COUNCIL OF THE CITY OF PHILADELPHIA COMMITTEE ON PUBLIC HEALTH AND HUMAN SERVICES Remote location using Microsoft® Teams Tuesday, November 21, 2023 10:00 a.m. PRESENT: COUNCILWOMAN CINDY BASS, CHAIR COUNCILMAN MICHAEL DRISCOLL COUNCILWOMAN QUETCY M. LOZADA
Thank you and good morning. Before we begin the public hearing, I will make the following announcement: City Council Committees are currently meeting remotely. We are using Microsoft Teams to make these remote hearings possible. Instructions for how the public may view and offer public testimony at public hearings of Council Committees -- of public hearings of Council Committees are included in the public hearing notices that are published in the Daily News, Inquirer and Legal Intelligencer prior to the hearings and can also be found on PHLCouncil.com. I now note that the hour has come. Clerk, will you please call the roll to take attendance. Members that are in attendance will please indicate that you are present when your name is called. And also, please say a few brief words when responding so that your image will be displayed on screen. Madam Clerk.
Thank you. A quorum of the hearing is present and the hearing is now called to order. This is the public hearing of the Committee on Public Health and Human Services regarding Bill No. 18 230649 and Resolution No. 230753. Bill No. 210227 will be held at the request of the sponsor and will not be heard today. Madam Clerk, will you please read the title of the bill that is being considered today.
Bill No. 230649, an ordinance amending Chapter 6-400 of The Philadelphia Code to end the unlawful deportation of noncitizen patients by hospitals to the patient's country of origin without their consent. Thank you.
Before we begin the hearing today, I would just like to let everybody know that we will hear testimony on the bill, recess the public hearing into a public meeting to consider the actions to be taken on the bill and then return to the public hearing to hear testimony on the resolution. Before we begin hearing testimony from the witnesses we have for today, everyone who has been invited to the meeting to testify should be aware that this public hearing is being recorded. Because the hearing is public, participants and viewers have no reasonable expectation of privacy. By continuing to be in the meeting, you are consenting to being recorded. Additionally, prior to recognizing Members for the questions or comments they have for witnesses, I will note for the record at this time that we will use the chat feature available in Microsoft Teams to allow Members to signify that they wish to be recognized. In order to comply with the Sunshine Act, the chat feature must only be used for this purpose. Before I call the Clerk to call the first panel, would any of my colleagues like to make any opening comments? Councilman Harrity, did you want to making an opening --
Thank you everybody. Thank you everybody for coming. In the pursuit of justice and fairness, we introduced legislation to end the unjust practice of hospitals deporting residents of other countries in violation of their human rights. This initiative ensures that individuals regardless of their background receive fair and ethical treatment in the City. You know, I've said time and time again I don't believe this is an immigration issue. I believe this is a human rights issue. We should not be -- people that really shouldn't be traveling in the first place, sending them back to a country that probably can't treat them in the first place. They're here. Most are paying state and City taxes. You know, I just don't get it. So I please ask you to please support this bill.
Thank you, Councilman. We appreciate your heartfelt thoughts on this matter, and it is something to be taken very seriously. We know that medical care really can be life or death. And so, this is something that's not to be taken lightly. You know, everyone who is connected to, you know, who will be affected by this bill can speak to how important just basically having the ability to see a doctor, to know that your health care doesn't compromise your immigration status, to know that you're being provided with the best medical care possible regardless of what your status is. So we thank you for bringing this bill to light, to us, to the Council and look forward to hearing from today's testifiers. And with that being said, I'm going to ask if there is anyone else on Council that would like to make an opening remark? (No response.)
And not seeing any, I'm going to ask the Clerk if she will now call the first panel of testifiers.
Good morning, Chair Bass and members of the Committee of Public Health and Human Services.
I'm Dr. Cheryl Bettigole, Commissioner for the Department of Public Health. Thank you for allowing me to testify on Bill No. 230649 as it is proposed. This bill would ban the practice of involuntary medical repatriation within the City of Philadelphia. Generally, medical repatriation refers to the transfer of a foreign- born patient from a U.S. hospital to a hospital in the patient's own country. Although the information available on such transfer is limited, in my experience they typically take place when a patient who does not have U.S. citizenship or other authorized status experiences severe and prolonged illness and is unable to be discharged from the hospital where he or she is receiving care. Occasional hospital administrators respond to this situation by pursuing repatriation in an effort to stop ongoing costs to the hospital. Unfortunately, this decision often results in a poor outcome for the patient who may receive a far different standard of care in his or her own country than was being provided in the U.S. hospital. And the consent process for such repatriation efforts is sometimes deeply troublesome from an ethical standpoint. Coercion often through threats of thousands of dollars in medical bills or reports to immigration authorities and failure to address with (inaudible) or cultural barriers can be factors that leave families and patients at risk for involuntary medical repatriation. Bill No. 230649 offers important steps to prevent these cases. Hospital administrators attempting to pursue medical repatriation would be required to notify the Department of Public Health at least 10 days prior to transferring a patient. That consent in the preferred language of the patient or caregiver would be required and coercive practices would be prohibited. Hospital staff pursuing such repatriation efforts would also be required to offer the patient and/or caregiver assistance with applying for insurance, including emergency medical assistance if eligible. None of these measures are perfect. Until our country addresses the gap in health insurance access that impacts millions of noncitizens, we will continue to see immigrants at risk of involuntary medical repatriation if they experience a severe health condition and long-term hospitalization. However, these are important steps forward to prevent coercive transfers of patients without true consent to countries that cannot provide the health care they need. Thank you for this opportunity to provide testimony on this important issue.
Well, thank you, Dr. Bettigole. We appreciate your medical expertise and weigh-in on this very much. Thank you. We're going to hold questions until the end. Madam Clerk, is there anyone else on this panel to testify?
Yes. Next I'm call up Claudia Martinez who will first read her testimony and then Julio Rodriguez will be translating in.
Good morning, everyone. My name is Julio Rodriguez. I'm with the Pennsylvania Immigration Citizenship Coalition and I'll be translating on behalf of Claudia, a community member who you just heard from. Dear members of the --
Before you proceed, I'm sorry, Julio, if you could pause for one quick second. Member Lozada, did you want to speak now or after the translation?
If I can speak now just because I'm almost getting ready to disconnect.
And I'm going to say it in Spanish. Julio can translate in English. This is more so for Claudia. (Response in Spanish). Thank you, Madam Chair.
Thank you. Thank you, Councilmember. Julio, would you like to translate?
