Yes. And25 94 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 while you're looking it up, what is the2 cost differential between consultant and3 employee by way of the category of doctor?4
It's a difficult5 question to answer only because we do not6 pay physicians for benefits. We pay them7 a salary that should allow them to8 purchase benefits. And if we contract,9 there is an overhead rate, obviously, for10 the contractor.11 We have looked at those issues12 so we've --13
No. What is18 the --19 (Councilwoman Tasco now chairing20 hearings.)21
I just24 wanted -- they aren't equal, and I already25 95 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 know the answer to the question. So I2 just want them cited on the record of are3 they full-time doctors, or do they have4 relationships part-time with other5 hospitals? What is the relationship and6 what is the cost differential by way of a7 consultant versus an employee?8
The issue is9 full-time and part-time. So the full-time10 salary for a physician employed by the11 City of Philadelphia is, on average,12 somewhere between 125,000 and 130,000 a13 year, which is below market rate for a14 starting physician in this area in the15 primary care field.16 And as a result, for hiring, we17 can -- it actually, depending on the18 specialty, it would work for a starting19 position, but we can't go up. So that to20 hire a full-time physician is very21 difficult for us in the health centers.22 As an alternative, physicians23 are hired on a part-time basis. It's not24 that they work somewhere else; it's that25 96 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 they work hourly for the City. Some work2 by contract and some work directly, paid3 by the City in Civil Service as a4 part-time employee.5 And what has happened over time6 is, we have used the mechanism to, in a7 sense, bring in new people through8 contract and ultimately do our best to9 move them into the Civil Service, because10 we are committed in the Health Department11 to reducing the number of contract workers12 that we have.13 So the real issue here, and the14 difficulty in interpreting the data, has15 to do with full-time versus part-time. In16 fact, if we look, the number of --17
-- full-time19 physicians in the Health Department is20 vanishingly small.21
And I'm going22 to stop now, but is it not true that we23 pay $162,000 for a physician? And on24 salary, they're $97,000?25 97 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
So this has to do2 with full-time versus part-time and the3 hourly rate.4
Is it not5 true -- and I'm going to use Wilson6 Goode's lines -- that we pay $162,000 for7 a consultant versus $97,000 for an8 employee?9
So the answer to10 that -- I want to answer your question.11
I think that your13 question is a good one, and I think that14 it's difficult to tell from the budget15 what this means.16 So a practicing physician in a17 health center, full-time, is not paid18 $97,000.19
How much --20 okay, I'm going to stop, but I will come21 back.22
And I want to24 know how many physicians do we have on25 98 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 contract?2
Approximately 509 on contract and 55 in the Civil Service.10
So there's an11 equal amount. And there's a differ --12 there's arguably a differential of -- and13 this is what I'm looking at -- 162,000 for14 a consultant and 97,000 -- and do the15 consultants get paid for malpractice16 through our Risk Management?17
I'll wait my24 turn.25 99 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
Doctor, also,7 could you provide to the Chair and answer8 the question, could you tell us, in those9 numbers, full-time doctors, how many? How10 many?11
Could you20 tell us how many of those are residents of21 the City of Philadelphia?22
How many are24 residents of the City of Philadelphia?25 100 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
Of the contracted2 physicians -- of the -- I actually have3 that number.4
The part-timers, I12 have the number; I just have to find it.13 I will provide it to the Chair.14
Thank you20 very much.21 The Chair recognizes Councilman22 Green.23
Thank you,24 Madam Chair.25 101 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 Doctor, just out of curiosity,2 what is an industrial hygienist?3
What is an4 industrial hygienist? It is a -- it's5 a... an individual hired in the Department6 who helps with employee safety issues.7
Okay. So8 that's an administrative function9 currently unfilled? How is that job --10
It is being15 performed by other members of the16 Personnel Department in the -- Personnel17 Division in the Health Department who are18 trained in employee-safety, OSHA kinds of19 issues.20
Okay. And21 what does an automotive driver do in the22 Administrative Department?23
We have a number24 of what I will call "courier functions,"25 102 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 so the -- we have 16 locations for the2 Health Department.3
