COUNCIL OF THE CITY OF PHILADELPHIA PUBLIC HEARING BEFORE THE COUNCIL COMMITTEE ON APPROPRIATIONS - - - Room 400, City Hall Philadelphia, Pennsylvania Thursday, May 7, 1998 9:24 a.m. - - - BILL NO. 980193 - Authorizing transfers and appropriations for Fiscal Year 1998 within the HealthChoices Behavioral Health Revenue Fund from the Department of Public Health to the Department of Public Health, the Department of Human Services-Offices of Emergency Shelter and Services, and the Director of Finance - Contribution to School District. PRESENT: COUNCILWOMAN JOAN L. KRAJEWSKI COUNCILWOMAN ANNA CIBOTTA VERNA COUNCILMAN MICHAEL A. NUTTER COUNCILMAN RICHARD T. MARIANO COUNCILMAN W. THACHER LONGSTRETH COUNCILMAN FRANK RIZZO - - - VINCENT VARALLO ASSOCIATES, INC. Registered Professional Reporters Eleven Penn Center, Suite 600 Philadelphia, PA 19103 (215) 561-2220 2 APPROPRIATIONS COMMITTEE - BILL 980193 I N D E X Dean Kaplan. . . . . . . . . . . . . . . . . . Budget Director, City of Philadelphia Commissioner Estelle Richman . . . . . . . . . Health Department, City of Philadelphia Gary Ledebur, Executive Director . . . . . . . Family Resource Network, School District of Philadelphia Pat Redmond. . . . . . . . . . . . . . . . . . Philadelphia's Citizens for Children and Youth Vernard Johnson, Executive Director. . . . . . Healthy Family Healthy Life, Inc., and Bartram Cluster Resource Board 3 APPROPRIATIONS COMMITTEE - BILL 980193 P R O C E E D I N G S
The Committee on Appropriates is now in session. Will the clerk please read the title of the bill.
Bill No. 980193, authorizing transfers and appropriations for Fiscal Year 1998 within the HealthChoices Behavioral Health Revenue Fund from the Department of Public Health to the Department of Public Health, the Department of Human Services - Offices of Emergency Shelter and Services, and the Director of Finance - Contribution to School District. (Dean Kaplan comes forward.)
Thank you. I'm Dean Kaplan, the City's Budget Director. With me today are Estelle Richman, the City's Health Commissioner; Michael Nardone, the Deputy Managing Director for Special Needs Housing. And to my left, Gary Ledebur, who's the Executive Director of the Family Resource Network for the School District of Philadelphia. 4 APPROPRIATIONS COMMITTEE - BILL 980193 We are appearing before you today to offer testimony on Bill 980193, which would make Fiscal Year 1998 budget appropriation transfers within the HealthChoices Behavioral Health Revenue Fund to support two important programs. As you know, the structure of Community Behavioral Health (CBH) provides for the accumulation of certain funds not necessary for the payment of claims, expenses, or the City's reserve, but to provide appropriations for social services and human services in the City. The bill 13 before you today would appropriate $1 million of these reinvestment funds in FY 1998. Commissioner Richman and Deputy Manager Nardone are going to describe each of these projects providing for a winter initiative for the mentally-ill homeless and for the Children's Behavioral Health Services project in the City's public schools in some more detail. What I'd like to say in brief is that the project would, from a sheerly budget perspective, the project -- the legislation would transfer $410,000 to the Health Department, and $90,000 to OESS for the Winter Mental Health 5 APPROPRIATIONS COMMITTEE - BILL 980193 Initiative, and 500,000 for the Director of Finance contribution to the School District for the Children's Behavioral Health Services project. As members of the committee are aware, there was some significant confusion in the process of setting up the program. And as a result, we have established a new process whereby in the future, all CBH reinvestment projects will be submitted to Council in advance.
So, in other words, you'll come to Council before you spend the money.
Absolutely. And, obviously, that will be a change from what happened this time and, we believe, a significant improvement in the process. And, therefore, I respectfully request that the Committee approve the proposed legislation allowing this transfer of $500,000 in CBH reinvestment funds for the Winter Health Initiative and 500,000 for the Children's Behavioral Services Plan. If the Commissioner or the Deputy Managing Director or the Executive Director would 6 APPROPRIATIONS COMMITTEE - BILL 980193 like to jump in, you know, I think they should go now.
