Most parents work. You have families where both parents work, so getting to health centers before 6 o'clock is virtually impossible 'cause they have to make difficult decisions -- putting food on the table and/or taking care of the needs of their children. And currently, there is one half day on Saturday in one center. What kind of consideration, if any, has been or should be given to evening hours and expanding that to all the centers across the city?
It is, it is, but our ambulatory health services have been fairly creative in doing some shift modification and other interventions that are not necessarily budget-impacting, and we now do have evening hours in all of our centers. 972 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00
And it's not across the week, but each center has one evening session per week.
On of your testimony, young people who have parents who are involved with the community behavioral health, specifically drug and alcohol addiction.
Please touch on the kinds of things you're for doing that, those type of youngsters who are in such an unforgivable circumstance.
Yeah, I think this is an area that -- just in terms of getting you accurate information and complete, I'd like to ask Mark Bencivengo, our Assistant Commissioner for the Coordinating Office of Drug and Alcohol Programs, to help me out with this. (Mark Bencivengo comes forward.)
Mark Bencivengo, Assistant Health Commissioner. There are a number of activities that target young people -- those who are at risk for 973 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 drugs and those who are already using drugs and have demonstrated, through their actions, that they're using drugs. Prior to actually showing drug abuse, there is a portion of monies that the Health Department receives in the Coordinating Office for Drug and Alcohol Abuse, which is for prevention of substance abuse, so that there are drug and alcohol prevention programs in the majority of public and parochial schools in Philadelphia and also something that the Department calls "The Youth Risk Reduction Project."
It's called "The Youth Risk Reduction Project." It involves approximately nine community-based organizations that perform after-school prevention activities and do prevention work during the summertime. We have monies that come that we must spend on prevention, and that's the way that we elect to spend the prevention money, both school- and community-based. On the treatment end of things, it 974 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 becomes actually considerably more problematic, and we're having discussions about it within the Department now that we know that large numbers of people appear and attempt to access treatment in their early 20s and in their 30s. Invariably, when we ask them when they began to use drugs, they report they began to use drugs at 11, 12, 13, 14. However, they don't access treatment at that age in the kinds of numbers that they do when they're older. Nevertheless, we have residential opportunities in place for young people and something that we call "the Juvenile Intensive Program," which offers outpatient treatment services for youngsters who have a substance abuse problem and are looking to attempt to do something about that substance abuse problem. So there are treatment opportunities, but one of the issues that we're facing is that the youngsters don't avail themselves of those treatment opportunities at the same rate that adults do.
In your reply, I heard you mention -- well, first of all, the 975 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 public schools are somewhere in this equation, but I heard you say "the majority of the Philadelphia public schools." So I'm curious to know, A, why not all? And, B, what kind of assurances do you have in place that these drug and alcohol abuse programs for kids are working?
Well, the answer to why not all schools? is an issue of money.
We have prevention specialists, as I said, in a number of schools. We do not have prevention specialists in all of the schools, and it is a funding issue. As far as the efficacy of the programs, we look at this in two ways. We have groups that talk with the young people, both on the street and in programs, those who are in programs, to ask them what it is they like about the program, what aspects of the program they find most acceptable to them. And also, we provide both pre- and post-test instruments to the young people about their attitudes towards drug use prior to the time they start treatment and then when they're ready to leave. 976 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 Now, there's a real gap between attitudes and behavior.
And we know that, and I think everybody who's looked at knowledge, attitudes in behavior studies point to the fact that attitudes and behavior, there's a real variance there.
Nevertheless, we are able -- if a youngster has gained some information and some different views regarding drug abuse as a result of participating in a program, we think that that youngster has a better chance of staying away from drugs on into the future. So that we're trying to measure the effectiveness of the programs by doing knowledge, attitude, and behavior studies.
A couple follow-up questions. How do you arrive at the list of schools that participate? Do schools say, "Yes, I want to participate?" or the Health Department has a strategy that says, We will deal with X- schools? I'm always curious to how the agencies 977 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 arrive at the decision on which schools, which constituency gets the benefit of the service.
