Committee Hearing, June 16, 2008

Good afternoon. It's a pleasure for me to address you today, Madam Chair and the other distinguished members of City Council present. I am Irene Hannan, a Senior Vice-President at Citizens Bank working specifically with healthcare institutions and non-profit organizations within the commercial bank. Today I come before you as a proud member of the Board of Directors of the Urban League of Philadelphia. It is my intention to bring before you research, data, conclusions and action items as to the present condition of blacks in Philadelphia and to urge you to prepare the way to improve these conditions and to ensure a brighter and more productive future for all of our citizens and our city. 189 6/16/08 - PUBLIC HEALTH - RES. 080140 I believe that our future success rests squarely in a deliberate, reasoned partnership between the private and public sectors of our community. No 6 one sector of our city alone can repair the damage nor clear the path for the future. It will take all of us working collaboratively to succeed. As you know, the Urban League's report, the State of Black Philadelphia, presents research and statistical findings focused on five major areas and collectively assigns the equality index. Those areas are health, education, civic engagement, social justice and the one I want to focus on, economics. The economic profile looked at income earnings and poverty in the City, as well as labor and the working class and, lastly, housing and transportation. On a percentage basis, the economic sector rate was the largest of the five sectors, with an overall weighted rating at 30 percent. The overall average 190 6/16/08 - PUBLIC HEALTH - RES. 72 to one. 64 to one. In all economic areas researched, blacks were less well off than whites. The median household income was $15,000 less for blacks than white. The earnings gap was even wider for households with families. Here it was a $25,000 gap. For earning power, it was the same. Fifty-five percent of blacks earned less than $30,000, while whites, the number was 37 percent earning less than 30,000. When examined on the basis of a one-parent household, the disparity is far greater. The results of the examination of poverty statistics included the percent living below the poverty level. Poverty rates by age, dependency on entitlement programs, and homelessness statistics all highlight an overall 191 6/16/08 - PUBLIC HEALTH - RES. 080140 disturbing disparity. Twice as many blacks live below the poverty level than whites, 32 percent versus percent. 5 For black children, the odds of living in 6 poverty are far greater than for white 7 children. Greater dependency on food 8 stamps and TANF undermine the economic 9 independence of Philadelphia's black 10 citizens and reinforce the poverty cycle 11 for youth. 12 A major contributor to the 13 income and earnings picture is the 14 unemployment rates. At twice that of 15 whites, you begin to understand the 16 snowball effect that combines to keep the equality factor gap between blacks and whites from shrinking. While we know that home ownership is the foundation of personal wealth and asset value, blacks here also show poorly in comparison. In Philadelphia, 64 percent of whites own their own home while only 53 percent of blacks do. The value of those properties 192 6/16/08 - PUBLIC HEALTH - RES. 080140 owned also varies widely. The median home value for whites is $174,100 while blacks' home values are set at $75,100. Such disparities will result in a greater proportional dependence on Social Security and other government-supported programs at retirement. And, finally, the report indicates the heavy reliance of black citizens on the use of public transportation, where it is twice as much as whites. This can restrict access to new job opportunities in areas not well served by their current mass transportation system and also places usage burdens on our aging systems.

Comprehensive and coordinated policies are needed to bring about specific tactics for much-needed change. Doing nothing is unacceptable. Doing something is too little. If we are to be a world-class city, we must act now to do better by our citizens, all our citizens. Specifically, I would urge your 193 6/16/08 - PUBLIC HEALTH - RES. 080140 consideration of the following: Programs to place youth in jobs earlier and with more training support. Don't just set, but enforce minority business goals in City government contracts. Fund opportunities for minority businesses by encouraging micro lending programs with tax advantage incentives and establish rewards for corporate partnerships with such entities. Increase job training and retraining programs in conjunction with post-secondary educational institutions and their educational programs. Improve vocational training programs in the public school system. Support public/private initiatives for financial literacy. And encourage programs in support of first-time home ownership. In closing, I recognize that the scale and scope of the issues facing many black Philadelphians in our city can 194 6/16/08 - PUBLIC HEALTH - RES. 080140 be daunting. However, to do nothing because the issues seem overwhelming only perpetuates the problems, frustrates and demoralizes our citizens, and guarantees a negative impact on the economy of our city and our state. We need visible and vocal leadership to set the agenda, to plan the action and to ensure the success that all Philadelphians want and deserve. I thank you very much for your attention and your consideration.

Thank you very much. Next we'll have Reverend Kevin Johnson. Welcome you, my pastor, to your first testimony before City Council.

Thank you so much, Madam Chair, Councilwoman and Majority Leader -- I like all of that -- Tasco, as well as to Councilwoman Blondell Reynolds Brown as the other Council. I believe Councilman Goode may have stepped out. 195 6/16/08 - PUBLIC HEALTH - RES. 080140 I am blessed to be here today not only as Pastor of Bright Hope Baptist Church, but also as a Board member of the Philadelphia Urban League. As I begin my remarks, some background is needed in order to fully appreciate the circumstances of disparity that exist in the Philadelphia community, as was so compellingly detailed in the Urban League of Philadelphia's recent publication, the State of Black Philadelphia. To put it bluntly, the economic landscape for black Philadelphians is bleak. I wish to bring your attention to just a few of the highlights from the report or, more accurately stated, the low lights. Almost one-third of African-American families live in poverty, 32 percent, compared with less than half that rate at 16 percent among white families. The unemployment rate for blacks is double for the rate of whites, standing at a discouraging level 196 6/16/08 - PUBLIC HEALTH - RES. 080140 of almost ten percent compared to about five percent of unemployment among the white population. The median income of African-American families is approximately two-thirds that of whites. Only 53 percent of African-Americans in Philadelphia are homeowners compared to 64 percent of whites who own homes. And to drill down a bit deeper, of the 53 percent of blacks who own homes, their property values were on average $100,000 less than the property values of whites who own homes. And we're not even talking about past years of redlining. Shockingly, almost 7,500 African-Americans right here in our community use homeless shelters over the course of a year compared to the comparatively very low number of 500 whites. And black businesses in Philadelphia count for only half that of white businesses, white business ownership. 197 6/16/08 - PUBLIC HEALTH - RES. 080140 Each and every citizen of our wonderful community and certainly each and every elected official representing the citizens should be disturbed by these statistics. And I implore you to remember that while statistics can seem distant, removed, cold and impersonal, they represent real people with real stories of difficult daily living in our midst and, in some instances, downright despair. But that's where I come in: Keep hope alive, Bright Hope Baptist Church is here. Now it is time for us to act. It is our hope that this needed action will begin with you, our beloved political leaders, the honored public servants and elected officials of our community. Fortunately, many of the best and the brightest of our concerned Philadelphia citizens, leaders in business, faith-based institutions, academia and, yes, even those populating the political landscape for their tenures 198 6/16/08 - PUBLIC HEALTH - RES. 080140 of representation of our citizens have addressed the potential particulars of what might comprise an appropriate Action Agenda to tackle the issues of economic disparity that exist all around us and I would say, until eradicated, define our community and thus define us. Looking at the shining examples of success some in our community have achieved is inspiring, but we cannot linger there while looking away from the urgent needs and the disheartening levels of disparity between the black community and the rest of the population of Philadelphia. So here is what we can do. Please notice that I said "we," because the answer lies in our collective willingness to address these issues together. The Bright Hope Baptist Church, so aptly named in this regard, is one community faith-based institution that is beginning to tackle the seemingly 199 6/16/08 - PUBLIC HEALTH - RES. 080140 insurmountable problems that we face.

As an example of leadership that can begin to change the conditions of disparity that now exist, Bright Hope Baptist Church sponsored a Black Family Symposium in 2007 to inaugurate my becoming Senior Pastor of the church with a symposium called Crisis in the Village. The symposium goal was to engage in meaningful dialogue that would lead to concrete proposals for village restoration. This concept of village restoration emanated from the book of Dr. " The symposium aimed to create an intensity of education and deep understanding of the unique issues that face the black community, but, further, to be a clarion call for renewal around the black community's economic concerns while keeping identified needs in the 200 6/16/08 - PUBLIC HEALTH - RES. 080140 forefront of action planning and implementation. And so we did it. Out of the symposium, we expanded the mission of the Bridge of Hope Community Development Corporation, our Pennsylvania non-profit, faith-based community organization. It was incorporated to promote and maintain the physical revitalization of the community in which Bright Hope Baptist Church is located. " Among other important work, Bridge of Hope Community Development Corporation has the purpose of harnessing the expertise and resources necessary to acquire vacant lots, and in particular, we're in the process now with the Goldenberg Group to acquire the John Wanamaker School so they can serve as a permanent home site, not just for education but also for economic development and activity in North Philadelphia. 201 6/16/08 - PUBLIC HEALTH - RES. 080140 This is but one example, one collective effort that if it is to be sustained will require the continued good will of the community and the official support of the people who represent us here in City government; that is, you, the esteemed members of the Philadelphia City Council Committee on Public Health and Human Services. I am humbled to have been included in the roster of extraordinary individuals who testify before you today. As I conclude my remarks, may I once again draw your attention to the Action Agenda of the Urban League of Philadelphia's State of Black Philadelphia report. The Action Agenda gives us guidance and it provides a road map, as it were, to address the daunting inequalities that have existed for far too long, far too long, in our community of diverse peoples. I encourage you to join with us to urgently accomplish these five important tasks. 202 6/16/08 - PUBLIC HEALTH - RES. 080140 First, provide youth with early access to work. Even in the Bible, first thing that happened before Adam could get a wife, he had to work. Enforce minority business opportunity goals at local levels to ensure greater minority participation in government contracting. Create opportunities that build capacity of minority business through expansion of micro-financing, equity finance and the development of strategic alliances with major corporations. Four, adopt policies that improve Philadelphia's competitiveness around business development and growth. And, fifthly, develop legislative public policies at state and local levels to increase home ownership among African-Americans without resorting to predatory and subprime mortgage lenders that have led to the current crisis, among many other action items. Ladies and gentlemen of the 203 6/16/08 - PUBLIC HEALTH - RES. 080140 Committee, I thank you for your time, your energy, your serious commitment of resources to address the critical inequalities I and my esteemed colleagues are addressing before you today. In conclusion, I wish to share with you this quote from the State of Black Philadelphia. "It is essential to ensure equal employment opportunity for minority group workers and equal opportunity for minority-owned businesses.