Sure thing. And I will also do my best to translate Councilmember Lozada's remarks. Good morning, everyone. My name is Claudia. Dear members of the Philadelphia City Council Public Health Committee, my name is Claudia Martinez. , the patient a local hospital tried to deport in 2020. I'm speaking in support of Bill No. 230649. This is my testimony of what happened on Monday, May 11, 2020. m. He had been hit by a motorcycle on Roosevelt Boulevard as a pedestrian. When I showed up at the hospital, I wasn't (inaudible) my uncle. He was on a stretcher connected to several machines. He was unconscious and he had severe injuries all over his body. At that moment I went into shock. It was a very strong impact to see my uncle between life and death. They didn't allow me to spend much time with him and it took me out because it was in the middle of pandemic. The next day I called but the hospital did not answer and it was difficult to get someone on the line, so I started calling every single day to find out about him. I always tried to ask for an interpreter because it was very difficult for me to communicate in English, but the hospital wasn't adept in interpreting. Shortly after one of the doctors stated they were preparing to discharge my uncle because he had only two weeks left in the hospital. My family and I were shocked. We didn't know what was happening because we looked at him and he was in really bad shape. The hospital told us he couldn't talk anymore but the hospital was preparing everything. A nurse mentioned to us that they told her that my uncle's wife had authorized the removal. That wasn't possible because his wife was in Guatemala and she does not speak English. In the second week of June 2020 I received a call from the hospital social worker who asked me, what is your uncle's immigration status. When I responded, she told me that they had already prepared everything to discharge him. I asked her to please provide me with an interpreter because I did not understand and she never called me back. The next call I received was from a worker from the MedEscort air transfer company that the hospital hired to remove my uncle to Guatemala. Neither the hospital nor MedEscort had authorization to do this. My uncle was still unconscious. He couldn't even ingest food and I was in charge of making medical decisions for him. The man at MedEscort told me that they had contacted hospital in Guatemala where they would take him, which we discovered was a lie. They also lied when they said that his wife authorized his departure. Everyone in the family was really confused. The person (inaudible) my uncle called me speaking in Spanish and threatened me several times. He told me to cooperate and to not make things more difficult. They insisted that I sign to move my uncle. When I told him that I did not consent because I saw my uncle in very bad condition and because in Guatemala the hospitals were saturated with patients due to COVID-19, he threatened me. He told me that if I didn't sign he was going to leave my uncle's body outside of my house. This experience is very difficult and no one should feel the way they made me and my family feel when our family member was near death. The hospital called me a week before June 24th and assured me that everything was already scheduled to move my uncle. When I saw my uncle, he was intubated and unconscious. I felt so much pain and sadness seeing him there connected to tubes through his neck, his stomach and throughout his body. My uncle is alive and has been able to receive treatments and improve his condition thanks to God and the efforts of the entire anti- medical deportation team. Today I will also say end medical deportation and the community united. A big thank you to Councilmember Harrity for introducing the bill. We really appreciate him. Today I ask the Committee and all the counselors to vote in favor of 230649 to protect immigrant patients like my uncle.
Members of the anti-medical deportation campaign including myself has done a lot of work to educate the community about this inhumane practice. No hospital in Philadelphia should separate an injured person from their support network. This bill will give people the information that they need to make the best decision for their family. Thank you for listening to me. And then Councilmember Lozada's remarks were saying, sorry for your family, what you have experienced and I'm glad your uncle is doing better. Our hope is that this does not happen to another family and thank you to your strength and thank you for being a voice in the community. Thank you.
Thank you. Thank you for that translation. And, you know, we thank Ms. Martina -- Claudia Martinez for sharing her story, which is just, you know, it's -- no one should be treated as her uncle was treated. Totally, totally unacceptable. Chair recognizes Councilman Harrity.
Thank you, Madam Chair. I just wanted to point out what was actually said there. Claudia's uncle was hit by a motorcycle while on Roosevelt Boulevard in the City of Philadelphia by most likely a resident of Philadelphia. And if that's not our responsibility, I really don't know what is. So thank you, Claudia, for your testimony.
We are going to -- just in light of trying to stay on schedule, we are going to ask folks to keep their testimony to two minutes. Try to just summarize your testimony so that we can get -- we have a very lengthy list of folks who would like to testify so we are going to ask that you move quickly through your testimony so that we can get the vote we would like to have so we can have this heard on the Council floor. So the next speaker, was it Ms. Lee?
I will try to be really brief here. Thank you so much, Committee, for considering my testimony. My name is Jennifer Lee. I'm an Associate Professor of Law at Temple Law School and I run something called Social Justice Lawyering Clinic at the Sheller Center for Social Justice and we're involved with working closely with immigrants and communities, organizations that provide legal support to help create systemic change for these communities. And I appreciate the opportunity to testify today about the City's practice of medical deportation. Since many others will address the actual practice, I wanted to focus my comments a bit on the proposed ordinance. I'll discuss what the bill does, potential preemption and why the bill was such a historic step forward for Philadelphia. So there are three key things that I've already mentioned that the proposed bill does. And I just want to talk about why these three mechanisms I think will be effective in helping to address this issue. So the first is the informed consent feature that really is the idea of moving it in a way of being this coercive practice to one where people are required to give informed consent, which includes things like meaningful language access, preventing best representation, medical options available to patients. And it's not a very onerous process for hospitals to have to employ to get informed consent for patients. The second is about reporting. And reporting is really important in this context because this is such a hidden practice. Once folks are deported, we don't hear about them unless that somehow folks are connected with the community or organization. And so, being able to collect information and get reporting from hospitals when they're engaging in repatriation to ensure that they're not engaging in medical deportation practices as we heard from Claudia, is something that I think will be an important component of this bill, and again not incredibly onerous requirements for hospitals as they already are subject to multiple forms of health reporting. And finally, it provides an avenue to actually file a complaint about a medical deportation practice. So just so folks know, currently the only option for victims is to really try to shoehorn their complaints under something like tort law and make a claim for false imprisonment, so this ordinance would actually provide victims with the ability to bring a claim directly to court for violations of this practice. Finally, just a quick comment on preemption. I know we're always worried about what the City's authority is when an enacting ordinance are in new areas. I just want to say there's a federal law that's kind of close on this subject that's called the Emergency Medical Treatment and Active Labor Act known as EMTALA. But what's important to note is that EMTALA explicitly states that local law may regulate in areas if there's a direct conflict with federal law. And none of these requirements appear to conflict with federal or state law. And just a final comment, which is there's no law in the country that I'm aware of that does anything similar. And it's pretty safe to I assume that neither the federal government or Harrisburg will be taking on this issue any time soon. So in keeping with Philadelphians' longstanding commitment to welcoming immigrants and recognizing their contributions to our City, this ordinance will help to end this inhumane practice of medical deportation. Thanks for considering my testimony.
And thank you very much for your testimony. We appreciate your expertise and your ability to help us break it down. So thank you very, very much. Very helpful. Madam Clerk, does this complete the panel of witnesses, the first panel?
So I'm going to ask that you call them in panels of three.
Okay. So it will be Dr. Rachel Tally, Jonny Rashid and Cathryn Miller-Wilson.
