We look forward to the follow-up information. Thank you. If we can start with the Police Department and follow the rest of the panel. I know and I want to apologize to our officers. I know that the 25th Police District is having an extremely important event today where they are hosting a community block party and many of our officers are here and can't attend. And that's an extremely important event because they recognize that community residents are sometimes living in communities or in neighborhoods on blocks that are occupied by individuals that don't allow them to come freely out of their homes or kids can't play out in the street. And the 25th Police District has year after year ensured that the community has a day for them to feel like they can run and jump and play and be in the community together, and that is happening today and many of them are here with us and can't participate. So I want to make sure that I give Deputy Commissioner Rosario an opportunity to respond to some of the questions that this panel has so that they can get to the community that is really excited about having them be with them.
Madam Chair, I'd like to recognize a representative from Merakey who will be joining this panel. Natasha Lundy.
If Ms. Natasha can join us at the front, that will be awesome. Let's start off with Deputy Commissioner Rosario. Thank you so much for being with us today and for being patient through this long process. I think that again many of the questions that we have are basic commonsense questions, right. Your offices are out every day. They're out hours a day. Can 24 you please share with us some of the experiences that your officers have shared around the challenges that they have when they've encountered individuals who are involved in consumption, the illegal activity of consumption, on our streets? What are some of the challenges that some of your officers experience when that individual says to them, officer, I know that I'm wrong, I know that I am in bad shape, because I've had the opportunity to speak with many of them and they recognize what their situation is. What are the challenges that some of your officers experience getting people into beds, getting people into some of those services that they desperately need? DEPUTY COMMISSIONER ROSARIO: Good afternoon, Councilwoman and body. It's a privilege to be here before you today to be able to speak before you in our community and provide you with a significant update. To answer your question, first of all, I want to acknowledge that I have Inspector Bullick -- Inspector Luca -- sorry, I promoted him -- Inspector Luca, Captain Bullick, Lieutenant Pittaoulis, Sergeant Hannesson, Lieutenant Casale. I really want you guys to understand what we are trying to create here, the type of atmosphere understanding that the community of Kensington has been an afterthought for such a long time, right. And under the leadership of Mayor Parker and Commissioner Bethel has been made a priority again to re-establish a certain quality of life, a certain expectation of public service from its police. So one of the mandates that Commissioner Bethel has had for us is to make sure that we staff our area appropriately. And I just really want the community and you as a body to understand from the Inspector to the Captain, to the new Inspector we have here, Inspector Vann who's running the mini station, Sergeant Hannesson, these are all people that have had the opportunity to lead, and they've done their time and they could go anywhere else in the department, and they asked to stay here to be part of this process. There was a core group of footbeats assigned to the Kensington mini station prior to the class that just graduated. They were all volunteers who want to be here and work. So that speaks volumes to them and to their character and to why they're here and to the value that they have for our community. For the officers that encounter the unsheltered population every day, it's challenging. We've seen through our own analysis that our officers encounter these individuals about times before they'll accept the 6 service, right, so 17 encounters 7 before they're willing to accept 8 some type of social service through 9 our unconventional approach, as 10 that's partnering up with Merakey, 11 our third service provider, and a 12 police officer, right, that 13 co-responder model that we're very 14 proud of that we're setting a model 15 for here in the state. And there 16 is value to that. 17 Understanding that a lot of the individuals that we're encountering are suffering from not only their addiction physically but a poor mental hygiene, right, not being able to make correct decisions every day, so the officers that we have working that service detail, again I want to tell all of you they're all volunteers. These are all that applied, interviewed and were vetted by the Inspector and the Captain to make sure that they have that correct mindset to be able to work in this space. And it is challenging work. Seeing the amount of human suffering, first of all, that our community is subjected to every day, that keeps me up at night.
Understanding that us as leaders are responsible to manage our way out of this, it's a huge weight. And it's a responsibility that me and my team do not take lightly, and we really press that upon our police officers reminding them that everyone is in this space should be treated with dignity and respect. But that just doesn't go to the unsheltered or to the people suffering with addiction. It goes back to our community, right. All the residents that are here, all the children that go to school in our area, the businesses that are trying to make an honest buck on the Avenue, they're all deserving of a certain quality of service that as a police department we're mandated to give them. So it is challenging work. We do this work every day with that in our forethought making that a priority, but understanding that a lot of times as managers and leaders we have to play Solomon and split the baby, right, the rights of the individual that's suffering from addiction and the rights of our residents who are suffering through this as well. And that's challenging. And we all don't always get it right, but we try very hard to take every encounter on its own merit and treat everybody with respect and navigate that. The officers on the service detail handle everything. You know, it's funny. True story, I was on the Avenue last week. One of the residents came up to me and said, Commissioner, I need a favor. And I'm very popular in this area so I get approached by a lot of folks. I need you to introduce me to Sergeant Hannesson. I'm like, oh, okay, it's not me you want to meet. It's Sergeant Hannesson you want to meet. That goes to the work that him and his crew do every day, and they have really been a catch-all, like there are things we are creating for him every day to handle that's not in their job description. So not only are they leading that effort to have our first level of response dealing with the unsheltered, but they're partnering up with my colleagues here. The other responsibility the Commissioner has tagged me with is this area has led the City consistently with homicides and shooting victims, I mean No. 1. 24th District, PSA No. 2 has been consistently No. 1 in violent crime for the last couple of years. So a large part of our strategy has been to come here and stabilize that, understanding that my colleagues next to me cannot come into this space and do their jobs effectively without making it safe for them. So that's also been a large part of our strategy, to come in and to just really stabilize the area and create that bubble for our folks to be able to come in and be able to be effective at their jobs. You know, we're a month in. The class has graduated a month ago. I know our community is very eager to see immediate change. And I know it's not going as fast as some folks had hoped it would be, but I'm here to tell that we're moving in the right direction. I can tell you I know we're dealing with a lot of issues with displacement, and we knew displacement was going to happen, right. The challenges I've given Inspector Luca, Inspector Vann and Captain Bullick have been to make sure that we're fluid in our response. So we're very active with community through various means, either 911 -- many of our partners in the footprint contact us and let us know, hey, we've got an issue over here. We try to quickly respond immediately to provide the appropriate level of service that's needed, whether it be through enforcement, whether it be through the social outreach, whether it be contacting my colleagues here to provide some type of improvement to qualityof-life issues through clean-ups or what have you. I mean, but it is a lot of challenging work. And to say that the police have been saddled with doing a conglomeration of things is an understatement, right. We're no 8 longer just the police officers. We're the social workers, the first responders. From soup to nuts, we do everything.
But it's a challenge that we enjoy and really understand that the folks that we have working in this space right now I want you all to know, at the leadership level they all want to be here. We've had the addition of the officers. June 17th they graduated, June 18th so we needed to have more sergeants to the mini station. Every single one of those sergeants are volunteers. They want to work here. Lieutenant Lisa Pittaoulis, the Lieutenant who runs the area, you couldn't drag her out of here. She wants to be here every day. So my point is I just want you to understand the level of commitment that we have, the responsibility that we understand in meeting our oath both to the community at large, to the individuals that are suffering addiction and making sure that we're able to stabilize and make a difference.
Thank you for your testimony. Can you tell me, Deputy Commissioner, have people approached your officers and asked to be taken to treatment? DEPUTY COMMISSIONER ROSARIO: I don't have specific numbers for you, but that's something that happens on a constant basis. And again, we're that first level of response, right. So whether it be we're contacting our network partners, we have a lot of affiliations with our other folks that are involved here, a lot of the faith-based groups that come out here, we make those connections by any means possible. Understanding that when an individual approaches a police officer, whether they work night work or the last-out tour, the midnight shift, when that person finally says, hey, I need help, we have to take advantage of that. We encourage our officers by any means necessary to either establish the connection, understanding that when someone needs help and they're coming to you right then and there, it's never good to say come back to me later tomorrow or I'll call you tomorrow and try to figure something out. We have to be immediate with our preparational services, so we have those assets and we're trying to build additional assets, especially during the midnight shift. So we're currently in the process of working through Merakey to be able to provide an additional social service component during that last- out tour so that we're covering all shifts at all times.
Is there a point during the course of the day or during the course of the week that presents a challenge for you to connect people with services? DEPUTY COMMISSIONER ROSARIO: I mean honestly, yeah, the weekends. The weekends are challenging for us. Right now the way our systems are set up, it's basically a Monday-through-Friday 16 hours. Sometimes we can enhance those outreaches if we make a request. And again, I'm not talking about police. I'm just talking about additional support. But past that, on the weekends it's a little tougher for us to be able to access some of that support.
So when someone comes to you, when an individual on the street comes to a police officer and says, officer, I'm ready for treatment, and it's Saturday at o'clock p.m., what 10 does the officer do? DEPUTY COMMISSIONER ROSARIO: So normally in that type of instance that's when we go to our other folks that we have on that. Prime example is we have resources, the connections that we have here at Rock Ministries, understanding that Rock has connections, a lot of those third- party providers also. So if we're not available to access our City agencies, a lot of times we'll access --
So every officer has a list of providers that they can reach out to for services? DEPUTY COMMISSIONER ROSARIO: So the Sergeants keep all that information handy so it's just a matter of the officer in the field, especially the newer folks that we have now that haven't built those relationships yet, they'll call the Sergeant or a lot of times they'll call one of the veteran officers and ask them, hey, we need a hook-up for this individual, how can we provide that service.
