COUNCIL OF THE CITY OF PHILADELPHIA COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES Room 400, City Hall Philadelphia, Pennsylvania Tuesday, May 21, 2024 2:00 p.m. PRESENT: COUNCIL PRESIDENT KENYATTA JOHNSON COUNCIL CHAIR NINA AHMAD COUNCIL VICE CHAIR QUETCY LOZADA COUNCILMEMBER KENDRA BROOKS COUNCILMEMBER NICOLAS O'ROURKE COUNCILMEMBER RUE LANDAU COUNCILMEMBER CINDY BASS COUNCILMEMBER MICHAEL DRISCOLL COUNCILMEMBER ANTHONY PHILLIPS COUNCILMEMBER MARK SQUILLA COUNCILMEMBER ISAIAH THOMAS COUNCILMEMBER JEFFERY YOUNG, JR. RESOLUTION 240197. - - 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Good afternoon. This hearing is called to order. This is a public hearing of the City Council Committee on Public Health and Human Services. The purpose of this public hearing is to hear testimony on Resolution No. 240197. Just noting my councilmembers who are in attendance as committee members. Councilmember Lozada, who is vice chair, Councilmember Thomas, Councilmember Driscoll, Councilmember Landau is almost here, and Councilmember O'Rourke. Will the clerk please call the roll?
Here. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Present. COUNCIL CHAIR AHMAD: Thank you, Mr. Terry. I also want to acknowledge the presence of Minority Leader Kendra Brooks, the sponsor of this resolution. And will the clerk please read the titles of title of the Resolution 240197?
Resolution No. 240197, a resolution authorizing the Committee on Public Health and Human Services to conduct hearings concerning the rapidly evolving and worsening crisis of overdose deaths and their impact on neighborhoods, particularly in Black communities across Philadelphia.
The chair recognizes Minority Leader Brooks for opening remarks.
Good afternoon, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. everyone. And I want to thank Chairwoman Nina Ahmad for your office's leadership in helping schedule today's important hearing. I appreciate all my colleagues on the Committee of Public Health for their participation today, and I look forward to discussing with you further about today's topic. Overdose prevention, harm reduction, and addiction support services are all the issues that I worked on during my first term in Council. I worked on these issues because they are personal to my family, to my community, and to my city. I want to be clear about today's hearing and the importance of it. Some in this body remember when I led a trip to tour over those prevention centers in New York City. Overdoses in Black and Brown communities are a public health crisis, and I am committed to making sure Philadelphia gets this right. We cannot repeat the mistakes and trauma of the war on drugs undertaken by the Reagan administration in the '80s. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. I'm reminded of the Black women leaders who have fought this fight for decades, people like Dr. Rashidah Abdul-Khabeer, who was born in Nicetown and who was the care coordinator and caregiver for the first HIV AIDS patient treated at Albert Einstein Medical Center in Philadelphia. She trailblazed a Care First approach during a time of deep panic over poorly understood disease. She went on to found Blacks Educating Blacks About Sexual Health Issues, Bebashi, a non-profit providing food justice, sexual education, support services for people living with HIV AIDS. It took a concerted effort and broad investments in addressing root causes to turn the tide on HIV and AIDS. But that tide is still leaving too many Black people without access to HIV AIDS resources and treatments. Still, I firmly believe that that kind of concerted investment can and will return -- will turn the tides in today's epidemic of overdose deaths, especially as we learn from our past. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Overdose deaths in my neighborhood in Nicetown have nearly doubled in the last five years, according to the data from the Philadelphia Department of Health. This trend is not just limited to only North Philly. We're seeing similar increases in overdoses in Kingsessing, Port Richmond, Southwest Philadelphia, parts of Center City, and up into the Northeast. Just this year, I have referenced in my remarks in front of this Council body, we had nearly a dozen elders overdose in their homes in Nicetown over a course of a couple months. The way substance-use disorder and addiction is showing up throughout our cities underscores the urgency at which we must work to address these issues. The growth of substance use in areas outside of Kensington also underscores why it's important to look at how it shows up in areas that just do not have an open drug air market. In fact, one of my first budget hearings this year, I received -- joined my first budget call 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. here -- this year, I received a call to my phone about connecting an individual to treatment services. He had just experienced an overdose of someone close to him, and he wanted to take the steps to get better. This happened -- this happened to coincide with the testimony of our city's health department. My team and I sprung into action and were able to identify a bed and rehab center for this individual. I'm happy to report that today, this individual has entered into a long-term recovery program, and we continue to support his journey. Unfortunately, this story falls outside the norm of treatment in Philadelphia. Most people experiencing these issues cannot access beds, and they cannot -- and they have to wait for days, weeks, or even months to get into treatment.
But we know that the majority of the people who are struggling with substance use aren't able to wait that long, and too often, that delay leads to relapses. Our Council and the Parker 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. administration has been contentious -- has been in contentious debates about the future of addiction services and what that looks like. And to that end, I want to make sure that all of us are hearing from all different folks affected by substance-use disorder. And I know that in my community, the root cause of why we're seeing elders overdose in their homes alone requires a different approach than those who are experiencing homelessness and housing insecurities. While our city has correctly focused on opioids, fentanyl and tranq, I have seen how misinformation has led residents to believe that overdoses are only a product of those drugs or that drug. This was detailed in an article in the Enquirer that showed the shifts in overdose between Philadelphia neighborhoods. For today's hearing, I want to put together a collection of individuals who could educate, contextualize, and share their personal stories on how overdoses are showing up in their community and in their lives. Through this, I 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. hope to continue the dialogue I started in my first term about how we can best reach and help these communities. As I watch this debate unfold on how to best address the public health crisis of overdose deaths, I have to admit that I have some frustration with the way harm reduction has been minimalized only to needle services or safe consumption practices. I want to clear up that information today and hope to work with my colleagues to grow a better understanding on how I approach this issue. Harm reduction is about providing people with the tools they need to survive and eventually receive treatment. We have Narcan. We have fentanyl test strips alongside other resources here because we strongly believe that living this principle and providing harm reduction resources at every opportunity is a critical part of saving lives. Narcan and test strips should be widely available at rec centers, schools, fire stations, and other city facilities, and we need to have a 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. comprehensive plan to distribute them across the city. But harm reduction is also -- is about so much more than even just these life-saving resources. For me, harm reduction is a broad range of services including healthcare, mental health care, education, and most importantly, directly addressing the root causes that often compound substance use disorder. Lack of housing, well -- or lack of well funded public education, lack of economic opportunities, and poverty in our community are all root causes of this public health crisis. That is why during my time in office, I've also worked to make housing more secure and affordable, improve the wages and benefits for workers, and investing in green spaces in predominantly Black and Brown neighborhoods throughout our city. Thank you so much. COUNCIL CHAIR AHMAD: Thank you, Councilmember Brooks. Is there anyone else who would like to be recognized? Councilmember O'Rourke and also 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. minority whip.
Thank you, Madam Chair. Good afternoon, everyone, and thank you so much for coming out to participate in this critical conversation. Thank you to Chairwoman Ahmad as well as to Vice Chair Lozada for helping to put this together and especially to Minority Leader Brooks for pushing this hearing forward and for painstakingly laying out how this overdose crisis is showing up in real time and who it affects. One point of emphasis is avoiding the mistakes of the past, mistakes that still haunt us. When Department of Public Health officials testify before Council that they think our funding approach will lead to an increase in the contraction of HIV and hepatitis C, that's a blaring siren that we're moving away from what has worked in the past. Sirens are meant to be heard and heeded, so today, we'll be exploring the full spectrum of, quote, harm reduction, which isn't 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. just syringe exchange, wound treatment, or even intake services -- though it is those. We'll hear about an expansive set of practices that take place within as well as without local government. And we need to understand this landscape well since this overdose crisis is escalating so sharply, specifically in Black communities. History demonstrates that the state has an unfortunate record of harming instead of helping Black folks in acute crisis, and we need to be deliberate about making a different impact in this moment. In my view, that starts by taking a carceral response to those suffering in this crisis of fatal overdoses off the table because the jails are in the depths of crisis, unfortunately, too. We want and need to impact the conditions that generate substance use disorders, say, for the people leading these drug distribution operations that work shouldn't include a significant role for our prisons department. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Before we get started, I just wanted to raise that just across the hall, there's a listening session for Philadelphia's reparations task force that we were just at, an initiative that I'm actually very excited about. I said in there and I'll say it again that we have so, so, so much to heal from. Part of that healing is moving past the stigma that is related to this issue, right? And I want to maintain this room as one that is free from the shame and the fear, and especially the isolation that can come with this issue. So it is my hope that our dialogue here today can lead to less isolation, more community, better care, and ultimately, a city of opportunity that works for everybody, even those who are often on the bottom of the socioeconomic ladder and who are on the margins of society. Thank you so much, Madam Chair. COUNCIL CHAIR AHMAD: Thank you, councilmember. Are there any other members who want to make a comment? If not, the clerk will please 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. call the first panel to testify.
First panel is Andre Chaney, Robin Walker, Noelle Foizen, and Dr. Palak Nelson. COUNCIL CHAIR AHMAD: Thank you all for being here. Please state your name and proceed with your testimony.
Hi, everybody. Good afternoon. Noelle Foizen, director of Overdose Response Unit. Good afternoon, Chairperson Ahmad, Vice Chair Lozada, and members of City Council Committee on Health and Human Services. I am Noelle Foizen, director of the Overdose Response Unit for the City of Philadelphia. I will provide testimony for Resolution No. 240197 on behalf of Mayor Parker's administration, and I am joined by colleagues in key leadership. On behalf of the administration, I would like to thank you for bringing attention to disproportionate rates of overdose amongst Black Philadelphians, a data trend that is reflected nationally. As alluded to in the Resolution, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. rates of fatal and non-fatal overdoses are at crisis level in Black communities. We share your sense of urgency in this matter and stand ready to continue to advocate for increased treatment opportunities, distribution of life-saving resources, and improved information dissemination, all of which must be culturally competent, centering the needs of Black Philadelphians. We have multiple data sources available that provide insight into the devastation of the overdose epidemic in Black communities and lay bare the intersectional considerations and embedded in our data. The medical examiner's office provides us with quantitative data related to toxicology and the number of lives lost, while qualitative data sources include the Drug Use Health Survey, OD Stat, which is our overdose fatality review, and more recently, data collected by Philly Counts, provides insight into lives and experiences and can help us better identify people that may be at risk of overdose. Additionally, data sources like the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. 2021 Maternal Mortality Review report lay bare the connections between Black maternal mortality and substance use. It is from that report that we know, for example, that non-Hispanic Black women made up 43 percent of births in Philadelphia from 2013 to 2018 but accounted for 73 percent of the pregnancy-related deaths, and that 58 percent pregnancy-associated deaths had a history of a substance use disorder. Further, this report informs us of increasing rates of drug-related deaths in the perinatal period, with 66 percent of drug-related deaths occurring after the traditional six weeks postpartum period. Many times, it seems as though drug use generally and overdoses specifically exist in racially segregated silos. In recent years, we have seen sharp rises and fatal overdoses amongst non-Hispanic Black Philadelphians. We also know from toxicology reports that use patterns differ between non-Hispanic Black and non-Hispanic White populations. For example, deaths involving opioids 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. only, like fentanyl, increased among non-Hispanic Black and Hispanic individuals and declined among non-Hispanic White individuals, while deaths involving stimulants, like cocaine or crack, contributed to the sharp rise in overdose deaths, particularly among non-Hispanic Black and Hispanic individuals. In the city of Philadelphia, the demographic group with the largest number of overdose fatalities in 2022 was non-Hispanic Black males with a median age of 55 years old, which I believe is related to the war on drugs. For decades, Black and Brown folks were subject to disproportionately punitive responses related to drug sales, possession, and use. One of the lasting effects of the war on drugs seems to be that people of color are understandably less likely to openly identify as a person who uses drugs, and thus less likely to proactively seek out harm reduction and treatment resources. Non-Hispanic Black males aged 55 were in their mid-twenties during the early 1990s, some of the harshest years of war on 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
drugs related policy. We believe there is a connection between overly punitive treatment back then and access to resources and services now. Data from recent years illustrates the citywide nature of the overdose epidemic. While the highest number of overdose deaths occurred in 19134, which is Kensington, other Philadelphia ZIP codes with a high number of overdose fatalities in 2022 include 19140, 19124, 19139, 19133, and 19132. Further, fatal overdose rates are increasing most rapidly in ZIP codes outside of the Kensington area. The majority of people that die from overdose in the city of Philadelphia are Philadelphia residents, and the majority of fatal overdose deaths occur inside residences, inside homes where many times, friends, family members, or roommates may not be aware that that person is using drugs. The data shows us that for many reasons, it is not as easy to identify who may be at risk of overdose as one would think. This identification and outing as a person who uses 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. drugs should not and cannot be a precursor for access to overdose prevention tools and substance use treatment resources. Much like we collectively understand that no single office, agency, or initiative can singularly prevent gun violence, we must also do so with overdose prevention. It is for these reasons that the city must take all available actions and opportunities to blanket Philadelphia with overdose prevention tools and treatment resources through multiple, layered, culturally competent approaches. While the city of Philadelphia's existing overdose prevention program is a start, we must stay the course and continue to grow and expand. For example, the Department of Public Health's community doula support program operates to support pregnant and postpartum parents with a focus on those parents with a history of substance use disorder. Support through this program includes assistance, identifying supportive paths to care for and manage recovery from substance use while parenting, advocacy with 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. healthcare providers, ensuring parents are clear about what is happening and coming up with questions to ask, and continuous support through the labor delivery. As stated in the Maternal and Child Health Journal, this is the only doula program in Pennsylvania offering one year postpartum support to birthing people affected by SUD or substance use disorder. In addition, as alluded to in the resolution that brought us together today, and as reflected in the national substance use landscape, Black people experiencing addiction are less likely to be prescribed medications for opioid use disorder or MOUD. Separately, we know that Black Philadelphians are overrepresented in the prison systems, and also that individuals leaving incarceration face an incredibly high risk of overdose. 4 million of the first infusion of opioid settlement funds to ensure adequate dosages of buprenorphine in prison. We hope to find additional funding to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. ensure individualized care plans and dosing, all of which reduce the risk of relapse and subsequent overdose for returning citizens. An additional highlight, a portion of the opioid settlement funds also went to the Overdose Prevention and Community Healing Fund, which was created in alignment with opioid settlements spending guidelines that called for community inclusion. The purpose of the participatory grantmaking program is to put funding decisions in the hands of community members to allocate funds to neighborhood-based community organizations. These community-based organizations are most likely to understand what is needed in their own neighborhoods with respect to substance use prevention and community healing.
In recognition of rising overdose rates citywide, the ORU, my team, coordinated with the Scattergood Foundation to create specific funding pools for the Kensington area, North Philadelphia, as well as a citywide catch all. This was to ensure equitable distribution of opioid settlement funds across 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. all of Philadelphia's most impacted areas. In spring of 2023, the ORU, Overdose Response Unit, developed a citywide overdose outreach and engagement work group at the request of the former managing director in response to sharp rises and overdoses in Black and Brown communities in Philadelphia. A key consideration of the plan is the understanding that many of the resources needed to develop and execute an equitable overdose prevention plan already exists within various city agencies. In response, the city of Philadelphia's citywide outreach and engagement workgroup address information gaps and resources in areas of and within communities experiencing rising overdose rates. The overall goal of this work was to leverage and align existing resources to ensure they equitably expanded across the city and ensure all Philadelphians, one, understand what overdose and substance use looks like in their area; two, have Narcan and know how to reverse an overdose; three, know how to access substance use 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. treatment; and four, understand how to access overdose adjacent resources. The development of this work group led to, among other initiatives, an incredible partnership between the city of Philadelphia's Overdose Response Unit and Office of Community Empowerment and Opportunity, also known as CEO. The door-to-door overdose prevention canvassing program aims to increase naloxone and fentanyl test strip distribution by bringing them directly to the doors of all Philadelphians. We have strategically deployed canvassers to ZIP codes with the highest increases in overdose fatalities outside of 19134. Approximately 70 percent of engaged households express interest in taking naloxone, fentanyl test strips, and treatment information. Since October 2023, when the program launched, CEO's Philly Counts canvassing team has knocked on over 100,000 doors, engaged in more than 10,000 conversations, and distributed 17,960 doses of naloxone and 20,978 fentanyl test strips. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Both locally and nationally, the response of the door-to-door canvassing has been overwhelmingly positive. My colleague, Andre Chaney, will be providing more detail shortly. However, I would be remiss if I did not tell you all that this program has been praised in national media, attracted immense interest from other jurisdictions, in which one expert said, quote, could be one of the most effective tactics, unquote, she's ever seen in her 25-plus years of working in harm reduction. Once again, I thank you for your time and attention and look forward to answering any questions you may have. COUNCIL CHAIR AHMAD: Thank you. The next witness state their name and proceed with their testimony.
Good afternoon. My name is Dr. Palak Raval-Nelson, and I'm the deputy health commissioner for the Health Department. Chairperson Ahmad and members of City Council, I am here on behalf of the Philadelphia 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Department of Public Health and our Division of Substance Abuse and Prevention and Harm Reduction, commonly called SUPHR. I will present testimony today on behalf of the Department and that Division on Resolution 240197. Substance use and overdose are matters that touch Philadelphians. The Division of SUPHR, in collaboration with our city and community partners, works to monitor overdose trends, provide free resources and referrals, institute policy changes to increase the health and well being of the people who use drugs in Philadelphia, and mitigate substance use related to harm that may impact the community. The Philadelphia drug crisis has been compounded by rapidly changing drug supply and a series of infectious diseases such as hep A and Shigella and synthetic barriers that limit the number of available resources for people who use drugs. Recently, overdose deaths have disproportionately increased among communities of color, particularly among non-Hispanic Black individuals. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Since 2021, the number and the rate of overdose deaths among non-Hispanic Black individuals has persistently surpassed other racial and ethnic groups. Between 2020 and 2022, the largest increase in overdose rates was observed among non-Hispanic Black individuals and those aged 45 to 64. In 2022, there were 1,413 unintentional fatal overdoses in Philadelphia, an 11 percent increase from 2021, and to date, the highest number of overdose deaths reported in the city. The increase coincides with the overwhelming increase in fatal overdoses among non-Hispanic Black individuals. From 2018 to 2022, the number of overdose fatalities increased by 87 percent among non-Hispanic Black individuals compared to 43 percent increase in Hispanic individuals and a 12 percent decrease among non-Hispanic White individuals. The increase in overdose deaths among non-Hispanic Black individuals has primarily involved stimulants, notably cocaine, but with and without the presence of opioids, primarily 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. fentanyl. Among the non-Hispanic Black individuals between 2018 and 2022, fatal overdoses involving a combination of an opioid and a stimulant increased by 146 percent. Overdose deaths involving stimulants without opioids increased by 64 percent. Overdose deaths involving opioids without stimulants increased only slightly by 36 percent. While fatal overdose among non-Hispanic Black individuals have increased overall, the impact of these deaths has been observed most predominantly in specific geographic areas of our city. In 2022, Philadelphia ZIP codes 19134, 19139, and 19140 experienced the highest number of overdose fatalities among non-Hispanic Black individuals. Preliminary data shows a similar trend for 2023, with similar proportions of overdose deaths among non-Hispanic Black individuals as observed in recent years. SUPHR has instituted a range of programs that directly respond to the increase in fatal overdose among non-Hispanic Black individuals. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. We formed a specialized outreach street team dedicated to engaging the Black community in high-risk areas, primarily North Philadelphia. Teams performed direct outreach to individuals, groups, and businesses by presenting overdose data and distributing resources like naloxone and fentanyl test strips at local events and outside community hubs such as libraries and grocery stores.
The team, in collaboration with our bereavement and neonatal assistance syndrome programs, uses these interactions to promote and support programs in Black communities. Dedicated social workers, counselors, and peer recovery specialists provide connections to resources and treatment, individual counseling, grief supportive groups, and workshops for children, adults, and families affected by substance abuse. Recognizing the need to engage with people who do not see themselves as substance users or are concealing their substance use, in the fall, we mailed literature about the increase in overdose and available resources to every 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. household in the five high-risk North Philadelphia ZIP codes, specifically 19133, 19132, 19140, 19144, and 19141. Approximately 85,508 mailers were submitted or mailed out. We also supported Philly Counts teams and performed the door-to door-canvassing in these areas. We continue our partnership with Philly Counts by supplying them with naloxone and fentanyl test strips to distribute citywide. To target the Black community citywide, we supported overdose response unit and vital strategies organization during the Black radio campaign. To specifically target people who use stimulants, we developed education resources for healthcare providers to comfortably discuss stimulant use-related risks and strategies for safer use with their patients. Our medical program will also host a supplemental webinar to provide additional support to medical professionals. On a larger scale, our team is developing media campaigns to educate the public on the risks associated with stimulant use, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. including intentional or unintentional mix of stimulants and opioids. Thank you for the opportunity to provide testimony on this topic. COUNCIL CHAIR AHMAD: Thank you.