Actually, our participation of schools goes back a number of years, when we selected some schools that we worked with to see how accepting they would be to having prevention specialists.
Did they want folks in there, were they going to work with them, were they going to allow them classroom time?
And because the dollars haven't increased significantly over a number of years, we haven't gone into new schools to ask about that. I would say that I do frequently get letters from principals asking, could they have a prevention specialist? but because of the shortfall in our revenues, we're not able to supply that.
That's understandable. I would like, if you would, to present or submit a list of the participating 978 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 schools to the Chair.
And is it middle schools, high school, or a combination of both?
Thank you very much. The Chair recognizes Councilman Rizzo.
Commissioner, you have a modest increase of eight employees planned? You have eight employees planned for the next fiscal year to hire, eight additional people?
And then you're asking in your Personnel Services Budget increase $1,200,000. Can you explain 8 new people and a 979 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 request for 1.2 million.
This is Ellen Steiker, Deputy Health Commissioner for Finance and Administration. The budget contains a $1.1 million increase for the wage increases that are in the contractual agreement, so that's one major source. The other thing is, even though when looked at the exhibit and you saw just a small increase, there actually are vacancies. And when there are vacancies in the current year going to a more fully-funded level in the budget, you also have an increase for that.
I believe -- I will double-check this, but I believe it's 39 vacancies in the General Fund from the time that the budget was developed.
Is that an unusually high number of vacancies or is that about a norm that you deal with, 39 vacancies?
That's a rather normal number for us. 980 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00
Okay, good. Thank you very much. Thank you, Madam Chair.
Thank you. You're welcome. The Chair recognizes Councilwoman Tasco.
Some time ago during budget hearings, we talked about the Health Department billing -- collecting money from clients who have insurance, or billing the State for Medicare.
How is that coming along? Could we get a little status report on that? Are we up, are we down, are we keeping in step with the number of clients, are we billing in a timely fashion to capture the reimbursement?
We -- I'll get you some specific detail on that, Councilwoman Tasco. But in general, we have an aggressive program to 981 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 capture all third-party revenue that might be available to us. We're particularly focused on that with the -- given the fact that the number of uninsured who are turning to the health centers for care is going up so substantially.
How is the welfare reform impacting on our health centers? Is that what where you're getting the increase of uninsured?
Yeah. I think all of the aspects of welfare reform help to contribute that. Clearly, we have fewer -- about 50,000 fewer people in Philadelphia now on assistance than we had some years ago. And in addition to that, there's been the confusion around the issue of insurance and who has it and who doesn't, and the issue that the State had about a year ago, where they inadvertently -- some people who were eligible for assistance were dropped and then they were placed back on, that created a huge amount of confusion. So under the direction -- with the support of the Director of Social Services, we've been able to deploy some benefit counselors in our 982 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 centers to help people turn to us for care and navigate the confusing terrain of medical assistance and health insurance in general. They've been successful. Right now, we've got 1,000 more people back on assistance, back on health insurance that we didn't have before, and we've got about another 2500 that are just about to be returned to the rolls because of that intervention.
Mm-hmm. We talked earlier about the pharmacy and the increase in costs of medication. Has that had an impact on the Health Department's pharmacies to provide medicine? Is there a backlog in ordering medication that we probably didn't have this problem before?
We don't have a backlog in ordering medication. We've got a good procurement system, we're able to get the medications, which is a dramatic improvement over the situations, say, about eight or nine years ago.
But the impact is 983 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 substantial in the number of people who turn to us for care. For example, this year, we expect to fill about 465,000 prescriptions in the health centers.
How much of the money for the Sidewalk Behavior Bill is coming from CBH?
In FY 2000, the current year, there's about $4 million going into the Sidewalk Ordinance, and that's all coming from the reinvestment dollars from the behavioral health system. In the FY 2001 budget, we have about million coming from the behavioral health system and about 2 million in the General Fund. So we have 4 million ongoing budget for this project.
Do you think that you will continue to appropriate money from CBH to the Sidewalk Behavior Bill in the future? Or will it come from the General Fund, or you don't know?