If you can provide this Committee with the same list that your officers have -- DEPUTY COMMISSIONER ROSARIO: Sure.
-- so that we can see who those providers are and how they compare to the list that we receive from DBHIDS and others that will testify today, it will be greatly appreciated. Are there members of the Committee that have questions? The Chair recognizes Councilmember Squilla.
Thank you. And thank you, Deputy, for all your hard work and for your responsiveness. It's so important. When people reach out and they have a chance, they know that they will get a response. And you and your officers have done an amazing job in that. We are hearing some individuals at certain times, sort of what Councilmember Lozada was saying, weekends and overnight sometimes that we as a city are not providing those opportunities to either get a bed or go into treatment at that time. So I hear that you see that as more of a challenge for you also. I mean, I want to take it with our guys, our colleagues here, that maybe we have to then challenge our departments to have providers or put an RFP out for providers, somebody who can not only do the outreach overnight but also to be able to place people not just Monday to Friday but weekends, and somebody at o'clock, 10 o'clock or 2 o'clock in the 11 morning. Now, you say you have a list of people to go. But those folks, when you contact those folks, are they able to then take those people even if our PAD at that point is not an available option? DEPUTY COMMISSIONER ROSARIO: Correct.
So where do those individuals go at that point? DEPUTY COMMISSIONER ROSARIO: As I mentioned, there's a lot of -- Sergeant Hannesson and Lieutenant Pittaoulis and their folks have a list of other providers, mainly the faith-based groups that operate in the area consistently. A lot of times on those nontraditional hours they can be responsive for us. Part of my job when I was took this posting was to be deliberate and collaborative in meeting with a lot of members in our community. And today I'm over 120 individual meetings with members, whether it be individuals, businesses, churches, principals. They wanted to meet, we sat down and talked. So we built relationships that way. There's a lot of individuals that are willing to participate and be a point of contact for us. So we've been able to have those relationships and use those nontraditional connections. And again, that's really -- they're of a last resort so they're used during those nontraditional hours. The mini station when it first started operating in 2021, my dream was it to be days a week, 7 24 hours a day. But because of staffing, we couldn't fulfill that. The best I could give you was 16 hours, 5 days a week. And again, thanks to the Commissioner, he waved his wand and made stuff happen, understanding that in order for us to change, we had to step it up a notch. So we were able to increase our availability seven days a week, three shifts a day our folks are out there trying to answer the needs and be responsive to this community.
Now, I think it's up to us to make sure our availability for these things, not just the unorthodox organizations or the religious organizations or neighborhood organizations are going to take people in but people who actually have contracts from the City of Philadelphia to also be able to be available at those times, because you know when people need help it's just not 9-to-5, right, people need help at all times. And so, maybe that's something we can work on too with DBHIDS and the Health Department and look at ways to how we can make sure that is also available not only for you but also for our other providers and people who are trying to get help on their own, and that's a very important process. And we do appreciate those neighborhood connections and places just like this and other folks' places that may be able to take somebody in at o'clock. But as a City-contracted provider, I don't know who we have to do that and maybe that's something we can work on with us and DBHIDS and the Health Department. Thank you.
Thank you. Are there other questions from the -- the Chair recognizes Councilmember Ahmad.
Thank you so much, Deputy Commissioner, for moving testimony to show what your officers face and we appreciate the work that's being done. Quick question about these recent sort of cleaning of the Avenue and people's concern has been people scattering other places. Have you seen any change in the activity from the dealer side after you have made these -- DEPUTY COMMISSIONER ROSARIO: Sure, yeah.
Is that a tangible something? Because when we're asked why are we doing this if we're just scattering people around, to me it seems that we are messaging that we're just not going to do business as usual, you're going to have a presence and this is not going to be a comfortable place to do business. I just wonder if there were actual numbers to back that up to say, yes, you've moved the needle on at least the dealer activity? DEPUTY COMMISSIONER ROSARIO: So numbers?
Meaning, you have -- I don't know how you assess what activity is, how you keep track of it, but whatever metric you have has the needle moved because of your presence in this community? DEPUTY COMMISSIONER ROSARIO: Councilwoman, because of my intimate knowledge with this area I can tell you the 24th District -- so let me give you this perspective. So there are police districts in the city of Philadelphia. Each district has its own challenges, right, West Philly, North Philly, Northeast. And I dare so each of those Captains on average have five, seven, maybe eight different blocks that they have to kind of focus now, right, part of our pinpoint strategy that we utilize to kind of combat crime, they're the drivers for violent crime. The 24th District had about over 200 narcotics corners, right. And they've been dealing with that for the last four or five years. And it seems after COVID and the civil unrest it really exploded. We call Allegheny Avenue from G Street to Jasper the Flea Market, right, because there's just so many different organizations that will go out there and sell. And it's frustrating to me as a police officer, right, to tackle that effectively, so it's hard for me to quantify that for you. I can tell you what we've been doing is exactly what you're saying. We're trying to reset the norms. And to Councilwoman Lozada's point, it's not acceptable in the Northeast, it's not acceptable in South Philly. And I've been reminding my team that it's not acceptable here and we really have to start changing that narrative through enforcement.
No, thank you because we asked early in the morning about what is happening if you're just scattering people from one place to another. But there's a much bigger message out there which you articulated and I believe in saying it is not business as usual. This is not a forgotten corner. We're not just going to put everybody in there and forget about you and I thank you for doing that. One way to measure it would be to look at it as 200 corners were reduced in numbers. That would be one way to assess -- DEPUTY COMMISSIONER ROSARIO: That's part of the analysis that we're in the process of doing.
When we can message that to the community at large, it says that some work is happening. People find it hard to believe that work is happening. And every day your officers are working so hard. It would be good to be able to tell the rest of the city this is what was done, this is what has happened, this is the outcome. It is working at least in this frame. So I thank you for the work and we would like to message out your good work. DEPUTY COMMISSIONER ROSARIO: Thank you. And we're just getting started.
Are there other questions for Deputy Commissioner Rosario? DEPUTY COMMISSIONER ROSARIO: Thank you. It was my pleasure.
I'd like to recognize Controller Christie Brady who has joined us. Thank you so much for being with us this afternoon. (Applause.)
I'd like to just stay on topic with the police and the work that they're doing. I'd like to just ask a question to our friends over at the PAD program. We talked a lot about beds today. We talked a lot about getting people in treatment and some of the challenges that they experience. Can you, along with our friends at Merakey, can you guys talk to us about what some of the challenges are when the PD brings individuals to you that qualify to be a part of PAD and what happens when you make those calls and you can't get them into any type of program? What's the process? There is a perception that officers will bring individuals to your door because they want to avoid being arrested. And then soon as the officers turn their backs, these folks then decide, no, I don't want services, I want to come back out. Tell us about that process of people coming into your doors and what happens. And what are some of the challenges that you experience for those individuals that actually stay and want to see services?
Good afternoon, everyone. My name is Joelle Anderson. I'm an Operations Manager for the Office of Public Safety for the PAD Unit. So some of the challenges that we see in the community is that with the constant change of the drug supply so when a person is going through withdrawal, time is of the essence. We don't have time to wait until the next business day. If a person is ready to get into treatment, we contact Merakey. We let them know of the situation. The police do their thing with them and explain the PAD program, but we probably got about 45 minutes, if that, to get that person to treatment or get that person set up. We also act as the buffer between the community and the police when getting diversions as well. We let them know if you run into any issues along the way, you call me, you call one of my colleagues. They get our information and they keep us updated every step of the way of their process. If something goes wrong when they enter into treatment, they let us know. We intervene and we fill those gaps. Also, when they go over to Merakey, Merakey, they do a quick intake. Like I said, time is of the essence. And then we'll get them off to detox treatment, things of that nature. Also, outside of arrest diversions are our social diversions, where any person in the city of Philadelphia can come up to a police officer or come to us -- I'm stationed out of the 24th, 25th Districts. They can come into the district and not have any police contact as far as getting their record ran and things like that and ask for services. It could be mental health. It could be immigration papers. It could be a mother and children who's experiencing domestic violence, for example, and then we will connect them to one of our five providers, Merakey, Salvation Army, One Day At A Time, ODAAT, Prevention Point. Also, if a person is trying to get out of the Kensington corridor, we have a new site at 16th and Susquehanna, our ODAAT-PAD site, where we have beds available right then and there where they can come. It's a quick intake. We start the process of getting their treatment plan started, whether there's warrants, whatever the case may be. And then they can go ahead take a shower, lay down, sleep it off. And then the next morning the case managers at ODAAT will get the process started. Everything is in realtime. We don't wait. Everything is in realtime. We don't have time to wait and debate and things of that nature. We get it down right then and there. Also, for our social diversions we also have our mobile resource fairs where we're having our next resource fair at Frankford and Cottman tomorrow where we meet the people literally where they're at and all of our providers, the police, the CERT team, the PAD officers, Salvation Army, Merakey, various providers throughout the entire city come and meet the people where they're at and help the people navigate various systems of things that they need.
How many people do you think that you provide services to a day, individual people, unique individual people? How many people do you think that you all provide services to a day?