Good afternoon, Chairperson Ahmad, also Vice Chair Lozada, and other members of Council. My name is Andre Chaney. I am the community engagement supervisor at CEO, which is the Office of Community Empowerment and Opportunity. I want to thank Councilmember Brooks for introducing Resolution 240197, which I am testifying on today, and I also want to thank Councilmember Gauthier and Young for having joined us out in the field during our efforts canvassing the neighborhoods, and we would like to also extend the invite to any member of Council to come out and join us. Your presence is greatly appreciated by myself and also the canvassers out in the field as well. Just a little bit about the work, my job is to manage a group of about 20 canvassers 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. as we deploy into neighborhoods that do experience high in-home overdose rates. We meet five days a week at a central location where we can give out some of these resources to the canvassers as they deploy into the neighborhoods as well. With that said, I knock on doors myself, and I have personally seen how impactful the work is, and I wanted to share a personal story just to kind of add credence to how, like we said, impactful the work is, which is also going to second some of the experiences that Councilmember Brooks said that she experienced, which is not the norm at all, but it is a beautiful breakthrough nonetheless. So while out in the field, we did encounter a young woman named Mary -- and that's not her real name. I just want to protect her privacy. And she was encountered by a few of our canvas members who called myself and our other supervisor, Anthony White, who isn't here today. And while the canvassers are out, we do have these resources, but outside of these resources, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. which is fentanyl test strips, which can help avoid an overdose, Narcan, which can help reverse an overdose, there's not much else that they can give at the door. The next step is to do a soft handoff to myself and other members that we are in connection with. And with that said, I had the opportunity to come out and meet Mary after our canvassers encountered her. And she was in distress, she was in despair. And she had told us that she wanted to go into recovery and she desperately needed the help. She said that she didn't want to involve her children who had already seen her journey with recovery because she didn't want to disappoint them. And we started to tell her the resources that we had available, our connections with DBHIDS, and things like that, and I think when it started to become real to her, she started to become a bit hesitant. And we told her, well, let's just call one of our specialists, have them come out into the field and talk to you and tell you what resources can 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. be available to you, in which she said, yes. So in the time that it took for them to get there, we actually drove her to Burger King and decided to sit down and have a meal with her. And during that time, we got to give her some of her humanity back, make her feel human again, just by -- just seeing the different side of her that isn't the addiction and things like that. Once DBHIDS arrived, they spoke to her. She said that she wanted to go into treatment. Unfortunately, she did go, and she said that she wasn't ready to commit, which is saddening, of course. A few days after that, though, fortunately, she did call back. We got a call from Rick Tall in which she said that she actually wanted to commit and go on the road to recovery, which, upon our last check in, she is still currently in recovery, going through that process, which is one of the beautiful things that we've seen out canvassing in the field. Every door that we do knock is an opportunity to meet another Mary in the field.
That's why we do the work that we do. Just to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. add some credence to the work, the canvassers as well, they also experience these encounters as well as they're knocking on the doors, currently referring folks who are at the door to a lot of different opportunities for treatment and things like that. Since October, we have had the opportunity to knock on 104,820 doors. We also engaged 10,306 individuals by way of conversations. We distributed 17,960 doses of Narcan and 20,978 fentanyl test strips. We want to expand the work, and I can't sit here and say that we do all the work, because as I look around, there are a lot of other members in the room that do the work and are dedicated as well. But to add credence to that, we also implemented what we call a trusted messenger program, which is us empowering folks of the community, giving them these resources and the information that we have, whether that's harm reduction pamphlets, community resources, fentanyl test strips Narcan, so that they can be a voice to the community members that trust them, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. thus spreading the messages on a much broader citywide range. Because we want to extend the work citywide. We've been in multiple communities, such as 19133, 19121, 19140, but we want to reach the entire city because it's that necessary to do so. With that said, we have been able to, with the trusted messenger program, connect with non profits such as the Black Male Community Council of Philadelphia, Ridge Allegheny Hunting Park Civic Association. We've had a very interesting and beautiful collaboration with Delta Sigma Theta and even a partnership with Philadelphia Housing Authority as well. And there are many other, including a number of community development corporations, as well. These training sessions have been particularly effective in reaching Black Philadelphians with participants identifying with 45 years or older, because we understand that that's our most affected population, and it's really important, what we found, for peers to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. talk to other peers. I want to thank the ORU team for partnering with CEO on this and the support of the City Council for the work that we do. I don't need the paper to say that I really do believe in the work that we are doing. When we go out in the field and we have these encounters on a daily basis, seeing folks say things like, I wish that you would have arrived yesterday because we just experienced an overdose just yesterday. Even canvassing in the Hill Creek apartment complex and talking to the project manager, who told us they had experienced about six or seven overdoses prior to us being able to canvass that area, it's very saddening, but the work is very necessary. So I am just one part of the work. Philly Council is just one part of the work. We all are together collectively a part of the work. So thank you so much for the opportunity to testify. And Robin --
Good afternoon. I'm Robin 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Walker, the deputy executive director for Place Based Initiatives in the Office of Community Empowerment and Opportunity. The work Andre just testified to is a great example of the new resources that are available at CEO since we completed our merger with Philly Counts and the Office of Civic Engagement and Volunteer Services in July of last year. Our merge team provides the capacity capacity to reach more deeply into communities to connect residents with resources available through door knocking, phone calling, text messaging, tabling at resource events, and other strategies. In addition to this important work with ORU, CEO has memorandums of understanding with other outreach programs, including the Philadelphia Water Department, to reach residents facing shut off to get them enrolled in customer assistance programs. Our MOU with the managing director's office supports text and phone calling for more than 22,500 households that have selected oh, I apologize that were selected 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. for auto-enrollment in the zero-fare program. We make sure to have we have the most up-to-date addresses and that we know how to look for the they know how to look for the zero fare card in the mail. We're also better connecting the residents we talked to through this outreach to other CEO programs like BenePhilly that helps people enroll in more than public health benefits like Medicaid, SNAP, 12 LIHEAP, and other programs, as well as the with 13 our community health worker program that 14 addresses social determinants of health. 15 I think it's really important for 16 Philadelphians to see city government bringing 17 resources directly to them instead of asking them 18 to come to us, so I'm proud of this work and this 19 team. We're grateful for the support of City 20 Council for the work and for the chance to testify today. Thank you. COUNCIL CHAIR AHMAD: Thank you. We'll take some questions from Chair recognizes Minority Leader Brooks. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Thank you so much, Chair Ahmad. So I wanted to say thank you. I'm going to start from Andre and Robin. Thank you so much for sharing your story, and it made me reflect on what brought me to this hearing, so I'm going to share a little bit before I go into my questions. It was the beginning of our budget hearings. I live in 19140, and I was traveling that weekend. And my phone Thursday night, Wednesday night, Friday night, each time, it was a community member that I grew up with, because I'm within 45 to 65 I'm not going to say the age; I'm in between there that such and such OD'd, such and such OD'd -- such by the time I got to four, that's a lot over a weekend. And it continued to grow, and my fear heightened. Because then I also got a phone call saying, the block is hot. It's getting ready to be a problem. Because these are people's parents, grandparents that are passing away, and folks were angry, some of which people didn't 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. know that their grandparents were getting out. It's a whole thing. I want to thank you guys for responding to call. I told my office, please call someone. We need to have an emergency resource event at a park. I called the park. You all made it happen in just a matter of a couple days, and I just want to say thank you so much for that, because you said, you know, they say, oh, just last week, you just made missed it. I couldn't have allowed this to continue, and I have access to information and the ability to make it happen. And I know you guys came out, knocked doors, gave out stuff at the park, did all of that. So when I give the testimony, I talked about the individual. They called a friend of mine and said, I'm ready. Can you call your girl? Because I'm ready to go. And we were able to do that while we're sitting in a hearing. We had him in a treatment center immediately. And it's sad because that's not the norm, because his friend was like, oh, it happens 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. that easy? Well, I'm ready, too. He wasn't quite ready to go, but it's the thought, and that's what we need to continue to create, those opportunities, and stop this notion that it's not happening to Black folks, like it's not happening to our seniors, and it's an invisible thing. So you had mentioned I mean, one of the questions is, we know that the substance abuse in our community is tied to criminality, and there's a lot of social stigma that comes with that. So what is the what are some of the steps that you guys are taking to address the stigma and ties to substance use and criminalization? What are some of the things you do around those two issues?
First of all, that's a really good question. We've been out, I want to say, since October, we've been canvassing, and that has definitely come up in a lot of the presentations that we give with the trusted messenger training that we do and things like that. I think the biggest thing is really 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. just education, informing that there has been an issue with criminalization of folks who have been taking substances and things like that, but also the information as far as how to be more informed with the things that is going on now. I'll be completely honest. When we did Canvas Hill Creek Apartments, the property manager said that one of the biggest things that she wanted to do with the fentanyl test strips was give it to the local drug dealers, only so that they can be more informed with what they were given, because what they were given was unfortunately ending a lot of lives. And upon doing that, it's like, you can't stop it. You can't necessarily go out. You don't have the jurisdiction to do so. So upon doing that, they were actually, they it's not that they wanted to kill the people that they were giving the substances to. So just the opportunity to be more informed was something that she took pride in being able to do. So I would just say education overall on all facets of the work is extremely important, so 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. that's something that we've been trying to do.
And I'm glad you shared that particular. When I went to visit OnPoint in New York, actually, they work with the police department, and at OnPoint, they actually test the drugs for the neighborhood and work in conjunction with the drug dealers. Because they couldn't figure out how to stop it, so how can we just stop people from dying? So this is the conversations that we need to have about it. And some people are like, oh, my God. I can't believe it. But, I mean, it's a proven way to reduce overdose deaths, so thank you for sharing it. I know you was like, this is an uncomfortable thing, but I just had to certify that, that there are programs that actually are doing that.
Thank you. It's not the final solution, but it is a step to a solution.
I just would add at the door, that the canvassers have a script that they use, and part of it is just making it normalizing that these are resources as of the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. other resources that we provide to them. So in the same way, we ask them about, do you need help with food security? Do you need help with resource connection? Do you need Narcan in your home? And without saying, are you using, are you doing this? It's just another tool that we provide for them.
Thank you so much for your testimony. I have questions for Dr. Palak Nelson. I'm sorry
We can take all questions back to the Health Department, though, and get back to you with a written response.
Okay. I have some I can just skip past. I have more. There's a lot. Noelle, so I have some for you.
So it's our understanding that the city is continuing to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. gather and evaluate overdose data from last year. What is the latest data available to your department on overdoses in the Black community, and what groups were most impacted, and when will the 2023 data will be available?
Thank you. That's a great question, and it's actually something that we are anxiously awaiting as well. And so what we're able to talk about publicly is the 2022 data. We are able to have planning discussions with a limited data set from the first half of 2023, but the full data set probably is not coming out until the summer or so, and that's because the medical examiner's office needs to there's a whole toxicology report that they do. They do interviews, and they want to confirm that all the overdoses are actually overdoses before they put the numbers out. We do know that preliminary numbers are that there's been a slight decrease in Philadelphia. But for the first half of the first half of 2023, the rates were similar to what we saw in 2022 with the racial disparities, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. unfortunately.
So public health experts, doctors, and stakeholders strongly agree that overdose prevention centers and needle exchange are important components, components of effective municipal harm reduction strategies. But they are far from the only tool in the home reduction the harm reduction toolkit. Can you tell us more about other harm reduction tools and how they can be used to reduce the number of people dying from overdoses in this next year?
Yeah. And so we look at harm reduction as a continuum, right? And so there's so many services and resources that align with that. Housing First, we consider harm reduction, like really trying to meet people where they're at and provide supports and resources. We did a recent, quote/unquote, audit of our harm reduction continuum, and there's about $40 million across city departments in this space, beyond syringe exchange, like everything else that we do as well. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. This door-to-door canvassing is part of our prevention. I would put that in a harm reduction bucket. There are a lot of access to treatment programs, but housing is really one of the top things that I would say is one of the best things that we can put in place, especially if someone is even starting to think about treatment or entering recovery. If they're not securely housed, it's going to be near impossible for them to maintain that, so that's one of the top things that we focus on for sure.
Earlier, I'm not really sure who said this, but often people say people die in their homes. Can you talk about the difference between where people are dying and where they have a residence?
And one other thing. And also the gaps in terms of the death occurring and the lack of services that are available to people.
Yeah. And so that's 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. something that we've been looking at because the, that's how I was able to say in my testimony, that a majority of the folks that are fatally overdosing in Philadelphia are Philadelphians. Because we look at where the incident occurred, where the fatal overdose happened, but also where there are residences of record, and majority of the time, it's the same location. And so that's how we're able to verify that. That is something that when the 2023 data comes out, I do want to make sure that we're doing a deeper dive into that, because even preliminary information that we've seen, that's the case even in Kensington, that a majority of the folks that are overdosing Kensington are Kensington residents. And that's why, in my testimony, we haven't launched door-to-door canvassing in that ZIP code yet, because it needs to be a very different conversation at those doors, right? When we're going in these other communities, part of the script is like, do you know that overdoses are happening in your community? The residents 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. of Kensington are acutely aware that there's overdoses happening in their community, right? And so but yet, there are still a lot of overdoses that are happening in their homes. And so we're missing something, right? We're not getting the right information to the folks that need it, and there needs to be a more nuanced plan for that.
I'm sorry. Please submit them, and we will absolutely get a written response back to you.
Thank you so much. COUNCIL CHAIR AHMAD: Recognizes Councilmember O'Rourke.
Thank you. And thank you for your testimony today and all that you do. My colleague, Councilmember Lozada, has been explicit that the Kensington caucus is not against harm reduction. They recognize the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. critical value of harm reduction efforts. At the same time, they recognize that there are times when harm reduction strategies with good intentions can have had negative external impacts on neighbors in the broader community. If we're not mindful about how our harm reduction approach is, it's possible to cause harm while trying to help. With that, my question is this: From a public health perspective, what steps do you think harm reduction advocates can take to ensure that their necessary life saving services don't have the negative external impacts on neighbors in the broader community in the rollout of your efforts?
And so that's something that we've -- that's a discussion we've been having for a little while, right? Because we have to hold the balance between the individuals who are using drugs and require harm reduction with the community that's impacted as well. And that's specifically been a difficult conversation to have in the Kensington area. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. And so it's something that's always in front of mind, making sure that we are creating an environment where any individual that needs support is able to access it in a way that is humane, that keeps them safe, and provides them support, but also is thinking about what are the other unintended consequences of this outreach as well. And so we try to keep that balance, and it's something we'll continue moving forward as well. COUNCIL CHAIR AHMAD: I have a question about the 17,000 doors, I believe, that were knocked. What is the follow up of that? Meaning, do you have any data going forward saying six months later in that ZIP code where that was knocked, did we see a change in the profile of what sort of drug use was going on? Or, I don't know what measure you could have to see what was the impact of doing this.
Yeah, that's a great question. And that's actually -- so we launched this program in October. We secured funding for another fiscal year to do this program, and so 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. part of that is going to be a program evaluation of what we're doing out there. There's a ton of data that they've been collecting, qualitative and quantitative data, every day that they're out canvassing. My hope, and I think all of our hope, is that in a year or two, when we start looking at where we were canvassing, what census tracts we were canvassing, and we put the layer of, unfortunately, where fatal overdoses occur, my hope is that we will see less of them, right? But the program just started in October so it's a little too soon to say that, but we are going to do an initial analysis once we get the finalized data for 2023 to compare with the canvassing that started in October.
I think for a more immediate answer as well -- because I know that that will take some time, of course -- our CHW component, our community health worker component. So right after we are finished with the door or speaking to a resident in the event that they need a more specific follow up, our community 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. health workers are the ones who do the immediate follow up to see if that resource was able to be met, whether they wanted to go into treatment or whether they just needed something from housing, internet access, food insecurity, or anything like that. Our CHWs are constantly checking in with folks, doing that immediate follow up, because I know that data is going to take some time. So we have that component of the work as well. COUNCIL CHAIR AHMAD: And that was my question about, this is harm reduction to make sure people stay alive, but the next step is how do you not have substance disorders, right? And what tools -- and you just mentioned that there's a follow up. How intentional is that in terms of, as we've heard, people might not decide the first time they might need continued follow up to check on when people are ready to actually go into treatment, and are we well resourced if, for example, 17,000 people, and I'm not saying that's 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. the number, decided to say, okay, I want to go into recovery. Do we have the resources, prerequisite resources, to then follow up and give them those recovery services?
Hi, everybody. My name is Keli McLloyd. I'm the deputy director of the Overdose Response Unit, and I'm also a person in long term recovery myself with over years of 12 continuous sobriety. So to answer that question thank you one of the things that's really important is that we want to give people the autonomy, right, to be able to access treatment when they're ready. And I think the other thing that's really important about the work that we're doing is that this is primarily in Black and Brown communities that have historically been oversurveilled. And so as we were developing this program, we thought about, well, let's loop back in and do a second pass six weeks later. But that's a little bit too much, right? We're already showing up at people's doors in what 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. census tract that they're in, and so our goal is when we go to knock on people's doors, we also, in addition to giving them the fentanyl test strips and the Narcan, one of the things that's really important is the resource guide that I believe you all have right there. And one of the things that can be really confusing about accessing treatment is you don't necessarily know who to call, where to go. And within the resource guide, we have information around how to access harm reduction resources and also how to access treatment, the many different ways that you can access treatment, when and if somebody's ready. COUNCIL CHAIR AHMAD: It seems like this population you are working with are people who are housed. They have homes. They are potentially, many of them are working. I know some folks are able to do all that. What is the as opposed to a lot of unhoused people in the Kensington area, where you have people coming from elsewhere or even people from there, but they don't have they're not housed, right? So 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. you see the actual impact of people living in encampments or on the street as opposed to this community. Do you also see unhoused folks as you're doing this, or is it mostly since you're door knocking, it's an address, right? So I'm trying to understand what are the needs that are different than the needs in other communities we have seen where housing becomes a real priority. In this case, that is not the issue, it seems. Correct me if I'm wrong, but I'm trying to understand how substance disorder presents itself in these doors you're knocking as opposed to other populations.
Yeah, absolutely. And what we mentioned in some of the testimony before is we are still very much living with the war on drugs, right? I think that many of us would like to believe that this was something that happened and that it stopped and that it's over, but I think, especially in urban centers, we really are still feeling and seeing the effects of the war 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. on drugs. We all know that Black and Brown people, specifically Black and Brown men, right, between that age group of 45 and 65 were subject to extremely harsh, overly punitive measures under those war on drug tactics. And like we mentioned, if you play the tape back and you look at the time limit or, excuse me, you look at the age of the folks that were around years old 12 during that time, those are the folks that are 13 now 45 to 65. We have not done the research on 14 that. We have not looked into that, but there's 15 got to be something there, right? That's not a 16 coincidence. 17 And so the difference is, we know that 18 if folks have historically been subject to 19 over punitive measures, they're not going to 20 raise their hand and say, yes, I'm a person who uses drugs. I need Narcan to hold in my house. Yes, I need fentanyl test strips. They're not going to approach that table. Anecdotally, one of the stories that we've heard is that we have all sorts of 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. different ways to access treatment. We've heard from providers that have tried to provide mobile services in North Philly and West Philly, and people do not come to access the services. At the same time, we see the data, and the data is telling us that people in those neighborhoods need those services, and people are actually experiencing fatal and non fatal overdose at higher rates than other areas of the city, but still, folks are not accessing those services. We know this is happening. We just know it's happening differently and behind closed doors. And while, of course, we want to make sure that every Philadelphian houseless, unhouseless, wherever you're living, we want you to have access to the resources, but we want to make sure that even that people that don't identify as somebody who's using drugs, somebody that might be in their home, has them as well. And one of the things that I think a lot of times we have told ourselves is that, oh, I don't need that. I know who uses drugs. I 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. know what these people look like. They're over there. They're hanging out in the gutter. That's not what's true. That's just absolutely not what's true. And I think that because of that, we cannot identify who are people that are using drugs. So the assumption needs to be, is that we all need to carry this. Like I always say, you know, when I you go into anybody's house, you can ask somebody for an Advil. You can ask somebody for an aspirin. You can ask somebody for Pepto Bismol, right? And most people are going to have that in their homes because we don't have an emotional attachment or any judgment connected to any of those materials. They're just tools that they go in the toolbox. And so that's where we want to get to the place with fentanyl test strips, with Narcan. COUNCIL CHAIR AHMAD: So what I'm hearing is, the war on drugs has probably caused the reticence to actually access or come out and say, I need help, because there could be criminal outcomes if one were to say this public in a sort 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. of government setting.
