1400 homes, 2100 children. COMMISSIONER DOMZALSKI: Yes, sir.
Okay, that's the ratio you feel is -- COMMISSIONER DOMZALSKI: That's what the current situation is.
Okay. And we've talked about the fact that based on utilization or non-utilization of pediatric services or other health-related services, there is some unknown population of children who may have lead poisoning but we're not unable to track them at the moment because they're not necessarily being seen by anyone; is that correct? COMMISSIONER DOMZALSKI: I think that may have been somewhat of a misstatement on our part, Councilman. They may be, in fact, bein screened and seen, receiving pediatric attention, but we just may not know about the result of that screening process that may or may not have gone on. 1351 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET
Well, I understand that, but it is quite possible that there are just some children who are not being seen; is that right? COMMISSIONER DOMZALSKI: Yes.
Okay. Now, let's talk about your current budget, and I know that the Health Department is a vast and fairly complex place, but I found on -69, Childhood Lead Poisoning Prevention Program, is that the program that we utilize -- COMMISSIONER DOMZALSKI: Yes, sir.
-- to both screen for and is this also where we do the abatement services? COMMISSIONER DOMZALSKI: Yes. Yes, sir.
So the budget is $728,971? COMMISSIONER DOMZALSKI: Actually, Councilman, the -- and I apologize. I have to give you a gross figure, which is about $3.5 million, which includes grant funds as well, some CDC funds and also some Title V funds that are for childhood lead poisoning prevention.
Okay, could you -- and you don't have to do it at the moment, but as I 1352 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET said, I found that particular page. Can you tell me where the other $2.8 million might be? COMMISSIONER DOMZALSKI: (Addressing colleagues.) I can't see it here, but is it in the Grants Fund? Can someone point us to a page? (Commissioner Domzalski confers off the record with colleagues.) COMMISSIONER DOMZALSKI: Thank you. Yes. We have in the lead --
I'm sorry, Commissioner, can you tell me tell me what you're reading from. COMMISSIONER DOMZALSKI: Yeah. I'm reading from just a breakout that I was given to sort of help me focus on what we have in terms of existing resources --
Right. COMMISSIONER DOMZALSKI: -- that are related to the part of lead poisoning that we're talking about. We have a Lead Prevention Grant from CDC; that's 700,000. We have a grant from HUD of $771,000. 1353 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET And under the Childhood Lead Poisoning Title V provision, we have $728,000. And those three total just under $2,400,000. And in the General Fund, we have $1,264,000, and that --
All right, hold on for a second, Commissioner. The CDC was 700,000, HUD was 771, and Title V was 728. COMMISSIONER DOMZALSKI: Yes, sir.
Right? Okay. That gives me, it looks like, $2.199? COMMISSIONER DOMZALSKI: I rounded it to -- my papers says 2.3, 2.3.
All right, we won't argue about it. And the 1.244, where is that from? COMMISSIONER DOMZALSKI: That's from the General Fund, sir.
From the General Fund, okay. Now, how many -- and what was the number, 800 children this year that you expect? 1354 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: Yes.
And that represents how many households, how many new households? COMMISSIONER DOMZALSKI: Let me see if I can get something that won't be a guess. (Addressing colleagues.) How close are we on that? (Commissioner Domzalski confers off the record with colleagues.) COMMISSIONER DOMZALSKI: My expert tells me there will be about approximately 600 households.
That's 800 kids, 600 households. COMMISSIONER DOMZALSKI: Yes.
So is it fair to say that, notwithstanding the efforts of the Department, about every year, there are 600 new households? COMMISSIONER DOMZALSKI: Actually, yes, yes. That is the rate of intake of new work, approximately 50 a month.
Okay. Your earlier testimony was that there was a backlog of 1400 homes; is that correct? 1355 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: That's correct.
Now, how much does it cost to treat a house? And I need to ask you what does "treat" mean? COMMISSIONER DOMZALSKI: All right.
How do you make a house safe? COMMISSIONER DOMZALSKI: There are probably 3 categories of three houses in that 1400, and 10 percent of them would be amenable to what is called "a super-clean": Two guys, two days, and the house is super-clean.
What does that mean, what's a super-clean? COMMISSIONER DOMZALSKI: That means that they go in and they use a washing technique, and it's no surface -- it's no treatment of the surface; it's cleaning, cleaning of the household of dust both by washing as well as by using what are called "high-efficiency vacuums to suck up the dirt and dust, and about 10 percent of the houses would be amenable to that.
Does a person have to relocate for the two days while this is going on? 1356 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: It's better to have people out, yes, to let people clean around, but it's not --
They can leave all of their stuff in place? COMMISSIONER DOMZALSKI: Yes, yes.
Okay, tell me about the rest. COMMISSIONER DOMZALSKI: There are --
I'm sorry, Commissioner. How much does that cost? COMMISSIONER DOMZALSKI: That costs about $1,000, about $500 a day.
So $1,000 treatment for the 2 days. COMMISSIONER DOMZALSKI: Mm-hmm.
Okay, all right. What's the rest? COMMISSIONER DOMZALSKI: There are 60 percent that require actual surface stabilization. That means that the paint that may be peeling needs to be removed and that a suitable surface coating is applied over that condition. There may also be in that process, depending on how bad the 1357 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET deteriorationis, a need to replace a floor surface or two.
A what? COMMISSIONER DOMZALSKI: A floor so that they can be cleaned.