Per day that definitely varies. I can definitely look into that and get you those numbers. But at our resource fairs, we service -- because everyone signs in, we service no less than 100 people at our resource fairs in a matter of three hours. To date, I can give you some numbers. So to date from the beginning of January until now, we have engaged with 3,935 people. We have linked 1,973 people to services. 209 of those people have been to the CRC. 681 people have been into inpatient. So I did want to answer Councilman Squilla's question when I got to it. 268 people have been connected to IOP, which is ongoing. 227 social diversions and then social services are 588.
And you all as a -- or you or whoever you connected them to, you're able to see how they've continued in their --
Yes, correct. Be it our peer support, our great staff, our great case managers, whether it be Salvation Army, ODAAT, Prevention Point, University of Penn as well, we're able to literally follow them every step of the way, can tap in at any time and ask can I get an update on so-and-so, can I get an update on this person's progress. We also get monthly reports from each provider that give us a detailed breakdown of how many people we serviced in a month. And we also have our data from when we do our mobile resource fairs with the Office of Public Safety.
Thank you. Thank you for coming prepared. (Applause.)
Just to go back on that too, because that's sort of what we were talking about, how many people to what levels of care, right. So how many people went into 3.7 WMs, how many people went into 3.5s, how many people went into 3.1s. You don't have to say that now. But if you can just provide that to the Chair, I think it's important for us to see that, because then also how many people completed then, right. Since you follow them all the way through, how many people stayed the whole 30 days, right, how many people went from a 3.7 to 3.5 and then a 3.1. And then we could then see. Because as you heard from the earlier panels, and I wasn't here but I know some of the programs that they run, as we look through the continuum of care how we're trying to follow folks through that process where we need to improve on, we could then hopefully be able to dictate that by stating where people are falling off, where they're continuing and hopefully that'll help make our decision, help our providers make decisions where do we have to put more resources at.
Understood. And just piggyback off of that, that's where myself, my colleagues, other APMs, James Williams, Noah White, Louis Soto and Kenneth Walker, that's where we come in at. When there are gaps, that's when they contact us and they will let us know like I'm having a problem, it can be any type of situation, but that's where we come in and we help fill those gaps to get that person to the next level and we follow them. It's not just a one-and-done situation. We're not looking at them as just a number, you understand what I'm saying. And to take it a step further, when you look a person in their eyes and you tell them I've been there, that starts to break those walls down and they understand that this person really cares, this person really understands what I'm going through.
So you probably see some areas where people are falling off, right?
So you see that, so that would also be helpful to us and to our providers and people who are helping. So whenever we see a big increase where they get into a certain space and then they either disappear or not doing it, that's where we will need you to hopefully engage additional resources to help that individual.
Yeah. And I'm sorry, just to add on I would say mothers and children, that's another barrier that we -- especially a mother that may be a domestic violence victim and that has multiple children, that's where Salvation Army will come in. But as far as navigating the landscape, trying to get them housed as soon as possible or trying to get them away from -- they're fleeing, they're ready to get out, that is a barrier that we have seen in the past, and that's something that I have spoken with Councilwoman Lozada about in the past, and that's something that we're trying to fill those gaps with as well.
Merakey, would you like to add to what some of the challenges are? You all seem to be able to connect people to the services that others seem to have challenges with. Are there challenges that you all experience when you're connecting people to services? And if you don't experience challenges and you're successful, you're so successful at connecting people to these beds that are apparently a problem, how are you guys able to do so? What are you all doing that's different than other providers to be able to connect people to the services they need?
My name's Natasha Lundy. I am the PAD Director under Merakey. I wouldn't say that we're doing anything different or anything better. It is just networking sometimes. Sometimes when we do have difficulties with beds, it is just a matter of calling our APMs or our City resources to locate these beds. There are often times, as was mentioned before, where the level of care doesn't necessarily match. That is absolutely a thing where we need a 3.5 bed but there's only Level 4s or a 3.7 bed and there's only Level 4s. And I know that that is kind of facility restrictions and things like that. Some people have medical levels. Some people don't. So it really just depends on where exactly we are referring to. Most of my staff is ASAM- certified so when we're doing an assessment, it is an ASAM assessment. We do have those struggles where we call the insurance company, they do want a flip of services or the treatment provider themselves will say, hey, I have a 3.7 bed if CBH will approve it, we got you. But then we got to kind of figure out or send to a CRC --
Or compromise because we don't have availability in the needed area.
That's more like a compromise because we don't have the availability in the assessed area.
Sometimes it is a compromise. Sometimes it's beyond our scope and we do have to refer to a CRC, but we try the best that we can around the systems that are in place right now.
I think part of the conversation that we are going to have to have as a Committee and with our counterparts is how do we change this level structure, right. And going back to the very beginning of this hearing, how do we make a bed a bed in order to respond to the person's need at that moment, right. It doesn't make sense to me and to a lot of other people, right, when you have someone that has been suffering and living in addiction for so many years and finally they are there and they say, I want help now. And we're saying to them, you got to be a Level 4 or you got to be a Level 5. You know, how dare us minimize their need in order to get them into a bed. My question is if this person's level of need is greater than that of the bed that is available once they get into -- okay, so you made the compromise and you got them into that bed, what happens when that person is in that bed and that provider then says, wait a minute, this person's need is greater than what I'm getting paid for?
Then those doctors there would evaluate and call the insurance to make appropriate recommendation.
Have we ever experienced a situation such that the insurance says, you need to get them out of that bed or we can't provide that level of service? What happens in that case?
Not in my experience that has not. Not that I know of at the PAD office that has not occurred. Typically in the few times that it has happened where we had to do a lesser level of care, typically the provider then will call the insurance company and get it flipped up or send them to the hospital, whatever is needed in that moment.
So they are removed from the bed and potentially sent to a hospital where their --
If it's needed. Because some providers don't always have -- not every provider has the exact same level of care. And Eagleville has the level that can handle acute medical care. Kirkbride can't handle that in their facility. They don't have lev -- you know what I mean. It just really depends on the facility that you're referring to what beds are available and what we can actually do to service the participant at that time. Sometimes it is just talking to the intake worker, okay, what can we do. Sometimes it is getting them to a CRC and having the doctor-to-doctor conversation, because that is a thing with the insurance company, which I very much understand with high utilization and AMAs and things like that. That is 1,000 percent a thing where sometimes the insurance company wants to try a lower level of care first like an outpatient methadone opposed to the inpatient, where it does happen. Again, not on us but it does happen. So we just work it the best we can at that point.
I'm looking forward to the day when a bed is a bed. When a bed is a bed and people go into that bed and receive whatever level of care it is that will determine a successful healthy journey of recovery for them. I'm looking forward to that. I'm going to remain optimistic. Thank you so much to PAD and Merakey.
Can I just say one more thing to add to that? I do think a recommendation that would help a lot would be the aftercare process and maybe case management for the shelter system. A lot of times people are discharged with not the supports -- I believe the doctor said it this morning, they don't have the support when they leave rehab. So they can stay at the self-helps and the Kirkbrides for 90 days, but if they don't have anything when they come out, they're right back in the same situation.
Thank you for that. Thank you. Thank you so much for that. Thank you, Merakey. Thank you, PAD. Thank you, Deputy Commissioner. Let us move to the MDO and Office of Homeless Services. Mr. Holloman, would you please state your name for the record and start your testimony.
Good afternoon, everyone, Chair Lozada and members of Council here. First and foremost, I just want to apologize to the community for the trauma that you have been facing for years. I have been doing this work for a while. I've been working with a number of these partners here and have been fortunate of also working in the hospital settings and understand some of the challenges that's there. But again, I understand your frustration. I think it's admirable that you're continuing to beat this drum because change is needed in this community and we're looking forward to being part of that solution to help break down barriers to think about things different. I think one of the things that I heard earlier today is that there isn't one model. I think we need to think about this in many models that bring about different ways of success. Kensington over the last several years, especially in 2018 when we had the heightened of the large encampments under the bridge when we shut down Gurney Street. We saw a difference in the drug supply of the heroin to the tranq to the fentanyl, and those approaches take all different methods. You also have Kensington where not everybody here are Philadelphians. There are people here from surrounding counties because of the drug supply and also some of them may be on private insurances, things that create barriers. So I'm looking forward to talking about what solutions we should be thinking about as a collective community, but again the Office of Homeless Services is here to be partners.
Thank you so much for that. I think one of the questions that I have for you, Dave, is your outreach teams are out there on a regular basis. What's the shift? What are their working hours? When can or when should we be able to see your outreach workers out in the community? And what is their feedback when they are trying to get people into treatment and are told, yes, there's a bed, no, there's a bed, this level bed, that level bed? What do they do then?