Yeah. I'd say that I don't want to say there's causation, but I would definitely say that there's a correlation there. COUNCIL CHAIR AHMAD: All right. Thank you.
I have a few more questions that I missed so I'm going to go back up. So what kind of long term residence and support systems are in place right now to help folks who have been addicted for decades? And what kind of multi month or year long programs exist? And what is the City doing to expand those programs?
So that is a question that we can take back to the Department of Behavioral Health, because treatment usually lives in the Department of Behavioral Health. But we can say that we know that there needs to be different types of treatment for everybody. People are going to have different needs, and I think especially when you're talking 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. about an older population, right, there are some very specific needs related to that. We want to make sure that people can attend treatment when they're ready and that there's also opportunities for them to find the treatment that's the best fit for them.
And to that point, historically, we have criminalized Black womenhood and motherhood through cultural ideas like the concept of a welfare queen or a crack baby, right? So can you talk about how we are attempting to support pregnant people who are either using drugs currently or are in recovery, and how are we making sure that families are staying together?
Sure. So I think there are some other folks that could probably speak to that a little bit better than I could. So I do want to point to the community doula program out of the Department of Public Health. They do amazing work. They are the most compassionate, kindest folks you have ever met; 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. non judgmental. One of their aims is to support people who are pregnant and using drugs both through the pregnancy and into the perinatal period. We also know that there's a really intense support, as Black and Brown pregnant people who use drugs also have higher incidences related to perinatal mood disorders like depression, postpartum depression, and postpartum anxiety. So we know that the doula program works with them, stays with them through the actual delivery, advocates for them with respect to any custody proceedings they may have, and supports them for up to a year following birth.
One other question, kind of not related, but related. So if the brick and mortar locations where people know to go for wound care and showers are no longer available, would portable showers and treatment options be a viable solution alternative? You mentioned it in community where people are housed, but when we're talking about moving folks around, is the option 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. for portable services available, and what are the some of the barriers to some of this as well?
So with respect to portable showers, I feel like there are probably some implications with health codes there that I wouldn't be able to answer. And with respect to portable treatment, I think that it is making sure that treatment is available at the level that somebody needs it, right? So we have outpatient treatment. Outpatient treatment is essentially, in a way, portable treatment, that it can exist wherever. But some people, just based on their ASAM criteria, which is the American Society for Addiction Medicine, that's really the rating system that somebody goes through to figure out what their best level of care is going to be. Some people are always going to need inpatient treatment. Some people are always going to need intensive outpatient treatment. And so I think the goal is to just ensure that we have adequate treatment for the level of treatment that's needed. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Sure. COUNCIL CHAIR AHMAD: Okay. Thank you for your testimony. My colleague here, Councilmember Rue Landau.
Thank you so much. Thank you so much for being here, for all of the work that you do. Your compassion comes out in your testimony as well as the work you do. The knocking doors is fantastic. It's such an amazing way of actually reaching people where they are. I've got a question about funding and money. Let's start with this: Does all of the opioid settlement money come to your department?
Hi. Thank you for that question. So it does not all come to our department, but we are part of the team that facilitates where it goes. And so funding goes to DBHIDS to do specific initiatives. Funding goes to OHS to do specific initiatives. Funding 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. goes to CEO to do this amazing program that they're running for us. And so we're we are shepherding the funding through the process, but it doesn't all come to my office.
How much money has the City gotten so far? Do you know?
Yeah. So so far we got so in the first year, we got two payments and it totaled million, approximately 20 million. 13 And then our technically third payment but 14 calendar year, second year of the program, was 15 another 13 million. So we've gotten total 16 approximately 33 million. 17
Great. And you 18 said it was only 1.4 million to 19
For -- that was 20 specifically sorry. That was specifically for DBHIDS to increase the dosage of buprenorphine at the prisons.
How much does it cost to run the door knocking program?
So door knocking program 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. approximately for what we're doing for 100,000 doors and the trusted community messengers is 800,000
I can give you a rundown of everything we're doing with the settlement money if that's
We want more programs that work, and we have more money coming 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. to Philadelphia.
And so the money that we've gotten so far is part of the national distributors settlement, and that has really specific allowable uses in Exhibit E, which you can find online. The Walgreens settlement does not it's not tied to the same allowable uses and has much broader implementation of that. That funding, I believe, we're not receiving the City until Septemberish in that.
Yes. Do you know approximately how much is coming out?
I think it was 20 million a year. COUNCIL CHAIR AHMAD: How much? 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Thank you. 5 Appreciate this, and thank you all so much for 6 what you're doing. 7 COUNCIL CHAIR AHMAD: Councilmember 8 Thomas. 9
Considering the 10 context of today's conversation and listening to 11 some of the questions around funding, a couple 12 questions. 13 Number one, as we look at those 14 alarming numbers, despite ethnicity, do we know 15 what percentage or how many people are 16 Philadelphia residents compared to people who 17 aren't necessarily Philadelphia residents? Do we 18 know that number? 19
It's in the 70s, I 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. believe, 70s or 80s. I can follow up with the Health Department.
So not -- so my numbers would not I don't necessarily mean people who've been here 30 days that established residency because they've been here 30 days. I mean, people who long term residents of the city of Philadelphia. Do we know what percentage that is?
It's a very high percentage. I can get you the specific number from the Health Department, but for fatal overdose addresses, it's the medical examiner's office confirming that they have an address within the city of Philadelphia.
I mean, do we do anything to differentiate folks who are short term Philadelphia residents compared to people who are long term Philadelphia residents?
We I don't believe the medical examiner's office does that differentiation. If they're a Philadelphia resident, they're considered a Philadelphia 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. resident for this data.
Thank you. Considering what Councilmember Landau asked you about revenue collected and looking at the percentages of fatalities, do we disperse our money that we get in a way that's reflective of the need? So if we get $10 million because of opioid settlement money, are we spending 8 million out of the 10 million in a certain space, and then other demographics aren't necessarily benefiting from those dollars? Or are we dispersing it in a way that's equitable and that's reflective on a need based on that chart right there?
Yeah. So if the question specifically around the settlement dollars that we've been investing, we have been really intentional with trying to make sure that we are getting those dollars into the communities that need it the most. One way is through our door knocking, canvassing, overdose prevention program that CEO 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. was just sharing. Another way is the overdose prevention and community healing fund that we established. It's in the second round. We will have provided $7 million out into the community at the end of the second round.
So who for example, that who would those grant dollars go to? And how are you not the the who doesn't matter. Let me take that back.
I don't want to get in trouble. The more important thing is, how do we assure that the grant dollars we're dispersing are being distributed in ways that's reflective of the need, right? Because at the end of the day, I'm not talking about geographic based, because as I'm listening and learning about this issue, it's not necessarily about socioeconomic status. It's not necessarily about what neighborhood you live in. It's an individual person base by base. And if we see that there's a large spike happening in Black and Brown neighborhoods, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. I think what I'm asking is if the large spike is happening in certain parts. Not saying other neighborhoods aren't in need, but are we distributing dollars in a way that's equitable and reflective of the actual problem?
Yeah. So specifically, with the overdose prevention and community healing fund, the way that we identify the priority pools for the funding, we look at the fatal overdose data to identify those packets. And so for the first round and the second round, we had a designated fund for Kensington, a designated fund for North Philadelphia, and then a, quote/unquote, citywide catchment to recognize that it's a citywide crisis that we're in. If we do a third round of the fund, we would, again, look at the overdose data and see if there's other areas that we need to be prioritizing that. But that's just one program for an example.
So I listened to a couple councilmembers ask to be a part of some of the initiatives that are happening, because 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. they are they have expertise in that area. I'm not volunteering myself because I think that there are a lot of other councilmembers that's a lot more qualified than I am, but I do think that Council should be included in the process of how we disperse these dollars so we can make sure it's done in a way that the percentages specifically speak to the need. I would love for us to come back here in a year, after we've gotten a lot more settlement dollars, and be able to say that African American communities make up 40 percent, hypothetically speaking, of the overdose issues that we're facing, and we can assure you that at least 40 percent of the dollars have gone to African American communities. So I just want us to be intentional with how the dollars are being dispersed, because as I'm listening to all of the revenue that's coming down the pipe, nobody has found a solution to this problem. And if they did, I think Philadelphia would try our best to replicate it. Looking at how packed this room is today, clearly 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. a lot of people care about this particular issue. But I think that it's imperative that there's a collaborative effort between your office and the members of Council who are experts in this particular area to assure that as we collect this revenue, it's being dispersed and distributed in ways that's reflective of the problem. Thank you for that. And Councilmember Landau, thank you for your line of questioning, because you inspired me, listening to some of the revenue questions that you asked. Thank you, Madam Chair. I appreciate it. COUNCIL CHAIR AHMAD: Recognizing Councilmember Young adding to our did you have a question? And he has a question.
Thank you and good afternoon. Just wanted more of a comment than a question just to put some things in the record here. So I do know in my district, I represent North Philadelphia, primarily parts of Center City. There is a I guess it's taboo in 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. our community to talk about the issues of overdose and opioid addiction and things like that. And I just want to commend Philly Counts for doing the hard work of trying to convince people that harm reduction is a good thing, right? And so as we were walking around in parts of North Philadelphia, we were passing out Narcan, passing out fentanyl test strips. And community members seem to be very reluctant at first when we come and we show them Narcan and tell them what it's for, and they tend to be a little hesitant on taking the resources, but then we would walk away and walk about half a block, and then they'll come back out and say, hey, you know what? They thought about it for a second and really realized that these are resources that we all need. Because at the end of the day, this issue knows no social demographic at all. In my own personal life, I've dealt with issues. My father passed away due to complications of an overdose, right, so I've 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. dealt with this personally. And so I just want to put on a record that we, as a city, as a community, as a Black man in this city who's lost father, cousins, friends who are all Black, right, to this, we have to really pay attention to it and take it seriously as we see the numbers are trending up. Because I don't think that there is a sense of urgency in our community about this issue. And again, we don't know what's out here on the streets. And I think it's really, really important that we continue to fund initiatives like Philly Counts. I think it's important because they are the and they were folks who look like us going on knocking on these doors, right? And so we're trying to really convince people that this is a good thing for them. I had a conversation with a gentleman. For about a good 10 minutes, we were going back and forth because he just was so adamant that this was not necessary in our community, and then he chased us around a block to come and get the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. resources afterwards, right? And so I think as long as we can continue to get this message out there, that this is a problem in our community, and we aren't afraid to talk about it as a problem in our community, then I think that we can really alleviate some of the issues that we see. So, yeah, just more of a comment to get that on a record, because I just want people to really realize the seriousness of this, because people have no idea what they're taking. None whatsoever. And in an instant, your life can be gone. In an instant. And so we yeah, I just want to stress the seriousness of this. And so I want to commend the sponsor of this resolution, Councilmember Brooks, Councilmember O'Rourke, for this legislation, because it's something that's near and dear to my heart. And I think representing North Philadelphia, this is something I'm going to continue to go knock on doors with Philly Counts, right, to tell them that there is someone like myself, a councilmember, who cares about the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. community and who cares about saving your life. And so as long as Philly Council keep knocking on doors, in North Philly, I'm going to be there knocking and passing out Narcan because it's something that we have to we have to show that it's not taboo to have harm reduction models in our city. So I just want to thank you and commend you for having us here. COUNCIL CHAIR AHMAD: Thank you, councilmember, and thank you, panelists. The clerk will please call the next panel to testify.
Madam Chair, the next panel is Dr. Movita Johnson-Harrell, Nikima Porter, Ava Kane, and Rev. Dr. Michelle Simmons. COUNCIL CHAIR AHMAD: Just wanted to acknowledge our City Council President, Kenyatta Johnson, who was here listening in. Thank you. Okay. Hello. Good afternoon, panel. Please state your name and proceed with your testimony.
Good afternoon. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Good afternoon to the members of City Council and everyone attending this hearing today. I want to thank Chairperson Ahmad, Vice Chair Lozada, Minority Leader Brooks, and members of the Committee on Public Health for hosting this hearing. Thank you for the work that you do every day advocating for vulnerable, marginalized, and disenfranchised communities here in Philadelphia. I would also like to thank the councilmembers for allowing me to share my testimony today on overdose in the Black community. Today, my testimony will be a combination of my professional expertise and my lived experience. My name is Dr. Movita Johnson Harrell. I am a social worker by trade and training for almost 30 years. I hold five degrees, including a master's degree in social work from the University of Pennsylvania and a doctorate of philosophy from Seca University. My professional expertise is in co occurring and multi occurring disorders, which 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. includes chronic mental illness addictions as identified by the Diagnostic and Statistical Manual, accompanied by medical frailty, which includes chronic and intermittent physiological disorders, and my resume includes decades in targeted case management as a trauma in MISA specialist. MISA is an acronym for mental illness and substance abuse. I worked at Horizon House, Philadelphia Health Management Corporation, and I am the former senior program analyst for the Chronic Homeless Initiative for the city of Philadelphia. I used to train city staff on how to engage homeless individuals with addictions and mental illness, which often included Philadelphia police officers and personnel. I oversaw the New Keys and Home First programs, which were harm reduction housing programs for individuals living living with drug addiction and mental illness that had extensive episodes of homelessness. These programs did not dictate that people stopped using drugs to receive housing and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. services. The programs provided intensive case management and supportive services accompanied with access to recovery options if they so choose. I also come from five generations of addicts. The running joke in my family was that they put wine and beer in my baby bottle and blew marijuana in my face as a toddler. I used, voluntarily and involuntarily, for 28 years. I'm a person in recovery with 29 years clean from drugs and alcohol. I got clean September 15, 1994 with the threat of my children being taken away from me. I spent almost a decade in an active crack addiction. I've spent all of my years clean as a member of a 12-step recovery fellowship. Since getting clean and staying clean for 29 years, I have traveled the world carrying the message of recovery to addicts that are active and in recovery. I have sponsored countless women and worked with thousands of addicts, supporting them with finding recovery to change their lives. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Addressing addiction and finding recovery is unique for each individual person. Addiction is an illness. Regardless of the person's color, it is an illness and it has historically been stigmatized in Black and Brown communities, which keeps people from seeking treatment. The war on drugs was actually a war on Black people. Black people were told that they were responsible for their addiction and they were sent to jail instead of being sent to treatment. How can people pull up their bootstraps if they have no boots? Here in Philadelphia, we are seeing history being repeated with the disinvestment of resources and the criminalization of people living with addictions. The disease of addiction is marked with shame, guilt, embarrassment, and it is seen as a moral deficiency in communities of color.
That added to the public narrative, discourages Black and Brown people from exposing their disease and seeking help for it. The disease of addiction does not discriminate, but how we address addiction in 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Black and Brown communities does discriminate. The opioid epidemic is not new in this country or in this city. Historically, Black communities have been criminalized for being addicts, and that criminalization has fueled mass incarceration, where people were incarcerated instead of being provided with the care and resources necessary to address their illness. It is assumed that the opioid epidemic is currently a White problem. It is not. Heroin has always been a problem in the Black community, including our sons being sent home from Vietnam addicted in the 1960s and '70s. Opioid use and deaths have been on the rise over the past decade because of the pharmaceutical companies putting profit over people and pushing the pill mills with narcotics like OxyContin and Percocet. This resulted in the increase in the sale of heroin on the streets because people could no longer get the pills because of the lawsuit against the pharmaceutical companies. And not only is heroin cheaper, it's easier to get. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. It became even more detrimental and deathly with the influx of street narcotics being cut with fentanyl. First, it's important to understand how strong a disease of addiction is and that an addict will not stop using until they are ready. Each person's bottom is different. I was very fortunate. The first time I went into rehab was enough for me, but that that is not statistically true for a large population of the people. This also does not discount the many attempts I tried to get clean on my own, and I was very unsuccessful, which further degraded my self esteem and my sense of self worth. I thought that I was the problem, not the disease of addiction. Many addicts have several attempts at stopping before they are successful with staying stopped. This is why it is so important to meet people at the level of their need and to have recovery options available. It's important not to shame people when they are not successful on their first, second, or even third try in getting 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. clean. Second, it is imperative that when a person is ready to stop, that there are adequate resources available to aid them in the recovery process and to reduce the opportunity for relapse. It's critical that this city fund harm reduction programs like needle exchange to reduce the spread of disease like hepatitis and HIV. Harm reduction programs like New Keys and Home First, where it's not demanded that people stop using drugs in order to be treated like human beings. It is also critical it is also critical that the city support the advocates in the organization working with these vulnerable individuals and fund the necessary resources to support quality of life for people in active addiction, people in the beginning stages of recovery, and people seeking long term recovery. These resources need to include access to addiction education, detoxification programs, rehabilitation programs, life skills, housing, recovery education, jobs, and training. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Discharge planning starts the day of admission. Meaning, from the onset of engaging individuals living with addiction, we should be helping them to develop the roadmap to a life of sobriety. The City needs to be intentional about how they address addiction in the Black community, and intentional about decriminalizing addiction and properly funding those resources that will help all Philadelphians, including Black Philadelphians living with the disease of addiction, to recover and thrive.
This Council must understand that if we are not a part of the solution, then we're part of the problem. And also remember, therefore by the grace of God goes I. Thank you.
All right. So just read my testimony. My name is Rev. Dr. Michelle Simmons. I'm just going to read the testimony as it is because I could go off the beaten path. So ladies and gentlemen, esteemed members of City Council and our beloved community members, I stand before you today as Reverend 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Michelle Simmons, a woman who has known adversity intimately yet refuses to be defined by it. My journey has been one of redemption and resilience and relentless commitment to uplifting others. Formerly incarcerated, I have walked the path of recovery for years, a 9 journey marked by forgiveness and transformation 10 and unwavering determination. But my story 11 doesn't end with a personal triumph. It extends 12 into the heart of our communities where Why Not 13 Prosper, a home for women coming from prison, a 14 beacon of hope stands for 23 years. 15 We've been on the front lines, 16 extending a hand to those who have stumbled, 17 offered solace to those who have been forgotten, 18 and embrace with open arms those who seek a 19 second chance. At the core of our mission lies 20 the Rollling Engagement Van, affectionately known 21 as REV. It's not just a vehicle, it's a 22 lifeline, a mobile unit that travels the streets 23 of Philadelphia, delivering not just resources, 24 but dignity, respect, and compassion to the undeserved, especially our brothers and sisters 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. who have experience in the criminal justice system firsthand. Maya Angelou once said, you may not be not control the events that happened to you, but you can decide not to let them not to be reduced by them. These words resonate deeply with me, for they encapsulate the essence of harm reduction. It's also it's about acknowledging that we cannot undo our past, but we can shape the future. It's about recognizing the humility and humanity in every individual, regardless of their mistakes or misfortune. Harm reduction is not just a concept. It's a philosophy of love and action. It's about meeting people where they are without judgment or condemnation. It's about providing the tools and the support necessary for individuals to reclaim their lives and rewrite their stories. The REV doesn't just dispense resources. It embodies hope. It's a tangible manifestation of the unwavering belief in the power of second chances, in the resilience of the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. human spirit. From bus passes to birth certificate to mental health to wound care kits, the Narcan, the REV offers a lifeline to those who are often overlooked under deserved. But our work don't stop there. We recognize the urgency of addressing the opioid crisis with compassion. That's why we advocate for medicated assisted treatment, because saving lives is not negotiable. It's about recognizing addiction is a disease, not a moral failing, and offering support without stigma or shame. Today, I stand before you not just as a voice, but a plea. We need more REVs. We need more vehicles of hope traveling through our neighborhoods, offering light in the darkest of places. Because when people are stuck, they are stuck, and our city suffers. But when we extend a helping hand, we offer a hug. And when we provide a pathway to redemption, miracles do happen, and our communities are safer. So let us commit ourselves today to the cause of harm reduction, to pursuit of justice tempered with mercy, and a belief that every life 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. is worth saving. Together, let us be the change we want to see, one REV at a time. COUNCIL CHAIR AHMAD: Thank you. I can take the next testimony. State your name, please.