Good morning. And I'm going to be brief because I know that we are low on time. My name is Rachel Tally. I'm a psychiatrist and an assistant professor on the faculty of the Perelman School of Medicine at the Department of Psychiatry at the University of Pennsylvania. , and I'm part of the leadership team through psychiatry training at UPenn's Department of Psychiatry, and I'm testifying in my own capacity. And so, the views expressed here today do not necessarily represent those of the University of Pennsylvania Health System, the Perelman School of Medicine or Horizon House. I'm here today to testify in support of Bill 230649 to combat the deportation of noncitizen patients by hospitals to the patient's country of origin without their consent. As a health care provider, I feel that bills like this are critical to ensure that our health care systems are following the ethical standards that are foundational to the practice of medicine, including our obligations to respect patient autonomy to do no harm and to advocate for justice in the form of equal treatment for all patients. In light of incidents of medical deportation reported as having occurred in Philadelphia in recent years as well as in 2021 from the Free Migration Project and the University of Pennsylvania's Law School's Legislative Clinic documented hundreds of instances of this practice across the country. I'm very concerned that the rights of our noncitizen patients are being violated and we do not currently have enough processes in place to routinely track for and address these violations. This bill provides important safeguards both to better characterize the frequency of medical deportation and to ensure that there are enforceable consequences for health care systems that engage in this harmful practice that restore health outcomes and traumatization of vulnerable patients and families. And my opinion one of the main strengths of the bill is that it goes beyond simply tracking to include mechanisms for enforcement and accountability, in particular a mechanism for patients and families to make a report that there's a concern for a violation of their right to informed consent. Enforcing provisions like this are critical to ensuring that patients and families are receiving truly informed consent and have avenues for redress in the event that this does not occur. In my clinical work, I provide services to lower-income individuals with disabling mental health conditions predominantly of a racial ethnic minority background. These are individuals who particularly are vulnerable of being taken advantage of by our systems of care. And I often hear from my patients that they feel misunderstood or unheard in health care encounters, including feeling that they do not always receive adequate explanations for health care recommendations and decisions. And it is my experience that even when health care providers come with the best of intentions to fully explain a health care decision, we can fall short in truly ensuring that a patient understands all of the factors to consider in making their decision. Noncitizen patients are predominantly of a racial ethnic minority background and may disproportionately struggle with barriers to informed consent such as limitations in health literacy and English proficiency. For a health care decision as significant as to whether to be transported to another country to receive services for a critical injury and illness in a different setting, we simply cannot allow for there to be any margin of area in terms of these most vulnerable and marginalized patients to fully understand and consent to the decision being presented to them. And health care systems need checks and balances to make sure that they are holding themselves accountable in respect to patients' rights.
And finally from a mental health standpoint, noncitizen patients often struggle with higher rates of mental health conditions, including depression, post-traumatic stress disorder and anxiety often related to traumatic experiences in their home countries. Deportation, particularly when it leads to separation of families can absolutely exacerbate mental health conditions both for the person subject to deportation and the family that is left behind in the United States to cope. Enacting to prevent the practice of medical deportation, our system can play a critical role in stopping an unjust practice that potentially contributes to the retraumatization of vulnerable patients who may already have higher rates of mental health conditions owing to adverse life experiences. And so, in closing I urge you to support this bill to protect the rights of Philadelphia patients. And thank you for your time and your consideration of my testimony.
Thank you for your testimony today. Very informative. Can we have the next witness who has been called forward to testify. State your name for the record and proceed.
He's waiting to be let in. In the meantime since Jonny isn't in yet, we can hear from Cathryn Miller Wilson from HIAS, which is the Hebrew Immigrant Aid Society.
Yes. Good morning. Thank you so much for inviting me to testify. My name again is Cathryn Miller Wilson. I'm the Executive Director of HIAS Pennsylvania. We provide immigrant legal services and social services to immigrants and refugees in PA. Last year we helped people from 165 different countries. I have submitted detailed written testimony. In the interest of time, I'll just summarize those points today. Eventually three reasons why I want to testify in support of this bill: It's a bill that promotes public health, it's a bill that promotes economic security and it's a bill that has a moral imperative. So a couple of points: Immigrants, particularly those that are undocumented -- and to be clear, so many undocumented persons are people who are eligible for deportation and in fact have already filed for documentation. But the law have used them as undocumented and typical years and years and years after filing a petition when they're granted legal status. That's an important thing to recognize. But in any case immigrants, particularly documented immigrants, have fears already of accessing any public system, including public health care. And as we just saw, we're just coming out of the pandemic people who avoid treatment and diagnosis can be a danger not only to themselves but to their communities and their loved ones. So the last thing we want to do is enable a system that would reinforce those fears. So there are really critical public health reasons to support this bill to ensure that immigrants get the message loud and clear that you will not be at risk if you seek treatment. Economically I also want to point out that unfortunately while most hospitals have social workers whose very job is to try to find payment options for those who are unable to pay, the truth is between language access problems and just sheer ignorance, all too often they shrug and say there's no option, there's no way to pay, which is what drives hospitals to this terribly draconian decision. In fact, my understanding of the deportation that was stopped by the Free Migration Project was one of those very instances. After the dust settled, in fact the person was eligible for emergency medical insurance but they were this close from deporting him because they felt that they had no option for him to pay for medical care. So I really think that a system that makes sure that people really investigate the options that are available is critical. We should not reinforce kind of bad social work, if you will. And then finally, the more imperative I think is fairly obvious. Someone who is in critical condition should not be put on a plane and deported potentially for their death between the fact that they're in critical condition and the fact that they will end up in a country that they fled from, you know, is a certain double reason why this should not happen. So again, I thank you very much for the opportunity to testify. I hope you'll read my full remarks and support this bill, which is really important. Thank you very much.
And thank you so much. And we'll make sure that the bill -- that your testimony is circulated to all the members of the Committee and it is digested. Thank you.
That will be Jonny Rashid. He's the pastor with West Philadelphia Mennonites.
I think you're on mute. I think you're on mute. I can't hear you.
I see you're talking, but we can't hear you. COUNCIL TECH SUPPORT: You might have to go to your audio settings and change to your --
No 12 problem. We hear you now loud and clear. Please state your name for the record and proceed with your testimony.
Jonny Rashid, Pastor for West Philadelphia Mennonite Fellowship. I'm also a child of Egyptian immigrants. Ending medical deportation in Philly is important and personal to me. Because of my heritage and my background, we know it's a practice that's used by hospitals that deport immigrants in the United States without consent or even through coerced consent of the patient and family. They charter private flights to transport undocumented patients to their country of origin to avoid having to pay long-term medical care. I had a grandma who could have been vulnerable to that. So this is the first in the nation built to end that practice, so that's a wonderful thing, the bill prioritizes the rights of immigrants that need health care and receive in-language information and decision-making power. It provides a lot of important oversight of the practice of medical repatriation and it ensures that patients and families can get the information they need in a language they can understand to make the best decision for their families, for their care and with full consent. And it makes sure that there are ways to hold bad actors accountable and that creates a pathway for the City to enforce legislation and levy fines on those who violate patients' rights. It puts an end to international patient dumping. Patients and their caregivers should have the option to choose or decline repatriation and be given support to apply for emergency medical assistance if they choose to seek care in the U.S. In Pennsylvania, these patients have options and hospitals should give patients all the information they would need to make decisions about their health. Enforcing deportation can result in death. It can aggravate illness and injury. Medical deportations can occur even if the patient is not in the condition to travel safely or receive adequate care in their country of origin. They separate patients in critical condition from their families. There's an issue of justice, it's an issue of compassion. It's unconscionable, especially in a city like ours that wants to be a sanctuary city, wants to care for migrants. Immigrants are the least of the siblings among us. As Jesus my Lord says, he is within. So when we care for them, we also care for God. And Jesus himself was an immigrant. So for me, I have a religious conviction about this too so I feel it as a Christian duty and also as an immigrant to implore you to pass this bill through the Committee and get it on the floor. Thank you.
Well, thank you. Thank you for your testimony and your important perspective on just how important it is that we pass this bill out of Committee. Thank you for being here today and for taking the extra time to have some patience with us as we work through the technical difficulties. So thank you so much.
Absolutely, absolutely. Keelan, do you want to call up the next panel.
