This happens because people in leadership don't care enough to make a change. Somebody built that building for some totally different reason.
It looks like you are ordering a hamburger to go with fries on the side. And you have the abuser, you have the woman, and the children all together listening.
You have your whole neighborhood listening. It is a huge waiting room 24 full of people who can all hear every word you are saying. 324 12/18/02 - PUBLIC HEALTH - BILL 020613
Councilman, hamburger joints are more friendly, they smile back. We need to take it up. We need to take it on.
I mean, it is the whole system that is in disarray. I mean, there is a whole culture, from top to bottom, that needs to be changed. And the thing is that we have real people getting abused. Not only by their husband or mate, but then by the official agencies that are supposed to help them.
To that end, Mr. Chairman, you mention in your testimony, you said that there are three venues where dialogue is had.
However, and I quote, the processes are not shared. Could you briefly speak to that, the examples of where that's not happening.
These are by and large good things. Children's Hospital, Philadelphia DHS, and the Philadelphia Children's Alliance all do some form of multi-disciplinary case conference. Each of the agencies has or entities has 325 12/18/02 - PUBLIC HEALTH - BILL 020613 developed their own protocol for how they assemble that group of professionals and how they review the case, what they talk about, what issues are on the table, and how that information does or doesn't get recorded. Well, there are only a small minority of the total number of cases in the system gets that approach. Their approaches are disdain. Among the three, they are each, in a sense, unique. They are similar only by coincidence; some of the same people sit on the same processes. Now, we don't need one uniform cookie-cutter approach. We certainly by law are required to have that approach available for many, many more of the cases. Some very large number of the cases qualify under state law for multi-disciplinary review, and the systems don't begin to have the capacity at present to handle them. So it is a chicken and an egg. If the systems were to send more cases into that pipeline for a better approach, we might not be able to handle them. And, yet, that's the approach they 326 12/18/02 - PUBLIC HEALTH - BILL 020613 need. It is like a long waiting line at the emergency room. It just doesn't make sense. It is like a little hole in the wall for a domestic-violence case. It just doesn't make sense.
More than a nudge. A protocol is required of the children and youth agency, police, and DHS, and the District Attorney's office, that tripartite approach to a law enforcement child-abuse case. And that protocol needs to have teeth, it needs to be expansive. It needs to say which cases get handled where.
So it does beg the question, and it goes back to Councilman Nutter's umbrella question, who is in charge. Where do all these lines --
The law is explicit in this regard. The law is explicit that the District Attorney is in charge on that score. Their protocol was developed when the law was passed to meet the 327 12/18/02 - PUBLIC HEALTH - BILL 020613 minimal requirements of the law. So, in a sense, it passes muster of state law. It, I think by their own admission, doesn't pass muster of a citywide program.
That's what they set out to do at that time, which was in 1997.
And if you remember in terms of the special victim's unit, one of the problems that we uncovered as we went along in the testimony was the miscoding of the aspects of cases. And we have no data on that in terms of this area of investigation. And is there the possibility that that has been happening, both miscoding in terms of the case and in terms of women, and then how you miscode them? Because, like you say, if there is a woman that is being abused, there is usually a child that's being abused, and so on. Have you found, Frank? And we have no 25 data available along those lines. 328 12/18/02 - PUBLIC HEALTH - BILL 020613
That's my understanding. In the small sampling that was provided to us in special victims, in which several representative advocates actually read the hard-copy files, we found them, their coding, to be dramatically improved, but we didn't find too many coding problems. And that's just on the children's side. The DV side, as you heard, it catch as catch can.
So we need perhaps a meeting to be able to get together and look at what the situation is with the advocates, the agencies, and maybe do the same thing with Commissioner Timoney and his unit, and get together to see what we can come up with in terms of realistically putting in and getting the correct data into a place that we can actually understand it.
I think I and my colleagues stand ready to read more of their cases and give them all the criticisms we can.
You know, we will try to make that available and feasible, so that we can come up with a system that actually is in place and functions. 329 12/18/02 - PUBLIC HEALTH - BILL 020613
Alba. Thank you for waiting. COMMISSIONER MARTINEZ: Am I still on my honeymoon period?
We are not mean to anyone here. All we are doing is trying to get information and help, where we can, to provide more resources or be the advocate of agencies that we feel need to be able to do a better job, and they don't do a better job because the resources are not available and not because of incompetency or insensitivity. And I think DHS is one in which people attempt to do a great job, but the workload and everything else and the situation is horrific. So, Commissioner, identify yourself for the record, please. COMMISSIONER ALBA MARTINEZ: Good afternoon. It is a pleasure for me to be here. My name is Alba Martinez, and I am the Commissioner of the Department of Human Services. And I want to congratulate Council, and 330 12/18/02 - PUBLIC HEALTH - BILL 020613 in particular Councilman Ortiz and the Public Safety Committee, for holding these hearings and convening these hearings and doing it in a collaborative way with our State Representative. This is clearly an issue of great importance that does not get sufficient attention in the City of Philadelphia or nationally. Now, I do have some prepared remarks that I will read. But I want to start by saying that all of the recommendations that I have heard here today sound good to me. And they, I believe, are consistent with the aggressive reform agenda that DHS has undertaken. The mission of the Department of Human Services is to ensure the safety, well-being, and permanency of children in the City of Philadelphia. And, last time I checked, children cannot be parented without a family in which they can be safe, well, and properly taken care of. So, therefore, when a parent in the family is unsafe, that is a concern of the child welfare system. And the safety of every family member is a concern of the child welfare system. Now, at DHS, the mission of the 331 12/18/02 - PUBLIC HEALTH - BILL 020613 organization has been constant over the years: Safety, permanency and well-being. I think what is changing in DHS is not that we are backing away from our mission, but that we are rethinking the way in which we act upon our mission. So, for example, when DHS speaks about permanency for children, we think that we must achieve permanency for children in a timely way. We believe children should not be raised in foster care. We believe that government has a very important role to play in society, but one of those roles is not being parents to children. When we talk about the department's mission around safety and well-being, we believe that we should not wait for children to get hurt or for someone in the family to hurt somebody else in order to take those children into custody. That's why we are focusing more aggressively on prevention. And in relation to our focus on domestic violence and family violence, the Department of Human Services stands ready, stands ready to do everything we can to support safety of all family members. 332 12/18/02 - PUBLIC HEALTH - BILL 020613 And, we have a lot to learn. And we cannot do that work without the leadership of Council, like what you are providing -- and I want to say very clearly -- extraordinary support and guidance and patience. But pressure, too, which we welcome, from the advocacy community, the child advocacy community and the family violence community. Now, the context in which we are doing this reform work is that there is a history of fragmentation, isolation, lack of collaboration, and lack of trust among domestic-violence advocates and child welfare advocates historically. This is not a city problem; this is a national problem. And at a national level, actually, in the National Association of child welfare leaders, there are policies being developed to try to bring together the domestic-violence agenda and the child welfare agenda.
As we make changes to integrate the work of violence against children and violence against women and other members of the family, we will confront the difficulties that come from resistance to change, which you have already addressed; 333 12/18/02 - PUBLIC HEALTH - BILL 020613 tradition, "I have done this before. We tried this before. This will never work"; the cynicism that comes from having been part of a system that has promised to change and has not delivered on change. We will also confront the more sticky issue and painful issue of conflicts in philosophy and conflicts in policy that have to be worked through. And, lastly, we are going to confront the painful challenge -- and it is particularly painful for me -- of our need to move fast because children and families are in danger every day. But, unfortunately, our move to -- our need to move sequentially sometimes and in order to move properly sometimes, we do not move -- we cannot move as fast as we would want. Nationally studies have shown that the co-occurrence of domestic violence and child abuse can be at high as 97 percent. In Philadelphia, we look at our data from case reviews, since at this point we still do not collect concrete data about the incidences of domestic violence, which is a problem that should be addressed. 334 12/18/02 - PUBLIC HEALTH - BILL 020613 But our case reviews suggest that the rate of co-occurrence in Philadelphia, Department of Human Services cases, is anywhere between 50 percent and 75 percent. It is an expectation of our department that, over time, we will collect specific data around domestic violence.
How do we begin doing that? COMMISSIONER MARTINEZ: One of our major reform projects is the redesign of our front end of services, which includes our hotline, our child-abuse hotline, our screening unit, and our investigative unit. That would be what we define as front door, the gate of the system. And so as we reconstruct our system for service criteria and our system for placement criteria, and as we reconstruct our hotline process, that is when we can incorporate new data elements. And, in fact, we are not only in need of collecting more specific data about domestic violence, but about other critical issues, too, that would help us in planning.
Again, how do we 335 12/18/02 - PUBLIC HEALTH - BILL 020613 overcome -- I think Ms. Freedman from legal services testified at the beginning of the hearing, because this usually begins with a phone call to the police department. And we try to establish a framework in which the police department, with its own institutionalized manners of behaving and insensitivity at many times, they have begun a process of trading and change. And I think it is happening. It is happening slowly, but it is going on. How do we begin? Because I thought it was a natural, sequential process that would take place. How do we get into the prevention aspect? So that if we have a repeated family that is constantly calling, 911, but has not gotten to the point in which that family, that woman, or that child, really has gotten really beaten up, but the violence is there, because it is verbal, it is communicated in other ways. And I said we should have a flag in which we should be able to refer that family to family services or DHS, for example. 336 12/18/02 - PUBLIC HEALTH - BILL 020613 Ms. Freedman says that would be bad because families -- and I know. I used to remember dealing with Puerto Rican families when I was in legal services. And I had to tell them, you know, we have to get your caseworker, and the whole spectrum of what DHS meant, which it meant taking the kids away immediately, and so on, that there is the fear of women. And her statement is that that would be a wrong thing to do because women are afraid to go to DHS for assistance in this way. How do we begin breaking that state of mind? COMMISSIONER MARTINEZ: In a large, in a general sense, I would think about a three-prong agenda. One is culture change, which has been addressed here. And I think at DHS we have made huge progress around culture change. In other words, not only setting an expectation to the internal staff of DHS and our contracted providers that we are moving in a different direction, but allowing people the 337 12/18/02 - PUBLIC HEALTH - BILL 020613 permission to change. Because government can be quite a punitive place, and I think people act out of fear. So, number one, culture change; for people to understand that we will work with them as a struggle for new ways of doing business; and that they are not always going to do it right and that there will be mistakes, but we are okay with that. So giving people permission to change the culture of the organization. Second of all, practice change. And when you talk about how do we do this, well, you have to change practice. The reason why families are often afraid of DHS, like they are afraid of police, you know, we know in certain communities people are afraid of the police and afraid of DHS, is because of the tradition of these systems of having to invest or choosing to invest most of their resources in intervention techniques. In other words, waiting -- that's why I said that one of our big shifts is to prevention, not waiting for people to get hurt in order to actually offer services. And then often we throw 338 12/18/02 - PUBLIC HEALTH - BILL 020613 the kitchen sink at people. So people have fear that DHS historically has been perceived as being an all-or-nothing kind of game. We leave you alone until you hit a certain point on the thermometer, and then we are going to throw everything at you, including involuntarily intervene in your life. So how do we do that is, first of all, DHS changes its culture and invests more money in prevention services so that over time, hopefully not over a long period of time, this is starting to change, the public in Philadelphia and the citizens of Philadelphia understand that, number one, we will never apologize for our responsibility to remove children when they are in imminent risk of harm, because that is our job. At the same time, we are not looking to remove children; we are looking to build safe families. So when we identify -- you also asked about data.