Both public and private leaders should make the elimination of racial disparities in economic opportunity a high priority in a city, our city, where 44 percent of the population is of African-American descent. Sustainable economic growth cannot be achieved without eliminating racial disparities in economic opportunity. The adoption of policies to foster full participation in the economy by all members of the community is critical to the economic well-being of 204 6/16/08 - PUBLIC HEALTH - RES. " Lastly, I would like to say Dr. Benjamin Elijah Mays will say it's not failure, but low aim that is sin. Let us continue to aim high.

Thank you very much. Mr. McRae. MR. McRAE: Thank you, Madam Chair and Blondell. Good to see you again --

You have to speak into the microphone, please. MR. McRAE: Thank you. Good morning -- or I guess at this point it's afternoon.

Yes. MR. McRAE: My name is Phillip McRae. I'm President of GladRuth Services, but today I'm here in my capacity as a Board member of the Urban League and Co-Chair of the organization's Economic Advancement Committee. 205 6/16/08 - PUBLIC HEALTH - RES. 080140 The State of Black Philadelphia report poignantly highlights with quantifiable facts the status of the City's largest minority group, African-Americans, at 44 percent. Moreover, it outlines the grave challenges that we face in one of America's greatest cities. The disparities between blacks and whites are abundant and clear. Some of these stats you would have heard before, but I think they bear repeating. 9, while the national average was just over five percent. This translates into a pool of unemployed blacks and disaffected workers considerably higher than that of their white counterparts. There are far fewer black business owners. White businesses more than double those of blacks, and the businesses that are owned by our white counterparts are considerably more profitable. 206 6/16/08 - PUBLIC HEALTH - RES. 080140 Racial inequality in Philadelphia's business ownership can be easily seen in the 2002 Survey of Business Owners. In that survey, of the 67,000 businesses in Philadelphia, only percent -- that's a little over 8 10,000 -- were owned by 9 African-Americans. Of the $111 billion 10 generated in that economy, less than 11 eight percent, or 850 million, were from 12 black-owned establishments. 13 It is the result of these grim 14 statistics that I urge the Council to 15 consider supporting the areas relating to 16 economics outlined in the Urban League's Action Agenda. I have took the liberty and placed some of these key recommendations in a category that I've headed SOS for skills, opportunity and support. Skills training and education are paramount whether seeking a job or as I hope that others coming out of schools begin to do, start a small business. Why is that 207 6/16/08 - PUBLIC HEALTH - RES. 080140 important? First, as you've heard, education and skills create root behavior. They're foundational, fundamental and strikes at the heart of most successes that we see, and the children of Philadelphia suffer educationally. Secondly, two-thirds of college students plan to become entrepreneurs at some point in their careers, and business schools and textbooks stress large rather than small firms during their education, a reality that a lot of students find frustrating. I believe that the classrooms are filled with potential innovators who have the capacity to impact Philadelphia communities, including and especially those in economically depressed areas. The key, however, is that we help provide this emerging talent with knowledge and skills. So the skills and education action items I recommend Council 208 6/16/08 - PUBLIC HEALTH - RES. 080140 considers include providing a program of access to resources that enhance employability. Think about the Urban League and the Council as a bridge that can help employ the students and have gained access to areas they typically would not have access. Improving the skill levels of our workforce by strengthening the public school system and ensuring resources to provide quality education. Increase the availability of financial literacy training in public schools on a consistent basis to assist youth in their future. Opportunities: Opportunities I feel are enabling and encouraging individuals to start small businesses, which could be an enormous opportunity for Philadelphia's broader economy. Most people don't realize, but nationally small business total over 23 million, and roughly 75 percent of the firms have no employees. That means one 209 6/16/08 - PUBLIC HEALTH - RES. 080140 person can do what she loves in the City of Philadelphia, earn money, start supporting her family and can begin paying taxes to the very city that is supporting her.

The action items for opportunity I respectfully request Council to support include developing and enforcing minority business opportunities at state and local levels to ensure greater minority government contracting and small business development. Expanding second chance programs for high school dropouts, ex-offenders and at-risk youth, and increasing funding and programs aimed at securing a GED, job training program and the understanding and the embracement of entry-level employment. Provide youth with early access to work. That could be done with partnering with the schools and businesses that are right here in the City of Philadelphia. 210 6/16/08 - PUBLIC HEALTH - RES. 080140 Support: Ongoing support is absolutely critical, as it is the link between outreach actions, entrepreneurship and thriving economic activity. According to the Global Entrepreneurship Monitor, GEM, there's a strong correlation between national economic growth and the level of entrepreneurial activity. For example, 71 percent of our would-be entrepreneurs expect to create over jobs. 14 The action items for support 15 which I hope that Council will adopt 16 includes helping to create capital 17 capacity, whether it's financial capacity 18 or human capacity, that would be designed 19 for entrepreneurs, whether it's 20 micro-financing, as you've heard, or equity financing or strategic alliances, which I think that we have the absolute gem of a city to participate. Adopting policies that involve our City's competitiveness to spur 211 6/16/08 - PUBLIC HEALTH - RES. 080140 business development and growth, with a specific analysis of the Philadelphia business privilege tax that we have employed for generations. In closing, I would like to recommend members of the Council that for the 91 years the Urban League has existed, it has been in part a voice for the voiceless. The need for SOS, skills, opportunity and support, for 44 percent of our population has been clearly articulated in the Urban League's report in the State of Black Philadelphia. I encourage the Council to consider when, not if, we adopt the aforementioned recommendations that are coupled with my co-panelists and the panels you've heard before. Thank you.

Thank you very much. Thank you for your testimony. Mr. Altman.

Good morning -- good afternoon, Chairman Tasco and 212 6/16/08 - PUBLIC HEALTH - RES. 080140 members of the Council. My name is Andrew Altman, Deputy Mayor for Planning and Economic Development, Director of Commerce from the City of Philadelphia. I am pleased to be here today to provide testimony on Resolution 080140 authorizing the Council Committee on Public Health and Human Services to hold hearings on the findings and recommendations of the Urban League of Philadelphia report, the State of Black Philadelphia, and further authorizing the Committee to seek advice and recommendations on how Philadelphia can level the economic playing field for all citizens. The findings of the Urban League report illustrate the staggering economic divide separating our city's African-American and white communities. As the report suggests, many of these inequalities are inextricably linked to a long history of discrimination against minority business owners, as well as an 213 6/16/08 - PUBLIC HEALTH - RES. 080140 increasingly transformative industrial structure, which has left behind many of our city's African-American workers. 9 percent, more than two times that of whites. The median household income of African-Americans is $26,728, just 63 percent of whites. And the poverty rate for African-Americans is 32 percent compared to percent of 13 whites. 14 In recognition of the 15 socioeconomic challenges facing 16 African-American residents, the City has tailored its economic development strategy to stimulate job growth, encourage minority business development and improve access to housing and other services. Among the initiatives currently underway are the City's adoption of economic opportunity plans for its initiatives, creating the Cultural and Commercial Bond program and 214 6/16/08 - PUBLIC HEALTH - RES. 080140 the New River City program. Both of these bond-funded programs set a goal that minority employees account for 43 percent of the hours worked. PIDC loan programs during 2007 and 8, percent of loan volume amount 8 went to Minority Business Enterprise 9 borrowers. In 2008, PIDC, Philadelphia 10 Industrial Development Corporation, 11 introduced a privately funded program 12 called the Emergency Loan Program, which 13 provides short-term working capital 14 financing to minority and women-owned 15 businesses. 16 The City's Community 17 Development Block Grants and related 18 programs are used to subsidize 19 development of new affordable rental and 20 home ownership units. And for the most 21 recent six-month period reported by the 22 Office of Housing and Community 23 Development, African-Americans 24 represented 72 percent of the 25 neighborhood-based home ownership 215 6/16/08 - PUBLIC HEALTH - RES. 080140 participants, 71 percent of the home ownership rehabilitation participants and 54 percent of the PHIL Loan participants. The ReStore Philadelphia Corridors program, which aims to revitalize neighborhood commercial corridors and shopping areas and re-establish their historic roles as central places to shop, to work and to meet neighbors. In addition to Community Development Block Grant program, the State's Main Street program and other City resources, the City has dedicated $59 million from the $150 million Cultural and Commercial Corridor Bond to support this program. More than half of the ReStore streetscape committed to date as part of that bond initiative has been targeted in predominantly African-American communities. To build on these achievements, the Nutter Administration will implement new strategies that strive to further reduce racial inequality, including the 216 6/16/08 - PUBLIC HEALTH - RES. 080140 creation of the Economic Opportunity Cabinet, which will include the Mayor, City Finance Director, City Solicitor, Deputy Mayor for Planning and Economic Development, the Deputy Mayor for Transportation and Utilities, and the Procurement Commissioner.