The next group will consist of Sameer Khetan, who is a licensed social worker and a psychotherapist; Professor Lewis Rulli, who is a law professor at UPenn; and Medha Makhlouf who is a law professor and Director of Medical Legal Partnership Clinic at Penn Law School.
Thank you all for being here. If we could have any one of you, if you want to state your name for the record and proceed. I'm going to ask that you condense your writing. Again, you can put it in writing and we will digest it. Only because we want to make sure that before we lose a quorum that we can have enough votes to be able to pass this bill today so we really need to move along a little bit faster. So thank you for being here and please state your name for the record and proceed.
Good morning. My name is Sameer Khetan. As mentioned, I'm a psychotheraptist and licensed social worker in the state of Pennsylvania. I want to zoom in just a little bit, and this was touched on earlier, in our field all types of approaches of practictioners are diverse. A commonality of our work is trauma. It is in helping clients identify and safely address hurt experience in their lives. And when left unaddressed, the legacy of that trauma remains, actually shedding on how we think and how we feel every day. Trauma doesn't only look one way. It is person-to-person and cannot be singularly defined or measured nor can it be predicted on any given kind of hurt, whether it's living in a war zone or experiencing childhood neglect or bullying might lodge within a person and affect them in the short, medium and long-term. The family at risk of medical deportation or lack of sufficient resources, how much trauma have they already likely endured by virtue of being in their current circumstances. The father and mother who is actually deported or suffer significant medical ailment not having sufficient care, are we considering the trauma we are creating not just for the parent but the entire family and likely compounded by further access for the lack of access to resources and care. We might normalize this impact when we shuffle people through systems, but the trauma we create is lifelong and it's critical for us to keep it in a full unadulterated view. I'm just going to repeat that last bit. This is really, really important because none of us are immune to this tendency even though as we view this work every day. We might normalize the impact of trauma, dilute it when we shuffle people through systems. But the trauma we create is lifelong and it is our duty to keep that full unadulterated view. Thank you.
Thank you. Thank you for that testimony. Thank you for that very important testimony. Can we have the next panelist please state your name for the record and proceed.
Good morning. This is Lewis Rulli. I'm a University of Pennsylvania Law Professor.
It is my pleasure and I thank you for the opportunity to testify this morning, Chair Member Bass, Councilmember Harrity. I applaud you for this very important bill. I direct the Legislative Clinic and the Civil Practice at the University of Pennsylvania Law School and I've also prior to coming to Penn was the Executive Director of Community Legal Services here in Philadelphia. So for the last almost 50 years I've served low-income vulnerable Philadelphia residents, and that's why I'm here today to say that this bill deserves your full support. It is critical. Two years ago two students in my Legislative Clinic prepared a comprehensive report on medical deportation. I think it was aptly called Fatal Flights, and that was in conjunction with the Free Migration Project and I've provided that along with written testimony for the Committee. I'm in support of Bill 3 230649. Because we're short on time, I just want to emphasize two points: Number one, in my experience I have found that medical deportation like many other practices that are nefarious operate in the shadows and outside of public view. And when you have strong financial interests as we do here of hospitals, to sacrifice medical care, and that's pitted against the health care needs of Philadelphia residents, it's time for Philadelphia City Council to step up. And that's why I'm so proud of this bill and of this effort to be the first in the nation to address medical deportation. , a very compelling case here in Philadelphia. You know, just three years ago Philadelphia City Council stepped up in passing a 2019 ordinance to provide for 180 days before a hospital could close. City Council was protecting the medical needs of our residents, right, against those economic harsh forces that exist. At that time, a City Council Councilmember said, the harsh realities and destructive practices in the health care market means that City Council has got to step up. And you did. You did it successfully. You made a difference and. Now, again you have the opportunity to make a difference and to be the first in the nation to do so. This bill is comprehensive. It has five critical elements and we've heard about it. I'm just going to mention them because they are so critical to really addressing medical deportation, which by the way is really international dumping, right. Let's be frank about what it is. The five elements are that hospitals have to have a protocol that is known to the City Health Department, right. Secondly, that informed consent has to be meaningful. And that meaningful means it's got to be the primary language of the patient. There has to be a notice of patient's rights. There has to be oral and written explanation of those rights, right, with the full explanation of consequences. So informed consent means really no risk and benefits. And that's what this bill requires. Third, it's an opportunity to minimize health risks. You already heard from Cathryn Miller Wilson that sometimes there really is coverage that hospitals are not even aware of from emergency Medicaid in Pennsylvania. And so, reducing of those health risks means really searching for potential coverage, and we have many experts in our health care community that can assist with that. And what about charity care in hospitals? We know that they are underspending charity care, and this is another way that we can address that critical issue. The fourth element is reporting. None of this is really going to work without reporting to the Health Department and the Health Department having the oversight responsibilities. And so, this bill 18 does that. And then finally, just as we've done with every important civil rights issue, we've provided for private enforcement as well as public enforcement with the potential for fines and costs, attorneys' fees to really give tooth to these things. I want to end on one note. This bill is entirely consistent with medical ethics.
The AMA Council on Ethical and Judicial Affairs has urged doctors, and I quote, to not allow hospital administrators to use their significant power and the current lack of regulations to send patients to other countries. This will provide regulation. It will provide oversight. It will fulfill that ethical mandate. 8 tells physicians they should resist any discharge requests that are likely to compromise patient's safety. They should prepare discharge plans without regard to socioeconomic status, immigration status or other clinically irrelevant considerations. This bill will influence that. Thank you, members of Council, and thank you for the opportunity to testify today.
And thank you for your testimony. We really appreciate the thoroughness in your preparation today. Thank you so much. If we can have our next panelist please testify.
Yep. Good morning. My name is Medha Makhlouf. I'm a Professor of Law at Penn State Dickinson Law in Carlisle, Pennsylvania. I'm also the Director of the Medical Legal Partnership Clinic there. Thank you very much for the opportunity to testify today. The clinic provides free legal services to people who are experiencing health-harming legal needs. We partner with health care providers to ensure that their patients who struggle to make ends meet are able to get the legal services that they need to resolve their intertwined legal and health issues. The clinic's work specifically focuses on ensuring people's access to public benefits such as medical assistance and the majority of our clients are low-income immigrants. As a researcher, I examine issues at the intersection of health law, immigration law and poverty law and I've written numerous articles in scholarly journals of law, medicine and public health. And one thread of my scholarship focuses on immigrant access to health care. So in my testimony today I'll address three topics briefly: First, the reasons medical deportations happen. Second, how Bill No. 230649 would protect immigrant community members from harm. And third, how this bill might inspire efforts in other jurisdictions in Pennsylvania and beyond. So first, why medical deportations happen. The root cause of medical deportations is the lack of a true health care safety net in this country. A review of all of the publicized cases of medical deportations reveal that hospitals will typically consider medical deportations as an option only when they're unable to discharge a patient to a more appropriate facility because the patient lacks health insurance. Many undocumented people and people with vicarious statuses, including DACA, temporary protected status and pending asylum applications are not offered health insurance by their employers and do not qualify for Medicaid because of their immigration status. And unfortunately, this is where many hospitals will end their inquiry. This bill requires hospitals to determine the patient's eligibility for any program that could cover the cost of their care retroactively and going forward. It specifically names emergency medical assistance, which is often overlooked by hospitals as a potential pair for rehabilitative and long-term care services as Cathryn Miller Wilson emphasized. Advocates across the state, including the students enrolled in my clinic at Penn State Dickinson Law have successfully obtained emergency medical assistance for patients who the state may not have initially believed were eligible for it. And our strategy has been to closely read the laws, federal and state, the regulations, the administrative guidance on emergency medical assistance and to work cooperatively whenever possible with the Pennsylvania Department of Human Services to adopt our interpretation of the law. There are numerous experts on emergency medical assistance in Philadelphia and across the state who hospitals can work with to explore alternatives to medical deportation. Hospitals will not be left alone to deal with the consequences of the inadequate health care safety net. Second, how the bill protects immigrant community members from harm. This bill will protect immigrant community members in several ways. Most obviously by reducing the physical and mental health risks of medical deportation and the threat of medical deportation creates for patients receiving care in Philadelphia hospitals. In addition, the requirement for hospitals to report cases of medical repatriation to the Philadelphia Department of Health and this Committee will enable Philadelphia to be the first jurisdiction in the country to deliberately collect data on medical repatriations. Professor Lee also spoke about the importance of the reporting requirement so I won't elaborate on that point.