We will look at our options on that as we go forward, I would say.
Okay. One other 984 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 question about the lead paint. How are we -- are we getting cooperation from our landlords in treating their properties when they -- when a family moves out and a new family moves in? Is there any (unintelligible) in treating the properties for lead paint?
Yes, with some guidance and nudging from us. When we do find a child with an elevated blood lead and it's sufficiently elevated to require remediation of the property, we issue orders for that property to be remediated by certified a contractor to do that, and then we go in and clear the property afterward.
You know, on rental properties, you mentioned that the highest level of lead -- of incidence of lead in children is in North Philadelphia and West Philadelphia, where you have the oldest properties. A lot of these properties are rental properties, and in order to rent those properties, the homeowner has to apply to L&I for a license. Is there any coordination between the request application for a license and prior to that license being issued, the Health Department 985 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 does an inspection, or L&I does an inspection for lead?
Okay, I need to have Mr. Tobin join me here on that issue, but while he's arriving, we have increased our coordination with L&I in relation to the permitting and licenses of many establishments in Philadelphia. And it's because of our close working relationship there on other issues that we've been able to identify new businesses coming in that require both an L&I license as well as a Health Department license and/or permit with regard to the lead. Dick? (Richard Tobin comes forward.)
Thank you, John. Richard Tobin, I'm Director of the Childhood Lead Poisoning Program.
There is no requirement that a homeowner or the property owner get that inspected prior to licensing. However, under the Disclosure Act, which was passed by Council several years ago, a renter does have a right to get an inspection of the property prior to 986 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 finalizing the lease. I frequently tell people working in old neighborhood that you can almost assume there's lead and you need to take the precautions that will protect your child from lead poisoning, because lead paint, in many of our older neighborhoods, was the rule and not the exception.
What would be your -- is there anything wrong with us passing an ordinance to require an inspection prior to issuance of the rental license?
I see problems in that. Mainly because of the cost of the inspection and the cost of remediation, it could cause some problems with housing. But I think it would be doable, I think there are private inspection companies around the city sufficient to make those inspections available, and there are certified contractors by the State now that would enable homeowners to have that work safely done.
Do you see a decline in the number of rentals to families with children because of the lead paint issue? 987 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00
Not really. And, in fact, when we look at properties that are in the enforcement process, we find that probably more than 50 percent of those properties that are backlogged in that process are owner-occupied properties, not tenant-occupied, and only about 30 percent are owner-occupied when we go out and do the inspection. So we probably get better compliance from owner-renters than from owner-occupants across the city. We haven't seen it because when we go out, there already is a child in the property, but we're running about the same percentage of our caseload in tenant-occupied as in owner-occupied that we've had for the last ten years.
Thank you, Councilwoman. I see that Councilman Cohen is out of the room. Councilwoman Reynolds Brown, would you like to follow up?
Yes, yes, yes, I would, on the lead poisoning question. 988 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00
Councilwoman Tasco raised the question on whether or not this body has an opportunity or a responsibility to speak to homeowners -- rental -- landlords having lead inspections done, and you spoke about the cost. What are you referring to, the cost of. . .?
I was referring, I think, to the overall cost of doing such a program. There are actually thousands and thousands of rental properties across the city, and there would be, I think, a great deal of probably difficulty right at the beginning trying to get them all inspected.
I think in terms of -- if I may, Councilwoman, in terms of when we're dealing with lead poisoning and we're dealing with issues that can help prevent a child from becoming lead-poisoned in the first place or for the disease to progress, you know, the costs that we're talking about really are, while they're important from a budget standpoint, they wouldn't be the basis on whether we would decide to do or not to do something as important as that. 989 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 I mean, a larger issue is how we most effectively interface, from a regulatory standpoint, with the landlord-tenant unit so that we don't end up taking -- creating -- so we do it in a way that doesn't reduce the availability of housing, you know, for people in the city. I think it's an area that we need to look at a little bit more closely and maybe get back to you with a more analytic and thoughtful analysis on this.