Okay. COMMISSIONER DOMZALSKI: And the cost for that -- and, you know, no matter -- I'm much better with the gross figures, but the cost for this may be in the neighborhood of between 3 and $5,000 a premises.
All right. And what about the other 30 percent? COMMISSIONER DOMZALSKI: The other 30 percent probably need all of the above, but there's a huge question mark about them in the sense that they may need some larger-systems repair such as a roof, such as plumbing, those kind of things, before they can be adequately treated. And this is the reason why need this -- in this new strategy, we need --
So we could call that maybe "major abatement." COMMISSIONER DOMZALSKI: Yes, yes. Major 1358 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET systems stabilization.
And what do you think off the top of your head, $10,000? COMMISSIONER DOMZALSKI: Perhaps. I know Mr. Greene at the Housing Authority, when he talks about a rehab of a house, a basic system repair, talks in the neighborhood of $12,000. What we need to do, since we're not housing people, we need to get all of these 1400 houses triaged and assessed with housing experts to look at just how much and to what extent they are suitable for any kind of an abatement.
All right. Let's talk about at least the 70 percent -- we've got 10 percent at $1,000 for a 2-day treatment. The 60 percent, the surface stabilization, how long do you think that treatment takes? COMMISSIONER DOMZALSKI: That can be a couple of weeks.
A couple weeks. And that, you're saying, is estimated at 3 to $5,000 in cost? COMMISSIONER DOMZALSKI: Yes.
Okay. Now, for this 1359 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET upcoming year: 800 kids, 600 households. How many of them will the City attempt to treat? And who actually does the treatment? COMMISSIONER DOMZALSKI: We do in general. There are families who become aware of the condition and have the wherewithal, the resources to do it on their own, and they will. There are some of who will be living in landlord-controlled premises, and the landlord will have the responsibility for doing that. Outside of that, it would fall on our City abatement crews to do this work.
How many people do this work? COMMISSIONER DOMZALSKI: We presently have two abatement teams and one super-clean team.
And when you say "two abatement teams," is that two teams of two people? COMMISSIONER DOMZALSKI: Two to three and a crew chief.
You have two abatement teams and one super-clean? COMMISSIONER DOMZALSKI: Yes.
And how many people 1360 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET are in that? COMMISSIONER DOMZALSKI: That's usually two people we would deploy on the super-clean.
So are we talking about two abatement teams of two to three people, so that's four to six, plus a crew chief. And a super-clean team has -- COMMISSIONER DOMZALSKI: Two people.
So you have somewhere in the neighborhood of 7 to 9 people? COMMISSIONER DOMZALSKI: Right.
And how many houses will they abate? COMMISSIONER DOMZALSKI: We have a capacity when we really get it ramped up --
What does that mean? COMMISSIONER DOMZALSKI: -- to do 100 a year with the abatement teams.
When you say "really ramped up," what does that mean? COMMISSIONER DOMZALSKI: We are not at that level at this point. We'll produce about 70 1361 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET this fiscal year, and beginning the next fiscal year, because we'll have more of a year to work with -- we just did get one of those teams -- we'll have a capacity to do 100.
All right. So let's say, even at our best, which is 7 to people, 100 8 houses. 9 COMMISSIONER DOMZALSKI: Right.
And there's 600 households identified with 1400 properties on a backlog list. Last year's backlog was 1100, which has now gone to 1400, which is soon to be 1900. COMMISSIONER DOMZALSKI: Right. Last year we had a backlog of 1100 to a backlog this year of 1400.
Well, I mean, again, I commend the best efforts but, I mean, obviously the numbers are going in the wrong direction. Generally when you have a backlog, you're trying to work it down and decrease the numbers. Let's go back to where Councilwoman Tasco was, and then I'm going to get into some of the numbers here. The buyer/seller transaction, the 1362 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET mortgage/no mortgage, people come to an agreement. Now, the earlier testimony was that the seller has to disclose if the seller knows that there's lead. COMMISSIONER DOMZALSKI: Yes.
If you've lived in a house for some time some time and possibly had it painted within the last five, ten years, I will, one, assume that you did not use lead-based paint. I think it's not sold anymore; is that right? COMMISSIONER DOMZALSKI: That's correct.
Okay. So if a person has painted their house a couple times and now it's time for the sale, do they have lead in the house or not, and how would they know it? COMMISSIONER DOMZALSKI: Yes they do. How old is the house?
50, 60 years, average house in Philadelphia. COMMISSIONER DOMZALSKI: They'd probably have lead in that house.
Okay. Do they know it? COMMISSIONER DOMZALSKI: They may not.
So they put "no"? 1363 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: They put, "No, not to my knowledge."
Okay. But even if they did know it, their requirement is to -- COMMISSIONER DOMZALSKI: Disclose
-- disclose. What's the requirement to treat or abate either by the seller or the buyer? COMMISSIONER DOMZALSKI: Unless there is a -- well, if you're talking about the real estate transaction and all of the ins and outs of it, I would suggest get that we get a real-estate attorney up here to talk about the real-estate transaction. But what we're talking about here is the buyer-seller transaction where that there's a requirement that if you know, to disclose.