Third, the bill would protect immigrant community members from harm by safeguarding their right to autonomy and health care decision- making and their bodily integrity. The informed consent provisions in the bill serve that purpose. Fourth, the bill gives victims of medical deportation a remedy, which may help to mitigate the harm suffered from the medical deportation. My third point, how the bill 13 might inspire other jurisdictions. S. jurisdiction's recognition of the injustice of medical deportations. The bill is measured in my opinion and the action that it requires hospitals to take recognizes both the dilemma that hospitals face when they have no safe discharge options for uninsured patients and the helplessness that those patients feel when medical repatriation is presented as the only option. S. that encounter this issue will look to this bill as a model worthy of replication. This Council is already well-known for its groundbreaking efforts to protect the health of communities, as Professor Rulli and others have emphasized. Passing this bill to end medical deportations would be another accomplishment, cementing its status as a leader among legislative bodies in the United States in safeguarding the health and well-being of its constituents. Thank you very much.
Thank you very much for your testimony. And can we ask the Clerk to pull up the next panel of witnesses, call up the next panel of witnesses.
We have Remy Steven who is a Certified Nurse. We have Representative Khan who is State Representative of the 194th District, and Diane Robinson who is the Clinical Director of Make the Road Pennsylvania.
Okay. And we're going to just change the order just a little bit because I know Rep. Khan was in and out. If he's still available, maybe we could just bump him up because I know that he's got to go. Let's see -- okay, there he is. So, Rep. Khan, if you don't mind, we're going to just slot you in really quickly next because I know -- actually you were supposed to be on the first panel so my apologies for that. So if we can have you give your testimony, and I'm going to ask that everyone be brief so that we can get this voted out. I think that we all realize how important this is and really how groundbreaking this is, but we have to get it voted out of Committee for it to happen. So we're going to ask you to really condense your testimony, if possible. And if you could really hone in on any points that haven't been made, that's for all of the testifiers. Any points that haven't already been made, if you can sort of hone in there and make your testimony two minutes or less so that we can get this voted on and get it out of Committee today. So that being said, Representative Khan. STATE REPRESENTATIVE KHAN: Thank you, Chair Bass, and thank you to the Subcommittee. I also want to thank Councilmembers Jim Harrity, Sharon Vaughn and Councilmember Jamie Gauthier and Councilmember Lozada for this bill and for this opportunity to testify. I'm a Ph.D.-prepared nurse-practitioner and a fellow at the Center for Health Outcomes Research and Leonard Davis Institute at University of Pennsylvania. As Councilmember Bass also mentioned, I'm also a State Rep. I share some turf in Northwest Philadelphia. I'm so excited to do that with the Councilmember. Also, in my rookie year I'm super excited to be working with City Council on community initiatives to help our City achieve its great potential. I'm going to keep this very brief and just say I'm very proud of this bill that establishes rights for immigrants as human beings, especially when it comes to health care access. This bill would affirm our City's place in being a leader of human rights for all people. And it's just very important to note that private medical deportation is not only a violation of the oath that we take as health care providers, it's out of line with our values as the City of Brotherly Love and Sibling Affection. Every person has the right to seek and receive adequate care, especially those in life-threatening conditions. The last thing that should be on anyone's mind when they're needing health care is will this mean that I'm going to lose my place here in the City of Philadelphia. So that's all I wanted to say. Thank you so much. I greatly appreciate you all. And hopefully, we can get this voted out of Committee. Thank you.
Thank you, Representative. Appreciate you, and thank you for your support on this very important bill. Thank you. STATE REPRESENTATIVE KHAN: Thank you.
Yes. Please state your name for the record and proceed.
Thank you. My name is Remy. I am a nurse in an emergency room and thank you all for allowing me to speak this morning.
As I said, I work in -- I'm sorry. I work in an emergency room and if patients come to our ER, if they're intoxicated or if they're using illegal substances or if they come in with cuts on their arms that are consistent with smashing a window, we don't call the police on those people. We don't report them for potential criminal activity. When I was in college, it was drilled into all of us that if somebody drank too much, we should always call 911 or campus security to get that person help, and the school was really clear that they would not enforce any anti-drinking policy for the patient or for the friend that called for help. And the point of those rules is to ensure that people who need medical assistance seek it without fearing repercussions. Medical deportations are first and foremost barriers to seeking care. They make people afraid to come to us when they need us. When we transfer a patient from my ER to a different hospital, it's because they have services that we don't have. For example, the patient needs a neurosurgeon and we don't have that at my hospital. But in cases of medical deportation, people are often transferred to facilities with worse care than the place where they were started from. Hospital officials forcing patients to be transferred to places where their quality of care will decrease is absolutely against our duty of care to these patients. Passing legislation to enforce an end to medical deportations will make health care safer, more accessible and more in line with what we as members of the health care community are tasked with doing for our patients. Thank you so much for your time today.
Thank you for your testimony and your professional expertise in this matter. Thank you.
Hi. Good morning, everyone. I'm Diana Robinson. I'm the Civic Engagement Director at Make the Road Pennsylvania. We're a community organization that works with Latinx, Black and immingrant working-class communities. And I'm here today to express also my support for this bill. We heard from Claudia and we've known of other cases outside of Philadelphia where people are being deported where they are in horrible conditions. And it's unfair, as many have stated already. This bill was just a much- needed oversight in language access so that families receive information in the language that they are most comfortable. It will help alleviate the undue stress to families and those being deported in sometimes critical conditions. Most importantly, this bill makes sure that there are ways to hold bad actors accountable. This creates a pathway for the City to enforce legislation and levy fines on those who violate patients' rights. No family should have to go through a family member being deported in critical condition with no information about what is happening. I urge the Public Health and Human Services Committee and all of the Philadelphia City Council to support the passage of this bill. All families deserve protection, dignity in our health care system and access to information and to have their rights respected. Thank you for your time today. And I do hope that we move forward with passing this bill out of Committee and to full passage.
We have two more testifiers. The first one will be Maria Peon, who is an advocacy specialist at CASA Pennsylvania. And then we have Julio Rodriguez who's the political director at the Pennsylvania Immigration and Citizenship Coalition.
