact that's the case, we know that they're Philadelphians. 4/15/24 - WHOLE - BILL 240179, ETC. It's about three-quarters of the folks who have a Philadelphia address or have had a Philadelphia address. So they're Philadelphians.
Is that because we've allowed them to use an address that is Philadelphia --
No, no, no. We're talking about an address because they have received services from CBH at some point, right? So it's not just, well, they're using one of the places to pick up their mail. So if there are folks who are -- and I know they've had conversations. We've had conversations with the state about this. We've had conversations with Secretary Arkoosh and Deputy Secretary Smith, and I know that they are aware, and also DDAP Secretary. And when there are people who come from elsewhere, we can work with the people there. Like our Single County Authority that works under Amanda's division, 4/15/24 - WHOLE - BILL 240179, ETC. Amanda David's division, has single county authorities that they work with all the time. If there are people here from there, they will contact them and they will work on where is the best place for that person to be treated. And if they're Medicaid, then the Medicaid of the place they're from is the actual responsible party to pay the bills. So we work on this all the time, so --
Dr. Jill Bowen, do we have the numbers? She just asked for specific data.
I'm sorry. 675 who were engaged in the past 90 days, 142 are chronically homeless, 119 fall in this -- they have more than three contacts, so they don't meet the HUD definition. And then 61 percent have only had one to two contacts. And if you want --
So give me the total number of people you say are out there. You didn't give me that. You went kind of around that. What was the 4/15/24 - WHOLE - BILL 240179, ETC. total number?
Let me ask you this, Dr. Bowen. I know this is your swan song and we're getting ready to wrap up for our break and the stenographer has to take a break as well. I know it's on your website, but the Chair requests that you provide the data to the member and members of Council as a whole as opposed to us going --
Give us the official report. And then I've been working with you for a while. I know it's your swan song, but I did get a whole lot of -- like you gave like 10, 15 scenarios as to 4/15/24 - WHOLE - BILL 240179, ETC. why the situation is, when I think we want more of a strategy and proactive approach on here's how we're addressing the issue, because when you talk about all the reasons why a person is out there or they're not from Philadelphia but they come in here and they're getting high and how they provide a service, like what is our plan as a city, though, to track and strategize on how we treat those individuals so we can have our own dashboard to kind of gauge how we're being effective in that area.
One of the things -- so our strategy, okay, is to bring people in off the street. So we say at DBHIDS, and we've been saying this for a while, harm reduction is step one, it's not step done. That's our thing, right? So our strategy is to connect up and bring in for treatment. That has always been our strategy. What we do to try to make that as effective as possible is identify 4/15/24 - WHOLE - BILL 240179, ETC. every barrier to getting people to come in. And so this past year the focus has been on the wounds, because that was a huge barrier. We broke down those barriers to help people come in that would not have come in. So we get more people off the street than we would have. Now, the other barrier is really knowing who is out there and making sure that our strategies are effective, right?
But that was what the data piece is, and also to be responsive to the community that wants to know what's going on.
The Chair recognizes -- no. The Chair requests that you provide the data to the Chair of Health, who is Nina Ahmad, and the gentle lady from Kensington, who is working very aggressively on this issue in partnership with Councilmember Jim 4/15/24 - WHOLE - BILL 240179, ETC. Harrity, Councilmember Mike Driscoll, and Councilmember Mark Squilla. That's why you're getting these lines of questioning.
Absolutely. And I know we have a second round, so you'll have an opportunity to do any additional follow-up, because I'm sure members -- there's several members who are queued up for our second round, so we will -- yes. So folks are still on the first round. And so after lunch, we'll finish at 2:30 and we'll see everyone back and we will go from there. Welcome, Dr. Marquita Williams.
And this is why I'm doing this today. Thank you. (Recess from 1:58 p.m. to 2:36 p.m.)
4/15/24 - WHOLE - BILL 240179, ETC. This hearing is now resumed. The Chair recognizes Councilmember Jeffery J. Young.
