I have a couple different questions, but I'd like to actually address these specific questions to CODAAP in the area of drug treatment. The recovery houses -- and those are the ones out in the neighborhoods -- the ones that we, 1378 3/4/03 - FY '04 OPERATING BUDGET as Councilmembers, interact with all the time, those individuals that help us do community services and sometimes we can just pick up the phone and get someone housed that needs housing. I believe -- and I'm sure a lot of my colleagues agree -- that they're an important ingredient in the drug treatment environment here in Philadelphia. My more specific question regarding recovery houses, how can we help them get funding? Can you give me information on the per diems that the other programs get? And I know recovery programs don't get a per diem, but maybe they can because they are actually housing most of the clients that a lot of the other programs are serving. I'll give you a chance just to answer those two.
As you move to answer that question, start out by defining what is a Behavioral Health entity versus a recovery house. What's the distinction between the two? 1379 3/4/03 - FY '04 OPERATING BUDGET
Okay. I'm going to ask Assistant Commissioner Bencivengo to help me with this one. But let me provide a little background and backdrop on this. There are recovery houses that are funded through the Coordinating Office of Drug and Alcohol Abuse. That funding started over about seven years ago. There are currently providers 10 under contract and they provide supports to about 11 350 individuals. So that is a part of the CODAAP 12 housing initiative, those 350. They are not funded 13 as part of a Medicaid benefit. They are not a 14 covered benefit. They're what's called a supplemental benefit, and the funding for those come from the Department of Health at the state and/or the Department of Welfare. So unlike outpatient and residential treatment for children, they are not an entitlement in that nature, which is why that growth has been measured and slow over the years. Because as we've been able to gather additional grant funds, we've been able to do some additional RFPs to expand the network of recovery houses. Some of those support mothers and 1380 3/4/03 - FY '04 OPERATING BUDGET children. Some of those are specifically dedicated around the Hispanic population. There's a small number of beds that are dedicated to individuals with HIV, as well, in the recovery centers.
Sure. We can provide you with a list as follow-up of those and where they 10 are located. 11
For example, is 12 One Day at a Time one of those programs? 13
Okay. I just wanted to make sure we're talking about the same types of programs.
So you're saying that those houses are funded through a supplemental benefit through the State Department of Health and Welfare?
The funding would come from one of three sources. It would come from either a state criminal justice source, because many of the 1381 3/4/03 - FY '04 OPERATING BUDGET recovery houses are linked to individuals coming back into the community, or health or welfare state resources.
I just noticed, some of the recovery programs in my district are in desperate need of financial assistance. And I know that they serve hundreds of people year after year, and we're constantly meeting with them to try to figure out ways to help them fiscally manage and get fiscal money to keep these programs alive. They're an integral part of neighborhoods. And I support them strongly. I want to see them continue and just need to figure out if we can figure out a way to help them get some financial assistance.
And I think that recognizing that has been difficult over the years because of where the resources come from. We generally do do that process and we could include anybody who you may recommend in any future RFP mailings as well.
I will do that. I don't want my time to be up. I want to talk a little bit about the SAP program that you have in schools and teen or 1382 3/4/03 - FY '04 OPERATING BUDGET adolescent drug treatment programs. I had occasion to help a constituent whose son smoked this drug, I believe called "wet." It has something in it, a tranquilizer or something -- it's PCP you said? It just threw his whole mental health just totally off balance. And we've been through a series of 302s and all kinds of things to try and help get this child treated. What is available for teens here in the City?
Well, there are a variety of access points. Let me touch on a couple of those first, in case there's any confusion about how to access services. Community Behavioral Health Member Services is one critical access point for the City of Philadelphia. And I can provide you with the 800 number where either this individual or any individual necessary can call. They will also help out with trying to figure out, does the individual have Medicaid benefits or not, and also provide some linkages for getting those benefits, as well. The other thing that they would do is also give you an array of potential treatment options. Whether the person's Medical Assistance or 1383 3/4/03 - FY '04 OPERATING BUDGET not, we do have a funding stream which will support some of the non-Medicaid individuals, as well. That would be a referral to some of the gaps that Councilwoman Brown indicated before, either some type of a traditional outpatient or rehabilitation service or potentially some of the school-based services that exist throughout the City, including the Student Assistance Program, including use of the Consultation and Education Specialist, and up to including, if necessary, some therapeutic supports that are provided one to one to children through Behavioral Health Services.
Most of it is on the outpatient basis. There is some residential capacity as well.
What exactly does the School Assistance Program, what kind of services do they actually provide?
They will actually do two things. Number one, they will help school personnel in the assessment of anyone who's 1384 3/4/03 - FY '04 OPERATING BUDGET identified with potentially problematic behavior. So they will, number one, work with the child and also the school personnel and the families. Their other major component is actually linking someone to services that are out in the community for either mental health or drug and alcohol or some type of ancillary service, as well. So it really is an assessment and then a linkage function that they provide.