I'm the Advocacy Specialist for CASA Pennsylvania. CASA is a low-income Black and Brown immigrant and working families organization. CASA Pennsylvania supports Bill No. 230649, which ends unlawful deportation of noncitizen patients by hospitals to the patient's country of origin without their consent. We urge (inaudible). CASA members from all over Pennsylvania in the immigrant community at large should not fear going to the doctor. Getting critical care for individuals and their loved ones keeps families healthy in which it forces people to make their decisions between their health and keeping their families together. Medical deportation is a practice used by U.S. hospitals to deport undocumented immigrants often without informed consent or through the coerced consent of the patient's family. The practice of private deportation by hospitals is unregulated and with little transparency. Medical deportation can happen even if the patient is not stable enough to travel for hours to their home country. We strongly believe that the passage of this bill will help prioritize the rights of long-term interim patients. This bill will ensure that patients and their families will receive all of the information they need to make an informed decision about their care in their primary language as well as banning hospitals from engaging in medical deportation. This legislator -- legislation plays a critical role in building trust within families and critical ways that keeps them healthy. I'm here this morning to ask you to consider this issue and pass this bill. As an essential step in becoming a doctor, medical students must take the Hippocratic Oath. One of the promises within that oath is first do no harm. Yet how can this promise be fulfilled when people are being deported while they are in their most vulnerable state and sometimes to countries who don't have medical resources to ensure their survival. The passage of this bill will become a beacon of hope of our collective commitment to nurturing a health care system that treats everyone in the community with dignity and respect and prioritize their health and well-being. Thank you.
Thank you. Thank you for your testimony. And our next speaker?
I think Mr. Rodriguez indicated that he was not going to be speaking in the --
Okay. Madam Clerk, is there anyone else who is calling in to publicly testify or offer public comment on this bill who didn't sign up to testify?
Okay. Were there any other additional comments from members of Council? (No response.)
Okay. There being no further comments from members of the Committee and no other witnesses to testify on this bill, I will ask again if there's anyone else present in this hearing whose name we have failed to call and that wishes to offer testimony on the bill being considered today? (No response.)
Hearing none, I want to thank all of the panels of witnesses for their participation on the legislation today. I want to remind the public that we will be moving to a public meeting to vote on Bill No. 230649, which was heard by the Committee today. After consideration of the bill and public meeting, we will return to a public hearing to hear testimony on Resolution No. 230753. So we will now go into a recess for the hearing and then go into a public meeting to consider the action to be taken on the bill before this Committee today. At this moment, we are going to ask -- my apologies. If we can find out technically do -- I believe we are supposed to ask those who have signed on to testify to now disconnect from -- (inaudible). Okay. I need you to disconnect. Thanks everybody. We'll now recess the hearing and go into a public meeting. And I'll ask the Clerk to now call the roll.
Councilwoman Lozada. She left, right -- yeah. Councilman Thomas. (No response.)
Quetcy said if we texted her she would get back on for the vote.
Okay. We're going to pause for a second while we wait to be joined to make quorum. So we need one additional member.
No problem at all, Councilmember. So we're ready to proceed with the vote on this matter. Madam Clerk, who do we have to offer the amendments and to second?
Okay. Councilman Driscoll, can we get you to offer a motion?
Madam Chair, I make a motion that we move to consider this bill.
Well, let me just formalize it, if you will. The Chair recognizes Councilmember Driscoll for a motion on the amendment to Bill 230649.
The Chair notes for the record that Councilmember Vaughn seconded the amendment to Bill No. 230649 be approved. All those in favor of the motion will signify by saying aye. (Aye.)
The ayes have it and the motion carries and the amendment to Bill 230649 has been approved. And now, regarding Bill No. 1 230649 as amended, Chair recognizes Councilmember Driscoll for a motion on Bill No. 230649 as amended.
Madam 5 Chair, I move the motion that Bill 6 No. 230649 as amended be considered. 7
Chair 11 recognizes for the record that 12 Councilmember Vaughn seconds the 13 motion. And it has been moved and 14 properly seconded that Bill No. 15 230649 as amended be reported from 16 this Committee with a favorable 17 recommendation and further move that 18 the rules of Council be suspended to 19 permit first reading of this bill at 20 the next session of Council. 21 All of those in favor of this 22 motion will signify by saying aye. 23 (Aye.) 24
Okay. The ayes have it and the motion carries. Thank you very much.
Madam Chair, I just want to note that Councilmember Lozada and Councilmember Thomas are both present.
Yes. My apologies. Yes, I thought we recognized Councilmember Thomas. I thought we knew you were here. But I did not realize that Councilmember Lozada was back. So thank you for bringing that to my attention. I greatly appreciate that. I want to make sure people know that you were present. But thank you very much. That will conclude our public hearing on Bill No. 230649. And we will now return to the public hearing of the Committee on Public Health and Human Services to hear testimony on Resolution No. 230753. Will the Clerk please read the title of the resolution (inaudible).
Resolution No. 8 230753, resolution authorizing the City Council Committee on Public Health and Human Services to hold public hearings exploring the effects of recent pharmacy closures, including Rite Aid in the City of Philadelphia and the impact this has on prescription access and vital pharmacy health services for senior citizens.
Thank you very much. This is a critically important bill. I want to ask first if anyone on the Committee would like to make an opening statement regarding this resolution?
Councilwoman, do you need me to stick around for a quorum?
We would love to have you if you're available, but I know that you're very busy. So if you need to --
Well, thank you. Thank you much. We appreciate that. So listen, this is an important bill so as long as you have enough time to hang around, we greatly do appreciate that. This is something that's affected every single one of our neighborhoods, and particularly underserved neighborhoods where we've seen significant pharmacy closures. So thank you, Councilman. Did anybody have an opening statement from the Council? Did anybody want to make an opening statement before we begin public testimony? (No response.)
And I don't see anyone. I'll just double check. Okay. I don't see anyone. So why don't we proceed. Madam Clerk, if you can call the first panel.
Dr. Cheryl Bettigole would be the first panel, but I believe -- okay, here she is.
Yes. Sorry I got a little confused. So good morning, Chair Bass and members of the Committee on Public Health and Human Services.
I'm Dr. Cheryl Bettigole, Commissioner of the Department of Public Health. Thank you for allowing me to testify about the recent announcement of closure of Rite Aids across the City. Rite Aid recently announced that they're planning to shutter hundreds of locations nationwide, including stores in Philadelphia. This decision has raised concerns for many community members and leaders of Philadelphia who are familiar with the important role these pharmacies play in access to care in our City. The term pharmacy desert has been used to describe a low-income neighborhood or community in an urban area where more than a third of the population live over one mile away from the nearest pharmacy. One in four neighborhoods across the U.S. qualify as a pharmacy desert. And Rite Aid's decision to shutter many pharmacies in Philadelphia will add to the number of City residents who live in a pharmacy desert. Communities will not receive the same quality of care if and when these pharmacies close. And while online pharmacies are useful to many people, they are not a replacement for brick-and-mortar shops. There are residents in our City who lack Internet access and others without a home address to receive medications or who may be concerned about their ability to rely on whether they receive packages. Neighborhood pharmacies provide easy access to medications for acute and chronic illnesses as well as a trusted source of health advice. Pharmacies also provide important access to immunizations. As we're approaching flu season and a we see a slight uptick in cases of COVID-19, neighborhood pharmacies remain critical partners in our efforts to administer vaccines. These closures mean that many residents will no longer have an easy source of seasonal vaccines near their homes, making it less likely that they will get the flu and COVID- shots they need to maintain their protection against these infections. Those in low-income neighborhoods are already at increased risk of developing conditions such as high blood pressure and diabetes, which puts them at a higher risk for developing a wide range of health complications. When neighborhood pharmacies close, City residents with high blood pressure, diabetes or heart disease would find that they need to take multiple buses to fill their prescriptions every month and they delay picking up their medications or decide to take their chances off medication. Unfortunately, older Philadelphians are also among the most disadvantaged due to the pharmacy closings. The elderly make up a considerable percentage of prescription users, and this disruption of care will only lead to decreased medication adherence and reduce positive health outcomes for many of our City's seniors. This may create further health problems for individuals down the line and add to an already overwhelmed health care system. Poor access inevitably leads to poor outcomes. I'm grateful to this Committee for your attention to this important issue. Thank you for the opportunity to give testimony today.