This cabinet is tasked with finding the best platform to achieve its current and future goals for minority business enterprise participation and minority workforce participation. To address predatory lending concerns that are disproportionately impacting African-Americans, an additional $2 million will be spent on foreclosure prevention activities in Fiscal Year 2009. This funding will support the Save Your Philly Home hotline, additional housing counseling and legal services, and a partnership with the Pennsylvania Housing Finance Agency for low-fee fixed-rate home purchase and housing rehabilitation loans 217 6/16/08 - PUBLIC HEALTH - RES. 080140 to be made available to homeowners with less than perfect credit. In addition to protecting African-Americans from predatory lending practices, the reduction in foreclosures expected from this program will help prevent an even greater disparity in the home values between African-American and white-owned houses. To improve access to public transportation, the City is supporting a number of transit-oriented development planning initiatives to encourage more mixed-use development around transit hubs. The Planning Commission has completed plans for Girard Avenue, West Market Street, Allegheny West and Frankford, and the City is involved with current and pending transportation-oriented development plans for 46th and Market, Parkside, Temple Regional Rail Station, Wayne Junction, Central Germantown, and Broad and Erie. Once these plans are implemented, 218 6/16/08 - PUBLIC HEALTH - RES. 080140 predominantly African-American residents in these communities will have -- hopefully have, I would say, increased opportunities to live or work near public transit. For the first time in recent years, the City plans to dedicate a portion of its federal Community Development Block Grant fund to support technical assistance for micro entrepreneurs and small business. One of the objectives of this initiative is to target technical assistance to existing business owners located in neighborhood commercial corridors. Working with partners such as the Enterprise Center and the Business Center at the New Covenant, we plan to offer technical assistance to business owners located on corridors in predominantly African-American communities such as Walnut Hill, Central Germantown and West Powelton/Saunders Park. Additionally, the Commerce 219 6/16/08 - PUBLIC HEALTH - RES. 080140 Department has been developing a City Small Business Loan Guarantee program that would provide partial guarantees for banks and other lenders that make loans to small business who can't qualify for conventional financing. We've been working with Councilmember Goode and we've testified in previous hearings on this. Representatives of the Commerce Department are meeting with the GPUAC Small Business Lending Task Force and with most of the banks that participate in the Lending Task Force in order to develop a City guarantee-backed loan product that would be offered by the banks. Based on the input provided by the banks, we have structured proposed guidelines for such a loan product and identified initial funding for the guarantees. Although the Task Force members initially responded positively to the Commerce proposal, the interest of the 220 6/16/08 - PUBLIC HEALTH - RES. 080140 banks' lending departments has waned due to the ongoing credit crisis confronting the financial markets. And Commerce staff continues to meet with bank representatives, and we believe that we will be able to initiate a program acceptable to the banks in the near future. Commerce is also looking to lending partners outside the banking community. The City has a number of established community development financial institutions who have the capacity to utilize City loan guarantees.

Many African-American businesses have closer relationships with CDFIs than with banks and, as a result, we are optimistic that CDFIs will have the ability to make loans to the business community. In close, the State of Black Philadelphia is a troubling one. The findings of the Urban League report reveal the grim reality within which a number of our City residents currently 221 6/16/08 - PUBLIC HEALTH - RES. 080140 live. While the aforementioned initiatives offer hope to many of these residents, it is crucial that we as a city continue to aggressive innovate and legislate strategies that aim to alleviate the social and economic pain afflicting African-American households. Thank you for the opportunity to speak on this important issue. I would be happy to answer questions.

Thank you very much. Councilwoman Brown.

Thank you all very much for your testimony. Dr. Anderson, what is your opinion around this new phenomena called green-collar jobs and how, if any, role they might play in penetrating the inequity that exists in the labor market for citizens of color?

Well, I thank you, Councilwoman, for your question. I think the reference to green-collar jobs 222 6/16/08 - PUBLIC HEALTH - RES. 080140 refers to jobs that are created in connection with efforts to address problems of the environment, and that is simply a sector of concentration for job creation. You can look at environmental job creation as job creation in just another industry. Whether that's related to manufacturing or services or what-have-you, it's a sectoral concentration. Now, that's okay, but in all of these measures, what's important to address the problem of racial inequality -- remember, the burden of my remarks is the gap. It's the inequality. And we begin with a profile of inequality that is described vividly in this report. The question is, we -- the fact is, we know where we are. The question is, how do we correct this condition, how do we get to where we want to be from where we are. And I'm suggesting that there are two absolutely essential requirements to do that. One is to create more jobs. 223 6/16/08 - PUBLIC HEALTH - RES. 080140 There has never been a time in the history of this country since slavery when African-Americans have made relative economic gains when it occurred outside an environment of expanding economic opportunity. Never, ever. Let me just mention one thing. Look at what happened during World War II when thousands, millions of members of the American population, mainly men, went off to war, fight the war in Europe and in the Pacific. That created a labor shortage in many manufacturing industries, especially the war-related industries, in the Northeast, the Midwest and in the West. Who filled those jobs? Where did they get the labor? Well, it turns out that that was a period of time when there was segregation in the military. There were relatively few African-American men who were taken into the military. Many of them were in rural areas of the South and so forth. They didn't join up. They didn't go in. Some 224 6/16/08 - PUBLIC HEALTH - RES. 080140 of them did. Now, what happened, during that period of time, between 1940 and 1950, there was the largest migration of African-Americans out of the South into the North and the Midwest at any time in our history. Where did they go? They went into the basic manufacturing industries in Ohio, in Western Pennsylvania, in Ohio and Indiana, in Michigan, in Wisconsin and all of these places you read about. Two things happened as a result of that. One, there was a significant increase in the earnings of African-American men during World War II as they got out of the rural agriculture in the South and got jobs in the manufacturing industries. They were not high school graduates. Many of them were darn near illiterate. But the nature of jobs in the manufacturing industries at that time did not require you to have a high school education or anything beyond 225 6/16/08 - PUBLIC HEALTH - RES. 080140 that or any particular skills. All you needed was a strong back and the ability to work and to work long hours. The conditions weren't all that good in the automobile manufacturing plants, but they were good jobs. Much of the middle class of the Midwest today, African-Americans, is attributed to that increase in economic status of the black. Those are the people whose sons and daughters went to college at Ohio State and Michigan State and other -- Indiana University and other places like that. They became school teachers. They became black professionals. Look at the -- one of the people in -- one of the greatest African-Americans in this city who was recently honored with a chair -- first African-American chair of Temple University, Dr. Bernard C. Watson. Watson is a classic example of that. So what I'm saying here is that 226 6/16/08 - PUBLIC HEALTH - RES. 080140 there's no secret about what needs to be done to eliminate the disparity. I'm not just talking about increasing opportunity. What I'm trying to focus on is eliminating the disparity.

In order to eliminate the disparity, it is absolutely essential to have job creation. The green job -- now, I am getting back to your question. I have a tendency to digress.

We love your passion.

The green jobs will be another opportunity for job creation.

Outside of the public sector.

What is the other side of that? We've got to be sure that African-American workers get those jobs. Now, what's going to be necessary for them to get the job if they're not -- if they don't have a high school 227 6/16/08 - PUBLIC HEALTH - RES. 080140 education, if they don't have good skills, they aren't going to get green jobs any more than they get the white-collar, blue-collar, pink-collar jobs. So there are two things that need to happen. One, we've got to improve the quality of the labor supply. And I didn't mean to neglect that in my remarks, and, in fact, the paper that I presented for testimony includes that. But you can't convince young people who are running up and down the streets, who don't have jobs, who are into all kinds of behavior that Bill Cosby talks about -- and, by the way, I support Bill 18 Cosby. I want to make that clear. I think the speech he made at NAACP was right on mark about what's necessary to improve the education of African-American youth. They have a responsibility. Their parents have a responsibility. Their families have a responsibility. But once that is done, we've got to be 228 6/16/08 - PUBLIC HEALTH - RES. 080140 sure that they participate fully in these jobs that are created. And green jobs, that might be a new target of opportunity. Many of the other jobs are being outsourced to India and other places, Indonesia. So it's a new opportunity, but simply identifying it as a new opportunity is not enough. We have to find ways to assure that there is full participation of African-Americans in that sector of job creation.

Ms. Hannan --

So that means when the door is open, if they're prepared, they have to be let in.

That's right.

No 20 barriers can exist to prevent them from coming in.

No barriers to them walking through those doors that are newly opened.

229 6/16/08 - PUBLIC HEALTH - RES. 080140 Ms. Hannan, you provide a number of recommendations. Can you provide an example currently wherein your recommendation, encourage programs in support of first-time home ownership. Just cite briefly any examples that currently exist. I mean, this is the first time I've seen that kind of recommendation in all of the discussions we've been having.

I think recognizing the importance of home ownership to the community in providing not only stability, but in an effort to build wealth, it's very important that that concept be tied to fiscal literacy and programs that help inform people about the importance of things like good credit and how to save and how to build wealth so that home ownership is not beyond the reach of the majority of citizens of the City. And I know my financial institution, Citizens Bank, as well as many others have partnered with 230 6/16/08 - PUBLIC HEALTH - RES. 080140 many, many of the community-based organizations to provide those programs and to help build the concept of home ownership throughout the City.

Just two more questions, Madam Chair. A number of you mention in your testimony provide youth with early access to work. Let's define "early." Because the flip question becomes, what are corporations, the private sector, willing to do in engaging young people early. Are we talking about 9th grade? Are we talking about high school students? Higher ed is called early intervention, tapping them 5th, 6th, 7th and 8th grade.

Yes, ma'am. When I refer to early, I'm thinking about how I got started. There was a gentleman who at that time he was a Commissioner when I lived in Texas, and he gave me an internship. I never worked at a McDonald's. I never worked at a Kentucky Fried Chicken. He gave me an opportunity 231 6/16/08 - PUBLIC HEALTH - RES. 080140 to work. I made a thousand dollars a month. I didn't know what to do with all that money. But that was an opportunity to start, and then he really served as a mentor. Then there were other people who came along who really allowed for me to -- they were secretarial or typing jobs, but they were in legal departments or they may have been in political arenas, and so it exposed me versus just frying chicken or flipping hamburgers. And those are good jobs, don't get a misunderstanding, but it expanded my horizon. So when we talk about early work opportunities, I think it's incumbent upon not only just corporations, but also as it relates to political leaders, because the internships, that allows for people to dream beyond where they are. And if they can see a world that is not what they see every day, it expands that opportunity 232 6/16/08 - PUBLIC HEALTH - RES. 080140 and it also expands the opportunities to go on to get further education, which will take them into a totally different realm of life.