Right. COMMISSIONER DOMZALSKI: And so by having disclosed, I, as the buyer, now know that there's a condition in there that could work to the detriment of children. And so I need to either -- I need to address that in some fashion. And we do not get involved unless there's a child exposed. 1364 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET
Well, I understand, but let's go back to the example provided by the Council President. Specially in a mortgage situation, I mean, the mortgage company won't give you a mortgage unless you give them a certificate that you've had a termite inspection, and I think you have to have a radon inspection. The question is: What is it that we can do as a City government in that transaction that you have to have a lead test done and you can't make the transaction unless someone, either on the seller's side or the buyer's side, abates and gives the certification that there's treatment? COMMISSIONER DOMZALSKI: Probably we would need another piece of legislation where the responsibility is to disclose, not to abate.
I understand that, but that doesn't help -- it's not directed at you, but that doesn't help the subsequent child COMMISSIONER DOMZALSKI: Right.
Whether they were alive at the time or subsequent. I mean, they -- you know, they just kind of, like, popped out, if you will. I mean, they're here. 1365 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: We need more -- a different ordinance on it. I don't think I'd argue that.
All right. What would it take to significantly address -- I mean, it's hard to even talk about trying to deal with the 1400-property backlog when we know just from this morning that we're going to contribute to the backlog, so let's first talk about the 600 households. How do we get it from you guys treating 100 households to at least the 600 and not consciously contribute to the increase in the backlog, and then, is there a backlog strategy? What would it take to address the 600 households in the upcoming fiscal year? COMMISSIONER DOMZALSKI: It would take about seven teams. I think -- you know, I'd like go -- could I leap ahead just to maybe put a couple things together?
Sure. COMMISSIONER DOMZALSKI: Okay. We have a backlog of 1400 houses.
Right. 1366 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: All right. The only thing that's happened to that backlog in the past year is that it's gone from to 14. 5
Right, and going to 6 19. 7 COMMISSIONER DOMZALSKI: The new work 8 coming in is at the rate of about 50 a month. My 9 view is that we cannot get engaged in managing the 10 backlog. 11
Right. COMMISSIONER DOMZALSKI: It's a trap that managers -- because of, I guess, the way we look at things, we fall into it. We cannot do this. We've got to take that backlog and set it over here and deal with it separately. Now, we've got to take the new work and look at that in and of itself and deal with that. That will take seven teams to deal with that.
Seven teams. COMMISSIONER DOMZALSKI: Seven abatement teams that we would use as a mixture of teams, all right? Some we would do super-clean and some we would do abatement.
Seven additional 1367 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET teams beyond the ones that we've talked about? COMMISSIONER DOMZALSKI: Seven just to keep up --
Because the ones that we talked about are dealing with the first 100. COMMISSIONER DOMZALSKI: A total of seven.
Seven new teams? COMMISSIONER DOMZALSKI: Yes. A total of seven. We already have two.
So you need five new teams. Now, what would it cost to have 5 new teams just to deal with the 600 properties? COMMISSIONER DOMZALSKI: Probably we're talking in the neighborhood of a million and a half dollars -- with supplies, with personnel.
I understand. Just... 1368 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET What does it cost either the health system or the social-service system over a one-year period of time, a three-year period of time, a five-year period of time, possibly a lifetime to do nothing? COMMISSIONER DOMZALSKI: About -- if you do the arithmetic on it, one figure I've seen is about $135,000 per child for doing nothing. If you multiply that out just with the 2100 children that we're dealing with, we're talking about somewhere in the neighborhood of $290 million.
So if all that math is correct, you're saying that we could make a million-and-a-half-dollar investment today and save $295 million at a later point in time? COMMISSIONER DOMZALSKI: No. The investment would be much more, and that much more would include dealing with the backlog.
I'm sorry, you're right, you're correct. COMMISSIONER DOMZALSKI: Would include dealing with the backlog. And that is a significant increase in resources.
I understand. 1369 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: And it's for precisely this reason that what we're doing is pulling together people who have never worked on this problem before, and that is the housing agencies, the public-health people, the health maintenance organizations, all right, in terms of looking at what other states have done in relation to getting Medicaid waivers, because it's the houses that are making these kids sick, and so we've got these players that we need to bring to the table to deal with this. And I include on that list not only the agencies that I've mentioned, but also HUD -- and I'm on their calendar for later this month -- but also the EPA and also the CDC.
Well, I understand that and, you know, I love a collaboration as much as the next person but, I mean, I'm more than prepared to sit here -- and I actually don't want to hold you here for Councilwoman Blackwell, I was certainly being somewhat facetious. But I don't want to leave here today with a discussion about a collaboration, 'cause I would feel that I have not done what I was supposed to do. 1370 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET So what I need is -- Madam President, can we have the Budget Director and the Managing Director and any other financial person that is here to answer any questions? Can we have them at the table?
Is Mr. Dubow here? The Managing Director is here.
When I started talking about money, Mr. Dubow probably found the need to be absent from the chambers. (Laughter.)
Good morning, Madam Managing Director. (Ms. Richmond comes forward.)
Good morning, Madam Managing Director. MANAGING DIRECTOR RICHMAN: Good morning, Councilman. I am Estelle Richman, Managing Director.
I lost track of you 1371 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET in the room a while ago. Have you had much of an opportunity to hear some of the exchange? MANAGING DIRECTOR RICHMAN: Unfortunately, I've heard pieces on and off, and I do know you're talking about lead poisoning and children, how's that?
