Madam Chair, I have to leave the chambers now, and I'd like to leave a "yes" vote for this bill. Thank you. 69 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165
Are you all leaving me? Everybody can't leave 'cause I have to have a quorum when I'm calling it out of committee, okay? And we only have a few more minutes.
Okay, all right. It shouldn't be long. After we finish with Councilman Nutter, we have three groups to testify and we should be finished. Thank you. Okay, all right. If I need you, we'll call you. Councilman Nutter.
Thank you, Madam Chair. In light of the current situation, Madam Chair, if you just tell me how long you'd like me to talk, I will talk as long as it takes for the members to come back to give you a quorum. (Laughter.)
We know how long you can talk about. 70 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165
It is a courtesy that we're allowing you to answer these questions, and I will cut you off if you get too long. (Laughter.)
And she's my friend. Just a couple quick questions. Thank you, Madam Chair Director Richman, on the first page of the testimony, just literally for the sake of asking, since it's obviously pointing out one way to do this versus another way, about toward the bottom of the last paragraph -- or halfway through, "Although the City contracts with CBH, a nonprofit corporation created by the City to carry out the program on behalf of the City, CBH assumes none of the risk of management of the program. Instead, it is the City that is contractually required to maintain the risk for the program throughout the term of the contract. To date, the City has 71 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 protected that risk through a variety of required and elective financial reserve and reinsurance structures acceptable to the City and the Commonwealth." Just to understand the other side of what's being laid out. If the City were not assuming the risk, who would? Or what other structure or model, or models, are there that would have the City not assuming the risk?
For the other counties in Pennsylvania, the risk is usually transferred to the managed-care entity, which means they have the right to set the policies, enforce those policies, and determine how they are run. We did not shift risk to CBH for a variety of reasons; the first one at that point being that they were brand-new and had no ability to be able to accept that risk. They are nonprofit entities, so they didn't carry reserves coming into this, and we at the City reserve the right to review and enforce and change any policy or procedure to make sure that it's in line with our own value system. But in other counties, the managed-care 72 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 entity, in which case they're all a for-profit company, makes those decisions, creates those decisions, and holds the risk.
Well, let me just finish that area of questioning. Five years later -- and I'm going to ask you some financial questions in a few minutes. But five years later, and assuming that there are some reserves, has there been any reexamination of that particular decision? I'm not asking the question because I think you should or should not; it's simply informational.
Um... unofficially, I probably review some of those decisions all the time. Officially, no. 18
That's a pretty decent response. Let me ask on the last page -- I know Councilwoman asked about the Good Neighbor Policy. Can you tell me, is there a plan going forward related to siting of community-based specialized housing -- that's siting with an S.
There isn't generally 73 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 because of the way the funding works year to year with the Commonwealth; that determines how much new development will occur in a given year, since usually by the time the Governor's budget is approved, we'll have some sense of how many new homes we may be developing during the course of the year. But at this point in time, we're not in a position to say over the next months. We 11 could take a guess at that but wouldn't be able to 12 define that. 13
I was going to say, 16 because it's all determined by new money coming in 17 from the State. I mean, it's not that we can't 18 tell you what we want to do, but we can't do it unless we know that the State is going to give us new residential dollars.
The other variable that plays into that are -- and what we've found more and more recently are the type of housing necessary, meaning more handicapped-accessible housing, ranch-style homes because of the 74 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 populations coming out of either the State hospital or State --
So a year for my State rep to find a house, two years.
Well, I understand that and I know that you can't make your final decisions until you know what your dollars are. But on the other hand, I have to assume that you must make some assumption about what you're going to get, or in a perfect world, if you just believed or estimated that you were going to get X-amount of funding, you must have some idea as to where you would want to be if you had funding available. And so, again, I'm asking the question: Over the next, you know, two to three, three to five years, if things just continued on the way they've been going, and I understand that, you 75 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 know, kind of past funding is no guarantee of future funding, but you must have some plan related to where you would put facilities, you know, kind of all funding being equal.
