Yeah. We bill 16 insurance, so we're a full-force pharmacy. One of the challenges, as I understand it, to the pharmacy has been over time, that our pharmacy system, we have a computerized pharmacy system, it doesn't speak directly to the billing system for the Health Department, so that each prescription that's written generates 00131 a report, which then has to be key-entered into the billing system in order to generate bills, which is a cumbersome process. One of the things that I'm anxious to do with the electronic medical expansion is to fix that.
For those individuals who are uninsured, who gets billed?
Okay. And what is that number? what does that represent in dollars projected for '09?
Okay. And, also, the management of the records, of the pharmacy records, is that done in-house or is that done --
It is. Does it make any sense -- and, again, 00132 you've been here a short period of time, has anyone institutionally in the past years looked at the possibility of going out to privatize that to working with the local or national or regional health-care insurer that may have also back-office operations that handle pharmacy management and recordkeeping?
The prescription purchasing, the billing, the uninsured, all of that.
The issue there is that we are, as a federally- qualified health center, we receive discounted rates, and our partnership with the pharmaceutical manufacturer is very much in place because we're a nonprofit, urban, city pharmacy system. So that the department has apparently looked at this before, and the expense to the City of that partnership, including overhead costs 00133 and things like that, is more than the cost that we currently do per prescription for the services that we currently provide.
So that the -- so the partnering with a nonprofit or a for-profit entity is more expensive than what we do now?
Okay. How involved is the Health Department in the ongoing 311 Philly Stat project, and could you explain what your interface has been with the Managing Director's Office in this process?
The Managing Director's Office has a task force specifically around 3-1-1, and every department participates in Philly Stat. 00134 So the Health Department actually was only one of two departments that had its first Philly Stat presentation televised, and we have our next presentation sometime -- I think it's in the third week in April, and we will continue to do that.
Who attends that Philly Stat meeting from your department?
Many of the division directors, particularly those who are concerned -- we have a large department that's very diverse, and the amount of time for Philly Stat is -- has to be limited. So what we are doing is targeting specific areas within the Health Department over the course of the year. We have what I would call overall -- "overarching goals" for the department, and then we have goals by division. So we will rotate through 00135 the division so that both the goals of those divisions and the customer- service expectations can be presented to the public.
How are the employees and supervisory staff responding to this new advent of --
I think people are a little mystified by the process but encouraged by the potential.
And I think the cultural change that is implicit has been embraced pretty well by the department. We've been about customer service for a long time, so this isn't foreign to the department.
Thank you, Madam Chair. It's my understanding that the Philadelphia Nursing Home contract expires June of '09; is that right?
And what thought has been given to the future of the home, and how many patients on average reside there, and what is the current state of capital-project repairs for the nursing home?
So the total number of occupants, as of March 27th, was 448, but a number of those occupants are currently hospitalized, so the number of people actually today is 417. And the second part of the question? I'm sorry.
What is the future of the Philadelphia Nursing Home and its capital repairs that are so 00137 desperately needed?
The capital, actually, investments have been moving forward. I was at the nursing home this week. I went around to look at the particular areas that have b een under consideration for capital investment. There are three wings of the nursing home, which have yet to be renovated. And I went around to make sure that both the conditions were safe, that the facility was clean, and that inhabitants who are there are not in any way particularly disadvantaged by the need for capital improvement. But, I have to say, I was very impressed, both with the management of the facility in general, with the cleanliness of the facility in particular, and by the state of residents there, many of whom are young for a nursing home population.
It's my 00138 understanding that paraplegics that -- are also there along with our seniors, so there's a combined combination of the types of residents there.
Absolutely. They aim to -- each unit is organized in the state-of-the-art, I think, fashion, which is by functional limitation. So that however old someone is, the therapy that people receive is consistent with where they're located, and there's been an attempt to match the particular people on a given unit with the therapies that are immediately available to them. So I was impressed by that. I will say that the boiler at the nursing home is about ten years old, and there's currently discussion with the current contractor about when a boiler should be replaced. It currently functions, but the question is, what's the life expectancy of a boiler? and we're discussing that and 00139 discussing it with capital for the City. Going forward, we will have a request for proposals put out over the course of the next fiscal year to look at the current contractor and create an open process for other bidders, again, based not only on cost but also, as much as we can, on quality and the capability of a vendor to meet the requirements of the City. But I will say that at the moment, the City has been quite satisfied with the current vendor.