I would underscore that and add that so very often you hear statements about young black kids that simply are not correct, and they say, Well, they don't want to work, they don't have a work ethic. Well, let me tell you, you can't teach the work ethic without work. You need work to learn the work ethic. And, by the way, the first place one can learn that is at home. When kids are young, when they're being raised at home, I believe they should have some obligations to do something around the house. If that's not even more than cleaning up their room, learning that you don't just throw your dirty socks and your underwear all over the place and have your mother come in and clean it up. Learn that at home. Then when they're in school, we 233 6/16/08 - PUBLIC HEALTH - RES. 080140 don't want to start them working for money too soon. Let them understand that the very first thing -- I'm sounding like an old fuddy-duddy, but --

It's all good.

-- this is the thing. The first thing is to get an education, learn to read, to write and compute. Now, when they become teenagers, let them get a part-time job after school. Don't work too long. Part of my career I was Assistant Secretary of Labor where one of the responsibilities was administering the Fair Labor Standards Act in child labor. So there are laws about how long they can work and what hours they can work. Adhere to those laws, but let them get a job. And I know that Reverend Johnson isn't talking against the job -- there's nothing wrong with a job in McDonald's. If you can get a job serving customers 234 6/16/08 - PUBLIC HEALTH - RES. 080140 and making change and that sort of thing, you learn on the job. But the point is, understand that that is only the place to start, that's not the end point. If you have a part-time job after school in McDonald's, that's a way to earn a little bit of money. You can buy your -- what is it, iPod, whatever these things are. I don't have one of those, but that doesn't matter. The point is that you get a sense of responsibility after school. You know, when I was in high school -- I'll just say this and then I won't hold up the time -- I had a job after school as a soda jerk on the campus of the University of Pennsylvania. That was when the trolley cars ran above the ground, 34th and Woodland. I'm dating myself. 34th and Woodland, ran across the University of Pennsylvania campus. I took the trolley from Bartram High School to the drugstore on that corner and I made hamburgers and milkshakes and that 235 6/16/08 - PUBLIC HEALTH - RES. 080140 sort of thing. I was paid the grand sum of 75 cents an hour. That was the minimum wage at that time. But that teaches a young person the importance of responsibility, how to do a good day's work for a good day's pay, and that's important for young people. The fact is, far too many young black kids today never have that opportunity, for reasons that we all understand. So we need to create more summer youth employment. The Chamber of Commerce announced a summer youth employment program, I believe, so many thousands of jobs. That's good. They need to double that, triple that so that a significantly larger number of young black males and females in this city have something to do during the summer months. Finally, that is something that the public sector should be supporting to a greater degree. I don't know whether the budget of the City would allow the 236 6/16/08 - PUBLIC HEALTH - RES. 080140 City to fund a summer youth employment program.

We just did.

But if you can do that, take some money from somewhere else and fund a summer youth employment program. Those programs help create employment standards that are helpful for young black kids. It gets them off the street. They can do all sorts of things, work in Fairmount Park, do all these other things. It's important to have work opportunities for young people.

My final comment is to underscore remarks shared by our Commerce Director, because all of you mentioned it in your testimony, and, that is, don't just set, but enforce minority business goals in City government contracts. Only in the last eight years that I've been here -- and Councilwoman Tasco reminded me last week that many other municipalities' City 237 6/16/08 - PUBLIC HEALTH - RES. 080140 Councils who don't do this, but equal opportunity plans are now by law because of Councilman -- they are law. So when anybody comes to that table and is seeking opportunity to do business with the City of Philadelphia, if they don't have the equal opportunity plan that is written and a part of the legislation, my philosophy is, if it's not written, then it doesn't exist. The conversation actually stops on this side of the table. So we get it and are clear and are committed to equal opportunity plans. Our challenge, however, does remain around enforcement, where we have to continue to be police officers once many of those companies get these contracts, because we've had incidents where we've had to call back the general contractor and walk them through what happened or what did not happen with regards to their MBE/WBE participation. But know that this Council has come a mighty long way in ensuring that 238 6/16/08 - PUBLIC HEALTH - RES. 080140 those plans are part of the legislation. Thank you for your testimony.

And I'd just like to say to you that you may not remember, but last year in our budget, the City Council put in a million dollars to add to the support for the summer youth program, employment program, and this year the Mayor in his budget has put the money in his budget so that the funds will be there for summer employment. And so the City -- we don't have as much money as we'd like to have, but it's there. Mr. Altman, you want to end up? We have one more panel, and they have been here all day.

I was just going to add to the point the Professor made, which is the Mayor did challenge the Chamber this summer to actually double the number of summer internships, I think up to 2,000. I'll have to check on the exact number, but they've been working 239 6/16/08 - PUBLIC HEALTH - RES. 080140 diligently on that.

Councilman Goode.

Thank you, Madam Chair. I have to leave. I wanted to make some brief comments, particularly regarding Mr. Altman's testimony. I was pleased with a lot of the things I found within it. What particularly stood out for me was the considered use of community development financial institutions as a necessary intermediary to open up access to capital within African-American and minority neighborhoods. What really struck me about that was that that recommendation was contained within the last Urban League report ten years ago. I know because I authored the essay. And beyond that, the first piece of legislation that I authored in City Council was related to community development financial institutions. And I did other policy 240 6/16/08 - PUBLIC HEALTH - RES. 080140 work, but for whatever reason, the last Administration didn't see fit to use that vehicle. So I was encouraged by seeing that and seeing that you were exploring that, but also other parts of your testimony are things that are being done or things that were contained within that essay ten years ago. So I was very pleased with your testimony. Thank you.

Thank you all very much. We appreciate it. Thank you for waiting. Thank you for your time, and thank you for your participation with the Urban League. Now you can go back and see that you have a lot of work to do. Our next panel, the health panel, and we certainly apologize, but this is a big report and we didn't realize all that when we were putting it together. So, again, I apologize for your coming and staying all day. I 241 6/16/08 - PUBLIC HEALTH - RES. 080140 appreciate your staying here. So we'll ask Glenn Ellis, Sara Lomax-Reese, Michael Rashid and Dr. Schwarz to come forward. And this will be our last panel, unless there's someone else here to testify. (Witnesses approached witness table.)

Hello. Thank you so much, but I'm certainly sure this has been informative to you also. The report is a fine document, and when I talk to Pat about it, I thought we ought to have this discussion again when we come back, because this will not be the final discussion on the report. We will call you back as an individual panel for a morning, and that will be the only panel. So each panel will have -- we have four panels. We'll have four different sessions, but you will be invited to come if you'd like to all of them. But I think we can have more in-depth discussion and invite the 242 6/16/08 - PUBLIC HEALTH - RES. 080140 public to testify. The public can come in and offer their input into what's going on. I think we could end up with some stronger actions at the end of the day. So, Mr. Ellis, we'll let you be first since your name was on here first.

Thank you, Councilwoman. If you don't mind, I'd like to defer to Ms. Lomax.

That will be fine.

Thank you. I am very grateful. I'm very grateful.

Okay. Thank you. That's fine.

Thank you. Good afternoon. I'm Sara Lomax-Reese, and let me first acknowledge the incredible work done by the Philadelphia Urban League in this year's State of Black Philadelphia report. I have managed to edit my remarks down a little bit over the course 243 6/16/08 - PUBLIC HEALTH - RES. 080140 of these last few hours in the interest of time, but I want to thank Councilwoman Marian Tasco for convening the hearing and Pat Coulter and Michael Rashid for inviting me to participate. Today we are embarking on a journey of self-discovery, taking a critical step towards self-analysis, in hopes of identifying specific strategies that will begin the process of creating lasting, positive change. My entire professional career has been devoted to health education, advocacy and awareness, specifically targeting the African-American community. As the founder and publisher of HealthQuest: Total Wellness for Body, Mind and Spirit, the first nationally circulated African-American consumer health magazine in the country, and today as host and producer of HealthQuest Live radio show on 900 AM-WURD, my mission has always been clear: to offer information and inspiration to black people as a way 244 6/16/08 - PUBLIC HEALTH - RES. 080140 to change behaviors and, by extension, change the alarming rates of disease and untimely death in our community. Whether it's diabetes, hypertension, prostate cancer, breast cancer, depression, heart disease, HIV/AIDS, obesity, infant mortality, African-Americans are disproportionately affected. Plain and simple, we are in the midst of a major health crisis. The State of Black Philadelphia report illustrates this reality. And I quote the report: "Nearly twice as many black infants are born with low birth weights compared to their white counterparts, according to data from the Pennsylvania Department of Health. " It's easy to become numb to 245 6/16/08 - PUBLIC HEALTH - RES. 080140 these statistics, but these numbers represent real human pain and suffering for thousands of Philadelphia families. There are complex and powerful forces conspiring against achieving real health fullness for the majority of Americans. In my opinion, there needs to be a total paradigm shift that moves us from the current sick-care model that is focused on medicating disease to one where prevention is central, incorporating education, life-style changes and natural healing strategies, with a goal of not just avoiding disease, but creating a foundation for optimal wellness. What we eat, how much we exercise and how stress is managed are three of the most powerful life-style factors that influence quality and duration of life. As a registered yoga teacher and certified holistic health and nutrition counselor, I'm a huge proponent of a mind, body, spirit approach to 246 6/16/08 - PUBLIC HEALTH - RES. 080140 health and life. Identifying ways to reduce or manage stress in a culture that thrives on being on hours a day, 365 5 days a year is not just helpful, it is 6 essential. Some healthcare experts have 7 even claimed that 80 percent of all 8 disease is related to stress. When we 9 consider the devastating impact of 10 homicides on our community -- the State 11 of Black Philadelphia report states that 12 "five times as many blacks are murdered 13 per 100,000 than whites in 14 Philadelphia" -- we know that stress is a 15 significant ingredient in this equation. 16 In addition to its role and 17 physical and mental health, stress has a 18 direct impact on life-style choices. It 19 can leave us feeling overwhelmed and 20 undersupported, setting off a chain 21 reaction of unconscious behaviors that 22 can be extremely damaging to health, 23 things like smoking, substance abuse and 24 overeating, to name a few. These life-style choices deeply 247 6/16/08 - PUBLIC HEALTH - RES. 080140 interconnected continue to influence our trajectory towards or away from debilitating disease.

