Does the use cause congestion in the public streets or transportation systems beyond that, which would be expected?
Not at all. This is a very well-served corridor, and most of the people who come to the clinic are on transit.
does the use overcrowd the land no this is in an existing building when that building is not
a very dense building or tall comparison to all the buildings in the area do the proposed group
medical uh services uh use impair uh light and air no there's um there aren't any buildings
close there's a street on one side and a vacant lot on the other and a vacant lot across the street so
really no no impact on on adjacent properties um does the uh proposed use uh overburden the water
sewer school park or other public facilities no in fact there's been a fundamental population
decline as you know in the recent decades the infrastructure is very well um sized does the
use uh impair or injure the uh the proposed use does it impair or injure the use of adjacent
properties? Again, there is a vacant lot, or I should say a parking lot across the street,
and then just adjacent to our building is a public street, and then a vacant lot on the
other side, so it does not affect those properties. And it's almost, it goes without
saying, but I have to ask it anyway for the record. Does the proposed group medical service
use endanger public health or safety by fire or other means? I think it's the opposite. I think
that many people who are in that neighborhood depend on it, and it's a life or death question.
And is the clinic consistent with Philadelphia's comprehensive plan?
It is occupying the border between the two plans, two district plans, and neither plan
addresses this corridor. Are there any detrimental impacts proposed by this use beyond that,
which you would normally expect from group medical office use?
And again, when I saw that terminology normal, I had to cast it in the normal definition for this neighborhood, and I would say no.
And would you expect any detrimental impacts tied from the increase in sole practitioner to group medical services?
No, I think it would have a negative impact because the whole design of the medical services requires that there is a integrated menu of services that reinforce one another.
So once you start to separate them, then they all become less effective.
And so just so I can make sure I'm clear here, do you believe that there would be more negative impacts caused by a reduction to sole practitioner or that there would be more negative impacts caused by the increase to group?
practitioner or that there would be more negative impacts caused by the increase to group medical?
I think that if you distribute the uses out over multiple sites which might happen that you would
have more you could have potentially have lines out in the street there would it would it's better
to have them all together so that there's the person can go in the building get out everything
they need and leave the building in one trip. I have no further questions for Ms. Woodcock.
Mr. Woodcock, one question. They talked recently about hiring security expert and people to
handle security problems. Did that change the structure outside or you were not involved in
that? I was not involved in that. That happened before I started to prepare this study. But I
will tell you that when I was comparing this site to the other clinics, there were often people
around the other clinics when there weren't people at the prevention point site. Now,
So I obviously I was I'm not there. I was not there all day for many days.
So there may be other folks that have to. Was that helpful that they had security to do that?
Yes, I think it is helpful because the security folks are not only there to act as like police would, they're ambassadors.
I understand. It's an outreach.
and to just build on that quickly uh is the addition or um uh provision of uh security
guards at the property at all uh related to or uh with the lack of any security guards cause any
negative impacts specifically related to the provision of medical care not at all it's mainly
for the exterior environment.
Thank you.
But I guess to go back to Tanetta's issue,
so they hired security because of the problems outside?
There have been security at the property.
I mean, there are issues with, I mean, there are dealers on the corner.
There are individuals all around.
So this security is globally for the property, not limited to this use.
Okay, thank you.
The following witnesses I'll have will be much shorter and should just speak to the
medical uses that are specifically provided and open up any questions that the board may
have of the medical providers.
But my next witness would be Dr. Jessica Meisner, who is the Assistant Professor of Clinical
medicine and infectious diseases at the university of pennsylvania powerman school of medicine
did we see her hand hi could you please state your name and spell for the court sonographer
sure my name is dr jessica meisner j-e-s-s-i-c-a-m-e-i-s-n-e-r
We are a firm to tell the truth, the whole truth, nothing but the truth.
Who's she, counsel?
Dr. Meiser, can you just briefly state your credentials for the board?
So I am a board-certified physician in internal medicine and infectious diseases, and I'm
an assistant professor at the University of Pennsylvania.
But my favorite role is being the sauna clinic medical director here at Prevention Point.