And what are we doing with those individuals since the numbers have increased due to Safe Streets? What are we doing with the individuals that are seeking treatment, and do we have the capacity to help them?
Actually, at this point in time we have had the capacity to address the increased demand. We've seen an increase of about 190 individuals per month prior to Health Choices starting. And, touch wood, at this point of time individuals who have expressed an interest in getting into service we've been able to accommodate.
Do you have more programs, or the number of programs that you have in place are enough? 1385 3/4/03 - FY '04 OPERATING BUDGET
Currently the number of programs are enough and they've been able to expand to meet that additional demand.
Okay. You know, drugs, the use of drugs in our neighborhoods is what keeps our crime and safety rates up. Sometimes I think if we could get better control of the drugs and the use of drugs, then we wouldn't have so much crime in our neighborhoods. So it's a particular interest of mine. I strongly support recovery programs and I'd like to set up a meeting one on one to further discuss this whole recovery issue.
I would say, Councilwoman, that the knowledge of what RFP opportunities are there are very important. And I think we should take a proactive role and get that information to you and also to others that may be interested. Sometimes the business of doing business with the government ends up in somewhat more of a maze than it needs to be. I think we can 1386 3/4/03 - FY '04 OPERATING BUDGET help with that.
We would appreciate that. Commissioner, on -51 of the detail, you're requesting two contracts with PHMC. The first one is for $173,000 for administrative and analytical support services. The second, for $194,000 for management information and computer services. Would you please explain what PHMC is and what services they provide? Because as we go through the detail, there are numerous schedules. There's one on , 180, 190, 207. Again, I'm asking to explain what PHMC is and what services they provide?
PHMC is Philadelphia Health Management Corporation. I don't know how much information you want, President Verna. It started about 30 years ago when there was something called the Experimental Health Services Delivery System, which kind of didn't get off the ground, but the organization developed and 1387 3/4/03 - FY '04 OPERATING BUDGET it was staffed primarily by people who had an interest in public health, and they developed some expertise in providing public health related services. They've grown. And they are a non-profit organization that through which we are able to get services accomplished in an effected and efficient way. One of the things they help us with, for example, President Verna, is that we're one of the few cities that has an up-to-date and ongoing community health survey that goes on. Many cities do not have that. Philadelphia Health Management Corporation puts that together, conducts the survey, and it's a basis from which we get an awful lot of our health planning data, including data that helps us apply for grants. Philadelphia Health Management Corporation also enables us to get some of our work done in an expeditious and cost effective way. And they are an organization that we contract with to do various related services. For example, we have one contract on one of those pages, President Verna, of something like $1.2 million with Philadelphia Health Management Corporation that has to do with childhood 1388 3/4/03 - FY '04 OPERATING BUDGET lead poisoning. As I may have mentioned earlier, we do supplement our lead abatement services with private contractors. And it is through Philadelphia Health Management Corporation that we contract with those private contractors. So it is kind of a back office administrative support service that we contract for.
The make-up of the board, it is about 30 members and they're representatives of hospitals in the community. They're representatives of the Health Commissioner on the board. There is a representative of the Delaware Valley Hospital Council, the Family Planning Council, all principally non-profit health-related organizations are represented on the board.
I don't think my first question was answered about the $173,000 for administrative and clerical support services. And the second is for $194,000 for management information and computer support services.
I believe what we're 1389 3/4/03 - FY '04 OPERATING BUDGET contracting there for are support of nutrition services, supporting our health centers and some nutrition counseling services. These would be individuals that we are contracting for. So we contract for a certain amount of individual professional time and we contract with PHMC and they provide and pay for the individual.
Commissioner, in your detail, you show a PHMC and a PMHCC. Who is PMHCC and are they related to PHMC?
Well, President, I'll take the non-detailed response that, one, they're not related. They do provide a similar type of service. However, one began as a focus, primarily PMHCC, in the behavioral health/mental health area. I think Mr. Covone can pick up from there.
PMHCC was established back in 1995 as a result of a Robert Wood Johnson Grant that the City of Philadelphia received. They provide a variety of both direct clinical services, as well as some support services and management of programs for the non-Medicaid population that exists in the City.
Thank you. 1390 3/4/03 - FY '04 OPERATING BUDGET At this time the Chair would like to recognize Councilman Nutter.
Thank you, Madam President. Commissioner, I'd like to go back to an area where Councilman Ortiz was a little while ago. He was asking you about vector control. And you and I have had a number of conversations about some of those issues. What I'd like to understand for the record, actually, is what is the City's policy with regard to possum?