I think based on some of the history and based on some of our experience with the population, probably the Northeast area and the Roxborough and Andorra area have been areas that we've looked at on the mental retardation side primarily because of the type of housing and the need for detached homes there. On the mental health side, it actually is broader, and we've probably looked much more citywide. Generally homes in support of individuals with mental illness are larger than three persons so that we're generally looking for a home that can accommodate anywhere from 8 to 12 individuals. So we do have a broader range to look at there.
Tell me briefly, and if you've gone over this before, then you don't have to go back through it, but in the context of 76 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 the Good Neighbor Policy, what are the protocols related to making the site decision, contact with the community, and contact with the respective elected officials? And at what point in time is there contact in the course of the process?
Generally, when an agency identifies a particular site, we ask them first to notify us so that we can look through the information that we have internally to see if there are multiple homes in that particular area, since we now have the ability to look across systems might there be other systems that also have homes in that area. And again ---
Now, when you say when they've identified the site, I mean, is that "We found a site and we think it's nice," and they let you know? Or is it, "We found a site, we have an agreement of sale, and we're possibly proceeding to zoning and then we'll let you know what's going on"?
We generally require agencies to check with us for that very reason so that we're not tripping over something that may have been developed by another social service.
And at what point in time are elected officials and thereby neighbors --
We ask agencies and, again, appreciate the feedback if it's not happening to, with that notice, identify at least a contact with the local Councilperson that they are interested in pursuing a home in that area.
Okay. The last paragraph of the testimony talks about, This is a contract with the Commonwealth to provide funding for calendar year 2002 with four additional annual renewal options in favor of the Commonwealth. First, you're saying that this particular contract is basically a one-year contract with four one-year renewals; is that what we're talking about?
Yes, it was, except that 78 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 it --
It was a total of five years. The first contract was three years with two renewals at the discretion of the Commonwealth.
Okay. So under this particular proposal, and should the bill pass, there would be no requirement to come back to Council for any of the four one-year renewals or any of those one-year periods?
The reason we're here that we're here is it crosses fiscal years. In other words, the contract is on a calendar-year basis, and because it crosses calendar years, it's considered a --
Okay, so you're saying every year, you're going to have to come back?
Yes. 79 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 (Ms. Richman confers with colleague off record.)
That's correct You know, part of my misunderstanding we originally, on a one-year contract, we didn't have to come back to Council.
But it's not -- when it crosses fiscal years, our legal counsel tells us that we have to come in because it hits two of your years mas opposed to one of these.
Good morning. I'm Cheryl Kritz, and I'm with the City Solicitor's Office.
In answer to your question, Councilman, about the term of this contract, we brought the original contract, the 1997 contract, to Council for its approval and bringing this contract because essentially, the City is being asked to assume the payment obligation.
As a general proposition, when the City receives money, we've taken the 80 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 position that those contracts typically do not come to Council for approval; it's only when the City is spending money. Under this contract, we are doing both: We are both receiving money and we are assuming the obligation to fund the program over, across fiscal years.
It is stated that the City obligated to fund medically necessary service to see eligible services -- who are financially eligible, income-eligible, but I will turn it over to Ellen now, who can give you some idea of the numbers.
Okay, but why don't you just hang in there for a second. Again, just going by the testimony, it says you're looking to secure City Council approval 81 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 to secure the City's obligation to fund the program as of July 1, 2002, which is the start of the next fiscal year. Tell me about this cross-fiscal year situation.
Technically, the City's existing contract has been extended to June 30th.
So that we could bring this contract before you. Once it is executed, it will be effective for calendar-year 2002.
So only for a six-month period, and the next contract is from January 1, '03 through December 31, '03 covering those two different fiscal years?
So are you, in fact, anticipating coming back very every year because of this cross-fiscal year situation?
Yes, we would, we could. I mean, the City would be assuming the obligation to 82 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 fund the program for another calendar year as of January 1. It's an unusual type of contract, but why don't I turn it --
Yes. The original contract was a three-year term with two renewal options in favor of the Commonwealth
I understand. Did you come back for the last two years?
