Committee Hearing, February 16, 2001

COUNCIL OF THE CITY OF PHILADELPHIA PUBLIC HEARING BEFORE THE COMMITTEE OF THE WHOLE FY '02 OPERATING BUDGET - - - Room 400, City Hall Philadelphia, Pennsylvania Friday, 2/16/01 9:30 a.m. - - - BILL 010005 - Adoption of FY '02 Operating Budget. PRESENT: COUNCIL PRESIDENT ANNA C. VERNA, Chair COUNCILWOMAN JANNIE BLACKWELL, Vice Chair COUNCILWOMAN BLONDELL REYNOLDS BROWN COUNCILMAN DARRELL L. CLARKE COUNCILMAN DAVID COHEN COUNCILMAN FRANK J. DICICCO COUNCILMAN JAMES F. KENNEY COUNCILMAN THACHER LONGSTRETH COUNCILWOMAN DONNA REED MILLER COUNCILMAN MICHAEL A. NUTTER COUNCILMAN FRANK RIZZO COUNCILWOMAN MARIAN B. TASCO - - - VINCENT VARALLO ASSOCIATES, INC. Registered Professional Reporters Eleven Penn Center, Suite 600 Philadelphia, PA 19103 (215) 561-2220 707 2/16/01 - FY '02 OPERATING BUDGET I N D E X DHS Alba Martinez, Commissioner . . . . . . . . . John Zanier, Fiscal Officer . . . . . . . . . Estelle Richman, Social Services Director . . Harriet Dickter, Office of Child Care . . . . Joyce Burrell, Deputy Commissioner. . . . . . David Fair, Community-Based Prevention Svcs. Wanda Mile, Children and Youth Division . . . Department of Health Dr. Walter Tsou, Commissioner. . . . . . . . Michael Covone, Deputy Commissioner. . . . . M. Bencivengo, Office of Drug and Alcohol. . 708 OPERATING BUDGET LOUIS ROSSMAN .............................. 871 COM. WALTER TSOU ........................... 876 BARBARA WATSON ............................. 876 PATRICIA BASS .............................. 884 MICHAEL LUCAS .............................. 890 MICHAEL COVONE ............................. 896 MARK BENCIVENGO ............................ 899 RICHARD TOBIN .............................. 910 SUSAN LIEBERMAN ............................ 916 ESTELLE RICHMAN ............................ 930 JUDITH DOGAN ............................... 933 JOHN DOMZALSKI ............................. 941 RANDALL HIRSCHHORN ......................... 951 MICHAEL NARDONE ............................ 955 SALLY FISHER ............................... 961 VICTOR RICHARD ............................. 968 JANE GOLDEN ................................ 973 WILLIAM CARAPUCCI .......................... 991 ELLEN SPECTOR .............................. 1001 RICHARD CHANDLER ........................... 1012 WILLIAM MIFFLIN ............................ 1014 THOMAS KLINE ............................... 1040 709 2/16/01 - FY '02 OPERATING BUDGET P R O C E E D I N G S

Good morning, everyone. This is the continued hearing of the Committee of the Whole regarding Bill No. 010005. The first department to be heard is the Department of Human Services. (Witnesses come forward.)

Good morning. Kindly identify yourself for the record and proceed with your testimony. COMMISSIONER MARTINEZ: Good morning, Madam President and members of City Council. I'm Alba Martinez, Commissioner of the Department of Human Services, and I am very pleased to report to you the products of DHS's efforts over the past year and our vision and plans for for Fiscal Year 2002. Mayor Street has challenged me to find ways to improve services and supports for the most at-risk children and families in Philadelphia. Over the past year, I have listened to and learned from hundreds of community members, DHS staff, child-welfare experts and advocates and many others on how to achieve the results we want for 710 2/16/01 - FY '02 OPERATING BUDGET kids. It is clear to me that to achieve our vision, there must be change within DHS and also externally in the way systems that affect people's lives worth with one another. There are four guiding principles that inform all of my decisions at DHS: accountability to our children, families, taxpayers, and lawmakers for the quality and efficiency of our services; accessibility to our services and resources; reintegration of our work and services with other key systems that serve children and families; and the prevention of abuse, neglect, and delinquency of children and youth. At the beginning and end of each day, I challenge myself and my staff to ask, How are our children doing today? Are they safe? Are they in healthy and caring environments? Are they with parents or caregivers who know how to obtain the help they need for themselves and their children. We are raising the bar on the quality of DHS services and are aligning all of our resources, including our proposed budget, to achieve stronger outcomes for children and families. 711 2/16/01 - FY '02 OPERATING BUDGET DHS's budget request for Fiscal Year 2002 is approximately $479 million, an increase of percent over Fiscal Year 2001 estimated 5 obligations. 8 percent of the total appropriation. Over the past four years, DHS has aggressively increased revenues for services to children and families in Philadelphia. Total spending on services increased from $308 million in Fiscal Year 1997 to 444 million in Fiscal Year 2001. During the same time, revenue from other governments increased from 263 million to 391 million projected in Fiscal Year 2001. 8 percent 24 in Fiscal Year 2002. 25 It is my vision that over the next 712 2/16/01 - FY '02 OPERATING BUDGET several years, DHS will continue to generate increased revenue for children's services and will utilize those dollars for quality, accessible programs that truly make a difference for those in most need. At DHS, we have a renewed commitment to ensuring that our agency responds to the needs of families and communities in very concrete and effective ways. We want to create and be a part of a DHS that people will know and will use to access resources without fear or doubt and a DHS that will be a resource for all families in Philadelphia, not just those that become involved with our system. DHS has been embarking on an aggressive agenda for reform of our system and practices, and we have made significance progress over the past year to improve our work product. I'd like to highlight some of our efforts in a few important areas, the first being the prevention of abuse, neglect, and delinquency. In November, DHS established the Division of Community-Based Prevention Services to better coordinate a wide array of programs designed to prevent the abuse, neglect, and 713 2/16/01 - FY '02 OPERATING BUDGET delinquency of children in Philadelphia.

This division is composed of: The Office of Community Family Centers, which provides a variety of preventive services for children and families in locations 7 throughout the City; 8 The Office of School and 9 Community-Based Truancy Prevention, which helps 10 families of children who are truant, both before 11 and after referral to Truancy Courts; 12 The Office of Delinquency Prevention, 13 which provides programs for children youth whose 14 circumstances put them at special risk of 15 involvement with the juvenile justice system; and 16 The Parenting Collaborative, a new 17 effort we are designing, involving our 18 long-standing Parent Action Network, as well as 19 some planned new community-based programs and a public education campaign. Community-based prevention will also be instrumental in the expansion and enhancement of quality after-school programs, the implementation of home visiting programs for new mothers where the risk of abuse and neglect is particularly 714 2/16/01 - FY '02 OPERATING BUDGET high, and the expansion of a school attendance improvement project to provide social service support to a absent elementary school students before they are excessively truant. In addition, we are working on developing new models of service delivery that will link community-based prevention services to DHS's intake system. This will allow for direct referrals of families that need help without becoming a formal part of the child welfare system, which is a more effective and less costly alternative to DHS placement. In the area of parenting education and support, we are publishing the City's first Comprehensive Guide to Parenting, Education and Support Services, which we will issue as part of our recognition of "Child Abuse Prevention Month" this April. This guide will be regularly updated and made available free of charge to family centers, libraries, and community organizations and through a new parenting information line to be established at DHS and through the Internet. Another area of great importance to DHS is what we do with children in our custody and how 715 2/16/01 - FY '02 OPERATING BUDGET well they do. We are encouraged by data that shows that the number of people in dependent placement settings declined in Fiscal Year 2000 over Fiscal Year 1999 and is anticipated to decline again. The Department has also continued to increase the number of finalized adoptions over the past several years. Adoptions have gone up from Fiscal Year 1995 at 212 to Fiscal Year 2000, when we had 650 finalized adoptions. This has been done through improvements in technology and management information systems, which have allowed us to track better the adoption process, and also by working with Family Court to accelerate the adoption hearing process. We are working aggressively to minimize the length of time children remain in temporary placement and their families remain involved in Juvenile Court. In Fiscal Year '02, we will improve 24-hour emergency hotline and our responsiveness to crisis calls. We will develop a midnight-to-8 onsite shift for emergency investigations, which now operate on a limited standby basis. In the area of abuse and neglect investigations, we will 716 2/16/01 - FY '02 OPERATING BUDGET be specializing the handling of sex abuse investigations to improved coordination with law enforcement and with other advocacy organizations. We are also proposing the addition of 39 children and youth social workers to decrease caseloads to staff who provide case management service overall, and we will move towards specialization of caseloads to improve quality of service and greater supports for staff. Finally, DHS has committed to building capacity to ensure accessibility of health-care services for children in our care through the development of a new Clinical and Educational Services Unit. I want to close by addressing plans for Youth Study Center.

Overtime in the Youth Study Center is a great concern, and we have begun to tackle aggressively the serious overtime problem in a number of ways. We are strictly enforcing the citywide sick-leave policy, lateness policies, and overtime policies. Sick-leave use has been reduced from a projection of 27 days per year to 17 days per year through monitoring and strict 717 2/16/01 - FY '02 OPERATING BUDGET enforcement of these policies already. Lateness has been cut in half in the last four months at the Youth Study Center. We are proposing the addition of 28 additional youth detention counselors to further reducing amount of overtime at the Youth Study Center, and this increase will not require an increase to our budget because this increase in staff will significantly reduce the amount of overtime that is currently being spent. And, finally, our administration is committed to building a state-of-the-art detention facility which will meet the needs of the community and the youth it serves, and we are actively engaged in a predevelopment process for the development of that new Youth Study Center. And I welcome your questions.

Thank you, Commissioner. I would like to commend you and your staff on its success in maximizing federal and State dollars for children and youth services. Would you please elaborate on how you plan to accomplish your vision so that over the next several years, we will not only continue to generate increased revenues from children's 718 2/16/01 - FY '02 OPERATING BUDGET services, but we will utilize those dollars for quality, accessible programs for our community. How do you plan on accomplishing your vision? COMMISSIONER MARTINEZ: Well, the Department of Human Services is actively developing a blueprint for reform, and this will be an agenda that will have very clear pathways to get us there, and we will work on multiple strategies at the same time. The development of a community-based prevention services division is an important vehicle, which allows us to elevate prevention to an equal level of importance that we have intervention. And so it is our hope that as we accelerate the process of achieving permanency for children, that we will be able to reallocate resources to prevention activities. What that means is that we will be able to help families sooner when they appear before us in a crisis and, therefore, we will prevent them from entering the intervention stream. Another area where we're actively working is in the area of improving our capacity to do policy and planning. We're working with a 719 2/16/01 - FY '02 OPERATING BUDGET central personnel department and a staff reorganization, and we're doing a lot of planning to build that capacity in order to make sure that we are investing in programs that we know work and are properly evaluated. We want to get away from the concept of historical budgeting, which means that you fund things because you funded them in the past, regardless of whether those strategies are working for the children and families of today. And we will develop that policy and planning unit more and more, but we're already moving in that direction.