Thanks for that question. So we operate the Encampment Resolution Team. The regular homeless outreach teams are through the Department of Behavioral Health Intellectual Disabilities. However, our Encampment Resolution Team works with Sergeant Hannesson and various other teams such as CLIP and I think they do for what they have a pretty good job. They run into challenges too with trying to get people in when there isn't a bed available. I think some of the struggles that they have, especially in the early morning when people -- you hear this term a lot -- people want to get well. So if you don't capitalize on that hour by the time they get up and until the time they get to a bed, that is a problem. Many of the folks that I hear from directly, and I even come out with the team, is that many of the folks don't want to sit for a six- to eight-hour assessment because of the withdrawals that they go through. And so, what we try to do is work with the Merakey team, see where like at Prevention Point where they can do some dosing to give people comfort so they can go into a 2B or a 3C level of care. I think they need more of that. I hear that directly from my team, how do you get people a level of comfortability without having them to go through the act of withdrawal. The best time of the day and our team is out there from 7:00 a.m. to 4:00 p.m. on a daily basis, unless we see a time where there's a spike or we're conducting some type of special operation with law enforcement or during a quality-of-life event where we may say, hey, we're going to double up these shifts there. Right when we did the last encampment resolution on April 4th, prior to that I authorized not only my Encampment Resolution Team but staff from my intake at the shelters to do outreach hours a 4 day in this community. That made a 5 significant imprint on this 6 community. We were able to engage 7 so many people and get people into 8 services during that time. 9 Now, if we had the ability 10 to double up an Encampment 11 Resolution Team because they have 12 the ability to do service day 13 clean-up, they're a little bit 14 more -- in my thing, a little bit 15 more aggressive with trying to 16 engage people to get people in, I think that would be helpful. But again, they come with a different philosophy. They're under the direction of One Day At A Time. So as you heard earlier today, they're already locked into a number of different systems that they're able to get beds and access to.
Can you tell me why there is a difference in assessments? Why do some assessments take 15, 4 minutes or immediate and there are 5 other assessments that take six to 6 eight hours if the service that's 7 needed is exactly the same? 8
Yeah, so it 9 really depends. So a lot of folks 10 in this area go to the CRC. CRC is 11 designed to deal with a multitude 12 of behavioral health challenges, 13 and sometimes it depends on the 14 day. One of the things in my 15 experience for a number of years 16 from the 5th of the month to about 17 the 22nd of the month, most of the 18 people who receive some type of 19 entitlement benefit are out of 20 their money. So you start to get an influx of more people that come into those assessments, and especially CRCs that are coming in to get treatment. And so, when you have people who are struggling with addiction along with behavioral health challenges going to a CRC that may only be equipped to deal with a certain number of foot traffic in there because they're dealing with the traffic the night before, that can create problems. The other thing, if a person has, whether it's CBH, Magellan, Bravo or private payer, those all play a significant factor. One of the things they talked about was what does a person call in, they look at their clinical history, whether they recently had an AMA, were they connected to IOP. Some insurance won't pay for certain levels of care if a person looks to be a frequent flyer that comes out. And then the other problem, we really need to make a dissemination between short-term rehab beds versus long-term and detox beds. There's always -- and I think I can attest to this -- by 11:00 a.m., every day probably by that time most detox beds are completely gone because most people want to get well. There's a disconnect when people talk about the availability of short-term rehab, which is 2B, 3C, 3A and all of those levels up. There's capacity there but most people again can't sit long enough to get that assessment or get well soon enough to get to those beds. And the other challenges there, which I control in my system, shelters save lives but the reality is you need to invest in long-term housing so people can get connected to a well ecosystem to maintain their recovery and sobriety.
Are there any questions from members of the Committee? The Chair recognizes Councilmember Nina Ahmad.
Thank you, Madam Chair. Good afternoon. I want to thank you for your testimony. The overlap of your intake with the CBH intake, are you very distinct or do you hand over work to each other? How does that process work?
So we're very distinct. Shelters are first come, first serve. We have intake and after hours, which our traditional intake hours are 7:00 a.m. to 5:00 p.m. and then after hours kick in. Shelters are designed to assess anyone. They do not provide medical services in there because they don't have that expertise, but we work with DBH, our counterparts. If someone comes in and throughout their assessments and a social worker says, hey, I'm struggling with behavioral health challenges such as substance abuse, we're able to work directly with our partners to them referred to the resources that is available for them.
So is there any hiccups in that process with timing or availability that would be smoother so that folks here specifically in Kensington, should there be like a parallel service at the same time frames because you're probably encountering a lot of people with SUD?
So let me give you a capacity snapshot. The Office of Homeless funds 2,926. A breakdown of that is 1,383 family beds. Of that, 200 DBHIDS beds which are specialized. There's 1453 single beds. On each given day, we have about a 93 percent utilization rate. The average length of time that a person stays in a long-term bed and shelter is about 132 days right now. And so, our beds turn over about four times per year so there's always a need for more.
So that means that overlap could be very useful so your beds can be opened up for people who don't have SUD?
What happens if someone comes in -- and I think you touched on this a little bit. What happens if I am a DV victim but I also suffer from substance abuse disorder and I also have open wounds but I show up at the shelter, at a shelter, right, what happens in that situation? And tell me where your intake, your central intake -- I remember when I did Constituent Services at 1401 Cherry Street. You walked into there, we knew send everybody to 1401, they're going to tell you where to go, right. Does that still exist? Is there a priority if I am a -- if I'm suffering from substance abuse, if I'm a DV victim, if I have all of these wounds, is there a priority to get me -- and I'm walking into the shelter which means I'm saying, hello, I need help and I want it now and I have all of these other existing issues that I'm bringing with me, is there a prioritized list that this individual goes to?
Yeah. So all of our intake sites anyone can go, whatever agenda that you identify with. One of the things we try to do is have people access. In that situation that you just described, the first thing that intake is going to do is do what they call an assessment of that person. Is their substance abuse right now and the medical needs are more prevalent than the DV. DV shelters are set up to be specialized. There's legality issues there. There's survivor's things there. There are certain requirements that only allows you to place someone in a DV shelter. In that situation there if I was someone was doing the intake, the first thing that I'm probably going to address, more likely going to address is that substance abuse issue. The reason why I want to do that is I want to try to get you stabilized in a hospital setting or a recovery-based setting and then address that DV issue because now I have other clinical support that's surrounded around you. The reason why you probably will not automatically put that person in a DV shelter -- I'm almost 100 percent sure on this -- is, one, there's state law that prohibits without that legality issue that's at play of placing someone there because you have to keep in mind there may be other people's lives at risk and someone who's not ready or potentially would stay there could also jeopardize others who are in a domestic violence situation. But the first thing a person should do or any social worker or intake worker should be assessing that from a pyramid-based model on what is the most pressing need first and try to get the referral. That's why early on I always state that we have to do better assessments of people and try to get them stabilized. The key is not to -- you want to help them right in that moment, but you want to set them up for success and put them on the right track. And so, that assessment is so critical and what's available to them. And part of this is about, you hear that term networking and communicating with different partners, that is so critical. We have all housing case managers in our shelters. Some of them have behavioral health case managers in there. If they're coming during the traditional hours, we should be able to connect that person right away to the necessary resources that they should have. And after hours is a little bit different because you're just trying to get that person off the street in that moment to save their lives.
You're under the umbrella of government, right. DBHIDS is under the umbrella of government. CBH is under the umbrella of government. Police is under the umbrella of government. Do you all share with each other what beds you all have available? Is there a transparent process for that and do you communicate with one another when this person is looking for a bed? And I'm not talking about a coded bed. I'm just talking about a bed. Do you all communicate with each other to say, hey, tonight I have beds and Sergeant Hannesson 13 or any of your officers 2 o'clock 14 in the morning come across someone 15 that is ready to get into a bed, 16 this is where you can go? 17
We can do a 18 lot better in terms of 19 communicating on that. I think we 20 communicate, but it doesn't -- in 21 my opinion, I think that area can 22 be actually much better on how we 23 do that, especially with all the 24 partners that are in that system 25 there.
And would you benefit from what we've talked about earlier which is a dashboard that would be accessible to everyone --
All right. Thank you so much for your testimony. The Chair recognizes Councilmember Squilla.
Thank you. And thank you, Dave, always for your responses too. I know we are constantly working with your office on issues and concerns, and your whole team has been very responsive and it's a challenging job. But as we heard, I think the goal through this whole thing is stop working in silos. Like everybody was doing good work on their own, and we're not picking on any providers or anything, but we weren't coordinating efforts and collaborating with each other. Do you think -- as far as with your encampment resolutions and working with folks, do you think that there is a model that we could change or a policy that we could change that would make it better to coordinate with other providers to be able to help the people who you engage to get them into services that are needed, without getting in trouble?
This is Dave speaking. I do think in this neighborhood here we should create a pilot. One of the things I heard about earlier and hopefully that my colleagues from Project HOME talk about, so when we did an encampment resolution April 4th, we know that there are people that were going to scatter to other different neighborhoods and blocks. I think police can probably share this. I think PAD can probably share this. We should know where there are spikes at. One of the things that we have in this community here and I give credit to the Administration trying to build this wellness ecosystem, but we have a PAD site here now. We have a number of different wound care vans that are in this area that have the ability to do MAT, suboxone, buprenorphine, again the goal here is to make people comfortable to get them to that bed. We should be thinking about how do we look at maybe a four or five block radius, use the PAD site, use one of these wound care vans that are in this area, maybe stick them there. You have clinicians there. You have doctors that are there. Let's look at for the next three months and say, okay, instead of having an officer, two officers because there's two officers that come off street and go to the CRC, they're in there for about eight hours. How about us go to the PAD site, dose someone there while they're doing the ASAM and try and get them into a bed, that's much quicker. By the time you go to the CRC, again keep in mind you're dealing with everything. And that time to get to the CRC is about eight hours. But we have resources and we know if I walk out of this corner here and ride down there, there's probably 50 people around the corner or 60 people on these small blocks. We should literally target maybe four or five blocks here and do something unique. Take one of those wound care vans. We have the best institutions around, Penn, Jefferson who testified earlier here tody. See if they will be willing to dose much quicker at a PAD site. This way it makes it much easier for when they're calling around and saying, hey, do you have a 3.5 bed. I already made this person comfortable to come in. This way if they need to get stepped up to a higher level from a 3.5 to a 4.0, now they're under the care under medical eyes so they can monitor those vitals, withdrawal symptoms. But they're in a medical institution. But the key there is that they're reducing their anxiety away in a CRC or in an assessment site for eight hours. That's Dave speaking. Again, I don't know if that would work, but I think we should try different models. Models are made to be shaped, rebroken. So what if we fail. If we have two persons, we learned something from that.