The way to collect this data, it begins when we get a hotline call. We already collect some data. It has 339 12/18/02 - PUBLIC HEALTH - BILL 020613 been collected historically on paper. The social worker wrote it down, they would transfer it to a clerical person. We have changed that. We are now demanding that our social workers input data directly. We are changing those fields.
Do we have access to that data? Do we have availability to the data that is currently coming in to the hotline that you have in terms of abuse in children cases? COMMISSIONER MARTINEZ: Yes, we do. But we are restructuring it. We are redesigning that right now because the data that is collected is not all of the data that we need. So, for example, I am not sure, I don't believe, that we have a field -- someone here might be able to correct me in terms of my own systems, as they have been suing it longer than I have been running it. But I think --
One of the ways we bring about change is through the courts. COMMISSIONER MARTINEZ: But I don't think that we are collecting specific data that we can pull technologically around domestic violence, 340 12/18/02 - PUBLIC HEALTH - BILL 020613 but that can change. And one commitment that I want to make here today is that, based on these hearings, I am bringing this to the forefront of my consciousness that I will go back and say, we have to collect that data up front. But I think that, again, we have to have conversations with advocates. Because I think they are going to have some concerns, parent advocates, about how that data would be used. I think that having the data for planning purposes is good. So once you have that information, then --
But we need to set the process and get the people that can be helpful to begin putting the system so that that data can be available for the changes that are needed. COMMISSIONER MARTINEZ: We have a very sophisticated data system. Frank Cervone also raised the question about having data and having processes and not necessarily using the information. For example, the multi-disciplinary team 341 12/18/02 - PUBLIC HEALTH - BILL 020613 reviews. Better to have them, than not to. However, how we use that information to drive change is a separate issue. And, again, it is two related conversations. But the fact is that at DHS, the good news is, we have a very sophisticated infrastructure; however, our hotline needs huge reform. We are working on that right now in terms of the tools we have in place. But the other part of how do we actually make this happen is critical to the DHS reform agenda, is building a differential response system. Now, this is being done in other parts of the country. And what "differential response" means is that you don't treat every case the same way. DHS intervention should be tied to levels of risk.
For the record, and, again, going back to what I think Frank and Ms. Freedman said, the training that the caseworker -- because it is the attitude to change at the lower levels that needs to be done. And, for the record -- and I know that 342 12/18/02 - PUBLIC HEALTH - BILL 020613 you stated in your testimony -- the training that takes place for the average caseworker in DHS, in terms of recognition of the symptoms, the tell-tale signs of domestic abuse that may be occurring, what is the training that is currently in place and how can we begin in order to help you bring about that cultural change. And, from our side, what is it that we need to begin putting into place in terms of the resources necessary to be able to change, one, the budget that comes down, the ability to be able to give the tools that are necessary. What is that training currently, and how can it be changed. What needs to be changed within the training, if anything. COMMISSIONER MARTINEZ: There are, I say, three main vehicles that child-welfare workers get training. And one is the state, Pennsylvania competency-based training and certification program. And I have brought to submit for the record copies of the summaries of workshops and curriculums that they have related to domestic violence. So social workers need a minimum of 20 343 12/18/02 - PUBLIC HEALTH - BILL 020613 hours of training a year to just maintain the county license, and social worker supervisors all the way up to the directors. But they often get more. Not in domestic violence, though; in general training. When we think about how complex this area is, hours doesn't sound like a whole lot. 9 You know it is good, but it is not really a whole 10 lot. So you have the state training system. 11 Number two, there is the Pennsylvania 12 Council of Children, Youth and Family Services, 13 which is our provider network of agencies. And they 14 do significant amount of training that DHS helps 15 fund and participates in. 16 But, number three, in the last two years 17 I have created a staff training and development 18 support center because we are now abiding by the 19 philosophy of life-long training. 20 The issue is, however, that historically the way it has been done, training, has been that each staff and each supervisor of that staff person fill out a form and say, "This is what I think I want training on," as opposed to the system saying, "Wait a minute. 20 hours is not a whole lot. We 344 12/18/02 - PUBLIC HEALTH - BILL 020613 are going to set the priorities here on what we want people to have training on." Because if we are talking about changing culture radically, people need to be trained almost on everything. And, so, we really are struggling with how to prioritize training. We have excellent domestic violence training researchers in this city, excellent training; Women's Law Project, Women Against Abuse, Legal Services, Women in Transition. The question is, how do we tie those resources into our infrastructure, using them, and then practicing. Because you can get training. You can get training and not apply it, and you forget it.
And we need to come here. And we need the commitment, and the commitment comes from DHS, the Health Department that says, "This is what we are going to do." Because I am interested in prevention and building a system that creates an educational perspective coming out of the city and the different agencies that we have, and that they are interconnected. 345 12/18/02 - PUBLIC HEALTH - BILL 020613 For instance, one of the things that has shocked me more than anything else -- and I will go back to the whole, the glass and all of that -- but the fact that people go down to -- most of, a lot of the numbers is during weekends, for instance. And women are forced at all hours of the night or day, or whatever it is, to go down to the judicial center by themselves, alone, no attorney because these individuals probably don't have one. They go before a Master that probably, and has been according to the testimony we get, really has very little training in terms of issues of domestic abuse. She goes in there for a petition for protection, and then she has to go back home to serve it herself. And I was thinking. And I asked, "Do we have any social service personnel there?" Because, if anything, she not only needs somebody to tell her the legalities of filling out the petition; she needs somebody, more than anything else, that can guide her into some family training or family therapy or family advice or whatever it is that needs to happen. 346 12/18/02 - PUBLIC HEALTH - BILL 020613 She needs a social worker or a person that can lead her. And it seems that is natural, one of the things that we should have and that DHS maybe could look into. Because this is about resources and expanding those resources. That we have personnel there that can say to Mrs. Jones or whoever, "Listen, you know, we need to open a case on you. We need to be able to start this file in order to do the following things." That woman leaves that judicial center and goes back to an abusive environment, hopefully with a policeman, to try to serve the abuser. I mean, I said, it is like, if I get assaulted by somebody in an alley, I then have to go and get a warrant to serve on the guy, and I have to go and serve this warrant on the guy who assaulted me in the alley. Again, we are looking at this as a crisis in public health. And there have to be services available from the beginning, not after the fact. But if a woman gets the courage to go down to file for a petition, there has to be some 347 12/18/02 - PUBLIC HEALTH - BILL 020613 institutional services there at that site when that woman goes there. Because it is not just the petition that she needs; she needs guidance and support services. COMMISSIONER MARTINEZ: I would like to respond to that, if I may. I am a little out of the loop as to what the domestic-violence organizations are doing this minute in relation to court and service. But when I was a director, we started the Latino Domestic Violence Program. Prior to that, I supervised the domestic-violence unit at Legal Services. I served on the Board for a long time. And the bottom line is, there is a network of organizations in this city that get state funding --
There are four. COMMISSIONER MARTINEZ: Yes, there are four that get state funding to do these kinds of services. And I remember at that point not having enough resources to serve all women, of course. However, that they had a strong presence in the 348 12/18/02 - PUBLIC HEALTH - BILL 020613 court. And I think that perhaps it is about looking at how we strengthen the resources that are already there and to also advocate more aggressively at a state level. Because the federal domestic violence money does not flow to the City of Philadelphia; it flows to the state, Pennsylvania Coalition Against Domestic Violence. And I think that there is some advocacy that can be done by the city to the state in relation to securing additional funding. And we, people like Council Members and people like me in my position, can perhaps help the domestic violence advocacy coming into here make a stronger case for state and federal funding. That being said, the Department of Human Services can definitely become more intentional and more clear and strategic on how we invest our resources in a way that impacts favorably on domestic violence because, of course, our line of business includes reducing family violence. And I stand ready to say not only that we have a commitment to fund domestic violence 349 12/18/02 - PUBLIC HEALTH - BILL 020613 services, but that we already do. And the question is, how do we capitalize on our investments to be more strategic. And, to the extent that I can help continue to identify resources, I will. But I think it is very clear that we understand that there is a pot of domestic-violence money nationally and at a state level, and we should evaluate how much growth there has been at a national and state level and whether that growth has flowed to Philadelphia proportional to our need. Because I know that at least in child welfare, we get 50 percent of the child-welfare budget in the State of Pennsylvania because we need to get it because we have 50 percent of the problems. I'm not sure what the share is in domestic violence. And I would be part of being -- part of a work group to fight for resources.
I think we need to find out what our share is that we get. And if it is not the proportional aspect, then we need to begin advocating. COMMISSIONER MARTINEZ: Because, 350 12/18/02 - PUBLIC HEALTH - BILL 020613 Councilman, what I struggle with is the notion that we continue to talk about cutting taxes and cutting resources and cutting back and fiscal crisis, and then we talk about, well, we need to add services. I think we in the city need to get really aggressive about fighting for our fair share. And I am not saying that in this particular instance we haven't, but fight for our fair share --and we have a State Representative here -- from state resources and federal resources, in addition to maybe sacrifice some things that we are doing that may be less important than other things.