Thank you. You state on of your testimony that in the area of after-school programs, you have budgeted $5 million of the expected new Temporary Assistance to Needy Families Funds to support the Mayor's commitment to continue enhancements and expansion of after-school programs throughout the City's neighborhoods. What are the restrictions of those funds? COMMISSIONER MARTINEZ: John?

Good morning. John 720 2/16/01 - FY '02 OPERATING BUDGET Zanier, DHS Fiscal Officer. The criteria for getting TANF dollars are pretty broad. The State has additional -- because of the drops in the enrollees under the Title (indiscernible) Program, the State has allocated more dollars into child welfare. The restrictions are -- they're really broad and they're not too difficult. One of the restrictions is, Do you meet 400 percent of the poverty level. For a family 4, that would be $120,000 (sic) a year. Another restriction would be if you're -- it's not a restriction. I mean, another eligibility criteria would be, Are you on medical assistance or receiving food stamps or any kind of assistance. They're the only two restrictions on using these funds. COMMISSIONER MARTINEZ: And in terms of the objective of these forms, the ultimate goal is that the funds be used to help achieve self-sufficiency in the lives of low-income people.

And will that 721 2/16/01 - FY '02 OPERATING BUDGET be a citywide program? COMMISSIONER MARTINEZ: Yes. These funds will be available in citywide -- on a citywide basis within the context of those eligibility criteria. We believe, however, at DHS that we do need to make sure that we target the majority of our resources to the highest-risk neighborhoods, given that those are the neighborhoods where most of our abused, neglected, and delinquency cases come from.

Thank you. You state in your testimony that you have piloted the School Attendance Improvement Project in some clusters. What clusters is this program currently operating? COMMISSIONER MARTINEZ: I will -- I don't have that information here, but I will make sure that you get it as soon as possible.

And apparently, it's just in certain clusters? I'd appreciate that response. Do you have any plans of expanding this program? And if so, where? So if you wouldn't mind letting us know, I would appreciate it. 722 2/16/01 - FY '02 OPERATING BUDGET COMMISSIONER MARTINEZ: We will give you the information. It is the expectation that we will expand the program to all clusters. I personally want to see the Department target those schools where we have the greatest risk initially, but this is a program that is needed and should be available on a citywide basis.

When do you expect that expansion to take place? COMMISSIONER MARTINEZ: The plan is for the next fiscal year, on a small scale. We know we have 44,000 children in the school system that do not attend school more than days a year, and 15 this number of children that are in elementary 16 school is a very significant number as well. 17 But we will make every effort to make 18 this available throughout the City in the next 19 year. 20

Thank you. 21 When do you expect to select a site for 22 the new Youth Study Center, and when do you expect 23 the new center to be in operation? 24 COMMISSIONER MARTINEZ: Well, the stage 25 we're in now is in pre-development. We have just 723 2/16/01 - FY '02 OPERATING BUDGET completed -- with the support of the Managing Director's Office and Capital Programs Office, we've completed the selection of a planner to get us through the pre-development phase. That phase concurrently will be inventorying potential sites throughout the City, but we can't really pick a site until we finalize the design process for this building. It would be my goal that we will complete this project as soon as possible. I would like to see it move on an aggressive timetable, and will personally put a lot of time and effort into it. But there is no specific timeline because it depends on how accessible a site is going to be. However, the Mayor has made a public commitment to push forward the concept of developing a new Youth Study Center because the one we have is no longer suitable to meet the needs of our children.

Councilman Nutter has just reminded me that it has been approximately ten years that we've been taking about a new site. How can you -- I don't know. 724 2/16/01 - FY '02 OPERATING BUDGET Are we putting the cart before the horse? I thought you had to get a site and then you drew your plans -- COMMISSIONER MARTINEZ: Well --

-- and your design. COMMISSIONER MARTINEZ: Well, a site has to be appropriate for the design. And we're going to look at possible sites concurrently, but the design is really around -- we're not going to be architectural designs. It's --

Well, what kind of designs are you doing? COMMISSIONER MARTINEZ: Well, it's planning; it's more planning. For example, how many courtrooms will be needed? how large is the Youth Study Center going to need to be? how much recreational space we're going to need? The Youth Study Center has a school; how large should the school be? So once we have a sense of the amount of space we will need, we won't design it and then find a site, but we will at least have some space planning, some conceptual sense of how large it 725 2/16/01 - FY '02 OPERATING BUDGET needs to be. And then we need to make sure that we find a site that can fit that. And, of course, we also need parking. So we won't do architectural designs. It's more, you know, space planning is the space we're in.

Thank you. The Chair recognizes Councilwoman Blackwell.

Thank you, Madam President. Certainly, I too would like to commend you. You're a wonderful Commissioner and doing a great job. And we're very impressed with the family centers. I've seen you in action there, and they are absolutely wonderful for our community, and the way they are tapered to meet the needs of that particular community and offer other social service programs to all segments of the community is just fantastic. COMMISSIONER MARTINEZ: Thank you.

And even there, when you have programs, the -- just feeding everybody is such a positive. Parents, children, 726 2/16/01 - FY '02 OPERATING BUDGET everybody comes out to participate, and that's a great program. We would also like to let you know what a great job Miss Ramsey has always done for us, and we appreciate her efforts in our district. We've been through a lot of battles together, especially over group homes, et cetera, but things are going well. Let me ask you a few questions though, one on the cluster-based Truancy Courts. I've attended a few -- in fact, I wasn't supposed to be there, but a few meetings in one of my police districts. And I assumed that that ties in with the Truancy Courts. How does that interrelate with probation officers, how does that interrelate with meetings they have in the police districts, and who is involved? Because in some court situations, they have members from community groups who volunteer to make suggestions as to what happens to a kid, whether the kid is allowed to go home with a parent, whether they should be referred to the Youth Study Center or some other facility, et cetera. 727 2/16/01 - FY '02 OPERATING BUDGET COMMISSIONER MARTINEZ: Hmm. Well, the Truancy Courts are a joint venture between the Department of Human Services, the school system, Police, Probation, and a number of other partners. I believe it's one of the most successful joint ventures that I have seen. However, it is in early stages of development because the scale of the truancy program in the City is enormous. But I will say this: that the partners are definitely at the table, and what they are working on aggressively is on finding models that -- where everyone who's involved in the life of this child can play an effective role. There are a number of strategies that are used in the truancy system, and I need to say up-front that I am not an expert on it, so I will share what I know and I will answer your question in more detail as follow-up. But generally speaking, we do know that police have a strategy which involves picking children up and taking them to school. We know that the Family Court and DHS and the School District have developed a system where once they identify children with 25 or more unexcused 728 2/16/01 - FY '02 OPERATING BUDGET absences, they are referred to a community-based court system where their parents are required to attend, where a hearing is held, a formal hearing is held; and those children, whenever appropriate, are connected to community-based services that are then going to track their future attendance. There's a preliminary evaluation of that program that shows that attendance increases after the Truancy Court intervention. And we also know from that evaluation that community-based court involvement is more effective on impacting on truancy than the court that works outside -- or within Family Court. I would like to have the opportunity to answer in more detail your question about the specific interrelationship Police, Probation, DHS, and the School District, but I will say this: I believe that to tackle the truancy program, we absolutely need a comprehensive strategy where the role of every single one of the partners is very clearly defined. And I think that that's a very powerful question and one that I, hopefully soon, will have an answer to personally.

Thank you very 729 2/16/01 - FY '02 OPERATING BUDGET much. With regard to Youth Study Center, we visited the CEP program, Community Education Partners Program, for children with problems, with discipline problems last week 'cause we didn't get a chance to go to Texas; we couldn't leave town. And we were very impressed with the program. And, in fact, I learned then that they do have a particular site, because my question to them was, can't we -- since the Youth Study Center, I understand these people are looking around the City, even in my area and, you know, we believe that in West and Southwest Philadelphia, we have room for everything, and we thought maybe we could join the two, but I think they already have a site. COMMISSIONER MARTINEZ: Yes.

I'm very impressed with the notion that the Youth Study Center will be, in principle, like a youth center, not just perceived as a youth jail, but a place where community can interact, where maybe you have a gym, you have classrooms, you have a room for the community to meet -- and thank you for that 730 2/16/01 - FY '02 OPERATING BUDGET information. And I think that we could really, really finally turn it around to be something that we can be proud of, where kids in trouble are treated and it is viewed differently instead of just some negative jail. But we really certainly would like to work with you and your department in any way possible to help make that a reality, and we're looking and our district and that sort of thing. I wanted to note that. COMMISSIONER MARTINEZ: Well, I will request that the individuals engaged to do the space planning reach out to all City Councilmembers to interview them about what their ideas and concerns and preferences are regarding the new Youth Study Center. I, too, believe that if our funding allowed, it would be ideal to build a Youth Study Center that also included some type of service for the community that receives it. I think that that would be the ideal. Of course, the cost of the Youth Study Center is going to be a factor on how much we can do. And we certainly want to build a very cost-efficient facility, and we also want to 731 2/16/01 - FY '02 OPERATING BUDGET make sure that it is state-of-the-art. So we will be balancing those two needs. But I certainly agree 100 percent, and I certainly think that it will be an asset to any neighborhood where it is at, because the truth is that these are our children from our neighborhoods that are served by the Youth Study Center. So thank you for your kinds words.

Certainly. And the President asked, how many youth do we have at the Youth Study Center now and what capacity are we looking for in a new center? COMMISSIONER MARTINEZ: We recently did a detention study. The National Council on Detention just completed a study that shows that we would need a Youth Study Center with a capacity of approximately 154 beds, and so that would be in line with what the City had been thinking about in the past, but now we have some pretty strong data that shows us that those numbers are good numbers. Right now, the Youth Study Center has between 140 children, around 140. We have brought it down in the last year sometimes to under the cap of 105, but the number goes up and down. 732 2/16/01 - FY '02 OPERATING BUDGET But the critical issue here is that the number of kids in the Youth Study Center is affected by policy decisions and practice decisions that are made within the juvenile justice system. Sometimes children are in the Youth Study Center because there is no program to send them to. So, therefore, the development of appropriate programs for children to be trans- ferred to for treatment and rehabilitation is an essential component to managing the population. There are other types of reforms that we are working actively with Judge Sylvester, our new administrative judge, and Judge Gellen (ph.), who oversees a juvenile justice branch to make sure that children flow more quickly through the court process. So it's important to recognize that the population of the Youth Study Center is driven by policy and practice, and that we could manage the population to make sure that it doesn't exceed the cap. And DHS is working aggressively, in part, through our policy and planning development. You need to have good policy and planning capacity to tackle these issues to manage that population. 733 2/16/01 - FY '02 OPERATING BUDGET But it would be at around 150.