I think one thing we learned, what we were doing wasn't working so I think new ideas, if it doesn't work, it's not a problem. But I do think that the idea of combining those resources to help make those folks that are suffering through that phase of where they are able to then get the treatment instead of losing them at that time when it's taking too long to get them where they need to be and then make sure those beds are also available so they can get transported to them or whatever assessment, level of care is required.
And I'm not putting that all on the treatment system. If we create a model like that, I'm willing to move some of our intake workers, some of our teams there because somebody may not want that level of care. They just need a bed, long-term bed from a shelter standpoint. We're willing again to bring resources to the staff to move staff there so it will be a whole well ecosystem of not just DBH but it will be OHS, the Health Department should be there, a combination of the different agencies.
Thank you so much. That makes a lot of sense, and sometimes we struggle with basic commonsense things in order to improve quality of life. And so, I'm hopeful that our government is going to move towards some commonsense practices. The only question that I have for Noelle because I know that you've managed some of the opioid settlement dollars, and earlier we mentioned just the need to be able to pay for some of these commonsense practices, right. How do we ensure that some of those opioid settlement dollars that are coming into our city are used very specifically to address some of the changes that we need to make within this community to be able improve quality of life? What are some of the challenges that you see and what prevents us from being able to use funds for things like a dashboard or for us to be able to work with providers who are doing that great work but are very small and very grassroots? What is preventing us from allocating those dollars to them?
Everybody, good afternoon. Noelle Foizen, Director of the First Response Unit. So thank you so much for that question. So up until this point we have received $33 million from the National Distributor settlement. We're going to receive an additional million in the 9 fall and that's a separate 10 settlement. That's a Walgreens 11 settlement. 12 The difference between the 13 two settlements is that the 14 National Distributor settlement has 15 allowable uses. And so, you 16 actually find them online but it's 17 a list of bucketed items of things 18 that we can use our dollars on. 19 The Walgreens settlement has no 20 allowable uses tied to it so we can put that towards anything that we think will help with the fight in the city of Philadelphia. Up to this point, of the 33 million we have received 14 million of supported treatment and recovery-focused housing. 8 million of that has gone towards the Office of Homeless Services to support recovery-focused housing. The additional 4 million, they're just receiving that so that has not been spent yet. And 6 million has gone towards increasing access to treatment. And so, a portion of that 6 million has been supporting the Kensington wound care van that DBHIDS spoke to, increasing the bup dosage at the prison and also launching oral methadone. You asked -- there's really not much that's stopping us from doing additional things with the money. It's just a finite amount of dollars so up until this point we've tried to prioritize funding towards treatment but also spending towards prevention and trying to make sure that we're trying to avoid additional people using drugs and trying to save lives and reduce overdoses as well. There's definitely the possibility that moving forward we can reprioritize, especially with as we're looking at our practices and doing evaluations and figuring out what's effective and what's not, there's always the opportunity to fund additional programs moving forward. One thing I did want to share with this group just because it's something that our team has been speaking about a lot with Deputy Commissioner Rosario and Chief Public Safety Director Geer has been up until this point all the teams are doing everything they can with the resources that they have, but it does feel like a little bit like a one-size-fit-all model and we're not resourced appropriately to have a more nuanced approached. But something that might be more effective is thinking about if we have an individual that has only been in Kensington for two weeks, that's a different situation than someone that's been there for two years, right. So trying to figure out what are the different populations within that subgroup of individuals that are unsheltered here and what are the different intervention strategies. And that's something DC Rosario and Director Geer have been very interested in learning more about.
Thank you so much for that. I think that part of what we want to start talking about is how do we use some of those funds that we can use for things that are going to help providers that are going to help those who are doing the very necessary work to be able to respond to the crisis that is happening in Kensington, right. And so, we are going to probably call on you to help us figure out what is the path forward, how do we take some of the ideas that we have discussed here today, which I think have been some really good ones, right, how do we move them forward. When we came here a year ago, some community residents spoke about some very low-hanging fruit. And I think that some of the things we heard today I think are very easy for us to be able to put in place, but of course it is going to depend on some money, right. And while that's frustrating that we don't do certain things because we say we can't find the money. We know that there's money available that the City received as a result of what the City allowed to happen here, right. And so, we should be able to use that money to be able to respond and fix what we have caused. And so, this Committee will be calling on you and on members of your team to be able to help us move some of these ideas forward with that pot of money that is flexible. Are there any other questions for anyone on this panel from any of the members of the Committee?
Just real quick because we did get notice that there was rejection to some of the opioid dollars that were spent. What happens in that case?
So the Law Department and the Administration is looking at our options. But there's an appeal process that the Trust has in place.
I have to follow up with the Mayor's Office on that, but yeah.
Thank you. Thank you to all of you for your testimony today. Thank you for joining us. We will be reaching out probably to each one of you at some point. Thank you. Will the Clerk please call the names of the next panel.
Thank you for being with us today. Please state your name for the record and begin your testimony. I ask you to speak right directly into the microphone because we want to be able to hear all the great things you have to say.
Thank you for being with us today. Please begin your testimony.
I do just want to note for the record my full testimony is on file and documented. I'm going to focus a little bit more on some of the topics that we've been talking about today in order to kind of get straight to the point and deal with some of the issues that have come up. Gaudenzia, for those of you who don't know, was founded in 1968. Over the last 56 years our agency has continually evolved adapting its capacity, reach and treatment model to meet the growing needs of our clients. Today we are the Commonwealth's largest nonprofit provider of evidence-based treatment for substance use and co-occurring disorders offering a full continuum of care that includes residential, outreach treatment, medication-assisted treatment and an expansive array of emergency, transitional and permanent supportive housing programs in this area through contracts and partnerships in the city of Philadelphia and the Commonwealth of Pennsylvania. Recognizing there's no 20 one-size-fit-all approach to treatment and recovery, Gaudenzia offers specialized programs to meet the needs of a diverse range of client population, including pregnant and parenting women with their children and re-entry populations as well. Gaudenzia admitted a total of 2,773 clients to programs for treatment and mental health housing programs in Philadelphia alone throughout the 2024 fiscal year, with an additional 2,196 admitted to our emergency housing program and 151 households served in transitional and permanent- supportive housing programs. While the need for low-barrier, evidence-based treatment like that which Gaudenzia offers has never been greater, our treatment programs consistently operate below their average capacity. In 2024 fiscal year, Gaudenzia Philadelphia-based treatment program saw a daily average utilization rate of just 72 percent of our total bed availability. This trend in underutilization is not unique to Gaudenzia. People need more time to recover and authorizations in order to get that time. With those grappling with homeless and behavioral health needs, Gaudenzia is prepared to provide crucial alternatives to incarceration that foster readiness and acceptance of treatment over time. From a provider's standpoint, organizations like Gaudenzia and many of our partners and other providers in the area need an increased ability to engage clients in care as quickly as possible with reduced administrative burden on program staff and greater emphasis on swift, direct care at the front end of the treatment continuum. A time when a client's decision to enter and remain in treatment is often own at its most fragile point. We must continue to work in this direction to streamline an effective low-barrier continuum with reduced wait times and immediate access to life-saving medications like buprenorphine, naltrexone, methadone and naloxone. Internally Gaudenzia has addressed many of these barriers with a 24/7 treatment and referral helpline which assists callers with screening, referrals, insurance authorizations and securing transportation to treatment, but we recognize these barriers may exist for other treatment providers throughout the City. Our agency also recognizes an opportunity for streamline coordination between referral sources, agents of the City and treatment providers by creating a centralized online tool reflecting realtime accurate data on available services and provider capacity throughout the Greater Philadelphia region. In closing, I will say this: We here at Gaudenzia have beds. Providers have beds. We also have a 24/7/365-day-a-year helpline that we can admit a patient to at any point immediately. What we need is communication on availability, faster access to care, decreased administration burden, approval for both the initial authorization and ongoing authorizations of continuing care and support for long-term full continuum care of services if we actually want to make a meaningful change. This is not a one-and-done, fix it and move on.
We have to invest in long-term care in order to make some changes. I'll turn it over to you. So we are here in the streets of Kensington. You're here every week at this point?
So firsthand trying to work with individuals, one of the things that came up was the PAD program, which is an amazing program and Warren attends their weekly meetings there. But as we are not one of the providers, that availability for the immediate call, we need someone, we need a bed is not there. I was able to connect today actually with someone who -- specifically to women and children. We have a center right around the corner here on Tioga where we can take women immediately. We have availability up to three children. And they didn't know we were there because we're not in that initial five. And so, the communication and coordination needs to be available to everyone so that everyone can understand if we're not that initial network, that doesn't mean that other providers aren't available. So the discrepancy between the availability of beds versus do we know who to call when is the problem.