And we have both5 medical supplies and other professional6 supplies, so lead supplies and other7 things, which are moved both among8 buildings and among sites.9
Okay. And10 are pharmaceuticals involved in that11 transport at all?12
Pharmaceuticals...13 yeah, I can check for you. I don't know14 the answer to that.15
Okay. How16 much would a courier -- do you know the17 number of trips they take between the18 facilities and how much a courier would be19 versus an automotive driver plus vehicles20 on staff? Have you done an analysis?21
I can get you the22 numbers. The Department looked just23 before I arrived, but we can look again.24
Okay. So I25 103 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 have a very similar question to the last2 question I asked you. And instead of the3 difference between '08 and '09, it's4 between '09 and '10.5 The FY '10 includes an increase6 of 77 positions from the January increment7 run, yet the Class 100 appropriation for8 FY '10 is decreasing by $892,000, falling9 from $34.6 million to $33.7 million.10
Now, is12 that possible -- what is the reason for13 that?14
Remember that we15 are reducing our budget between Fiscal16 Year '09 and Fiscal Year '10, so the17 reduction represents a reduction in budget18 for the Health Department. That includes19 the elimination of vacant positions.20
Well,21 actually, you're increasing positions by22 77.23
The 662 that you're24 comparing against the 739, okay, the 662,25 104 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 it is at a point in time that it is -- a2 filled level General Fund position is3 full-time. That was done basically at the4 end of December.5 So it's the same issue that we6 had before, okay? Which you wanted to7 know 662 -- based on 662, how many -- what8 it will be, the projected, for Class 1009 by year-end. We could get that for you.10 But the 739, it is a budgeted11 number. So when you look at that, it12 looks like, yes, we are expected to13 increase it the numbers, okay?14
Right, but in15 other words, there's three moving pieces16 to this, okay?17
And so, now19 it kind of looks like a shell game. The20 middle pieces, the increment run, the21 other two pieces are what you're saying22 you're -- what you actually spent in '0823 and what you're saying you're going to24 spend in '10.25 105 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
The middle7 piece, okay, is based on 662, and it's8 annualizing that, or should be, okay? And9 what you're saying is, you're actually --10 so you're going essentially from 662 to11 739, and you say you're saving 839.12 What that means is, you're not13 reflecting properly in what you've14 provided to City Council what you're15 really going to spend through the end of16 this year. And that difference, okay, the17 FY '09 estimate is something that would be18 added to the Fund Balance, which would be19 available to us to lower the taxes of our20 citizens.21 And I want to know what that22 number is.23
And we will get it24 to you.25 106 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 But this is the form, this is2 the financing, this is the way the budget3 is structured, but I can understand you4 looking at a certain point in time in5 filled positions versus budgeted6 positions, okay, and dollars in where --7 the actual dollars versus what we call8 "estimated," which is really a budgeted9 number.10
And I'm not11 blaming --12 (Indiscernible; parties talking13 over each other.)14
The Health17 Department does great work, and this has a18 nothing to do with the Health Department.19 This has to do with the way this20 information is presented to City Council.21 And the way this is presented to City22 Council is misleading -- not purposefully.23 I don't believe, because we've done it24 this way since 1950, but maybe we ought to25 107 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 update our system so that we can have2 accurate information to work on when we're3 trying to figure out where the dollars are4 in the City budget.5
I just want to be6 sure that you know that the Health7 Department will provide you with the8 information that you're asking, and we're9 always happy to provide that information.10
I appreciate11 that, Doctor.12 So the FY '10 budget includes13 $1.5 million in savings based on formulary14 restrictions. The formulary will no15 longer include -- your testimony indicated16 that medical staff will be closely17 monitoring patients' adherence to18 recommendations involving OTC medications19 and their health-care outcomes.20 Is there any cost differentials21 to patients between OTC medications they22 now receive from the health center23 formularies and buying the medications24 from drug stores?25 108 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 (Timer bell rings.)2
Yes. Currently,3 over-the-counter medications are given for4 free.5
Okay. So how6 do you think this will impact patient7 treatment?8