Well, Councilman, I'll take a step back and just note that, as we all know, I live up in Zip 19144 and we've got a lot of woods there. We kind of moved there and the possums were there. We'll continue to have possums. We'll continue to have raccoons. I will tell you two things. We do not have a specific service related to possums or raccoons, but I will tell you that we will provide a service anytime our furry friends are interfering with the quiet enjoyment of persons and their property, so we'll help people out. 1391 3/4/03 - FY '04 OPERATING BUDGET
Well, I understand that. Therein lies a little bit of the rub. I need you to explain, as my constituents have called -- and some of these areas are not necessarily wooded. They are in the flatter open landscape of West Philadelphia where we have at times a very serious possum/raccoon problem. And what people are generally told when they call is that they have to rent some traps, then get the trap, then date and place the trap and then when the animal gets in the trap, dispose of it. Now, do you think that anybody in Philadelphia is going to go through something like that? I wouldn't be touching it, personally. So it's just an unreasonable situation to ask constituents involved with these animals. They don't know much about them. They're dangerous. Some of them are vicious at times, if not rabid. We don't ask people to go out and trap rats in the street. Why are we asking them to deal with possum and raccoon and the like, which are much bigger?
I will tell you, Councilman, here's what I think about that. And my staff are probably either smiling or grimacing at this point. I think all of that is outrageous. To the extent that -- and I would say this to every member of Council. We do communicate. In fact, I was just looking over my files coming over here. In the last year, I've had 209 requests for service from various members of Council. And what I would like to have happen is, anytime you get that response -- first of all, I am going to try to weed it out on my end. I've got that responsibility. We shouldn't be telling people to pick up a raccoon or to trap a raccoon or trap a possum and rent a trap and all the rest of that. First of all, the first response that I will get -- and if you'll permit me -- is that, well, Commissioner, we cannot trap every raccoon and every possum in the City of Philadelphia. Of course we can't. And we're not asked to do so. We're only called when it's making an incursion on someone's property. So we can do this and we will do this. I will work on my end to make sure that those kinds of responses either are a thing of the past or that 1393 3/4/03 - FY '04 OPERATING BUDGET they never happen from this point forward. And I think I will have some help with that. In addition to that, if any Councilmember gets a response like that, I'd like to be called.
Our relationship is such that I have let you know about that. And you've been tremendously responsive. In an urban environment, after you get over a little bit of either the shock or the surprise or the kind of laughability of it -- and I've received some of these calls and, I mean, it is stunning to me where some of these animals show up. Again, I understand why they might possibly be in at least some parts of my district, close to woods and the like. But 56th and Master is not exactly close to Valley Forge Park. So I don't know how they are getting to these places, but they are running around. They terrorize people, adults and children alike. And the raccoons, they are some of the nastiest, most vicious animals you've ever possibly run into. That response from the government is really insane. The other thing that happens -- and 1394 3/4/03 - FY '04 OPERATING BUDGET vector control has been very helpful with this -- is I seem to recall last summer and in the fall -- and I don't know whether this is a climate issue, temperature issue or whatever the case may be -- but you'll get these, like, outbreaks of rats in the neighborhood, running around all over the place. And again, vector has been responsive on that particular issue. I'm actually very serious about some kind of policy to deal with these larger, nastier, more dangerous and oftentimes diseased animals that is a response above "go get a trap." That's no 14 response.
Absolutely, Councilman. You couldn't be more correct. And more than that, we've, in a lot of our programs, and with the advent of PACCA, we've actually discovered the information age. What we're going to be doing is keeping track of these kinds of complaints. When we begin to get, at 55th and Master, complaints like that in an urbanized area, something else is going on here that we ought to be attentive to and a little more proactive on as a government and as an animal control agency. 1395 3/4/03 - FY '04 OPERATING BUDGET In addition to that, on the rat piece, that's the kind of thing that we do need to be proactive on and we do need to focus on. And while we have an obligation to know what's going on in the City from that perspective, we'd also like at any point to invite you to call us -- and other Councilmembers as well -- when there might be an issue going on. Sometimes it's something as traumatic but simple as a broken sewer line or a lateral that we can identify that we can issue an order on to get corrected so that we can abate that particular problem.
Or where you have significant construction or demolition activity, significant disruption to the ground and other areas. A lot of times, again, the vacant buildings. They're literally scurrying and running. They're just out, again, in a row house community with kids and other people around. And it can be a quite frightening experience. And I don't know why it happens and I don't know what we do, for instance, when we have major demolition activity going on in certain places, if we prepare for that or anticipate that that may happen, but also let neighbors in the 1396 3/4/03 - FY '04 OPERATING BUDGET community know that it is a possibility, but also send our people in immediately subsequent to the demolition to anticipate it. You are disturbing some of these natural habitat kinds of places. And we want the demolition to take place, but we also don't want people in danger as we try to improve the community out there. So I think some of that coordination between the folks who are doing demolition, whether it's us or contractors, and the vector control people to anticipate that. I mean, you take down three or four houses, you might have that kind of activity going on. Obviously, we've got significant demolition activity that we're anticipating over the course of the next year through the NTI program, through the Office of Housing and Community Development activity. These things will happen. And I just think we need to be ready for it.