After publishing HealthQuest magazine for ten years, I realized that, like stress, our relationship with food was intimately connected with our individual and collective health outcomes. Every day each of us eats two, three, four, five times, and each time we put something into our mouths, it circulates through the entire body, either nourishing or depleting our system. In short, food can either serve as medicine or poison. According to the Centers for Disease Control and Prevention, 78 percent of African-American women are overweight, and 51 percent are classified as obese. We also know that being overweight is a leading contributing factor to diabetes, hypertension, heart disease and some cancers. It is very clear to me that 248 6/16/08 - PUBLIC HEALTH - RES. 080140 right now so much of the so-called food widely available in African-American communities is really poison masquerading as food. Fast food joints, corner stores laden with chips and soda, school cafeterias with vending machines no 8 longer popping out sodas but now popping out sugar-drenched chocolate, vanilla and strawberry milk, it's no surprise that childhood obesity is on the rise. There's an article in Time Magazine that just came out. It says a staggering 90 percent of overweight kids already have at least one avoidable risk factor for heart disease, such as high cholesterol or hypertension. 90 percent. No wonder there are behavior issues -- this is going back to the food available in schools. No wonder there are behavior issues and learning disabilities in the schools. While, of course, poor nutrition is not the sole culprit, how can we expect our children to excel and thrive academically if 249 6/16/08 - PUBLIC HEALTH - RES. 080140 they're essentially malnourished, overdosing on sugar, caffeine, white flour and other energy-depleting foods. Under the heading Quality of Life, the State of Black Philadelphia report reveals the startling reality that, quote, "Philadelphia has the second lowest number of supermarkets per capita in the United States. Three times as many blacks have difficulty locating fresh produce in their neighborhoods than whites. " What we eat, the quality of the food, how much is consumed, when it is eaten and under what circumstances is one of the most profound areas that directly impact our health on a daily basis. I am hopeful now that the Urban League has raised this point the City will be proactive and creative about introducing not just supermarkets to underserved 250 6/16/08 - PUBLIC HEALTH - RES. 080140 black communities, but investigate bringing more farmers markets with locally grown fresh produce, cooperative markets that offer affordable healthier options, and ensure that these places accept public assistance vouchers. Additionally, offering education and information about healthy food choices, eating and cooking is critical. Continually evaluating the foods available in the public school system is also essential to ensuring we do not continue the current cycle of poor health, burdening future generations with the likelihood of earlier onset of disease, creating a lifetime marked by chronic illness and shortened lifespan. I also want to just add in here that ensuring that comprehensive physical education is a real critical part of the educational curriculum. It's also really important. I'll close by reiterating something I said earlier. I urge City 251 6/16/08 - PUBLIC HEALTH - RES. 080140 Council to look at healthcare through a new lens, where prevention is central, incorporating education, life-style changes and natural healing strategies into an integrative model that goes beyond treating sickness and instead creates a foundation for optimal wellness. Thank you very much for hearing me.

Thank you. I'm just going to make some comments. I know you may have to leave. I see you have your son with you. He has been so good. You've been real good. (Applause.)

But I just wanted to let you know, I certainly appreciate your testimony and want to say to you that we are moving with the supermarket issue in the City. As you know, State Representative Dwight Evans passed a $16 million supermarket 252 6/16/08 - PUBLIC HEALTH - RES. 080140 initiative with the state, which is causing more supermarkets to move into the inner city. A new Shop Rite was just opened at 52nd and Market. I think there's one planned for Broad and Jefferson at the OIC -- Progress Plaza. I ran into some trouble with my neighbors in one part of my district because I let a vegetable truck stay on the street, because the supermarket is not nearby and I thought it was important that that vendor stay there so that he can provide fresh fruit and vegetables for that community. The other thing, we do have a market on Wednesdays in City Hall right in the Courtyard, so that citizens can get fresh fruit and vegetables. So we are very conscious, and our Councilwoman here -- let her bring up her issue. She'll tell you what she's doing to address some of the things you've said.

I would just add that the education piece is really 253 6/16/08 - PUBLIC HEALTH - RES. 080140 important, because access is critical, but educating people to know how to take care of themselves is really, really essential, because you can go into any supermarket and get the wrong stuff and still -- okay.

I agree. Well, we have a new Health Commissioner who is going to testify and he's going to testify about what he's going to do about that, because he's on the cutting edge of consumer education and health and all of that. Councilwoman Brown.

I will be brief, because I was actually going to pose this question to the leadership there. But be advised that I've introduced a menu labeling bill, and the trigger for me was the National Institutes of Health report about the crisis facing childhood obesity. So trust that I'll send you a copy of the bill to ask you for your comment, because 254 6/16/08 - PUBLIC HEALTH - RES. 080140 you actually underscored all the reasons why I think our city needs to look at how we do the -- the question is how, because 83 percent of Americans want the information. The challenge for us from a public policy perspective is how we do that in a way where we do not handicap or strangle businesses in the restaurant community. So thank you for your testimony.

Thank you. Who is next? Glenn, you're next.

Thank you very much. Chairwoman Tasco, I just want to say thank you for convening this testimony and these hearings on this issue. I want to assure you that what may have appeared to be impatience was my passion and enthusiasm to see that this issue is brought before this Council, particularly health. We've talked about housing, 255 6/16/08 - PUBLIC HEALTH - RES. 080140 social justice, economic development and education. We can survive in this society without all of those things. Health is one that is critical, that without it, none of those other things are possible to even pursue and certainly to enjoy. So I'm really committed to trying to do what I can to be a part of this type of dialogue to make sure that the Council is both informed, engaged and able to receive whatever support it needs to do the work to ensure that this issue is one that is given the proper amount of attention, particularly in the City of Philadelphia as we talk about health disparities. I have submitted already into your possession a formal --

Testimony.

-- testimony, and so for the sake of time and brevity and respect for the time of the other panelists, I will, if you will be so permissible, allow me to just be very 256 6/16/08 - PUBLIC HEALTH - RES. 080140 brief and try to skirt through this document.

Sure. It will be a part of the record.

Pardon me?

The full testimony will be a part of the record.

Okay. Well, let me just begin by just reiterating, my name is Glenn Ellis and I'm the President of Strategies for Well-Being. I'm a health advocacy communication specialist. My work is focused on health disparities, medical ethics, patient safety, clinical trials and cultural competence in health and medicine. I write nationally and I travel globally bringing the voice of underserved populations to the discussion and thought on these issues. I want to begin by just saying that today we are here to address collective concerns over the government's ability to carry out the charge that is 257 6/16/08 - PUBLIC HEALTH - RES. 080140 stated in the Constitution, to provide for the common defense and to promote the general welfare. So today I accept this privilege of offering some insight to the Council to try to better facilitate the ability to develop policy that focuses on the elimination of health disparities here in Philadelphia, ensuring that every resident, man, woman and child, enjoys the highest quality of life. Let me say this: This is what is not at issue here today, that Philadelphia has some of the leading medical education and healthcare institutions in the nation. It is not at issue that Philadelphia is recognized as a leader in medical research and medical advancements. It is not an issue here that Philadelphia's home is to one of the best children's hospitals in the world. It is not an issue that 80 percent of the pharmaceutical companies in the world have a presence here in the Philadelphia 258 6/16/08 - PUBLIC HEALTH - RES. 080140 region, nor is it an issue that 67 percent of the global revenue from drug sales end up in the Philadelphia region. S. city. On virtually every measure of health and well-being, African-Americans have fared worse than whites. African-Americans are less likely to have health insurance, receive lower quality care and are more likely to have many chronic diseases and injuries, and are more likely to die prematurely. I won't be too redundant because I'm sure as we've already heard and we'll certainly hear all the 259 6/16/08 - PUBLIC HEALTH - RES. 080140 statistical things, but it's important just to point out that African-Americans are less likely to even be diagnosed as having depression, and once they are diagnosed, the statistics and the data shows that they're less likely to receive anti-depressants, and when they are, they're more likely to receive cheaper and what's known to be clinically shown to be less effective clinical medications -- effective medications. We are more likely to die of heart disease than any other racial or ethnic group. A third of African-Americans visit emergency rooms for a condition that could have been treated by a regular doctor. That's if one had been available to them. And we have the highest rate of death, as I mentioned. Now, throughout my comments, Madam Chair, I would like to suggest that please follow the money, because this is what this all boils down to. We can cite 260 6/16/08 - PUBLIC HEALTH - RES. 080140 all the statistics, which we will, and we'll talk about some suggestions and some recommendations, but all of this is about money. According to an analysis from a CDC health interview survey, it reveals that African-American stroke survivors were more likely to become disabled and have difficulty with activities of daily living. The issue today is why is there such vast health disparities for blacks in Philadelphia and what can be done to eliminate them. Some of the agreed-upon factors which contribute to racial health disparities include the availability of healthcare services, stress, environment, genetics, behavior, economic resources and socioeconomic status, access to, distribution and quality of healthcare service. One study by the Commonwealth Fund finds that eliminating the gap in healthcare between African-Americans and 261 6/16/08 - PUBLIC HEALTH - RES. 080140 white Americans would save nearly 85,000 lives a year.