Thank you. Shortly, we're having hearings on another matter before Councilman Goode's committee to deal with SEPTA tokens. And, obviously, I am sure that DHS supports it. I don't know what we're going to get from SEPTA 'cause the whole notion of kids needing tokens and how it impacts on truancy obviously is an important one. But we assume that when that time comes that you'll testify for the need for it so we can get kids in school to begin with. COMMISSIONER MARTINEZ: Absolutely.

Are there special programs that your department has to reunite children with their parents or with extended family members? Are you finding that during this time, that we need to focus more on that we need to focus more on that, or is it that it's so bad now that generally, when they reach a certain point, we really, really do need to try to do placement or deal with youth in other ways? COMMISSIONER MARTINEZ: Well, it depends. You know, it depends on the situation in 734 2/16/01 - FY '02 OPERATING BUDGET every particular family. I mean, there is a law that governs how child welfare needs to act, and that's Federal Adoption and Safe Families Act, and that act very clearly says that you must make reasonable efforts to keep a family together or to reunify a family whenever possible. And so we are obligated to provide services and supports to families to try to make sure that that family can remain together. In many cases, the Department of Human Services does just that. We have approximately 3,000 families presently under our supervision, where the children are with the parents and we are providing services in the home. Then, of course, we also have almost 8,000 children in placement because they have not been able to stay at home. But of those 8,000 children, a significant number are with relatives or caretakers. When you are with a relative but you are in foster care, it's still considered foster care. DHS puts enormous importance, and the law requires us to, in finding relatives to care for children first and foremost, before putting a child in foster care with someone who they do not 735 2/16/01 - FY '02 OPERATING BUDGET know. We put a tremendous value and importance on reunification of families. I believe we can do better, I believe we can do better. And I go back to the need to develop a policy and planning infrastructure that helps us understand which are the programs that truly work with families. I know that Council is very aware that substance abuse and untreated mental illness, Behavioral Health programs are a significant factor in destabilizing families and the removal of children. We are working really closely with the Behavioral Health System to again develop an integrated approach to not only planning for better-quality services, but getting those services to people when need them, and also making sure that we manage our resources efficiently. So, absolutely, we support reunification, but we also support child safety, and that means that when a child is not safe at home, we will take every step necessary to remove that child and make sure they are safe.

Thank you very much. 736 2/16/01 - FY '02 OPERATING BUDGET And, finally, my last question is, you know, those in the third tier who are trying to make their transition from welfare to work and have been so far unsuccessful and those who are seeking shelter et cetera, how does that relate to you department and what do you think we can do to help them? COMMISSIONER MARTINEZ: While I don't have any hard facts to present right now, a significant number, a significant number of the clients that the Department of Human Services interacts with are individuals who are low-income enough to receive TANF. So, therefore, they will be affected by the lifetime limit, many of them. Many of them fall into the category of being excepted from the work requirements. So it is a major concern for our department. And one of the priorities for me personally is to make sure that the Department of Human Services integrates much better with the employment and training and workforce development systems in the City. And that's why one of our business principles is integration, because while our clients need that support, we cannot do it 737 2/16/01 - FY '02 OPERATING BUDGET without the support of the workforce development system. COMMISSIONER RICHMAN: I'm Estelle Richman, Director of Social Services. And I just wanted to add a little bit to that because I think it's such an important area in the potential impact that it could have on the City. COMMISSIONER MARTINEZ: Yes. SECRETARY RICHMAN: We're currently negotiating with the State to receive a major grant that will be targeted at the women on TANF who have less than months remaining. As you 14 know, March of Year 2002, which is barely a year 15 from now, we are expecting to see a major number 16 of women lose their assistance -- that won't lose 17 medical assistance, but they will lose their cash 18 assistance. This puts us at fairly significant 19 risk if all of these women can no longer pay their 20 rent, no longer can support their families. 21 The State has agreed to give us a 22 fairly large amount of money, which we are 23 negotiating for now, to be able to first identify 24 these families and then begin to support them. And if the women will work with us, they will 738 2/16/01 - FY '02 OPERATING BUDGET extend the 60 months, which is what we're after. It also, incidently -- and I'm not sure many people fully understood it, but for those folks who had an exemption for health reasons, the clock has continued to tick. So even if you've been on exemptions for 3 years, the 60 months continues to apply. We believe that many people are under the impression that if you had an exemption, the clock stopped. It did not. So in light of the impact it could have on both the homeless system and on DHS, there will be a major initiative July 1st. It doesn't give us a lot of time on folks who will be hitting on March 1st, but it gives us an opportunity to contact them and have their time extended.

Thank you. That's so important, as you say. Our office has been, unfortunately, in situations where even when the mom went to work, kids have acted out, their grades have dropped, we have increase in truancy, and we have reports that even one child as young as five tried to commit suicide. So this whole area could really expand 739 2/16/01 - FY '02 OPERATING BUDGET our roles in ways we hadn't even considered yet because this is a population we need to treat. Madam President, I'll wait for another round.

Thank you. The Chair recognizes Councilman Nutter.

Thank you, Madam Chair. Good morning, Commissioner Martinez. COMMISSIONER MARTINEZ: Good morning.

I only had a small note on this particular item, because it does come up from time to time. Let me preface my remarks by saying that the Youth Study Center, or the new Youth Study Center project, and where it is or where it is not is clearly not your fault, but now as Commissioner, it ends up being your responsibility. So my comments are in the context of, you have come into a situation -- not only yourself but Director Richman and Mayor Street -- on a project, on an issue that has, at least for all of the time that I've been here, has been a topic of the conversation. And my only 740 2/16/01 - FY '02 OPERATING BUDGET expectation, I guess, was when you arrived, that someone would actually hand you a document or a report and say, you know, we've been working on this for a while, and this is where this is, and it's ready to go. And I guess to hear that, I mean, we're still in somewhat of a study stage or a search stage, and I did say to the President that this has been going on for sometime, and then in a comment with Councilman Rizzo, I'm reminded that in the time that we've been talking about a new Youth Study Center, a couple of other things have happened around the City: There's a place called the Constitution Center that I think is up and under construction and will probably open later on this year; the Regional Performing Arts Center, now the Kimmel Center, will be open soon; probably before the new Youth Study Center opens, we may have two new stadiums, at a billion dollars worth of cost; and I heard the other day we were going to have a new museum in the City; at least six or seven hotels -- the Loews, the Hyatt, the Ritz Carlton, two Marriotts and a couple of others have all 741 2/16/01 - FY '02 OPERATING BUDGET opened in the time frame that we've been talking about a new Youth Study Center. Now, maybe this project needs to go over to PIDC and they'd figure out a way to get it done quickly, if somebody could figure out how to make money off of it. And I think you understand my point. We work on the things that people think are important at the time, we figure out a site, what we want to do with it, we find the funding, and all of those places, or almost all of those places, are up and running. And they happen. And so, 154 beds, 160, 130, whatever the case may be, it seems that this project has just kind of been around, and we like to talk about it, and we'd like to have a new one, but the things that we want, we do. Now, who's in charge of this project? COMMISSIONER MARTINEZ: Well, even though it is a collective responsibility because it's a capital project and it involves the investment of a whole lot of money, and so, therefore, the Mayor's Office has a strong interest, the Managing Director's Office and the 742 2/16/01 - FY '02 OPERATING BUDGET Capital Projects Office, I will take responsibility personally for whether this project happens or doesn't happen within my administration.

I understand that and -- COMMISSIONER MARTINEZ: So you can hold me responsible --

I understand that and I believe that. COMMISSIONER MARTINEZ: -- if it doesn't happen, and you can hold the Mayor responsible if it does. (Laughter.) COMMISSIONER MARTINEZ: But I will say this --

That is very generous of you. COMMISSIONER MARTINEZ: But I will say this: I was handed information about the Youth Study Center, and I made the decision that the information that was handed to me was not of acceptable enough quality for me to proceed ahead with the investment of 30 or $40 million of 743 2/16/01 - FY '02 OPERATING BUDGET taxpayers' money. So, therefore, I think that it's much better for us to invest a little bit more time in some quality space planning to ensure that whatever we do and we moved forward is going to be exactly what our kids need. So I agree with you that this is, you know, a timely project, and during the transition phase, advocates make very, very clear that the timeline that I thought was aggressive, which was five years, was totally unacceptable to them. So I am hoping that we will be able to move this project forward much more quickly. We do have the support of the Mayor, the Managing Director's Office and the Capital Programs Office. And I personally am going to work very closely with Deputy Commissioner Burrell to make sure that we're working on this project every week, that something happens every week. The national research and data that we have now, however, about the size, a recommended size, we did not have before. And so, therefore, different stakeholders would have had, you know, more of a debate around the size. 744 2/16/01 - FY '02 OPERATING BUDGET

Sure. COMMISSIONER MARTINEZ: Some people want a larger Youth Study Center.

Right. COMMISSIONER MARTINEZ: We want one that's just the right size. And so I think that we do have some better data. And also, there was a site apparently chosen that did not work out. The ideal site, of course, would be right next to Family Court. And there was a site that a number of people were interested in, and apparently, that site fell through. So I am going to advocate for us to concurrently, while do space planning, that we concurrently start identifying sites and not wait until we finish our plan to possibly look at sites because that will delay the process. However, of course, we can't pick a site until we know the size of the center we need.

One, I commend you for having, quite honestly, the courage to make the tough decision that it's better to have good information going forward than to just make a rush 745 2/16/01 - FY '02 OPERATING BUDGET to judgment. And I will trust your analysis of the information that you were given. You're the professional in this situation to make that critical judgment that if the data and the information is not good enough to go forward with a sizeable project, notwithstanding delays, notwithstanding criticisms, you know backseat drivers, Monday morning quarterbacks that may raise a question about it, you did you make the tough decision, and I commend you for it. I will certainly support your efforts in this regard, and if I can be of any assistance in my own small way, I'd be glad to be of help. COMMISSIONER MARTINEZ: Thank you.

You're welcome. I do want to ask a question, and it seems most appropriate, although I did not necessarily see anything in the testimony, but then I couldn't figure out who else might handle this, so I'm going to assume that it's somewhere within DHS. It's the issue of the Office of Child Care, which is a relatively new office. I will promise my colleague across the room that I will not exhaust all of the questioning in the Office 746 2/16/01 - FY '02 OPERATING BUDGET of Child Care, so there will be something left. COMMISSIONER MARTINEZ: Well, luckily, that's Estelle Richman's responsibilities, so here she is. COMMISSIONER RICHMAN: I am Estelle Richman, Director of Social Services for the City. And the Office of Child Care does function directly under my supervision.