Thank you. One last question dealing with the pharmacy. It's my understanding -- how do you deal with the issue of rotation of pharmaceutical products that have reached their expiration date, and has that been a problem in the past?
There was a time when we had some expiring 00140 prescriptions; that time is in the past. So currently, there's a rotation policy that's put into effect and inspection that's done so that our pharmaceuticals are handled just like a regular pharmacy would be in terms of sending them back, disposing of them, and so forth.
That is a particular problem that is not just with the public Health Department, but it's also been prevalent dealing with our prison population because of the short-term duration and, you know, people's prescriptions expire or, you know, sit on the shelf. And we -- I don't know if there is a piggyback purchasing process that happens between your department and the prison system at all, and is that something that could be considered?
I've met with the director of prison health services on 00141 the City side, not the contractor, to think about how we might improve efficiency, efficiency both in the service itself, things like how we purchase pharmacy and so forth, and also in the issue around paying for specialty service, which, you may know, is a substantial issue for the prison.
You're welcome. The Chair recognizes Councilwoman Brown.
Thank you, Madam President. There was one remaining question that I couldn't find amongst these papers. It's somewhat sensitive, but Madam President and Mr. McPherson alerted me that -- of a pending transfer ordinance from City Council to the Health Department that will be 00142 considered at the end of this FY budget process specifically for the Children's Report Card. And the reason for the transfer, I completely understand and I'm okay with. If you're not able to answer the question at this time, I am curious to know, is or will the administration remain committed to the creation of the Children's Report Card, which has been a valuable public-policy information tool for those of us in government going forward. The transfer $267,000 transfer was for the creation of the Children's Report Card.
Even though those dollars are coming to 00143 health? (Indiscernible; parties talking over each other.)
-- which is, I feel badly not too, which is -- certainly, it's an important document, and we've heard Council's both appreciation for the document and the utility of the document.
Yes, okay, all right. So I'll leave it there for now. Thank you. Thank you, Madam President.
You're welcome. Doctor, I want to thank you for your candor. I think we, too, got 00144 much more from your testimony than I can tell you. At the request of the stenographer, I think we're going to take a break. Supposing we recess until 1:30. We'll recess until 1:30, at which time we will then hear from -- we can hear from the Office of Supportive Housing and then Behavioral Health and the Department of Human Services.
Thank you. (Recess taken at 12:39 p.m.) (Proceedings resume at 2:12 p.m.)
The 82 is now back in session. The next department we will hear from will be Behavioral Health. (Witness comes forward.)
All right. Please identify yourself for the record and proceed with your testimony.
Good morning, President Verna and members of Council. My name is Dr. Arthur C. Evans, Director, and I'm here to present testimony on the Department of Behavioral Health and Mental Retardation Services' FY '09 budget. 8 million in the Health Choices Behavioral Health Fund. The Department of Behavioral Health and Mental Retardation Services' FY '08 [sic] budget will support 297 positions, 33 in the General Fund, 264 in the -- 264 in -- 264 in the Grants Revenue Fund. 1 billion, or 75 percent, in the Behavioral Health Services. The mission of the department is to support people in an environment of recovery focused on prevention, wellness, self-determination, and the realization of personal goals, leading to improved quality of life. We work with consumers and clients, families and providers to ensure that services are accessible, effective, appropriate, and of high quality. The Behavioral Health component of the department coordinates the City's behavioral health treatment services for approximately 100,000 adults and children annually. Mental Retardation Services is a component of the department responsible for the 00147 development, coordination, and monitoring of services for approximately 12,000 children and adults with mental retardation. In FY '09, the department will continue its efforts to address behavioral health and mental retardation needs of Philadelphia citizens. Key activities supporting these activities include enhancement of consumer- and community-based recovery and resiliency supports, including the hiring of certified peer specialists, engagement of the faith community, and the transformation of traditional facility-based treatment premises. Secondly, sustaining supports to vulnerable underserved populations, including the recent expansion of services to the homeless, the Southeast Asian community, the LGBT community, and individuals leaving prison. 