We are a provider for CBH. We are contracted. We are not a member of the five identified facilities (inaudible) but we participate. We go to the meetings and offer services.
How many beds do you all have access to on a daily basis?
Just in Philadelphia, I have 223 beds in Philadelphia. That does not include our long-term housing, which I believe we have another couple of hundred.
We are operating over the entire last fiscal year at about 72 percent occupancy. So my actual occupancy for my Philadelphia programs was 159.51 and total past days, 223. And we offer all levels of care.
And how often do you all communicate or do you communicate with the outreach workers, the people on the ground to say, hey, Gaudenzia is here, we have capacity, we're ready right now to take in anybody, here's my contact information, I'm up the street or around the corner? How often do you do that and how is the response?
The vacant bed list is sent out to the provider CBH, DBHIDS Monday through Friday. That's sent out every day, how many beds we have in the Philadelphia area. And in our programs in West Chester, Lower Bucks, that's sent out daily. If I may, I was a Division Director, the Director at Gaudenzia. I retired in 2021. In my heart because I've been in Kensington, I used to shoot drugs in Kensington. I've been out of Kensington for 28 years. I worked with Gaudenzia since 2004. I'm retired. I probably should be home taking a nap right now and my wife thinks I'm crazy, but it's in my heart. 7 medically-monitored program. I think the funding may be the issue and we heard that a little earlier. We initially started coming into Kensington when Jose Benitez was at Prevention Point. He invited us down here and we came down. We did a presentation to all the staff, and I was given a cubicle at Prevention Point to come down here every Tuesday. So I come down on Tuesday at the PAD meeting. Everyone knows about the services we have. I talk about the bed situation we have on Tuesdays and I'm available at Prevention Point for any referrals that may come through Prevention Point, Merakey, you name it, whoever's at the PAD meeting. That's why I'm scratching my head. There's beds available. Deja and I were talk -- beds are available. I think the funding may be the issue. And the other issue is I think we need to make it more inviting for people to come into treatment, because I mean sometimes people don't want to come into treatment. That's the bottom line. If everybody out there wanted to come into treatment, we wouldn't have no beds. I think we need to figure out, and Deja and I were talking about, how can we make it more inviting. One of the things that we started doing was, and because I'm in a kind of unique way, I can call Division Director down 1306. I know how many beds -- because beds fill and people leave and come and go as we're speaking now. I can call down there -- if somebody wants to go into treatment, I send them down there. We have a 24-hour helpline. And again, the number is 484-938-1881 where we can get a person into treatment within one hour. We can do the assessment -- the screening, assessment and we can have them placed within an hour. We even will send Uber to pick them up. The key is getting them there. We can't wait. We don't wait. If somebody wants to go to treatment, I send them down 13th and Spring Garden. And like you said, a bed is a bed. And I mean I might get fired, but I know how we used to do it. 7 bed or back then it was called something -- we were using a PCPC. If we had a bed in detox and no more beds in our inpatient program, we would put them in that bed overnight and work out all that other stuff tomorrow. I mean it's that simple. And right now again, I just send them on down, let them do all the clinical -- I mean, we have to get paid. I mean, that's a reality. But I think there has been situations where I think all organizations have to have some type of we used to call it scholarship. Even if a person doesn't have funding, we have relationships with BHSI, Single County authority in Philadelphia. We have relationships with all the other counties' Single County Authority. BHSI will pay for a person if they live in Cleveland and they're caught up in Kensington using opioids, they will fund them, they will fund them. I mean, we have connections where we call and say this is the deal, can you help us and it works out. Again, I'm not saying we're perfect, but I think that -- the folks that we work with that are in Kensington -- and the other piece is it ain't just Kensington now. I live in South Philly. Broad and Snyder is a little Kensington. 60th and Market, West Philly, Lancaster Avenue, they're all little Kensingtons. My thing is -- I was riding down Point Breeze -- I like to tell stories and I know we got to go. Deja got to leave.
I'm riding down Point Breeze Saturday, and I thank God for Carlos at Prevention Point. I got a case of Narcan in the trunk of my car. I'm going to a meeting and it's a guy underneath the water plug and I'm thinking they getting ready to drown him, he's out, he overdosed. And I said, let me stop. Gave them the Narcan. They gave him one shot and he came back. This is more than money. This is more than -- to me as far as I'm concerned this is about helping folks. I wouldn't be working for Gaudenzia if it wasn't an organization that I thought that was here to help folks. I left Gaudenzia once and went to a for-profit and it was about money with them and I came back to Gaudenzia. I don't know how much more we can say except that we have beds and if you need people to come into treatment, we can get them in. And this is the big boss.
I think just to sum it up, it's about communication and figuring out those people who are out there every day on the street, they don't want to call places and be 6 shuffled around. When they have 7 someone in front of them, they need 8 some sort of database, some sort of 9 phone number to say I don't care, 10 I know I have someone in front of me that I need to get somewhere, you all figure it out. And right now we don't have a coordinated way of doing that. We have a few -- we have a couple this and a couple that, but it's really not coordinated. So when these are full, who's next in line and it has to be minutes. It can't be hours. It cannot take three hours to figure out who has a bed because that individual is back on the street. They are not coming with you.
And everybody has to see the same information. Everybody has to see it realtime.
And I think that's what we're working towards. We're working towards eliminating the barriers to get into these beds, the codes that dictate when a person can get into what bed, and we are working towards a dashboard or realtime location where anyone, a provider, an outreach worker, an elected, a family member can go into and say, where can I take my loved one who has called me to say they're ready right now and get them there. And regardless of what type of bed it is, you get them into that bed, stabilize them and then move them into the more appropriate space, if necessary. That makes a lot of sense to us. And as I mentioned earlier, sometimes the commonsense things are the most difficult to get to, right, but we're committed to that right now. I think that it is important because as I mentioned earlier, we have a crisis here that we are going to respond to and we have to do things differently. And so, I would appreciate if you leave your information with my team. We get called often too. People communicate with me on social media to say, Councilwoman, I'm ready now, I don't know where to go. Councilwoman, there are people that are living on my sidewalk because they were moved from a different place, and I've had a conversation with them and they are ready now, where do I send them, who do I call. I think part of the challenges that we experience and as a community and as electeds is that during that time frame of 10:00 p.m. to 5:00 a.m., there's really no one we can call, there's really nowhere we can go, there's nowhere we can send them --
And there is, right. But what we're hearing today is that there is a disconnect of there's a lack of communication --
-- which proves to us that what we've been saying for a long time is right, we're on the path to listening to ourselves and community residents who have said we need a one-stop shop where everyone can see what is available and where it is available at, and people should be able to hold that bed with a touch of a button and advise your organization that John Smith is on his way --
-- or we should be able to reserve that bed and an outreach worker should be able to say, I'm on my way with John Smith, right, and that bed should come out of that pool of availability because we do that for a lot of other social desires. And so, we're going to figure this out. Thank you so much for your testimony.
Are there questions from members of my Committee? The Chair recognizes Councilmember Harrity.
Yeah. I mean, thank you for your work. I'm familiar with Gaudenzia. You guys have been around for a long time. How long have you actually been in this area? I know it's been a long time.
Yeah, Philadelphia and actually Kensington you created a few years --
It just seems ridiculous. Sometimes we get something, an interaction that somebody had with one of those organizations. Most of the time they're telling us that there was no availability of a bed. So if there's only five that they're going through and we know that those five are always filled up, I think we need to add six, seven, eight, nine or ten to that list.
And I think initially when the -- I actually brought a friend of mine, he used to be the Trial Commissioner, Keith Smith. He helped develop the PAD program. I brought him down and he was like, well, I helped to write the grant for it. I think that those five agencies were in the initial grant and that's why you have five agencies. Folks know about Gaudenzia. I'm at the PAD meeting, again a couple of -- I mean, your dashboard will be great, again, a 24-hour, 7-day-a-week dashboard. One of the things, Tuesday I'm going to drop off stacks of our business cards that has the helpline on it, the 24-hour -- that way the police department, if they need more, we can get them more and just drop them off at the police district. That way their officers can just pass them out, because we know about the 75 new police officers that were hired.
So you got 28 percent availability. So what you're saying --
-- you're not looking at their numbers. You're saying if there's a detox bed open and you can get somebody in it for a day or so until you figure out where the new bed is available, let's stick them in there. That's the kind of people I want to deal with, people that say, hey, this is what's got to be done, this is what we're going to do no matter what the ups and downs of it is, no matter what the cost of it is, no matter if we're going to lose a couple of dollars for a day or two --
-- or not. That's the kind of provider we're talking about.
How often do you all respond to individuals who come into your system that are from another county, another state, another country? And how hard is it for you to relocate them? Do you relocate them or do you use the services, the resources that we have here? I ask that question because we are always in contact with individuals who come from other counties. Just the other day I was contacted by someone who was looking for someone from Italy, who found themselves here thanks to the exploitation of many who think that it's okay to display what is happening here and then attract others to want to come, touch and feel what is here. So this individual, part of his story is he doesn't want to go back home, right. He doesn't want to be relocated. My issue is that that shouldn't be a choice, right. You come here, you have occupied this space in this community for long enough. You don't belong here. You don't have anybody here, so you're depleting our resources. And we experience that often. Maybe not as drastic as another country, but from the other counties, right. So how do we work with you all as service providers to say, we brought you into this bed because you were ready, we responded to your crisis situation, you're stable and your entire circle of friends and family and your origins come from another county, how do we do a warm handoff or do you do a warm handoff to that county so that that individual can be connected to their loved one so they can become a part of their journey?