Director Richman, can you give us, I guess, a little bit of preliminary information about the scope of the office, its role, its responsibility, its size, staffing, and where things are at the moment with this office. COMMISSIONER RICHMAN: Okay. I'm going to take a shot at all of those questions, and if I don't cover them, I will bring up Harriet Dickter (ph.) for whom the office directly reports. The Office of Child Care was established last year for the first time. It reports to Director of Children's Policy within my office. We have hired a Director of Child Care, and that individual has one staff member. One of the things -- the office is the 747 2/16/01 - FY '02 OPERATING BUDGET first for is it City of Philadelphia, and it is something that we're actually very proud that we've been to develop at this point in time. Since its inception in the spring of 2000, which is just a little less than a year ago, we've been able to distribute about $354,000 to a Health and Safety Fund within the City to support child-care providers in the City. Some of this money is directly City money within the Grants Fund, and these dollars actually reside within the Grants Fund of the Behavioral Health System, partly because of the source from which some of them came. Some of them are from the Safe Schools Grant from the federal government, and some of it is from the Child Care Matters Initiative. So the dollars that have been put together are coming from a variety of different sources. The Health and Safety Fund has actually funded projects in several different areas. Just let me give you a couple of the highlight. There have been funds for providers for fire detection and prevention, for safety needs adaptation, for health and safety regulation differences, for building renovations, heating and cooling for play 748 2/16/01 - FY '02 OPERATING BUDGET surfaces and fencing. They were put out on a basically RFP basis. We made 112 grants. To date, we are planning to have another round, an additional round as we get to Fiscal Year '02, and hopefully, we have planned so that there will be approximately 2 to 300,000 additional dollars for Fiscal Year '02. As you can expect, these dollars actually meet a small percentage of our need, but it's such an improvement over what we've had in the past, it's really seen by the providers as something they could apply for and that will give them some help as they begin to establish child care within the City and to bring it sort of above ground so that we can both monitor the quality of it and assure that our children are going to be safe.

Thank you, Director. My last question for this round is, I had begun to receive -- I will assume my colleagues have as well -- information or usually maybe a report indicating who had received what 749 2/16/01 - FY '02 OPERATING BUDGET grants. If you could forward to the Chair for distribution to Councilmembers any general information about this particular program and how an individual would go about applying for the grants. Again, obviously, I know that we can't support or sponsor everyone, but it would just be helpful to have just kind of the general background information on this initiative. And if we do get inquiries, we'd be able to point people in the right direction. COMMISSIONER RICHMAN: Okay, we'd be very glad to get you a summary of what's going on, how to advice your constituents to respond when the next round comes out, and a general summary on the program to date.

Great, thank you. SECRETARY RICHMAN: You're welcome.

Thank you Madam Chair.

Thank you very much. Let me likewise thank Deputy Commissioner Burrell. I've talked to her about the Youth Study Center. And around certainly 750 2/16/01 - FY '02 OPERATING BUDGET Clarence Holmes, who's now Director. I knew when he started, when he just a youth worker way back in the '70s, so, you know, life's funny. If you hang around long enough, everybody meets up again. Councilman Rizzo?

Thank you, Madam Chair.

You're welcome.

Commissioner, I also appreciate the fact that you've stepped back to take a look at this to make sure that it's exactly -- the facility is exactly what we need and hoping that you'll put it back on track and get it accomplished hopefully in the next few years that we have this new facility. But I want to make a comment, an observation. I don't want to suggest that you were the only commissioner, but I think that you were one of the very few that communicated with me, and I'm sure other members of City Council, back in January, asking us if we had any concerns or questions of you prior to this hearing. I believe you were the only commissioner in this 751 2/16/01 - FY '02 OPERATING BUDGET administration that thought of this Council, asking if we had questions -- or at least of me. So I wanted to thank you for that. COMMISSIONER MARTINEZ: Thank you.

Thank you, Madam Chair.

You're welcome. Councilwoman Reynolds Brown.

Good morning. COMMISSIONER MARTINEZ: Good morning.

I would be remiss not to echo the sentiments expressed by President Verna, Councilwoman Blackwell, and Councilman Rizzo with regards to the manner in which you've embraced your tremendous responsibilities this past year. And most notably, let me commend you on two things: One, what you have done to leverage local dollars in getting both State and federal dollars; and, two, how you are really holding true to what you stated last January, and that is begin to change systems and make systems work better for kids. So hats off to you on that and much 752 2/16/01 - FY '02 OPERATING BUDGET speed as you pursue the goals that you've established. COMMISSIONER MARTINEZ: Thank you.

Let me start with where Councilman Nutter left off around the Health and Safety Fund, and Estelle Richman spoke to a number of questions he raised. My only additional question is, you stated -- is she still here? COMMISSIONER RICHARD: I'm here. (Estelle Richman returns to witness table.)

I agree with you that we're off to a great start with regards to the grants that have been provided to those who are providing services to children in the child care area. And you indicated that we're not at the ideal yet, meaning we haven't maxed out taking care of a tremendous need. Is there a waiting list, as such? and do you use standards to make a determination on how and which child care centers benefit from those dollars? COMMISSIONER RICHMAN: Harriet? 753 2/16/01 - FY '02 OPERATING BUDGET (Witness comes forward.)

I'm Harriet Dickter.

Good morning.

Good morning. There have been a couple of rounds so far for the Health and Safety Program, and in each round, there has been more applicants who have requested assistance than need has been able to be met. So the fund actually has had a set of priorities, and I'll articulate them so people understand how the choices have been made. I do want to say that we have been able to work so far just in the first two cycles of the fund be with about 7 percent of all registered and family child care group and center providers in the City of Philadelphia.

Did you say 7 or 70?

About 7 percent of the total group providers in the City we've been able to reach so far with the fund.

Okay.

The priorities basically are the following for the distribution for it: 754 2/16/01 - FY '02 OPERATING BUDGET The first is to assist our child-care provider community meet our local and State rules and regulations for the operation of their facilities; The second priority is to allow them to achieve best-practice standards for caring for children in a health and safe way in their program; And the third is to make sure that we are allowing providers to make appropriate inclusion of children with special needs.

Okay.

And so those are the three principles that are used to review the applications. There was a very active advisory committee for this fund that has drawn from both City staff as well as experts in the community basically to make sure that need is best being met throughout Philadelphia.

You say 7 percent, which equals to about 114 grants at the $149,000 price tag? Or is that the $3,000 price tag? 755 2/16/01 - FY '02 OPERATING BUDGET

That's for the total investment to date, that about 114 providers have been able to be included in the first couple of cycles of the program.

Okay. I know that the hard number for actual grants delivered, but I'm not clear about the price tag. Is the initial 149,000, or the anticipated or hoped-for 300,000? It's 149; is that correct?

Correct. Of the City's contribution.

Okay.

Okay? And I do again want to emphasize what Director Richman said here, that there has been other funding that this program has leveraged already. There has been private contribution from Child Care Matters. And in addition, Aetna U.S. Health Care Foundation actually made it's single largest year-end grant this year to help meet the demand for this program.

Let's speak at the future. What would be the ideal number, dollar figure to meet the need? And this is just for my 756 2/16/01 - FY '02 OPERATING BUDGET own education. If you had to in -- in an ideal world, what would the dollar price tag be? COMMISSIONER RICHMAN: I'm Estelle Richman, Director of Social Services. We've never requested that information from the child-care providers. And because they all differ so much, I'm not sure that I could tell you exactly what each one of them needs in those priorities areas. We know that it's probably fairly significant since there's never been an initiative to even help them identify all of their needs.

Okay. COMMISSIONER RICHMAN: That is something that we will probably continue to work on as we develop this area. But I'm not sure I can give you any realistic number right now, not having surveyed those providers.

And see where it is. COMMISSIONER RICHMAN: And see -- right.

Well taken. Okay, let me move before my time runs 757 2/16/01 - FY '02 OPERATING BUDGET out. Moving to the after-school programs. Miss Martinez, you indicated in your testimony that currently -- well, the new funding budgeted will allow for 2,000 new slots, and Miss Richman may have mentioned this in her testimony earlier this week, that brings us up to what level? What's the total level of after-school slots now that are funded? COMMISSIONER MARTINEZ: One of the exciting aspects of this after-school initiative is that it's being done in a collaborative way with the Office of Social Services and the Department of Human Services, so I'd like to be collaborative about answering your questions and ask Harriet to help me. COMMISSIONER RICHMAN: I actually have the information on this one. At this point in time, we are covering about 15,000 kids within our after-school program, and that's broken down, just so you understand the diversity, as Alba said, between: Fairmount Park, the Department of Human Services, the Family Resource Network, the Free Library, the Mural Arts 758 2/16/01 - FY '02 OPERATING BUDGET Program, the Police Athletic Leagues, the Recreation Centers.

Okay. COMMISSIONER RICHMAN: And the Mayor's Office of Community Services. And there are some other smaller ones -- and the School District in general. So there are a whole range of initiatives that get us to 15,000 kids.

Okay, then. And the total number of children in the City that need after-school programs, what is that figure? COMMISSIONER RICHMAN: We would like to see all children in Philadelphia who are of school age have some choices around after-school programs in Philadelphia. So that number is probably going to be in at around 200,000.

Thank you. Now to the family care centers. And my experience with family care centers is a little dated prior to coming to Council, but with that in mind, you discussed that on , I believe? COMMISSIONER MARTINEZ: Councilwoman, could you please repeat the question? I'm having 759 2/16/01 - FY '02 OPERATING BUDGET a little bit of a difficult time here.

Surely. The next is devoted to the discussion of the community-based family centers in the neighborhoods. COMMISSIONER MARTINEZ: Yes.

And for FY 2000, approximately 12,000 children were served? COMMISSIONER MARTINEZ: Yes.

Now, my experiences is dated. Prior to coming to Council, I had some involvement with family centers in West Philadelphia. And my observation at that hour, which was three years ago, was that that particular family center was not well-utilized in terms of numbers of children served. So the question is, what do you do with regards to outreach? And what kind of measures do you have in place that assure you, from where you sit, that the capacity is being reached in the family care centers, the family network centers? COMMISSIONER MARTINEZ: Well, we emphasized in our testimony intentionally the fact that we are actively evaluating the family centers 760 2/16/01 - FY '02 OPERATING BUDGET right now, because in fact, while I don't think that there's any question in anybody's mind that the family centers are an extraordinarily powerful weapon to fight the kind of problems we want to fight. Because they are based in schools and that's where the kids are and that's where families come, I think that we also agree that we do not have good enough data on the impact that we're having.

Okay. COMMISSIONER MARTINEZ: One of the great assets of the family centers is that a lot of what they do is driven by what the neighborhoods want. So we do believe that a lot of good things are happening within the family centers but we also believe that it is important that we be able to measure that. I too share some of the concerns that you're articulating in terms of ensuring that these family centers are used to the maximum potential and capacity possible, given that we have some limited resources to help people. So we are going to evaluate those family centers, and I will ensure that you get a 761 2/16/01 - FY '02 OPERATING BUDGET copy of any information that we are able to collect around the impact of the family centers.

Please. COMMISSIONER MARTINEZ: Some family centers have great utilization and others have more limited success, and I believe that outreach is an essential component of what those successful ones do.