00148 Thirdly, enhancement of services to individuals with mental retardation, including the department of -- including the development of new supports for individuals on the waiting list and affording individuals and families an array of in-home vocational and employment supports. And, lastly, promoting accountability through the development of performance expectations and performance-based contracting. The department is committed to supporting the core service and customer-service standards that have been articulated by the administration. Examples of the DBH MRS efforts include the following: First, during FY '09, the department will serve approximately 7800 consumers in inpatient psychiatric settings at a cost of $86 million per year. Approximately 14 percent return within 30 days 00149 post-discharge. This indicates insufficient treatment follow-up or insufficient home supports or premature discharge or subsequent crises. Effective linkages and interventions at the community level should provide a shift in dollars from inpatient to outpatient, as the consumer moves towards recovery. Initially, the goal is to reduce recidivism to the national Medicaid standard of 10 percent. Secondly, during FY '09, the department will provide school-based behavioral health services to 3,000 children in over 50 schools. This intervention is designed to improve attendance and afford children the appropriate balance between meeting behavioral health needs while, at the same time, maintaining the child in his or her own school. The long-term goal of this intervention is to minimize the 00150 use of out-of-home placement for children. Third, the department provides for the continued support of the transition of individuals with substance-use disorders from prison to appropriate community treatment. During FY '09, we expect that 2500 non-violent individuals will be afforded early release or diversion by virtue of their commitment to enter substance-abuse treatment services in the community.
The long-term goal of this effort is to assure that individuals will become active community members, thus reducing the recidivism rate back to the prison, which so many individuals face. Fourthly, the department will -- the department supports the administration's goal of healthy communities through the provision of early-intervention services to children 00151 0 to who are experiencing 3 developmental delays. The department expects the number of children to be served by this program to exceed 12,000 in FY '09. Research has shown that the of services at an early age impacts positively on children as a move into the educational system. In addition to supporting the core service initiatives of the administration, the department has also established initial customer-service standards, which will be refined and measured in the upcoming year. Examples of these standards include: Number one, requests for behavioral health rehabilitation services will be responded to within 48 hours. This requirement will be measured by assuring the appropriate review and response of all BHR requests within 48 hours. Failure to respond in the mandated time will result in the service being authorized as requested 00152 by family or behavioral health practitioner. A second example is, providers will be paid in a timely manner. Providers under contact with the department through the Healthy Choices program will be paid within 45 days of submission of claims. The standard will be measured electronically from the date of provider submission. Failure to meet the standard will result in the payment at a rate of 10 percent per annum for all payments beyond 45 days. And, again, these are examples. The department has continued its efforts of the past few years to increase the number of minority providers. Currently, over percent 22 of the department's contracts are with 23 community-based minority organizations. 24 Thank you for the opportunity 25 to provide this overview. I look 00153 forward to working with City Council in the upcoming year.
Thank you very much, Dr. Evans, and may I say welcome.
Doctor, you mention on of your testimony that failure to pay a provider within 45 days will result in the payment of interest at the rate of 10 percent. Is the penalty for late payments germane to your department only, or is it going to be a citywide practice?
Yes. That is for 00154 the Health Choices Program through CBH that is administered by CBH. So as a part of our contractual standards -- I'm sorry, as a part of our contract with the State of Pennsylvania, we are required to pay providers if we exceed that time period and we've not paid a claim.
Also, Doctor, on Pages 40 to 43 of your detail, you're requesting $397,095 for the Bucks County Council on Alcoholism and Drug Dependence. Can you explain what services they provide?
Those services are by an organization called "Pro Act." And they actually have a local chapter 19 within Philadelphia. They've been very instrumental in a lot of the work working with the Philadelphia recovery community. One of the most recent things that they've done is to operate a recovery center in Philadelphia. And, 00155 essentially, this is a place where individuals can go to receive information about substance-abuse treatment. They run groups there. But it is a -- an organization of peers. They -- and the recovery center in particular, it is an enormous resource because many individuals in our city are reluctant to walk into a formal treatment program. They're much more likely to walk into a community-based organization that is a part of the community. And those are the kind of things that Pro Act does for us.