Okay, that's a good start. Commissioner Domzalski has taken us through some treatment processes based on a type of problem in three identified types of properties. His testimony is that this upcoming year, we anticipate 800 kids possibly suffering from lead poisoning, which represents 600 households, with 1400 properties on a backlog list. His present staffing will only allow for the treatment of 100 of the 600 properties in the fiscal year, and so last year's backlog was 1100, which has now gone to 1400, which is soon to be 1900. So obviously, we are, in fact, contributing to the backlog problem. What I asked him was to narrowly focus on the currently known information, separate from the backlog problem, to try to figure out a way to at least not contribute to the backlog and that we're 1372 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET dealing with what we believe is, in essence, 50 new cases a month, 600 a year. When we went through the costs, Mr. Domzalski estimates that he needs -- not because he jumped up to the table and offered all of this information, but in response to questions, answered the question that was asked. The estimated cost is million and a half dollars for five teams to just deal with current cases. Dealing with the backlog is a separate issue. He talked about collaboration, he talked about meeting with the EPA, L&I, and a variety of other agencies, which is all well and good. What I need to know today is, can we, in the FY '03 budget, figure out a way to at least not contribute on the backlog, address the 600 known properties, and not have the government consciously adding to a horrendous problem but for lack of either money or direction of resources? MANAGING DIRECTOR RICHMAN: Councilman, I certainly know the dangers of lead and the cost and the backlog from previously looking at this budget.
I know. MANAGING DIRECTOR RICHMAN: The Budget 1373 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET Director and I will get together with all of the relevant players and get back to you with a plan on how we plan to address the issues you just put forth, which are how do we plan to make sure that we don't contribute to the backlog? how do we begin to begin to address the backlog? and how do we address the budget issues related to both of those? And we will have that before you vote on the Council budget testimony for this year.
And Mrs. Rich, I would like Mr. McPherson to also be present at your meeting so that he could fully apprise us. MANAGING DIRECTOR RICHMAN: Okay.
Thank you, Madam Managing Director. Let me make sure that I completely understand what you said. The expectation here is that before concluding the budget process, you're going to come back to us with a plan on how to deal with the 600 properties, which may, and more than likely will, have to include some additional funding or rearranging of funding sources to deal with this particular issue, at least for the 600 homes, and we'll have an additional discussion about the 1374 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET backlog? MANAGING DIRECTOR RICHMAN: Yes. At least dealing with the 600 homes that would add to the backlog each year, we'll come back with either rearranging dollars or with how we will address the issues you've put forth before you complete the budget process this year.
Okay. And the expectation is that if that game plan ends up being acceptable, that we would either need to make some amendment to the budget, but the goal here is to identify a way to treat the 600 houses that we know of; is that correct? MANAGING DIRECTOR RICHMAN: That is certainly the goal here.
Do you have any more questions of Mr. Dubow and the Managing Director?
Not at the moment. I do have more for Commissioner Domzalski, although they are budget-related questions.
Thank you. 1375 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET And, Councilman, your time has been up.
A long time ago. The Chair recognizes Councilman Ortiz.
Thank you, Madam Chair. Since we're doing the same sort of thing that I asked before, from the lead, can we start looking in terms of how we can begin tackling the infant mortality issue along the same way and the same lines. Commissioner, in one related question, because we do have an industry that's highly dependant and an economy that's highly dependent on restaurants and how they're serviced and so on, how many sanitation inspectors do you have in terms of restaurants and how long before an inspector goes to each restaurant? What is the timeline between inspections in restaurants today? COMMISSIONER DOMZALSKI: We have 20 sanitarians that are associated with our retail food sanitation program; and as far as the interval is 1376 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET concerned, that interval now is every months that we get around on a regular basis to those facilities.
For cities such as 6 Philadelphia, is there a measurable comparison that 7 we can do between, say, Boston, Washington D.C.? 8 What is the timeline between inspection in these 9 areas? because if you remember a few years back, we 10 had some problems and some rumors that began about 11 Chinatown and almost forced the Chinese restaurant 12 in Chinatown to almost close just because of a 13 rumor, and all that it would take to harm an 14 industry such as this is for something to happen. I 15 mean, 17 months seems to be a long time between 16 inspections. 17 COMMISSIONER DOMZALSKI: That's an improvement.
Well, I know that it's an improvement, but still -- COMMISSIONER DOMZALSKI: When we first looked at this several years ago, that interval was 37 months. And we do think that within -- a couple things have happened 'cause all we're really talking about here is the outcome, what is the outcome of 1377 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET either not inspecting as frequently as other jurisdictions do or going too long, and that outcome is on, you know, the impact of food-borne illnesses in the community. We have devoted a lot of effort through our environmental health services to doing -- it was only about three years ago where people didn't have to have any training at all to handle some of the most hazardous foods that that might be, and now all of that has changed as a result of action by the council now.
Right. COMMISSIONER DOMZALSKI: But now the food-manager certification law has gone a long way toward improving the sanitation practices in the facilities.
Isn't the national standard six months? COMMISSIONER DOMZALSKI: Well, it's all over the place; some say a national standard is every four months or every three months. The FDA, I think, to the extent that they're doing inspections, might look at six months. We look at what's appropriate for the community. 1378 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET Certainly, we'd like to do it more frequently, but we do think with our inspections and with the improvements we have made in the process that we do have a safe retail food industry in Philadelphia, thanks largely to not only our efforts but the committed efforts from the retail and food establishment associations, including the group we just worked most specifically with, which is the Dominican Grocers Association.