And the photo that is up on the screen right now, is that your office or an office at Prevention
Point? Yes, that's the main clinic room that I work in. Okay. And can you please just explain
for the board the services that you provide and the types of patients that you see? Sure. So we
offer full HIV primary care, regardless of the patient's background or type of insurance. And so
that means I manage both HIV, but also any other medical problems they have, just like anyone's
primary care doctor would. So that includes hypertension, depression, diabetes. We do
preventive care. So I do vaccinations. I even do pap smears, STI screenings, but the clinic is very
low barrier, which means patients can come in and see me or one of my colleagues. If they have an
issue, they don't have to call and make an appointment two weeks out. But because of that,
we're able to engage and retain patients in our care that wouldn't happen at any other location.
wouldn't happen at any other location. An example of that is we have a long acting HIV
An example of that is we have a long-acting.
injection medicine program, which has grown to over 30 patients, and they get an injection to
control their HIV. And we've had zero missed doses, zero patients lost to care and 100%
viral suppression in two and a half years, which is something my clinic at Penn honestly couldn't
even say. And it's because you're comfortable seeing me here and have that we can able to get
that. And, you know, part of the importance of HIV medicine is a suppressed viral load means
the patient's health, but also that they're not able to transmit it to other individuals,
which is directly helping the community at large as well.
Thank you. And can you just speak to what you believe the effect would be if the
use were decreased from multiple medical providers to only allowing one medical provider at the
property? A lot of my patients would have a huge impact on their health. They don't feel
comfortable going to other clinics, and so it would either delay when they can come in and see
me or have them fall out of care, which would impact both their HIV and also their other medical
problems. And do you have anything else to add or anything else you'd like to advise the board
about the services or work that is done at prevention point? You know, I think because
this clinic is low barrier and exactly where we are, I'm pulling people into care that would not
get pulled in elsewhere. But we're pulling them in for HIV care and for everything. And it's,
it's truly saving lives. And if that's disrupted, I really do worry that some of my patients would
pass away. Thank you. I have no further questions for Dr. Meisner.
Any questions? Why don't we move on to your next question?
Thank you. I'd like to call Dr. Monica Van Zandt.
They've been allowed to speak.
Hi, could you please state your name and spell for the stenographer?
Sure, it's Dr. Monica Van Zandt, and it's M-O-N-I-K-A, Van Zandt, V-A-N-S-A-N-T.
or affirm to tell the truth the whole truth is nothing but the truth
yes please proceed counsel uh dr visit can you just please uh advise the board of your
professional background yes i am board certified in family medicine and addiction medicine
and i'm assistant professor at the temple medical school lewis katz school of medicine
And do you provide medical services at 2913 Kensington Ave?
And you do so on behalf of Prevention Point Philadelphia?
I do, and I specialize in linkage to care as well as the primary care and substance use.
Can you just briefly describe your work and the services you provide and the patients you see at the property?
Certainly. So I treat patients 18 years and older, adults only.
If we should encounter anyone under that age, I refer them to CHOP or UPenn's Adolescent Medicine.
We do not do obstetrical care there, but if I encounter persons that would be pregnant,
we do engage them and then link them to hospital care, obstetrical care.
In my role as the specialist for linkage to care, we get patients into the detox and rehabs, low barrier access.
So they will often call their counselors, caseworkers in the evenings or weekends.
They will then refer to me.
We will link them on the weekends and evenings whenever that patient might become ready for care or treatment.
They can go up to two hours away outside the city for treatment if they should choose.
So that's where I specialize in that linkage to care.
um speaking to the community at large there are community members in the neighborhood that i
personally treated at prevention point for medical care after their hospitalization because they
didn't have insurance and could not afford medications that were life-saving for blood
clots they did not have substance use disorder they were not there for hiv or hepatitis c there
were community members that needed a bridge to care until their insurance was activated and it
could take 30 to 60 days for that. As far as public health, last year we treated, and it was
an outbreak of infectious disease, diarrhea shigella, where once we got the information
from the hospitals what antibiotics worked, we were able to treat patients without sending them
to emergency rooms. We were able to start treatment quicker, you know, kind of dissipating the outbreak.
um when patients need skin grafting for these wounds so partnering with and being on staff at
temple temple one of their requirements for skin grafting and healing of these wounds is the
Temple, one of their requirements for skin grafting and healing of these wounds, the requirement is that patients be outpatient for six weeks before they can skin graft them.
requirement is
So it would break the barriers for the skin grafting and the healing of the wounds.