I was rather puzzled when I saw Bucks County Council on Alcoholism, and I thought to myself, You mean to tell me we cannot find --
-- an agency here in Philadelphia that can do 00156 the same thing?
Well, they are based here in -- they have a Philadelphia presence. They have an office, I think, on Arch Street or Race Street, that part of the City. Part of the -- there's been a national movement around organizing people who are in recovery, and most states have statewide organizations. The Philadelphia vicinity has Pro Act. And, again, they have a local presence, but they are a regional-type organization.
Do they live there, at this facility? Do the clients live at this facility?
Is this -- explain what it is, please, 'cause I'm not familiar with this at all.
Okay. As I 00157 mentioned, the -- there is a national movement to organize people and essentially put a face on recovery. There are chapters or organizations literally across the country. Philadelphia -- or Pennsylvania has several. The one in this geographic area, the five-county area, is Pro Act. And they have chapters within each of the five -- the local five counties. What they do is enormously important to the City. They do put a face on recovery, they organize various activities to promote the idea of people getting into recovery. I mentioned the recovery center that they operate for us. And so they are very important in terms of getting the word out about people accessing recovery services. And, again, they have a very local presence. They're very invested in this community. They organize a 00158 walk here in the community. And, as I mentioned, they operate the recovery center that I mentioned.
Would you have any indication at all as to how many clients they see during the year?
Well, they don't really see clients; they're not a treatment provider.
So if this -- we're paying almost $400,000? For what?
They provide, as I mentioned, information to individuals. They help us -- they train people for something called "pier specialists"; it's a certification that the State of Pennsylvania has created for individuals who are in recovery to work within the field. They provide some of that training and they provide a variety of other kinds of educational activities. 00159
Doctor, I would appreciate it if you would provide me written information on this, please.
And precisely what the responsibilities is of this Bucks County Council on Alcoholism and Drugs.
Also, on Page -- on the same page, you're requesting $500,000 for Safe and Sound for Department of Social Service Cares. Can you explain what services Safe and Sound provides?
President Verna, you probably know that last year, or the year before last year, we had a blue-ribbon commission that looked at 00160 children's behavioral health. And out of that commission we developed something called "The Philadelphia Compact." The compact was -- is essentially a group of City agencies, provider agencies, community people that are -- that come together around promoting and implementing the recommendations of the blue-ribbon commission. What we have are a couple of staff that work with us to implement those recommendations. And the -- the request that you see there is for the implementation of those recommendations.
Doctor, can you explain how CBH funding can be used for capital-improvement projects?
Well, we have a -- at -- if the department, which is capitated for the Medicaid population 00161 has a surplus, we are able -- part of that surplus has to go into our reserves, but anything over and above the reserve amount allows us -- we're allowed to reinvest those dollars back into the system. In fact, we're required to reinvest those dollars back into the system. The State puts several stipulations on that reinvestment. One is that it has to be primarily targeted to the Medicaid population; secondly, it has to be behavioral health in nature; thirdly, it has to be something is that can either be sustained within the Healthy Choices program so that we use those dollars as seed money, or they have to be one-time costs. And so one of the things that the contract with the State allows us to do is to make investments into small capital investments into providers who are providing those 00162 kinds of services.
Well, in this case, we gave providers up to $15,000 to do a variety of small capital projects; for example, it could have been a health and safety issue. Some providers needed to upgrade their health and -- to come into compliance with health and safety regulations. Some chose to use that money to fix up their waiting rooms, for example. We also had a match to providers who wanted to match the amount. They could get up to $50,000. And, again, those were primarily residential providers. These were individuals who are providing services to people with serious mental illness or serious addictive problems and who are running residential facilities. Those providers were able to get up to $50,000 if they wanted to match that 00163 money with what we were giving them.
I see here that, actually, the appropriation for that service is a million dollars.
Child ren's Crisis Treatment Center, a million dollars.
Right. We have not -- we have not made that -- we have not given that -- those dollars. And at this point, we're not sure that we will. This is a provider who was able to get a match from one of their board members who was willing to match what the department was able to put 00164 in. This is a provider who provides services to children and is in a building that is really not adequate at this point to adequately serve those. And we were presented with an opportunity to match funding from one of their major donors.
Doctor, are you saying, then, that that million dollars should not be appearing in the budget?