Hi. My name is Ava. I'm Ava Kane. I am a core member of Philadelphia Project SAFE. We have been in existence for 11 years. I'm also the lead coordinator of a 12 project that is being developed with Project 13 SAFEcalled the Black Resilience Project, focused 14 on racial disparities in the Black community, and 15 overdoses, and supplies of harm reduction 16 supplies and education. 17 I don't have a testimony, so I'm just 18 going to go off the muscle if you guys don't 19 mind. One of the terms that has been used that 20 I'm not going to lie, it offends me and it offends it should offend everybody who has black skin in here, and that is the phrase war on drugs and how calmly it's being used here. Because if anybody's familiar with the term war on drugs, it was and it's a quote 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. from Henry Anslinger. Reefer makes the darkies think that they're good as the White man. Most Negroes, Hispanics, Filipinos, and entertainers, their satanic music just swing a result of marijuana use. This marijuana causes White women to seek sexual relations with Negroes, entertainers of others. And Nixon, who -- Nixon, domestic affairs advisor, also made a statement similar to that, basically saying that we knew we couldn't make it illegal to be either against the war or Black, but getting the public association with hippies and marijuana and Blacks with heroin and then criminalizing both heavily, we could disrupt those communities. So for anybody who's Black who is in the community of harm reduction or anything involving assisting those who are in the dynamic, using the phrase war on drugs, you're basically insulting yourself as well. But to return us to who I am and what I do, I have been a member of Project SAFE since 2016. We deal with mostly women, trans, and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. queer folks on the streets of Philadelphia. It started in Kensington, but we have branched out further. We do more than just give out supplies, we give out support, because that's what also harm reduction is. I have been inside of courtrooms. I've been inside police stations. I've been inside, chest to chest, ready to get physical with doctors in the city of Philadelphia who failed to want to treat people because of their presentation. I have been to the medical examiner's office to claim the ashes of bodies of people who were not fairly treated, even to go as far as to look at iPads of dead bodies to confirm that this person is this person, having to, unfortunately, watch videos of one of our members, or many of our members, being viciously assaulted in public. So I don't have, as you guys had established, testimonies written out, but I got a lot up here. So with that being said, again, good afternoon, everybody. Good afternoon to you as well. Thank you so much for having me.
Thank you for giving me 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. the opportunity to speak today. My name is Nikima Porter. Addiction has impacted my family in a way we would never have imagined. In June 2021, my brother, Edward Porter IV passed away from an accidental overdose at the age of 36. Edward was so sweet. No matter what he was going through, he found time to tell me how much he loved and appreciated me. He was full of love. If you met him once, you were friends. My brother battled with addiction for more than years. He went to rehab. He went 15 to jail. He went to group sessions. As a family, we had more interventions than I can remember. With everything we tried, nothing seemed to work, and we couldn't figure out why. Edward felt shame and embarrassment because he had an addiction. Edward tried to convince us he was clean. Many times, we believed him. We believed him because we loved him and wanted the best for him. Edward had a job and many friends. He hid his disease from many people. We had no idea 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. the magnitude of his drug use until he was gone. Edward struggled with addiction, but he was so much more. I wish I had known many things when Edward was alive that could have helped him on his journey. Our family made him feel comfortable, as comfortable as we could, but the community he lived in did not. The Black community needs unity and love. We need to support and care for each other as individuals. In 1987, the American Medical Association classified addiction as a disease. Disease is -- addiction is similar to cancer and other diseases that harm your body from the inside out. We need to eliminate the shame associated with addiction and treat people with addiction with the same compassion and care as those with cancer. It's important to reduce the negative stigma surrounding addiction and educate ourselves about the disease. With education and knowledge, we'll be better equipped to help, and hopefully, those struggling with addiction will be more inclined to seek help. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Edward never had an individual therapist, so he never had the opportunity to sit down with a professional and work out the things in his mind. Looking back, I wish I had encouraged him to seek therapy instead of pushing rehab. I believe having a therapist would have greatly helped him on his journey. In closing, the Black community needs to do better. We should uplift our people instead of tearing them down. We should support each other and have an open discussion about addiction. The opioid epidemic is taking a devastating toll on our community, and it's important to address the reasons behind it. It's essential for Black individuals to feel comfortable seeking help from within our community. We should be more inclined to help rather than hinder each other. It's time for us to come together and support each other. Thank you. COUNCIL CHAIR AHMAD: And do we have Nikki Grant here? She's listed. Oh, okay. I'm 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. sorry, she's next panel. We'll take questions. Councilmember Kendra Brooks.
Okay. Way to start. So for the panel, what do you guys think about harm reduction practices? And can you tell me how they helped you through your lived experience on how harm reduction practices have helped you or would have been helpful?
So harm production practices were supported for me because I had a support team that kind of let me keep bumping my head and bumping my head until I was ready. Trying to making it mandatory or putting me out and making me go wasn't the process that I went through. It was like, okay, when you get ready, you'll bump your head on the wall. We'll be right here. That's harm reduction to me. That's kind of what was supportive, and I think that is that helps a person get ready, you understand? If you keep saying, hey, you've got go here, and I ain't going to feed you, and you ain't going to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. be able to use the bathroom, and you ain't going to have nothing until you go, it just kind of just pushed me back out there more to what's comfortable. Because I'm already plagued with guilt and shame while I'm sitting in my own being anyway, because I've missed a lot of opportunities and misfortune. So I'm already rid with guilt and shame, and now you telling me what I need to do? And until I get ready in my practices, what I do now is that I have to get a inkling from an individual that they are ready before I even start to pursue any type of suggestions or offerings. Because if they're not ready, we're really just kind of spinning our wheels, I feel like, because they're not going to buy into the process that we're putting before them. So for me, harm reduction, let me be where I was at until I got to my bottom, like Ms. Movita said, is real important because the bottom is the place where you get to look up, and that's where the that's where the journey starts 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. from. But if I'm forced into my journey and I'm not really ready, I might do it for the mom, I might do it for the kids, I might do it because the judge told me to, or the PO made me, but it's not an internal walk that's happening, which usually results in a relapse or incarceration. COUNCIL CHAIR AHMAD: Thank you for that, Reverend Simmons. And I wanted to start by just thanking you for your work. I want to thank you for being a person that I can reach out to when women reach out to me.
Yes. COUNCIL CHAIR AHMAD: Not a whole lot of questions asked. Give them my number, which is not something that you get from people, and I just want to just publicly acknowledge the support that you have always been available to me when folks call me in crisis. So thank you for that.
So in my professional expertise, when I was a part of Horizon House and I was the senior program 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. analyst for the Chronic Homeless Initiative for the city of Philadelphia, we had the Home Keys and New First programs. And I think what was so beneficial about those programs was that even people who were not ready to get clean, they were provided with an act team. That's a case management team that does intensive case management. They were able to move into their own places. Some of these people had been homeless for 30 years. They refused to go into the shelter system because they preferred to live on the streets rather than live in the shelters. That's how bad shelters were. And it also provided them humanity, right? They were treated like human beings, even though they didn't want to stop using drugs. And over 80 percent of the people that we engaged on the street got into their own housing, provided them with medication administration. They had access to psychiatrists. They had access to recovery options. 80 percent of those people got treatment while living in those programs. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. We need to also remember that programs like needle exchange prevents the transmission of deadly diseases. When we reduce funding for needle exchange and programs like that, we are increasing the likelihood that people will contract hepatitis, people will contract HIV, and we're literally when we remove needle exchange programs, we're sometimes condemning people to a life of death. So we need to be doing the things necessary. We need to be making sure that we fund those advocates. Because I've seen people, just because they have access to things in the moment see, I come from the School of Social Work, and the School of Social Work is discharge planning starts the day of admission, right? The day of admission don't mean the day of admission into rehab. It means the day that you engage that person, the day that you make contact with that person, because everybody's bottom is different. And while they may not be ready in that moment of engagement, when you plant the seed, it begins to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. grow. So if it means that we've got to give somebody some clean needles until they make the decision that they're going to put the needle down for good, then we need to be providing them with those needles. If it means that we're going to take people off the streets and put them into efficiencies or one bedrooms, and make sure that they have clean water and access to toilets and the shower, and give them some sort of humanity, it encourages people to do what they need to do for their own lives. Just because they don't make a decision to stay clean in the moment doesn't mean that they're discardable human beings.
Okay. I'll just be fast. One of the aspects beause I'm just going to be honest, I kind of have an idea of why I'm up here. So one of the communities that is largely ignored when speaking of any form of deviant behavior or the such is people who are in the adult industry, people who are sex workers. I, myself, pretty front facing. I am a 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. IRL sex worker. I am still active. One of the things that a lot of things in harm reduction outside of clean supplies is information resources, cellphones cellphones are harm reduction. Mutual aid is harm reduction. So having the means to reach out to somebody, having the means to call somebody, another having a buddy system. There are people that we work with in the streets of Kensington, the streets of Philadelphia, that are street based sex workers. They don't have the privilege like I do to work on the internet, to work in luxury places as such, that don't they work alone. They use alone. And one of the one of the things we talk about, and it's just this is not new, but it's a buddy system, because unfortunately, not only are you subjected not only are users subjected to people who actively use people who are unhoused, sex workers are subjected to intense violence. I, myself, again, I come from a place of privilege, but I've had people who wanted to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. put their hands on me. I've had people pull out weapons on me. These people have had weapons pulled out on them. So that's another thing we need to think of, because it's a long running profession for a very long time. It's not new. It's taboo. There's probably people clutching their pearls, and I understand, but it is it is what it is. So that's another thing that we really also need to talk about, because you have not all sex workers use not all sex workers are drug users and not all drug users are sex workers, but and then you have people who are, again, who rely on the work and they live on the streets. They are homelessness is more than just living on the streets. It's couch surfing. It's in the bando, sleeping in the train stations. So I guess I wanted to just include that there's also besides clean needles, which helps mitigate the spread of infections, which helps reduce injuries, because blunt needles can harm you, broken stems, or straights for people 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. who smoke, can harm you. If you're not a person who smokes stimulants but you use it to smoke suppressants, that can harm you. You can have unnecessary overstimulation, because that's another conversation that is not brought up in Black communities with drug use. I've heard it mentioned, but when I've done my work in BRP and my work in Project SAFE, a lot of people don't know differences about being overstimulated to oversedation, which then, it turns into, well, what do you do? They don't know what to do. And witnessing in the industry, being in a venue or an experience with somebody, and they've done too much, and nobody knows what to do but freak out and splash water in their face and finally call 911. That's it.
I have some follow up questions. You guys went really quickly, so I'm going to start with you, Ava, and then I'm going to come back to Dr. Harrell. Can you tell us about the three main things that Project SAFE would want to see 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. prioritized over the next year to address this crisis?
Money. Money. We need funding. I don't can't speak for no other organization. I can't speak for no other organization, but we do not we do not receive public grants. We don't. We did not get any access to the opioid settlement. So we're running off of our own money and private donations and private grants we've acquired. Also money because supplies cost, resources cost, and work costs. And not just we don't most of us do not receive stipends or funding. We're doing this, again, off the muscle. We're doing this because we've been in that experience. Another thing is, when talking about drug use, safe supply, because we cannot we cannot cure addiction. I wish we could do all the things. In a perfect world, nothing exists, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. but drug use is going to happen. There is we just finished our phase of a two year research project with a major hospital here in Philadelphia that's taking the work over to a state that is doing a that has statewide testing. They're able to intercept drugs, and they were able to detect, at the earliest and at a very small margin of error, when xylazine came into the supply, when fentanyl started making its way, and mapping it out a little bit more accurately. What would another thing Project SAFE would like because I could keep going safer consumption sites. Again, drug use is going to happen whether anybody in this room 19 likes it or not. But if we can monitor that, if we can work with the public, if we can work with other entities, we can work with medical professionals, with at least monitoring how people use, where they're using. There is an OPC in New York that they had at least five years of research, studying how 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. many supplies, syringes, works were dropped off, studying the collectives of people who were living on the streets, who were actively using publicly. They were able to take that, and when they operated their OPC, which offers a lot more than just a place to safely use, it offers resources similar to REV, and offers plenty of resources what we have, they have. And within 365 days of operation, they saw a 90 percent drop in the supplies in drop off boxes. They saw an increase of people coming in, an increase of people saying, hey, you know what, I think I kind of want to get some help. You know what, I think I really want to look into how can I embetterment. In the state of Massachusetts, they had a buyback program where they were offering unhoused folks $500 for their tent and for their vehicles, like carts and stuff like that, for their supplies. And in exchange for the $500, offered them the option of housing into a program. Philly, for all the bells and whistles 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. that we have I love my city, born and raised we don't got too much. And I'm confused as to why, as we're the most bustle we're one of the most bustling cities in the United States. We are the most diverse city in the United States. We have we got some coin, but why don't we have this into the programs that could help these people? We I see on the news, I've seen on the news, I've seen in person, countless reports of these of homeless encampments, of the people overdosing. I'm seeing on social media the videos of people recording, oh, I don't want to see this in my own my train on my train. People actively using and sleeping on these trains, but they don't have anywhere to go. They don't got nothing. Can't get blood from stone. So that's what I would love I would love all of that that I just said again, perfect world, I know, but hear me out. I would love at least, if not a stagnant, because I'm certain all of you are familiar that this is not the first time there was a talk of OPC and people 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
on the news shouting, not in my neighborhood. Well, in your neighborhood, there's crackheads, and in your neighborhood, there's people using. In your neighborhood, your families are using. I have family members who are active users. I've lost friends, lifelong friends, who were due to usage, due to using a loan -- which, by the way, Project SAFE has a 'zine that talks about never using a loan because that's another thing that could that's dangerous. But unfortunately, in the Black community especially, we are unfortunately encapsulated in shame, because when we have the jokes, as was mentioned here, we have the jokes of, oh, of the putting alcohol in the bottles and weed in the face, and then the jokes of hide your purse, hide your purse, cousin such and such is coming. We don't have that conversation of the actual conversation of, how can I help? What can I do to support you? So because of these jokes, because of these stigmas, we're going to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. do we're going to hide. We're going to be ashamed. We're going to use. We're going to self medicate to escape to the point that we're deep in the trenches.
So I have a little switch. You said you talked about sex work. So the charges related to sex work and the quality of life experience have been declining since 2017. Have you seen that trend change this year, and how has it impacted you and your community.
So criminally, there has been and again, I work with folks who do street based work. I've worked with folks who have been in the police things and bus that have occurred, if not here, then over the bridge. Though criminally, a lot of things have been kind of because the officers, Larry Krasner, had worked pushed forward, you know, let's not loitering and solicitation charges. Even though that has been on the decline, other charges are still on the up and up. So I actually have a little bit of 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. notes, if you guys don't mind. I talk fast. I know time is time's of the essence. When speaking about sex work in a space of privilege of being housed or can work from the internet, we're facing we're facing more than criminal prosecution. Losing websites, losing access to cellphone service, losing our banks, losing the ways of digital transactions such as PayPal, Cash App. Even when we're not working, just existing. So we were stuck with resorting to prepaid cards and stuff like that, which then turns into a bigger issue not a bigger issue, but another issue. So most of these places do not accept prepaid Cash App cards, so we are then denied services and access to spaces like a hotel again, even if we're not working. Making some minor purchases again, even if we're not working, it's because we're using a Visa prepaid card or a Cash App card or a Chime card. But it's important to note that while people are not being charged, people are continuing to be harassed by civilians and by 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. authorities. That never left. People continue to sleep peacefully with their belongings and were continually trashed. They were filmed without their consent to violent means. However, while criminalization may have decreased, affordable housing evaporated, inflation shot up, and so did disability claims, all of which led to homelessness. Whatever benefits that were achieved through less criminalization was undone because there was no actual safety net. There was no 14 actual social support. Social services have been experiencing gradual defunding, which means people are not receiving the support that they need, which adds to the citywide frustration around unhoused people and drug users. Some of these people are, as I had mentioned, I keep saying over and over again, of sex workers. Regardless, we are now continuing we're now facing continuing defunding, and gutting plans of affordable housing, and funding, funding eviction and diversion programs, which, through the work I've done in Project SAFE and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. talking to people who have been who have experienced these diversion programs, they don't work. They don't work at all. And I guess the intention behind them are good, and I'll give you all that, but some of these programs are not exclusive, so people are excluded. They don't get the services, they get the mistreatment. Some of the diversion programs literally just lead to other issues, okay? I don't get charged for solicitation, but now I'm going to get charged for different other 14 things. 15
Thank you so 16 much, Ms. Kane. 17 I have another question for Ms. Porter. 18 Thank you for coming here and being with us. 19 And you were speaking as a family 20 member of a person who uses drugs. Your brother, Edward, passed, but he did have some successes. In his obituary, your mother called recalled a young man from Prevention Point telling her, I can't tell you how many people Edward saved. Can you speak to how he interacted with 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. the family and attempted to be a father even though he had an addiction to opioids? One second, before you speak Dr. Harrell, also, I didn't get a chance to just thank you as well for being an ongoing support around this issue, criminal justice reform, and all the amazing work that you've done in the city. Been a mentor to me from the beginning. So I just want to say thank you so much for showing up and being just a blessing to me in this work, before you leave.
To the members of the Council, I apologize. I have a 4:30 meeting with the DA.
Well, before you go to that meeting, let me second the emotion of my leader. Also appreciate your work and your presence and all that you have done and who you have been. Love you much.
Edward was great. Edward, despite everything he was going through, Edward tried to Edward was a great brother. He was a 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. great son. He tried to be he was the best father he could be, but he was the greatest brother. But he was regular. He was normal. He was a regular person. He just happened to have a disease.
So how does the overdose impact the family and the loved ones? And what goes your head and what kind of support do you think the City could be could offer to family members that are left behind?
So how does it affect our family? So Edward for years, he struggled. 15 So in the little education we did have, it was if he didn't stop doing drugs, he was going to die. The end. So we  and it was rehab, rehab, rehab. So we Edward, go to rehab, go to rehab. And he went to rehab and would come back and go for a couple days, come back, go for a month, come back. So the whole time, we looked at it like, oh, get clean. I know you can get clean. But he had a disease. And when my daughter is sick or she has a headache, I don't 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. tell her, babe, go get the Tylenol, and then I'll go get it for her. I'll put a rag on her head. So we could have did a lot more. I don't know what helping I would. But how does so what could the city do? So for instance, what they were saying about doing needles, using, not using by yourself, that would have been great for him if there was a place he could have went or felt comfortable going to use. I don't know, maybe, but because of the shame, because of the guilt, because he would walk down the street and, oh, he's a crackhead and a junkie and this and that, he hid and he cried to us, not to someone who could really help him. I love my brother more than anything. I couldn't help him. My mom loved him. She couldn't help him. But the people who could help him, he wouldn't go to because of the shame, because of the guilt, because of the stigma.
Thank you so much for sharing your testimony. I thank you all for sharing your testimony. Thank you. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. COUNCIL CHAIR AHMAD: Thank you to this panel. And before we call our next panel --
Madam Chair, I had one question. COUNCIL CHAIR AHMAD: Oh, yeah, sorry. Go ahead.
Good Reverend, it doesn't have to be too, too long, but I am interested. I'm glad to have you up here. I also pastor a small church, and I, for a long time, have always felt beyond waxing eloquent on Sunday mornings and Wednesday afternoons, ministry is what we do for and with people, and so, so grateful for the work that you have done. Can you speak just to a little bit about how faith based organizations are entering the harm reduction space, and just elaborate a bit more on that for the record?
Okay. So the faith community is broadening their horizons, meaning they're starting to learn, okay? And so they're probably you know, I'm a Christian, and I love God, but it was a lot of judgment, period. And 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. so a lot of them asking questions now, and a lot of them are open up their doors for ministry rather be fleeing, rather be letting the NA meetings be done in their facilities. So I see an uptick in that. That's one. I feel like there still need to be work with the faith community. I love them to death, but I had a young lady that was at Why Not Prosper, and she was cutting. It wasn't time to pray with that lady. It was time to call 911. Do you understand? They're getting more educated, and then the next thing they get more educated is the judgment around medicated assisted treatment, all right? They thought that, oh, that's just using. And I kind of felt that way, too, probably 15 years ago. That's just another way of getting high. But when I studied the research and seen how a person that was on medicated assisted treatment versus a person that had a substance use or opioid situation and did not get on medicated assisted treatment, how their lives 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. just took a nice turn for the better, I started supporting it. So I'm doing workshops and teaching them. So the faith community is really, they have the heart to do and give and to be right. However, the thing of the education is needed, because we can love God and everything, but you've got to be still and kind of have some knack for what's going on because you could cause harm. But I just see some opening of the minds as it relates to supporting.