Part of prevention point is that base that we can affirm that the patients are getting, you know, MOUD or substance use treatment, that they can then follow up for these appointments to get this medical care.
So these caseworkers also make sure that they are compliant, get the medical care that they need. We also will supervise medication adherence. So that again is a public health issue as well. And I think that kind of summarizes some of the care.
Yeah. And the last question I have is the same I asked for Dr. Meissner. Can you just speak to what the impact would be of reducing the medical services at the property from group medical care to only allowing a solo practitioner and one physician at the property?
So it would really be devastating to the population and the community. And the reason
why I say the community there, because if you lose the patients to treatment, the risk of HIV
hepatitis C increases. The transmission, viral loads, which makes it, there's more of an impact
to the community because these patients are still there, but not receiving the care that they need.
So we're not suppressing the viruses. We're not reducing the transmission, you know, and again, these are contagious diseases, infectious diseases that, you know, affects the community at large.
There would be people that would not be with us.
They, again, we, they do resuscitative efforts there.
These patients would be dying on their doorsteps, quite honestly.
I have no further questions for Dr. Van Sant.
Questions?
I just have a question. What's the patient load?
uh it varies again because it's a low barrier and and really the clients will come um at the time
so i may see eight people in four hours i may see 10 people in four hours i could see two or three
in four hours um for the entire facility which is what's the patient load on a daily basis
so you mean just for the medical care just in general for the facility
That I don't know.
I'd have to ask Sylvana for that because you're talking about case management.
You're talking about drop-in services for housing, for insurance.
And again, it is the community as well as, you know, patients that are unhoused.
Right.
Right.
Dr. Van Sant, do people walk in just, you haven't seen them before they come in to see you?
I'm sorry, I didn't understand the question.
But what I'm saying is for people that are coming in, do they have appointments or they just walk in off the street?
So sometimes we schedule appointments. Sometimes they walk in off the street.
We try to accommodate everyone. So, as you know, even in a regular medical office, right, you could have patients scheduled.
You'll have a couple of no shows or they may show up late. So we really accommodate.
If only doctor's offices were so accommodating.
So I guess my other question is, it's very close to Episcopal Hospital.
Do the same type people walk in the Episcopal Hospital emergency room?
So yes and no.
And allow me to elaborate on that.
So we work very closely with Temple and Episcopal.
I'm on staff there.
So if a patient walks into Episcopal, that patient is either dead or dying because most of our clients will not go to the emergency room for treatment because of stigma, because of, you know, treatment.
Right.
So they'll get sicker when they get into Episcopal and they know they're going to have to wait four, six, eight hours for treatment.
because they're not high on the scale.
They didn't come in with a heart attack.
They didn't come in with a stroke.
You know, they're walking in.
So they're on the lower scale.
So if they're there, that's because they're dead or dying.
But if they get there, or if I'm referring them there,
we will bridge that warm handoff.
If I send them to the emergency room, it's because they're sick.
Or if Episcopal gets them, they might say to us,
we have someone who wants to come for treatment.
They'll call me and send them out to us.
And what hours do you have there?
What are the hours of the clinic?
So I believe Sylvana said it's 8.30 to 4.30, except Fridays, they close at 4.
So anytime after that, people wind up going to Episcopal.
Where do they go when they have problems when you're closed?
And Mr. Chairman, I would just like to call Sylvana Mazzella.
I think she's better equipped to answer the after hours.
Oh, sure.
And she has told me that she's prepared to answer some of these questions.
And I also do want to note, she did clarify board member Graham's answer,
and I believe Dr. Van Zandt did as well, that they do not see any patients under the age of 18,
no children. Okay, I heard that. Yep, I heard that. Okay, fine. But if we could just call