I am in total agreement with that. The thing is, we have some problems that as a city we need to face. And as we struggle with trying to get more funding, we need to be able to see how we redirect the resources that we have, or whatever resources we have we begin to prioritize. Like I said yesterday, and I said it today, and I think Frank made a referral to it, when we were discussing the IKEA 44 acres, this place was filled with people from the Administration, with Councilpeople, with everybody. I mean, we had a 351 12/18/02 - PUBLIC HEALTH - BILL 020613 room full of folks. Actually, we changed by zoning, we made somebody very rich by just changing the zoning. We transferred $20 million from -- we made a property that was worth $6 million worth a minimum of $20 million. But we need to be able to, as the Women's Law Project, Carol Tracy, and everybody said, this is a crisis that the city is facing. When you get 15,000 women -- and that is a small number -- filing petitions, then we as a city and as a government, both Council and the Administration, we have got to look at how it is that we can make a change. One of the things that hit me, because I didn't know it before, is, when they go down there, there are no services, family services, provided to this woman who is in a very distraught state of mind. So she goes down to the judicial center, comes before an individual that probably doesn't understand the problems that she is facing, is given some advice as to how to fill out a Protection Order, and then is told to go back home and serve it 352 12/18/02 - PUBLIC HEALTH - BILL 020613 on her husband. We need to be able to look at how we change that first step that is taken, from there on in, and what services are needed at that level. And it is family services, whether it be from DHS or getting some of the advocates together and saying, look, we need to provide 24-hour services down at the judicial center in terms of family practice and so on. Then we need to be able to look at how it is we are going to accomplish that. And we need to be able to get -- and, hopefully, with Ed Rendell in the Governor's office, while we still have a Republican Senate and a Republican house, that may be able to change. But the issue is, we have a crisis on our hands. COMMISSIONER MARTINEZ: Support at that point in time in a case is critical. I know that from experience. Not having support, when a woman has taken a step to file a petition, if there is any point -- I mean, you have to support them throughout the course of the case. 353 12/18/02 - PUBLIC HEALTH - BILL 020613 But that's one point where, number one, they could be putting themselves at tremendous risk. Because we know that violence escalates when they take action. So I believe that that's a priority. And I believe that there have been points in time where there have been resources there, and that's why I am a little surprised to hear that. And I think that government and the advocacy agencies and the state should work together to correct that problem.
I want to know how we achieve that. And I want to come out of these hearings with recommendations on how to achieve those things. COMMISSIONER MARTINEZ: And my position, to government, to my own agency first and foremost, but also to the nonprofit community, is that the answer cannot always be more money. The answer may also have to begin to be, well, what are we going to stop doing. What is of less importance to do this. And I think that, clearly, with the example that you are giving, you know, there are broader implications to this discussion. Because I 354 12/18/02 - PUBLIC HEALTH - BILL 020613 think the point you are making is that times there is always money for certain types of services and not enough money for others. But the bottom line is a social-service community controls a certain amount of resources. And within our means we need to make some decisions about what's more important and what's less important, or we have to fight for more resources at a state and national level.
State Representative LeAnna Washington. Did you want to say something? STATE REPRESENTATIVE LeANNA WASHINGTON: Alba, did I hear you say that you did prevention? What type of prevention services do you provide for domestic violence? COMMISSIONER MARTINEZ: Well, the Department of Human Services at this point, our prevention services are not specific to domestic violence; they are specific to family centers, truancy prevention. We do parenting programs. And within those programs there may be prevention around domestic violence, and certainly training is important. Our funding for domestic violence goes 355 12/18/02 - PUBLIC HEALTH - BILL 020613 to the Women Against Abuse shelter. We fund the shelter. We also fund the People's Emergency Center that, although it is not specifically a domestic-violence shelter, serves a lot of battered women. We provide funding to -- STATE REPRESENTATIVE WASHINGTON: Let me just say this: In terms of DHS, I think it is absolutely necessary that you, within your parenting and all those classes that you talked about, that there should be some signed of prevention mechanism in that that would help some of those people identify if there is a domestic-violence problem within that little program that you talked about. COMMISSIONER MARTINEZ: Absolutely. We fund $6 million in parenting education and support programs. And it is possible -- I don't remember exactly -- that a number of them are focused, although not it is not the only issue they cover, but focused specifically on domestic violence. It is our expectation -- STATE REPRESENTATIVE WASHINGTON: You said two different things there. You said you 356 12/18/02 - PUBLIC HEALTH - BILL 020613 didn't deal with domestic violence, now you are saying that you do. COMMISSIONER MARTINEZ: We don't fund specific -- STATE REPRESENTATIVE WASHINGTON: I am not talking about funding for outside programs; I am talking about what DHS does. COMMISSIONER MARTINEZ: Well, DHS is structured in a way that the direct services we provide almost exclusively are provided through contracts with other agencies. So of our budget of $550 million, $300 million are in provider contracts. STATE REPRESENTATIVE WASHINGTON: What I am asking you is this: I am asking you, in the prevention programs that you talked about, was there anything specifically in there that does intervention or helps to identify people who are in need of domestic violence services? COMMISSIONER MARTINEZ: I don't believe that we are funding programs that specifically focus on domestic violence only. I don't believe we are funding them right now. I am pretty sure we are not. 357 12/18/02 - PUBLIC HEALTH - BILL 020613 But I did want to just clarify that our parenting education programs, there is an expectation -- because, obviously, it is an issue that comes up frequently -- that they are able to respond to domestic violence and link families to programs that are in the domestic-violence network. We did publish a directory about domestic-violence resources. STATE REPRESENTATIVE WASHINGTON: Ms. Martinez, I am a domestic-violence survivor. So that pamphlet to a person, who is in desperate need, doesn't mean a lot. I mean, if I came to DHS for whatever reason, because my family was involved with DHS being in our lives, and there is nobody there that I might not be safe enough to talk to about domestic violence, and that can provide something for me, you know, a pamphlet doesn't really do a lot. COMMISSIONER MARTINEZ: Well, can I clarify? There is another thing that DHS funds, which is a pilot project working with the Institute for Safe Families. And that is -- perhaps I just need to clarify this. When I talk about prevention, the 358 12/18/02 - PUBLIC HEALTH - BILL 020613 programs that we are talking about, where we fund parenting education and support programs, those are programs that are out in the community where the families are not necessarily known to DHS.
However, when a family is known to DHS, what we do have in place right now is a program with the Institute for Safe Families, which is not sufficiently large, I want to say that up front. But it is a pilot where we try to integrate our investigative unit with domestic-violence services and with provider agencies. SCAN is the partner agency here. And what we are working on is learning how to, by using some specific cases, learn how to handle those cases in a better way. " It was to give more resources to our own staff at DHS, where often they don't even know who to call. And my position to my staff is, if you don't have the expertise on an issue, then at least know who to call to get the expertise. Your point is well taken. 359 12/18/02 - PUBLIC HEALTH - BILL 020613 STATE REPRESENTATIVE WASHINGTON: In closing, just want to say, with the service that DHS provides for the family, that it just seems to me that you wouldn't need a pamphlet; that that would be part of your resource information in your manual to be able to identify the resources that they need to refer somebody to a service or whatever is necessary. COMMISSIONER MARTINEZ: That's absolutely correct. STATE REPRESENTATIVE WASHINGTON: Just like they take children to shelters and do those kinds of things, they should be helping women to get to safe haven for themselves. COMMISSIONER MARTINEZ: I agree. STATE REPRESENTATIVE WASHINGTON: Thank you.
It seems to me that it is an easy answer, but it is a passing-the-buck answer, to say what we need are greater resources from the state and federal government. We all agree. But I think, beyond everything else, 360 12/18/02 - PUBLIC HEALTH - BILL 020613 what we need is a greater dedication by the city itself to make funds available for human services. There is a lot of dedication when it comes to economic development. There may be disputes about how we do it, whether this project or some other project ought to be used. But by God millions upon millions of dollars in special tax benefits are decided upon by the city in those areas because it is felt they are needed. What we need is some kind of commitment like that, that human services are every bit as important, I would say far more important, to the people who really count in Philadelphia, the people who live here hours of the day, 7 days a week. 16 I think commitment to human services is 17 badly needed. And it is no answer to say that we 18 got to get more help from the state and federal 19 government. We should, of course, try to do that. 20 But the best way of getting that is to 21 show our own ability within our own resources to 22 find the greater share for human services. 23 And to say it is shameful that 24 Philadelphia, among major cities, lacks so far behind in the adequacy of its provisions for 361 12/18/02 - PUBLIC HEALTH - BILL 020613 domestic violence. There was a statistic in yesterday's hearing that a shelter facility, a single-bed stays available in most major cities for every 523 female occupants in the city. In Philadelphia that number suddenly becomes 1 in, I think, 23,000. And that kind of a record is one that we ought to be ashamed of, and we ought to dedicate ourselves. You are the kind of person that can do that. You can spark that kind of fight. We know you can't make that decision. But within the Administration, your assistance in that direction would be extremely important to those of us outside the executive department in helping to shape the kind of budget that's really necessary. COMMISSIONER MARTINEZ: Councilpersons and State Representative, the best challenge you can give me is to say that I am passing the buck. You see, I take that as a challenge. Under no circumstances would I pass the buck on this or any other issue related to children and families. I think the point I am making, that in 362 12/18/02 - PUBLIC HEALTH - BILL 020613 addition, in addition to the issue of Philadelphia finding creative ways to invest more in this issue, that we should look at whether we are getting our fair share. That was my point. Because as we know, we have a city with growing needs and shrinking resources. So it wasn't, wait for the resources to do something. And I want to say that of course I would always want more resources for human services, because that's what I do. But under our Administration, we have really worked hard to put more money into prevention services and into children and family services under tough conditions. DHS, for example, is now spending $60 million on prevention programs and was spending 30 million on prevention when I became Commissioner. But, yes, we can do more. And domestic violence is an issue where I will concede as a city there has not been sufficient partnership between government and the nonprofit community to really make real change. We can't do it without them; they can't do it without us. 363 12/18/02 - PUBLIC HEALTH - BILL 020613 So thank you very much, and I accept the challenge as you have presented it to me today.