No, we did not. In part because of just the timing when we received those documents and...
The annual budget for calendar-year '02, from January 1, to December 31, '02 is about $500 million, and that is a combination of medical expenditures and administrative costs. 83 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165
All of which comes from the funding that CBH receives from the Commonwealth?
The 500 million is all capitation revenue. Above and beyond that, there is interest income if the interest rates, you know, provide for that.
Councilman, the money does not come to CBH; it comes to the City.
The City only gives CBH enough money to pay its bills. All of the money that comes in remains under the control of the City, and the movement of money from the City to CBH happens within another contract. The contract we're talking about is the contract between the City and the Commonwealth.
Once that money comes in from the Commonwealth, we then sign a contract with CBH to pass money for them as they need it to pay their bills.
All of the reserves sit 84 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 with the City, not with CBH.
All right, I understand. So let's go back. The $500 million in calendar-year 2002, you're saying that's what the City received from the Commonwealth.
That's a projection. We're paid based on the number of enrollees in the program and what category they're in, so that the 500 million is what we're projecting based on our projection of Medicaid enrollment in Philadelphia.
How much do you expect to spend in calendar-year 2002?
The rate was developed based on us spending the total amount on either medical expenditures or associated administrative costs.
So you're fairly well anticipating a complete wash of a match-up between what comes in from the Commonwealth and what goes out?
As of February 2002, those first two months, the contract has generated 5 million of surplus. But, you know, that can 85 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 change so we're just being cautious about that at this point.
Right, I understand. Why don't we do this: Can you produce for the committee and get to the Chair annual budgets since 1997?
And what level of fiscal planning do you do going forward? Do you have a projected budget for either this calendar year or next calendar year, or do you have three-year projections? Or how do you do it?
We normally do projections for the current calendar year, and we do them six months in advance based on our rate, you know, having to accept our rates at about that time.
Okay, all right. So if you could put together full and complete budget showing all sources and uses as well as, you know what the -- and the bottom line being what the revenues were coming in from the Commonwealth and what the expenses were and then any surplus for each year from 1997 up through current and whatever your next level of projections are over the course 86 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 of the next year, that would be very helpful
Has there ever been a year where you did not have a surplus?
The last fiscal year -- well, on an accounting basis, in year 2000, we showed a loss.
The loss that was shown on the accounting books for year 2000 was $27.7 million.
And an accounting basis for '01, we're showing an 11.5 million surplus. And this is based on -- what I will do is, we will give you a chart that lays this out. It's 87 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 confusing to present it in this matter.
I understand Last question. With regard to the year 2000 accounting deficit, is that where the whole issue of the City's risk come into play? Do we pay the $27 million?
Over the life of the program, including that loss, the City has earned $100 million of surplus over the five-year period. So with that loss, if you added that back before that loss, we had $127 million of surplus that we earned the. The State has allowed us to accumulate reserves under the program so that we're able to cover the fluctuations and utilization, the changes in the way programs roll out so that the City General Fund won't be at risk.
I understand. But now when you say that the City has accumulated a $100 million surplus, we don't put that $100 million in the General Fund, do we? Or do we keep it segregated for CBH?
Of that 100 million, 20 million we put into approved reinvestment 88 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 activities, and we came to Council with a plan that got approved several years ago.
The 80 million we've set aside as reserves. And there are two basic reserves that are contractual requirements that need to be covered, and they are overlapping reserves. One of them is an insolvency reserve that the State has, which requires us to put 60 days of unpaid claims aside so that if there was adverse circumstances, that the State wouldn't be left holding the bag on this, and that's about 74 million.
And then the other requirement is a required reserve that is sort of an equity reserve of million, or 5 percent of 19 revenues, that the State requires. 20 And those are both outlined in the 21 contract -- you can read about them -- and they are 22 overlapping. So we need to cover both of those, 23 and the 80 million we use to cover those reserves. 24
All right, last 25 question. The reserves are, you keeping them in 89 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 cash or other financial instruments?