Thank you, Mr. President. First line of questions are going to be devoted toward the Department of Public Health. In the Philly Joy Bank program, is it possible that you can provide us with data on income levels of the participants, the zip codes of the participants, and the amounts distributed to date? Also if you can provide us with who will be doing the assessment to see if this particular program has ultimately achieved the goals that we're trying to achieve. And I say that to say, you know, because guaranteed income is great in theory, but if we are really trying to target a population that is experiencing these health issues, I do think that we should -- the spending of the money should be targeted more toward those 4/15/24 - WHOLE - BILL 240179, ETC. things that are going to directly affect the outcome. So I just want to keep that in mind as you are going through this program. A thousand dollars sounds good until they spend that thousand dollars on things that ultimately contribute to the negative health outcomes that they were experiencing in the first place. So if we can keep that in mind. Second question is related to -- it's a non-budgetary question. I'm sorry. I'm going off task. But the regulations regarding the tobacco retailer permit here in the City of Philadelphia. In 2022, I believe the regulations were changed to state that no 19 new licenses will be able to be within 500 feet of schools grades K through 12. Now, in a prior life, I represented a corner store who her father died and she inherited that store, and when it was time to renew her tobacco retailer license, she was denied that 4/15/24 - WHOLE - BILL 240179, ETC. license because she was considered to be a new owner, although she inherited that store from her father, and that license was kind of like the backbone of that store that's been in that particular neighborhood in Fishtown for over 30, 40 years with no issues. And so can we talk about -- can you just explain the premise of this regulation and why if a property was already exempt, why now this new owner cannot apply for a license, particularly in this case where she inherited a business from her family, a business that she has worked there since she was a kid. Why is it now that she is unable to continue to sell a product, a legal product, that that store has been selling for over 40 years?
Thank you for your questions, Councilman. For the first line of questioning, I'm going to have Dr. Stacey Kallem respond, and for the second line, I'm going to have 4/15/24 - WHOLE - BILL 240179, ETC. Dr. Palak Raval-Nelson.
Hello. I'm Dr. Stacey Kallem, Director of Maternal, Child, Family Health Division. I'm going to try to speak more slowly this time so people understand me. So the program hasn't launched yet. The Philly Joy Bank will be launching tentatively June 22nd of this year, so in a month and a half. I think one of your questions was about who is eligible. So it's folks who live in one of the three neighborhoods in Philadelphia that have the highest rates of very low birth weight births. So that's Cobbs Creek, Nicetown-Tioga --
I'm concerned, yeah. And it's folks that are 4/15/24 - WHOLE - BILL 240179, ETC. making up to $100,000, right? So the question is again, I just want to make sure that we're clear on when we're collecting the data, can you provide us -- that's why I said can you provide us with the income data of the participants, their zip codes, again the amounts that's distributed per zip code and also -- yeah. That was it. So we can then determine -- and also tell us who is evaluating that data to determine if it is going to be meeting the goals of what the Health Department has.
Yeah. So for evaluation, we did an RFP and we selected researchers from Drexel University from their School of Public Health who will be doing our evaluation. We don't have the program data yet, right, because we haven't actually started, so no one is enrolled, but I can tell you about the neighborhoods we're serving. The median household income is about 20 to 30K per year, so we expect 4/15/24 - WHOLE - BILL 240179, ETC. most participants to be around there.
I'm familiar with that, but, again, your program states that it's folks that are making up to $100,000. So I want to make sure that how can we -- how are we targeting the participants, right? Because if you target folks that are mostly close to that hundred thousand dollar level, then the outcomes that we're expecting, the health outcomes, are a little bit different than folks that are living in poverty in the City. So, again, how do you target the participants?
So we're going to be recruiting in a few different ways, so really relying on trusted messengers in those neighborhoods, so prenatal care providers at our health centers and other prenatal care establishments, WIC, home visitors. So really folks that are in the neighborhood and trusted is where people who are pregnant might be is who 4/15/24 - WHOLE - BILL 240179, ETC. will be doing a lot of the outreach and recruitment for the program.
And what was the determination of that income, the income level, the hundred thousand dollar income?
So it's actually based on community feedback. So we partnered with researchers from CHOP Policy Lab and did formative research where we did community-focused groups of Black Philadelphians who had recently given birth or who were pregnant about the Philly Joy Bank and how should we make all of our design decisions, and one of the big points of feedback we got from community is to make sure we tie eligibility, not just to the federal poverty line or Medicaid eligibility but really thinking about those Philadelphians who maybe make too much to qualify for traditional public benefits but aren't yet making enough to thrive. So we looked at a living wage calculator, 4/15/24 - WHOLE - BILL 240179, ETC. and that's where we came up with the hundred thousand dollar sort of cap. But, again, knowing the neighborhoods that we're focusing on, we don't expect many people to be in that range.
Okay. So if you don't expect that, then why create that, I guess, artificial kind of like cap then if you don't expect it? You should set the cap at what your expectations are.