Thank you. See, I was going to get you go before that last question, but you can go. COMMISSIONER MARTINEZ: See, I talk too much, as always. COMMISSIONER JOHN F. DOMZALSKI: Good afternoon, Councilman Ortiz and members of the Public Health and Human Services and Public Safety Committee and Representative Washington. I am John Domzalski, Health Commissioner for the City of Philadelphia. Councilman Ortiz, I greatly appreciate the opportunity to come here and present the testimony about the Department of Public Health's involvement on the critically important issue of domestic violence. The Health Department adopted its domestic-violence policy statement in 2000. And this policy provides response protocols for cases of domestic violence among patients, clients, and employees. And before I proceed further with the 364 12/18/02 - PUBLIC HEALTH - BILL 020613 prepared testimony, I would just like to take a step back and say that our involvement from a public-health perspective on the issue of domestic violence is both patient-centered, prevention-centered, as well as looking at the issue from a community-wise, epidemiologic perspective. Domestic violence screening is considered the standard of care. And this is an important standard of care, if we are all at the Health Department providers of services. We identify, treat, and respond to victims of domestic violence and actively collaborate with other organizations in the community, and especially domestic-violence providers, to reduce and prevent domestic violence. I would like to spend a few moments responding to several of the specific issues that were raised in the questions from which our testimony was prepared. The Philadelphia Department of Public Health operates a review team that is called the Philadelphia Women's Death Review Team. This team is the first multi-agency, multi-disciplinary effort in Philadelphia designed 365 12/18/02 - PUBLIC HEALTH - BILL 020613 to prevent future violence-related deaths to women. The team employs a public health model to identify deaths where there is evidence of our history of domestic violence in the lives of women. The team began collecting data on these deaths in 1997. For 1997 through 1999 -- these are the last years for which we have data -- there were 129 homicides of women between the ages of and 60 10 years of age. 58 of these homicides were due to 11 intimate-partner violence. 12 In 2001, the team began collecting data 13 on women who were pregnant at the time of their 14 death or died within a year of giving birth in the 15 Year 1999. women died either while pregnant or 17 within a year of giving birth. Two of those deaths were related to intimate-partner violence and one death was unsolved at the time the case was reviewed. In our health centers, in our health-care centers, a recent survey of charts of women and patients ages 14 to 44 showed that 3.5 percent of patients admitted to current abuse and 8.1 percent admitted to past abuse. 366 12/18/02 - PUBLIC HEALTH - BILL 020613 Because women are frequently unwilling to divulge abuse, we believe that the prevalence is much higher. A recent charts review demonstrated domestic violence is routinely addressed as part of the health histories of patients in almost 50 percent of cases across our health centers. We have seen an upward trend since instituting a screening protocol known as RADAR. RADAR, whose initials stand for Routine Screening, Ask Direct Questions, Document, Assess Safety, and Respond and Review Options and Make Referrals --
Does this happen at all the community health centers? COMMISSIONER DOMZALSKI: Yes, sir. Yes. We made this a standard.
And the personnel is trained to be able to go through this whole process? COMMISSIONER DOMZALSKI: Yes. And the standard was preceded by --
Because Carol is there, and I know that she was interested in this a long time ago. COMMISSIONER DOMZALSKI: In fact, Carol 367 12/18/02 - PUBLIC HEALTH - BILL 020613 has been instrumental not only in getting our materials together today, but also keeping us informed and focused on this critically important issue.
That's why we have confidence in you and your department, see, because you have people like Carol. COMMISSIONER DOMZALSKI: And we are wise enough to know the value of the people we have, and we hope it will stay that way. An important element of this, our assessment program in the health centers, is that all staff must be aware of the problem, not just physicians and nurses. We have continued the training process with numerous followup sessions and refresher courses. The Institute for Safe Families has been instrumental in helping us implement RADAR in each of our health centers. Our behavioral health services system is an important component of the public health approach to domestic violence in Philadelphia. Anecdotal reports estimate that 85 to 95 368 12/18/02 - PUBLIC HEALTH - BILL 020613 percent of women who are using behavioral health programs have experienced violence in their lives; however, the true prevalence of domestic violence among these women has not been studied.
Go ahead. COMMISSIONER DOMZALSKI: Indeed, Carol Tracey, who was kind enough to share with me a recent report that she prepared on behalf of the Behavioral Health System, the report was important in identifying the relationship between, you know, substance abuse and trauma. And that the substance abuse is kind of a self-medication kind of thing, and where it is the antecedent to the substance abuse issues is, in most cases, the predominant aspect in relation to the substance abusing behavior.
That to me is an amazing number. From 85 to 95 percent of the women who are going through our behavioral health programs in this city have experienced violence in their life? COMMISSIONER DOMZALSKI: That's what these data indicate. It is significant of a problem. 369 12/18/02 - PUBLIC HEALTH - BILL 020613
And we don't have a way of empirically being able to establish that? COMMISSIONER DOMZALSKI: I think with the --
And, if so, the next step is, do we have programs instituted, and within the department, to redirect those women to corrective measures? COMMISSIONER DOMZALSKI: We do, and they are extensive. And, Councilman, I have also been fortunate to have Assistant Health Commissioner Mark Bencivengo.
I see him back there. COMMISSIONER DOMZALSKI: He would be happy to help us out with the substance-abuse issues.
A week and a half ago Mark and I were in the gym together. As you can look, the gym is having not having an effect. But he told me that he had prepared the material already. COMMISSIONER DOMZALSKI: He did. Are you interested in having that 370 12/18/02 - PUBLIC HEALTH - BILL 020613 discussion at this point?
Go ahead. I mean, but just -- COMMISSIONER DOMZALSKI: Continue with where we are?
We can have a discussion. COMMISSIONER DOMZALSKI: Mark, did you want to come up and talk about this?
Go ahead. Just finish. And then we can remember and we will come back to this. COMMISSIONER DOMZALSKI: As we are talking, the city's Behavioral Health System has played an active role in the provision of services through survivors of domestic violence, particularly in the area of staff development and training. The office of Mental Health and Mental Retardation and CODAAP have benefitted from these training sessions. In 1998 the behavioral health systems training efforts were expanded through an innovative partnership with Greater Philadelphia Works. In response to behavioral health needs of women 371 12/18/02 - PUBLIC HEALTH - BILL 020613 transitioning from Welfare to Work, Greater Philadelphia Works placed behavioral staff at each of its regional service center where people received assistance in preparing for and finding employment. These employees have conducted workshops for clients about domestic violence, motivating some women to request assistance at those sites. Greater Philadelphia Works has also worked closely with staff from behavioral health systems and the Health Department to provide comprehensive trauma training, the comprehensive trauma training initiative. This initiative addresses the issue of domestic violence within a broader context of violence that also includes childhood, physical, emotional, sexual abuse, rape, and sexual assault. All of these issues contribute to a cycle of violence that is passed down from generation to generation. Through this initiative, over 1600 staff, from adult and children's behavioral health and other service systems, have received basic information and skills training on the nature and impact of domestic violence, sexual assault, 372 12/18/02 - PUBLIC HEALTH - BILL 020613 childhood abuse, and the nature and impact of trauma as it relates to individuals and families. substance abuse and mental health 5 agencies have been trained to provide a group 6 intervention model known as Trauma Recovery and 7 Empowerment. More than 180 women are attending both 8 or have completed the group so far. 9 Feedback from both clients and group 10 leaders has been exceptionally positive, with 11 clients reporting increased feeling of self-esteem 12 and support and decreased feelings of self-blame, 13 shame, and isolation. 14 Behavioral health services provides 15 funding to women in transition and -- 16
Do we have numbers as to how many individuals have gone through this? COMMISSIONER DOMZALSKI: We do. They are either in the material we have supplied or we will follow up with those.
They are? COMMISSIONER DOMZALSKI: Yes. Behavioral health services, in funding Women in Transition, an agency that serves women who have been victims -- 373 12/18/02 - PUBLIC HEALTH - BILL 020613
Excuse me, Commissioner. Do you know the number offhand, Mark? Come up just place it on the record. Identify yourself for the record.
Mark Bencivengo, Assistant Health Commissioner, City of Philadelphia. Over 1600 staff had been trained in a series of programs called the Cycles of Violence. And that training program has been offered a number of times. And over the times that we have offered it now, we have reached 1600 staff to train them on this particular issue.
And in terms of clients that have gone through, do you have numbers, in terms of individuals who have been advised, counseled through this by these individuals?
Well, we have the groups, the trauma empowerment groups. And there are several substance-abuse treatment programs that offer these specific groups to women who have been exposed to trauma; that can be physical or sexual abuse, domestic violence, so forth. 374 12/18/02 - PUBLIC HEALTH - BILL 020613 The feedback that we get from the women is extremely positive. They enjoy these groups, they find these groups very rewarding to be able to articulate what it is --
Do we have the number of individuals who are anticipating in the program? Just to get --
180 women are in those groups. Now, that's a very small fraction of the number of women in substance-abuse treatment programs. That's the number that are involved in those groups. Within the women and children's drug treatment programs, physical and sexual abuse and domestic-violence services are embedded within all of those programs. So while the number that I gave you of approximately 180 are getting the specialized trauma empowerment groups, the programs all deal with domestic violence, the substance-abuse programs. And upon entry into a program, a woman is screened for being exposed to domestic violence or to physical or sexual abuse. Now, often a woman does not want to 375 12/18/02 - PUBLIC HEALTH - BILL 020613 acknowledge that up front on an intake interview. So during the course of the treatment, she is more likely to acknowledge. And what's extremely important is to be able to have staff who are trained to address these kinds of disorders which the psychiatrists and psychologists would say are posttraumatic stress disorders, dissociative disorders, and so forth. So it takes a trained staff to be able to address those kinds of things.
If you identify a woman as a victim of abuse, what happens? What happens with her? What does the department set up to do at that point?
Well, since the number is so high within drug treatment programs, 85 to 90 percent of the women have been exposed to either physical or sexual abuse, it is a part of the program that within their individual and group therapies, these issues are addressed.
You say the number is a small fraction, and you have explained how they are identified. Is it then optional, voluntary that they 376 12/18/02 - PUBLIC HEALTH - BILL 020613 participate in this group?
The agency has to have people who have been trained in that particular approach. So agencies apply to the county office to be part of what we call the trauma empowerment group training. And then we select them and they go through a series of trainings in order to be able to offer those groups.
So these professionals rotate? The professionals that go through the training, they then rotate to provide the services to these women, or are they housed?
They are housed specifically within the agencies that have been trained.
So if you identify someone as being in that, and the individual that is perpetrating the violence, he is identified, so what happens?
The individual perpetrating the violence is not necessarily identified by name. I mean, the women may have been -- 377 12/18/02 - PUBLIC HEALTH - BILL 020613
But what happens then? I mean, that's information you have of a violent act being committed against a woman. And what is -- I mean, I just want to know --
Nothing. We are a public health agency, and we provide public health services and behavioral health services to these ladies. I would say that throughout the course of this testimony, one thing that I found particularly fascinating is that we focused, and clearly should, on the woman who has been the victim that have kind of violence. But we need to focus on the perpetrators. We need to do the kind of education that Commissioner Martinez talked about with families. We need to do parenting training. Extraordinarily important for us to be able to do that.
