You spoke about how you are working with Dr. Schwarz around the issue of the uniform registrar system.
So what does that mean? What role is your Federation playing?
The role that the Federation plays with respect to community health centers, who are members of the Health Federation, is a representational one. In other words, through the Federation, I'm able to help organize the community health centers to 186 6/15/10 - PUBLIC HEALTH - RES. 100260 give their input, to share their information and concerns, to build the bridges between prenatal providers and the hospital delivery sites, and to represent those health centers then when Dr. Schwarz convenes the hospitals that he mentioned, the six delivery sites, and the community health centers to plan together how to make this registry work. It is I who come to that.
That's helpful. We've just heard from Ms. Sorn who has made it very clear what the challenges are, and she's actually done better than that. She's offered a couple of recommendations on what we as a city can do to create better access for the Cambodian community and our Philadelphia health system. So what role is there in a recommendation like that for the Federation?
Well, there's several. One is that from an insurance standpoint, all of the community health 187 6/15/10 - PUBLIC HEALTH - RES. 100260 centers provide care to whoever shows up, without regard to immigration status, insurance status or ability to pay. They all provide services on a sliding fee scale. With respect specifically to the language and cultural issues, the Health Federation holds a contract with the City of Philadelphia to provide language access support to various City departments, including City health centers. So we have done extensive training of bilingual staff within the health centers, for instance, in skills as medical interpreters. We also subcontract with two other firms that provide in-person interpreters and telephonic interpreters and document translation for City departments. And so while that's not as good as having a doctor or a nurse practitioner or a social worker who speaks your native language, the next best thing is to provide interpretation services. 188 6/15/10 - PUBLIC HEALTH - RES. 100260
It surely is a short-term solution. So I will challenge your organization to consider her broader recommendation, and, that is, to actually speak with the six hospitals that we have here who have nursing programs where you might have a young aspiring nurse of Cambodian descent or some other and link them when they're in college, link them with healthcare centers and the City so that there really is a continuum in terms of a career path as well.
Yeah. There certainly could and should be incentive programs for professionals who are particularly in high demand, incentives not only to enter into health professions, but then to come back and serve in medically underserved communities rather than going into a suburban practice or into academia or research or something else. I might mention that one of the 189 6/15/10 - PUBLIC HEALTH - RES. 100260 things we've done with respect to training interpreters is that for the last three years, we have been working with medical students at Jefferson. They have organized all of the interested bilingual, bicultural medical students and we've provided them with interpreter training and certification, and in turn, as payback for that, they volunteer at district health centers as interpreters so that they are now not only proficient in an understanding of medical issues, but also as certified interpreters.
Thank you very much. Is there anyone else here to testify on this resolution? (No response.)
We'd like to ask Ms. Jordan to come back to the table, please. 190 6/15/10 - PUBLIC HEALTH - RES. 100260 (Witness approached witness table.)
I just have two questions, and then I guess we'll sum up as to where we go from here. As a follow-up to your earlier comment, how much money comes to Philadelphia from the State for home visits, and how does this compare to other areas of the Commonwealth?
Let me answer that in twofold. One is, Philadelphia receives an appropriation from the State to the City in the figure of 3.25 -- $3.2 million. However, they use their funding around home visiting to -- they can use a portion of those funds, of course, in many ways, so I can't tell you exactly how much of that that they allocate for the home visiting program.
That's an appropriation that comes into the City 191 6/15/10 - PUBLIC HEALTH - RES. 100260 from the Title V, as well as from the State appropriation here to Philadelphia for maternal/child health services.
So this is the total budget that comes from your department?
That's correct. I have to look to my Director to make sure I got that correct.
Okay. And a portion of that is up to the discretion of the department to --
The department has the discretion to use those funds and support home visiting, to support prenatal services, to support infant healthcare services, preventative healthcare services. So that's their preparation. I was also going to add, a few minutes ago we talked about the 192 6/15/10 - PUBLIC HEALTH - RES. 100260 additional funds that would be coming out that was recently released around a new home visiting program. The President has released $90 million -- and let me look to my federal colleague to make sure I got that correct. Ninety million dollars was just released by the federal government for a home-based visiting program. Philadelphia -- I'm sorry. Pennsylvania stands to receive approximately -- this is approximate funding from the feds -- $2,070,398, and that's an approximate amount of money that will be coming into Pennsylvania for home visiting.
And how much do you think would come to Philadelphia?
Well, I can't answer that at this time. 193 6/15/10 - PUBLIC HEALTH - RES. 100260
But your department will be administering those dollars?
My department will be providing the -- in the guidance, it does require the Title V officer and State to provide the statewide needs assessment for it. However, the Governor has the discretion to determine if the Department of Health or the Department of Public Welfare will be the entity that will implement this particular program, and at this time, the Governor's Office has designated the Department of Public Welfare to be the entity that will move forth. And so we will be working very closely with the Department of Public Welfare in implementing the home-based visiting program.
Why would the money go to the Department of Public Welfare?
It is the Governor's discretion to allocate who 194 6/15/10 - PUBLIC HEALTH - RES. 100260 will be the lead on this particular entity. So at this point, the Governor's Office has decided that this is the way that it will be implemented. However, we are working very closely together with the Department of Public Welfare in putting together the guidance that will eventually go out.
What department in the Department of Public Welfare? What subdepartment? I mean, if you know, you have to answer the question.
Secretary Harriet Dichter is overseeing this particular implementation, and I am not familiar at this time who Secretary Dichter has designated within her purview to lead this particular effort. However, the Department of Health and I will be working very closely with Secretary Dichter.