Absolutely. Part of the permitting process requires some abatement. But I will tell you, though,that one thing I think I need to go back and look at is to what extent do we communicate that in the neighborhood, as to what's going on. So I'll be happy to follow-up, 1397 3/4/03 - FY '04 OPERATING BUDGET Councilman.
Okay. Commissioner, I know that there's been extensive discussion prior to my arrival with regard to lead paint abatement, and I won't take you back through all that. What I did want to get for the record, though, is I seem to remember last year when we had a fairly significant breakthrough -- and I commend you for your efforts in this area. We talked last year about the significant backlog, as well as the new properties coming on-line. This was last year at this time, so we were talking about the current Fiscal Year. I'm trying to remember -- and I thought both from your testimony and material that I received from people in the advocacy community about this, what's the average cost of abatement for whatever anyone might consider a typical house in Philadelphia?
Good answer. We had a hearing a couple weeks ago and there was some discussion about lead paint abatement and the impact that that has on another entirely different program of the government having to do with settlement costs 1398 3/4/03 - FY '04 OPERATING BUDGET and some funding for a program that helps first time home buyers. And we'll deal with the subsequent decision later, but apparently a decision has been made to end that program because of a change in some federal regulations around lead paint abatement. But Secretary Hanna, who is the Secretary of Housing and Neighborhood Revitalization, I believe, quoted a figure of $10 to $12,000 for lead paint abatement. I had thought that that figure was exceedingly higher than what we had heard last year. Can you tell us based on any information you have where the $10 to $12,000 figure comes from?
Yes, sir, I can. I think in my responses and comments I need to give myself caution to say that what I'm talking about are those houses that has something to do with a child who is lead poisoned in the first instance. So my figures are related to that and that alone.
I don't mean to interrupt you. Because for some reason I had in my mind that there was a figure of $1,500 to $2,000 in our discussion last year. Do you remember that?
There was, yes, sir. That was a super clean, where we didn't have -- 1399 3/4/03 - FY '04 OPERATING BUDGET maybe a little bit of spot removal. In terms of where the larger abatement number might come in --
The to or maybe 7 even 10 to 15. 8 There are two parts to abatement. 9 Sometimes there is basic system repair that must be 10 accomplished before you can begin abatement. That 11 means that if there's a roof that needs to be 12 repaired, that has to be done. Sometimes it's an electrical system that's very hazardous that needs to be taken care of. Often, it's a plumbing system that needs significant interior repair. Those things need to be done, need to be done, before you begin abatement. So my $5,800 has to do with our treatment of surfaces within the house that are covered with lead paint. It does not include the preparatory work that may need to be done to those basic systems. I can tell you, Councilman, that we have worked with OHCD to get our properties on lists so the basic system repairs can be done. We've been successful with that. We've also known that some of 1400 3/4/03 - FY '04 OPERATING BUDGET those basic system repairs can be as much $7,000 to $10,000 on their own. So the figure you quoted, sir, doesn't surprise me when you looked at it comprehensively.
So we have a $2,000 job. We have the $5,800 job. We've got a $7,000 one and a $10 to $15?
And we might have something somewhere between $2,500 and $5,800 depending on just what needs to be done in the premises.
Okay. I just thought, again, based on last year's testimony -- I mean, I've never heard of $10 to $12. It didn't stand out. I'm sure there was some discussion of it in the larger context. I mean, these figures, are these numbers associated with your kind of average Philadelphia house which is kind of 16, 18 feet wide and 20 or so some odd feet deep, or are we talking about your larger twins and singles and all that kind of stuff?.
No. It's the basic house. And the thing with lead paint is, is that, one, if somebody didn't put it there in the first 1401 3/4/03 - FY '04 OPERATING BUDGET place, kids wouldn't be getting poisoned now. And when those houses deteriorate, the more deterioration there is, the more expensive they become in terms of both the abatement itself, as well as the basic systems that may have to be repaired in advance of the abatement.
Couple last questions. And I think part of these were asked earlier. The Philadelphia Health Management Corporation, I thought I heard a question regarding its board. There's a board?
I believe that the president of the board makes the appointments.
How was this entity created? This is a private, non-profit? 1402 3/4/03 - FY '04 OPERATING BUDGET
My version of history, sir, is that it grew out of the Experimental Health Services Delivery System that was kind of in vogue in the late '60's, early '70s. It kind of never got off the ground. The core structure remained public health-type professionals who began to do things in the non-profit world like data collection and some service provision, and it has grown to the entity that it is and that we rely on fairly heavily.
Okay. Well, I heard what you said, but someone had to create it or file 18 articles of incorporation or get a name registered. Who did that and what role did the City play in any of that?