Okay, my follow-up rhetorical answer or reply is: What costs more, getting landlords to do the right thing or saving young people from lead poisoning? And that's a rhetorical statement. What are we doing to educate landlords about their responsibility with regard to lead?
We've had an active outreach program for landlords across the city, and we've sent out mailings over the past year to every licensed landlord in Philadelphia, advising them of what their responsibilities are in terms of housing upkeep and in terms of disclosure to 990 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 their tenants of potential hazards. And we have offered, and continue to offer, a monthly course to landlords on safe lead hazard remediation.
So measures are in place to help them understand that they've got a role in this?
An additional follow-up question again around the health centers. Again, there are eight, if my memory serves me correctly from reading the testimony, eight health centers?
Yes. We have eight health centers and an additional center located at Broad and Lombard that is a specialized center that provides sexually-transmissible disease services on a specialty clinic basis.
And by this time next year, all of them will have play areas for children?
No, forgive me, I'm misreading the testimony here. 991 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 By this time next year, all of them will have expanded hours?
Okay. On the play areas, what's the status of play areas in the health centers, 100 percent? Where are we with that?
Well, if I can just refer to a note on this in terms of where we have the supervised play areas. In Health Centers 2, 4, 5, 6, and 10 in Strawberry Mansion, we do have play areas that are supervised. These are not full-day sessions. However, in Health Center 6, we do have full-day supervised play areas in that facility, at Third and Girard.
Okay, I'm just trying to make sense of what you just said. So, one, can we draw the conclusion that there's no 21 uniformity yet amongst all the health centers getting the same kind of treatment when it comes to supervised play areas?
Okay, all right, 992 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 then. Thank you very much.
You're welcome. Councilwoman Tasco, you had a follow-up?
Thank you, Madam Chair. I'd like to follow up about the lead so I think I need the. . . The Delaware River Port Authority has just announced that they are going to repaint the Ben Franklin Bridge, and there's going to be a big lead abatement project going on on that bridge. I'm fairly confident that the contractors that do that contain that and what the airborne consequences are, but has there been any critique with them on what effect that possibly could have on nearby residents in the summer recreational activity that goes on in river? Is there any kind 993 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 of interaction to critique exactly what that project's going to entail and what effects it could have?
You're correct that a project of that magnitude does require extensive environmental controls for that very reason.
I haven't heard from the Port Authority in terms of the bridge, and this is the first I've heard that the project was going on. But we have been involved in bridge projects in the past and we have done sampling in the neighborhoods while they're being worked on. We haven't found a major problem. The protections, at least that they've put up, have been sufficient to keep a very large percentage at least of the blow-by and thing off the area, but we will be more than glad to work with them on this.
I'd appreciate your reaching out to them 'cause this is going to be the biggest project that they've ever undertaken, and this is the first time, I believe, that all of the lead-based paint is going to be removed from 994 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 the structure and primed and repainted, and I'm confident that there's going to be some effect on Philadelphia and also on New Jersey. So it would be good that we do make contact with them to find out what exactly they plan to do and how we're planning to deal with it. And that monitoring is very important, especially with the recreation that goes on beneath that bridge in the summer.
Absolutely, and we'll in touch with them this afternoon, Councilman.
Thank you very much. Councilman Cohen, did you have your light on, sir?
Thank you, Madam 995 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 Chair.
First, with respect to a specific budgetary item, I just don't understand it and I'd just like clarification. Apparently, in the Grants Revenue Fund, for mental retardation, there seems to be an increase of $40 million this coming year. Could you tell us what that's about? (Witness comes forward.)
Mike Covone, Deputy Health Commissioner for Mental Health and Mental Retardation. Part of the Governor's budget that was announced last week included a major expansion in the mental retardation field to begin to address what has been called "the waiting list."
The waiting list initiative, so that a large portion of that $40 million increase is the portion that Philadelphia would anticipate receiving since, obviously, Philadelphia has the largest waiting 996 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 list of any of the counties throughout the state.