Thank you for your work to heal and help God's people. Thank you so much.
Thank you. COUNCIL CHAIR AHMAD: If there are no 19 more questions from our colleagues, we'll excuse this panel. Thank you very much. And before we call up the next panel, I just wanted to make an announcement that we are facing a hard deadline at 5:00 to stop, and we will recess this hearing, and then we will have another date for those who have signed up. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. We'll probably not be able to do the full panel after this, as well as those who were signed up, so we will keep all of that and make sure we let you know when that next date reschedule to do the remainder of the hearing. So now, we're going to call the next panel.
Madam Chair, the next panel is Noah Barth, Nikki Grant, Sterling Johnson, and Samuel Kelton Roberts. COUNCIL CHAIR AHMAD: Thank you. Go ahead. Please state your name and begin your testimony.
Good afternoon. My name is Nikki Grant. I'm the policy director at Amistad Law Project. Over the last decade, Amistad has organized in mass incarceration and advanced a healing justice framework for our communities by strategic campaigning and legal advocacy. Thank you for the opportunity to speak today about the overdose crisis and Philadelphia's Black communities, an issue that 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. has intersected with our work in a few interesting ways. We work closely with people incarcerated in Pennsylvania's prisons and their families. Time and again, we have heard from our clients about how their lives were torn apart by drugs in their community. The destruction shows up in at least one of a few ways. Primarily, people suffer from substance use disorder, and their lives spiral out of control as they suffer from the consequences of their illness. Another way is when people get caught up in the drug economy to make money, and then they're stuck in the silent cycles of violence. Because of this, at Amistad, we treat the opioid epidemic in Black communities as simultaneously a public health issue and a public safety crisis. What we have seen is that whenBlack folks struggle with addiction, we don't get a response of care and compassion, but of police and prison. The city of Philadelphia relies on criminalizing and punishing people who use drugs, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. while also making the most effective and evidence based forms of healthcare inaccessible. And when people can't get the care that they need, the end result is incarceration or death. Drug offenses are the leading cause of arrest in Philadelphia, accounting for nearly half of all charges in the city. And even though we know that most racial groups use drugs at the same rates, Black people are overrepresented when it comes to who is arrested and held in jail for drug related charges. Black people are about 40 percent of the city's population, but as of April of 2024, over 70 percent of the jail's population is Black. What this means is that Philly's jails, which are currently under court monitor due to a host of issues, are sadly a major treatment center in our city. In 2019, percent of 21 people newly admitted into Philadelphia's jails, 22 or about ,5200 individuals, were treated for 23 symptoms of opioid withdrawal. 24 According to data acquired by Right to 25 Know Law, between January 2021 and June 2022, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. there were nearly 2,000 patients on Suboxone in Philly's jails. Studies have shown that in the days and weeks following release from incarceration, individuals are at particularly high risk of dying from overdose. S. jails, we have tragically seen that play out here in Philly, where since 2020, nearly 30 percent of deaths at State Road have been the result of fatal overdoses or unassisted withdrawal from many of these deaths occurring within the first few days of their incarceration. We know that there is a massive lack of drug treatment beds available in the community, but jail is a completely inappropriate environment in which to receive treatment. During the two month monitoring period last year, there were 181 weekly backlog appointments for MOUD treatment. Our recommendation for addressing overdose deaths in the Black community is simple. Philadelphia must stop treating addiction as a 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. criminal justice issue and start treating it as a public health crisis. The city must stop arresting and jailing people for drugs and instead invest in addiction services, social supports, including voluntary treatment, housing, employment, harm reduction, recovery services, and peer support.
At Amistad, we advocate for the expansion of community mobile crisis response teams, or CMCRTs, which are community based first responder teams funded through DBHIDS consisting of a mental health clinician, a peer specialist, and medical personnel that can respond to behavioral health crises. In addition to CMCRTs, which operate 24/7 throughout the city, there's also a pilot program called AR2 that works with a fire department to respond to overdoses, focused in Kensington. We believe that these programs should be expanded and deployed throughout the city in order to prevent overdose deaths. The good news about programs like this are that they are 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. immensely popular with the Black community. Last fall, a Movement for Black Lives national survey reported that 77 percent of Black Americans support ending laws that make drug possession a act and investing in community rehabilitation programs. Additionally, 86 percent of respondents support non police first responders who could deescalate violence and provide mental health support and other social services. Those results align with a local survey done by Lenfest Institute earlier last year, which told us that 87 percent of Philadelphians believe we need more access to mental health services and drug treatment. Above all, we need to treat people who struggle with substance use disorder with the care and dignity that they deserve. We have to see the humanity in people who are our neighbors and family members, and see them as deserving of help and not further trauma. Let us as a city commit to supporting and affirming life. Thank you for your time. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Leader Brooks, Chairperson Ahmad, and fellow councilmembers, my name is Noah Barth. I am the prison monitoring director for the Pennsylvania Prison Society and a proud Philadelphian. Since 1787, our organization has monitored conditions inside of the Philadelphia prisons and those across the commonwealth. We are inside the prisons on State Road multiple times per week, meeting with incarcerated Philadelphians who ask for our help. We are honored to have been invited here today to share some perspective from that experience, and in particular, how it pertains to the overdose crisis in our city and how that interacts with our city's jails. Over the past three years, I've personally led 14 monitoring walkthroughs of our city's prisons, interviewing over 600 people in custody across all five facilities. These interviews, combined with the many hundreds of individuals that our dedicated volunteers meet with on State Road, paint a disturbing picture 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. that should caution any lawmaker against steps that would increase the number of avoidable arrests. The Philadelphia jails are in a crisis. It is as simple as that. Former Prisons Commissioner Blanche Carney said that at current staffing levels, the Philadelphia jail population would need to be reduced from the current 4,700 to 3,500 to adequately ensure the safety of incarcerated people and the staff who work there. Since 2020, at least seven people have been murdered in the city's prisons, and people in the custody of the Philadelphia Department of Prisons took about 100 trips to the emergency room per month last year. Since the start of the pandemic, the Philadelphia prisons have seen at least 55 deaths, more than Rikers Island in New York City, which has six times the population of Philadelphia. The majority of people we have interviewed over the course of the last three years reported being locked in their cells for days or even weeks at a time with no staff 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. present on their units. Just last week, I spoke to a man in the Philadelphia Industrial Correctional Center who told me that he has multiple heart conditions and a seizure disorder. He explained that in-cell buzzers in the unit do not work. Our staff escort confirmed that they are non operational building wide. I asked the man, what does he do if he has a medical emergency? He replied that he was fortunate enough to get along with the guys in the next cell who will bang on the door and scream until help arrives. No one should have to rely on that. What happens when the next person in that cell isn't so concerned? What happens if they don't scream loud enough? The mayor's public safety plan mentions the word police over 200 times. It does not mention the words jail or prison at all. The city's approach to the addiction crisis in Kensington is couched as a treatment response, but is being implemented largely by the police department. More police contact will result in more 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. arrests and hence more people in jail. That is inevitable. We cannot ignore or make invisible that part of the equation. I have met with dedicated employees of the Philadelphia Department of Prisons nursing staff, and they are beleaguered. The most common complaint that our office receives from the Philadelphia jails is delays in medical care or outright lack of access. How do we expect this overworked medical team to respond to an influx of individuals with substance use disorders? I have met members of the counseling team at the Department of Prisons, and the men and women we interview in custody are routinely positive about these people, but they share how they are typically assigned to cover two or more housing units of 75 or more people each, and thus are totally unavailable to the incarcerated population.
Again, how do we expect this overworked counseling team to respond to an influx of individuals with substance use disorders? We have heard time and again, including 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. here in City Hall, how desperately understaffed the security team is of the Philadelphia prisons. These are the people responsible for alerting the medical team to emergencies and transporting individuals to treatment. My office receives calls and letters every week of instances where corrections officers are unable to carry out that critical function. Once again, how do we expect this overworked security team to respond to an influx of individuals with substance use disorders? Lastly, I want to note that prisons are not drug free spaces. Our city and state invest millions of dollars in untold man hours every year in an attempt to interdict the flow of drugs into prisons with little discernible effect. I have been escorted off of housing units because the fog of potentially toxic synthetic marijuana smoke was so thick. I have had a staff member tell me of developing a respiratory condition for the first time in her life due to working in smoky prison units. Sadly, too many Philadelphians have 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. lost their lives due to overdoses inside of our city's prisons. And so I want to be clear on one key point: prisons are not detox centers, they're not sober living houses, and they are not treatment facilities. Moving the city's very real substance abuse crisis behind prison walls will not solve it. What it will do is further strain a system that is already on the edge of collapse, and it will guarantee increased suffering and hardship for our neighbors who are struggling with addiction. The Prison Society is not here to shame or berate the prisons or this body. We are here because we know that better is possible. The Council and the other people who run this city, including the staff of the Department of Prisons, have an awesome responsibility and a grave task. It is our intention to be of service, offering assistance both to the incarcerated population and our leaders to foster safer, more humane prisons. From the perspective of jail 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. conditions, the most important stakeholder on this issue cannot be here today. The individual is incarcerated in those very buildings. I'd like to close my testimony today with a small selection of quotes taken directly from those interviews I conducted during our walkthrough last week. The security staff said they won't call medical. It's all up to COs. If they don't call, they don't call. I got diabetes and my blood sugar be low, and I be calling and nobody comes over here. We have to beg for everything. I'm a victim of abuse here. I had to flood my cell to get someone to pay attention to me for my mental health. I got serious mental health. The whole week we was locked in, there wasn't no COs around. Someone could have died here. I'm scared. The Prison Society is encouraged that this hearing is happening today, and we are appreciative of the opportunity to speak. Thank you for your time today and Godspeed. COUNCIL CHAIR AHMAD: The next witness 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. will state their name and proceed with their testimony.
All right. I'm going to just go through this quickly. There's a lot of people here that would like to speak as well, so my name is Sterling Johnson. I'm an organizer for the Philadelphia Housing Action. We're advocates for housing and harm reduction. Generally, we've come out of the 28 Parkway encampment that was able to have a land trust and is able to hold land and support people in it. There are people in this room that were part of that. There's a whole movement of people that are people that are fighting for housing in the city, especially people that are directly impacted, people experiencing homelessness. We fight primarily with people with disabilities and people in recovery, and also focus on people reuniting families who have been separated at family court. This overall focus that we have in this issue is around permanent housing, and that means solving the issue permanently around people experiencing 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. homelessness. I have a lot of things to say, but I want to  and you have the testimony, so I just wanted to kind of stick to the personal story around what happened for me. I know I also knew Edward and very sad and thinking about some of the ways that we can do better with more people. My cousin also died of an overdose. I've been to treatment. I've been to AA. I was an a for Alcoholics Anonymous for 10 years, so I'm aware of all the sayings that go along with it. And I can say that, at least for myself, that did not work. I respect people's recovery that for people that don't use substances, but I am also in recovery. I use drugs. I'm an HIV positive person. I'm not dirty. And in general, in the Black community, we can say that, yes, Black folks use syringes, use opioids. Black folks smoke meth, they inject meth. If we want to end the HIV epidemic, we have to be more open about what is happening in our communities and not have a shame around it. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. And also raise up Black gay men, Black trans people, Black trans masc people, Black trans women, Black straight masculine people that cannot be open or are not open, usually known as the DO, Black sex workers. We have to raise them up in our communities. There's no more secrets. As I mentioned, this isn't about it's about finding where harm is actually happening and also support every single Black child, Black girl and trans folk and trans folks that are young and in their development, to let them know that there's comprehensive education around their sex, their sexual practices, and also drug use. Just to talk about what are the ways that we should be going forward. I mean, there is a national Black harm reduction movement that is emerging in this country that says that it's going to be different. This is not just about syringes. This is about building a whole new infrastructure that centers Black people. A few additional thoughts are around, what is what are the actual reparations that 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. can be done around here? And I just say reparations, right, because of the harms that have been done to Black neighborhoods. We start with decriminalizing drugs and sex work simultaneously. As was mentioned earlier, you cannot just simply decriminalize that in one part. You have to be investing in health, housing, and employment opportunities as well. I think that's a very important part we have here, because we know that people that are selling at the bottom of the market, they need opportunity, too. Constantly, we're seeing them as the scapegoats instead of the people that we should be investing in. We know people on the block come to you and they ask you for a job. They're like, what can I do? Where can I get training? How can I make this get connected to services? So I just want to say in the small time that I have, we have to be supporting that.
And I only say that because most of these people are Black men, are Black masc people, and by making sure that we are actually supporting a lot of 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. supporting those people, supporting myself, thinking of myself as a boy in this country, a Black boy in this country, and what I needed in terms of mental health, in terms of opportunities, I just want to say, that's why we're here. That's why we're all here, because we care about the people that have died, the people that are not with us. And when you get when you start to get older and I'm 39, almost 40, and you start looking around, and you don't see your friends, you don't see other Black men around you, you wonder what happened and how we can make another world. It isn't about trying to under whatever the political space is like. It is only about trying to make sure that we are protecting Black families, and that means Black men, but also supporting all the Black trans folk and Black women and Black queer folk in this city. Like I said, you have my testimony. I really want to focus on this thing around Black men, but and lastly, this is what I talked to Dr. Farley over and over again in the early 2016, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. and he was intransigent, as always, as most older men are. But I said, when you talk about the opioid epidemic and try to stop people from getting access to medication, it creates another market that makes it more dangerous for all of us. And what did we see? More people died from fentanyl and other things that are on the street. And now xylazine, and then another thing, and then another thing will become the next drug that hurts everybody. And so we've got to say we've got to be very open that people need methadone. People need to be prescribed heroin. People need to be prescribed OxyContin. They need Adderall. They need fentanyl, they need to be prescribed fentanyl. They need to be prescribed Dilaudid and hydromorphone, which are possible in the hospitals right now. They are not doing that. They need to be prescribed those so they can treat their pain and be kept alive. And when I say that, I don't mean it as some dream in the world. I am talking about the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. things that can be done just by doctors being trained the right way to support people that are alive in their emergency departments today. And I just want to say the last thing around this. All the tropes that have come up around fiending and addicts and things of that sort, and the fact of the matter is that as a Black person, as a Black man, you will be fiending. Those are physical reactions that you're having. And when you see a Black man where that is happening to them, they need treatment. They need medication to help them. I'm just tired of this thing around whenever there's a White person that is suffering, then people treat you with care. And then we are called fiends or we are called monsters or so many ugly, disgusting things that I don't like to I can't even can't even tell you how many people have called me ugly names just for needing help. So as a person that has gone through some stuff and that supports a lot of people and works I mean, I support people, but all the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. people that are around me, we support each other. That's the thing. Because we are people that use drugs. That is what we do. We are people in recovery, people that use drugs, and we're not going to make apologies for it. No, I'm not sober. We're people that use drugs. That's it. Thanks.
Good afternoon, all. It's a pleasure to join you for this important meeting, and I extend my thanks to Councilmembers Brooks, O'Rourke, and others, not just for the invitation, but more importantly for the leadership, your leadership, on this issue. My name is Samuel Kelton Roberts. I'm an associate professor of history and sociomedical sciences at Columbia University's School of Arts and Sciences and also Columbia's Mailman School of Public Health. I'm a founder of a founding member of the National Black Harm Reduction Network, and I also sit on the board of directors of OnPoint NYC. I have researched and written about the history of public health and medicine for a bit 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. more than years. I have worked in the area of 4 drug policy and politics history for nearly 15. 5 Along with appearances at public and 6 private meetings such as this, I also teach 7 courses on health inequities, drug politics, HIV 8 AIDS, and harm reduction. I have never had the 9 pleasure of being a resident of Philadelphia, 10 which I greatly regret. I love the city. I've 11 been here I came here early on Sunday just to 12 experience just a small bit of the city. I'm not 13 a resident. I have many friends here, including 14 some people I've met today, and I love to visit. 15 That said, my comments are broadly 16 historical and not specifically about the 17 specific issue here in this city. The prompt, 18 which Councilperson Brooks's office gave me, 19 regarded a question about how public policy 20 response to the crack cocaine epidemic, 21 principally the war on drugs, affected the course 22 of the epidemic and public health, specifically 23 the health of Black communities, which were the 24 most affected by the war on drugs. 25 This is through hyper policing and mass 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. incarceration and myriad other state institutions and mechanisms. The answer is complicated, but I will do my best here to give a broad overview. I have also forwarded to Councilmember Brooks's office an article on the subject which I published last year. When we talk about the war on drugs, we're referring to the collective actions of the legislative, judicial, and executive branches of the government at all levels. That is the federal, the state, and the local. In the system of American federalism, funding for the war on drugs typically originated in Washington, with guidance on how that money should be spent at the state and local level. The general assumption is that the war on drugs actions have been solely, or at least mainly, in domestic and international law enforcement, investigations, policing, prosecution, and incarceration. That is, in fact, true to an extent. However, what also should be considered are all of the effects which the war on drugs has had on other aspects of 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. governance. Today, I will address three of those broadly. They are the economy, including labor, education, wealth, and property; medical care and public health; and then thirdly, political efficacy. Again, the issue is complicated, particularly its history. It's a nearly 50 year history. In my courses at Columbia, any one of these could take up an entire class or more. Bottom line, if the goal of the war on drugs, as its proponents often have stated, was to if that goal was to end the harmful use of drugs, so to speak, then it can be said to have been nothing more than a spectacular failure. On this, historians are in virtually unanimous agreement, I want to be clear. In the realm of economics, among the drug war's effects are the economic immobilization of millions of people through blemishes on their criminal records.
For many, it is almost insurmountably difficult for those with drug violation records, especially felony records, to attain the kind of professional 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. success that they would have without those. Remember that we're talking about people who have served their time and would have had and should have the same rights as all other citizens. Then there's the income lost to families. Many of us would like to believe that people who use drugs are only that, but they are also earners and supporters. , etc. War on drugs actions have interrupted educational attainment, thereby foreclosing on another avenue of upward mobility in this country. It is costly to stage a defense of oneself after an arrest, also especially if your real estate, automobile, or other possessions have been seized in criminal forfeiture. Whether found guilty or not, such events interrupt generational wealth transmission. Moving on to a macroscopic scale, I want to remind you that at the time of the 1986 and 1988 Drug Abuse Acts, American cities, including this one, including my city, including 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. the city in which I grew up, and veritably, all of them in this country, were in dire financial straits. In the Reagan era and afterwards, Departments of Education, Health, Housing, and Homeless Services, and other social service agencies experienced severe budget shortfalls but were forced to stand by and watch drug war task forces receive more and more money each year, a trend which was not limited to the Reagan '80s or the Bush '90s or the Clinton '90s, continued well into this century. Secondly, it is in medical care and public health that the deleterious of effects of the war on drugs have been most profound. Those effects are too numerous to recount in one sitting, but at the moment we might consider a few aspects. First, if you, like most Americans today, and I encourage you to check the public opinion polling on this, if you believe that substance use issues are issues of mental health and not moral failing, then you have to conclude 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. that we have spent hundreds of billions of dollars over the past half century to police, to surveil, and to incarcerate individuals who would have been better off with good mental health care and social support. Further, our current social attitudes and legal structures have been responsible, directly responsible, for driving people who use drugs underground. They therefore become, and understandably so, very reluctant to seek healthcare of any sort. A general physical checkup or emergency room visit often may occasion stigma, rebuke, and scorn, and even may end in arrest. A pregnant woman dealing with a substance use problem may be reluctant to seek prenatal care if she knows that that detection of her condition may result in imprisonment, and worse, loss of parental rights. In driving people who use drugs underground. The war on drugs had the effect of exacerbating the HIV AIDS crisis in the 1980s, in the 1990s, and beyond. Where it has been 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. illegal, for example, to possess a syringe without a prescription, individuals are more likely to not keep clean syringes on them, and therefore, will be more likely to share them. That is a simple fact that is backed by 40 years of science. If you do not believe that, I want you to think of all the innovations in science that have happened in the last 40 years, Google, Amazon, all that, and then tell me you don't believe in those, because that is how long we have had this scientific knowledge. Everything I've said thus far has been about an individual's health and well being.