We were really trying to be responsive to the community feedback, which they told us to set it higher than sort of a traditional federal poverty level.
Okay. Thank you. I appreciate that. And then the question regarding the tobacco retailer license and the 500 feet from K to 12 schools.
Essentially, again, the rationale is -- 4/15/24 - WHOLE - BILL 240179, ETC. the premise of my question is because I had a client whose father owned a store that she inherited and then at the end of the year she had to apply for a license and was denied, and I'm just saying if the goals are to decrease tobacco use, I understand that, but this particular property has already had tobacco use -- tobacco sales for almost 40 years in that particular neighborhood. It doesn't create any kind of new disparity or new issues because they've already been there. So if you can elaborate on that.
Sure. And I just want to clarify for the record, it's a tobacco permit. I don't want to confuse it. It's a tobacco permit, not a license.
And tobacco permits are not transferable. So the permit is associated with the person and the establishment. So it's issued -- 4/15/24 - WHOLE - BILL 240179, ETC. it's similar to a driver's license or a liquor control license. It's issued to the person and the establishment, and it's non-transferable. So that's what ended up happening with the person that you were representing. It's not transferable. And then they probably -- and I don't know the address, so I don't have the details, but I'd be happy to follow up if you provide the address. But if -- since it's not transferable and if it's in a cap, which was legislation to prevent youth tobacco access, so there's no -- there shouldn't be tobacco stores in -- we want to make sure that the poorest of our neighborhoods are not saturated with tobacco retailers. So if she's in a cap or he's in a cap, then they wouldn't be able to get the permit.
So I tell you that this isn't -- I guess at one point it might have been, but this is in Fishtown, right, where there's no issues with income or low-income folks or 4/15/24 - WHOLE - BILL 240179, ETC. whatnot. So I made the argument at the -- we appealed and I made an argument at the Board. Only one person on the Board who was actually a lawyer understood my argument, but everyone else turned it down. But I just say that to say that we think we really need to take a look at our systems, because it is prohibiting small businesses from operating in our city, and I don't think we want to prohibit small businesses who have been operating in our city for years with no 16 issues whatsoever. And so I think we should look at our regulations to make sure that our regulations are meeting today's standards and today's needs, particularly in those particular neighborhoods. And I heard the bell, so thank you.
Thank you. Thank you so much, 4/15/24 - WHOLE - BILL 240179, ETC. Councilmember Young. We will now move to Councilmember Phillips. The Chair recognizes Councilmember Anthony Phillips.
Thank you, Majority Leader, Councilwoman Katherine Gilmore Richardson. Just quick rapid-fire questions for the Department of Behavioral Health. There's a waiting list of children and families for services. How long -- how big is that waiting list?
So I don't have that directly, but I have to say that the services are embedded in the schools, and so there really shouldn't be a waiting list to be able to get access to treatment. There's providers right there in the schools. They can tap into a whole array of specialties depending on what the needs are of the kids, and there's also prevention providers. So are we talking about people 4/15/24 - WHOLE - BILL 240179, ETC. just calling to sort of separately get -- we also have expanded our PACTS program, which is very trauma focused for the kids. There's now -- 6
I just 7 wanted to make sure there's enough 8 providers to be able to serve our 9 children in those schools. So if there's 10 not a waiting list -- 11
I'm getting no 12 waiting list. So what I'm concerned 13 about, though, if you hear that there's a 14 waiting list, again, that concerns us. 15 So we want to make sure that they call 16 Member Services, because there should not 17 be a waiting list for kids. 18
Okay. 19 Great. 20 Providers should be delivering 21 intensive behavioral health services year 22 round in the home and in the community 23 settings when not in schools. What does 24 intensive behavioral health services 25 utilization look like in the summer 4/15/24 - WHOLE - BILL 240179, ETC. months and are families being engaged, as well as in what way is DBHIDS and DHS providing services for delinquent and dependent children?
So IBHS is year round. They are in the schools when there's summer school. They are at the homes or in the community. So they do maintain connection with people who -- kids who have met those criteria. And also remember these are providers that are also in the community. IBHS is always in the community, in the home and community, which is what I was saying.
Can you provide data around academic improvement of the kids who received these services?