Waiting list, individuals who are living at home with their families, who heretofore haven't received services.
Waiting for services, that's correct. So we anticipate major expansion occurring not only next year, but over the course of the next five years.
Is it expected that those services would involve any change in the status of the individual that's living at home now?
Would it be expanded services to the person living at home?
Does it provide for greater opportunities for working --
It should provide not only for some in-home supports but also for some day 997 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 activities, including employment activities, and for those individuals who would require it, out-of-home placements.
What is the current budget for those kinds of services?
Has the money been 18 appropriated by the federal government? 19
No. It was included in 20 the Governor's budget so we should hear by -- when 21 the Governor's budget is approved, we'll get some 22 sense of what portion Philadelphia will receive 23 for this initiative by late spring. 24
And this 40 million 25 in the current figures that I see, that's our 998 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 approximate estimate of what will come.
That's very good. While you're on, I'll go on to my third question and I'll hold the second for later. A third. I'm interested -- as you know, we've had many discussions on community health, particularly with reference to the Warren E. Smith Community Health Center, but not just limit to do that in concept. Has there been a change away from community board thinking in the professional field? When did the concepts begin developing about the advantage of having community boards and the importance of having them? Instead of, you know, just having mental health treatment centers like, you know, doctor's offices.
I think in origin, that dates back to late '60s early '70s, the issue of community mental health and mental retardation organizations. And that was originally established with a variety of federal grants that were available back in the '70s. I think that's evolved over time as the 999 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 funding of these services has evolved to both a -- to more of a managed care environment, but the organizations have had to change as they've moved forward through the '80s and into the '90s as well.
And so to what extent does the concept of community boards remain an acceptable and sort of a forward-looking concept in the professional field, among professionals?
I think the concept of community involvement in both the mental retardation field and in mental health field, many of the organizations, since organizational structures have changed over the years, still maintain family advisory committees or consumer advisory committees, even though, you know, it may not be in the same format that it existed in 10 and 15 and 20 years ago. But family and consumer involvement is in all the services, I think, throughout the Health Department, has continued to be an important health aspect.
It's still felt that 1000 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 community involvement is important.
And that the involvement of different groupings in the community, in addition, I assume, in addition to the family? Or is that merely a technique for getting families involved?
Well, clearly, the initial outreach are to families who may be receiving services, who may be on waiting lists. Many families have been involved for years that weren't receiving services but knew at some point in time they may need services, so they had been involved in a number of the advisory committees in our planning efforts at the county office as well.
Now, has -- whatever has happened over the last 30 years, how has that changed the focus of the City's mental health office with respect to the question of community involvement? Has it meant more attention, less attention, or about the same amount of attention? 1001 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00
I think clearly from the City's perspective, there's been more involvement with both consumers and family members being involved both with the county office and also with the agencies we contract with in a variety of feedback loops. For example, within the office, we have planning advisory committees that aren't only represented by professional staff, but do include family and consumer involvement. There's a variety of both children and adult organizations who provide feedback on everything from the mental health service that is we operate to our mental retardation plan that was submitted that may yield that $40 million that you requested previously.
Mm-hmm. And does the City still play some role in how the centers operate? Does the City accept any kind of a financial oversight role.
The City has a financial oversight role for all of the agencies with whom we contract, yes. And they're required to submit annual audits to us for the services that are we're purchasing. 1002 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00
There's been no 3 change in that responsibility of the City? I'm raising that because I had raised a question with respect to certain financial matters in a mental health center and got a reply back saying that it's not the City's responsibility.
Well, there are two pieces. These organizations will have contracts with the City's Department of Health, and some of them may also have contracts with community behavioral health who are performing the services previously done by the Medical Assistance Office at the State, and perhaps that's what you're referencing. There is a contractual relationship that's changed over the years relative to the medical assistance funding.
Well, I don't believe it involves the medical assistance fund, but I brought to the attention of the Health Department what I regard as a financial irregularity of a conflict of interest of a principal sort of dealing with his own family in a contractual arrangement and received back a letter which seemed to indicate that the City said, 1003 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 That's not our responsibility, that's the responsibility of the mental health center. And so I just wondered because I've never seen that before in any other kind of financial situation. And I was wondering whether there were changes.