We're keeping them in a combination of cash and other financial instruments. We follow the City Treasurer's policy on how those assets are invested. And, in fact, the City Treasurer is the one who manages this for us. We attend quarterly meetings to exchange information, but since the reserves rest on the City's book, the City Treasurer manage those.
I apologize that I missed all of these questions, and I would 90 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 appreciate it if I ask a redundant question, just tell me it's a redundant question; you will not hurt my feelings
Councilman, most of those financial decisions are micro-managed by the State as to what happens with money and how it's collected, what's maintained, and what happens to what is maintained. It's pretty well guided by the State and by the contract.
Sylvester Johnson announced that he wants to do prevention rather than just to rest, and since most of those arrests are usually drug-related, what services are going to be available in order to implement the policy of prevention? Because if we're going to be doing that, 91 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 that means that we're going to need more treatment centers, more dollars for treatment, and perhaps more dollars for education and outreach to certain communities. Prevention does not come cheap. So I want to know if CODAAP and CBH -- how are we talking about this plan? Or is there conversation going on between the Police Department and CBH?
Actually, Councilman, that was my 11:30 meeting that people are waiting for me right now on. But let me have Mark Bencivengo, the Deputy Commissioner, come up and address that because that is a very active subject for us right now.
And how we address that and how the Behavioral Health System as a whole, with the Coordinating Office of Drug and Alcohol Abuse Programs take the lead on it.
And while it doesn't come cheap, it might be cheaper than incarceration. (Witness comes forward.) 92 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165
My name is Mark Bencivengo, and I'm Assistant Commissioner in the Behavioral Health System with responsibility for the Coordinating Office for Drug and Alcohol Abuse Programs. We generally, within CODAAP, regard prevention as taking place prior to a person's becoming involved with substance abuse, and to that end, we run a number of after-school programs, youth risk reduction projects, and also do prevention starting as low as the 3rd or 4th grade within the public and parochial schools. Commissioner Johnson is talking about prevention in the same sense that I'm talking about prevention, but he's also talking about neighborhood activities to rid those neighborhoods of individuals who purchase or use drugs. And to that end, as the Philadelphia Police Department is more active in some neighborhoods where there's significant drug use, we in the Behavioral Health System can anticipate that a number of those individuals are going to want to go into treatment or in fact perhaps be stipulated into treatment by 93 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 the criminal justice system. We also anticipate that a number of those individuals coming into contact with the Police Department and ultimately the Behavioral Health System are not yet going to be on Medicaid, meaning that they would not be eligible for services paid for by Community Behavioral Health, but that they would have to be paid for by the Behavioral Health Special Initiative. Which is a part of the Behavioral Health System. Or by county dollars. And in fact, as the Managing Director said, the 11:30 meeting this morning, which I'm sure is going to be held later, is going to strategize on looking at the ability of the Behavioral Health System to accommodate those individuals. We have a number of different types of programs available in the Behavioral Health System: Detoxification programs, long-term residential treatment programs, outpatient, drug-free programs, methadone maintenance programs for individuals --
These are treatment 94 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 programs.