That's the reason9 for the we're-going-to-monitor-closely10 piece we believe, so that we believe that,11 in most cases, we have nominal fees; in12 some cases, we're not sure, and we're13 going to watch that closely.14 Part of the answer to your15 question is: What is the rate of16 adherence of patients currently to using17 over-the-counter medications? The18 indications that we have are that they're19 not highly adherent on the particular20 pieces involved in this, and we're going21 to look carefully at that.22
The Chair25 109 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 recognizes Councilwoman Brown.2
Thank you,3 Madam Chair.4 Last year, there were a number5 of questions around the CHIP Program --6
-- and8 where we were with regards to the outreach9 and identification of children.10
Just give12 us an update in terms of where we are now13 in terms of capturing all children who14 qualify for CHIP.15
We continue to16 work very hard in our -- with our, what17 are called, benefits consultants. These18 are folks who work in each health center19 who are --20
-- who have22 referred to them parents with children --23 parents as well as parents with children.24 And they work both to provide information25 110 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 to those parents and to actually sign them2 up for insurance, help them filing3 applications. And then we look at, the4 next time people come in, whether or not5 they're covered.6 In addition, we work with Public7 Citizens for Children and Youth, as you8 know.9
And that has a11 really terrific system for advocacy and12 helping people who have had difficulty13 getting insurance to get insurance. And14 we're currently looking at our benefits15 counselors throughout the system to assure16 that the -- they have adequate information17 and that all of our procedures and18 practices are optimizing the ability for19 people to get insurance.20
I have to say that22 if we look at people who come in23 uninsured, so what proportion of people24 who come in to the health center for a new25 111 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 visit, what proportion are uninsured. And2 we compare that to the proportion of3 uninsured overall. It looks like as4 though we're able to get a substantial5 proportion, about 30 percent insurance --6
-- of the8 uninsured, but we are still always of the9 belief that we can do better.10
So then,11 what impediment exist, if any, to move you12 towards that one hundred percent coverage13 for Philadelphia's children?14
There are15 practical impediments which relate to16 people having other things to do on a17 given day and not necessarily wanting to18 spend time on a given day.19 But I think more profound, we20 have a substantial proportion of uninsured21 people who were not born in this country.22
And as the24 activities around people who are not born25 112 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 in this country have become more intense,2 I think there's a lot of misunderstanding3 and fear.4 And many of the parents whose5 children might be eligible, because the6 children may well have been born in this7 country, are afraid to provide information8 --9
-- or to file11 applications and other things. And we've12 made the determination that we will always13 provide care to the children.14
So while we work16 with them, we educate, we advocate, we17 hope that people will be able to get their18 children insured.19 If parents are afraid and don't20 want to, we don't in any way force them or21 coerce them into doing that.22
So then is23 there a potential role for the24 Philadelphia School District or the25 113 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 Archdiocese and their nursing departments2 to help towards that impediment?3
I'm not -- there4 definitely is a role because we certainly5 don't see all uninsured children. So6 there will be other uninsured children who7 go to school and could certainly use help8 and advocacy.9 It's one of the things that10 Public Citizen for Children and Youth11 does, but all the help we can get, the12 better.13
And I'm sure that18 they could always use a pep talk and19 assistance in this activity.20 But I think you're right:21 Everyone needs to be working on this,22 particularly as the economy gets worse.23
And so24 there's a designated department or a25 114 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 school official that's working with the2 Health Department and the benefit3 consultants to ensure that the goal is4 attained?5
That's a great6 question. And the answer, I'm afraid, is7 no, we don't have that person identified.8 We do certainly talk with the District,9 and we talk with Public Citizen for10 Children and Youth, but I think the idea11 of better coordination is a good one.12
Okay. Let13 me commend you and the Department on14 topping the rates of every other large15 city and most states when it comes to16 childhood immunization. Will budget cuts17 impact the Department's ability to18 duplicate the same success in FY '10?19