Right. Going back to the health centers, and you made, rightly so, an emphasis that the health centers should be the main instrument, institution that citizens look to in terms of the provision of health services. A few years back, Councilman Cohen and myself sponsored a legislation about the staffing of those health centers. And how is the staffing? can you give us detail in terms of the services that are being provided? does each health center have a director? who are those individuals that are directing the health centers today? If you can let us know and send us a list of that. And could you give us a staffing of each and every individual health center and what is the 1379 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET budget that you have now for each health center and what are the differences? COMMISSIONER DOMZALSKI: Sure, I'd be happy to break that down, and should I send that to you?
Send it to the Chair. COMMISSIONER DOMZALSKI: Certainly.
Okay? I'd like to look at how we're budgeting and the caseload that is coming in. As you stated, HIV is on the increase, chlamydia, all of these. What is -- I'd like to see a breakdown in terms of -- by district of the sexually-transmitted diseases, how we're treating them. Also a breakdown in terms of how many people make assess of the health centers and how we are budgeting it. COMMISSIONER DOMZALSKI: Okay, will do.
And do you have vacancies in them right now that are not being filled? Do you? COMMISSIONER DOMZALSKI: No. We have -- to answer your whole question, we do have some vacancies. For example, we had six nursing R.N. vacancies; four of those positions are filled 1380 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET already and we're interviewing for the last two
Where were these vacancies at, in what areas of the City? COMMISSIONER DOMZALSKI: They're in various districts; I can give you that breakdown.
Do we have relationships between the community health centers and hospitals? COMMISSIONER DOMZALSKI: Yes, absolutely.
Could you detail part of that relationship, please. COMMISSIONER DOMZALSKI: Yes.
And tell us which hospitals are those? COMMISSIONER DOMZALSKI: Yes. The relationship backs up our family medical -- our primary-care program as well as our prenatal program. And relationships that we have for prenatal run the gamut from HUP in West Philadelphia to -- well, let me just give you for primary-care services, Councilman. Health Center 2, the backup hospital is Methodist Hospital; for Health Center 3, it's Misericordia; and the same applies for Health Center 1381 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET 4; for Health Center 5, it's Temple; and for Health Center 6, it's St. Joseph's; for Health Center 9, it's Medical College of Pennsylvania; for Health Center 10, it's Temple; and the Strawberry Mansion Center is Medical College of Pennsylvania.
Do we have individual contracts or is it a part of a package that we do with them or -- COMMISSIONER DOMZALSKI: They're Individual contracts, and we'll be working to, I think in some cases, to a unitary contract where the terms and conditions are the same.
I'd like to see some details as to those contracts, how much is it and how much we spend. COMMISSIONER DOMZALSKI: Sure
What are the services that each contract is supposed to be providing? COMMISSIONER DOMZALSKI: Well, I could give you in general: For the health centers, it's for referral services. So if it's a situation where a patient needs to be seen by a neurologist or an orthopedic specialist or dermatologist, we would make that referral to that backup hospital for that 1382 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET service. And for the prenatal program, it's for obstetrical care for labor and delivery service at the hospital.
Well, do you have numbers for how many families, women are accessing the prenatal program? COMMISSIONER DOMZALSKI: Absolutely.
Do you have objectives that you place in terms of that, you know, per area? COMMISSIONER DOMZALSKI: Yes.
Do we have numbers that we try to meet, and are you meeting them? Do you have that in writing? COMMISSIONER DOMZALSKI: Absolutely, and we can send that to you.
And you can send that? COMMISSIONER DOMZALSKI: Yes, sir.
You're welcome The Chair recognizes Councilwoman Brown.
Thank you, Madam President. 1383 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET Following up on Councilman Nutter's analysis of the answer to the question of why the backlog? is training an issue, training of professionals that are responsible for the actual abatement of homes? You mentioned also that you're not up to speed. COMMISSIONER DOMZALSKI: Well, you know, part of that had to do, Councilwoman, with when the second team came on during the fiscal year. So we have them on and we're up to speed; they are trained and they're working at full pace at this point. Training is an issue -- this is hazardous work and we don't want to, as a result of protecting the -- getting the lead out in the environment to expose the people who are doing the work. So there is training, and in fact, everyone in Pennsylvania who does this work must now be certified by the Commonwealth of Pennsylvania that they've had a training course that prepares them to do the work.
And to what extent or how is DHS involved with the temporary, some might say, "displacement" or relocation of the family during the abatement process? COMMISSIONER DOMZALSKI: Well, we need to 1384 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET sharpen that up a little bit. Right now -- and unless what we're looking at are -- with OESS to have some temporary housing facilities for a week or two where we could move people while we're doing the work, then --
How has that been handled in the past? COMMISSIONER DOMZALSKI: With great difficulty; we have been trying to work around the family. At one point, we did have what were called "safe houses," but we don't have those now for a variety of reasons; a lot of it has to do with the intensity of the management that goes along with those facilities. So to be able to have a resource -- and in fact, that was a part of the conversation in terms of the collaboration that we were talking about with Carl Greene, that we would be able to make some places available for people on a temporary basis.
How comfortable are you or how confident are you that the coordination of DHS is done in such a way where families are not penalized for it while that 1385 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET activity is going on? COMMISSIONER DOMZALSKI: I will tell you, working with Commissioner Martinez in the past and in my new role, I have absolute confidence that she's not going to let any family be compromised by a matter such as that.