Well, thank you, Dr. Bettigole, for your understanding of this critically important issue. And I guess my first question for you would be how is the Department of the Public Health prepared to address, handle, supplement these closures, especially in light of the fact that we have, you know, I don't know exactly how many (inaudible) citywide, it's in the tens, I'm assuming. And we have I think just 10 City health facilities, public health offices. So are we reaching out to other providers to provide pharmacy services? What is our plan, I guess? What is the plan to address this gap that is happening in these underserved communities?
Yeah. No, it really is a challenge. And we obviously can't just step in and be --
We are trying to as I think you know to expand our network. We currently have eight City health centers. We confuse everybody by numbering so --
-- so eight centers, but we have an Health Center 10. But we are working on building two additional health centers. That will help somewhat in terms of the demand for care. We also are operating it's called the Bridge program, which is a federal program operated through the Health Department to make sure that free COVID vaccines are available in the City. Working with partners across the City, including our independent pharmacies, and I think they are a really important network that we've come to appreciate over the last few years. We were just out at Shop and Carry Pharmacy, which is an independent run by a local pharmacist who looked familiar. And when I asked him who he was, he told me, you know, it's Jittu George. Jittu George is a pharmacist who during the pandemic would after he closed up shop take whatever doses of COVID vaccine he had and just go vaccine people in their homes. And so, our independents are a really important part of our network too. But this is tough, and we are trying to think how can we best support people, how we've created this primary care finder which I want to make sure everybody knows about. It's phila.gov/primarycare that helps find at least a primary care network in the City for people who are either uninsured or underinsured. But it's a scramble right now where our health care system has lots and lots of flaws and this is one that's (inaudible).
Sure, sure. And we wanted to have this hearing because we -- and we realize, listen, there's a lot of challenges that have happened since 2020 when COVID hit the scene, and we just really wanted to make sure that this doesn't get lost in the shuffle because it's just having such a major impact in all of our neighborhoods. One of the things that was a big challenge was that during various situations where there was public unrest and there was some loitering -- looting of pharmacies and, you know, the Rite Aids, the Walgreens and so forth, and one of the things that was of great concern to so many of us members of Council was how does my mom, my grandmom, my whomever, my uncle, how do they get their medication because now the Rite Aid at The Shoppes at LaSalle on Chew Avenue now that that's no longer online, where are they going to go, how are they going to be served for a critical need, for a lifesaving need. This is not something that's optional. This is something that in most cases it's very much lifesaving. And so, we just really wanted to make sure that the department was totally engaged and on this and that there was a plan in place. So while you guys are scrambling a little bit just to keep up with these unprecedented closures unexpectedly happening, is there any additional information, resource or assistance I guess that the City of Philadelphia through City Council can be providing to you to help make life a little bit easier for you and most importantly for all of our constituents?
Yeah. I think it may be useful for us to put together one -- what to do if your pharmacy closed. For example, there are a lot of pharmacies including some of the independents who'll deliver. So maybe you can't get to your pharmacy, maybe your pharmacy can get to you. And thinking about also how do you get a prescription transcript because that is an option for many people, so you don't necessarily need a brand new prescription. You can ask the pharmacy to transfer the prescription over to a different pharmacy. So we can put together some information and then having Council's assistance in helping make sure people are (inaudible) --
Sorry. Once we put that together with Council's assistance, we can share that with (inaudible).
Okay. So what I would like to do is to ask the Department of Public Health to work with this particular Committee and any additional members that are interested to help formulate that plan and assist you in getting out the word, whether we need to do a mailing to every resident in the City, whether we do an insert into water bills or, listen, taxes are getting ready to be mailed out, you know, and all these other ways we're going to be communicating with people. I think we have to hit them in multiple ways with tons of information about what we're doing on this issue again because of the nature of it. We need to let them know where to go to get assistance on this matter and how it's being handled by the City of Philadelphia.
Yeah. Mailings to all Philadelphians they're big numbers and expensive.
So we may want to look at other ways of getting to people. But let's take a look at that.
Sure. And actually when I say mailings, I know that we like to do stuff online but everybody is not online as you know. A key part of your constituency I would say through the public health system is probably not online or limited in their ability to be online. And so, therefore mailing becomes important in a situation like this. But there are other things we can do to supplement mailings. We can be at our senior centers, other places, our libraries, our rec centers. In particular areas, we can go door-to-door where we know the Census Tract says that this is a population that's most likely to be most affected. So that's what I'm saying, if we can all sit down at the table and come up with some solutions and some ideas as to how we're going to tackle this and work collectively, I think it will serve all of our citizens best.
Sounds great. And I do think that ultimately having everybody access to care --
Ultimately having everyone with access to care in the City is important.
Yes. Well, thank you. Are there any other questions from members of the Committee for the Commissioner? (No response.)
I don't see any. All right. Commissioner, if you can just hang around for a few minutes. And, Madam Clerk, if you can call up the next testifiers.
Okay. Great. Please state your name for the record and begin your testimony.