I'm saying that at the time that the budget was prepared, that was -- that money was there for that particular provider. There have been some changes that may make that more difficult, and so we're not clear at this point whether or not that will go through.
-- 00165 that are going to be made or suggested since the preparation of the budget was made?
Okay. I have several other questions, but I see that we have Councilmembers waiting. Councilman Jones.
Can you describe for me the evolution which split the Health Department from your department and how that occurred?
That predated me. I'll tell you what I know about that split. 00166 The department has historically operated two components within the Health Department; one of those components was called "The Coordinating Office of Drug and Alcohol Programs" and the other was "The Office of Mental Health, Mental Retardation." The department -- or the City, ten years ago, also created something called "Community Behavioral Health," which is essentially a Medicaid managed-care company, a 501(c)3 company that manages the behavioral health benefit for individuals on Medicaid. Over the years, historically, what the City has done is to try to combine those behavioral-health entities and operate them as one system. And, in fact, Philadelphia is one of the few places in the country where all of the behavioral health dollars are managed by a single 00167 entity. If you go into most communities, most states, Medicaid is managed by a Medicaid agency. City or state grant dollars or block grant dollars will be managed by a different agency. The problem with that is that the individuals who may be on Medicaid today may be unentitled tomorrow. And what happens is that their care becomes fragmented. You're not able to follow those people from a clinical standpoint well because they are being paid for through different funding streams that have different criterial for admission to treatment. And as a result, I think the people in Philadelphia have had the foresight to say that you really have to manage all of the public-sector dollars in one entity, and so there was an emphasis or a push to combine those into one administrative entity, and that's when the department was 00168 formed, my position was created, and I was fortunate enough to be able to come here and to manage the department as its first director.
In that I see in your testimony that you subcontract out to 251 different providers --
Well, those would be everything from hospitals, like Temple Hospital and other hospitals, to residential providers who provide services for people who are addicted, or it could be residential providers who are providing psychiatric services for children. It would be outpatient providers who are providing outpatient psychiatric or substance-abuse treatment. It would be people who are providing case-management services, 00169 people who are providing prevention services. It's really a whole range of services that the City provides to the department.
How do you evaluate service delivery with so many providers?
Yeah, it's a good question. We evaluate that through multiple means. One of the things -- and you heard in my testimony that what we look at is the recidivism rate, so we will look at the numbers of people who are going into inpatient care and how many of those return back to care within a certain period of time. Obviously, we want that number to be as small as possible, as an example. So we look at key indicators that tell us whether or not the service that we're paying for is a -- is being effective. 00170 Furthermore, the department, through the Philly Stat process and also through an initiative at the state level to move to more of a pay-for-performance system, is looking at other measures to refine how we look at individual providers
Could you elaborate on that a bit? When you say you're rethinking how you evaluate, from what to what?
I wouldn't say that we're rethinking; I think what we're saying is that we want to refine how we look at providers and to create incentives for provider performance. Heretofore, while we've looked at those aggregate numbers, we've looked at them really in total and we've looked at how do we make system changes that tell us whether or not the system is working appropriately. We want to move to a system that looks at individual providers and 00171 says, This provider's performing well versus this provider who is not performing well. For the provider who is performing well, we want to provide some --
I think it's providing -- comparing apples to apples, but it's also making sure that we reinforce the behavior that we want from our provider system. Again, for example, one of the numbers that we look at, as I mentioned, was recidivism.
And if you look in our system, or any other system, most systems, there's like an 80/20 -- there's an 80/20 rule. Eighty percent of the resources are being used by twenty percent of the people, which means that if we can do a better job of 00172 working with those percent, we can save substantial resources that can be reinvested into the system. And so, last year, one of the system changes that we made was to introduce substance-abuse case management, because heretofore, we did not pay for case management, those kinds of case-management services for individuals who were receiving substance-abuse treatment. What that allows us to do, then, is to target those individuals who are the recidivists, to make sure that they step down through the continuum of care.
Is that what 19 you meant when you said that the 20 chronically homeless that you have substance-abuse problems, you're looking at how you (indiscernible) recidivism?