I have not mentioned the cumulative community level effects in cycling millions of individuals through the criminal legal system for some 40 years. The war on drugs has had the effect of ripping apart families and communities. A handful of people with a substance use problem treated unfairly by the criminal legal system is certainly an injustice. However, when you get to the level of hundreds of 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. thousands, or even tens of thousands from a single community, then you're going beyond that and looking at  you are then looking at systemic and structural racism and social inequity. For example, one need think only of the so called million dollar blocks which emerged in the 1990s, as city blocks were in Philadelphia had one, New York had one, Chicago had one. Every city of any size pretty much had one. And these were cities where city, state and federal governments spent a million dollars or more annually to incarcerate a single block's residence. And that's in 1990 dollars. A million dollars doesn't really go that far these days. This is that was real money in the 1990s. Lastly, there's the issue of political efficacy. C. 4 million Americans have been disenfranchised, denied their right to vote because of a felony conviction. That's two 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. percent of the eligible voting population. Figures from the Federal Bureau of Prisons indicate that between 40 percent and 50 percent of individuals incarcerated in federal prisons this does not include the state and city prisons but nonetheless indicate that 40 to 50 percent of them are there for drug infractions. 2 million individuals in this country who cannot vote simply because they have a felony drug conviction record. Anyone who believes in the fundamental premises and ideals of a modern democracy should find this to be odious. They've served their time and theoretically are free among us, but that so called freedom can hardly be called such without the franchise. Further, you cannot really say that a particular community will be able to exercise a requisite degree of self determination when so many of its members cannot vote. Remember, I said two percent of the general American 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. population, but that's not distributed evenly. That's not a lottery. It is concentrated in our communities, and there will be no 6 self determination as long as that continues. Disfranchisement on a massive scale hits a tipping point where political leadership eventually come to regard these communities as not being part of their constituency. Further, the dilution of a community's voting power due to disenfranchisement brings us back to the pre 1965 days before the Voting Rights Act, and even as far back as the Three-Fifths Compromise. I cannot say in conclusion, I cannot say strongly enough how damaging this so called war on drugs has been on our communities. It has been stated before, and I will reiterate as the concluding speaker, it is really a war on people and on our communities. It has been a waste of effort. It has been a waste of resources. It has been a waste of political imagination, and most importantly, a waste of human potential. Again, I thank you for the invitation to be here. I've enjoyed the speaking of the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. public speakers, and I look forward to decisions that your body will make in the future. Thank you. COUNCIL CHAIR AHMAD: Are there any questions for the panelists? Just a point of order here. Making a slight change in the announcement we made earlier. This hearing will continue, and I'm making a motion to appoint Councilmember Brooks as a temporary chair for the remainder of the hearing. All in favor? ) COUNCIL CHAIR AHMAD: Okay.
So she's now got the gavel, and I apologize that I have to leave, but this has been an amazingly informative hearing, and which I will look for the rest of it on tape. And I thank all of you for being here, for taking your time to make these the commitment so that we can, as you said, take this colossal waste of money and time and look at how we can fundamentally change the dynamics to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. really support people. There are a lot of questions, but I thank all of you for your time and patience to being here.
Well, since I'm chair, I'll take liberty first with questions, and then if anyone else has questions, they can follow. My first question is for Sterling Johnson. Harm reduction is in a politically difficult situation right now. If it does not solve the problem of overdose deaths, it reduces harm along the path towards solutions, buying time by extending people's lives until they can get treatment. Can you talk about what kind of interventions would solve overdose crisis, and why harm reduction is just a part of the constellation of policies that the city needs to pursue?
Oh, for myself, yes. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Thank you. So, yeah, thank you for the question. As we know, we're at a pretty politically troubling time because of concurrent crises of health crises, a homelessness crisis, honestly, a gender based violence crisis as well, and a gun violence crisis. So the fact of the matter is that we have to bring it back to the basics of economic development without displacement, housing that is actually permanent supportive housing, but also increases in affordable housing. But then I think, lastly, we have to understand how we're going to use community based supports in healthcare to provide the social support and actual medical support for everybody in our community. I think that is quite difficult because it is it is unclear how we do that just by having a case manager for each person. But I do think by partnering with a lot of community based organizations that are doing a lot of the work on the ground, by taking seriously these ideas around how people relate to each other, how we 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. change our culture, especially around masculinity, around understanding that being an ally, and reproductive justice, and the relationship shifts that happen between people to people, but also people that you that are not near you, right? So it's almost like returning to this idea of a village and treating people as part of that. And I think that kind of starts inside. So I don't believe just going towards a sober culture is what leads us to that. It is changing the culture around how we fund organizations and how we hold all these other organizations that are currently getting money accountable in some way. I'm a harm reductionist, so I believe that the things that needed to be implemented immediately are supervised consumption spaces and also making sure that people that are using fentanyl are actually prescribed fentanyl in a meaningful way, and that can be done in the ERs that we have. I just don't want to take this in a 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. space where it seems like we're dreaming when we know that effective treatment from the public health insurance system, like making sure we raise that up and we hold those people accountable. We need to make sure that that system is working for us. And as a disabled person, I demand that it does work for us. Because the fact of the matter is that while the number of Black men are dying and it continues to go, actually, the amount of White people that have more money and that are getting access to good treatment, their deaths are going down. And we're going to see the same disparities that happened with HIV in terms of HIV and the amount of people that are taking preventative measures, like through PrEP and things of that sort. And the White population is quite high, so then it seems to be a thing that doesn't really matter. But we know people that converted last year, right? It's like, for us, the HIV epidemic has never left. It is still here in our 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. communities. People are still dying, dying from the stigma of it. So when we talk about what we need to do, it has to be at the public system, and it has to be a community base. Thank you.
Thank you. Thank you. The next question is for I'm just going to do, while you're right here, too for Noah Barth. In what ways does the criminal, legal, and public health system perpetuate substance use and abuse cycles, and how is that connected to the ways the Black community is targeted and marginalized?
That should be your question. I'm very aware that I'm sitting next to the professor who's quite an expert on this topic, so I might tag him in, but, you know, I think that's the big question, right? It's complex. Our country, from its beginning and layered. Our country from its beginning has largely been based on the labor, physical, and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. economic exploitation of Black and Brown folks, right, in various forms over the centuries and decades. Exploitation, abuse, family disruption, physical trauma, emotional trauma these are things that lead to addiction in any population. But it's been a key aspect of American society to inflict that upon Black folks in particular. When we're looking at the criminal legal system, to a large extent, the criminal legal system enforces the rules of the game as decided by lawmakers and business elite. And so for a lot of our history, some would argue up until today, that is aligned with exactly that same exploitation. And so it is part and parcel of creating the circumstances that make addiction not only likely, but predictable. I don't know if you want to add anything to that.
And thank you, Councilmember Brooks, for the question. I would also encourage the body to 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. think in terms of also about the bottom line economics of this system, of the criminal legal system. A body that goes through that, a human being, will give value to somebody, monetary value, at every step of that process. Arrest means officers get overtime to arrest people. Then they go through the court system. People get paid for that. Then they go to prisons where we constructed a lot of prisons in the 1990s, and a lot of them were basically jobs programs, and they often run that way as well. I mean, we have a lot of people in prisons to this day who would do better not there, but because they're there spending upwards in the state where I live, I think we spend close to maybe 50,000 a year to incarcerate somebody. Somebody makes a profit off of that. If you force someone into an ineffective treatment program, somebody's making money off of that. A human body, particularly a Black body that goes through all this, it's like a conveyor belt, like Ford making the Model T, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. except they're not putting anything in it. They're actually deconstructing it. At every step, someone's making money off of that the entire time. And that's where also, I think, the exploitation is as well, so I would really encourage all of us to think of it in those terms as well. Because that money could be spent elsewhere. It could be an investment where it's not an investment right now.
You might as well stay. Thank you for those points. And Professor Roberts, what are the key takeaways from the response to the crack epidemic as policymakers look into the opioid epidemic? And what mistakes should we be avoiding repeating, and what lessons should we be implementing?
How much time do we have? Short answer is, we did crack cocaine entirely wrong. Unless your goal from the very beginning was to mobilize stigma, to disempower certain communities, to put the fear in other 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. communities so that they vote for you Ronald Reagan, for example, but also many Democrats as well. But otherwise, from a public health point of view, we did it absolutely wrong. All it was was stigma. All it was was exploitation. All it was was neglect of our communities. At the moment, by the way, when those when we needed attention. This was a period of federal disinvestment in our cities. And that was not that was not on accident. That was where that was the base of more of the liberal democratic votership right there. And in a Reagan in a Reagan White House, that was not to be countenanced. So the war on drugs very much was economic, and it was political as well. In terms of what that means for the opioid epidemic, I think, first of all, obviously, stigma has to be thrown out the window. Secondly, we really have to well, also throw incarcerated solutions out the window. We will not incarcerate our way out of this problem. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. And thirdly, we need more political imagination on this one. I think absolutely a lot of things that we have assumed about the use of drugs are very much false. I like many of the ideas that Sterling introduced earlier on are very much imaginative and need to be explored. We really need to think about prescription because people will get drugs anyway until they are able not to. We, as a public health measure, we need to ensure safe supply. We need to ensure, really, all the social support, because the other thing is that we're talking about, for this afternoon and in the national conversation, we've been talking about drug users, but that's just that's a social construction. These are people who have all these other needs as well. And it's only when we talk about drug users that we say, oh, we need drug use treatment. It's mental health, the same mental health that all of us need. I see my therapist every week. Pay good money for it, but it's worth every dime. But when we talk about 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. drug use, oh, they need drug use counseling or something. No, a lot of them just need good mental health that is unavailable in this country.
Thank you so much for those points. Nikki Grant, what kind of harm reduction vehicles would combat our overdose crisis, and is there interest in or capacity for expanding the fleet of service vehicles supported by the city of Philadelphia?
Right. So as I mentioned earlier, there's AR2, which is the one pilot program I started in 2019, I believe, which is a correspondent model. It's with the fire department on DBHIDS. And so it's just one vehicle, I think, in Kensington that is like an EMT vehicle. And that, if we could expand that, that would be great. But honestly, all we actually just need is a car or a van, because what's most important are the people in the vehicle. So we need a social worker, a medical professional, and a peer 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. specialist in the vehicle. And that's really the basic that you need to run these programs. Whether that there is interest and capacity to expand any kind of fleet remains to be seen at the question for the administration. Treatment, not trauma. My coalition that we work with, mainly social workers and that coalition, have been advocating for the past three years for the expansion of these programs, and we're still in pilot level. So I think we need to expand these vehicles, these units, in order to serve the entire city.
Like I mentioned before, we need emergency vehicles. The emergency system, obviously, but we also need long term stable housing. We need access to longer term behavioral healthcare. Like you were mentioning before, it's actually really hard to navigate the system. I'm a competent adult person with depression and anxiety, and I have a hard time 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. figuring out how to get a therapist in this city. So it's for us people who are going through more, it's basically impossible. We need case management systems, and we need community education and support for harm reduction. Hearing about the Philly Counts earlier, that's a good way to get more education out there in our communities, so more of that would make a holistic system.
Thank you so much for that, Nikki. Does anyone else have questions?
Mr. Barth, how many people are incarcerated in Philly jails and prisons that have died from overdose deaths while they were incarcerated?
If we're looking back to 2020, at least 15 people have died from overdose deaths, but the number is almost certainly higher. Five reported deaths still have cause pending from the department.
You said 15 people since 2018? 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Correct. But I think it's 6 important to know that that number is almost 7 certainly higher. There are five reported deaths 8 that the Department still lists as cause pending. 9 It's also fairly common practice, not just from 10 the Philly jails, but in prisons across the state 11 and presumably the country, where people will 12 enter into a medical crisis of whatever form, be 13 transported to a hospital, and declared dead at 14 the hospital. And it doesn't get recorded as a 15 jail death, even if the causative factor occurred while they were on the jail's property. And the other note of this is, the number I gave you, that that is due to right to no requests and investigative journalism. There's a generalized lack of transparency around prisons that I mean, that is the nature of prisons. But even on something as basic and fundamental as who has died and how and why and when is not something that we have very clear public numbers on. And that, I think, just 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. speaks to the problem of the overuse of jails, one of the dangers of the overuse of jails.
And what is the total percentage of deaths while incarcerated? Do you know?
The total percentage of deaths while incarcerated?
Yeah, it's about 30 percent. But again, it may be higher because there's still some cause pending deaths.
For returning citizens, how does incarceration impact the likelihood of an individual overdosing on rentry, if you can speak to that for the record?
Yeah. That operates on a number of levels, and I would invite my fellow 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. panelists to chime in as well, but I think just right off the top, a couple of the important things are the average stay in the Philadelphia jails is about 100 days. So that's 100 days of additional trauma along the lines of what my testimony was trying to give light to, right, of people living in the system that is highly traumatic, that can exacerbate addiction disorders. It's also 100 days where if you had an apartment, you're not paying rent, so you probably don't have that apartment to go home to anymore. If you had a car, note that car's gone, right? If you got child support, alimony, other kinds of payments due, they're still racking up. Your debt has accrued while you probably just lost whatever job you had because you were absentee for three months and change. And again, all of these stressors, all these economic pressures are the very things that push people toward drug use in the first place. Additionally, people coming home from prison, they're largely going home to these same 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. neighborhoods that are being overpoliced and criminalized, and they're entering criminalized spaces where they're oversurveilled, they're stigmatized, where, again, they're experiencing these social pressures that my fellow panelists were doing such a good job elucidating, again, pushing people toward the very real desire to find some relief when life is that difficult. I don't know if anyone wants to chime in on public health impact of being in prison, but just social pressure and basic logistics.
Yes. I just wanted to speak to the difficulty in even getting someone into a housing option, the qualifications that that would take, the federal qualifications, this sort of, kind of labyrinth of issues you need to know to understand how this affects that. So, of course, it's many people have children, so you're just trying to it's either you're trying to reunite somebody with their family or trying to get them into their own place, but then they won't have space to see their children, and that's maybe their goal. So 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. then that really is the delay. So unless there's a real comprehensive way to understand where is somebody able to live that also is connected to all the social supports they need, it just is not what it is. And to tell you the truth, it's very disappointing that when we are when there's often maybe an elderly White person that does not have a felony on the record or something of the sort, it's much easier to get them into a thing. So what is often left are the people that are, quote/unquote, more complicated, when it's like, no, you have to have a directed reparations and restorative based program to assist the people that we know or we die. That's just what it is. Because the way that nonprofits work is they're going to cream off the top the people that are easiest so you can get those numbers. And I just I'm bringing this to nonprofit industrial complex kind of speaking, but that is the world that we need to be in and understand that those dynamics. You understand the way that 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. history is erased if you do not understand all the coming from places that are enslavement are sort of apartheid in a city, dealing with discrimination, understanding that we have to undo those, and in a very intentional way. I guess they were talking about in the other in the section in the other hearing that was happening very similar to now, but we have to have reparations for all the harms that have happened in this country, or it keeps being it keeps going over again, right? This thing keeps on happening again. The decriminalization that occurred in the in the prisons as easy yes, okay, now we have even more higher we even have even higher percentage of Black people in the in the prisons and jails because the decriminalization was not focused on those individuals specifically. So I guess when I say that, it's like, as a person that is going back and forth with the housing authority on so many occasions, I pray that we're really focusing on those individuals. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. And even gun possession card, even attempted homicide, because at least I'm telling you, but the people that I know, they got attempted murder charges, but they still deserve housing. So I just want to be clear about what we're even talking about.
Any other questions from the panel? Any other questions from Madam Leader? Thank you for your responses.
Just want to add, also, just thank you all so much for being here and for sharing your very rich and informative testimony.
Just want to thank everyone who has come out today for this hearing. I noticed we're moving into our last panel. As you've seen, our Committee has gotten a little smaller the course of the time, and I just want to, again, thank you all for being there. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. I'm going to step out now, but everything that's been shared today obviously goes a long way in us being able to address this issue that's often overlooked, and I thank you for your contributions to us being able to do that in making this a space where we can talk about this openly. I guess the first act in making sure that we push back on the shame that comes with this is by using spaces like this to have this kind of conversation in an open way so that we can get towards a resolution. Thank you so much for your time today. God bless you.
Thank you, Councilman O'Rourke. And I want to thank the panelists that are leaving. I'm sorry. I had a personal emergency I had to run, so I want to thank you all for coming out and taking the time to come and speak today. Your testimony is really appreciated. Ms. Way, you're next. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Thank you. Hello. My name is Jessica Way. I'm a registered nurse in Camden, New Jersey, and my position in New Jersey, we have a position called ARCH Nurses, which were created by the State Department of Health and together in conjunction with Rutgers University. I work with Camden AHEC, a non profit committed to harm reduction, and a large majority of our patients are currently homeless and struggling with substance use disorder. While this includes a number of different drugs, many of our patients are struggling with a reliance on opioids such as fentanyl and crack cocaine. First, a quick overview of Camden. The city has a population of just under 71,000 people. City residents are 90 percent people of color, with 42 percent of the full time residents identifying as Black, and over 50 percent identifying as Hispanic according to the most recent census in 2022. The average resident in Camden makes around $19,000 per year, and the average 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. household pulls in $36,000 per year. This is compared to Philadelphia, where the average resident makes around $33,000 per year, and the average family makes $57,000 per year. Now, I want to be clear. I don't want to be making the case that Philadelphia is just rolling in the dough. Just trying to make the case that in Camden, we're struggling. We're struggling a lot right now. 6 percent of our residents are in poverty compared to percent in Philadelphia. 14 And in Camden, 20 percent of the population 15 currently is classified by our Point In Time 16 survey as having severe housing issues. In our 17 small city, 633 residents were tracked as being 18 homeless. 633 residents in a city of 70,000 19 people. And I promise you, that is a 20 conservative, conservative number. New Jersey 21 has been seeing a consistent increase in 22 homelessness without an additional increase in beds. In contrast, according to the city of Philadelphia's own data, homelessness is actually 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. improving across Philadelphia. The 2022 data snapshot from the Office of Homeless Services stated Philadelphia decreased the number of unsheltered persons by 27 percent in the last five years, with an overall percent decrease 8 in the number of homeless persons for the same 9 period. 10 We have seen the exact opposite trend 11 in New Jersey. In Camden right now, our homeless 12 rates are going up. We have only 22 food banks 13 and soup kitchens for a city of 71,000 residents, 14 or one for every 3,227 residents, which is 15 roughly about 60 percent of what Philadelphia has 16 for its residents right now. 17 But we are right across the Ben 18 Franklin Bridge from Philadelphia, a bridge that 19 many residents from Philly walk across to receive 20 necessary services from Camden. And every day, I 21 have been hearing for the past month since the 22 sweep started in Kensington, my patients tell me more and more people from Kensington and Philadelphia are coming to the encampments in Camden. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. And every day, the people at Cathedral Kitchen keep continuing to serve the larger number of people who keep showing up from across the bridge. The ER at Cooper Hospital is continuing to treat everyone, regardless of their health insurance status, from New Jersey or Pennsylvania, and the numbers are going up. m. for a bed. And my coworkers at Camden AHEC are moving mountains to make sure that we patch every wound, find a rehab, or procure the HIV medicine for anyone who walks through our doors, even if they just rolled into Camden. But I feel like we're getting punished, because in Camden, we've chosen not to embrace tough policing of the homeless.