Racial inequalities alone are thought to cost five times as many lives as those that are saved by the advances in medical sciences. One of the greatest and most undertreated threats affecting African-Americans in Philadelphia today is mental illness and behavioral health. In spite of the recent major advances that have been made in recent years in this area, much work remains to be done here in Philadelphia. Our increase in knowledge and awareness of health disparities has not made the solutions any more obvious. Multiple factors combine to impede the development of a program for solutions toward the amelioration of healthcare disparities. It's my belief from my work in this area that concentrated efforts must be made in the microcosm of the sociology of illnesses, because African-Americans are the historic and present losers and 262 6/16/08 - PUBLIC HEALTH - RES. 080140 the least advantaged in this whole process. I would like to just touch briefly on clinical trials. Although pharmaceutical researchers are beginning to fully understand the reasons for selecting multi-racial and multi-cultural clinical trial samples, this does not mean that the selection of the participants in these studies has been or is in practice necessarily fair nor equal. Firstly, clinical trials are not generally performed in cash-strapped public hospitals or free-care clinics. In fact, the clinical research industry in Philadelphia is at the core of the economic engine of our multi-billion-dollar healthcare industry right here in the Philadelphia region. Similarly, the providers of medical care in historically African-American neighborhoods are typically limited in resources and access 263 6/16/08 - PUBLIC HEALTH - RES. 080140 to the information about ongoing clinical trials. Secondly, even with universal provision of clinical trial opportunities, African-Americans as a community are often reluctant to trust the medical establishment. Consequently, as African-Americans participate disproportionately less than their citizen counterparts, the application of medical and pharmaceutical care is generalized based on non-ethnic indications, such as age and gender. So we're finding medications, pharmaceuticals, technologies, procedures and equipment and medicine are being developed, researched and approved and put out into the general market without their having been an adequate scientific and clinical application of inclusion for African-Americans, who ultimately are going to be impacted by this in the general market. 264 6/16/08 - PUBLIC HEALTH - RES. 080140 So what this means is that Anglo-normativity persists in the trials of pharmaceuticals, and specifically the predisposition of African-American groups to be beneficiaries of a particular drug is unknown. We know that at present the medical establishment underserves minorities and that even those members of a minority group who are similar in socioeconomic status to their citizen peers of other ethnicities are as well at a greater risk. I'll move on and say that a recent Brookings Institute study found that half of the top ten and four of the top five private employers were health or educational institutions here, and they accounted for 70 percent of the jobs of the top ten businesses. Their impact in this region is not trivial. In fact, in a few days, Thursday to be specific, a major conference is taking place right here in Philadelphia and the major 265 6/16/08 - PUBLIC HEALTH - RES. 080140 attendees to that conference will be real estate lawyers, architects, bankers and contractors. " It reads, "Throughout the country and especially throughout our region, educational and medical institutions play a leading role in economic development, investing billions of dollars to weave themselves into their communities, bringing jobs, housing, retail shops and other amenities to often underserved areas.

" The four academic health systems here, Penn, Temple, Jefferson and Drexel, which includes Children's Hospital of Philadelphia and the Fox Chase Center, attract patients -- they 266 6/16/08 - PUBLIC HEALTH - RES. 080140 all attract patients from outside the region. In the mid 1990s, the SRI international study estimated that 44 percent of the output of this region's healthcare services were exported. This obviously means less resources available for and directed towards those who are here. Though health and educational institutions are often seen as local economic engines, they also play an export role that is increasingly true of those in Philadelphia, which is home to more than 80 colleges and universities. The region benefits substantially from their collective economic impact. The largest schools are in the City, and as many know, prospective college students throughout the nation have increasingly been drawn to Philadelphia. Most of Philadelphia's colleges and universities have not only seen an increase in enrollments, but an increase in enrollments from outside the region. And 267 6/16/08 - PUBLIC HEALTH - RES. 080140 this all while estimates as high as 60 percent stand out for young black Philadelphians who don't finish high school. Needless to say, black Philadelphians are almost totally absent in the medical school classes around the City. In fact, on close examination, these numbers are actually embarrassing to us all. With such low educational levels by an overwhelming number of Philadelphia blacks, the connected issues of health literacy presents one of our greatest challenges. Just consider an asthmatic child that has to make repeated emergency room visits because their parents could not read the labels on the medications the child was supposed to take properly. Or the elderly man who has a deadly drug reaction because he took the wrong medication. Or the patient who struggles to understand the language in the consent form for a procedure that they have to 268 6/16/08 - PUBLIC HEALTH - RES. 080140 undergo and in frustration just signs it anyway, having no idea what rights they just signed. The question remains are we sufficiently taking care of our own here in Philadelphia. Bioethics is the application of ethics to the field of medicine. And ethicists ask two questions: What is the right or good thing to do and what are our obligations to one another. I humbly suggest that this body consider the following recommendations for policies and/or legislation that will: Explore the possibility of connecting all City funding and support to health and medical entities with their proven ability to provide adequate effort in health literacy for patients; To assess the capability of the City Health Department in collecting the appropriate data to more precisely track the gap in health disparities. Nationally this is an issue that is 269 6/16/08 - PUBLIC HEALTH - RES. 080140 becoming more and more focused on, is the accuracy of the data that's being provided, what is the database. And specifically right now we're moving in an area, Madam Chair, where there is an issue that speaks to race-based medicine, and so many times the issue of what is the definition of race, who is black is the question, and in most cases, the federal government's mandates or the NIH says it can be self-identified. So regardless of who you are, how you look, you can determine who you are and there's no other criteria. So we have to stop and think about race as it plays a role in medicine, which impacts funding, allocation of resources and distribution of services. And so it then becomes a case of how do we know what is the appropriate way to have a scientific conclusion drawn from a social basis, a concept that is purely social. We need to look at our recommendations that ensure the increase 270 6/16/08 - PUBLIC HEALTH - RES.

080140 of medical school enrollments of black students here in Philadelphia, along with support to secondary schools in preparing students by putting them on the proper academic science tracks. Madam Chair, right now as we speak, in this country less than three percent of all the physicians in America are African-American, less than three percent. And of that figure, only 50 percent of them are actually practicing medicine, and half of them are actually Board certified to have privileges to work in hospitals. So we should consider also the formation of an oversight body that monitors the clinical research in the City to ensure inclusion and retention of African-Americans in this city. I would also like to recommend the commission of a study to examine the socioeconomic factors that are involved in health disparities. As Ms. Lomax pointed out so brilliantly, there are 271 6/16/08 - PUBLIC HEALTH - RES. 080140 numerous social and economic factors. We should also consider examining cultural competence in the current delivery of healthcare in this city, because as I just gave you those statistics on the number of African-American physicians, in a city this large with this large of an African-American population, it's obvious that the overwhelming majority of African-Americans here do not have African-American health providers. The question becomes how do those providers determine or find out who I am and what do they think about who I am. Is my life as valuable as someone who is a non-African-American. So we need to look, examine cultural competency. We need to look at establishing systems to be sure -- to ensure that the growing population of African immigrants to Philadelphia are receiving culturally competent care. Without many of us knowing it, there is an increasingly large number of African 272 6/16/08 - PUBLIC HEALTH - RES. 080140 immigrant populations here in this City. And Africa, I would like to remind, is a continent comprised of 54 countries. So to be treated in a medical institution as an African immigrant also has to be taken into consideration what is the language and the culture of the specific country and is there competent care to address Liberians as there is to address people from French-speaking countries. And, finally, to develop mechanisms that ensure that City controlled and/or funded health agencies have measures that prevent and eliminate health disparities for any citizen of Philadelphia. Madam Chair and your distinguished colleagues, I want to thank you immensely for taking the time to really take a look at this in such a formal and official setting. Thank you very much.

Thank you very much for that compelling testimony. 273 6/16/08 - PUBLIC HEALTH - RES. 080140

Madam Chair?

Councilwoman Blackwell.

Thank you. These are very, very important hearings, and these are excellent speakers and contributors to health throughout our city and beyond. Unfortunately, I have to leave, but I will be remiss if I didn't say that Glenn Ellis was special in my life, and due to his advice and help he provided, my mother lived years longer than she would have lived because of the herbs and food that he prescribed when she was even on a feeding tube. And he's a special man. I know about the works of all of these men, but I had to make sure that I give respect always whenever I see him, because I had my mother some three, four years longer than I would have because of him. 274 6/16/08 - PUBLIC HEALTH - RES. 080140 Thank you.

Thank you. Thank you very much for your testimony, Councilwoman. Michael. Mr. Rashid. I'm sorry.

Thank you. Councilwoman Tasco and members of the Committee, ladies and gentlemen, I'm very happy to be here as part of this very exciting initiative to address the State of Black Philadelphia and beginning to take action to improve the human experience for the black community and for all residents of the region. It's very obvious to me from today's activities and the scholars that have been testifying today, as well as your patience, your interest and the questions that members of the City Council have been offering us that there is a new spirit existing both in the City Council and in the Administration of this city, and I think you see that there's a 275 6/16/08 - PUBLIC HEALTH - RES. 080140 new spirit that is existing in the presence of the Urban League of Philadelphia. And we truly and honestly are encouraged by this spirit and we want to work with you as much as possible. I think today is the beginning. We really want to work with you and the Administration as much as possible on moving, as someone said earlier, moving the needle forward on some of the things that are in the State of Black Philadelphia report. Councilwoman Tasco, I'm very grateful and I'm proud of the Urban League under Pat Coulter's leadership in moving this critical initiative forward. We're talking a lot about legislative and policy changes today, and obviously we need to harness the power of government to support good health for all Philadelphians. But even though this is a great and intelligent legislative body, the City Council of Philadelphia, you can not legislate good health. This is 276 6/16/08 - PUBLIC HEALTH - RES. 080140 something that just cannot be legislated. What we need to do as a society is to change the healthcare system so that people can make the right decisions for their own health and so that they can get healthcare when they need it. There's still too many people with no health insurance or inadequate health insurance. The major policy initiative that we would like to recommend and that I'm sure you agree with is that we need to make locally and hopefully nationally efforts to make sure that everyone has health insurance. We need to advocate for legislation that provides coverage for all. This is a big part of improving and maintaining health, as studies demonstrate that people who put off preventive care -- people will put off preventive care if they have no 22 insurance. We need real healthcare reform, not more patches to holes in the safety net. In my experience, however, 277 6/16/08 - PUBLIC HEALTH - RES. 080140 having coverage is no guarantee that people will receive optimal care. There are other barriers to care as well. I see these every day in my work as Executive Vice-President of AmeriHealth Mercy Family of Companies and Keystone Mercy Health Plan. The members of Keystone Mercy have health insurance through the medical assistance program. However, many of our members go to the emergency room for primary care issues such as colds and stomach aches. And many women do not get prenatal care, although we try to reach out to our members who are pregnant and to get them into care. What we face is more than just a crisis in healthcare and it will take more than just the healthcare system to fix it. All of us in this room have to come together to make a difference. But the question is, what can we do right now to reduce health disparities and improve healthcare in our 278 6/16/08 - PUBLIC HEALTH - RES. 080140 community? We can work to make sure that all eligible residents, especially children, receive public insurance if they're eligible. Not everyone who is eligible for medical assistance or the Children's Health Insurance Program is enrolled in those programs. In fact, according to a study by the Kaiser Commission on Medicaid and the Uninsured, 74 percent of uninsured children are eligible for Medicaid or CHIP, Children's Health Insurance Program.