So I don't know that we have that. We can talk to our school partners, but IBHS is a Tier 3 service, just so I am clear on that. The school does have services for universal, 4/15/24 - WHOLE - BILL 240179, ETC. Tier 2. They have school counselors. They're even a provider for CBH in the step space, but IBHS is a Tier 3. So it's folks that are really struggling with need -- you know, a certain level of treatment. So I do not know for those kids where the academic -- and it's not necessarily going to be something that can be seen short. It might require like longitudinal data. So I'll get you the answer to that to know to what extent they're tracking it, but I think it would be the school system that is going to have that data. You know, they are partners with us, so we can check that out.
Thank you, Dr. Bowen. Thank you, Majority Leader. That's my time. I'm good. Thank you.
Thank you, Councilmember Phillips. The Chair now recognizes 4/15/24 - WHOLE - BILL 240179, ETC. Councilmember Nina Ahmad.
Thank you, Majority Leader. Just a few other questions. One was about the relationship of DBHI with the gun violence prevention programs and if you worked on the cognitive behavioral therapy support that we were told they now include in their programming.
We have cognitive behavioral treatment infused into a great deal of the work that we do to real evidence-based practice. So when we talk about gun violence, we always talk about trauma, right, because trauma leads to gun violence. It also is a result of gun violence. So we're very, very trauma focused and, therefore, the PACTS, which is the Philadelphia Alliance for Children Trauma Services, right, is a very 4/15/24 - WHOLE - BILL 240179, ETC. intensive trauma-focused, cognitive behavioral therapy. So we have trained a whole bunch more providers so that they have those particular skills and we have expanded the network of PACTS providers within the City, and it's across the City everywhere in the City. So we have cognitive behavioral therapy infused into the work that we do with the kids throughout and also the school -- training the folks in the school.
So actually my question was about the actual programs that are doing anti-violence work. Is your department intersecting with them? These are the grassroots folks who are on the ground doing -- violence interrupters, all of those different smaller groups, not the School District or the bigger entities.
So we support IMA, Mothers in Charge, Black Men Heal, and they are engaged with us on a number of initiatives. Like one that's called From 4/15/24 - WHOLE - BILL 240179, ETC. Trauma to Triumph, and it's a list of those folks who are providing the services to the kids, and it's meant to be preventative from going down the gun violence road, and it actually came out -- the types of programs that are being offered by the community-based organizations that are focused on gun violence is based on the work of the external stakeholders around former perpetrators of gun violence and what was going on in their early lives and how can we prevent that happening for the kids that are currently --
My question is really, yes, you do work with them, and do you have data to show over time that your involvement with these CBOs have done what? Do you have -- have you collected information around that?
So we'll get you whatever information that we have. The initiative that I just told you about is a newer one that is standing up, but we 4/15/24 - WHOLE - BILL 240179, ETC. do support -- we have supported this sometimes, Healing Hurt People, Cure Violence, CeaseFire. So we are funders of this and we do have data there.
Because I just want to see how embedded CBT or other things of that nature are -- each of these programs, because it is abundantly clear that we need it, and so I wanted to see if there's a comprehensive policy around all anti-gun violence work from the City of Philadelphia that's funding of any sort, whether DBHI is connected or connect to providers who do that. So I just wanted data around that, how many are getting --
We can get you that, but sometimes there might be an initiative where we have a grant that they -- and they bring in a provider there. Often they're also part of the network. And so in a sense, we are part of what they're doing there, but sometimes it's not necessarily like we 4/15/24 - WHOLE - BILL 240179, ETC. have the data for that particular program, but we'll get you what we have.
I just want to be a collective place where we get all this information.
And your department seems to be the most appropriate place, whether or not you're --
Yeah. So we need a report to say we've done this, this happened in one year, two year, this is good, this is bad, how do we move. That's all.
All right. Thank you. Thank you, Mr. President -- or Madam Chair.
Thank you. Thank you so much, 4/15/24 - WHOLE - BILL 240179, ETC. Councilmember Ahmad. The Chair now recognizes Councilmember O'Rourke.
Thank you, Madam Chair. It's Black Maternal Health Week in the Commonwealth, so I want to highlight that. Of the top ten most populated United States cities, Philadelphia has the highest rate of infant mortality in the first year of life, and when we look even closer to race and ethnicity, Black infants in our city are over four times more likely to die before their first birthday than white infants. This is a crisis, but we do know how to solve it. When we design solutions that see the whole person and the barriers that they face, we can achieve true success, and the Philly Joy Bank pilot program is exactly the kind of response that I believe that we need. So I share Dr. Ahmad's excitement about the program 4/15/24 - WHOLE - BILL 240179, ETC. launching in June. I want to thank all those who have put in work there. I just wanted to ask for it to be stated on the record clearly. Can someone just speak to some of the common impacts of guaranteed income programs in general just so we can state on the record for this portion, please.