I don't know that the City played an actual role, but I think that there have been various leaders. The present executive director is Richard Cullen (ph). And preceding him -- Richard has been there for, I think, 20 years. 1403 3/4/03 - FY '04 OPERATING BUDGET And then Jack McMeekan (ph) of Crozer Chester Health Systems had been involved with it. I think Carl Moore from South Philadelphia was involved originally in its creation, Mr. Carl Moore.
I don't know if this was asked earlier, can you give us a list of the members of the board, as well as the executive staff?
Now, why does the City contract through this particular agency as opposed to contracting directly with the providers?
It's a lot more timely, efficient, expeditious to do it this way. I'll give you an example.
I was just looking for Rob Dubow. This the part where the person at the witness table, Rob gets worried that they're going to say that it's just the way to get around the City's procurement process and avoid coming over here for anything. Is that now when you want to say that part?
It's an efficient process. My lead abatement piece is a good example 1404 3/4/03 - FY '04 OPERATING BUDGET of this. I have eight contractors that I contract with. If I were to contract with those eight individuals directly, I'd still be probably in the process of getting the first abatement done. PHMC does the business aspect of that, runs the contract, pays the contractors, we pay them. It works very, very well from that perspective. They do some other things that are a little more technical and intricate from a public health perspective, like the community health database. And they actually run some other programs in other parts of the department. But that's my interface with them essentially.
What's their administrative cost for providing these services and programs, or what's the percentage of the City dollars that they take?
And how much money does the City send over to PHMC? Mr. DOMZALSKI: From the public health 1405 3/4/03 - FY '04 OPERATING BUDGET side, about $10 million in total contracts.
On the Mental Retardation Program, they provide early intervention case management services. I believe that's about a $3 million contract.
So total of from 10 the government? Any other source of funding? 11
They would also bill on the 12 mental retardation side for the federal share. The 13 case management draws Medicaid money, as well. So they would bill the state directly for a portion of the Medicaid money.
Do they provide any service to anybody else, or are we the prime customer?
I understand that they do provide some health services to other jurisdictions. I believe somewhere out in Montgomery County, they've done some work for either the county or for the Borough of Norristown. And I think that they've done some work in one or two upstate communities, as well.
All right. Thank you very much. I'm going to assume that a list of contracts was already requested?
Has anyone raised 1407 3/4/03 - FY '04 OPERATING BUDGET the question with you with regard to level of participation by way of diversity in the contracting of the Health Department in terms of minority or female contractors?
Let's have a conversation about that. Of the various providers that you contract with, either directly or through PHMC, can you give me any information as to either number of contracts or contract amount with regard to minority or female contractors?
Yes, sir, I can. If I can just look at what our participation was overall in 2001 --
When you say overall, are you talking about the entire department?
Yes, overall. And also across the minority, women and disabled spectrum. We were at 16 percent. In our '03 Budget, that 16 percent has become 23 percent and --
Back up for a second. 16 percent represents what? 1408 3/4/03 - FY '04 OPERATING BUDGET
That represents the overall percentage of our contracts that are with either minority, women or disabled vendors.
Do you know within the percent what goes with which category? 7
Yes, sir. In the 8 General Fund -- and I'm going back to '01 -- there 9 was 4 percent minority -- did I say that wrong? The 10 total of all contracts -- instead of me taking you 11 through this line by line, my fiscal person suggests 12 that I tell you that we had $912 million in 13 contracts. Of that amount, $34 million, or 4 14 percent, were with minority vendors. Another $44 15 million of that was with women vendors, which 16 amounts to 5 percent. And a very small amount in the disabled community of $10,000. I can certainly provide this breakdown, Councilman.
That would certainly be helpful if you had a full report. And that's for the Department of Health?
Would you have '02 figures yet? 1409 3/4/03 - FY '04 OPERATING BUDGET
Why don't you put those -- unless you have them handy?
I can give them to you now. The minority contracting in '02 was at 6 percent.
I'm sorry. It's $1,000,064,000 of contracts. Of that, $28 million were with minority contractors, or percent. There was another $43,799,000 that were with women, which is percent. And, again, a negligible amount in the disabled community.
So actually you experienced a drop or a decrease from FY '01 to FY '02 in terms of minority contractors of $6 million.
If you can get to 1410 3/4/03 - FY '04 OPERATING BUDGET the Chair a full report on that. And do have any information in the same realm with regard to CBH?
Yes, we do. The numbers that Commissioner Domzalski was quoting includes Community Behavioral Health, but the breakout, we'll provide that as a separate line item.
That will be helpful. Thank you. How do you select the providers? Is there an RFP process, is this Professional Services contracts? How do you end up with the people that you end up with?
There is an RFP process. Just to be candid, Councilman, there have been times when people get into a situation of using the same vendor because they know the vendor or whatever.
We've gotten away from this. We're now looking at performance-based contracting where we're looking at the performance of contractors. We're paying more attention to our work statements and what we expect of contractors and we're also making changes in the contractors by 1411 3/4/03 - FY '04 OPERATING BUDGET going through an RFP process across the board.