Yeah, you said that, but who in the Department of 195 6/15/10 - PUBLIC HEALTH - RES. 100260 Public Welfare has the experience? Is this a new role for them to play?
No, it's not. No, it's not. The Department of Public Welfare has implemented and have moved forth with the Nurse-Family Partnership program that provides home visiting programs in the State, and they have taken the lead on this and have been doing so for over ten years now.
So this is not a new entity. They have expertise in doing this, and, again, they will draw upon the Pennsylvania Department of Health to assist in this effort. However, the Pennsylvania Department of Health will move forth with the statewide needs assessment that is required by the federal government to implement this program, and there will be also other department or statewide agencies that will participate in this, such as the Department of Substance Abuse -- Alcohol 196 6/15/10 - PUBLIC HEALTH - RES. 100260 and Substance Abuse will also be a part of this, in addition to the Department of Education at the State level.
Well, as of today, we've -- not learned. I guess it was reinforced that it's just not -- the whole issue that we're talking about today is not just about prenatal care. It's a holistic approach to health and how do we treat the health of the individual and particularly the mother. So what we have to begin is a holistic dialogue about how we provide health services so that -- we start when you're an infant so that you grow up to be a healthy adult and then you can produce healthy babies. So the cycle goes around. But I do, after listening to this dialogue today, know that we just can't have the discussion around prenatal care and maternal and infant care, but it's the holistic approach to health, which has sort of triggered a lot of 197 6/15/10 - PUBLIC HEALTH - RES. 100260 ideas and thoughts in my mind about what as a city we might do, but we have a lot of work to do.
Absolutely. I also wanted just to add a couple of comments that was made again around preconceptional healthcare. Again, I want to bring to the attention of the Council that, again, from the State level and from Title V dollars, we provide four of your hospitals here in the City of Philadelphia with funding for preconceptual healthcare, and that is counseling and healthcare prior to a woman becoming pregnant. And, again, a number of those individuals were here today, but the University of Pennsylvania, Thomas Jefferson Hospital, Temple University and also Drexel University. All of these entities do receive funding from the Department of Health for preconceptual care. I want to also add approximately $7.5 million comes into 198 6/15/10 - PUBLIC HEALTH - RES. 100260 Philadelphia also for maternal/child health at these institutions, as well as into the City of Philadelphia through its Health Department. And so there's a tremendous amount of resources that do come into the City to address a number of the recommendations that people have made here. And so I ask you to take that into consideration as you look at restructuring and as you look at moving forth. And I again applaud the City of Philadelphia for moving forth with the life course perspective, but I also want to caution that is a one-day activity. I hope that we will move forth with a very strong strategic plan to address these issues and to figure out with all of the non-profit organizations, working with our WIC office as well -- as I mentioned a few minutes ago, we have over how many agencies in Philadelphia? We have about 600 stores in Philadelphia that provide services and, as I mentioned, $50 million that also provides services in food and 199 6/15/10 - PUBLIC HEALTH - RES. 100260 $11 million to our north organization that provides outreach, breastfeeding services and so forth to the communities. But this is an opportunity, I think, for the City also to bring together the various organizations to work not only with your hospitals, but work with all of the organizations that deal with women, infant and children and find strategies that can address these issues in a more comprehensive and strategic manner.
So you've mentioned -- you've given us several challenges. Put them in priority order, one, two and three, in terms of what you view the next steps to be.
Well, again, I think you need -- I would suggest, one, again, looking at your available 200 6/15/10 - PUBLIC HEALTH - RES. 100260 allocations, looking at what your current priorities are in your city and addressing your healthcare needs, where you can work in a collaborative manner with your hospitals. You had a number of your institutions here today, all very supportive of your Health Commissioner, and he's done an excellent job in working also with the State. And so, again, bring the entities together to work towards, one, how you can maximize the funding that comes into Philadelphia to address, again, some of the core issues, your core public health issues, and so you can then probably gain more efficiencies that way by working across all of your, like I said, all of your agencies. In addition to that is to work with the community at the community level, identify those organizations that are in the community and move forward with, again, a plan -- and I know the City of Philadelphia is working on a 201 6/15/10 - PUBLIC HEALTH - RES. 100260 plan -- to address the core issues, the core public health issues here, and they need to be a part of that, need to be a part of that strategy, need to be part of the conversation to move those things forward. And then three is to be able to put together how you plan to evaluate the success of those programs, how do you plan to measure your success, identifying some of those areas, your key areas, where you have high infant mortality rates, again, what are the key measures that you will put in place to be able to determine some progress.
Thank you 202 6/15/10 - PUBLIC HEALTH - RES. 100260 very much. Is there anyone else to testify? (No response.)
There being none, let me say that we will recess this Committee to the call of the Chair so that if we want to come back, we can just do so without having to go through a long process of reintroducing a resolution. We thank you all for coming out today. We thank you for your testimony, and thank you to the lady from North Carolina for coming to Philadelphia. Thank you. This meeting is recessed until the call of the Chair. (Committee on Public Health and Human Services recessed at 1:40 p.m.) - - - 203 CERTIFICATE I HEREBY CERTIFY that the proceedings, evidence and objections are contained fully and accurately in the stenographic notes taken by me upon the foregoing matter on June 15, 2010, and that this is a true and correct transcript of same. -------------------- MICHELE L. MURPHY RPR-Notary Public (The foregoing certification of this transcript does not apply to any reproduction of the same by any means, unless under the direct control and/or supervision of the certifying reporter.)