What I want to get to is, how are we -- what is the plan? And, obviously, Estelle, excuse me, the Managing Director, explained that that was the meeting that was going to be held, and obviously, you are not going to have an answer, but we would like to see a plan that goes to that. Because it's going to be a combination of CBH services, as I see it, because for your program in terms of treatment, they have to be -- they have to be adjudicated, perhaps, or maybe voluntarily, they go into certain programs. But what's the coordination going to be like? And how much -- what in terms of education that goes to prevention treatment and how is this going to be interlacing with the Police Department? That's the area that I -- 'Cause I know your programs, and the thing is, usually, over the years, we haven't had sufficient monies to fill the need that we have out there in the communities in terms of people who need treatment and available slots that we have for treatment. Is that true? 95 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165
Well, one of the very attractive aspects of the Behavioral Health System is that we now have the opportunity to use the most appropriate funding source to support an individual in treatment. For example, if an individual is involved with the criminal justice system, we receive monies from the Pennsylvania Commission on Crime and Delinquency, and we will tap that account in order to pay for the person's treatment. That money is all a part of the Behavioral Health System, but we just recognize that the person coming in eligible for that funding stream. If the person coming in on Medicaid, we will tap another funding stream. If the person is low-income, uninsured, not involved with the criminal justice system in the sense that they're stipulated into treatment, we will tap yet another funding stream. I think that part of the issue around the availability of treatment slots also goes to the issue of staffing needs, which are throughout the United States. Programs throughout the United States are reporting that they are not able to hire 96 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 qualified, certified staff to support those programs. Philadelphia is no exception to that. When the Behavioral Health System looked at the number of treatment slots licensed by the Commonwealth of Pennsylvania in Philadelphia, we also looked at how many of those slots could actually be filled because the programs had adequate staff, because there was a staffing ratio of 1 staff person to 35 clients. We found a number of slots that were licensed that could not be filled because of inadequate staff. So we're working with providers and with educational institutions to create individuals who could fill those slots.
Also, Councilman, the meeting that I need to go to is very soon.
Many of the social service directors, because to look at prevention is more than just like looking at drug and alcohol. So I have John Domzalski from the Health Department who will be there and Rob Hess of Adult Services, and Alba will be there because much of this is with 97 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 moms or families that have been involved with DHS or children that are within the custody system. Tom Costello will be there because we know when people come out of prison, if we don't do something preventive or supportive, then they will use again and come back to prison again. We also have the Rec Department there because we know that, depending on how we keep people busy and what they do, we can add some prevention programs. And the agenda of Safe and Sound is one around prevention. So, basically, I will have the full cadre of social services to --
Thank you, Councilman. I would love at some point in time to be able to have the schools involved and have the right person from the schools involved in those initiatives, but what we're going to do is a planning initiative that addresses prevention, treatment, and recovery, and that we coordinate back with the Police Department to be able to do this. I'm hoping -- obviously, we still need 98 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 to do this within a budget and I -- incidentally, just to clarify, from my perspective, my part of the job is to keep people out of the prison and reduce the cost of the prison, but Behavioral Health Services are not necessarily on an inpatient basis less than having someone in prison, just as a clarification. To keep someone in prison, it costs us about $70 a day; to keep someone in a treatment program is...
In a residential treatment program, it's roughly $130 a day, but in that residential treatment program, they're receiving a variety of services.
Thank you very much. All right, I think you might be free. Any more questions so the Managing Director can go to her meetings? (No further questions.)
Thank you very much and we'll call on the other guests here today. Dr. Anthony Arce, M.D., North Philadelphia Health Systems. 99 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 Thank you very much for your testimony. (Witnesses come forward.)
I am Dr. Anthony Arce, a psychiatrist, and I am the Chairman of the Department of Behavioral Medicine at North Philadelphia Health System. I would also like to introduce my partner and colleague, Gloria Zancovski (ph), who is a senior vice president at North Philadelphia Health System I want to thank the Council for permitting us to give this testimony today.
I already read your 100 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 testimony into the record so --
We have it. If you'd like to summarize it, we'll put it in the record.