And I have every confidence too that that would Not happen knowingly, but we know of instances where the system may break down and DHS may become involved for the very right reasons only to discover that the reason why the children there are suffering from lead poisoning is because of the lead. So does the contact happen on the front end, or is DHS contacted -- at what juncture is DHS a part of the process? COMMISSIONER DOMZALSKI: It needs to occur on the front end and at every stage of the process because of just the number of issues that attend the families that we'll be dealing with.
And I would suspect and hope that that issue, too, is a part of the strike force that's been pulled together, to tighten the coordination. 1386 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET COMMISSIONER DOMZALSKI: Absolutely. Well, that team that I mentioned is just the core; we need to add partners from DHS, from Housing on this, as well as some of the other agencies, which is really the key to solving this problem.
One final question. You mentioned in your testimony -- speak to the relationship with the Office of Behavioral Health and the manner in which you deal with young people who have intensive needs. What happens to the child that is too disruptive for the classroom but not seriously in a circumstance where they require residential treatment.
Well, I'll take a shot and you can add on. COMMISSIONER DOMZALSKI: Okay.
Generally, what exists currently is that child would be potentially appropriate and appropriate for wraparound services.
Which could include anything, from a therapeutic staff-support to a mobile therapist who would work with him both in the class and in the home. 1387 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET
Very well. I know about that, that's a valuable service. So that answer my question. Thank you. Thank you, Madam President.
You're welcome. The Chair recognizes Councilman Nutter
Thank you, Madam Chair. I'll be relatively brief and let Mr. Domzalski and other people get back to work. Let's go in the budget book. I have four or five items, the first of which, actually, is, what's the current status -- I think last year, there was a big issue at our public schools, and I think Councilman Ortiz may have had some -- I think it was Councilman Ortiz who may have had some hearings about this particular issue. What's going on with the drinking water at schools? COMMISSIONER DOMZALSKI: Yes. In 1999, the Environmental Protection Agency contacted the schools, the School District of Philadelphia, and made them aware that in their view, there were drinking-water outlets in the schools that exceeded the EPA drinking-water standard for the lead, and 1388 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET that standard is parts per billion. The issue became one of who is going to deal with the coordination of this and enforcement action. The decision was made that the Health Department would be that entity, and we put in place a consent order and agreement with the School District of Philadelphia that required the School District to test all of its outlets, those outlets that are found to be above the standard, to take those outlets out of service, and to remediate them; that is, put in parts into the faucets or change the systems so that the outlet, the water outlet, would not be producing contaminated water. And that in the interim, should the number of water fountains be compromised and if there were not enough to serve the children while process was going on, there's a requirement that bottled water be provided in the schools so that the children would have a safe supply of water.
Okay. Well, that was 1999; what's happened in the interim? How much testing has taken place since then? how many schools have either solved their problem or not solved the problem? and how much water is available in bottled 1389 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET form for every child in the school system? COMMISSIONER DOMZALSKI: We have -- let's see. Okay, we're dealing with 299 buildings.
I understand, and 264 are school buildings. COMMISSIONER DOMZALSKI: Right.
The rest, I'm assuming, have a -- COMMISSIONER DOMZALSKI: Well, to some extent, they also see children in their for different activities and so we're concerned about that as well.
All right, 299. COMMISSIONER DOMZALSKI: So the total number of water outlets identified for repair or replacement is 4,504. And we presently have 92 schools that are using supplemental water; i.e., that is bottled water.
Well, let me understand that. Are you saying that at those 92 schools, none of the outlets are available or -- COMMISSIONER DOMZALSKI: An insufficient number is available.
Okay. So they're 1390 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET using alternatives. COMMISSIONER DOMZALSKI: Yes.
And what's going on at the other 172? COMMISSIONER DOMZALSKI: They are either all right or they're in the process of remediation. And during that process, they have sufficient outlets. Those outlets that are producing contaminated water are turned off.
How do we know that? COMMISSIONER DOMZALSKI: Inspection.
Was every school inspected during the course of the current school year? COMMISSIONER DOMZALSKI: Yes, and some of them several times.
What's going on at the 92 schools? COMMISSIONER DOMZALSKI: The 92 schools they are -- you know, this process has changed a little bit. I will admit that I have not always been, you know, satisfied with the progress. And to change that, I had a meeting two weeks ago with the Chief of Staff of Mr. Nevels to 1391 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET go over this with the new team over there to talk about just what needs to be done, and quite frankly, some of my concern about this was informed by community residents who have called about concerns they had with the availability of bottled water. And when we looked at those usual suspects, we found that they were, in fact, accurate in that assessment and so --
Accurate about what? COMMISSIONER DOMZALSKI: About there not enough water available.
Not enough water available. COMMISSIONER DOMZALSKI: Right.
Okay. COMMISSIONER DOMZALSKI: And so we brought this to the attention of a man by the name of Mr. Seaford (ph), who has given us his assurance -- and not only that, he has put six additional plumbing teams devoted soley to this so that by the end of this fiscal year, by the end of June, they will have something like 35 of the first 50 schools completely remediated.
What do you mean, 35 1392 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET of the first 50? COMMISSIONER DOMZALSKI: Those are the one that are determined to need the remediation the most in terms of being able to have a consistent supply of water that comes from an outlet as opposed to water coming from a bottled source.
But you gave me a number of 92 schools earlier. COMMISSIONER DOMZALSKI: Yeah, I did. They're the number of schools that are using bottled water.