Great question. There's a couple of caveats on that one. So I will go into it a little bit. We do have the benefit of being a larger organization, so we do cover most counties in the state of Pennsylvania, all the way up to Erie and then to our neighboring states as well, so Maryland, D.C., Delaware. So we do have that ability to have coordinated care, to work with them publicly to say what does the best path forward look like for you. There are a lot of individuals here specifically in Kensington that are not from Kensington.
There a lot of individuals here that are not from Kensington. This is their home right now. What is best for them, it's case-by-case. But typically an individual who is afforded time to heal, time to recover, to build their lives, to go back to school, that ability to reintegrate and become a force in society, one, it means time but typically it means a different location, not always, but sometimes it's helpful to get away. You mentioned people, places and things. If you got out there on that street, some of them are used to a cycle. They're used to, okay, I'm going to go in here, I'm going to get my medication because I don't have my $20 to hold off withdrawal, but they're going to kick me out after a couple of days because I won't have courage and I'll just go right back to the street, so they know that. So to get serious with the people that are out there, we need to actually get serious and we need to say, we're going to give you care, we're going to give you an opportunity. Day one, that's not their mindset, but over time people will heal. Their minds will clear. They will be able to say, hey, I'm being afforded an opportunity, what's the best path forward for my future and my life, and that's where we see success. But when we stick to these regimented you have 3 days for this, 15 days for this level and then you're going to have to figure out where to live because you know they don't have anywhere to live and nobody's planning for that. So unless we think about that as the issue, we're not going to get anywhere. But if all we need to do is think about that full continuum as the issue, we're going to make a lot of headway.
And if folks, and if I can add this again, if they're in Kensington and they have no 9 insurance, they may be from Camden or whatever, the Single County Authority will pick them up --
There are funds available for someone who is here who has nothing. We will figure it out. There are other providers who can do the exact same thing. They can figure it out and access the resources. No funding is not an excuse not to get care because we can help to get funding.
Thank you. Are there additional questions from members of the Committee? Thank you so much for being with us today.
I have a quick question. How do you measure success for the industry?
The industry is interesting, but we do have a very robust research department that is tracking our outcomes. So they're tracking -- there's different measures of success is the answer. Is success abstinence? Well, not if they're still homeless living on the street and unhealthy, but they may be abstinent from drugs, but is that success? What does that look like. So we measure multiple layers of success so that it is not a very easy, yes, you're successful or, no, you're not. But if you measure just abstinence, I can get that number for you.
Well, we're looking to see if all this work to see is there a population of people who are self-medicating because of all this. Is it sustained in recovery and are you seeing a reduction of people who are needing services that --
Unfortunately, no, there's not a reduction in utilization. That's why we continue to have -- that's a much bigger conversation which I'm happy to have offline, but --
Ultimately, we would not be here if we didn't think that we were helping contribute to the solution.
A lot of people think it's summertime, people don't go into treatment. I've seen summers where a lot of people are in treatment. It's just -- to me if they show up, they want to come, that's success because at least they have a little bit of what we are offering and they know where they can come and get help. We have packages for you too and I also dropped a couple cards off with your staff back there.
Leave them with my staff on the side there. Thank you so much. Thank you for your testimony today.
Will the Clerk please call the next panel to testify.
Yes, Madam Chair. The next panel is Eric Gremminger and Sarah Deutchman. And following Mr. Gremminger's opening testimony, there will be a short presentation.
Thank you for being with us today. Please state your name for the record and begin your testimony.
Thank you, Chairperson Lozada and the Committee, for the opportunity to testify today. My name is Eric Gremminger. I am the CEO and co-founder of ERPHealth, a Philadelphia-based digital behavioral health community. I'm also a certified drug and alcohol counselor. I have with me Sarah Deutchman, Chief Operating Officer for Pyramid Healthcare, who will speak on behalf of Pyramid's work n the Kensington community, their use of our technology and their commitment to enhancing bed availability in Philadelphia. We were contracted by Chairperson Lozada to establish a bed management solution that would display realtime information on what beds are available to those in the Kensington area seeking help for substance use disorders and mental health condition. There is a tremendous need for this, because when an individual reaches out for help, they're often at a critical point in their addiction journey. This moment of readiness to change should be capitalized on immediately as the window of willingness may close quickly. This isn't possible if bed availability isn't visible and accurate. I commend Chairperson Lozada and the Committee for recognizing the value of realtime bed visibility. To a person in their darkest days of addiction, a bed represents a chance at a new life. It represents potentially freedom from active addiction. It represents hope. I know firsthand the value of it. In addition to being a clinician, I'm also a person in long-term recovery from substance abuse disorder. For many years I was stuck in the vicious cycle of addiction, and I wouldn't be here today if it weren't for family, friends and a community that believed in me when I couldn't believe in myself and made available resources that were personalized to meet my specific needs. While access to beds is a necessary first step, it's not sufficient on its own. To have lasting change is critical that when possible we're matching individuals to personalized culturally appropriate care. In other words, we have to get the right people in the right beds for them. While in the past this was difficult, advances in technology have made it possible to prioritize both access and ensure personalized high quality care at the same time. I've seen this firsthand in treatment centers like Pyramid Healthcare who are being transparent with their outcomes in using data to individualize the experience for people based on their specific diagnostic type, gender, age and cultural background. I recommend that in addition to offering access to beds, that a measurement-based care process is implemented right from the start. There are three immediate benefits to providers that are measuring outcomes of care. Number one, it improves the engagement of the person in care because treatment plans are being purpose-filled based on their specific needs. It also gives them an understanding that they have to have an active role in treatment if it's going to be successful. Clinically speaking we call that personal agency, so when they (inaudible) the personal agency. Number two, it provides the treatment center with realtime updates. So the clinicians can modify the treatment plan as the person is progressing throughout care. So they can see what's working and what's not working and iterate as necessary. And number three, the identified population health data can be shared with this Committee to inform future prioritization and resource allocation. I'm a passionate advocate for outcome- focused care because I've seen the impact that it can have in our community. So my company specializes in measuring outcomes in addiction treatment in mental health facilities around the nation. We had a third-party data scientist come in recently, and they reviewed a sample of 50,000 completed PHQ-9, GAD-7 and substance use skill, so they validated assessments.
They found that providers who are supported by our platform reduced depression in their patients by 32 percent, reduced anxiety in their patients by 30 percent and reduced craving for primary drug of choice by 40 percent. Individual providers like Pyramid Healthcare are using our tool to improve the quality of their care and can be a referral source for individuals seeking care while ensuring that they're getting a personalized experience. The technology is also able to connect individuals to outreach specialists, harm reduction experts and other key stakeholders pre and post-treatment, ensuring a collaborative care experience by including local resources that have existed for many years in the Kensington area and are uniquely qualified to work with this population. Improving the quality of care will also create bed availability by reducing recidivism rates. The National Institute on Drug Abuse use or NIDA estimates that relapse rates for addiction are between 40 to 60 percent. While there are many factors that can lead to a relapse, it's a very complex condition. I believe that nonpersonalized care and lack of outcome tracking by treatment centers are major contributors to treatment failures. By measuring and improving outcomes, we can reduce recidivism and create bed availability. Here's an example using simple math. If there are 1,000 beds occupied in the Philadelphia area and 500 of those beds are recidivism so people who've been to treatment multiple times to no 14 effect, by improving the quality of care and reducing the recidivism beds by just 10 percent, it's achievable. By just 10 percent, that will free up 50 beds for individuals seeking care. That's 50 more people off the streets of Kensington. 50 more people who have a chance to have freedom from addiction. This is not a quick fix, but a long-term innovative solution to a problem that's been addressed the same way for years. People want to know what's going to be different this time. I live five minutes from here with my wife and our six-month-old son. We've lived in this area for years. We love 8 the neighborhood. I plan to raise 9 my son in the area. 10 And I truly believe that 11 there will be a time when I can tell my son about how Kensington once was and how it's improved so much, and I truly believe that this starts with this Committee but also with thinking differently about this issue and coming up with innovative solutions. Thank you again, Chairperson Lozada and the Committee, for allowing me to testify today. I have a short presentation and then I look forward to answering questions. I'm happy to take questions while we wait for the presentation.
So thank you so much for being with us today. Thank you for the time that you've invested in listening to my frustrations, listening to some of the challenges that the community has expressed, and thank you for the work that you all have put into creating a dashboard, the dashboard that we've heard so much about, the need for a dashboard, the need for a one-place space where everyone can go to, to find the beds that are necessary to put people on the path to a successful helpful journey. The presentation is up. And so, we'll go to your presentation and then we'll come back to questions.