And I feel our current residents are really struggling with a lack of resources that they are competing for as Philadelphia is shutting its doors and allowing everyone just to come over to Camden. I don't want any of us who are working in social services to have to deny anyone the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. services that they so desperately need. I understand how people must feel in Philadelphia and Camden. I am the one ARCH nurse for the entirety of Camden County, and I do take care of everybody, both from within Camden and from suburban areas of South Jersey that are also coming into Camden to access our resources. And I know that Philadelphia has taken on a heavy lift that way, too. But now, we are taking on that heavy lift from Philadelphia. Just in the past week, the number of clients at our syringe access site increased 43 percent, and those new patients were coming entirely from Philadelphia. I want to just imagine what that would translate into if that happens to our shelters, our emergency room, and our addiction medicine clinics. We are asking for Philadelphia to be intentional and thoughtful about what happens next. When patients come from Philadelphia over to Camden, they do not have New Jersey Medicaid. They have PA Medicaid, which means that we can 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. bring them into the emergency room, but we cannot coordinate the services for them that they need to get well. So unfortunately, they are not able to get into local drug rehabilitation centers. They're not able to access methadone clinics, and they're not able to access any of our clinical caseworker services. And the issue is, when someone comes across and lacks identification because they may have lost their ID or they've lost access to anything that showed them having a permanent address, that doesn't get fixed anytime soon. They have to prove residency in New Jersey, which means they have to come into the shelters. They have to come come into spaces where people from places that the state recognizes, says, yes, we know who you are, and you are now a New Jersey resident. So what we're really doing is disrupting healthcare for those who need this healthcare the most. I must state adamantly that I cannot overstate the importance of vigorous and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. compassionate healthcare for those who are struggling with homelessness and substance use disorder. This year, I was able to assist patients to become undetectable for HIV. I've helped them procure treatment for their hepatitis C, and we've cured chlamydia, gonorrhea, and trichomoniasis. But I am the only ARCH nurse in Camden County, and if I have a 43 percent increase in patients, some of my folks are going to get missed, folks with endocarditis, septic wounds, bone infections. And when that happens, people lose their lives and they lose their limbs, and I don't want that on my conscience, and I don't think anybody here does. It's not too late to turn away from bad medical policy and to take a good look at the research and follow the science and not just knee jerk reactions to current public opinion. Thank you.
Yes. My name is Jamal 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Holmes. I am currently a certified recovery specialist, a certified peer specialist in the fields of drug and alcohol and mental health. I'm also a board member at Restoration Expansion Project, which is a CDC located here in Philadelphia that addresses the community at large. I just want to share both from professional and experience. It was wonderful to hear all the people who spoke today, from all spectrums, from the political side, from the financial side, from the actual lived experience side. We have to engulf all sides in order to find a real solution. But the one thing I failed to hear today was when it comes to harm reduction, I heard passion, I heard expression. I didn't hear empathy. Harm reduction is empathy. I have to see what I'm looking at as if I'm looking at myself in order for me to accurately want to support someone getting out of the situation that they in. Until we as a people, United States 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Constitution, first words, we are the people. That means people has no color, it has no race, it has no ethnicity, it has no sexual orientation. It has none of these things. People is people. That means you and I. Now, when it comes to the opiates that are within the urban communities and the overdose, I personally work in it. My job is strictly in the streets. I don't spend no time in the office that I have. I do have an office. I choose not to spend in the office simply because I am an individual who has 31 years of lived experience, and I also have 11 years of recovery experience. So and I'm age 53. So that means a total of 41 and a half years of my life has been centered around drug and alcohol. So that means I really only spent life for 12 years prior to starting and for the 10 years afterwards in recovery. When we walk this thing and we produce harm reduction, we have to consider the person that I'm dealing with. Do I see them as worthy? The communities at large means the communities 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. that are plagued with these things, a lot of times, the politics the politicians say, well, the community needs to clean up. When are we going to stop redlining communities when it comes to human life? Because we can't treat we can't treat those who are challenged with this thing as if they real estate, as if they buildings or commodities. No, these are human lives that are taking oxygen like I'm taking oxygen and you taking oxygen. So that means we cannot continue to redline when it comes to funds. We cannot continue to redline when it comes to support. We can't redline when it comes to care. Because obviously and definitely, we've come to learn that this thing called substance abuse has reached the rooter to the tutor, so to speak. There's not a level of life that it has not touched. There's not a monetary figure of life that it has not touched. There is not an ethnicity in life that it has not touched. So when we look at that, that means the help has to be inclusive. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. That means for us in Philadelphia, right, we've got to be able to say with the New Jersey side, if we don't work together and stop using these political boundaries and these ethical standards, that we can't cross lines and we can't mix measure and we can't deal with you because your Medicaid is from Jersey or your Medicaid is from Norristown, the things that the Black folks have historically been subjected to. And it's common known most of these grants that have been given and that has been extended from the federal government, it says to specifically serve the historically undeserved population. That's what these grants are saying, right? But I want people to understand the word historically means past tense.
Unfortunately for the Black and Brown, we have not experienced historically because we're still presently in it. We haven't had an opportunity to be away from it to where we can look back on how it used to be. We have not had a how it used to be yet. So when it comes to the overdosing 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. crisis in our communities, it became numb and normal. It's never been non existent. We just tend to walk past it as if it doesn't exist because it has become numb. We walk past the shooting and the killing. We don't duck when we hear bullets, which in itself is abnormal. But when it's plagued and done so long that it becomes a normal society, and now that it has extended its reckon to external communities around, now we're pressed with the opiate epidemic, when the reality is that there's none of these plants that these things derive from made in any of our communities. You cannot they come from different places, even when you try. So when we talk about how we need to stand as one, this city itself, in Philadelphia, I don't know about no one else, but when the last time we heard a hoorah about Philadelphia being the city of brotherly love? You don't even hear the terminology no more, because it is fading away, and it doesn't exist. We are living life in this mode of survival of the fittest, and we can no longer can 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. think that first law of nature, which is no first law of nature is survival. That's true. First law of man is love. But now we are I know what it is to live like in an animalistic state of mind. I wasn't an animal, but in addiction, you do whatever needs you have to do to get that thing that is now making the choice for you. The trauma results in I don't know about nobody else, but do you know what it is to be the disease that everyone has a problem with? See, everyone outside of being the disease has the choice to walk away, turn their back, forget about it, let go. But when you are that in which everyone feels there's a problem with, you can't escape that. So therefore, as a society, when we say, oh, it's their problem, no, it's our problem. Because the erection of it didn't begin with the manifestation of what we see. Kensington didn't become Kensington overnight. Prior to Kensington, it was North Philadelphia, West Philadelphia, right? 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. So and when we shuffle them, as she said, when we bust up the problem and we take it from under one rug and just sweep it under another rug, and then in another years, it'll 7 be all over again in another vicinity. We'll be 8 here in this political room trying to get some 9 adamant and adequate help and assistance support. 10 All it really takes is, can I care 11 about my neighbor like I care about myself? 12 Whether they have a house, whether they in a cut, 13 whether they own a cardboard, whether they 14 addicted, they are still my neighbor. So if we 15 have no empathy, we have no hope. Because I can 16 assure you this: just like the drug has done it 17 to a lot of people, just like war have done it or 18 the war on drugs, the word war itself is a word 19 of stigma. 20 The moment you say warfare is erected and the average person that hears that word, so once we get them in a state of fear, now we all doing things out of desperation and it's not being thought out with rationale. So when we address this situation, harmony, all these 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. components are excellent components. Because at the end of the day, the life is more important than the personality. The life is more important. So even if we sat here and everyone starts dying off and there's one person left on this planet, they are going not to desire you to be right, they are going to desire to see someone else that looks just like them.
Thank you so much. Thank you so much. Thank you both for your testimony. I do have a question for you, Ms. Way, because you mentioned the divide and you brought it up as well, Jamal. In what ways can our systems work together to coordinate the care and treatment of displaced individuals?
Well, sort of the big fan, you see, which is universal healthcare for everybody that gets handed on a national level. So we don't have New Jersey versus PA drama anymore. We're all on the same page. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. I do think that it's time for us to have more coordination happening across state lines, that we're all on the same page about the services that are being offered, and so that people's care is being coordinated regardless of where they are in the process of their substance use.
And I have some questions specifically about, describe some of the issues that arise when attempting to keep people in hospital, and are they provided with the correct medications to relieve the withdrawal pains, and are sufficient therapies for drugs that specifically affect Black communities? Sterling mentioned some stuff earlier. He's gone, so I'm kind of asking you to dive a little deeper into that.
So we just started a process in Camden that I'm really a big fan of. We paired up with the Cooper Center for healing out of Cooper Hospital, and one of the biggest fears that we found for folks who really do need higher level care is that they're going to go into 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. withdrawal because their symptoms are being poorly managed in the hospital while they're in there. So we worked and we got an agreement that we have a team that meets them in the ER now. If we have patients who are currently on the street, who need to come inside because they have an infection that's so bad it requires higher level interaction, we now I can text the folks in the emergency room and say, I'm bringing someone in, and they will meet them at the door to make sure that they are having their withdrawal symptoms handled appropriately, with an appropriate level of methadone, appropriate level of Dilaudid, and other medications required to keep them from going into withdrawal. But what we're really focusing on right now is just as you were saying, everything needs to be mobile, everything needs to be outside. You're right, we can't do this from an office. So we are trying to manage more and more chronic illnesses, more and more issues from the mobile van. We prescribe Suboxone from the mobile van. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. We have the NJCRI mobile van that's prescribing, treating, telehealth for hepatitis C treatment, for HIV treatment. We are mailing the medications to my office, and I will find people wherever they are and get the medications to them directly. Hold on to them if they need me to, because they don't trust that the medication is safe with them where they are. But I think it's time for all of us to think outside the box. But I also think that what you said is so true, which is that the most important thing is that we have to recognize that the folks we're treating are important and valuable wherever they are, and they deserve access to quality healthcare, and they deserve access to life. And so with that as our fundamental guiding principle, we can kind of move mountains moving forward.
Thank you so much, Ms. Way. Mr. Holmes, what kinds of treatment residents are available right now, and are there 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. enough beds to meet those current demands, and are these beds long term, and what does the long term mean to you?
Okay. Yeah, yeah. Good ear. First addressment, what is available right now long term. In the city of Philadelphia? Nothing. Let's be clear what long term is deemed as now based off of the Medicare or the Medicaid that will pay for it. A long term facility, now inpatient facility, treatment facility is considered 28 days. After that, they buy for seven more days. I'm coming to fit seven more days, right? They have to resubmit a justification rationalization to the insurances that they pay that pay for these for an extension. So that means if you really doing and you fight and, you know, this does happen, but overall, it's about 60 days before you will even have to drop down a level of care, things of that 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. nature. Are there all other facilities, halfway house, three recovery houses, right, but when we're talking about the long term inpatient module, the TC module really no longer exists because it got to the point to where a lot of things that are not monitored started to become unmanage unhumane, some things some treatments some unfair treatments, felt as though it was too harsh of a treatment. It was second to man, might as well be in prison. That was the aspect of it. If I got to get 18, months in the treatment, I 15 might as well go do the time. So the face was 16 there, even though three to six months, it's 17 adequate inpatient time. There are facilities 18 that offer that. 19 Philadelphia just really doesn't within 20 the county of Philadelphia. And that right there 21 in itself speaks volumes because the as you 22 said, the massive or what we see on the open 23 happens within the county of Philadelphia, 24 although Philadelphia is not the only one exempt, but it should be where it's at. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. So there aren't enough beds to meet the demand. There will never be enough beds to meet the demand. I mean, in reality, that we would have to make the whole city a rehab. Logically speaking, we know that that's not feasible, but mentally and spiritually, we can be a city that's a rehab, because the process of rehabilitation is many things, but as we speaking about the overdose or the opiate crisis, right, drug related empathy allows you to be a component. I heard this earlier from the board. What is the continuum of care or the curriculum of care, is empathy. I may not be able to do nothing. I may not even be able to understand your situation in that struggle. But as the old Hippocratic Oath said, do no harm. That simply means if I can't help, then I should do nothing to hurt the situation. And I have to have empathy in order to do that. Say, listen, I don't know. I work in this field and I'm outside all the time, and I'm not the solution for everything, but I know that 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. there is a solution. So even when I can't answer your question, I'm going to do my part to at least guide you in the right direction to receive the answer, not brush you off. Because I can assure you, in this fight against addiction, if any of them ever come to anybody and ask you for help, it means that they want it, right? They may not know how to get it and all the other things that we say, well, why they won't follow through? Recovery happens in the moment. It's not the five stages of change that we teach and that we learn from and that we get an understanding. Those five stages can happen in 10 seconds for a person that struggles with addiction. And if you're not swift on the foot with them, you just miss that window of opportunity. Don't mean it's the last window, but you miss that opportunity. So we have to really know Philadelphia can and does have the necessary stuff to really put a dent in the demand. But it's going to require the spirit of brotherly love in which this wonderful city ordained that name.
It's 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. going to require that.
Thank you so much. Thank you both for your testimony. We will now turn to public comment. Wait, wait, wait. Is there anybody else to testify on this Resolution? (No response.) We will now turn to public comment, and will the clerk read the names of those who registered?
Sarah Bellos, Sam Pfeiffer, Jasmine Henderson, and Jose DiMarco. Can you please come up? We're going to have to give two minutes per comment given the hour and number of folks commenting, so thank you for understanding.
Is it okay if Kenya Moussa take the spot of DiMarco? He's not here. Thank you.
Good afternoon, and thank you to the Committee for holding a hearing on such an important subject. In particular, thank you to Councilwoman Brooks for holding this hearing on such an important subject. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. My name is Sarah Bellos, and I am a staff attorney with the Pennsylvania Institutional Law Project. We are a statewide legal aid organization dedicated to advancing the constitutional and civil rights of people in incarcerated in Pennsylvania through providing legal assistance, advocacy, and representation. We aim to ensure humane conditions for incarcerated people, including access to adequate medical care, and my specific focus is on treatment for opioid use disorder, or OUD, in jails and prisons. And we've already heard from several people today about the importance of including jails and prisons in this conversation, but I just want to emphasize the important role that jails and prisons play in the overdose crisis, and particularly as it affects Black communities. As already noted, there are significant racial disparities in incarceration, and also people with opioid use disorder have high levels of criminal legal system involvement. In particular, the consideration of jails in this 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. conversation is important because the period of time after someone is released from incarceration is a particularly vulnerable time, and upon release from incarceration, people have a 12.7 times higher risk of dying from an overdose. Unfortunately, in Philadelphia, incarcerated people with OUD are not receiving the treatment they need for their disease, both due to the situation in the jails in general and also due to specific problems with the treatments available. The current state of the Philadelphia jails are reported on by a court appointed independent monitor as a part of the Remick v. City of Philadelphia litigation, and the monitor has stated that the trauma experienced by people incarcerated in the Philadelphia Department of Prisons is profound and clearly observable to all who work in, enter, or reside in PDP facilities.
Can you start wrapping it up? We're almost at the two minutes. I think I heard the timer.
Yes. I just want to note that all the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. reports from the court monitor in Remick are available on our website, pilp.org, and we've also written a report on the availability of treatment for opioid use disorder in jails and prisons, including in Philadelphia, that describes the issues with those treatments in detail. And all of that can be found on our website and in the more detailed comments that we submitted to the hearing today.
Hello and good afternoon. My name is Kenya Moussa, and I am the co chair of Positive Women's Network. I am co lead of Pennsylvania's HIV Justice Alliance, which is the only coalition in Pennsylvania dedicated to end the criminalization of people living with HIV in the commonwealth. I'm also an advocate of the Health Not Prisons Collective. HNP is a collective of five organizations that work together to combat the many ways that people living with HIV and communities most impacted by HIV are surveilled, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. policed, and criminalized. I'm also a Black woman in Philadelphia living with HIV. I work to end the criminalization of HIV and other public health issues, including the criminalization of poverty, substance use, and homelessness. For decades, people living with HIV have been targeted by racist, dehumanizing, surveillance, containment, and policing practices, and I have to speak out when I have seen the same failed backward practices being weaponized against people who use substance. Responding to substance use disorders through increased policing not only undermines the public health and human rights, but jeopardizes the long term survival of communities. Syringe service programs provide people with people who inject substances with new needles and injection equipment to reduce the harm from injection substance use. It's also a preventive tool to save people from hep C and HIV. Decriminalization is a harm reduction strategy that gives us the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. ability to treat substance use disorder as a public health issue rather than a criminal activity. Our budgets show our priorities. I ask the City Council, invest in Black communities, not backwards policies. Invest in harm reduction practices, not police. And finally, invest in health and our presence. Thank you.
Hey all, appreciate your help. My name is Sam Pfeiffer. I'm a local community organizer, a harm reductionist, a mother, and a child of parents who lived with substance disorders. I organized with the Positive Women's Network alongside Kenya here, and she explained to you who PWN is. Something she hasn't explained yet is that we run field programs for Geo TV efforts and Issue ID campaigns in North Philadelphia, the 11th, 16th, and 38th wards around Nicetown, Allegheny, around Connie Mack rec. We also engage in the decriminalization 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. of HIV laws in Philly and throughout and PA. In the last few years, the PWN PA chapter has been talking to our community through phone banking and door knocking campaigns about safe syringe programs and overdose prevention centers. We asked folks their thoughts and feelings about SSPs and OPCs and do education on the spot. Through these conversations, we have identified thousands of folks that support harm reduction tools. We have sign ons in the thousands of folks demanding that we keep SSPs and OPCs in Philadelphia. Although I know Councilwoman Lozada has already striked down OPCs, there's still hope for SSPs. Through these conversations sorry, I'm rushing. We have heard loud and clear that our community not only wants to keep, but also expand, harm reduction tools. Recently at a local town hall in Fairmount, we heard from Mayor Parker's managing director, Adam Thiel, on the administration's plan and future of SSPs. The Parker administration plans to cut $900,000 from the budget for SSPs from the city's 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. budget and also divert $1 million in funds away from the opioid crisis. After sharing with Adam that the elimination of SSP funding will cause a significant spike in HIV cases, he said that his administration is hoping that philanthropic organizations will backfill that loss. A hope is just that, an empty wish. There is no true plan to backfill those dollars, only hopes. I, along with those thousands of people that I spoke about earlier, harm reduction supporters, are urging City Council to do something about the significant pending loss in SSPs. I had some facts to share, but folks before me have already done that, so I just really hope that you all can get into the ear of our mayor and move some harm reduction tools forward. And I really thank you all for being comrades and allies in this fight.
Thank you so much. Thank you all. Clerk, can you read the name of the next folks? 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Will Carlita Ferrer, Jamie Walker, Rashid Village, and John B. Shah please come up?
Hold on. We're going to try to get four people up at a time.
All right. Please state your name for the record and continue with your testimony.
My name is Jamie Walker. I'm a local community organizer. I work with multiple organizations, and I sat here and I listened today. I just want to mention that every one of those numbers is connected to a name. Every one of those names has a family. Every one of those families have friends and families. So one overdose has one big reach. But not only that, I didn't hear 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. anything about Roxborough, Manayunk, Germantown, West Oak Lane, East Oak Lane. I didn't hear nothing about harm reduction in none of those areas. All of those areas have Black and Brown families that are affected by this crisis. That's all I have.
Just to be clear, so we just this is a citywide. It's just the folks that came to testify. We're primarily from those particular areas. This hearing is servicing all Black folks in the city, and that's what this hearing is, to talk about solutions for all folks in the city. It's just that no one signed up from those areas to say anything, and I really do the neighborhoods that you named would be the ones that would probably be the most stigmatized to even come to a hearing to even talk about this.
You're welcome. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
My name is Carlita Ferrer. I've been working in nightlife for seven years now, and I've personally witnessed quite a few overdoses during that time. According to the Philadelphia Department of Public Health, there was an 9 percent increase in unintentional drug overdose 10 deaths from 2021 to 2022. In that time, I also 11 lost friends to overdoses by 2022. Philadelphia's communities of color were disproportionately affected, and specifically, non-Hispanic Black overdose deaths were increased by a whopping 87 percent. This issue can be improved by drug users having access to harm reduction supplies and resources, such as Narcan, needle exchange, testing strips, places to drop sharps, overdose prevention sites, other programs, shelter, access to food and healthcare. These are the resources that I wish that my friends had access to before they passed. When we speak on the safety of the community, we speak on the safety of drug users 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. in the community as well. Taking the necessary steps to provide human harm reduction supplies and resources can and will save the lives of community members. In order for the city to help lessen overdose deaths, we must prioritize harm reduction, including healthcare and shelter. Also, if the city stopped criminalizing drug users, it could help lessen overdose deaths. If the city continues to penalize people as punishment for coping, the need for coping will continue and create a toxic cycle that will inevitably lead to overdose. In conclusion, I believe that having access to more harm reduction supplies and resources such as healthcare, shelter, and access to food, in addition to the harm reduction methods already utilized by the city, can help reduce overdose deaths. And also, decriminalizing drug use can end a toxic cycle that can lead to overdose deaths. Thank you.