We have been very20 careful in where we have taken cuts to not21 impact that number. I do worry that it's22 going to be more difficult if we have a23 greater number of uninsured children, to24 reach those children.25 115 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 But, no, the answer to your2 question is no. Specifically in this3 budget, we have held harmless those4 dollars, largely because they're not5 General Fund dollars.6
You're.12 The Chair recognizes13 Councilwoman Sanchez.14
Thank15 you, Madam President.16 Good morning, Dr. Schwarz.17
Let me19 first commend you for -- I looked in your20 budget and I noticed that there were a lot21 of General Fund positions that you22 transferred over to grant funding23 opportunities, which -- which showed us24 that there was a lot of room there for us25 116 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 to play with some of these -- or not play2 with us but reallocate some of these3 critical positions.4 You talked about, in your Plan5 B, possibly eliminating certain programs;6 but, in your Plan A, making some severe7 cuts. I'm specifically alluding to the8 elimination of STD care at Episcopal9 Hospital.10 How many people were being11 served through that contract? And what's12 going to be the impact there?13 And my concern is there's been14 recent reports about -- as you know, that15 our STD program is -- our high school STD16 program is nationally recognized. There17 have been several articles in recent weeks18 about the growing number of STDs at some19 of the high schools in the Northeast and20 others.21 So who is going to be impacted22 by that?23
I'm inviting up24 Dr. Carolyn Johnson, who's the Director of25 117 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 Disease Control.2
So I will answer4 you directly, and my understanding is5 correct. It's about two years ago that6 the contract with Episcopal was severed.7
Those services9 have been picked up by Health Center 5,10 and we haven't noticed any detriment in11 services provided. So the number of12 people and so forth, STD rates, haven't13 increased in that part of the City.14
So we're15 serving the same amount of people even16 though we're reducing that by $55,000?17
So what22 are we doing to address the growing number23 of STDs at the high school level? What is24 it that we're currently doing?25 118 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
Okay. So we2 currently go to high schools in the City3 to test. We do this in collaboration with4 a number of partners around the City who5 are particularly concerned about STDs --6 the Family Planning Council and others.7 We, last spring, as part of a8 PhillyStat presentation, looked at, over9 time, what's been the impact of this STD10 testing. And what we find is that one of11 the dreaded complications, I have to say,12 having provided these services myself for13 a very long time, which is pelvic14 inflammatory disease in young women, has15 declined, and declined in concert with the16 specifics of the program and with another17 set of programs that are drop-in centers18 for the availability of condoms in high19 schools.20 So I'm pleased, actually, with21 the efforts and the impact of the efforts.22 One of the issues in saying that23 we have more STDs is that we're doing more24 testing. And so, we're detecting more25 119 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 STDs.2 The reason that we looked at3 pelvic inflammatory disease is, if we miss4 a case, then that case leads to a5 complication. So we wanted to make sure6 that we were reducing the numbers of7 complications.8 I think that's a more meaningful9 measure than simply the measure of how10 many tests we do.11
Okay.12 Yeah, I know, and I wanted to echo what13 Councilwoman Blondell Reynolds said. I14 think we need to better articulate and15 work with the School District as it16 relates to some of these school-based17 diseases, and particularly the schools18 that we've identified continue to have a19 growing problem.20 I had a question in terms of, we21 talked about coordination in health22 centers. In one of your PhillyStat23 questions a few months ago, there was some24 discussions around what is our25 120 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 relationship with some of the other health2 providers -- you know, Delaware Valley3 Health Federation, Esperanza Health4 Centers.5 And how is our fee structure6 going to be different than some of things7 that they do?8 And are we talking to them?9 because they manage to do a better job of10 signing people over to CHIP and other11 program than we.12 What is it that they're doing13 that we're not doing at our health14 centers?15
I think that's a16 great question. It's something that I17 wondered a long time about before I came18 into government. So I appreciate that19 question.20