Okay. And I guess my question is, when will all of the 92 schools be fixed such that bottled water will not be necessary and that there will be enough outlets to serve all of the children in those schools and eliminate that particular problem? COMMISSIONER DOMZALSKI: Mr. Seaford will be giving us a timetable; part of that timetable is that 35 will be done by the end of June.
All right. You're obviously the Health Commissioner, you're not the School District. At least I'm going to say for myself, that's unacceptable. 1393 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET (Applause.)
And we'll have the schools over here shortly. Commissioner, you'll continue to do what you do in that particular area to the extent that you can push the right people to do what they need to do, but if the identification was made in 1999, and this is now 2002, and we think that we're only going to get 35 out of 92 done, first, there is no question, as best I can tell, that there's not enough bottled water at all of the schools for all of the kids. (Applause.)
'Cause I know I have to send some myself. Second, if this was some other kind of problem, it would have been resolved. But the fact that it's in a school and we have all of these other competing priorities, and then we tell them, Well, we'll just get you bottled water -- I mean, bottled water is not the solution to this particular problem, and you know, I'm sure, from time to time that the kids are not following the directive of the sign that says "Don't Drink This Water" in the bathroom, because they're kids, so they do whatever 1394 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET they want to do, in many instances. So it's not a solution, it's not an acceptable level, it's not completely within your jurisdiction, and I'll leave that there. Let's go to -60 of the budget book, the HUD Safe Home Program, which apparently was a Grants Revenue Fund project from -- it looks like we received an appropriation in the current fiscal year. Can you tell me in about words or 11 less what the HUD Safe Program is? 12 COMMISSIONER DOMZALSKI: In very general 13 terms, the HUD Safe Home Program is where we go in 14 and check for clearance for lead, and that's the 15 concept, but this project was not funded.
Is that something we have to apply for or is it something HUD didn't fund anymore or -- COMMISSIONER DOMZALSKI: Again, you know, I understand about how vague this idea of collaboration is, but it's what's going to get us to where we need to go, and we really need to work with the key agencies on this and focus on just applying 1395 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET to treat 250 homes. When we have the situation that we have is that we really need to have our grant applications coordinated so we get the resources that we need from the housing authorities that are supposed to find (indiscernible) safe housing. So, yes, we do have to apply and that grant's coming up in the next 30 days.
All right. So it is currently still a program of HUD and we have not applied for it? COMMISSIONER DOMZALSKI: We have.
We have. COMMISSIONER DOMZALSKI: Yes, and we are going to apply again.
Okay, but the book says "not awarded in FY '03." COMMISSIONER DOMZALSKI: Yes.
Is that because we haven't put the application in or because of the difference in the funding cycles for HUD or -- COMMISSIONER DOMZALSKI: They did not accept our application for whatever reason.
I'm sorry? COMMISSIONER DOMZALSKI: HUD did not 1396 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET accept our application.
Did not accept our application. COMMISSIONER DOMZALSKI: Right.
Do you know why? COMMISSIONER DOMZALSKI: We're going to find out so we don't make the same mistake twice.
Who actually makes the application? COMMISSIONER DOMZALSKI: It's a joint application, I think. (Witness comes forward.) COMMISSIONER DOMZALSKI: (Addressing colleague.) Was this the one between OHCD and us, Dick?
Good morning, Councilman -- or good afternoon, sorry. My name is Richard Tobin, and I'm Director of the Childhood Lead Poisoning Prevention Program. The Home Safe Program was applied for by the Lead Poisoning Program. It was designed to look at a variety of environmental insults to children that occur in old and deteriorated housing, including lead and mold and mildew and a whole array 1397 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET of things.
It was an extremely competitive grant, there were several hundred applicants, and HUD only gave out five grants in that area last year. We intend to reapply in the coming year also.
No, we didn't receive one last year; last year would have been the money coming into this year. HUD works on a different fiscal year than the City does.
Well, let me just understand this. -60 says, "Fiscal 2000 Original Appropriation, $700,000." Are you saying did not receive that?
That was in anticipation of receiving the grant. We did not receive that, no. 21
Well, what were the five cities that were awarded the grant?
I don't remember right offhand. I think it was Los Angeles may have been one and Boston, and there were a couple of states 1398 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET also, but my recollection is that there were several hundred applicants, and it ended up with five grants.
I can appreciate that, but I don't really care how many applicants there were; I care about Philadelphia's application. Now, what was the quality of our application? I mean, what's the -- where do we rank in terms of other cities that have a lead problem?
Well, the grant wasn't just for lead; it was for a variety of issues. And I think the quality of our application was excellent and it wasn't -- it was one of the very last ones that wasn't funded, or at least from what we've told by HUD, and we intend to go back again this year with an application. COMMISSIONER DOMZALSKI: I think this is one of the reasons I'm on Mr. Pratt's calendar for -- Mr. Pratt's the head of the local HUD agency here in Philadelphia that makes those funding decisions, and I'm on his calendar for October 19th to discuss this, among other issues.
Okay. The next page is the grant titled 1399 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET "Smoke-Free Families," and that also is listed as not awarded in FY '2003, although there is an estimated obligation in '02. Did we receive this grant? COMMISSIONER DOMZALSKI: We did get this grant and -- (Addressing colleague.) Would you come up here so we can give the Councilmember the complete information? (Witness comes forward.) COMMISSIONER DOMZALSKI: This is Debra Roebuck; she's acting back in our Maternal and Childhood Health Program, and knows more than a little something about this. Debra, thank you.