Good afternoon, everyone. Thank you. My name is Zoe Soslow. I'm a 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Philadelphia resident and lead technical advisor for the work of Vital Strategies Overdose Prevention program in Pennsylvania. Thank you for the opportunity to discuss Philadelphia's escalating overdose crisis and the outsized impact on Black Philadelphians. Drug use is a health issue that requires an evidence driven public health response. Decades of research is clear and shows that successful interventions must focus on reducing criminalization, increasing access to evidence based treatments like methadone and buprenorphine, ensuring treatment services are voluntary and not coerced, and increasing access to life-saving tools like syringes, naloxone, and drug checking resources like test strips. Punitive responses like incarceration exacerbate health harms for people who use drugs and disproportionately affect Black individuals. Research from Philadelphia found that people leaving incarceration were 37 times more likely to die of an overdose in the two weeks following incarceration. Evidence based treatments like 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. methadone and buprenorphine reduced the likelihood of dying from an overdose by 59 and 38 percent, respectively. Yet, there are significant racial disparities in access. Research found that White patients were prescribed buprenorphine at twice the rate of Black patients following an overdose. We must support life saving tools like syringe service programs, or SSPs, which are associated with an approximate 50 percent reduction in HIV and hepatitis C incidence and a five fold increased likelihood of entering substance use treatment. Research also demonstrates public safety benefits. Despite misconceptions, neighborhoods with SSPs do not experience an increase of economically motivated crimes and actually see reductions in syringe litter compared to neighborhoods without an SSP. Equitable access and understanding how systems impact access is key. A study in Philadelphia found that concentrated policing efforts reduced SSP use among Black participants 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. at greater rates than their White counterparts. Research shows that harm reduction saves lives. However, it cannot be expected to act as a replacement for a robust social safety net. Harm reduction must be recognized as an evidence based public health service that should be community led and adequately and sustainably funded to address the potent, volatile, and increasingly synthetic drug supply. Thank you.
Thank you all so much for your testimony. Clerk, can you read the next names?
Will Florencia Roland, Jasmine Barnes, and Kelly Murray please come up.
Please state your name for the record and continue with your testimony.
I can go first. Hi. My name is Jasmine Barnes. I'm here representing the Center for Addiction Medicine and Policy at UPenn. I stand before you as someone with 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. lived experience. Both of my parents struggled with substance use throughout my childhood. I am living proof that recovery is possible. And when considering what to share, I reflect on my work and experience providing support to one patient in particular in my work, and I'll proceed with her story. As a healthcare advocate, I bore witness I'm going to call her Jane to protect her confidentiality. I bore witness to Jane's persistent efforts to seek help. Our health system became familiar terrain for her, a space where she shared her struggles in pursuit of understanding and support. However, the responses she encountered were often tainted by preconceived notions and biases, contributing to a sense of isolation that further separated her and the help that she desperately needed. Our attempts to provide services were met with the stark reality of a flawed system. We partnered with her to support her with starting medications for her opioid use disorder, securing recovery housing placement, discussing 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. her goals, and beginning to heal her relationships. Yet, the impact was hindered by a larger societal framework that stigmatized rather than supported. The very essence of Jean's identity, being a young Black woman with a substance use disorder, was a label that overshadowed any efforts to address theroots of her struggles. In the end, her battle reached a devastating conclusion, a life cut short by overdose. Her story, far from a neatly tied narrative, exposes the systemic failures that permeate our healthcare system and society at large. The stigma she faced, the discrimination she endured, and the ultimate tragedy of her passing reflect the harsh reality that countless individuals like Jane confront daily. As I reflect on the time spent supporting her, the weight of grief lingers. Her struggle was not a storybook tale with a happy ending. It's a stark reminder of the urgent need for systemic change, a call to dismantle the barriers that perpetuate stigma and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. discrimination in healthcare and beyond. These violent, pervasive structures kill hope and our core belief that recovery is possible for everyone. And one question remains, what happens when the hope for recovery is met with policies that undermine progress? Her story is a haunting plea for a world where individuals facing substance use disorders are met with empathy and not judgment. It urges us to confront these biases ingrained in our society, our societal fabric, and work towards a reality where every patient, irrespective of their struggles, every person, irrespective of their struggles, can access the support and understanding they desperately seek. Her death is a pressing reminder of the countless ways our systems fail to protect Black people who use drugs. And my hope is that her story will cut the deep enough to inspire us to work harder to create better policies that ensure equitable, non-stigmatizing care for all patients and hold each other accountable to their end. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Thank you.
Hi. My name is Kelly Murray, and I'm a certified recovery specialist and care coordinator at Penn Presbyterian Hospital. I have worked with the syringe program at Prevention Point for a couple years, and at my early recovery, which I feel saved my life. I was incarcerated, and I didn't feel I had any hope to find work, but they found it in they found the worth in me that I didn't see in myself. They put me through to be a peer support specialist, then to a certified recovery specialist, and now I took that to University of Penn to support people with substance use disorder. And being on the front lines, if not for the street engagement with harm reduction and the relations building trust these programs provide, I have no idea how many countless amount of people that those numbers would have risen so much higher. The harm reduction program is where 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. relationships begin and they build trust along with CPS for mental health, and a CRS with people in recovery at Penn emergency room, detox units, inpatient floors, and I work in the primary care setting as a recovery care coordinator. The continuum of care is successful. I have worked with over 500 people that I have I have books that I write everyone's name in. So I go I just that's just an average. It may be it has to be more because they're not all written down. But I must say that continuum of care that Penn provides as outpatient, as a long term treatment, I don't believe that inpatient is the only pathway to do this. I feel people need the social determinants of health to support their journey, like going through the which harm reduction has created so many programs, like the outreach mobile units for Suboxone. I worked on that on Kensington and Allegheny. We didn't even have a bathroom. We were doing urines right in the van. But you know what? People came every 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. week, and every week, little by little, they engaged more and more and more until they were able to get on that medication, and then we were able to help them with other services. And from my experience, sending people straight to a jail or a rehab in the drug supply today with the xylazine is inhumane. I watch people daily in the hospital go through withdrawal that is something like I've never seen. I have used Xanax. That was the most horrific withdrawal imaginable. And there are protocols for that, and people get treatment for that. They are admitted into hospital for benzos. They're admitted in a hospital for alcohol because it's so dangerous. So is xylazine, and so is fentanyl. And people are suffering. I've witnessed people in withdrawal so many times from the xylazine and benzos that need professional care. They need evidence based detox. In the past six years of my experience with patients in extreme withdrawal, this is what kept so many people out there, because they could 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. not come in, because they knew they would not get the proper withdrawal management. The reasons the inpatient and they have a good reason, due to the treatment that they get in jails and treatment centers. They're not properly they're not properly proper protocols to do this. They're throwing people in for supplemental withdrawal.
If you can begin to wrap up. Your two minutes is up.
Yes. I'm sorry. And I hope the city officials know that right now, CBH gives people five days of detox. That's it. And they only have to hav they have to have alcohol and they have to have benzos. They get sent straight to rehab, and that's because they're getting put on Suboxone. It's not that easy to get put on Suboxone. It takes sometimes 7, 10 days, 30 days to feel better. And I'm seeing people coming out of rehabs and jails that have been totally withdrawal. They went completely through 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. withdrawal. They come out, and that's they are a higher risk for an overdose. And that needs to stop. And I appreciate it. Thank you.
Florencia Roland. I am currently in recovery coming from Levittown. I'm from Kensington, my family is from Kensington, but I chose to go to Levittown to get recovery. She is my recovery specialist. I am a certified peer specialist as well. It took a bump in my head a few times just to get to where just to get even a chance to get up here to speak. Based off of everything that happens in the Kensington area as far as seeing it go from where things were not taboo to being taboo and people walking around with needles in their neck, being able to be call at your recovery right where you're at saved my life; Esperanza, Prevention Point, and those different entities together. However, as once I got my recovery and 270 days later, it's hard to get a job as a 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. peer supporter. Now, where's the help there to take somebody who's an ex offender/peer supporter, who's actually in the courts with a proper judge, Ms. Warrior, and then put them to work? If that's I mean, I have all the lived experience you possibly need, know exactly how the individual's up there, and bilingual, etc., etc. So why not put that to use for other individuals that are inside the prison system as well? Being able to attach those things and bring them people out and then work with individuals like this. I got a big tab out in Levittown that I've got to pay because medical doesn't cover Philadelphia. Philadelphia doesn't cover Levittown. I'm at the end of the day, I've still got to pay them people up there for holding me. But by the grace of God, they've been able to hold, hold not hold that over my head and allow me to continue on to work with women like Kelly and other individuals. But that might be another bracket that need to be looked at. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Try to get people back employed that had that lived experience like this and bring them back because the system does work. Certain judges are there if you're hungry enough. I come out here every day from Levittown with my own money that I don't got. So if I'm hungry enough to come out here, then that you should be hungry enough. Accountability is one thing to be accountable, but to say you're not holding everybody everybody needs to be held accountable, even me. That's what I got.
Thank you so much for your testimony. Thank you. Thank you all. Thank you. Clerk, can you read the next three names, please?
Brice Armond Patterson, Catherine Freeland, Sylvana Mazzella, and Beatrice Zovich.
Can you state your name for the record and continue with your testimony? And we'll just go in order. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179.
Okay. My name is Brice Armond Patterson. I have organized on the street for several years in Philadelphia. I think many of us have shared different positions on the streets, familiar faces on other sides, but I think that we can unify under some specific issues. Since I've been on the street, what I've noticed amongst my organization that I work for, along with when I have volunteered, is that in particularly West Philadelphia and Southwest, we have different characteristics when it comes to opioid use. It transitions from the street into the home, making the visual understanding of the scope of the issue very difficult. And although not thoroughly tracked, given the nature of our work, we observe overdose numbers among Black residents continue to rise. Through my few years of working on the street, via both independent community work, volunteering, and now as a peer outreach specialist, I have seen the same repeat outcomes, outcomes that result in harm reduction 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. groups and non profits being the last line of defense and care for vulnerable community members, especially when throughout all all other outlets, they are turned away, rejected, shamed, or criminalized. Our care is essential, but I think most of us can agree that we must accept that it is nowhere near what is necessary to solve these issues. We are a Band-Aid on the gaping wound of exasperated material conditions, and the reality is that our community has been failed by for profit interests and the necessities of life and subsistence, for-profit healthcare, and denial of housing and dignity so that real estate companies, landlords, and others can capitalize off of the dispossession and suffering of our people. Government leadership, which only sustains a slowly crumbling society while in a respectable degree maintains the streets, water systems, electrical infrastructure and roads, other infrastructure necessary for our sustainment, many politicians still practice the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. practice of consistent betrayal of our constituents, allowing them to be preyed upon by predatory developers, be denied critical care in hospitals, allowance for continued expansion between those who who have wealth and those who do not in the largest poor city in the United States. There is an avoidance at mobilizing industry and the productive development in the city that could be employed to generate stable income for generations of people denied jobs. These issues may seem like they are secondary to the epidemic of addiction and substance use, but the reality is that these are directly related. The issues of pharmaceutical abuse, the history of pushing addictive substances onto populations for profit, gaining billions from the death of our citizens, and making no attempts to support or maintain the result in a meaningful fashion. The denial of favorable material conditions such as stable housing as a right, nutrition as a right, advanced education and job training as a right, not only to make up for the 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. historical denial and destruction of our Black community and the rest of the community, but because these conditions would benefit society and our productive development as a whole. Instead, we see people, human beings, as temporary, exploitable resources. Who cares if we die in filth and retch? For a time, we generate labor, we take on debts, and when our communities collapse, the speculative value of the property plummets and can be reaped and collected up by your very own developer friends. So to solve this issue, the commitment is clear. We need a broad mobilization of wide reaching healthcare that is freely available to all people, no matter their condition or disposition.
A healthcare system which is centralized via a union of medical staff, workers, doctors, patients, and outside of the hands of executives, trustees, stakeholders, and investors. We must eliminate the exploitation of the for profit systems that weaponize our necessities of life for the self-described most 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. advanced country in the world, and form a union of frontline workers from the ground of harm reduction and critical community care that can work together to determine the best ways possible to guide our people through their recovery.
Can you begin wrapping up your testimony? You're at your two minutes.
This will not only come through the decisions this will not come through the decisions of vile, vampiristic politicians or developers or real estate moguls who work with the very individuals who exploit us, but from the populations that are at the root at driving the function of this very society with their labor. I think many of us have had our time. We're tired of being betrayed, and it is time for 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. others to listen to us and for us to stop asking for power and representation, and for us to start taking it within our own hands.
Good afternoon. Thank you to Councilmember Brooks for bringing this Resolution. I'm here today to share support. My name is Dr. Catherine Freeland, and I'm the associate director of public health at the Hepatitis B Foundation. And we've been working in the city for over 15 years to provide free hepatitis B screening and linkage to care. Philadelphia, as we've seen today, has seen a major impact of the opioid epidemic, and I'd like to just share some data about infectious disease and the impact that the opioid epidemic has had on infectious diseases in our city. From the Philadelphia Department of Public Health, data from their recent hepatitis reporting shows that hepatitis B, hepatitis C, and HIV are directly linked to the opioid crisis 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. in our city, and the report from 2021 demonstrated that individuals living with hepatitis B were more likely to be of Asian and African descent. Similarly, those with hepatitis C were more likely to be Black and inject drugs in our city. These same individuals can face challenges accessing healthcare, face stigma and discrimination. Harm reduction organizations are often non judgmental safe havens for care and a first step in accessing treatment. Infectious disease prevention is a really important part of this conversation. Black and Brown communities face significant challenges accessing healthcare for infectious diseases, and Philadelphia is known to have several healthcare deserts that impact these communities specifically. This is often exacerbated by substance use disorders as well, and we need to invest in resources to address some of these significant health disparities that are impacting these communities. Thank you so much for the opportunity 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. to provide testimony.
Good afternoon. My name is Beatrice Zovich, and I am a public health program manager at the Hepatitis B Foundation. First and foremost, thank you very much to Councilmember Brooks for introducing this Resolution, and I'm here today to express my support. Hepatitis B and C are grave threats to public health that are more pronounced in the community of people who use drugs, among which rates of acute hepatitis B have risen sharply since 2009, coinciding with the opioid epidemic. A recent study conducted by the Hepatitis B Foundation and in partnership with Prevention Point Philadelphia found high rates of both hepatitis B and Delta in the community, underscoring the ongoing urgency of this public health threat. Left undiagnosed and unmanaged, these viruses can have serious consequences up to and including liver cancer, which is one of the deadliest cancers globally. By not providing public health and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. social services for all those who are at risk for hepatitis B and C, both of which can be prevented with appropriate tools and resources, we are failing these communities, and we are culpable for the the adverse health outcomes they may experience. Given that Black communities in the city of Philadelphia continue to be disproportionately impacted by drug use, overdose, and hepatitis B and C, the issue becomes one of racial justice as well as health equity. Vaccine rates are lower among Black Philadelphians, leaving community members at higher risk of infection. Linkage to care for hepatitis B and C is challenging overall, and especially so in North Philadelphia, where significant healthcare deserts exists, as has been mentioned, and there is limited access to trusted care in the community. Resources for physicians and community organizations are needed to address these challenges and prevent long term chronic illnesses, and it is economical to prevent 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. disease and provide primary care. The city of Philadelphia is currently at a crossroads. We have the opportunity to take thoughtful and evidence based resource measures and to implement public health and harm reduction interventions that center communities and can prevent widespread disease outbreaks from further damaging communities already heavily and adversely impacted by the multi layered tragedies wrought by the opioid epidemic. Now is the time. Hepatitis can't wait. Thank you very much for hearing my testimony today.
Hi, good afternoon. My name is Michaela Jackson, and I am the program director of prevention policy at the Hepatitis B Foundation. So we've heard a lot from wonderful folks and organizations today, so I promise to keep it brief. So at the foundation, I actually work on the national level doing a lot of policy, and we see a lot of harm reduction groups. So as you've heard, there's a connection between 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. infectious diseases and the rising of them and the opioid epidemic, and we're seeing it across the nation. But I just want to say that Philadelphia has been a model for a very long time for a lot of states and a lot of cities on how we can do better on harm reduction. It's been a lot of cities just asking for Philadelphia to kind of be a leader. They're looking for Philadelphia to be a leader given what's going on in our communities and what they've been seeing. And the resources, the data, what we're putting out is really, really helping a lot of other people across the nation. So even though it might seem small and just to the city, this is definitely a national issue that's impacting a lot of groups, and I'm really proud of Philadelphia for being that leader, but obviously, resources are necessary. My work in the harm reduction community here in Philadelphia has been really, really impactful. You meet the nicest, most compassionate people. You hear their stories, 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. you hear what's going on, and it's moving to see. But in these communities, groups, they really want to help their groups, their people, and every member that is going on around them. So the resources and funding is just not there for them to sustain all of these resources for prevention services, for hepatitis B, for treatment, linkage to care that's needed. So I'm really glad that we've had this conversation today, and that we've heard from all of these groups to see the work that they're doing, and I think that we can continue on the right path and really increase the momentum. We're going to do great. Thank you.
Hello. My name is Ronnie Begum. I am an organizer in the city of Philadelphia, and I really want to start off my comment by particularly thanking the two of you for staying out this really long day. It has been really disheartening over the years when conversations on harm reduction are broached, that City Council members often leave the room. This is not the first time that 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. I am witnessing City Council members leave the room when there is a conversation of harm reduction going on. So I really want to thank the both of you for staying out and hearing of these conversations. As part of my testimony, I want to specifically raise the issue of disability and inequitable access to healthcare. While I agree that pharmaceutical companies are exploitative, and alleged pursual of their accountability has left disabled patients, especially Black, non Hispanic populations, in the dust, which also leads to overdoses. So what do I mean by that? For years now, I have watched developers encroach on disenfranchised neighborhoods, primarily Black neighborhoods. By skyrocketing rents, they are directly responsible for the booming crisis of the unhoused, who lose access not only to housing, but food and whatever little access to healthcare and other supports they have. Rising rents also raise other types of violence, such as gun violence, at an ongoing 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. SARS CoV 2 pandemic, also known as the COVID-19 pandemic, to which disenfranchised populations, particularly Black populations, are at risk of catching and also developing major disability issues after that. What this results in is not only the loss of basic necessities and healthcare and support and community, right? So rent is rising, people are getting sick, people are losing jobs, people are losing support, people are ending up on the streets. All of this also exaggerates ongoing and renewed disabilities. I really, really want people in this room to understand that there are people in our community who really, really need opioids. They really, really need stimulants and every other drugs known to human just to function and survive. I have watched people with debilitating disabilities be stabilized on opioids, be stabilized on stimulants, and then I have watched I have watched so many disabled people then lose access to these prescription opioids and 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. lose access to prescription stimulants because of rising hysteria and stigma against these medications. I have watched these same people, also often because of stigma and hysteria, also refuse medication which exacerbates their disabilities. Because of these things, because of because of loss to healthcare and loss to medication, not only do they become destabilized in terms of their healthcare, they also become disabled destabilized in other parts of their lives. Okay. More and more people then have to turn to street supply because they don't have access to prescription supply, and we need to understand that because disability is rising, right, like as COVID-19 just goes on, and as disability rises, as housing crisis goes on, as disability rises, prescription grade medications are disappearing. They're just disappearing off of pharmacies. They're just disappearing like doctors are just not prescribing them. People are afraid of prescribing them. So medical graded prescriptions are just disappearing. 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. Black disabled people are extremely impacted by this. To echo many of the panelists and many of the other speakers before me, harm reduction here means building a new infrastructure.
And I would personally recommend closing the funding to build this new infrastructure by redirecting funds from the police, actually really, really regulating these developers and the rent issue that is happening, and also really, really re examining the tax abatements that the city gives out to corporations and to institutions that don't actually pour back into our communities. Thank you for your time.
Thank you so much for your testimony. Clerk, can you read the next names?
Ashish Thakrar, Cheryl Hill, Preston Davis, EJ Indigo, and Carla Sofronski. I believe they're  they've all left.
Okay. Is there anyone else left to testify on this resolution? 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. (No response.)
This concludes the public hearing on Resolution No. 240197. Thank you. (Committee of the Whole adjourned at 6:15 p.m.) 5/21/24 - COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES - RESOLUTION 240179. CERTIFICATE OF TRANSCRIPTIONIST I, IVY JUNG, Legal Transcriptionist, do hereby certify: That the foregoing is a complete and true transcription of the original digital audio recording of the proceedings captured in the foregoing matter. IN WITNESS THEREOF, I have hereunto set my hand this 27th day of May, 2024. ______________________________________ Ivy Jung