Just summarize it, Commissioner. COMMISSIONER RICHMAN: Okay. Essentially, what we're asking to do is transfer a $1,410,000 to the Department of Public Health, 90,000 to the Department of Human Services for the Office of Emergency Shelter, and $500,000 to the School District for a collaborative process between the School District and the community mental health agencies to be able to put a preventive program into the schools for children with behavioral problems. Essentially, I also would like to say we have changed the process to make sure that all of the consideration comes to Council before any of the dollars are allocated. The homeless project did happen this winter. The school project isn't set until after Council's approval of it. And at this point, it would start in the fall of '98. So those dollars have not been spent. But the entire process of looking at 7 APPROPRIATIONS COMMITTEE - BILL 980193 reinvestment dollars will be before Council before any dollars are spent in the future.
Can you give me a list of those schools affected by this? COMMISSIONER RICHMAN: Yes, I can.
What are those schools? COMMISSIONER RICHMAN: Gary? (Gary Ledebur comes forward.)
Gary Ledebur, from the School District. Cooke Middle School, Olney High School, Central High School --
Cooke Middle School, Olney High School, Central, Steel, Birney, Cooke, Shellcross, Sharwood, Frankford, Hunter, and Heston.
Yes, I do. Can 8 APPROPRIATIONS COMMITTEE - BILL 980193 you tell me what criteria was used in selecting these schools? I would certainly think that a school such as Audenried would be included. COMMISSIONER RICHMAN: There was -- we have a couple different initiatives going actually targeted Audenried as a special project, outside of CBH money for this year, and we have a full-time person now at Audenried to facilitate all the behavioral projects at Audenried. And the two school clusters that we chose to work a special project through, not using reinvestment dollars, has been Audenried and Olney. If you would like to know more about what is happening at Audenried within the special projects, I do have Harriet Williams, and I think Gary also knows the activity going on with Audenried.
How does the program presently being conducted compare with what is being proposed today? COMMISSIONER RICHMAN: How does what we're doing at Audenried compare? It's much more comprehensive and much more inclusive because it takes the entire cluster rather than just the 9 APPROPRIATIONS COMMITTEE - BILL 980193 school, and it's designed to do an outreach to many more children than just these two projects. Can you put a dollar figure on what we're doing with Audenried this year?
Not off the top of my hand. It's an extensive project. COMMISSIONER RICHMAN: It's an extensive project. And we've used some of our federal grant in that cluster also. That particular project started last fall.
And it will continue until next year? COMMISSIONER RICHMAN: Oh, it's an ongoing project.
It's an ongoing program? COMMISSIONER RICHMAN: Yes. But we chose to do that with our allocation dollars coming out of the Office of Mental Health as opposed to reinvestment dollars.
And how do the dollars compare? COMMISSIONER RICHMAN: I mean, we've hired -- this one is for -- I will bring Harriet 10 APPROPRIATIONS COMMITTEE - BILL 980193 up, but it's for consulting and doing some preventive project. With the Audenried one, we hired a full-time staff and we have a whole range of activities that are going in to facilitate children being identified that have behavioral problems, getting them into design programs, providing case management services to them, and doing a whole range of activities, as opposed to just a small $50,000 project. In other words, these from reinvestment, each school is doing sort of a resource room for 50,000. For Audenried and Olney, we put in full-time staff to do ongoing activities that are far-reaching around the entire cluster. So it's a different project but much more intensive and much more inclusive .
How many respondents were there to the RFP for the School District? (Harriet Williams comes forward.)
There were 37, and the process -- 11 APPROPRIATIONS COMMITTEE - BILL 980193
I'm Harriet Williams. I work in the Office of Mental Health. We put out a request for proposal that required schools to work collaboratively with the behavioral health provider, and 37 schools responded to it. And a committee that included Parents Involved Network, other advocates, the School District, and our office, read and rated all 37 proposals. The names of the schools you heard are the schools that produced the best proposals.