Does it increase, decrease or leave the same business opportunity?
Are business opportunities enhanced, left the same, or possibly negatively affected by the RFP process?
Now, why do you think you have the small drop from FY '01 to FY '02 in your minority contractors?
I don't know. One of the things I will tell you with minority contracting is, just as I somewhat suggested to Councilwoman Reed Miller, that 1412 3/4/03 - FY '04 OPERATING BUDGET knowledge of opportunities needs to be out there. That we need to be very aggressive and proactive in making sure that all potential vendors know of the opportunities, not just those who may be on a particular list. And I'm not suggesting that there is a particular list, but --
Do you know how people are solicited presently or how people get information presently? Do you talk with Minority Business Enterprise Council, or do you send solicitations off of their list?
Yes. And we do ads. We'll advertise in the newspapers of general circulation. I'm not sure how much we advertise in neighborhood newspapers. I'm not sure how across the board we make opportunities known to people who may know of vendors from various places that are not in the business themselves, to actually have that as a business development part of our contracting process as well.
Let me ask this question. Has anyone ever raised this particular issue with you about levels of participation by diversity in the Philadelphia community in terms of 1413 3/4/03 - FY '04 OPERATING BUDGET what happens over at the Health Department or Health combined with CBH or Health combined with PHMC? Are any of their contracts a part of the figures you laid out to me, or do we not calculate what they do?
In the first part of the question, yes, people do talk to me about our minority participation. Our MBEC office reviews our RFPs, suggests targets of levels that we try to achieve. It's a focus and has been of the government to reach effective minority, women and disabled community participation. On the Health Choices side --
On the Health Choices side, I guess two things. Health Choices and Community Mental Health and Metal Retardation --
When you make reference to Health Choices, are you using that as a term of art? I mean, are you talking about CBH?
I'm talking about the Community Behavioral Health, yes, the name of the program that they operate. We consciously when we began that initiative back in the late '90s had actually had an "any willing provider" network for the first few years so that any provider who had 1414 3/4/03 - FY '04 OPERATING BUDGET been previously either through the state Medicaid system or through the variety of subcontracts that existed back then who were a behavioral health provider we allowed into the Community Behavioral Health network. So frankly, the network was probably larger than it needed to be, but we felt we needed to assure that opportunity existed at the time. Since then, expansion initiatives really have been targeted on the drug and alcohol side. RFPs are reviewed with MBEC routinely. We're looking at a case management initiative on the mental retardation side that we've reviewed preliminary drafts of that RFP with the MBEC folks and have solicited some feedback from them on that. So we consciously do try for new initiatives to go out there in a pretty open fashion.
Are there businesses or vendors out there who you think can provide the high quality of service that we should expect from either the minority or female-owned business community who are not participating or who we are not talking to or doing outreach?
I'm not aware of a lot of 1415 3/4/03 - FY '04 OPERATING BUDGET them. The larger minority entities have done a lot of business with both CBH and the community programs, at least on the behavioral health and the mental retardation side and continue to expand their service from that end of things.
Again, high quality should certainly always be first and foremost, but, I mean, you're up now up over a billion dollars in contracting opportunity. That's actually starting to get to be some fairly serious money. And as people are providing whatever service they're providing, and as long as quality is of the standard that we would like, I mean, a billion dollars goes a long way towards helping certain businesses function here in the City. I mean, as we talk about crime and drugs and a whole host of other things, I'm just a very firm believer that the best anti-crime program is a jobs program. And when people are working, they have a less of a tendency to get involved -- some -- in some other things, if they know that those opportunities are out there. I mean, if we're going to be in the business and we're going to provide these contracting opportunities anyway, the only 1416 3/4/03 - FY '04 OPERATING BUDGET real question is, who is getting the contract and ultimately who's getting paid. Let me ask one last question. And if you went on over this already, you'll just let me know and I'll read the transcript. The health centers, there was a story in the newspaper a while back with regard to the issue of reimbursement for services and co-payments at the health centers. Have you had this discussion on the record here this morning?
Why don't we be a little more in depth. How are we ensuring that we either get people signed up for the health care services for which we can be reimbursed or deal with the co-payment issue? Do we have people at centers who sit down with people and try to get them signed up for whatever health care they're eligible for?
Benefit counselors that are in all of our health centers. That has been since the beginning of the Fiscal Year.
Yes, sir. And we've 1417 3/4/03 - FY '04 OPERATING BUDGET ratcheted up that service since September to make sure that we have more benefit counselors, more people who can direct patients to the benefit counselors. We've elevated this to a very, very high priority in the Department. I personally met with every manager in our health centers. I've met with the medical staff. I've met with the medical leadership and the staff. And so we know the priority that exists for this for (sic) are no 11 longer to be not availing ourselves of the federal and state funds that support these programs and services.
Are prisons health services still under the Department of Public Health, or is that more a function of the prisons?