Sure. COMMISSIONER MARTINEZ: And the other impact is the relationship that they have with the school. That often impacts on the --

Success. COMMISSIONER MARTINEZ: -- success of the family center and also on the range of services that they provide. We want to make sure after-school programs, parenting support programs, access to information that people need when they need it are all available in family centers. We want to make sure that there are some basic elements that are present in every single family center, and those three are some that come to mind for me: after-school, parenting support and education, and 762 2/16/01 - FY '02 OPERATING BUDGET access to information and referral, which I think, unfortunately, is so hard to come by. As you may know, I've been doing Town Meetings, and another great asset of the family centers is, we've been able to use that network to do one Town Meeting per month and have had hundreds of people from the neighborhoods come and talk to us about what they want to see from DHS. And, of course, they take the opportunity to tell us what they want to see from everybody in the City. And so we are using the family centers there. But what I am also finding that is very disturbing is that sometimes people, you know, don't know the -- they're in the family center and they don't even know exactly what the services are that are provided there. We have a disconnect in this city of getting information to people of services they we do have. And I believe that the family centers can be a vehicle to provide that information and that connection for folks.

I agree with you completely, and do know that I will be interested in an assessment as well as the locations, where 763 2/16/01 - FY '02 OPERATING BUDGET they are currently. So I look forward to that information. COMMISSIONER MARTINEZ: Okay.

My final question revolves around the troubling realities we're facing with regards to girls. And you discuss that on , last paragraph on . COMMISSIONER MARTINEZ: Yes.

As an editorial comment, I look forward to the second Girls Conference, so please make sure that I'm on the mailing list. You state that "a 1999 study of girls in detention found that they are held in the same level of detention as boys with greater, more severe delinquency histories, primarily because of mental health and family problems." If you would, simply go into some detail and discuss for us some of the initiatives that DHS is currently pursuing to reverse the trend. COMMISSIONER MARTINEZ: Well, I would like to invite Deputy Commissioner Burrell to join me and help me answer that question. 764 2/16/01 - FY '02 OPERATING BUDGET But I can tell you that we are actively in development of programs that will allow us to serve children in their own communities through extended-day treatment programs rather than being institutionalized. We're trying to make every effort to make sure that girls can be served in their communities, particularly since many of the issues that they present are not about the severity of the crime that they may have committed, but more that they need really intensive behavioral health treatment. So we are going to be investing in specific programs, and we're also doing some research about the best-practice models that might be available to serve girls. But go ahead.

Good morning, Miss Burrell.

Good morning. Joyce Burrell, Deputy Commissioner. I think the Commissioner pretty much answered it. We really are looking at what the best practices are, we are making sure that our providers are aware of what basic components 765 2/16/01 - FY '02 OPERATING BUDGET should be present in any girls' program and the kind of issues that bring them to the juvenile justice system, which is very different from the issues that bring boys. Being around early abuse, around substance abuse, which gets tied into mental health or behavioral health issues is a part of the coping mechanism for them, so they come very complex, with very special needs that we can intervene in earlier. We're doing some mentoring programs with girls. A very exciting initiative so that we maintain the girl's place in her home is the development of these day and night programs that the Commissioner mentioned. Girls will be in program from 7 o'clock in the morning to as late as 10 o'clock in the evening, but as long as home is not abusive, to secure a place and maintain a special place for them with their own families. This initiative changes that take-them-out-of-the- home philosophy and forget that they ever existed.

Councilwoman Brown?

Yes.

Do you mind? 766 2/16/01 - FY '02 OPERATING BUDGET There are any number of Councilmembers that want to be recognized.

I do not.

We'll have a second go-around.

Sure. I just had one closing comment. Let me echo Councilman Nutter's comments with regards to your approach, which is to be driven by data and best practices verses anything else, and how it's data and best practices that move you towards coming up with strategy and planning that ultimately moves you towards implementation. So know that I join him and others here who support that approach, because the old way isn't working. COMMISSIONER MARTINEZ: Thank you.

I'm through with my questions, Madam President, and I thank you very, very much for your testimony. COMMISSIONER MARTINEZ: And thank you for your support during the year.

Absolutely. COMMISSIONER MARTINEZ: And your 767 2/16/01 - FY '02 OPERATING BUDGET guidance.

Thank you. The Chair recognizes Councilman Clarke.

Thank you, Madam Chair. Good morning. COMMISSIONER MARTINEZ: Good morning.

Councilwoman Blondell Reynolds Brown actually touched base on the question I was interested in, the family learning centers, but I just wanted to carry it a little further. And I'm glad to hear that there is, in fact, an evaluation process taking place because I too am concerned, and I happen to have one a couple blocks from me, at the Blaine School, and from time to time, I've gone by and I was somewhat disappointed in terms of the participation level. In this evaluation process, can you tell me a little bit more about that? Because my concern is the participation of the community members in the evaluation process, 'cause sometimes, we in departments and we of government officials, we evaluate things without having the 768 2/16/01 - FY '02 OPERATING BUDGET individuals that we are trying to reach be a part of that evaluation process. Can you tell me about the process associated with that? COMMISSIONER MARTINEZ: Well, I've invited David Fair, who's the Director of the Community-Based Prevention Services Division to help me answer that question. But I will say this: If the evaluation doesn't involve the input of the community and the residents, then it's not going to be a good evaluation. So I certainly hope that his answer includes that that's been taken into account.

Absolutely.

I agree.

My name is David Fair. The process we're engaged in now works very closely with the advisory boards that we require be in place for each family center, and we have specific money identified in our budget for the ongoing training of the members of the advisory board so that they are able to engage with us in a positive way about the plan and the delivery of services in the family center. We also support a program called "The 769 2/16/01 - FY '02 OPERATING BUDGET Family Leadership Institute," which trains people from the community to be able to participate in the advisory board of the family center system as well as other advisory boards that we're establishing for our division, such as the Parenting Collaborative and other places. I think that the motor that is driving the effort to restructure the family centers so that they're a more effective network for delivering services really has been the advisory boards. And concerns that you and others have raised about outreach is the primary concern that they have had as well. We are setting specific targets for the coming year for each of the family centers regarding how many people they need to see and where they need to come from. Many of the family centers have fallen into the habit of only working with children who are attending the specific school in which they're located. And so we have set very specific requirements that they be able to show us the strategies they will be using next year and specific targets on how many families they will serve. 770 2/16/01 - FY '02 OPERATING BUDGET

Have you given any thought, 'cause I hear you talking about the advisory boards, and sometimes the advisory boards don't participate as often as we would like, and I'm concerned that we would use that as primary tool. Is there any interaction with the other agencies? We talked earlier in the testimony earlier in the week about four or five different agencies who are responsible for organizing the communities, organizing block captains, and community leaders. Have you reached out to those particular organizations in your attempt to evaluate and increase your outreach process?

I have to say that we are in the process of doing this, and so in some communities, we've done well with those kind of connections, and in others, we haven't done as well. But it is a part of our agenda to be able to both talk to other organizations in the communities around the family centers and also to talk to organized groups of neighbors in communities that don't have family centers. We 771 2/16/01 - FY '02 OPERATING BUDGET hear a lot from people around the City who want to create a family center. And fortunately, we are now able to be a little bit more articulate about what we expect a family center to be able to accomplish. I'm not sure I fully understand your question, but the --

Okay, let me be more specific. I live in Strawberry Mansion. Our family center is not what we would like it to be. We happen to have an extremely strong block captains' network in that particular area. I have a mailing list of upwards of 70 block captains who are extremely active, and anytime I need something to be done, I send something out to these block captains and they get the job done. And I'm saying, would it make sense for us to use such a list in conjunction with the Mayor's Office -- I think the Managing Director's Office probably has that same list -- to get those people in, people who have already exhibited a willingness to go above and beyond their own personal responsibilities. I mean, block captains, they don't get paid, right? 772 2/16/01 - FY '02 OPERATING BUDGET

Right.

They do this because they care about their community. And should we possibly look at using those people?

Absolutely. And I can't really talk to you very intelligently about that particular family center, although I did finally get to talk to some people to begin to talk about what's going on out there this week with our staff. I want to reassure that you our strategy for the redefinition of family centers specifically requires those kinds of connections to be made, and we are hoping that we will ultimately be staffed up so that we can monitor that kind of relationship a lot better than we have in the past. In the past, for reasons that I'm not really clear on, the leadership of what went on in the family centers did not really rest at the Department of Family service, and so we are now trying to integrate this as a real service-delivery system, and everything we do in community-based prevention, that's one of the reasons I'm exhausted most of the time, is being 773 2/16/01 - FY '02 OPERATING BUDGET in the community and listening to people and trying to develop things in a way that really makes sense to them. So I'll make a commitment to you that on that particular topic, I'll follow up with your office to connect with those individuals, but I also want to reassure you that throughout the City, it is our intention to make sure that the family centers are integrated into whatever's going on in that particular neighborhood. And I believe that the Commissioner is willing to support whatever steps we need to take to make sure that actually happens. COMMISSIONER MARTINEZ: When I made my introductory remarks, I referred to some guiding principles that back up every decision I make at the Department of Human Services. And while some people might consider that somewhat naive or maybe an oversimplification, I want to say that I believe that some of what we need to do is really going back to basics, and I will say that I've been consistent from the day I walked in that if something as fundamentally community- driven as a family center is not attracting 774 2/16/01 - FY '02 OPERATING BUDGET community people, there is no justification in the world for continuing to fund that kind of program. And I will have the courage, sometimes even if it means pulling something out of a neighborhood where I'm going to have resistance, you know, if it's not working, we need to reprogram that money. And I'd like to introduce a broader -- have the opportunity to City Council our new Deputy Commissioner Wanda Mile (ph.), who replaced Maxine Tucker after many, many years of dedicated service. And Wanda's going to oversee both the Prevention Division and the Children and Youth Division. And Wanda also had the opportunity to help build one of the most successful family centers in the City, the Congreso de Latinos Unidos Family Center, which is in your district. And I wanted to see if Wanda want to do add thoughts her thoughts around family centers.

Thank you. I'm Wanda Mile.

Good morning.

And I hear your concerns about Strawberry Mansion, and we are concerned citywide, as David said, in building a system 775 2/16/01 - FY '02 OPERATING BUDGET that's really going to be responsive to neighborhoods and to families, but also produce data and outcomes that are good for kids. In North Philadelphia and in the Julio De Borgos neighborhood, it took Congreso many years to really establish the right kinds of partners and to really invest the school because the school is really pivotal and their cooperation and support is pivotal, but there's also an important organizing sort of level of sophistication that has to be developed in community-based organizations, and some have them and some don't. Partnerships are important, but that organizing capacity is really not just about understanding the demographics of your neighborhoods; it's about understanding how -- what collaboration really means. And collaboration is sometimes painful; it's really about sharing an agenda that ultimately leads to positive outcomes. And so, you know, we will join with you and support you in your concerns around your neighborhoods, but I also want to ensure you that 776 2/16/01 - FY '02 OPERATING BUDGET we know how, based on experience and based on really good talent in our department, about how to achieve those levels of collaboration in neighborhoods that are under-served. And hopefully our community-based organizations will join us in these efforts.