I have dedicated my professional career of over 50 years to serving the public-sector patient. Our facility is the largest and most comprehensive provider of mental-health and chemical-dependency services in the City, comprising hospital, residential, and ambulatory levels of care serve. We serve a predominantly African- American and Hispanic population, minority groups that have recently identified, surprisingly, by the Pennsylvania Department of Health as being seriously underserved both in quantity and the quality of health-care services. We have an average of over 3,000 admissions annually to our hospital-level services and over 1,000 admissions annually to our 101 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 residential services; over 700 monthly visits, both adult and children, to our outpatient mental health clinic; and over 800 daily visits to our chemical-dependency outpatient services. The net result is that we probably experience more service contacts with more monitoring and (indiscernible) visits from the Philadelphia behavioral system than anyone else in the City. I am here to testify on the possible relationship between North Philadelphia Health System and the Philadelphia Behavioral Health system and in support of the continuation of the City's contract with the Commonwealth of Pennsylvania for the City to administer a managed-care program. I will just highlight the features that I believe merit the continuation of this program. First, the Behavioral Health System is absolutely consumer-oriented and has married cost efficiencies and high-quality care. This is reflected by the multiple programs it supports throughout the City to meet consumer needs and in a comprehensive nature of its clinical and financial 102 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 audits. Second, and perhaps more significant, Behavioral Health System has also been consumer-activist and family-based advocate- friendly. Consumer activists and advocates are members of its board, and consumer peers are members of the consumer satisfaction themes that periodically interview consumers in various programs to identify consumer concerns. These are, in turn, communicated to the provider with a request for a response and steps taken to address the identified issues. Third, Behavioral Health System has demonstrated significant flexibility in working with providers to make sure that services meet consumer needs. Through the years, we have been able to form a partnership with Behavioral Health System based on our mutual core values of providing services to a vulnerable and a very impaired population. Together we have assessed and met needs and developed innovative and cost-effective programs to address those needs. Fourth, unspent treatments funds are reinvested in expanding and improving community 103 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 services. This is an essential feature if consumers, families, providers, and the public, the stakeholders who support the managed-care program needs are not to be alienated. These are the hallmarks of the behavioral system operations that contribute to its success. In contrast to other managed-care organizations, its bottom line is patient care rather than financial profit. Thank you. Can we answer questions?
Thank you very much. Are there questions from members of the committee? Councilman Ortiz?
Okay. Well, thank you so much for taking time to come out today to testify in support of the behavioral health system program. Thank you.
Our next witness is Jeffrey Wilush of Horizon House. 104 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 (Witness comes forward.)
Good afternoon Councilwoman Tasco and other respective Councilmembers. My name is Jeff Wilush, and I'm the Chief Executive Officer of Horizon House, a community-based nonprofit organization that provides rehabilitation, treatment, and support services in Philadelphia, its suburban counties, and the state of the Delaware to disadvantaged adults who are coping with mental illness, mental retardation, addiction, and homelessness. Horizon was House established in Philadelphia in 1952 as a self-help support group for former mental-hospital patients. Our founders believed then, and we believe now, that all individuals can reach their highest potential when they are allowed to make choices and then are helped to develop the skills needed to achieve their unique goals. We continue to actively support the fullest possible integration of every individual as a productive member of their family and of their community. Each year, Horizon House's clinical and 105 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 rehabilitation specialists provide residential, vocational, educational, case-management, outpatient, and partial hospitalization services in the community to over 3,000 individuals. Most of the individuals we serve today are multiply disabled. They have long histories of mental illness frequently compounded by addiction and also by homelessness. They may also be mentally retarded. Their childhood experiences contain a high incidence of physical and sexual abuse. They often suffer from years of neglect of their physical health-care needs. These limitations often result in low academic and vocational achievement and poverty. These disadvantages create special challenges for each individual to effect long-lasting changes in their lives. The agencies that serve these individuals are similarly challenged to develop a comprehensive array of services required to meet these multiple and complex needs. This challenge is further compounded by the often fragmented system of funding that supports service development. 106 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 Individuals receive costly supports from numerous systems in uncoordinated ways, missing the opportunity and efficiency that the current coordinated system allows. This complexity underscores the importance of the City of Philadelphia Behavioral Health Systems maintaining its leadership role in the coordinated, continued development and refinement of an effective, comprehensive, integrated, and humane behavioral health system. I am here today to urge you to support the ordinance before you to authorize the City of Philadelphia to continue to lead the HealthChoices behavioral health program under which mental health and drug-and-alcohol services are provided to Philadelphia residents eligible for medical assistance. Our strong support of this ordinance 19 is based upon the recognition that only through its continued leadership will the comprehensive array of integrated services necessary for those we serve to achieve their goals be assured with the continuity and consistency so vital to this fragile population. During my 12 years as Horizon House, 10 107 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 of which were as the chief fiscal officer directly responsible for the efficiency of our operations, one of the greatest impediments to improving the efficiency and quality of the services provided in the public sector was the previous fragmentation of the system. Your support of the ordinance before you will extend the opportunity for the City to continue the evolution begun five years ago, moving the Community Behavioral Health System to an even greater level of integration than has already been achieved. In closing, I would like to say that like you, we aspire to create a community where all of our members, including those disadvantaged and disabled, have access to the services and supports in the community that they need in order to become productive members of their community.