What do you guys do with that? Commissioner? 378 12/18/02 - PUBLIC HEALTH - BILL 020613 I mean, would with the batterer, with the individual, are they brought into the system? COMMISSIONER DOMZALSKI: They are brought into the system through the Behavioral Health System. And we do have a system response for batterers. Behavioral Health System provider network operates specialized outpatient programs that assess and treat individuals who are the perpetrators of violence. There are those individuals who require intensive inpatient treatment for violence-related issues. And DHS can authorize out-of-network programs that can best treat those at higher risk. So there is a Behavioral Health System aspect to this that recognizes the behavioral aspects of this and responds to it in a treatment context. Getting back to where we are with regard to the issues, the issues of recognition, awareness, and prevention. The issue of awareness is so critically important that I think one of the first meetings that I had after my appointment as Commissioner was 379 12/18/02 - PUBLIC HEALTH - BILL 020613 with representatives of the Institute for Safe Families talking about, you know, the fact that they had gotten some programs started of educating the staff in the health centers and were interested in continuing them. And I was then, and I am even more interested in that now, because of the critical nature of having everyone who interacts with clients being aware, aware of this issue. We understand that in the complex issue of domestic violence, that it may take as many as seven times for the issue to be raised with a client, with a woman who is a victim, before she will take a step in terms of either admitting and asking for help. So that issue of awareness is so critically important. And part of the issue is, is incorporating this into the treatment model, where, just as we finally have gotten physicians to begin asking people about things like, "Do you have a gun in your house? Do you wear seat belts," which is a very powerful question coming from a physician, to the question, "Is anyone abusing you?" And we also, in the public health and 380 12/18/02 - PUBLIC HEALTH - BILL 020613 health-care context, have to understand the full range of the complexities of this. We just completed about three weeks ago a training for all of our pediatric staff in the health centers. And I attended that session and gave a few opening remarks and stayed for -- just to see how this was different from the general issues that were outlined in our more generalized domestic-violence awareness reports from a practitioner. And the issue here is very complex, in that the practitioner has to be concerned about how that issue was raised when the caretaker, when the mother is bringing a child for care; so that it does not raise an issue back home where the child is put in the position of returning home and saying in the family context, you know, "We talked about the fact that, dad, you are beating my mother," in relation to the visit. So that has to be handled in a very professional and sophisticated way.
Commissioner, the testimony over the last two days have described the 381 12/18/02 - PUBLIC HEALTH - BILL 020613 situation in which women, the abuse of women and violence, domestic violence, as a public health crisis. Would you describe it in that way? COMMISSIONER DOMZALSKI: Yes. I would describe it as an issue that the health-care and public-health community has to understand within the context of the whole range of services for women. You know, I was in here at another hearing several months ago where we talked about infant mortality. And --
Isn't it something, I mean, that we are talking about that issue now in this Council. And I was the first one to hold hearings on it in 1986, I think it was; right? COMMISSIONER DOMZALSKI: Right.
And in the Year 2002, we are still talking about it. And we really haven't gone and done what we needed to do. We started. 382 12/18/02 - PUBLIC HEALTH - BILL 020613 Go ahead. I am sorry to interrupt you. COMMISSIONER DOMZALSKI: Well, you know that's important. And I would like to comment, you know, on that. In terms of the issue of infant mortality and in terms of the issue of women's health, I think, you know, also the Women's Law Project report pointed out that women tend to seek care in the context of either being a parent, a care-giver, or in connection with a pregnancy. And we need to also focus on the entire spectrum of women's health. Because if we are going to focus on issues such as infant mortality, we need to have, you know, women who are healthy across the spectrum of health needs and issues. And, to me, domestic violence is clearly one of these issues that confront women in our society that we need to focus on. And to be -- certainly to be aware, to be aware of, you know, the issues of stress that that creates. And I think in relation to the discussion you had with Commissioner Martinez about, you know, the issues that confront women when they 383 12/18/02 - PUBLIC HEALTH - BILL 020613 return home and they are going to decide, and having gone through the process of saying, "Yes, domestic violence is a factor in my life" -- and that's a big step, to say that -- and then to say, "Yes, I am going to do something about that," and then where is the wherewithal to be able to do that. That's an incredibly stressful situation which, you know, has to have negative impacts on women's health. So it is an important, hugely important factor with regard to women's health. I have to just comment also about several things I think that were significant to me in bringing the issue of domestic violence so poignantly to the fore for me. And I think one was the -- an event that we had on Valentine's Day in City Hall, where we focused on the issue of domestic violence. And there were two people there. There was a family, a woman who had been abused and her husband who was the batterer and who was recovering. And they both talked about their situation and what life was like before they decided to get some help with that. And another one was a man who was in an 384 12/18/02 - PUBLIC HEALTH - BILL 020613 earlier stage of recovery, talking about his relationship to violence and what the kind of empowerment that the exercise of violence gave to him in the context in which he was operating. And it was both of those things, one poignant and forceful and in the latter case chilling. The other event that was of significance to me was, I attended a reception very recently for welcoming the new executive director of the agency of Women Against Abuse. And two aspects of that. As I was in the room, I looked around the room, and I was one of three men in the room. And it occurred to me, you know, why is it just Women Against Abuse, I mean. And that was my own thought on it. But then as, you know, happens when you associate with tremendously talented and competent and creative people in government, I happened to be at the refreshment table with my colleague, Alba Martinez. And we talked about that a little bit. And she looked at me and she said, "Where is the 385 12/18/02 - PUBLIC HEALTH - BILL 020613 outrage? " And where do we raise these issues in -- not only in our professional lives, as we interact with our agency fellows and colleagues, but in our own social circles where we talk about this and say, you know, that this is wrong. " All right? It takes all of us, I think, to be articulating that position, to say that this is an issue, to recognize it. As embarrassing that it may be, to say that this is something that needs to be focused on.
I think that is what we have been trying to say for the last two days. In a very, very angry manner at times, we did say it. And I think we need to keep on articulating it in an ever louder voice. But, then, I think, as Councilman Cohen said, government has to make a commitment that the 386 12/18/02 - PUBLIC HEALTH - BILL 020613 outrage is going to be turned into action, and the resources are going to be provided, and we are going to bring in not only the government aspect, but all of the outside individuals, the agencies that are there. It is a huge problem, the magnitude of it. COMMISSIONER DOMZALSKI: And hearings like this, I think, are an important step to get that awareness out there, for us to be able to talk. I think the genius of this is that we hear what all of the agencies are doing, so that there can be cross-agency coordination, you know. We have a tremendous --
But the magnitude of the problem really hasn't been understood because there is not publicity. I mean, the only time you get publicity is when a woman is found dead, and then we find out that she had a ten-year history of domestic abuse. And then people say, "My God, somebody should have done something about that ten years ago. Somebody should have intervened in that ten years ago." 387 12/18/02 - PUBLIC HEALTH - BILL 020613 Well, you know, nobody did because I don't think we see it as the crisis that it is. I don't think we see it in terms of the problem that it is and the cost, societal cost, that it brings on us as government. So, yes, I think we needed to have that. And we need to have, when we have hearings like this, this room full of people expressing that outrage, that this thing and this message is not getting out. And when we do that, because, you know, when we have -- and I keep bringing it back. When we have a hearing here about building a baseball stadium, 500 people show up shouting and screaming. "If you don't approve that, you are going to take away our jobs." Well, you know, we need that same outrage about these family issues; that if we don't do something about it, you guys are going to take our jobs because the people will not get reelected. And we need that, and we don't have that. We don't have that. We don't seem to produce the same outrage and indignation. And then we have an incident like the one that Carol described in her 388 12/18/02 - PUBLIC HEALTH - BILL 020613 testimony of a woman and a child. And people knew about it, but nothing was done. And this happened this year. You know, so, yes, it is that the outrage needs to be expressed. And hopefully in this period of Chanuka and Christmas that has become the period of Santa Claus and extraordinary and extravagant consumers, that we can begin perhaps to look at how we spend, the government spends its money. Hopefully we can go on from there. Yes, David.
It seems to me that the Mayor of this city -- and that means the whole executive department -- spends more time explaining the difficulties in cleaning small streets from snow than in dealing with the problem we are talking about today. I have seen no executive leadership coming in saying, "This situation that exists is impossible. " And it seems to me the fault lies in the leadership of the city. People tend to listen to 389 12/18/02 - PUBLIC HEALTH - BILL 020613 chief executives. And if a chief executive acts as if this is not a problem or it is a problem that we can, you know, sweep under the rug, people will go for it. That's why there is no outrage generally. Because no one representing the City of Philadelphia, other than City Council or some Council Members, raised the issue over the years, no 10 one in executive leadership over many, many years has ever raised the issue that this is a vital part of life in Philadelphia. We are going to claim to be a world-class city, when every segment of our population finds help from government or from government-led activities that lead to people being able to live as human beings. And the person that's a victim of a batterer's problem doesn't live a human life. And we ought not to tolerate it, and the city Administration ought to take that position. We thought -- and that was the reason my sharp question went to Ms. Martinez. I was very excited when she became the Commissioner of her department, because I have known her for many years 390 12/18/02 - PUBLIC HEALTH - BILL 020613 and my wife has known her. We have known her as an intricate fighter for the kind of society we need and that government has to give leadership to. Yet, it seems that talented, very able people somehow get diluted when they occupy official positions. They seem to be overcome by the realities of the situation, rather than to be overcome by the enormity of the crimes being committed against our people. And I think it is a serious crime when government defaults on its obligation to the citizens. And, therefore, I am urging, in all of my questions, that the city take leadership in bringing this matter to the attention of the public to help us all organize a base of support for sufficient funding that would enable us to really have hotlines wherever needed, sufficient supports of services of all kinds to help people rid themselves of their battered victims; to help the batterers, who themselves are probably victims of some form of wrongdoing to themselves at some point, and they're living. Batterers also need help. 391 12/18/02 - PUBLIC HEALTH - BILL 020613 But the main problem that ought to be directed is to have a program so that everybody in Philadelphia who becomes a victim of the domestic-abuse situation, of a violent situation, knows where to go and gets help and service; doesn't get turned away, doesn't get people who act as if the people calling for help are somehow at fault. They are the people who most need help, and yet it seems to me at every turn we are ready to discuss but never to do for them. And I think we have got to begin doing things. And I think we are lacking badly in that regard, and I think the city Administration is lacking badly. I think the Mayor should have been here at the beginning of these hearings to say he regards this as one of the most vital and important situations. This is what determines the character of a city. Just as the nation's character is determined by the way in which its people treat the most vulnerable in society, so a city has to be judged in the same fashion. And I would like to see the 392 12/18/02 - PUBLIC HEALTH - BILL 020613 Administration subordinates free to state what I believe they feel. I have known you for many years. I can easily see you in the picture of a real warrior, you know, at war with the kinds of conditions that we say exist here and that you acknowledge exist here. But it seems to me you cannot do it by yourself.