Sure. My name is Rob Frankil. I am the Executive Director of PARD, which stands for the Philadelphia Association of Retail Druggists. We are an organization of independent pharmacy owners across Pennsylvania but concentrated in Philadelphia and the surrounding suburbs. We have about 300 members representing over 250 pharmacies. So first off, I want to thank Council President Darrell Clarke for the resolution to hold this hearing. Clearly, this is a big deal. Not just affecting the pharmacies that are closed and the patients that they serve, but also the issues that affect Rite Aid and why they closed also affect independent pharmacies and their ability to survive. So I want to talk a little bit about that. At the heart of the matter why Rite Aid is closing what is now going to be about locations in the 15 Philadelphia City, at least 20, last 16 I heard they were going to close up 17 to 1500 nationwide so that number is 18 going to grow, is for reimbursement. 19 The pharmacy benefit managers, the 20 insurance companies have bad contracts that pay pharmacies poorly and bottom line is if you're in Chapter 11 like Rite Aid, it means you don't have enough revenue to pay the bills. At the same time, we have overhead that is skyrocketing, the cost of goods, delivery costs, payroll costs, rent, utilities, et cetera, so you have a real bad squeeze for pharmacies being able to pay the bills. In addition in Philadelphia, we've had the problem with the riots over the last two years. That's been a tremendous stress and a tremendous cost to the pharmacies affected. As far as from what I can see, PARD has already had several members that have chosen not to reopen. Because of the riots, they've had enough. And the problems persist. The last round of riots is causing some insurance carriers to drop insurance from some of the pharmacies in our group. If you don't have insurance, you're not in business. So this is an immediate need we have to address this problem, to try to get liability insurance for the pharmacies that are getting dropped that are not renewed. I will say real briefly with regard to the Sunray group of pharmacies, they're very visible in Philly. I'm sure you folks know all about them. I know Brad will be speaking after me and he's part of the Sunray group, but they've had 39 incidents of riots and looting in two years. That -- can you imagine that? 39 incidents for those business owners. Their insurance is not going to be renewed and they have a problem. If they can't get insurance, can you imagine 20-something Sunray-affiliated pharmacies having to close. You talk about Rite Aid. This is a real problem, because the service that the Sunray pharmacies provide for the community and the patients, you know, they all deliver. They all do immunizations. They all do all of those things. This is a big, big hit if they can't get insurance. Here's what our asks are so we can stay in business to keep providing products and services to communities: Our ask is for protection from City Council. And by that, I mean a quick response from the police department. Yesterday morning, yesterday morning there were no riots, but the Sunray of K&A had two or three homeless people that camped out in front of their pharmacy. They were unable to open their pharmacy and get past those people to get to their gate to open. They called the police twice and didn't get a response. It created a conflict within the owners of that pharmacy and the homeless people on the street. And the response of the homeless people on the street said, well, we'll just come back after hours and loot your store. So this is the kind of challenges that --
-- is happening. And this was yesterday. This wasn't even in a time of riot. So bottom line is we need protection, we need a fast response. And by the way, pharmacies generally carry an inventory of $300,000 of drugs where dollar stores and other places that were getting looted don't have anywhere near that kind of inventory. So one would think that the police would give extra protection to the pharmacies. We are also going to request that City Council meet with us and the insurance carriers to work something out to make sure they don't drop us. Because if they do, it is not going to be pretty. I would also like to ask City Council to remain aware. Even though it might not be directly under your jurisdiction, but remain aware that the real issues that cause the problems of pharmacy closures, and that's what I said first, is bad payment from the insurance companies. We were lucky enough to get help from City Councilmember, Kathy Gilmore Richardson and she set up some extremely critical meetings with one of the health carriers in Philadelphia, and we met. The Councilwoman kind of put it all together and said, let's put a meeting together because these pharmacies are not being treated properly, and it actually resulted in a positive outcome in reimbursement with one of these health carriers. So I would like to ask the entire City Council to stay focused on this issue and help the independent pharmacies work with health plans based in the Philadelphia area so we can get their reimbursements so we can stay in business.
And this isn't about getting rich off of health plans across Pennsylvania. This is simply about being able to pay the bills. And if big corporations like Rite Aid can't do it, that sends a big signal. If the big companies like Rite Aid can't do it, how can the little pharmacies in Philadelphia survive.
Right, right. Well, listen, thank you so much for your testimony today. It's very informative. I was not aware of my colleague Councilmember Kathy Gilmore Richardson's efforts, but they certainly are laudable and I intend to follow up with her and her office to see how do we put this in place so that the protections that she has worked for, so that they are permanent, that there's some permanence to these matters and that it's something that is really going to be set in stone. I do want to recognize that the Chair -- Councilman Harrity. (No response.)
Okay. He may have stepped away for one second. Okay. We'll give him a second or two to come back. I'm going to ask the caller Mr. Frankil to --
I'm sorry about that. I had some technical difficulties because I put it into my car.
But all I wanted to do is just back up what Mr. Frankil said. I actually got pictures of the encampment outside of the Sunray. It's literally about a block and a half from my house, two blocks. It's just crazy what they have to deal with. And I know the guys -- well, I know the family that owns that one, and they actually reached out to me for help with trying to get them out because every day they have to go and try to negotiate with them to move from out in front of their store so that they can actually open. And as was testified, all these Rite Aids are closing down. Our Walgreens closed down at K&A. They're one of the only pharmacies left for my seniors, so I just wanted to make that known. Thank you, Madam Chair.
Thank you for letting us know. And, Councilman, why don't we connect, me and you and Councilwoman Lozada and also the Health Commissioner and the Police Captain. Maybe we can all put our heads together to be able to help out in that particular regard because we need our pharmacies open. We can't have this. We just can't have it at all. So would that be amenable to you, Councilman?
Yes. Absolutely, absolutely. So I'm going to ask the Clerk if she'll work to put us all in the room together to discuss that further. Chair recognizes Mr. Frankil.
Yep. Thank you. I am ready and willing to participate in any of these meetings to represent our membership and independent pharmacies across Philadelphia. Please include me if that's appropriate.
Absolutely. Yes, we will certainly reach out to you and include you when appropriate. I think that this might be a meeting that you can be helpful in. And so, we certainly will reach out. Thank you. Thank you for your willingness to help.
Appreciate it. A lot of times people raise the problem but want to leave it with us, not necessarily helping the solution. So we appreciate you being willing to roll up your sleeves and get the situation addressed. Thank you. All right. And if we can have the next panelists, Madam Clerk.
Great. Please state your name for the record and proceed with your testimony.
Hi. My name is Brad Tabaac. And I'm from Friendly Pharmacy, which is part of Neff Pharmacy Management. We are a Philadelphia-based independent chain of pharmacies here in the City.
And our biggest challenge right now is with all of the vandalisms that have occurred. There have been three waves of vandalism. Several of our stores have been totally gutted. Other stores have just had break-ins where things were broken, stolen. It runs the gamut. And what we're faced with now is our insurance carriers don't want to give us insurance because of where our stores are located and the frequency of these break-ins and vandalisms that we have absolutely no 24 control over. We have alarm systems. We have grates in front of our windows and doors. We've done everything we can possibly do to protect ourselves, but unfortunately when these outbreaks of vandalism occur, we're left vulnerable. And now, we're at the point where together with the closure of the Rite Aid stores, the closure of other chain stores because of vandalism and theft where a lot of stores are closing and these are inner city stores serving the residents of those neighborhoods. And now, we're at risk of having to close some of our stores or all of our stores because we have a lot of exposure financially. We have a lot of exposure professionally and we must have insurance. And that's a problem today.
Indeed. Indeed it's a significant problem. You know, we thank you for being steadfast on the issue and for advocating on behalf of the pharmacy network here in the City of Philadelphia. As you may have -- I'm not sure if you heard, that we are going to have additional conversations with Dr. Cheryl Bettigole, the Health Commissioner, and with other members of Council and with yourself, you would be welcome to be included and Mr. Frankil as well, to have these conversations directly with the police department in your neck of the woods and police commissioner -- the police captain in your neck of the woods and other relevant folks. So the conversation is to be continued. This is not a one-and-done.
Okay. Absolutely. Thank you. Thank you. Madam Clerk, is there anyone else left to testify?
Okay. Are there any other additional comments from members of Council? (No response.)
Okay. If there's no other witnesses and no 9 other testimony from members of Philadelphia City Council, we will now conclude our hearing. This concludes this hearing on Resolution 230753 and we are adjourned to the call of the Chair. Thank you. Thanks everyone. Thank you for attending today. (Hearing concluded at 11:44 a.m.) C E R T I F I C A T I O N I, hereby certify that the proceedings and evidence noted are contained fully and accurately in the stenographic notes taken by me in the foregoing matter, and that this is a correct transcript of the same. __________________________________ TANEHA CARROLL