The Philadelphia Department of Public Health currently receives a grant from Community Behavioral Health, CBH, that funds eight benefit counselors whose main responsibility is to enroll uninsured patients in the City Health Department clinics. We applaud CBH on its effort and we encourage you to make sure that this grant continues. As you probably know, over 24 percent of the patients in the public 25 health -- in the City Health Department 279 6/16/08 - PUBLIC HEALTH - RES. 080140 clinic are uninsured patients and 74 percent of those who are children are eligible for Medicaid or S-CHIP. If they could be gotten onto Medicaid or S-CHIP, it would really relieve the burden on the City in terms of caring for those uninsured patients. So it's just a relatively small dollar to continue to have benefit counselors in the City Health Department clinics to get those folks covered. The City of Philadelphia prioritizes hiring in the Police and Fire Departments. We would hope that the City Council would also assist by making it a priority to fill vacant positions in the Health Department. Dr. Schwarz did not ask me to say that, but it's a fact, it needs to happen. We can work together, the healthcare system, the community organizations and the government, to provide basic health and nutrition 280 6/16/08 - PUBLIC HEALTH - RES. 080140 education to the general public. We can emulate successful models of health information campaigns. We can increase efforts to make affordable healthy foods available in more neighborhoods. We need to start with our youth and educate them early in the schools. Studies show that the best dollars spent in healthcare is the dollars spent on prevention. And the best dollars spent on prevention is the dollars spent on education and the building of self-esteem. We encourage you to fund more health education in our public schools. We heartily endorse the comments that were made earlier in terms of building self-esteem among our youth. One of the men who testified here today was E. Steven Collins, who was one of the organizers of the 10,000 Man March, whose basic purpose and aim was to increase self-esteem and get African-American men more involved with their youth. We think that there's a direct correlation between 281 6/16/08 - PUBLIC HEALTH - RES. 080140 fathers being involved with the youth, self-esteem and the healthcare that is a product of those very positive efforts. We need to build trust and take healthcare into our neighborhood. An example is Keystone Mercy's Women's Health Ministry program where we partner with the churches to get important healthcare information to African-American women. Also, our Healthy Hoops Asthma program that helps children with asthma and their parents help better manage their asthma. These programs work and they can improve and even help save lives. I've seen this happen firsthand. On another note, Madam Chairman, I'd like to just say as the Chairman of the Urban League of Philadelphia, we see ourselves as a bridge between the community and the business community. As you know, the Urban League is a national organization that has been seen by corporate America 282 6/16/08 - PUBLIC HEALTH - RES. 080140 as sort of a legitimate organization through which they can speak to the African-American community. The national Chairman of the Board of the Urban League is the CEO of Shell Oil Company, and there are many national CEOs who are part of our national Board. We have regional CEOs on the Board of the Urban League of Philadelphia here. Just last week we were able to work with Deloitte Touche, international CPA firm, and the Urban League and Deloitte co-sponsored a CEO diversity conference that was held here in Philadelphia, and we got local, regional and national CEOs to come to town and to talk about and make further commitments in terms of their efforts to promote the diversity in their workplaces.

This is just an example of some of the things that the Urban League can do working with corporate America. One thing that we would like to ask you to do -- I know that corporate leaders come to you all the time trying 283 6/16/08 - PUBLIC HEALTH - RES. 080140 to get into Philadelphia, trying to get programs done in Philadelphia. We'd like to ask you when these people come to you and they said they want to do so much in the community, one thing you might do is to refer them to the Urban League and maybe they would like to commit themselves to be on the Board of the Urban League or to participate in the Urban League with some of our programs. They can come to you and they can say a lot, but here's one thing that they can do, is they can be on the Board of the Urban League and participate in some of the Urban League programs. We are very much appreciative of what you are doing here. Again, we really see this as a first step. We are appreciative of the Nutter Administration for sending his Commissioners and his people to come here. We heard what you said earlier, Councilwoman Brown, with respect to focusing and moving the needle. We are 284 6/16/08 - PUBLIC HEALTH - RES. 080140 working on that just as hard as we can. We really like the idea of working with the City and working with the Administration on things like lowering the dropout rate. We think that that's something that -- there's an initiative at the City to do that. We think that we can help in terms of engaging the corporate community in being mentors in terms of hiring people. We think that this is something that we can do, and we welcome the opportunity to working with you and with the Administration together in focusing on these couple of activities. The next time we come to you, we're going to come to you with a very clear outline of the two or three initiatives that we would like to focus on, and we hope that we can work together with you and the Nutter Administration on getting those initiatives accomplished. Thank you.

Thank you. 285 6/16/08 - PUBLIC HEALTH - RES. 080140 Thank you very much. Looking forward to working with you. I think it will be a good, strong partnership, because we need more advocacy groups and more action-oriented organizations. Dr. Schwarz.

Good afternoon, Chairwoman Tasco, Councilwoman Reynolds Brown, co-panelists. I'm Dr. Donald Schwarz. I'm Deputy Mayor for Health and Opportunity and I'm the Health Commissioner of Philadelphia. I am pleased to be here today to complete this day of testimony and offer comments --

You can sum it all up.

-- and offer comments on the issue of the disparities in health and health status that unfortunately continue to exist in Philadelphia. I want to commend the Councilwoman and the panel for bringing these hearings and for insisting that we 286 6/16/08 - PUBLIC HEALTH - RES. 080140 not only have a single day of hearings, but that you have asked that we come back in the fall so that this discussion continues. Rather than having a report that stays on the shelf, we should have a living document to which we respond. I'm proud to say that the Department of Public Health has a history of being engaged in addressing this important issue, particularly as it affects communities of color. I will say we need to do more. " The series illustrates the devastating relationship between poverty, race and health. Our hope in holding the meeting was to encourage leadership and collaboration in addressing health 287 6/16/08 - PUBLIC HEALTH - RES. 080140 disparities, and I believe we were successful in launching an awareness campaign with the 180 persons in attendance. We fully intend to continue to expand the campaign. The report of the Urban League of Philadelphia, the State of Black Philadelphia, includes three study areas in its Health Index: Maternal, infant and child health issues; death and disease; and illness prevention and quality of life. Regarding the maternal and infant issues, we in the Health Department administer the Healthy Start program in targeted areas of the City to address low birth weight, lack of prenatal care and infant mortality. Many of these neighborhoods are largely African-American, as are a large majority of the Healthy Start clients. Most of the services are provided through collaborative subcontracts with community agencies, including care coordination, 288 6/16/08 - PUBLIC HEALTH - RES. 080140 case management and health education, as well as services for perinatal depression and interconceptional care. Interconceptional care is defined as the care before and after a pregnancy and is provided, in part, to reduce the incidence of repeat pregnancies, especially among teenagers. As Councilwoman Tasco noted earlier, it's a very important group. In November 2007, we began youth clinics at Health Centers 5 and 6 in North Philadelphia where we provide information to teenagers about delaying pregnancy. Prenatal care is provided to about 3,000 persons annually and family planning services to about 9,600 persons annually, including emergency contraception, at all of the City's health centers. These eight primary care centers see patients regardless of their insurance status or ability to pay, and a number of the centers serve an almost exclusively African-American population. 289 6/16/08 - PUBLIC HEALTH - RES. 080140 Similarly, we recognize the disparities in the incidence of chronic diseases and increased death rates from these diseases in the African-American compared to European-American as well as Latino populations. S. has increased by 30 years during the 20th century, and in part, we can attribute our longer lives to amazing advances in medical technology and drug therapies. But we also know that there is a higher incidence of chronic diseases such as diabetes, hypertension and asthma in blacks that ultimately result in poor health outcomes and higher mortality rates in this population. Basic essentials for improving health outcomes for those with chronic diseases include improved disease management through eating healthy foods, as we've heard, quitting smoking, increasing exercise and having health insurance. The report notes that these 290 6/16/08 - PUBLIC HEALTH - RES. 080140 health factors continue to be problematic in the black community. Five years ago, the Department was successful in obtaining federal Centers for Disease Control and Prevention funding for the Steps for Healthier Philadelphia program, which targeted a population of half a million in a contiguous geographic footprint of the City.