All right. I'll leave that for them. Thank you, Commissioner.
I wonder, Councilman, if I could just correct something that may have been a little bit misleading. I hesitate to talk about the doubling of small numbers as being any sign of progress. But 1418 3/4/03 - FY '04 OPERATING BUDGET just to give you some idea about where we've been going. We had the small decrease between '01 and '02 from 4 to percent. In our '03 contracts, that number has gone to percent. And our projection for '04 is that that will be at percent. So it's small progress.
I understand. But I believe in progress. I do want to ask you one last question. Commissioner, specifically as your position as the Commissioner of Public Health, what are the City's efforts directly in the area of smoking, smoking cessation and the general issue in the public health arena about smoking specifically and secondhand smoke, as well?
Smoking is one of the most dangerous things to the public health than anyone can do. That's been recognized. What the tobacco companies have perpetrated has been recognized and those lawsuits have been settled. As a result of those settlements, Philadelphia has received some tobacco prevention and cessation money. We are putting that into both of those three or four areas. Cessation and then 1419 3/4/03 - FY '04 OPERATING BUDGET prevention. Another is counter marketing. And we are also providing some amount of money this year for nicotine replacement therapy. So as people go into McDonald's and see the monitor on the counter, they're going to be seeing our anti-smoking ads there. On some 40 screens, movie screens, across the City you will see at intermission and at the beginning of films, tobacco counter marketing. At 7-Elevens, on the monitors in there, you'll be seeing counter-marketing functions throughout. And we also are targeting our services toward pregnant women and toward creating culturally relevant programs throughout the Philadelphia community by engaging community-based organizations in the delivery of our cessation and prevention services.
There are a number of cities and states that have taken these steps. What is your position, as the Commissioner of Public Health, on the public policy of banning smoking in public places and enclosed environments?
Well, we have an ordinance in Philadelphia that does ban smoking in public buildings, such as this one, our City Health 1420 3/4/03 - FY '04 OPERATING BUDGET Department facilities and other City buildings. From a public health perspective, no one should smoke anywhere at anytime, period. They should not. Bad. Bad for the people. Bad for the people around them. This also gets caught up into a question of when a community may be ready to go for a full scale ban of smoking anywhere at any time. New York City is undergoing the throes of this right now where legislation signed by Mayor Bloomberg a year ago will take effect the end of this month. And that community is grappling with that. Presently where we are in Philadelphia with this is that, to the credit of the food and beverage industry in this City, we're having increasing number of restaurants and bars and facilities and diners going smoke free. And last count, I think we've got well over -- I know over a hundred, and that may have greatly increased since the last time I looked at that list, of people who voluntarily went out of the business of allowing people to smoke in their facilities.
Lastly in that area, what's your view on the issue of the impact on employees or workers in environments that are, 1421 3/4/03 - FY '04 OPERATING BUDGET again, enclosed, and as a matter of their course of holding employment, are subjected to tobacco smoke pollution. What's your position as Commissioner of Public Health on that particular issue?
That issue is so timely that the Justice Program on NPR last night aired about an hour of this where they had the debate on both sides of whether there's constitutional right to expose others to smoke, whether you can, as a constitutional right, interfere with others' ability to do that. From my position on a public health perspective is that we ought to be educating across this community about the dangers of tobacco. There's no doubt about that. There's no doubt about that at all. So my position is we educate, educate, educate. And probably more importantly is get children, get these educational programs out to the child, so that just as R.J. Reynolds was able to take Joe Camel and get people to smoke one and recognize him when they were three and five years old, we can do the same thing about people and children so that they never think about picking up a cigarette. 1422 3/4/03 - FY '04 OPERATING BUDGET
I understand. Last question in this area. Is it possible for a smoker and non-smoker to reasonably, and in a health capacity, coexist in the same enclosed place? Is there anything to a notion of a "no smoking" section 7 in an enclosed environment, such that the non-smoker can be protected from smoke?
Sure there is. The issue is, what is enough? Is it separation? Is it positive pressure room? We've all seen in airports where there are enclosed facilities where people can gather and smoke. It depends on the place. It depends on the variation. And it depends on the engineering as to whether or not how safe that environment can be made.
I understand that. I'm talking about just one open room and all those parties being in the same space?
Thank you. Thank you, Madam Chair. Thank you Commissioner.
Thank you very 1423 3/4/03 - FY '04 OPERATING BUDGET much, Councilman. Councilwoman Blondel Reynolds Brown.
Thank you, Madam Chair. Let me underscore interest and expressed concern around people of color and women getting a fair break and fair opportunity with regards to minority contracting that has resonated in Council during these hearings. And with the leadership of Councilman Angel Ortiz, who has actually taken this by horns, we're all paying close attention to every department and how they are or are not conducting themselves with regards to making sure that taxpayers who look like me, and women, are getting a fair break in this town -- and Angel Ortiz as well.