Okay. Why are we -- why is this transfer ordinance coming to us so late? COMMISSIONER RICHMAN: In the beginning, we had not set up a process under -- we had not set up a process between the Health Department and Council to know how we were going 12 APPROPRIATIONS COMMITTEE - BILL 980193 to move these dollars. And that's why the project has been postponed for a year for the School District. Those dollars have not been expended and have not been spent at all. In the case of the School District, dollars have not been committed. We've done the RFP process so we know where want to spend them, but none of the dollars within the school project have been expended. We did expend the dollars on the homeless project, but we were trying to do something for the homeless during the winter. We now will have all of the activity and will hopefully -- we will ha e even the winter activity before Council before we do any more expenditure of dollars. But the school dollars have not been spent.
How do you justify the fact that of the $22.5 million in savings, only $1 million is being spent or used for services? COMMISSIONER RICHMAN: Of the $22 million, we are under contractual obligation to the State to put 14.5 in a reserve that we cannot touch. So 14.5 of that 22 million is in a 13 APPROPRIATIONS COMMITTEE - BILL 980193 reserve. That's a one-time reserve that the State has required us to do. We have 7.2 million that we have established out of that million to have a risk 6 and contingency fund within the City just in case 7 there are any overruns or dollars that we need for 8 any -- if we have -- $7 million in reality only 9 would cover us for one month of activity if the 10 State didn't pay us. 11
I thought we were 12 not assuming any risk. 13 COMMISSIONER RICHMAN: We aren't, but 14 we -- 15
Why are we putting 16 the 7.5 million aside? 17 COMMISSIONER RICHMAN: If the State 18 were late on payment to us, we would need those 19 dollars to be able to pay the bills that come in 20 for the providers that pay that service, so we 21 need to maintain an ability to have cash flow in 22 case there's any unforeseen activity at the State. The State is very well known for being late on its medical assistance payments as we move towards June 30th. But the providers within the 14 APPROPRIATIONS COMMITTEE - BILL 980193 system still need to be paid for the services they are providing. So our being able to maintain some kind of contingency funds makes sure that we can always keep cash flowing to hospitals and other community providers that are small and need that continual cash flow. So we're trying to make sure we can meet all of the contractual needs we have to pay the provider system, have put aside the one-time State contingency, and are now beginning to put forth a plan for reinvestment.
Madame Chair, if I may, I would ask that we be given list of schools that have been selected. I know they were mentioned.
I could not write them as quickly as they were being said. COMMISSIONER RICHMAN: I will give you a copy of both the process, the activities, and the names of the schools.
Yeah, give one 15 APPROPRIATIONS COMMITTEE - BILL 980193 to each member. COMMISSIONER RICHMAN: Yes.
All right, thank you. Are there any other questions? (No questions.)
Thank you. Is there anyone else here to testify for or against this bill?
Could I say a few words from the School District on the School Link behavioral health project?
Absolutely. You know, City Council, the Commissioner, the Mayor are all to be commended for taking the risk in doing community behavioral health. I was at Audenried just the other day and talking to kindergarten teachers, and kindergarten teachers are talking about students that are acting out, that are hitting; older elementary kids that are experimenting with drugs. 16 APPROPRIATIONS COMMITTEE - BILL 980193 The school folks have to work in a very complex system of regulations, State and federal regulations that allow us to spend hundreds of thousands of dollars on kids that have very serious problems, but it makes it very difficult to spend on kids that are in kindergarten if we reach early can be helped. And through these projects, as well as the Audenried and Olney projects that the Commissioner talked about, we're able to reach out to students at an earlier stage and help them before they become more serious and more expensive. So I would urge Council to support that.
Do we have any of the schools in Southwest Philadelphia under this program?
Mental health projects that are in South Philly, we have them in -- spread across --
No, in the southwest. 17 APPROPRIATIONS COMMITTEE - BILL 980193
It's not in Southwest Philadelphia. They are -- our mental health projects are largely -- we've got several in Audenried, the South Philadelphia and Furness clusters.
All right, thank you. Is there anyone else to testify for or against this bill? Thank you very much.