I would be happy to look again into the specific of that situation.
I will just say, Councilman, that in our other services in relation to community involvement and consumer involvement, oftentimes, some of the most valuable information we get is from the consumer's point of view of people who commonly use some of our services who have either not had a good experience or could have had a better one, and that helps us to look at our services clearly from their perspective and then make adjustments accordingly.
Well, I would have thought so but it seemed to me that the Health Department was moving away from that concept and, 1004 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 instead, was moving in the direction of, We make a contract with an agency to operate this mental health center, and then that's the mental health center's -- you know, the people with whom we've contracted, everything is their responsibility, and if they choose on their own to expel the community from involvement and just take over its own involvement, that's okay, and the health center -- the Health Department has no interest in it. And I've just been very concerned and have hoped that it was only a short-term aberration from a long-standing policy, but I've actually been involved about a year and a half or two years, and that policy seems very firmly entrenched.
And I think the situation you're referring to is that of a debate between a community advisory board and part of a community operating board.
Well, there clearly is through a community advisory board, Councilman, in 1005 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 the situation that you're referencing with Warren Smith.
Because maybe I missed it, but I don't know how one misses the existence of a community involvement. I find no 10 community involvement -- in the sense that I know community involvement to be, I see none whatever. And then on top of that, I saw the City seemingly taking a hands-off position in what seemed clearly to me to be a financial impropriety, and I just couldn't understand it. It seemed so foreign to the usual way in which the City looks at these things. All right, you will look at it?
All right, that's the only question I wanted to raise with you. Since you were here, I raised it at that time 1006 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 instead of later. With you, sir, if you were asked, is there anybody in the City of Philadelphia who cannot get medical care without respect to whether they have health insurance or not? what would your answer be?
I think that there is a lot of care available. I think, clearly, our health centers, having served 86,000 individuals, making some 320,000 visits, makes significant contributions.
I said there's no 17 question about that. And I think it's a wonderful system.
And I think that it's getting increasingly challenging with regard to the services available for the uninsured, and I think that there does need to be a coordinated planning approach as to how we address the needs of the uninsured, and I think that one of the activities that we may be able to engage in is if 1007 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 the Governor gets his plan through with regard to the tobacco money, he's earmarked 40 percent of that to do some planning around providing insurance for those people who are now presently uninsured. And I know the Director of Social Services has been very focused on this issue and trying to address it through an envisioning process in Philadelphia in terms of looking at all of the agencies as to how we might collaborate together, understand what each other's doing, and seeing what the gaps are and how we might creatively respond to them.
What would you think of the application of the phrase "world-class city" to dealing with issues of, say, child care, adult care, health care in general? Wouldn't you think that a world-class city, or some city that wanted to be considered a world-class city, would want to take special pride in seeing that the health care needs of its residents are met?
Yeah, and I think that what we've done in Philadelphia, which pretty much separates us from a lot of other cities, world-class and domestic-class, is pretty 1008 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 commendable in relation to the extensive amount of health care that we do deliver, particularly to the uninsured.
All right. Now, having led you along this path, let me say, why do we have such difficulty in getting basic services like mom-mobiles all throughout the city? Why is there such a struggle to get them? And then when we get them in an area where we don't have them and we finally get it, and I sit back feeling good, then I learn that two other districts that had them before didn't get them, then it makes me feel sad again that we really haven't accomplished anything.
Yeah, the mom-mobiles are an important part of our ability to do community outreach. In terms of just trying to get myself up to speed as to the mom-mobiles and the contribution that they make, a couple of weeks ago, I spent a Friday afternoon with the people who operate the mom-mobiles, and I've learned a lot about them, I've learned about where they're deployed, I know we have a fleet of six of them, I have a better understanding about some of the 1009 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 services that we provide, particularly those services that are neither, you know, health-specific or social services-specific, but a combination of all of them -- everything from helping people to get an appointment, to helping with child care, to unbelievably helping with home repair. So they're a very important piece of our community outreach and we're going to continue to try to make the best use of the resources that we have in terms of doing that community outreach. They're important.