Thank you. 1400 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET
Okay, the funding for this grant will be completed at the end of March. It was funded under the Robert Wood Johnson Foundation.
There is not a opportunity to reapply at that time they issued the grant.
Okay, all right. Thank you. Commissioner, , Philadelphia Asthma Initiative, we have an FY '03 obligation level of $18,920, which is a $12,000 decrease from the previous fiscal year. Can you tell me what happened in this particular situation? COMMISSIONER DOMZALSKI: We have several asthma initiatives going on, Councilman, and I just need to focus on which one this is. 1401 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET (Addressing colleague.) Jane, do you have this or is it Ambulatory Health? No? Well, we have three other asthma grants, and I'll have to get that information for you.
Get it back to me. Last question: On , this appears to be a new grant, the Comprehensive Tobacco Control Program. Is as a result of actual settlement funds? COMMISSIONER DOMZALSKI: Yes, it is.
Tell me what you're going to do with this, please. COMMISSIONER DOMZALSKI: This is going to fund a series of tobacco cessation activities throughout the City, and we will be doing this -- we've been notified that we'll probably be eligible for up to $3.5 million for this go-around, and we'll be using it for some tobacco cessation in various venues in which we see patients, we'll be looking at areas where young people congregate, we'll be doing this in rec centers, we're going to be doing this in whatever access we can get to the schools to do this. So it's going to be a pretty aggressive program. 1402 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET
Now, let me ask this question in conjunction with that, and then I think I'll be completed. On of your testimony, you are -- your testimony is that 16.8 percent of pregnant women were reported smoking? COMMISSIONER DOMZALSKI: Yes, sir.
Down from 20.3 percent? COMMISSIONER DOMZALSKI: Yes, sir.
Will some of these funds be targeted to deal with that kind of issue? COMMISSIONER DOMZALSKI: Absolutely.
Okay. And, lastly, this may be more the jurisdiction of L&I, but it's related to tobacco. I'm informed recently and have one of the packages. There is this continuing issue with young people having access to tobacco, either through single sales of cigarettes, or now there is a product on the market called a "Blunt Wrap," which is a tobacco products which is sold in grocery stories and other places that makes it easier for people to essentially wrap whatever it is that they want to wrap, and most of them are not wrapping 1403 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET tobacco. COMMISSIONER DOMZALSKI: Right.
What, if anything, is the Health Department doing about that particular issue? COMMISSIONER DOMZALSKI: The Blunt Wrap -- and I have to get some advice on this. (Addressing colleague.) Is this included under the Sinai amendment, Nancy? No, it isn't? What we're doing about tobacco sales, which is a huge issue, is that we are enforcing the ordinance that requires that tobacco sales not be made to minors, and we do that by investigation. We also do that by working with a community agency called "TEACH," where we actually go out and have people attempt to make buys who are under age, and then make that referral to L&I for a citation if, in fact, the sale is made to someone under age.
Are those prevention efforts citywide as well as the investigations? COMMISSIONER DOMZALSKI: Yes, yes.
Okay. I'd like to talk with yourself and probably Commissioner MacLaughlin at another point in time about this 1404 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET whole Blunt Wrap issue. COMMISSIONER DOMZALSKI: Certainly.
You're welcome. Commissioner, when do you expect the additional federal funding for public health emergency response to be made available to the State? COMMISSIONER DOMZALSKI: We're going to know more about that in the next couple of weeks. The Secretary of Health of the Commonwealth of Pennsylvania and I have been invited to meet with the federal government this coming weekend to talk about just what the local needs are and how that money ought to best be distributed. In the federal system, the money will go first to the State Health Department, and then it will be made available for us. And for a number of reasons, the Secretary of Health has generally reposed his confidence in us to represent all of the local health jurisdictions in Pennsylvania and making clear what our needs are and how that money needs to be spent. 1405 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET So we expect to know probably very, very quickly, and maybe in the next the 90 days, about how much we'll be able to secure of that and when it will come.
Can you elaborate on the what the types of enhanced systems protective gear and personnel costs are that you're seeking from the State? COMMISSIONER DOMZALSKI: I will, Council President. The issue of bioterrorism is, in a lot of ways, a lot like stuff we do every day in the Health Department. There are some 60 diseases of public health significance that are required by law to be reported to the local health department, and when we get those reports, we review them, we follow up on them, we try to find out whether or not there are any similarities in the persons who have been diagnosed with the condition, and make interventions as appropriate. That system, while it's very good for the diseases we're talking about most of the time, is not as good as it needs to be when we're talking about an event of bioterrorism. With bioterrorism, 1406 3/4/02 WHOLE - CONTINUED FY '03 OPERATING BUDGET it's different than, say, a bomb going off. When a bomb goes off, you know the bomb went off; when this bomb goes off, you may not know about it for three, five, six, eight, ten days, depending on what the incubation period is of the agent that's involved. And so what we want to do is enhance our surveillance systems out in the medical-care community, particularly the large hospitals and emergency departments, where they may not have laboratory-confirmed disease to report to us, but there may be a constellation of symptoms that are showing up that are of significance to our infectious-disease docs to say that, Hey, we may we looking out there for something of that nature, and that's the nature of what we want to enhance.
Thank you. Mr. Covone, can you tell us, when an individual enters the prison, whether sentenced or he is a detainee, are they screened for drug use?