The area includes most of West Philadelphia and parts of Center City, Southwest, North and South Philadelphia, an area chosen to reach the largest portion of the population facing the highest disease-burden and disparities of the targeted conditions and risk factors. At the time of the application, the population was 66 percent African-American, and 28 percent of the residents were living below the federal poverty line. Targeting the more vulnerable of the residents in this area with disease management and prevention programs and strategies, we believe we 291 6/16/08 - PUBLIC HEALTH - RES. 080140 have provided a foundation for improving health outcomes. As the five-year Steps grant period comes to a close, the current Administration and this Council have approved funding to continue our chronic disease prevention efforts, which will focus on the most effective of the outreach disease prevention -- the most effective of the outreach programs currently in place for smaller community-based organizations. These programs promote healthy living, physical activity and improvements in the local built environment that will help prevent overweight, obesity, diabetes and cardiovascular disease in high-risk populations. I will say we can't do this alone. It's been a partnership. It needs to continue to be a partnership. I'd like to add that our data show that the person most likely to be diagnosed concurrently; that is, at the 292 6/16/08 - PUBLIC HEALTH - RES. 080140 same time, with HIV and AIDS -- and I should note, the reason this is important is, we know that the period between infection with HIV and disease of AIDS is on average at least ten years. So those who come in and are identified with HIV at the same time that they have AIDS are people who have had the infection for at least ten years. So those who have had the poorest access to testing and counseling. So by definition, people who concurrently come in with HIV and AIDS are late reporters, and the person in Philadelphia most likely to come in concurrently with HIV and AIDS is an African-American heterosexual male over 30 years of age, so people who have been diagnosed at age -- who have been infected at age 20 or before in many cases. The Department is implementing HIV prevention education and testing in a focused fashion to reach this population, 293 6/16/08 - PUBLIC HEALTH - RES. 080140 including implementing HIV rapid testing in emergency rooms, shelters, substance abuse programs and through mobile testing in areas heavily impacted by the epidemic throughout the City. Mr. Ellis pointed out that collection of information on disparities is critical to our ability to respond appropriately, and I think this is an example of where the City has been able to do that, target resources appropriately, and we hope to see improvement in health outcomes. Just as important to our health as the need for equity in healthcare, however, is the need for improved social conditions, as all the panelists have pointed out. We've all benefited from improved wage and work standards, universal schooling and civil rights laws, the things that help each of us to live a life with dignity. In fact, these advances are as essential to improved health outcomes as eating healthy foods, 294 6/16/08 - PUBLIC HEALTH - RES. 080140 quitting smoking, getting enough exercise and having health insurance. We also suffer from both economic and racial disparities, and these disparities can last a lifetime. In Philadelphia, there are 2,251 excess deaths to Philadelphians who live in poor neighborhoods compared to those who live in wealthier neighborhoods when all other factors, including race, ethnicity, age and sex, are held constant. Included in these deaths are infant deaths; that is, infants who die before their first birthdays. The infant mortality rates differ among white and African-American babies in Philadelphia. 9 per thousand live births.

Our social realities in Philadelphia have a direct impact on our fight to improve health and prevent 295 6/16/08 - PUBLIC HEALTH - RES. 080140 diseases. Good health depends on respect for human dignity. It is an indignity to be forced to suffer from social inequalities, to be without healthy food outlets, to work and live in unsafe conditions, to lack basic health services, to live under chronic stress and suffer from the effects of traumas, to not have the support or encouragement to finish school. Mayor Nutter and I are committed to addressing health in a broad context, with a special focus on promoting the full dignity of every man, woman and child in Philadelphia. Under our leadership, I aim to unite the Health Department's many programs into a broader common identity, one that upholds human dignity as we fulfill our mission to protect and promote good health. I challenge all of Philadelphia to join us in improving the broader context in which we provide and receive healthcare. I'll end my remarks here in the 296 6/16/08 - PUBLIC HEALTH - RES. 080140 interest of time. I'm prepared to answer questions, and I thank you again for convening these panels.

Thank you so much for your testimony, and we certainly look forward to working with you in providing the health for the citizens we represent. I had a question here for you. I can't find it. Councilwoman Brown.

In the interest of time, I'm going to pose two rhetorical questions, with the expectation that we will review all of these matters again in the fall. First to Mr. Ellis. You gave a lot of testimony to the fact that it's a fact that people of color are not engaged in trials. So Councilwoman Tasco and I were discussing how there are a lot of reasons for that. And so as we look to the fall, we need -- there may be opportunities for us in government to help citizens understand that it is okay 297 6/16/08 - PUBLIC HEALTH - RES. 080140 to be involved in clinical trial and education is important to help to diminish some of the fears that come with participating in clinical trials and that it's a two-way street, that the disengagement of people of color is not completely due to the fact that they have not been outreached to. You follow me?

Exactly. There's an African proverb that I use quite frequently when I do seminars or lectures, and it says that in order to come into my house, you must enter through my gate. So the outreach -- you may see posters and signs or you may see commercials with black people in them or whatever, but the question that the recipient is asking, are they really talking to me, do they really --

Is it authentic.

Are they really talking to me. So you can get into my 298 6/16/08 - PUBLIC HEALTH - RES. 080140 house, but did you enter properly. So was there some respectful, culturally competent way. And part of this in the context of your question is to look at obviously the legacy and our history of experimentations. I mean, modern medicine was basically developed through experimenting on live slaves. I mean, the field of obstetrics and gynecology was basically developed by the person considered the father of that field, literally cut open live black slave women to try to understand the anatomical makeups and functioning of how the reproductive system worked. Dr. Benjamin Rush, who is like the father of psychology -- psychiatry actually, had a term called "negritude" that was considered an official acceptable psychiatric condition that was only corrected if you kept a person in slavery, and that if you exhibited behavior that made you think you needed to be free, it was determined that this 299 6/16/08 - PUBLIC HEALTH - RES. 080140 was a psychiatric condition for a black person. And then obviously with Tuskegee and so on and Holmesburg and Dr. Klingman and all of these things that happened with the University of Penn's clinical trials. So you got to look at the history that we have --

Sure.

-- to overcome. So in order to even start to begin to address this part of educating the black population about clinical trials, you have to first make sure that you respectfully acknowledge that those things exist and that they are properly addressed, so to speak, to then make it. So it's not about saying people need to get into them, but I think we need to eliminate the barriers that prevent people from making good decisions about whether to get into them or not, and I think if we can eliminate those 300 6/16/08 - PUBLIC HEALTH - RES. 080140 barriers, we would see the numbers would certainly go up and would make sure that -- once again, Councilwoman, I want to emphasize it is crucial when we have medications that are being developed through clinical trials, whether it's the Lipitors or Crestors or whatever, Vytarins, or whatever, you want to make sure that once that drug has cleared a clinical trial and it's been approved by the FDA and allowed to be put on the market and now available to everybody, that the clinical trial was as inclusive of the population that it was going to ultimately benefit.

Indeed. Okay.

So we don't know -- the jury is really still out on the real pharmacogenetics of whether there's really some difference between Dr. Schwarz taking a high blood pressure and myself, but we want to make sure that both people who look like him and people 301 6/16/08 - PUBLIC HEALTH - RES. 080140 who look like me were included in the trials to develop the drug.

Right. Okay. And then to the leadership of the Urban League, as you deliberate this summer or whatever time you're going to use at the Board level and as we as Councilmembers review testimony and look for legislative opportunities on our end, my question is, what is the Board policy, if any, as it relates to how strong your voice of advocacy, how loud your voice of advocacy, whether or not you even step out and endorse or unendorse public policy that's coming from City Council and/or the state. So I don't know the answer to that, but I raise it because that is another way to make your voices heard when we ultimately want to introduce legislation that is intimately tied to what this report signifies. So I raise the question only as 302 6/16/08 - PUBLIC HEALTH - RES. 080140 to think about it, because I'm curious to know. I love the organization. It gave me a start in my career, but I clearly remember years ago when it was not a 6 practice to embrace or not policies 7 raised by those of us in government. So 8 I put that on the table for thinking and 9 for consideration, knowing that we will 10 return in the fall. 11 Thank you very much. 12

Thank you. 13

I'd like 14 to add to that, because you have a very 15 strong voice, and one of the reasons I 16 wanted to have this discussion today 17 about your study was to have the 18 opportunity to show the work done by the 19 Urban League, as well as try to encourage 20 you to be more vocal and be more 21 proactive in what we do in City Council 22 that helps us and gives us your 23 perspective on what we are putting forth 24 as policy issues. We can talk to 25 ourselves all day. We need to hear 303 6/16/08 - PUBLIC HEALTH - RES. 080140 what's happening. We talk to our constituents, but you all have another constituent group that we don't really hear too much from. So Dr. Schwarz, Michael talked about CHIP. You talked about CHIP. At the health centers, when young people, children, go into the health centers for service, can you all sign them up for the CHIP program?

If they're eligible.

Beg your pardon?

If they're eligible.

If they're eligible?

Yes.

Well, most of them, I understand, they are. Based on the commercial, every child is eligible. You may have to pay if you have certain guideline, income guideline. 304 6/16/08 - PUBLIC HEALTH - RES. 080140

The exception is children who weren't born in this country, of parents who were not born in this country.

I see.

As you know, an increasing proportion of those who are coming to our health centers who are uninsured are those who are from other nations who are not eligible for health insurance through the public system in this country.

Okay. Thank you very much. And, Mr. Rashid, I appreciate your involvement with the Fox Chase.

Yes.

I'm on their External Advisory Board, and certainly a lot of the discussions around clinical trials and certainly the ability for the diverse community to access the services of that institution has been made possible with your relationship with 305 6/16/08 - PUBLIC HEALTH - RES. 080140 them. So I appreciate that. It has been a good day, Pat Coulter.

It sure has.

We appreciate your staying. We know you haven't had any lunch, you're hungry, but we will follow through with this. However we do it, we'll work it out with the leadership and with the Executive Director of the Urban League to see what the next steps will be. So what we will do, we will not adjourn. We will recess until the call of the Chair. Thank you very much. I want to thank my colleague for hanging in with me. Thank you.

You're welcome. (Committee on Public Health and Human Services recessed at 3:05 p.m.) - - - 306 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 16, 2008, 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.)