Well, what additional funding would be involved in it if every health district were able to have a mom-mobile available?
Well, I think if I can ask Sue Lieberman to join me with this. I think part of the answer to that is to, you know, just look at the organizations that we now work with to see, you know, how much of the services that we can generalize, that we can work in a coordinated way to support what we've been doing with the mom-mobiles. 1010 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 (Sue Lieberman comes forward.)
Or good afternoon. The average cost of the mom-mobile is about $210,000 a year to run. So if we were to increase from 6 to 10 mom-mobiles, it would be about 4 times $210,000 or, I guess, over $800,000.
And isn't it true that the City is asked to only contribute about a third of that?
I was just going to add that one of the things that the Maternity Care Coalition who runs the mom-mobile has done an excellent job in is leverage additional money so that, for example, at compression Health Center 10, the City provided $70,000, and the Health Center 10 Board was able to work with the Maternity Care Coalition and leverage another $70,000 from Parkview Hospital and another $70,000 from Einstein Hospital. 1011 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 So that MCC does an excellent job in taking money and really leveraging it and using it to expand services.
Well, in discussions we've had from time to time with the folks from the outside that seem to work with them very actively in the mom-mobile field, they seem to feel they can leverage that money just about everywhere.
Because they get often citywide agencies to be supportive. I would just strongly urge -- I think that that's just a wonderful program from every aspect and so important to the health of pregnant women and often of single mothers, and reaches people and does in an outreach way what I don't see any other group matching in the scope. I know there are other groups that are trying and are working very hard, but they seem to be very outstanding in the outreach. Is there any outreach for ordinary adults? Suppose there's an old person, say, somebody like me sitting around in a little house, 1012 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 having maybe outlived, maybe lived too long so that most people known to me might not be there? Is there anybody going around checking on those folks? Is this any --
Well, there are a variety of things we do in term of checking. As you know, our Environmental Heat Program and the buddy system in the summer, where, you know, we've worked with the news media, we've worked with community groups work, we work with Philadelphia Corporation of the Aging on their help line to get the word out about protecting our senior citizens from the ill effects of extreme environmental heat. That's been effective. The other ways in which do this is, we get called in perhaps on an environmental investigation of an unsanitary condition in a living arrangement, and we'll find that it may be occupied by an older person who just lacks the ability, the physical strength maybe just to do, you know, do the necessary cleaning and those kinds of things, and our environmental health staff are service-integrated focus so that they can make appropriate referrals either to the 1013 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 Philadelphia Corporation of Aging or other agencies to help with that. In our health centers, the health center staff has been creative to design some programs specifically focused on our older consumers. For example, our Star 65 Program at Health Center 5, has been -- not only do we believe that its been successful from the standpoint of a care delivery system, but the overwhelming proof of it, in my view, is the fact that it's almost an oversubscribed program by senior that participate in it. So we're constantly looking at that -- as well we should, because of the increasing percentage that senior citizens occupy in our society.
Well, but there's also a whole bulk of people, say, in the range of maybe 50 to 65 who need care of various kinds and often don't get it. I'm wondering, is there any kind of service like a mom-mobile for the adult population generally, you know, some vehicle going out, capable of administering medical service, just checking on people in the area, or being 1014 OPERATING BUDGET CONT'D. - BILL 05 - 2/16/00 available in the same kind of way with the same kind of outreach?
And maybe some of my colleagues know, but what I would say about that in general is that there's -- there is a need to provide more services in communities and to be supportive of people who are older and to be able to keep them in their homes. We have a waiver program where we're able to bring some services through Philadelphia Corporation of the Aging to bring some attendant care and some assisted-living services into the community. As far as whether we have a van and outreach, maybe that does exist. I'm not aware of it, but clearly the need to relate to the specific social and health needs of senior citizens is very evident. And for a lot of reasons, I find them a pretty strong advocate of that.