Well, in part. One of things that we did this year was, as 00173 you look at the homeless population, what you find is that -- well, the first issue is that they're homeless, and that's the issue that you have to get at, but a number of those individuals also have behavioral- health problems. And what we found was that even though, I think, the City has historically has done a good job of doing outreach and connecting with those individuals, a lot of those individuals, when they were connected, did not do well in traditional addictions programs. And so what we've done now is to take existing capacity and convert it to specialize with working with homeless individuals. In particular, what we have done is to lengthen the length of stay in those services, so that individuals who are going into those services have a real shot at initiating recovery before we step 00174 them down to a lower level of care.
You mentioned recidivism, and the national Medicaid standard is percent. I 6 think we are this year 17 percent? 7
It varies for 8 children and adults. We are doing 9 better with children than we are with 10 adults. And while we want to get to the national standard, we actually want to do better than the national standard. I think we can do better than the national standard.
Well, through -- I think if you look at people who recidivate, one of the biggest predictors of whether or not someone is going to end up back into an acute level of care is the extent to which there is good planning from a hospital -- the hospital level of care to the next level of care. There are things 00175 that we can do to improve that with our hospitals. The case management that I talked about is another way that we can make sure that we have people working with people prior to them leaving a hospital level of care and essentially hand-holding to make sure that they get to the next level of care. Thirdly, we are improving the -- the quality of our outpatient services across the board by emphasizing evidence-behaved practices. There's a big disconnect from what we know from a scientific basis works in treatment versus what we see practice on a wide scale. That's true in health care in general. And so we're working with, for example, Dr. Aaron Beck who is internationally known and is "the Father of Cognitive Therapy" and working with him to increase the 00176 amount of our service system that's using that particular -- that particular technique, which we know is much more effective, which will engage people better and improve our outcomes. So we're really coming at this from a multi-facetted standpoint. All of those things are going on. There are other things that are going on, and we fully anticipate that, in the aggregate, that those things will have a huge impact on our recidivism rate.
We went, as a municipality, from a municipally- owned care facility to subcontracting. We closed that over a period of time and then outsourced some of this to private providers; is that correct?
And so the one on Roosevelt Boulevard, that is owned by whom?
It's no longer open. I think the State still owns that property.
All right. There's a facility on Roosevelt 00178 Boulevard that provides psychiatric care --
Further up. (Addressing Councilman Greenlee.) Well, you're at-large, Councilman Greenlee; I expect you to know those kinds of things. (Laughter.)
I'm in the 4th Councilmatic District. So based on performances, you're saying -- is it more cost-effective to do it the way we're doing it, by subcontracting, outsourcing. Or is it too mammoth a thing -- I guess what I'm saying --
You deal with services in prisons. You deal with catchment conduct situations with 00180 people off of the street.
So I'm trying to put my arms around how we evaluate, whether it's better to subtract or to provide -- I guess it's the same question I asked the Health Commissioner about owning our own facilities versus subcontracting.
Right. Well, you know, it's -- a lot of those decisions were made before I ever came to Philadelphia. We have essentially a contracted system, and the department is primarily a payor. I think that -- a personal preference, I think that that's a much better system in our case. I think it's different at the State level; the State has certain responsibilities; for example, the forensic population. And the State has to, in my opinion, run some facilities. Some states contract all of those services out. 00181 But I think, for us, it is a good system. It allows us to be more flexible and nimble than we could be if we were trying to run all of those services ourselves and some of those services, it would be impractical. It would be impractical for us, for example, to run, you know, acute services.
Excuse me, Councilman. I see that we have the Budget Director here and Dr. Schwarz. And, apparently, I asked a question, and they would like to clarify exactly what all of means. If you don't mind.
Point of order, Madam President, but we went 00182 through changes of the system to create the Office of Behavioral Health back in the '90s, when Mayor Rendell was here, to sort of streamline the system. And maybe Mike can give us a little overview. I can't remember all of the details, but we can tell you it's better 'cause Council was involved in the creation of this (inaudible).