Okay. I look forward to working with you. Thank you. Thank you, Madam Chair.

Thank you. The Chair recognizes Councilwoman Tasco.

Thank you very much. Good morning. COMMISSIONER MARTINEZ: Good morning.

Just a few questions. Could you call back Harriet Dickter? I just have a couple questions about something here. (Harriet Dickter returns to the witness table.)

Good morning.

Good morning. 777 2/16/01 - FY '02 OPERATING BUDGET

As you may or may not know, we've had some concern expressed to my office about -- oftentimes we're in opposition to the increase in the number of children in home day cares because the City only allows so many. And we just have to go on record, based on what the law is right now, and the opposition is only based on that law. But in a lot of instances, we get requests for more than, say, up to 12, or more than children in a home day care. 12 And I wanted to know, what is your office doing to work with the State on coordinating the number of children in a home and also the enforcement of regulations surrounding what needs to be done? If you have more children, then you have to have certain physical requirements of a facility. Does your office get involved in any of this day care regulation and monitoring and the number of day cares? Also, while you're answering the questions, on the grants that were given to providers, was there any effort to identify those homes, make sure those homes are legally zoned to be day cares? 778 2/16/01 - FY '02 OPERATING BUDGET

Okay, thank you, Councilwoman Tasco for the opportunity to respond on that. Let me start with your last question first, which is in the Health and Safety Fund, what steps are being taken to make sure that these are providers who in fact are complying with City zoning and are legally situated? And the response on that is that that is a core requirement for participation in the program. The program is open to sites that are registered or licensed, depending on their status, and have in fact demonstrated core compliance with the City of Philadelphia's zoning requirements. That's a great deal of concern to us as well. On your other question, which is really what steps are we taking, if any, through the Office of Child Care on monitoring? What I need to share with you is that the monitoring within City government of family and group and center child care occurs through two of the operating departments. Licenses and Inspections does a great deal of this because of their -- the family child 779 2/16/01 - FY '02 OPERATING BUDGET care license, and they do send out people to look at the facilities. They're very aware of the health and safety program and of the resources that are available in that program to assist providers in compliance. And the Health Department also gets involved through the Environmental Division and food service requirements in the programming. So that those are the two operating divisions within the City that really have lots of on-the-ground, face-to-face contact with the provider community. I think you also asked the question about what about the category of provider who is seeking to have up to 12 children? And that's what the State would call "a group day care home," 7 to 12 children. And the State actually will not offer the license to that home until the provider has demonstrated their compliance with City of Philadelphia zoning. And as you know, those zoning requests go to the Zoning Board and have to be approved for the most part by the Zoning Board before the State would allow such a provider to really go into a business and to get their 780 2/16/01 - FY '02 OPERATING BUDGET license.

Well, are we proactive in working with potential providers or existing providers that want to increase their numbers? Because my office will get complaints about the number -- the increase because the day care does not have the play facility or the service -- or can't provide the services to the children in the home. Then we have to be in opposition, which makes us appear that we are against day care, which we are not a against day care.

Right.

But we do have to remember that there are other neighbors in the community who are impacted by the increase in the number of children that go into these homes, and they don't have the recreation facilities for these children, plus the parking, because we've gotten complaints about driveways being blocked, signs that are put up that are illegal -- you don't have anything to do with that. But basically the traffic and the impact-- or the increase in the traffic. 781 2/16/01 - FY '02 OPERATING BUDGET

Mm-hmm.

What we try to do is steer them to a commercial site or someplace that has less impact on the community. But I do think that we have to figure it out, 'cause I don't want to be constantly at odds with providers over day care. We need to try and steer them to other places.

Right. I think that particularly Philadelphia, as you know, has very few group day care homes of 7 to 12 children. There are only 80 in the City of Philadelphia, and the strategy that has been adopted for that group is much the same as, in fact, the provider the community has adopted here. To suggest that if you're going to have that many children in a home-based setting, then there may be alternatives. I think the real issue is for us to continue to pursue -- have to do with making sure that the small family child care home, which parents often like to have neighborhood-based care, they want to have access in their neighborhoods to the child care home, is truly 782 2/16/01 - FY '02 OPERATING BUDGET available in enough quantity and in enough distribution throughout the City that it can really serve families and children well. There have been increasing efforts made to make sure that there's opportunities to support the providers that if they're legal, that they're doing a good job that they're not an intrusion in the neighborhoods. There's certainly more progress that we can make in that area, and there is discussion between the City and the State on these issues and discussion and work with the nonprofit community to try to make sure that enough support is given so we can strike a good balance between the residential character of the neighborhood and the preference of many, many parents to have access to home-based child care programs.

Thank you very much.

Thank you.

Miss Martinez, you're not off the hook. I have a couple of questions for you. I want to go back to the Youth Study 783 2/16/01 - FY '02 OPERATING BUDGET Center, not in terms of construction, but in terms of how children, young people are placed there. What is the general racial breakdown on any -- the average racial breakdown of the population at the Youth Study Center? COMMISSIONER MARTINEZ: It's overwhelming minority, African-American and Latino. Do you have a specific statistic Joyce? It's 75 percent African-American and 13.5 percent Latino. So that minorities are over-represented in detention, not only here but around the country.

Could you give any analysis as to why that happens? COMMISSIONER MARTINEZ: I would like to invite Deputy Commissioner Burrell, who is the President of a national organization of detention leaders in the country and is much better qualified to answer that question than I am.

Thank you. (Ms. Burrell returns to witness table.)

Joyce Burrell, Deputy Commissioner. 784 2/16/01 - FY '02 OPERATING BUDGET The over-representation of minorities in confinement in this country has a lot to do with the front door. Our neighborhoods are overwhelming targeted for initiatives that result in large numbers of arrests, but we have not historically had the community supports to receive our children and support our children. Many of the things that are being done under this administration are to build more very basic community supports that strengthen them. This community-based prevention initiative should assure that there will be other places in the community for children who get involved with the law early, to be referred somewhere else other than to the court system. In many communities, when you look at the difference, there are folks who step up to say, This is not my child but I'm willing to assure that this child returns to court. This is not my child, but I'm willing to assure that this child will have something to do after school every day, and I will, you know, step in to support the family. So we have to build a safety net in communities to make sure that there are 785 2/16/01 - FY '02 OPERATING BUDGET alternatives. And we also have to go to the mat sometimes to bring the minority confinement issue to the forefront so that more people are talking about it. There is a national committee run by the Youth Law Center in San Francisco on over-representation of minorities in confinement. And their issues are around early assessment of the needs of the children to make sure that there are these safety nets for children and that they get adequate and appropriate representation. Poverty drives this an awful lot. There are homes where, when the police pick a kid up, they cannot reach someone by telephone, and there is not a standard practice of going to the home to see if someone's there. And they have to immediately assure the safety child, but often, they are brought to the attention because of something that appears to be illegal. Therefore, that child ends up in a secure detention setting, even if it's for a very short period of time, until a parent can be found. The sad part of that statistic is once they're introduced to the law enforcement system, 786 2/16/01 - FY '02 OPERATING BUDGET they tend to befriend young people who are in that system and they have a greater likelihood of going on to more activity with children who are already in the delinquent system. COMMISSIONER MARTINEZ: I'd like to add an interesting fact that I've noticed since I've arrived at DHS, which is that the same zip codes in Philadelphia that include the highest poverty rates, the highest crime rates, the highest unemployment rates are also the same zip codes that include the highest juvenile arrests and the highest reports of abuse and neglect. So I want to echo what Joyce is saying, which is that at least in Philadelphia, poverty seems to be at the root of all evil.

You said something about the safety net and communities providing that. Could I conclude that the majority community here in Philadelphia has a stronger safety net for children of that community than for minority communities? COMMISSIONER MARTINEZ: Well, I mean, I think that the in lowest-income neighborhoods in Philadelphia, there are families facing multiple 787 2/16/01 - FY '02 OPERATING BUDGET threats at the same time. I mean, the level -- I mean, I think that poor families can be incredibly strong, and we have very strong families in low-income neighborhoods, but the threats that they face sometimes are often overwhelming. You know, the inability to access health care when they need it, inadequate access to transportation, as I believe Councilwoman Blackwell was speaking that, the issue sometimes is that families don't have enough money to send to school. So as a result, they are situationally truant. The overwhelming impact that drugs has on people's lives. And it's not only what's happening outside of your door; it's what's happening inside of your house. You can have a child or a partner or a relative who's using drugs and is draining your very limited resources. I mean, I believe that it is the environmental threats that are making our families vulnerable, and that sometimes what I have found in working in low-income neighborhoods is that those families are stronger than many families outside of those lowest-income neighborhoods because they've learned how to survive. 788 2/16/01 - FY '02 OPERATING BUDGET So I am not sure that I would conclude that our families have -- I know you were talking about networks of support; they definitely do not have sufficient networks of support, but I just want to make clear that I believe that the families in those neighborhoods are incredibly strong. And with minimal support that we could add, I think that they could do tremendously better. All things being equal, all things being equal, if a poverty, lack of community support, all things being equal, if an African-American or a minority youth is arrested and a youth from the majority community is arrested, what is the likelihood of both being confined, or one being confined and the other sent home, and how is that determined? COMMISSIONER MARTINEZ: We don't have the statistics on that. I think that on a national level, there is a belief that, you know, the race of kids plays a factor, but in Philadelphia, we do not have the statistics on that, but we would be happy to provide the statistics on that for you, or studies on that for 789 2/16/01 - FY '02 OPERATING BUDGET you.

Who would provide those statistics to us in Philadelphia? COMMISSIONER MARTINEZ: Well, I think that what we'll be able to provide is any kind of research that we have or any kind of analysis that we have on the issue of disproportionate minority confinement. I'm not sure that a study has been done for Philadelphia, but I believe that there's some information on a statewide basis that has looked at disproportionate minority confinement. So Joyce Burrell will make that available to you.

Thank you very much. With regard to funding for provider agencies, what opportunities are there for minority participation and the provider network? And what steps are being taken to develop minority providers. If you have any, how many; and how do you do outreach to encourage people to become providers? COMMISSIONER MARTINEZ: Well, I don't have the statistics available, but I will make 790 2/16/01 - FY '02 OPERATING BUDGET them available around the proportion of providers that are, you know, minority. But I will say this: I think that the Department of Human Services, prior to my arrival, had made some pretty aggressive efforts and has been successful in expanding the network of providers that represent our client population and that are based in communities of color and that are based and grown and located and hiring people from the neighborhoods that are of most risk. I believe that more can be done, and I think that it is imperative that we develop a network of support that is community-based and community-owned. And in terms of how make resources available to people, we are going to make sure that funding is awarded on a competitive basis, that we have clear criteria that anyone can find out about and compete for. And I think that we certainly need to give tremendous value to the fact that providers need to be culturally competent and culturally diverse and really be familiar with the communities that we are asking them to serve.