One of the issues22 here is whether the populations are the23 same. So that the City health centers, as24 you know, are known as the places of last25 121 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 resort. And hospital emergency rooms and2 others refer families who are uninsured3 disproportionately to our health centers,4 and they particularly refer people who are5 difficult to insure to our health centers.6 And I think you probably know,7 from your long history as an advocate in8 the community, that many of the federally9 qualified health centers who take people10 who are uninsured are at times not11 perceived as the places to go if you're12 uninsured, and we help educate people that13 those are places to go.14 But part of what you see in our15 rate of uninsurance is, I think, we16 receive the uninsurable in very large17 numbers, even for children. And we are18 committed to providing that care, so that19 our fee schedule will be below the fee20 schedule that's set at the federally21 qualified health centers.22 (Timer bell rings.)23
We're permitted to24 do that. We've talked with the federal25 122 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 government about what the levels can be.2 And that's where we're headed so that we3 remain the provider of last resort.4
The7 Chair recognizes Councilman Green for a8 point of information.9
You said10 something I wanted to just follow up on,11 and you said insured -- we are aware the12 uninsurable are sent by every other health13 center, emergency room, et cetera.14 And I think that that's an15 important thing for us to keep in mind.16 If we're thinking about closing down a17 health center, where else will they go,18 Doctor? And so I think that's an19 important fact for us to all bear in mind.20 My point of information is, you21 mentioned uninsured -- uninsurable,22 including children. Are there any23 uninsurable children in the State of24 Pennsylvania?25 123 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
Let me answer both2 of your points.3 One is, I don't want to close a4 health center, and I'm trying not to think5 about closing a health center. And I6 recognize pretty clearly the impacts of7 that.8 Two, children of undocumented9 parents who themselves were not born in10 this country are uninsurable in11 Pennsylvania.12
Of undocumented14 parents who were not born in this country,15 the children not born in this country, are16 not insurable, so if you --17
And, in fact,20 there's legislation currently in the21 Pennsylvania State Legislature to codify22 that and say that no State dollars can go23 to provide care to undocumented.24 We are highly opposed to that.25 124 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 We believe that it's bad both for people,2 particularly for children, but for people,3 and it's bad for the City of Philadelphia.4
Well, perhaps5 we can have our lobbyists work on that6 issue instead of whether or not we should7 have a property tax or a wage tax in8 Harrisburg.9
I don't know about10 property tax or wage tax but we are11 working on that issue.12
Oh. Thank18 you, Madam Chair.19 Good morning, Dr. Schwarz.20
I apologize23 if you have already answered this24 question, but I just want to ask you about25 125 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 that $123 million that's anticipated2 coming from the Acute-Care Hospital3 Assessment pending federal approval?4
Do you have6 any idea what -- well, first of all,7 what's the process for this approval?8 And, additionally, if it's not approved,9 how does it affect your budget?10
'Cause you're12 relying on -- to me, you're relying a lot13 on potentially to add 128 full-time14 positions.15
We've been every16 careful to carve it out, so that the17 budget, as you see it, outlines where the18 hospital tax dollars will come and where19 they will go. And we have not budgeted20 depending on it.21 The current plan for it is in22 Washington with the Center for Medicare23 and Medicaid Services. It's been applied24 by the -- the State has applied for a25 126 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 waiver. I understand that, as of2 yesterday, that we should receive an3 answer in May, and it will likely be4 positive, so that we are hopeful that we5 will receive the dollars.6 More even than the City, the7 other hospitals in the City, are dependent8 on the additional revenue that they'll9 receive from that tax.10
So that while I12 very much would like the City to be able13 to increase services.14
You're18 optimistic. Are there any restrictions on19 these funds?20
The funds are21 designated for health in Philadelphia, and22 they are designated for health centers,23 health information, including the Prisons24 health information system.25 127 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
Okay. Now I2 would like to touch on a topic that I'm3 very passionate about, and that is animal4 care and control.5
Now, I just7 notice in your testimony that you never8 mentioned it, and I understand why.9 There's more -- I don't think this would10 be the time to address that subject.11 There's more, I think, more important12 topics and issues that we have to address13 today, and many of my colleagues have been14 asking questions about them.15 But I just want to go on record16 and I want to just tell you that I am17 completely angry over the decision that18 you and the Mayor and the Administration19 made in awarding that contract. I think20 it's obvious that it was disastrous, and21 somehow, we're going to have to get22 through this.23 I'm also cautiously optimistic24 that we can work together, and I hope to25 128 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 work with you and the Mayor and the2 Administration to see if we can do some3 damage control, because that's what it is4 right now.5