Michael Covone, Deputy Director with the Department of Behavioral Health. Councilwoman is testing my memory, but actually, one of the reasons for the creation of the entire system under one department is, as Dr. Evans said, really goes back to what existed prior to 1997. And, I guess, for lack of a 00183 better explanation, that Behavioral Health, when it was contracted by the State to private for-profit entities were really taking the profit and not delivering the service. And the City's decision at that point in time in the creation of Community Behavioral Health and blending of the department was really to, number one, have an entity that, first and foremost mission, was to provide the services, not deny 'em and not to build stockholders' equity, for lack of a better term. And I think that's the fairly short and quick version of that. It came with a lot of risk, it came with a lot of anxiety, but I think it's been relatively successful in meeting those goals over the last ten years.
I would ask Dr. Schwarz to approach the 00184 table. I believe you want to clarify much of what's on ? I see there are a number of curfews; I don't know what that means.
Madam President, thank you. Steve Agostini, Budget Director. The Health Commissioner and I were talking about this, and what became clear -- and we apologize for the confusion about this. What became clear is that the page you're referencing, the 2008 dollars that are allocated there represent what was actually allocated for 2008. What we have for 2009 represents more of a placeholder, and it's a placeholder that tries to capture the following dollars. One, that the decisions at the State level haven't been made as to the actual dollars that are made available. We may end with up best less may, we may end up with more. 00185 In trying to sort of allocate in appropriately, what Behavioral Health did was sort of set dollars aside to, in essence, sort of reflect what had been spent in prior years, but that may change as our allocation from the State changes. It functions as a placeholder. It's not the best way to approach that, and we apologize for the confusion, but as we get more information and we have a better sense from the State, what we would like to do is bring that back to you and the Council to provide that information and provide that detail so that you have a more accurate snapshot of what that is.
I'm just checking to see if and where these curfew centers are; and if, in fact, they were in existence in 2007 and 2008.
The curfew, what 00186 that is not the curfew centers, per se; it's the Behavioral Health supports for the curfew centers. And it was --
Wait a minute, you lost me. Let's go back. What did you say? What is a curfew center?
The curfew centers are the curfew centers that are around the City. They are part of the administration's public safety campaign. The Police Commissioner is strongly supportive of them and the Department of Behavioral Health has been an integral part of them by providing Behavioral Health supports.
I agree with Dr. Evans. Essentially, we bring young people who are caught or found out after curfew to a center. And rather than just warehousing them, there are 00187 services. This represents the services for those young people. The expense for the curfew centers themselves, the facility itself is in DHS budget, in the Safe and Sound part of the budget. So there are two budget items here for curfew centers.
But this isn't Safe and Sound. Are those curfew centers? I doubt that any of my colleagues know where they're located in this budget. I don't know that many of my colleagues would know where these curfew centers are on of the budget. Could we possibly have a list of them, where they're located?
There aren't that many. If you have it before you, why don't you just give it to us for the record.
Yes, I can, sure. For the record, The Lighthouse 00188 at 141 West Sommerset Street. There's another at 42 -- I'm sorry, 4620 Briscom Street. Another at 4300 Germantown Avenue. Ray of Hope at 6640 Wyncote Avenue. 1319 North 52nd Street. 1601 Hellerman Street. 6517 Chester Avenue. 2551 North 22nd Street. 2029 South Eighth Street. 2700 North 17th Street. And 1920 South 20th Street.
So to the Budget Director, I ask: is something that we should not even be discussing at this point because --
-- we don't know what the State is doing, for one thing. And when would we know and how would we address this issue? 00189
Madam President, that's a very fair question. We should come back to you when we have a better sense of the actual allocation from the State. And then with our preliminary attempt to sort of allocate those dollars so that what you have before you is more accurately reflective of what we would do moving forward. I don't know the timeframe. I would defer to Dr. Evans or Dr. Schwarz on the timeframe. They're telling me by mid-May.
Thank you. All right. Councilman Jones? Doctor, thank you very much.
Thank you Madam President. Two quick questions. One, what percentage of the prison population requires mental-health services? And to what degree are they included in the general population? 00190
I don't know what the exact percentage would be; I'd have to talk to the Prisons Commissioner. The prison has a separate facility for individuals who have the most serious mental health needs, and they are sequestered. The other individuals who might have less severe forms -- less severe mental health problems are integrated into the general population.
To what degree -- and this is my final question. How do you take people that are maybe institutionalized and recidivise them into communities, and how are families and relatives involved in that process?