But I do think that the fine people who help compose city departments ought somehow to get together. I would even be for men joining that group. Because yesterday I raised the question about women in power now, and there doesn't seem to be any change that's existed when women took over the top positions. Maybe we need men and women. And your suggestion about more men, at least let's get the men in government working together with women in government and saying, "This is a very urgent policy that needs attention. " COMMISSIONER DOMZALSKI: Without a doubt. Councilman, with a little trepidation and a great deal of respect, I take a little bit of 393 12/18/02 - PUBLIC HEALTH - BILL 020613 issue with some of this from the standpoint that -- and I guess it isn't so much issue, as maybe a context. You know, at various times I have been pleased to describe the Mayor as the first public health Mayor that we have had. And let me tell you what I mean about that. It is more than just articulating good health practices and behaviors; it is the whole focus on neighborhoods. That he was kind enough to invite the Public Health Commissioner, in addition to the Public Safety arm of the city, and throughout the city this summer, beginning on the Saturday before Memorial Day, and continuing even now, we are out in those neighborhoods. And it is a message not just about -- it is, you know, the safe streets are incredibly important, but it is an aspect of making our neighborhoods healthy. And because of the things that have been put in place by Estelle Richman, the Mayor, and then Safe and Sound, where we are actually able to map health-status indicators on a 394 12/18/02 - PUBLIC HEALTH - BILL 020613 neighborhood-by-neighborhood basis, that's the focus that the Mayor has brought to this. And I think that focus, where he relies on us for the leadership on program, is where we have to come to the table. Myself as public Health Commissioner, I have got that responsibility. We talk about infant mortality. We can almost get a callus on our hands from patting ourselves on the back for having reduced the infant mortality rate in this city by 10 percent; from 11 babies dying per thousand live births, to 10. That is not anywhere near the story. When you begin to look at this -- not only on a citywide basis, but on a neighborhood basis -- we find that the infant mortality rate is sometimes ten times higher than that in neighborhoods. We have some neighborhoods where the infant mortality rate is over 19 babies dying per thousand. And with the neighborhood focus, we are able to bringing our mapping strategy and out intervention strategy down to the neighborhood level where we can address that with community 395 12/18/02 - PUBLIC HEALTH - BILL 020613 organizations. So I think the posture of the government at this point is extremely positive from a public-health perspective and able to get our arms around an issue as complex as domestic violence. Particularly in the social services component, where every week, because of the creation in this Administration of the social services component, we sit at the same table with the Human Services Commissioner, the Health Commissioner, the Recreation Commissioner, and we assess and talk about a coordinated approach to complex problems that we have not been able to do before. So I think that there are a lot of good things that are going on. That's not to minimize in any stretch the task that's in front of us. But I think the awareness that hearings such as this enable us to bring to the subject, our own individual commitments to articulate a position on this, and our willingness to coordinate services across the government I think are very positive things.
Well, we don't want to derogate some positive things that have happened. 396 12/18/02 - PUBLIC HEALTH - BILL 020613 But it would be refreshing to find that the neighborhood program talks more than just about buildings and lots and opportunities for developers. We would like to hear that the neighborhood program, part of that neighborhood program, is going to deal with the domestic-violence problem. We are going to have neighborhoods where domestic violence becomes an historic relic, that people say, "Oh, only in those dark, uncivilized days did this ever occur." But, we don't hear that. What we hear are how many lots are going to be cleaned, how many structures today were told that owners may have to install doors and windows. Well, that's all to the good. We don't need to say that's not useful. Though, it would be good if we understood that when you rebuild neighborhoods, you have got to in the first place to put in the center of every program the human lives that occupy the buildings we talked about. And it doesn't do any good to rehabilitate housing, if the people who live in the housing are victims of the battered-victim syndromes that exist, and particularly in the areas of 397 12/18/02 - PUBLIC HEALTH - BILL 020613 domestic violence. That's what we are calling for. We are calling for the same kind of leadership that the Mayor is giving to the physical aspects of life in Philadelphia, which a passerby can see. We think that same attention ought to be paid to the intrinsic worth of human community, of how does a man live with a woman or man live with a man or woman live with a woman. Whatever the form of sexual orientation, this problem seems to prevail in every form of human relationship. And we think that civilization requires at this stage that we think not only of buildings as representing Philadelphia as the first-class city, but the power and strength of its citizens, reflected through the proper availability of services that enable families to live in decent conditions. And we don't hear that kind of call, and that's what we are asking. Because we have a lot of respect for Ms. Martinez, for you, for Estelle Richman, for Joyce Wilkerson. And I have a lot of respect for John Street because he has advanced a long way, and the ways that we think his focus has to be broader in 398 12/18/02 - PUBLIC HEALTH - BILL 020613 developing Philadelphia as a first-class city. And that's why we plead with those of you who are leaders in his Administration to raise these issues. Say, yes, when we talk about mortar and bricks and streets and snow, let's talk about human qualities, human problems. That's the message we are trying to bring to everybody here. And we are trying to organize in our own way, which is different from the way executives can organize, we are trying to develop an ability that the people express their feelings strongly and have an impact on the city Administration. And we hope the message comes. I am trying to develop as much dissatisfaction with the conditions of women in this city as I possibly can. Because I think it is outrageous the way women's problems are regarded as, oh, that's just a woman's problem. Well, that's a human problem. And my experience has been that women are generally more right than men, and to many men who still live today in uncivilized -- COMMISSIONER DOMZALSKI: You will get no 399 12/18/02 - PUBLIC HEALTH - BILL 020613 argument from me on that score. Indeed, it has been said that women are much more evolved than men.
Right. Right. But a lot of the men live in the belief that, you know, hitting a woman is proper, because that's the only way to make her listen. You know, I thought those ideas went out 200 years ago. But there is a prevalence among white males particularly that kind of approach. Well, you need strong executive leadership to say in this city, all people, every minority is fully recognized as being a human being and is entitled to all the rights of a human being. And, equally, whatever their sex, whatever their orientation, whatever their color or religion or anything. And we would like to see a real crusade on that. Because, otherwise, Philadelphia is never going to be a world-class city in the real sense. COMMISSIONER DOMZALSKI: I agree.
Yes. Let me first thank my colleague, Councilman Cohen, for the clarification on his position with regards to why it 400 12/18/02 - PUBLIC HEALTH - BILL 020613 is so important when it comes to creating systemic change around this one issue. Two things have happened for me as a result of the testimony. One is and where I do agree completely with Councilman Cohen, is that we do need more money, if for no other place, for more beds. I am astounded by the fact that we have one safe house in the entire City of Philadelphia. So that's a challenge I think we need to meet and build -- our case is well-grounded, I think, and well-anchored. And the challenge is for us to take that to the Administration and to respond in an affirmative way to that harsh reality. Money is not the end-all, be-all. Because what testimony also revealed to me is that, in some areas, it doesn't take more money; it just takes the leadership of the department heads to insist on systemic change by just tinkering with SOPs, standard operating procedures, and insisting that staff up and down the staff line honor what is already in place. So I wanted to go on record to say to 401 12/18/02 - PUBLIC HEALTH - BILL 020613 all the advocacy groups, and to the leader on this particular issue, that I am here to work collectively with the unified voice. Because my experience in City Council is that that's what wins when we are trying to create change, to work collectively and in partnership with government to send the message that change needs to happen. And when we hear that Councilman Ortiz had hearings on an issue like infant mortality in 1986, and X number of decades later we are just beginning to see real tangible change, the up side to that is, change is incremental, it is a slow process; the down side is that, it still takes too long. But we need to be encouraged that we are seeing it. So hats off, again, to the advocacy groups. I have been enlightened, and I am prepared to work in partnership with you to act on the couple of priorities that have reared their face during these hearings. Thank you very much.
Councilwoman, it was the same year that we had the first hearings on 402 12/18/02 - PUBLIC HEALTH - BILL 020613 AIDS, also, at that time. Thank you, Commissioner. I really appreciate you coming here. Thank you, Mark and Carol. I know the data that you have provided, we will make very good use of it. The Department of Housing, Emily Camp-Landis.
We have your testimony, and we are going to put it in the record. Tell me about the individuals and how many beds you currently have in your system.
This is the Office of Homeless. Identify yourself for the record.
Thank you. My name is Emily Camp-Landis. I am Assistant Managing Director for Special Needs Housing with the City of Philadelphia. And I would like to point out that I am here, actually, on behalf of Robert Hess.
Where is he, by the way? 403 12/18/02 - PUBLIC HEALTH - BILL 020613
He is currently serving our city on a jury. So if it weren't for anything else, he would be here.
So did I. Thank you. So we really appreciate the opportunity to testify. And considering the late hour, I appreciate the fact that we will just get to the questions. Currently in the emergency shelter system, we have approximately 1900 to 2000 beds in our system at any one time.
They are. What is the universe of population that is out there in need of beds, do you have an idea as to that, although we have just a need for 2000 beds?
Well, to clarify, we 404 12/18/02 - PUBLIC HEALTH - BILL 020613 actually don't ever turn anyone away. It is our policy to serve anyone who comes in requesting services. To the best of our ability, we try to direct people either to other systems or to alternatives outside of emergency shelter. But if those aren't possible, we will house them. So if you look at our budget, for instance, we show that we have about 2000 beds budgeted. If the need goes up, we will serve people.
You say in the testimony that Mr. Hess provided that 30 percent of the women who come to the emergency shelters indicated some form of domestic violence as the primary cause.
30 percent. And what's the breakdown between women in those 2000 beds and men? How many men, how many women in the shelter system?
You don't know how 405 12/18/02 - PUBLIC HEALTH - BILL 020613 many men there are in the system, how many women there are in the system?
I would be happy to get back to you on that. I am probably more familiar with individuals versus families. In that case, we probably have 80 percent of the people in our beds at any one time are members of the families.
If a woman comes in with a family and she has been the subject of abuse, what happens to her?
If she actually identifies it to us at intake? We actually have several staff at our intake --
What happens at intake? I mean, a woman comes in with a baby or her kids, or she just comes alone, like, what happens?
She walks in and she talks to one of our service representatives.
I mean, it sounds 406 12/18/02 - PUBLIC HEALTH - BILL 020613 like you are selling a car. What happens? What happens to Mary Jones? What is the first question asked of her?
I honestly don't know. I apologize. I am not as well-versed as Mr. Hess is in our agency. We didn't want to not be represented here, but...
Paul Bukovec and Gerry Evans. Gerry had to leave. Okay. Sit down and identify yourself for the record, please.
I am Paul Bukovec, B-U-K-O-V-E-C. I have some things written. Shall I do that?