In order to move from aspiration to reality, however, we must have a consistent and coordinated approach to service-system refinement. We believe that passage of this ordinance holds the greatest promise for the City of Philadelphia, service providers, and the consumers we support to achieve this important goal. 108 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 Thank you for this opportunity to speak before you.
Thank you for this testimony. Are there any questions?
Could you -- because I'm really -- I'm so glad that we did what we did in '97 in terms of the amount of monies that we are putting back into the system. But could you image if this program had taken the route that the previous administration wanted and gone to be privatized, and would we be sitting here today talking about the same level of success as we are?
Councilman Ortiz, I do not believe so. I think the coordination involved and the level of care and the different types of services that individuals are in need of must be coordinated. And, also, there's a part of me that says it also must be free of the motivations that remove money, public money, from a system. There' certainly is more need than I 109 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165 think we, as providers, nor the system, could ever adequately fulfill to its fullest. As you mentioned earlier, one day, we certainly hope to put ourselves out of business.
But I don't think that that's going to occur. But, again, I think the Philadelphia Behavioral Health System gives us the opportunity to use to the fullest extent all of the resources possible, and I cannot imagine where we would be today if this had not been an initiative that had been approved five years ago.
Given all of the stories about how HMOs have been functioning across the United States, I just shudder to think if we had followed the directives that were coming in 1997 to privatize the system, and I want to thank Mary Hurdig (ph) because she's here, as one of the persons that led the battle and focused City Council's vision in terms away from the privatizing of the services. So I really I think we did the right thing. 110 4/30/02 HEALTH/HUMAN SERVICES - BILL 020165
I just wish we acted more often like that here in this Council. Thank you.
Thank you. We're looking for our last witness, Joe Rogers. (Mr. Rogers is not present.)
He's going to mail testimony in? I'm sorry it took so long. He was here, Mary. Is there anyone else here to testify on this bill? (No response.)
All right, there being no further testimony on this bill, we will go into our public meeting. - - - 111 4/30/02 PUBLIC HEALTH/HUMAN SERVICES PUBLIC MEETING
I believe we have a quorum. I would like to ask Councilman Rizzo or Councilwoman Miller to come back. We do note that some of our Councilmembers were here, left their vote, but I am reminded that you cannot leave a vote in a public meeting. (Councilmembers return to chamber.)
Madam Chair, I move that Bill No. 020165 be moved reported out of committee with a favorable recommendation and a recommendation that the rules of Council be suspended so as to permit first reading in the next session City Council. (Duly seconded.)
It has been moved and seconded that Bill No. 020165 be reported out of committee with a favorable recommendation and a request for the suspension of rules so as to be read at the next Council session. All in favor will say aye. Is there any opposition? 112 4/30/02 PUBLIC HEALTH/HUMAN SERVICES PUBLIC MEETING There being none, the bill is passed. Thank you very much. This meeting is now adjourned. (Committee proceedings end at 12:44 p.m.) - - - 113 CERTIFICATE I HEREBY CERTIFY that the foregoing proceedings of the Council of the City of Philadelphia's meeting of the Committee on Public Health and Human Services of Tuesday, April 30, 2002, are contained fully and accurately in the stenographic notes taken by me, and that this is a true and correct transcript of same. RE: Ordinance No. 020165 _______________________________, Josephine Cardillo Registered Professional Reporter and 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.)