One last question 791 2/16/01 - FY '02 OPERATING BUDGET on this round. We were successful in setting up the Kinship Care Program with the Department. And could you just give me a little status report on the Kinship Care activities? Have we seen a decline in the number of family members taking care of children, or have we seen an increase, or has it levelled off? COMMISSIONER MARTINEZ: We have seen an increase in the number of families that are caring for their own children. And as a matter of fact, the next stage that we're involved in in the Kinship Care Program is the development of a guide, a resource guide that is in development right now, that makes available as much information as possible to Kinship Caregivers about how to access resources that their children need. It is certainly a foundation of good child welfare practice to have children placed with relatives or people that know the children, who are able to care for them, as opposed to placing them in a group home or in an institution, or with a foster parent that may be great, but who doesn't have a relationship with that child. So 792 2/16/01 - FY '02 OPERATING BUDGET we will continue to move that forward. In addition to that, we're going to implement -- and this is reflected in our Fiscal Year '02 Budget -- the strategy of permanent legal guardianship, and this is another permanency strategy in addition to adoption, which will, I think, be utilized significantly by Kinship Caregivers. And what that means is that a family or a child where we move that child to permanent legal guardianship is generally going to be a child that's older, that is not really appropriate for adoption, perhaps because they have strong bonds with their families or because they're with a relative, let's say, maybe with a grandmother who's saying, Why should I adopt this child, he's already my child? but they are still as a Kinship Care family under the custody and supervision of DHS. Permanent legal guardianship, which is a new option that the State put on the table, allows us to transfer custody, legal custody, to that caregiver and continue to pay a subsidy. Because that is a big issue. There are families who wouldn't want to have custody but remain 793 2/16/01 - FY '02 OPERATING BUDGET involved in the Department because they need the subsidy that we are able to provide -- that they were able to provide. And in our budget, we have set a target of having 250 children achieve permanency through permanent legal guardianship, and that's going to be a tremendous resource for people because they will be able to take back control over that child's health care, educational care, et cetera; where, when DHS is involved, no 11 matter how good, you know, there's a third party intervening and having to, you know, help make decisions. And often, there's an adult in that child's life who should be making the decisions for them.

Thank you. Thank you, Madam President.

Thank you. The Chair recognizes Councilwoman Miller.

Thank you, Madam Chair. Good morning. COMMISSIONER MARTINEZ: Good morning.

I have a couple 794 2/16/01 - FY '02 OPERATING BUDGET of questions as it relates to the Office of Delinquency -- of Delinquency Prevention. And this is a particular of interest of mine because, you know, I always try to think of what can we do to prevent children from entering the juvenile justice system. But can you describe to me -- there's some -- throughout your testimony, when you talk about delinquency, can you tell us exactly what a delinquent child actually is? I mean, what are some of the things they've been involved in? how would you describe them? are they truant from school? Are they this, are they that? COMMISSIONER MARTINEZ: I'm again going to invite Deputy Commissioner Burrell to help me answer that. But I will say that the definition of "delinquency," or the label of "delinquency," is apply to do a child when they are adjudicated by a court of law and they have been, you know, adjudicated and found guilty of committing a crime under the Juvenile Act. And, you know, those crimes can be pretty, you know, minor in terms of being involved in a fight but where somebody gets 795 2/16/01 - FY '02 OPERATING BUDGET hurt, or they can be very serious, you know, and so they could be, you know, arson, it could be, you know, burglary, it could be a car theft. And what happens is that the level of the crime dictates what kind of treatment a child gets. So, for example, generally young people that are detained in the Youth Study Center may have represented a different kind of a level of risk to the community either because it is assumed that they will not return to court for a hearing or because this is a second offense. But the range of what can be considered a delinquent can be very diverse. Joyce, would you like to add to that.

Yes. Joyce Burrell. Often when you meet a child who has been adjudicated delinquent and you look back at the history, they have obvious patterns of truancy, they have obvious patterns where there has been minimal or a lack of supervision, and often, this supervision from parents who often work in two jobs. Sometimes it's as a result of a parent substance-dependent. We find that often these youngsters or 796 2/16/01 - FY '02 OPERATING BUDGET pregnant, are teen parents. They have had bouts with incorrigibility, where parents have actually sought services, but because a child has not been in trouble at a level that would get the attention of the juvenile justice system, there have been no 7 services for that family or for that young person. Many times, especially for girls, they have been the subject of abuse that has gone undiagnosed or has not come to the attention of the public entity that manages that, and so they become very disconnected, they become very angry. And often when we see them, it's as a result of a an assault that is about something that happened many years ago, and this assaultive behavior is their way of fighting back and preventing the same thing from happening again. Peer relationships drive many youngsters to the juvenile justice system. You know, in many cities and in most cities, if you're in a stolen car, every child in that car has a charge that's related to how they got possession of that car, which is very different from how adult matters are handled. But prevention of delinquency means 797 2/16/01 - FY '02 OPERATING BUDGET shoring up all of those normal child-serving agencies, recreation opportunities for youngsters, appropriate educational assessment, and services available to youngsters. Reaching out to those parents and getting them involved in a way that both meets the needs of the parents and of that child. Many of the parents of children in the juvenile justice system have not been parented themselves after about age or because of 11 many dilemmas that they faced in going up, so many 12 of them don't know the normal milestones in child 13 development, and what they see as acting-out 14 behavior is very much normal adolescent behavior, 15 but they don't have the skills often to deal with that adolescent behavior in a way that is both productive to them and to that child.

Okay. So then "delinquent" means that this child has been adjudicated. If someone has not been adjudicated, then they're not going to fall in the category or be labeled as "a delinquent," or maybe "high-risk."

That's correct. COMMISSIONER MARTINEZ: That's 798 2/16/01 - FY '02 OPERATING BUDGET correct.

Okay. So -- COMMISSIONER MARTINEZ: And precisely, the concept of developing a community-based prevention arm that is elevated in significance and is organized really well is because we know who those children are. You can tell by a number of indicators in a child's life, like those that have a problem of truancy or behavior problems, that they need intervention. And we cannot have a system only intervenes when a child is arrested. I mean, that's kind of turning the whole point of the system upside down. And yesterday, in a meeting with Family Court, the Family Court leadership was talking about the fact that they often have parents calling and saying, Please, place my child, you know, for this child's safety. And so the Family Court and the Department of Human Services and the Behavioral Health System are working in partnership to develop diversion options so that the answer is not to place that child either where they're not necessarily going to get treatment in the 799 2/16/01 - FY '02 OPERATING BUDGET environment they need, but to create options that are just like the options that they would get if they were arrested. We need to give children those options before they're arrested.

Well, we also get those kind of calls in my Council office, and we have, you know, parents that are frustrated, that are really seeking and looking out for help and have not been able access help because their children, or their child, has not been arrested and is not adjudicated. COMMISSIONER MARTINEZ: And the Office of Delinquency Prevention, which is where you led with your question, is precisely about that.

Okay, so -- COMMISSIONER MARTINEZ: It's about having a network of services that is well- organized, based on best practice, and known to people, where parents and teachers and, you know, Councilpeople can refer cases, and that we can intervene in those children's lives as quickly as possible to ensure that they do not enter the juvenile justice track where they're going to be labeled "delinquent." 800 2/16/01 - FY '02 OPERATING BUDGET

Okay, good. Thank you. Also, I'd like to know if you can identify the neighborhoods that have the highest number of children and youth who are in the juvenile justice system. COMMISSIONER MARTINEZ: We can absolutely do that, and we will share maps with you about that. Southwest Philadelphia is one of the areas, North Philadelphia, Germantown has a pretty significant number. We do have maps about it, and we are going to use data a lot in terms of figuring out how to target services. I would be happy to share that with you. It's pretty striking information, although it's kind of what we all know.

Yes, and we'd like to know that too. Also, the Philadelphia Youth Violence Reduction Project, is that going to expanded at any point in time? COMMISSIONER MARTINEZ: Yes, there are plans to expand it into the 25th Police District, which is the highest youth crime area in this 801 2/16/01 - FY '02 OPERATING BUDGET city.

Okay. Part of the 25th is also in my district. Okay. And I, too, want to just make a comment, that I also wondered -- and I'm glad that there's several of my colleagues that have asked the question regarding the TANF benefit cuts and how that would impact services to children and youth here in Philadelphia. And, also, I would like information probably by zip code about where the after-school programs are. You know, many departments talk about their after-school programs, and you go, Well, you know, when you wrote that you were going to expand 2000 slots, and I said, Well, is that under Recreation or is that under this one or that one? So it would be nice if there was a comprehensive list that laid out where all of the after-school programs are, and I guess the easiest way, again, would be by zip code. COMMISSIONER MARTINEZ: I am sure that we can make that available to you through the Office of Social Services. DHS would be able to provide it information about DHS, but we'll 802 2/16/01 - FY '02 OPERATING BUDGET provide it citywide through --

Right, I figured come through the Office of Social Service, but, as Councilmembers, we would like to know where they are. Everyone talks about expanding their after-school programs and we just need to know where all of them are. COMMISSIONER MARTINEZ: I also understand that also Philadelphia Citizens for Children and Youth has developed a guide, a resource guide about after-school programs, and we'll make that available to you too.

Okay. COMMISSIONER MARTINEZ: But we certainly understand the request.

All right. Now, does that guide include the 15,000 spaces? Does the guide include -- we have the guide in our office; I haven't personally looked at it. But does the glide include all of the after-school program slots that are funded through all of the various departments? COMMISSIONER MARTINEZ: What they know at the time was included, and so we'll update that 803 2/16/01 - FY '02 OPERATING BUDGET information with what we know about City-funded slots. That's the information that the Office of Social Services could provide.

Okay. I'd also -- I'm really kind of interested in the delinquent services to teenage girls. And I also wonder if any after-school programs are targeting teenagers rather than just children in elementary or middle school. COMMISSIONER MARTINEZ: I am certain that there are -- yes, there are programs that target teenagers, and that information will be made -- I don't know exactly off the top of my head, but absolutely. I mean, we recognize that what changes is the model you use, but that certainly, you know, older teens need a lot of support and supervision, so that is a major area. And it's also a major area of priority for the Department of Human Services in the highest-risk neighborhoods since know that youth get in trouble between 3 and 7 at night, and we want to keep 'em real busy. Wanda?

Both through our Juvenile 804 2/16/01 - FY '02 OPERATING BUDGET Justice Division and then our new Prevention Division, we are working to fund youth development programs. And also the after-school programs and the standards that were developed through the Division of Social Services has really focused on sort of involving older youth, involving them both in the programming but also in the staffing of after after-school programs. But we can also give you more specifics.

Okay, one other question. You know, there are a lot of young people in my neighborhood that are constantly asking me to help them find after-school jobs or just employment, period. Will you also service those types of young people?