No; just tell me what it is. 407 12/18/02 - PUBLIC HEALTH - BILL 020613 You have been here, you have been listening. Talk to me as to --
It will give me a chance to just introduce myself directly. As director of Menergy, a private counseling center for men created in 1994, I serve as chief clinician for a practice that specializes in the treatment of perpetrators of domestic abuse. As head of this treatment program for wife and partner abusers, I am responsible for programming, clinical supervision, and the coordination of all direct services, including evaluation and treatment of offenders. I was also the founder and director of Project RAP for Family Service of Philadelphia for over ten years. That was the first abuser treatment program in the Philadelphia area. So for most of the last two decades I have been intervening with abusive men to get them to stop their hurting ways. 408 12/18/02 - PUBLIC HEALTH - BILL 020613 As architect and director of two different treatment programs for men who have abused their partners, I have worked clinically with thousands and thousands of guys from all kinds of backgrounds and walks of life. I have given hundreds of lectures in scads of settings, put together a major two-day national conference on family violence in the late '80s, ran a monthly speaker series on related subjects for eight years, sat on countless committees, coalitions, and task forces. I was a member of the small group that wrote the statewide standards that serve as guidelines for the design of intervention programs for abusive men in the State of Pennsylvania. I had been interviewed in print and radio and TV, and in the last years I have seen 19 local battered women's advocates and administrators come and go by the dozens. I suppose I have been asked to address this body because of my experience in this field. I am honored and grateful for the honor, but I am afraid I also bring some skepticism to the table today. 409 12/18/02 - PUBLIC HEALTH - BILL 020613 The last time I was in City Hall, I was asked to speak in the Mayor's reception room on Valentine's Day earlier this year. I had made a wish list for changes in our fair city; some of which might, could bring about fundamental shifts and a potential break in the log jam that impedes a coordinated community response to dealing with perpetrators of domestic violence in Philadelphia. That wish list was very well received. Estelle Richman herself waved that list in her hand and declared it to be an outline for changes that needed to come. Unfortunately, in the ten months that have followed, there has been no substantive change in any of the items on that list. So today I am going to review some of those items with a tone of frustration and perhaps a little righteous indignation. But I am still doggedly optimistic that some reform might come, so I have made them into a holiday wish list. My first wish is regarding our court system. That the judges in our courts accept guidance and direction regarding the handling of 410 12/18/02 - PUBLIC HEALTH - BILL 020613 domestic-violence cases and recognize that their current narrow focus on anger management for perpetrators of domestic violence frequently misses the deeper, broader, and more dangerous issues in these cases. There is an amazing range and variety of abusive styles and a frightening array of possibilities and potentials for danger and/or lethality that walk into Municipal Court every day to be adjudicated for simple assault charges. Only a tiny fraction of these people are sent to agencies or clinical settings where people are trained and focused on understanding what to look for and what to do if they find it. Domestic violence intervention is specialized and difficult work, requiring specialized training. Clinicians need to be able to do specific assessment, to carefully ascertain the depth of the problem, the potential for dangerousness and even the potential for lethality in their clients.
Specialized treatment skills are also needed to address denial, minimization, and 411 12/18/02 - PUBLIC HEALTH - BILL 020613 supportively confront the entrenched resistances. Generic anger management is not that. The Pennsylvania Coalition Against Domestic Violence has suggested protocols and guidelines for intervention in these cases. Generic anger management is not that. The majority of our local judges have demonstrated much less grasp of the questionable value and significance of even the term "anger management" than Eminem did when he satirically co-opted the words for the title of his last national tour. At least the white hip-hopper has a fairly refined sense of irony. Every day our judges send scores of violent perps off to classes, without even a nod in the direction of careful assessment or evaluation of their potential dangerousness or lethality. They also routinely give three-month continuances in these cases. This is usually not nearly enough time to get the help that most of the defendants need. In most jurisdictions with good reputations for being tough on domestic violence, judges require treatment of twice or even four times 412 12/18/02 - PUBLIC HEALTH - BILL 020613 this duration. Philly judges have been notoriously resistant to training in domestic violence for a very long time. Instead, they have fixed on an easy, one-size-fits-all solution to a fairly complex and dangerous problem. Wish No. 2, that CBH, the City of Philadelphia's only managed-care behavioral health company for Medicare clients, finally find the will and the way to pay for specialized domestic-violence treatment of those poor, publicly insured abusive men and women in their case load. CBH has not paid for outpatient treatment for domestic-violence perpetrators for about three and a half years. They just stopped about four months after they began. No reasons given. If the powers that be or even the powers that used to be there at this alleged showcase project of city government would simply see the logic of providing payment for a much-needed service, some people who need this help but can't afford it could actually get it.
Political 413 12/18/02 - PUBLIC HEALTH - BILL 020613 contributions.
What could they be thinking? We will never know unless they return our phone calls. Wish No. 3, for DHS. That the Department of Human Services agree to grant its first ever regular contract for domestic-violence treatment for the hundreds of domestic-violence perpetrators in their case loads. The city-run agency, charged with the protection of our children in this town, has never seen it in its myopic wisdom to let a regular contract for treatment of domestic-violence perpetrators, who are also the fathers or caretakers of children under the DHS care. They can't, won't, haven't been able to commit to really dealing with domestic violence in a truly systematic way, though it affects a huge number of kids that they are supposed to protect. On a completely hit-and-miss, ad hoc basis, with no set policy, they have only granted a case-by-case contract to treat the occasionally randomly identified father. And then they take many, many months, even over a year, to pay for 414 12/18/02 - PUBLIC HEALTH - BILL 020613 their work. Strictly for self-preservation, Menergy had to refuse such deals unless and until DHS decides to create policies and regular plans and contracts with regular payment procedures for services for domestic-violence perps. DHS has been in the midst of studying the issue with a pilot project over the last two years. This has begun to have the feel of turning an ocean liner around in a swimming pool. Last wish, for our police department. That the police department of this city be willing to honestly and openly address the problem of domestic abuse perpetrated by police officers in their own homes by designing both appropriate internal policy and procedures, as well as a plan for the treatment of those officers and families in external treatment programs specializing in domestic abuse. One of the most visible positive changes in the criminal justice response to domestic violence in the last 20 years is the improvement in police policy and procedure for the handling of domestic-violence cases in this city. 415 12/18/02 - PUBLIC HEALTH - BILL 020613 Probable cause arrest policy and departmental directives have vastly improved the consistency and the fairness of our police response. The department deserves credit. It has truly shown improvement over the years. Unfortunately, within its own internal culture lie most of the same social ills and troubles which affect the community which the police officers serve. If the department would progressively address the issue of domestic abuse within the lives of its own internal community, it could take a leadership position in the city, state, and in the nation. There are very special and career-threatening consequences for police officers who are accused of domestic violence. Secrecy regarding even emotional abuse tends to be common and can become suddenly extremely dangerous. Wives and girlfriends need a way to get help for themselves and for their partners in early stages of trouble outside of the department's internal system for treatment. Cops themselves need a safe way to get 416 12/18/02 - PUBLIC HEALTH - BILL 020613 help with marital discord or power struggles that might lead to violence. The internal Employee Assistance type counseling program provided by the department is ilequipped to handle these cases due to the focus and skill base required. But beyond that, officers are not likely to be able to share openly about issues of domestic abuse in group treatment if all the other clients are also cops. The department could use an internal domestic-abuse program for staff and partners, could support its workers with externally provided services, and create a policy designed to intervene early and safely. Time and space require that I conclude the holiday wish list here. But there are other things we need, and there is always next year. Maybe then we will ask Santa for a few things from the probation department and the Defender's Association.
Do we have a copy of your statement? 417 12/18/02 - PUBLIC HEALTH - BILL 020613
Please. Could I have that. We will take that last statement to heart.
I am the director of a program that I began. There are five people who work for me, mostly part time.
There is one other group that's specifically focused on domestic violence, and that's the man who had to leave early, Gerry Evans. It is the Men's Resource Center. He has been doing it for a while. But we are the only two specifically focused on domestic abuse. Now, apparently there has been a burgeoning of anger-management programs in the city, because the judges are sending people to them. But 418 12/18/02 - PUBLIC HEALTH - BILL 020613 that's not what you asked me.
Could you explain again how your program differs from anger management.
Sure. Domestic-violence programs come pretty much out of the same movement as the battered-women's movement, but they came first. So we look at the problem from the point of view of abuse as a systematic problem; economic, social, emotional, financial. So we are not looking at anger as the problem; we are looking at how people get controlled in their homes around sometimes socially learned norms that men should be dominant in certain ways and so forth. So we analyze the problem very differently than it being an anger problem. You can be very seriously abused without a person being angry with you. You can be very seriously controlled by someone without being struck or screamed at. So domestic abuse is seen as a much more systematic function. And, so, we -- 419 12/18/02 - PUBLIC HEALTH - BILL 020613
Not just physical; but it is also kind of a socio-political understanding of the problem.
How many people could you handle, the facilities that exist, your organization and the other one?
We see about between -- well, what we do see is between 280 and 350 men a year. I could see, probably, double that. I don't know how big Gerry Evans' program is.
But you are the only facility of its kind in the city; right?
Well, Gerry Evans has a program, too. It is a little bit smaller.
There are two that deal with the perpetrator, with the batterer type of situation?
And between you two, you probably may attend maybe 300, 400 people a year?
We have a case load that the courts see of at least 15,000.
I would like to hear an evaluation of your kind of program from the victim's group. Would such a program be helpful or not? I am able to form a judgment as to whether or not that meets what we have regarded until you have talked about the victims. But I noticed certain speakers -- I know I was included among those -- who said that, I said, I thought that the batterers also had problems.
That they were kind of victims of some sickness or disease, I don't know what, that causes them to do the kind of battering they do.
Significant numbers of men who are batterers were abused as children or saw 421 12/18/02 - PUBLIC HEALTH - BILL 020613 their fathers hit their mothers. Sure. This is a learned behavior. And the context of the work is trying to unlearn that behavior, trying to teach people how to handle themselves differently.
Do the victim's groups have a feeling about the worthwhileness of that program?
Why don't you take the microphone for a minute, or somebody.