Excellent. So just starting on the left here, an individual. We heard a lot of testimony today about how we have community outreach on the street. We also have individuals from Pyramid Healthcare that can help with this. But we found somebody in need, the community outreach specialist, we asked them a series of questions just to see are they willing to accept treatment. If not, that gets documented as a refusal and goes to this dashboard. Do they need medical care, are there wounds that need to be healed up before they go to treatment. If that's the case, button's hit and we can triage and identify available beds that can do that. And this third category here, treatment. So once we are able to identify that it's not Category or 2, we can put them directly into touch with -- and I'll let Sarah speak to Pyramid Healthcare's role in this -- with a specialist at Pyramid Healthcare or whoever's participating in this process so they can do an ASAM and determine the best level of care for this individual. The beauty of the entire process is we're able to aggregate all of that information in realtime and provide it to this Committee and any other stakeholders who are participating, so we can see realtime bed updates. Next slide please. So we can see realtime bed visibility. And we can also see just down below the quality of care that's being offered. A great point was made early on, well, what determines if a provider is good enough even participating, isn't there some sort of criteria or benchmark. Right now there's not because we really don't have a way to gauge their clinical performance so we're strictly looking at claims or re-admits. There's a lot of variables other than that that we should be looking at that. So we make that visible as well. I think it's important to talk about, but I know priority right now is this realtime bed visibility. We are the aggregate, and we talked about a lot of silos that are working on this. I say pencils down, stop working on it, we have the solution. Let's bring everybody together and work off of this infrastructure that's in existence right now that's across the country. This is what we specialize in. This is what we do. And then the last slide is just a clearer view of this bed availability. Time-stamped and available for you all and every other stakeholder. I'm happy to take questions.
Thank you. Thank you for this. Can you tell me is this used somewhere? Is this currently being used somewhere and what has been the outcome? How successful have they've been using this?
Well, I shared the statistics with the third-party data scientists as it relates to reduction and symptoms, which is the primary use. So what we do as a technology company, we work with providers, payers, whatever government agencies and when we sit down and we say, what's the goal here, what do you like to accomplish, and then we build out that process. So we have the realtime -- the realtime bed visibility we would build in. The infrastructure's being used by thousands of patients daily, so the capabilities are there. This right here will be built out specifically for this community.
Thank you. Thank you so much for putting your thoughts in a graph and diagram. We just heard from a provider before you and when I asked them about how do we assess, there was not a good answer, right. And maybe there's different levels of assessment. How do you build in your model here what are you assessing? Are there different types of assessments or is there one kind of method we can use by saying, for example, here in Kensington if we were to see over time starting today in another year what has the change been in say, here's one of the characteristics that people in active use, right. Can we from this data just you pull out and say, we can look at this measure, this measure and be able to assess the health of Kensington?
I will answer it from a functionality perspective and perhaps Sarah can answer it from intaking somebody and what they would look at. So from a functionality perspective, we're able to customize the assessments. So I had mentioned GAD-7 PHQ-9 standards, psychometrically validated screener for depression. Well, we would also want to look at other probably very specific things that need to be addressed in the Kensington area, so we would build out that assessment with the specific data points that you all would want to see along with I would imagine the treatment providers and then we would have the ability to instantly select a time range, hit enter and have that information available to you.
One of the caveats in doing this is the quality of data and biases built into who's uploading the data, right. So I just hope that all our systems have that caveat built in so we can control for that. I mean, data is data. You can slice it and dice it any which way you want to see it, so there's an issue with that as well. So while we applaud this way of being able to visualize and seeing realtime, I just want to know that there are built-in protections to catching these things in terms of particular interested bias built into the data uploader who is doing that information.
I think I can maybe shed some light on that. So the clinical assessment tools are self-directed by the individual participating in treatment, so it's a little unlike an individual counseling session where there's collaborative notetaking where a client is responding and I'm documenting that response. So as the clients are completing these assessments individually, the data tends to be less bias for that reason. But at Pyramid Healthcare we have hundreds of thousands of other clinical assessment measures that we've accumulated. We've been in one common electronic health record for years and years and years. We have tons of data. But this visual, the ease of use and the ease of client interaction is something that we haven't experienced until we started working with ERP team. So I'll call that out as a differentiator as well, the ease of use, the visuals, the realtime access to data, the sophistication of the tool, the way that we can customize the data sets that we want to see on a level that we haven't experienced with our electronic health record.
And how user-friendly is it in terms of we have resistance as you've probably heard all through the day of everybody doing their own thing, and everyone thinks they're great in what they're doing but there's no way we can measure it if stacked up against each other. So how is it adaptable? Is it a service you sell and we go into the company where the place is and you manage that space or do they actually take a program and they manage it themselves?
So just from a user experience perspective, it was built to be able to be used by anybody as easily as possible. So 2024-looking technology, so you'll see some EMRs kind of looks like Windows 95 a little bit. We've built it very specifically with a consumer mindset in place, because we're counting on once their in-treatment patient reported, so this means that it has to be relevant and exciting, what they're used to seeing on their smartphone. So very user-friendly in that capacity. We have APIs where we connect to existing technologies. But the important thing is we heard from so many great providers today. But if they're building their own technology, they have a technology, and we're an agnostic company where the input doesn't matter where they came from. What we're able to do is aggregate and provide you with an objective third-party data set which we don't have a pony in this race. We just want to see transparency as community -- our headquarters, we were founded in Philadelphia. As I said, I live five minutes away. This is meaningful to us, so we're willing to work with anybody to make this very necessary dashboard available.
Including government. You had our Department of Behavioral Health here, right. I would think this should be at forefront of the $1. something billion budget to have this already. We don't. We're still kind of almost like paper reports coming in kind of situation, it seems like it. I don't know because I haven't seen anything. So I really think we need to up the ante in a very big way if they're going to be able to put Philadelphia in realtime. We can't wait for all this, are you going to give me this data, are you going to give that data. This is 2024 and we have these things available. It just frustrates me that we're not able to serve the real need because of bureaucracy getting in the way. So I yield my time.
But it's possible, what you're showing me is it's possible to do this. It's a matter of will and it's a matter of whether we're willing to accept new ways of doing things and the transparency because that makes yourself -- all of this will immediately show us right away who's doing what and how successful it is and you don't have to have a period to do that, you just click a button and that's where we need to be.
Thank you. Thank you for your question. Have you all had an opportunity -- your company has been in Philadelphia for how many years?
I've been doing this for years myself, but we've been officially really doing this type of technology starting in 2019.
So 7 have you had the opportunity to -- 8 I'm sure that, you know, I've only 9 been in office for 20 months. 10
Five- and-a-half months, right. Councilmember has been here for years. Councilmember Harrity's also new. But have you had an opportunity -- this conversation as you heard earlier today, this is a conversation and a problem that has been existing for years. Have you all or has your company had an opportunity to ever bring your product in front of City government. And if so, what was the response?
No, we have not. And this is our first opportunity. And really because of this Special Committee having Pyramid as a partner and bed availability, it was a salient instance of where we had a great partner and the existing infrastructure where we can make an immediate impact we believe here. So this is kind of our first foray into government. I do believe CBH, DBH and everybody who's up here earlier would benefit immensely from this technology.
Thank you so much. We look forward to continuing the conversation with you. Definitely want to make sure that we connect with you in the future and maybe bring some of our City departments, DBH, CBH, Office of Homeless Services, the Police, maybe bring you to a conversation hosted by the Special Committee just to talk in more detail about what this could potentially look like in the future to figure out how we can move this into a reality, right. I think that everyone agrees that we need to be able to access beds differently. We need to be able to look at the numbers and where we need to make adjustments for improvements, right. We need to track our providers better. Regardless of whether the bed is here in Philadelphia County or in a neighboring county, we should be able to have access to that. Our outreach workers should be able to have easier access when they encounter someone who's ready and who's ready now. How do we provide our outreach workers who are out there every day building and establishing these relationships with individuals who are living unsheltered, how do we provide our outreach workers with another tool for their toolbox, right. We talked often about creating legislation that will add to the toolbox to make it easier for us to respond and restore the quality of life in Kensington. And I think having a place where our outreach workers could access where this bed is at any time of the day to me would make it much easier for us to connect individuals to the resources that they needed. So I look forward to continuing the conversation. Again, my deepest gratitude to you and your team having invested so much time to create an application like this one that can really help us get there. Is it perfect right now? No, but I think that the willingness and the capacity is there. So I look forward to calling back on you with a larger group of individuals that could help this really be what we need to respond to the crisis that we have in Kensington. Thank you so much for being with us today.
Exactly. And again, it just exists. It's really just about modifying it and purpose-building it for what we're looking to achieve here, but the technology is in existence, it's driving better patient care, you know, tangible proof that this works to improve the outcomes of patients. So it's really just the --
We're a city of the first class. And somebody said earlier, we're Philadelphia, we can do anything. And so, this is part of anything we can do. Thank you so much again for being with us today. Mr. Clerk, are there other panels that we are to hear from today?
Madam Chair, there are no further witnesses testifying on the resolution.
I can't find my script. But there being no more panels to hear from today, we will move into public comment. If there is anyone here that is interested in public comment but has not signed up, members of my team are over here and can get you on the list. Will the Clerk please call the first person on the list for public comment. And I'm going to ask so that we can move this a little quicker, I want to be respectful of people's time as far as I don't want to overstay our welcome here. We're going to call five people at a time. And if you guys can just sit here and be prepared to give your public comment in a row, it will be extremely helpful, there at the microphone or whatever. We just want to make sure that we have multiple people ready to go and that you know that you are next.
Everyone will have two minutes to give your comment. It's unfortunate, but that's what we need to do. Mr. Clerk.