Early in my testimony I raised questions about the gap of service in South, West and Southwest Philadelphia. Know that I will look forward to the report, that end product, which will speak to what those discussions yield and how you're going to move to fix that. 1424 3/4/03 - FY '04 OPERATING BUDGET
And I would like to provide one clarification on that since our prior discussion. There is a new program opening actually in West Philadelphia operated by the Consortium Children's Program targeted at this population. There's a second initiative where we're actually putting together an application for funding for that particular area, as well. And I apologize for not updating you on those two earlier.
Sure. That's an important update. Give me your definition or opinion of recovery houses.
I will give you the opinion from the perspective of what the City funds, as far as recovery houses. They really are a series of homes, non-treatment facilities, operated by this network of 14 providers that we've talked about earlier who are engaged with folks who are in active treatment. And that's the key linkage to those that are funded through our CODAAP Office. They are residential facilities. The facilities themselves do not 1425 3/4/03 - FY '04 OPERATING BUDGET provide treatment. In most cases they are operated by individuals who are in recovery, former recovering individuals. And each of the individuals in those homes are actively involved in treatment during the day.
When we factor in the concerns raised by my colleague, Councilwoman Donna Reed Miller, many of which I share, for those agencies that want to move to capacity or grow to capacity in terms of meeting the protocols of CODAAP, first of all, do you have a TA, a technical assistance unit at all?
There would be program analysts who would be available to provide technical assistance.
And during the RFP process when you then get that X number of agencies that don't meet the protocol, that don't meet the criteria, what happens with them?
I believe they are afforded the opportunity to review the review of the RFP.
Okay. So that's a standard operating procedure that happens?
I think with the letters 1426 3/4/03 - FY '04 OPERATING BUDGET that go out, it advises folks if they wish to be debriefed on the RFP.
Does PHMC, where we give $15 million, do they provide technical assistance of any kind to those providing direct services, or is their contract strictly with the Health Department and your unit of the Health Department? Because you mention in your testimony, PHMC provides technical services.
PHMC, the contracts that they provide on the mental retardation side, are actually service delivery. They are a case management component for us from the mental retardation end of things. They also are a direct service provider in drug and alcohol residential, as well, and they operate a number of programs. So they provide a multitude of services, but some of those are direct services. And primarily the services on the behavioral health and mental retardation side are actually service provision, not technical support or some administrative skill.
Okay. The Consortium initiative you just mentioned, that is scheduled to kick start when? 1427 3/4/03 - FY '04 OPERATING BUDGET
So with that said, in your supporting detail, Professional Services and Care of Individuals on -53N, Child Guidance Center has not been funded for the last two years.
Right. Child Guidance Center elected to get out of the behavioral health business a couple years ago. A number of their services were picked up by Consortium, who picked up the outpatient services and also picked up and expanded the family base service that are provided in that area.
So would it be fair to assume that the services provided by the Consortium reach West, Southwest, and West Philadelphia residents?
Yes. There's two entities out in that particular area. The Consortium and Community Council is another provider in that area, as well.
Final question. The Center for Autistic Children, they also were not funded for the last two years. What might be the 1428 3/4/03 - FY '04 OPERATING BUDGET reason?
The Center for Autistic Children, actually, their funding shifted from primarily county contracts to Health Choices initiatives. We were able to negotiate. Because of the special nature of their program, there was a special contractual arrangement that was negotiated there that enabled us to move the resources from what had historically been Community Mental Health dollars to Health Choices.
New mothers visits. There was a lot of discussion about that last year. I didn't read anything like that in the testimony, but I am curious to know how are we doing with new mothers visits? Are we at capacity? What are you doing for outreach or raising awareness to let new mommies know that the service is available?
This is our David Olds Program that you're referring, Councilwoman, where -- David Olds, is kind of a brand name. It's kind of a patent that comes out of 1429 3/4/03 - FY '04 OPERATING BUDGET Colorado where David Olds, a Ph.D., has identified certain criteria that he believes achieves an outcome for first time mothers and their infants. And we've implemented that here in Philadelphia. We have a capacity and it's a good program. It's a good program. And I very much appreciate the availability of the funding that allows us to make this happen. We're learning a lot from it. I will tell you that we are at capacity, and the capacity is 400 first-time mothers and their children, newborns. I'm a little hesitant in this because when I use the number 400, the other number that's in my mind is 10,500, and they're the mothers and they are the babies, the newborns, that need home visiting. And we're going to do something about this. We are going to increase our home visiting process. We're going to inform our expansion that we're going to be doing through all of our maternal and child health existing programs. We're going to inform that by what we learn out of the David Olds project so that we can achieve the best health outcomes that we can for women and their newborns. This is one of the major ways in which 1430 3/4/03 - FY '04 OPERATING BUDGET we're going to impact on lead primary prevention in children. And it's also one of the ways in which we're going to impact on infant mortality.