Pat Redmond, representing Philadelphia's Citizens for Children and Youth. And because of the present business, I have prepared testimony which I'd like to submit. And I'd like to emphasize that Philadelphia Citizen for Children and Youth has heard repeatedly from school nurses and counselors and 18 APPROPRIATIONS COMMITTEE - BILL 980193 parents who support additional services located in schools.
Do you have copy of that, that we can submit for the record?
Well, just a minute, someone will get it for you. Thank you very much. Is there anyone else here who wishes to testify for or against this bill? (Vernard Johnson comes forward.)
Good morning. My name is Vernard Johnson. I'm the Executive Director of Healthy Family Healthy Life, Inc. I'm also a member of the Bartram Cluster Resource Board. And I don't have enough information on the bill to testify for or against it, but I certainly wish we would have had more information. I certainly wish that the Bartram cluster of schools would have received information so we could have received it. And I want to say this: That the 19 APPROPRIATIONS COMMITTEE - BILL 980193 School District has needs in a lot of other places regarding the health care of children. They're laying off hygienists, there are not enough nurses in schools, and maybe that is where we should be going. And if we think it's important to have behavioral health services in the school buildings, let me remind you that at least 60 percent of the students in the Philadelphia school system, by ninth grade, drop out. And that we're not only talking about -- when we're talking about children, we shouldn't only be talking about children who are in the public school system; we do have a parochial school system. And that we need to be considering providing services to those children, as well. And I want to close by saying this: The children that we work with who are having severe problems are the children who dropped out of school, so there needs to be some connection between CBH and behavioral health and the kids who are walking the street corners every day and are practicing in some sense criminal behavior. And 20 APPROPRIATIONS COMMITTEE - BILL 980193 those kids we need to save as well. And I think it's a disgrace that they would come here and not be able to provide you with a list of schools and tell you why they've chosen those schools over other schools in the District. And that's really -- that's all I want to say. But this whole system of practicing psychiatry in schools is something that we have been to this Council before and again and again on. And it doesn't work in schools. And the parents aren't going to go to schools and be involved in the effort to get their kids better if the schools don't change the way they receive parents. And so I'm not for or against -- I'm concerned. And we just found out about it sitting over here. And psychiatry in schools is something that hasn't work3ed, especially in the School District of Philadelphia. And we came here with this question around Ritalin and Prozac and how they prescribe drugs. You mean to tell me that we can't deal with kindergarten children without 21 APPROPRIATIONS COMMITTEE - BILL 980193 practicing psychiatry on 'em? That our kids are in such bad shape that we can't educate and teach 'em without practicing psychiatry? And if they need psychiatry, then in fact, we should be working with the parents to make sure it's being delivered in the communities.
Thank you very much for coming in. I appreciate your testimony. (Applause.)
Is there any more questions or any more testimony for or against this bill? (No response.)
That ends our public hearing. Now we'll go into our public meeting. - - -
Madame Chair, I move that Bill No. 980193 be reported out of this committee with a favorable recommendation, and a further recommendation that the rules of Council be suspended so as to permit first reading at our next session. (Duly seconded.) 22 APPROPRIATIONS COMMITTEE - BILL 980193
And I will vote in favor of it only if I receive the information that we asked for. And I would like to know, if Olney was one of the schools that was chosen and they are now chosen for next year, why wouldn't Audenried also be included?
They have another week, Councilwoman, before we pass this bill.
Well, I would like to have that information prior to next week's vote.
Absolutely, absolutely. Therefore, Bill No. 980193 is voted out of this committee with a favorable recommendation, with a suspension of rules so as to permit first reading at the next session of Council. Thank you all very much for coming. (Adjourned at 9:43 a.m.) - - - 23 C E R T I F I C A T E I HEREBY CERTIFY that the foregoing proceedings of the Council of the City of Philadelphia of Thursday, May 7, 1998, were reported and accurately by me, and that this is a correct transcript of same. RE: COUNCIL COMMITTEE ON APPROPRIATIONS BILL NO. 980193 __________________________________, JOSEPHINE CARDILLO, RPR