I am -- I7 think that if we don't have some kind of a8 -- some kind of a system whereby it's9 going to improve animal care in the City,10 I think that we have to go the other11 route, and that would be to have hearings12 to get to the bottom of this.13 I will speak more on this issue14 tomorrow in City Council. Again, I think15 that it would be more appropriate for me16 to do so than here.17 But I just want to encourage my18 colleagues to read the Philadelphia19 Weekly, which just came out today, about20 this subject and about this issue. And I21 think that once they do that, I think that22 it will give them some background, which23 would indicate to them of where I come24 from and why I think this is so important.25 129 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 To me it's a quality-of-life2 issue and it's something that's important3 to a lot of Philadelphians, and I will be4 addressing that, and I look forward to5 working with you and the Administration to6 see what we can do to improve animal care7 in this city.8 Thank you.9 Thank you, Madam President.10
The11 Chair recognizes -- is Councilwoman Miller12 here? No?13 Councilwoman Tasco.14
Thank you,15 Madam Chair.16 Dr. Schwarz, on -- and17 this may have been asked, I might have18 missed it, but on of your testimony19 you describe an electronic medical-records20 systems plan for the Health Department and21 the Prison system.22 What is the cost of this system23 and what is the timeline for its24 implementation? And what are the25 130 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 cost-savings for this type of system?2
The cost of the3 system is somewhere around $15 million.4 It depends on when we implement.5 The timeline is about a6 five-year timeline because of the7 likelihood of funding and how funding will8 come in and the rate of change that's9 required within the two health systems,10 both the City district health centers and11 the prisons.12 There is a cost-benefit analysis13 that I'm happy to provide that we14 undertook in writing the requests for15 proposes. So the steps are:16 The Department needed to assess17 its need in the Prisons; that was done.18 We need to put together a19 request for proposal meeting our needs;20 that was done.21 We needed to reassess the22 current environment; that was done.23 And the request for proposals is24 almost complete and ready to go out.25 131 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1
In anticipation of7 two things: One is anticipation of the8 hospital tax.9
And the second is,11 there are dollars in the Rivery Act for12 health-information technology, and we want13 to make sure that Philadelphia gets every14 single dollar that it's due.15 In order to do that, we have to16 move quickly, so we are moving quickly17 now. We had done, fortunately, all of the18 background work, so we are very well19 positioned.20
Some of the22 dollars are flexible enough. They will23 come through Medicaid, from the state,24 that we will be able to extend them over a25 132 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 little bit time.2 But I hope that answers your3 question.4
The7 Chair recognizes Councilman Green for a8 point of information.9
Madam Chair,10 I received a response from the -- I don't11 recall who it was from, but it was sent to12 you in response to a question I asked the13 head of DOT.14 That question was: Please send15 City Council, the Chair, all reports16 internal memoranda, other information,17 studies from vendors, et cetera, related18 to savings from the implementation of19 technology, which would include a20 cost-benefit analysis that has just been21 discussed here in Council this second.22 The response I received were23 that there were none in City government.24 Madam Chair, I really believe we25 133 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1 need to have hearings where people come2 back and answer our questions such that3 they are on the record, subject to the4 Charter and other things with respect to5 their answers to questions, or I am afraid6 we will continue to receive non-answers7 and information that is not accurate.8 If they have to sit there and9 testify, we're going to get the truth. If10 they can just put it in writing, we're11 never going to get the real answers to our12 questions, Madam Chair.13
I look16 forward to seeing that report as well as17 every other report in City government that18 is similar.19 Thank you, Madam Chair.20
You're21 welcome.22 COUNCILWOMAN TASCO:23 Dr. Schwarz, did you work in conjunction24 with the IT Department?25 134 4/22/09 - COMMITTEE OF THE WHOLE - FY '10 BUDGET1