Thank you, Councilmember. I defer that to Dr. Stacey Kallem.
Nice to see you, and thank you so much for your enthusiasm and for the question. So as far as guaranteed income --
Pardon me. Please state your name for the record and speak directly into the microphone. Thank you.
I'm Dr. Stacey Kallem, Director of Maternal, Child, 4/15/24 - WHOLE - BILL 240179, ETC. Family Health at the Philadelphia Department of Public Health. So thank you so much for the question. As far as guaranteed income and its impacts on birth outcomes, a lot of what we know comes from Canada actually from a program called the Healthy Baby Prenatal Benefit, which gives low-income pregnant people in Manitoba, Canada unconditional cash, and it found that it reduced rates of low birth weight by and a half percent and 14 reduced rates of prematurity by 21 15 percent. That is amazing and something 16 we're really excited about. 17 And then here in the U.S., we know that states that have an earned income tax credit and that also during COVID during the expanded child tax credit -- so not guaranteed incomes per se, but both ways of getting more cash to people during pregnancy -- also decrease the rates of prematurity and decrease the rates of low birth weight. 4/15/24 - WHOLE - BILL 240179, ETC.
We thank you for your work on this, Dr. Kallem, and all those who have gone into it. Look forward to helping to slash those maternity rates for sure. I want to turn my focus to Department of Behavioral Health and Intellectual disAbility Services. In the aftermath of deaths of Christian Hall and Walter Wallace, it was abundantly clear that as a city we needed to rethink how we respond to people in crisis. Deeply heartened, super excited about DBHIDS's plans to continue and expand the Philadelphia Community Mobile Crisis Response Teams. These teams send medical professionals to those who are in crisis and they free up other resources, like the police, to focus on other issues that they may be better trained for. Last budget cycle, thanks to the efforts of a number of Councilmembers, including Minority Leader Brooks, Councilman Jones, Councilman 4/15/24 - WHOLE - BILL 240179, ETC. Squilla -- sorry if the bell is going. I want to just finish this up -- Council President Johnson, Councilwoman Gauthier, past Councilwoman Vaughn, as well as Councilman Driscoll, an additional $3 million was added to this important work. Can you tell us how the addition of 3 million actually aided your work that was secured by those members?
Yes. That was specifically to build the bridge teams so that we can address the response rate. So that has been this past year building up those teams and getting them ready to hit the streets. So specifically what it was meant to do is what it was used to do. So bridge teams, that's what that part was about.
Thank you very much. Madam Chair, is there a Round 2?
Yes, 4/15/24 - WHOLE - BILL 240179, ETC. there will be a Round 2, time permitting.
So we'll get through the first round as quickly as we can. Is that good for you, Councilmember O'Rourke?
Excellent. Just please get in the queue. The Chair now recognizes Councilmember Harrity.
Thank you, Leader. So just checking these numbers. So you said right now out of a thousand or so beds that we have, there's about 175 available? I believe that was the number.
109 available, okay. That's not even -- all 4/15/24 - WHOLE - BILL 240179, ETC. right. And the number that you're saying of homeless addicted out in Kensington is about 675, you're saying?
The number that has been encountered during -- yes, is 675. And like I said, that now is publicly available data.
Okay. Do you have -- so what happens if we, say, send you 300 people in a day? What would you do then?
Well, we're about to start doing the Mayor's plan and we're planning on the AMP program and the PAD program, and I would imagine that during that process, you're going to have some very high numbers of people that are going to be needing to be put somewhere. I'd just like to know with 109 beds how you plan on doing that.
Okay. So first of all, we are part of and engaging 4/15/24 - WHOLE - BILL 240179, ETC. alongside the many agencies that are involved in this work. We are engaging folks every day, even today. We have not only the capacity, we also have overflow beds, and we are prepared for a surge, but we're also really looking at the rest of the continuum, because we also have slots available there. So it really depends on what they need, do they need outpatient and some form of housing, do they need --
I can tell you right now that none of these people need outpatient programs. They all need inpatient programs. There's no 17 way they'll be able to stay sober on an outpatient program going back to the place that they came from. That's just outrageous to even think that somebody that is on this type of drug is going to --
-- be 4/15/24 - WHOLE - BILL 240179, ETC. able to go to an outpatient program --