Cynthia Figueroa again from Women Against Abuse. And, yes, we do support very much the work, and that batterers' intervention programs are crucial to our work. Just to give a reflection, I was the one who talked about the tragedy about the shelter space that we have. Again, in Philadelphia, we were probably the poorest in the nation as far as dealing with this issue. A state like Massachusetts, that is much 422 12/18/02 - PUBLIC HEALTH - BILL 020613 smaller and has much less population, has approximately, I think, in the numbers of groups, 4 programs that exist for batterers. 5 And in a city like Philadelphia, we have 6 two very small operations. 7
And have you ever had 8 a contract from the City of Philadelphia? Or can 9 somebody go and somehow -- 10
Never; never. DHS has 11 never given us a contract. 12 And CBH doesn't even pay for outpatient 13 treatment for us. And we are -- what do you call 14 it? -- authorized by the state to receive such 15 payments. They don't pay us. 16
Well, I think we are 17 fortunate in that in new management -- for a long 18 time the management that directed the city -- maybe 19 will be able to tell us why that's so or tell us who 20 is going to look at it.
I just wanted to clarify that because there is lack of support from city government, there is a cost for services to go to Paul's program, which automatically cuts out a 423 12/18/02 - PUBLIC HEALTH - BILL 020613 really significant number of folks who can't afford the services because of the cost and the continued cost. So having services supported by the city would allow a whole other population access to this service.
Well, I know I would -- and I hope the Chairman would agree -- that this is an area that we would certainly want to look into.
We definitely will. And we will be in touch with you to continue this conversation. I would like to set up a meeting with you and talk about it. I saw Estelle come in. Is Ms. Richman here, Managing Director? Good evening.
Ms. Managing Director, thank you for coming. During the last two days, we have heard testimony that has been very distressing as to the current situation that we have in our city. And it is a situation that I think we 424 12/18/02 - PUBLIC HEALTH - BILL 020613 faced in other areas, and we decided to come up with the public policies to change it. And I hope that, out of this hearing, that that can be done. But I think it has been described as a public-health crisis in terms of domestic abuse and the situation we have. And you saw the last, you heard the last gentleman; that obviously we have women that are getting battered, but we also have the batterers. And there is no way, and programmatically we don't have programs and facilities and the shelters necessary to be able to even begin addressing the problem. And it goes from beginning with the 911 phone call, all the way up to the court system and the process that the women who have the courage to get to that point, the 15,000 of them yearly that get to that point, go through. And it is tragic. Because it seems like they get abused, and then the process, and at the end in the courtroom, they even get abused by the very process in which they have to partake. So hopefully you can come in and wrap it up for us and tell me and tell the committee that we 425 12/18/02 - PUBLIC HEALTH - BILL 020613 are going to begin entering into a process in which we are going to change this condition, and that we are going to get the advocate groups that have been coming forward into the same process that we use with the special victim's unit, which this obviously is also part of that. So, welcome. And you know the process. You can identify yourself for the record.
Good afternoon, Councilman Ortiz and members of the Public Safety and Public Health and Human Services Committee. I am Estelle Richman, Managing Director for the City of Philadelphia. Yesterday and this afternoon you have heard compelling testimony from a number of knowledgeable and committed individuals regarding the very serious issue of domestic violence. You also have heard about many commendable efforts to serve the victims of domestic violence and to prevent its occurrence. Behind the staggering statistics are individuals, families, children whose lives are affected by domestic violence in ways that touch every sector of our criminal justice, health and 426 12/18/02 - PUBLIC HEALTH - BILL 020613 social services systems. It is not an exaggeration to say that this problem is endemic in the lives of those who come face to face with our police, our courts, the District Attorney's office, the mental health and substance abuse treatment community, the child welfare and juvenile justice systems, and our health care delivery systems. In my view, there is no longer any questions as to the significance of this problem. There is no question about the recognition of the impact of domestic violence by those of us in the public sector, advocates, and private social service agencies who grapple with the consequences of domestic violence every day. The underlying question that faces us as we examine the lives, the statistics, and the overwhelming effects of domestic violence on families and communities is this: How can the considerable knowledge, resources, and commitment that exist in this city be brought together to help those who are victims of and those who are perpetrators of domestic violence? Over the past decade, I have had the 427 12/18/02 - PUBLIC HEALTH - BILL 020613 good fortune to work with many of those who have studied and addressed this issue. These individuals and groups have educated me as to the widespread nature of this problem and the absolute common-sense approach of a coordinated strategy to address it. Carol Tracy, an individual with whom I have worked for many years and for whom I have enormous respect, has been dauntless and relentless in her efforts at advocacy, research, and education regarding domestic violence as executive director of the Women's Law Project. A report recently issued by the Women's Law Project, at the request of the Behavioral Health System, responding to the needs of pregnant and parenting women with substance-abuse disorders in Philadelphia, paints a compelling picture of the documented link between exposure to violence and subsequent drug and alcohol abuse among women. This is but one of the bodies of evidence which shows that reducing and preventing domestic violence is a key approach to reducing many other social ills. As our city continues to attack the interconnected issues of homelessness, crime, 428 12/18/02 - PUBLIC HEALTH - BILL 020613 substance abuse, poverty, overcrowded jails, child abuse, delinquency, truancy, ann uneducated work force, our local economy, health-care costs and the quality of life in our neighborhoods, we must address the devastating effects of domestic violence and apply a coordinated response. I am pleased to announce today that Carol Tracy and Police Commissioner Sylvester Johnson have agreed to co-chair a domestic violence task force for the city. In January, I will appoint the membership of the task force, which will include advocates, medical and behavioral health practitioners, and service providers; public officials whose responsibilities include law enforcement, social services, and public health; educators, researchers, and other experts in the area of domestic violence and its effect; and, most importantly, representation from past victims of domestic violence, the true experts. Many of these recommendations have come directly from Carol Tracy and her colleagues.
The task force will be charged with assessing our current efforts at working with those 429 12/18/02 - PUBLIC HEALTH - BILL 020613 affected by domestic violence and determining how collectively we can do a better job at preventing it. I also will request that they make recommendations as to what operational policies, practices, and points of accountability should exist to drive a more coordinated response on the part of the city. And I will look to them to monitor the city's response to the recommendations contained in the recent report regarding pregnant and parenting women, as well as our response to recommendations which will result from their work. I am confident that our collective will and commitment to reducing and preventing domestic violence will draw upon the many existing positive local initiatives and will result in a more effective response and outcome. Thank you for the opportunity to speak to you about this important social issue.
Before I enter into something, Stephanie Gonzalez Ferrandez, who testified yesterday, was an attorney. Maybe you can help us in this situation. 430 12/18/02 - PUBLIC HEALTH - BILL 020613 One of the problems was about language and transformation services. It is a woman that is from Morocco. We had a hard problem trying to get, to finally get, an Order from the court. Today, Stephanie Gonzalez has been able to get a judge to give her an Order. When the paralegal went down to Family Court to pick up the Order, she was told that she could not enter the building by the guard. She explained that she needed to pick up this Order and was told that the doors were closed. Our paralegal is attempting, according to what you wrote me here, an alternate way to get into the building. Breaking and entering is not allowed. But the thing is that, there has to be a way for this woman to get this Order. And maybe you can --
My problem is, I have no 24 jurisdiction over the courts. I can break in.
With us. 431 12/18/02 - PUBLIC HEALTH - BILL 020613 34 South 11th Street.
No; it all belongs to the court. We have no entre to anything that's court related.
Get Massiah. Commissioner, I am incredibly glad you that are appointing the task force. We have problems in terms of the resources and the policies that need to be addressed before even the task force process works. And we need to see how some systemic changes come. Because we had some very compelling testimony in the last two days; from the amount of phone calls to 911, and the way that the different departments communicate or not communicate with each other, to the lack of services at the justice center when a woman comes before the Master or the Court, and for availability of counseling and other types 432 12/18/02 - PUBLIC HEALTH - BILL 020613 of social services that might be available and that DHS should be probably looking at to provide together with the social-service agencies and the applicants that we have here. And I think that before then, I think we need to be able to begin implementing and begin looking at how we begin changing. As you state, the underlying question in your testimony is, as we are examining the lives and statistics and the overwhelming effects of domestic violence, is, how can the conservative knowledge, resources, and commitment that exist in this city be brought together to help those victims. And how do we begin not a year from now, because that's too long a wait. But, how do we begin the process now? Because we have evidence of what needs to be done. And I think we should be able to start doing what needs to be done immediately.
I don't have any issues with that. I believe that the report that the Women's Law Project put together regarding the pregnant and parenting women with substance abuse outlines in detail exactly what needs to be done. 433 12/18/02 - PUBLIC HEALTH - BILL 020613 My hope would be that this task force would present the same thing. It is a very detailed objectives, goals. All the pieces you need to know about what needs to happen are there. My hope is that this task force would be able to do the same thing in about an eighth of the time. You are talking about speed. It took you about a year to put this together. My hope is they can do it real quickly, and then we can get to implement it.
Right now we have identified certain budgetary areas where we need some changes. For example, we need a hotline specifically along those lines. And some of the advocates put a price tag on that hotline of $900,000, 1-800 number, that can begin being implemented. We need to begin looking as to how do we provide beds and caseworker services as we go ahead and look at the task force work and so on. A city with only one safe house, and such an enormous problem. We should be able to see where the resources are going to be made available 434 12/18/02 - PUBLIC HEALTH - BILL 020613 to provide more than one safe house. For that, we don't need a task force to tell us that that is needed immediately. But an 800 number hotline is needed immediately. That, perhaps, social work and family counseling service are needed immediately at the place where women are going for emergency Orders. So these are things that we need to look at as to how we are going to be able to begin the responsiveness. And that will show, will show the commitment and seriousness that we have to begin going forward programmatically with the issues that have been brought forward. And I think that if those three areas, we can begin attacking those three areas and channeling and looking for ways to put resources, then I think the advocate community and the women of this city can really begin to look at us in a very serious manner, that we are committed to changing the conditions that presently exist. If we can begin working on those three areas immediately.
I certainly think it is 435 12/18/02 - PUBLIC HEALTH - BILL 020613 possible to look at those three areas and begin to look and see what we can do.
Okay. So if I see that and I hear that, and that's the commitment, we will begin immediately to look.
The commitment is to look at those areas. My hope is that we would be able to either find ways to sufficiently cut some of the activities that are currently done within the areas that we would look for these dollars or we would be able to get them from the state or federal government.
As long as we begin looking at where, how we are going to be doing that. And I will put that --
Thank you. No further questions. This committee stands in recess until the call of the Chair. (Hearing adjourned at 5:30 p.m.) 436 C E R T I F I C A T I O N I HEREBY CERTIFY that the foregoing proceedings of the Council of the City of Philadelphia of Wednesday, December 18, 2002, were reported fully and accurately by me, and that this is a correct transcript of same. RE: COMMITTEES ON PUBLIC SAFETY AND PUBLIC HEALTH & HUMAN SERVICES _____________________________________ DEBRA A. WHITEHEAD