Yes. And when I use the term "youth development," and I know that you know this, 'cause, you know, I know that we've worked together in the past. Youth development for us is a whole range of support and services. It's life skills training, it's support, it's connection to their community. But it's also -- we all know that older youth and youth as they grow older, and particularly in economically-challenged 805 2/16/01 - FY '02 OPERATING BUDGET communities, really need access to resources and need access to jobs. And so, as you know -- I know in Germantown and also at Congreso and at a variety of really quality community-based organizations, there has been that outcry and that request from systems to partner with them for resources for after school and for resources to hire kids and train them -- not just give them a job, but give them skills and supports that are going to help them on their road to adulthood. So, yes, we share with you that concern. Obviously, there are limited resources, but we are targeting resources where we can and encouraging our partners in the system to really look at that as a value.

Okay. So for now, if we have someone -- and I do have two young men that actually just came to my house last week -- do we just call you, Wanda?

Well, you can always call me, Councilwoman Miller, but I think that Harriet Dickter also wants to respond to that.

Okay. 806 2/16/01 - FY '02 OPERATING BUDGET

Yeah. There is a program that the Philadelphia Youth Networks runs, YouthWorks, which provides both summer employment as well as year-round opportunities for kids 6 and above. And so that is the other resource to 7 contact in terms of kids who are coming to you 14 8 and above, who are looking for constructive things 9 to do with some money attached to them, is to call 10 the Philadelphia Youth Network and to enroll 11 children through that mechanism. 12 And I think we want to add that this 13 year, there was a very good relationship 14 established with several of the City's after-school programs in terms of the model for the teen leaders to make sure that we were in fact bringing kids into those programs in a leadership and mentoring role through that. But that's an ongoing available resource.

And I would just like to add that the Freedom Schools is an effort that was initiated through the School District, but the Department of Human Services is very active in that partnership and helps to funds Freedom Schools during the summer, and that does provide 807 2/16/01 - FY '02 OPERATING BUDGET funding for summer jobs and training for kids. So you can call me directly about that.

Okay. Well, you know, my office works very close with, I still call it, the Urban Coalition around summer youth employment. It's the after-school, winter-type employment that we seem to not have access to. Or enough places that we can refer children to. But it would be great if we could just refer 'em to one source and know that they're going to get some assistance. COMMISSIONER MARTINEZ: Well, I will also sort of integrate your comment into our thinking as we design models and systems because I think that that's consistent with what I found, which is the fragmentation, the difficulty that people have in finding out information about what they need. You know, even if the service is not there, at least give me clearly the information about what is and what is not there. And I certainly agree that we need to do more around developing real options for kids for work during the school year. I know that there are options out there. I think that we need 808 2/16/01 - FY '02 OPERATING BUDGET more. And so I'm not sure how we will get there. Many people are working on that as we speak. But it has to be a combination, by the way, of public and private dollars. I mean, we really need to get the private sector to invest in our young people and put money on the table because the best way that we're going to develop young people is not only by keeping them busy but by assisting them in developing concrete skills that they can use when they enter into the workforce. And it seems to me that the private sector, you know, which has all of the resources and controls -- you know, many of the businesses here would be a tremendous partner to have at the table for this purpose.

Well, I certainly agree with that. One other comment. I'd also like to be kept abreast of anything you're doing special for teenage girls. I'm a mother of a teenage girl, and we have lots of teenage girls in our neighborhood, and we're always trying to figure out things to do with them. But I also know that at this time, 809 2/16/01 - FY '02 OPERATING BUDGET Germantown High School specifically is having a real problem in terms of violence, and the problems are basically the girls, not the boys. COMMISSIONER MARTINEZ: Okay.

So I was talking to the dean of students maybe two or three weeks ago, and he specifically asked me if I could help him get females to come out to the school. They haven't really structured whatever it is they want females to do yet, but maybe I'll give you a call and see, 'cause I told him certainly, we could put together a list of people. But I don't want to say on the record what their specific problem is, but I will certainly be glad to talk to you off the record about their problem.

And I hope that you will call me.

Okay.

I mean, you're welcome to call Alba, but I also would love to come and visit and sit with you. You know, as Joyce mentioned, that we're researching best practices for services for girls, and we want to do that both on the intervention and sort of delinquency end, but we 810 2/16/01 - FY '02 OPERATING BUDGET really want to do it on the prevention end. And any ideas or needs that you have, you know, we're very much interested in connecting with you.

All right, thank you. No more questions at this time, Madam President.

Point of information?

Thank you.

You're welcome.

I'd like to suggest, Commissioner, that for employment during the school year, that maybe an initiative with the Chamber of Commerce. Charlie Pizzi possibly would shepherd a program within the Chamber that might give some of the young people that we're taking about today employment opportunities. I know the Chamber is always interested in supporting efforts that we support, so I would suggest a letter to Charlie Pizzi and possibly the member businesses of the Greater Philadelphia Chamber would -- COMMISSIONER MARTINEZ: I'll tell him 811 2/16/01 - FY '02 OPERATING BUDGET that you told me he'd do it.

No, you don't really need to tell him I gave you the idea. COMMISSIONER MARTINEZ: I'll tell him you ordered him to.

You could do that, certainly. Also, I had a conversation with Mr. Mifflin, from the Fairmount Park Commission, and I know the Fairmount Park Commission is looking at developing a program to employ not just young people but others during the summer to take on many of the tasks that are sometimes not dealt with on a day-to-day basis -- trail clearance and trail restoration. Hard work, let's put it that way. So I would also suggest that the Executive Director of Fairmount Park would probably be interested in assembling a team of young people that could get out there and make the park a better place. COMMISSIONER MARTINEZ: Thank you for those ideas. It's wonderful.

Thank you, Madam 812 2/16/01 - FY '02 OPERATING BUDGET Chair.

Thank you. Councilman Nutter?

Yes. Thank you, Madam Chair. Commissioner, I had a couple last questions in the child care area, and then I had a series of hopefully quicker things to go through with regard to your testimony. I did want to get a good understanding, and I think Director Richman was going to touch on these items, and then I probably distracted her with another question. What is the size, what is the staffing level of the Office of Child Care?

The Office of Child Care at this point has two staff: a director and additional staff.

Okay. And I know it's a new office and you obviously have to start somewhere. At the same time, it sounds like we are asking for a significant amount of work and, I mean, there are a lot of children and issues in the City. Do we anticipate over some period of time that we might see some level of increase in 813 2/16/01 - FY '02 OPERATING BUDGET that office? I mean, I just don't know how a couple people do the enormity of the work that we're talking about. COMMISSIONER RICHMAN: They're actually doing an incredible job. And our plan has been to transfer originally someone from L&I who understands the child care regulations. That would have added another person. And to add one more person to that. So it would have been a staff of four altogether.

Okay. COMMISSIONER RICHMAN: We're still working on both of those. And hopefully, we'll get that done over the next -- I'm not sure we'll complete it by June 30th, but probably over this calendar year, we'll get that done.

Okay. Myself and a couple other members will be at a talking with Miss Dickter soon, and she and I have had some discussion about any opportunities to get out information either that we have or verified information that we have from others, utilizing certainly the City's Web site as well as cable television, the government-access channel, 64, and 814 2/16/01 - FY '02 OPERATING BUDGET that kind of scrolling series of information that's provided there. I think that any information that we can get out to people about quality programs that are out and available, recommendations on issues that are of concern to parents would really make this office the kind of top-notch place I know we all want it to be. And, again, I'm appreciative that the administration thought enough to have this kind of office. You know, I've, you know, having a close-to-6-year-old, I pay a whole lot more attention to child care issues than I ever imagined before. COMMISSIONER RICHMAN: Obviously, we're very interested in making sure -- I think Commissioner Martinez also mentioned that one of our challenges is to make sure people know about programs, know about resources. And we would be glad to work with you and obviously are working in the City to make sure that happens.

Lastly in this area, do you expect that the Office of Child Care will be involved in -- there is an ongoing process 815 2/16/01 - FY '02 OPERATING BUDGET to evaluate a variety of child-care and childhood education programs at the School District. The School District runs, for instance, naturally Head Start funded by the feds, we've got the comprehensive day-care programs as well as the parent cooperative nursery program, which had a little bit of controversy last year. All of those are apparently in the process of being evaluated. And I just wanted both not only for what they provide but also what we should be doing going forward, and I wanted to ask if the Office of Child Care would be involved in that effort so that we make sure that, you know, four- and five- and six-year-olds, and even, I guess, three-year-olds, can have a quality educational experience, even at those younger ages, as they move onto, you know, like 1st grade. COMMISSIONER RICHMAN: Right. One of the things that I want to assure to you is that the Office of Child Care is very involved in working with the School District.

Okay. COMMISSIONER RICHMAN: And that that relationship will continue. 816 2/16/01 - FY '02 OPERATING BUDGET Harriet, do you have a response to the specific question around the initiative going on right now?

I just want to affirm that we are very involved in the current thinking and planning over the problems that I know are of great concern with the parent cooperative nurseries as well as the rest of the programming. We're very fortunate, actually, to be doing a citywide right now in conjunction with a special private planning grant we have with the United Way, looking actually at child care quality in all types of child care settings, formal and informal, throughout the City of Philadelphia. And so we should have very good information to share within a couple of months that actually gives us a much, much better understanding of the kinds of experiences young children are having throughout the City, the School District settings, as well as other settings.

Let me just lastly say in this area, I mean, beyond my general concern and great feeling about the quality of the 817 2/16/01 - FY '02 OPERATING BUDGET experience that the young people have when we have them, I mean, there are, quite honestly, other motives that I have, one of which is, to the extent that 3- and 4- and 5-year-olds can have a good experience either directly with the City or with the School District, quite frankly, I think out of that, we get the opportunity not only to positively impact that child's life but we also potentially get to hold on to that child into 1st grade, and that that young person might actually go to public school, and we get to keep the parents, who, in many instances, have options. And they might have an okay preschool or kindergarten experience, but now comes the big decision about where is my child going to go to 1st grade, and if haven't had a good experience with us or with the School District, they make that decision right then and there, and they are out of here. And so, a part of this is, to the extent that we can kind of keep them in a path and keep them involved and that the child is enjoying their experience, obviously that gets translated to the parents in many different ways, and I think 818 2/16/01 - FY '02 OPERATING BUDGET that we get a chance to compete for those parents and keep them in the City and in our public school system. Thank you. COMMISSIONER MARTINEZ: Thank you.

On , Commissioner, of your testimony, you talk about the Office of School and Community-Based Truancy Prevention. It's my understanding that on any given day, the census of school-aged population seems to indicate that we have about a percent 13 truancy rate throughout the City. Has this office 14 done any analysis of truancy in the City, either 15 by school or by Council district? 16 COMMISSIONER MARTINEZ: Let me ask 17 David Fair to help me answer this question. 18

Thanks to the fact that 19 we've been doing an evaluation of the 20 effectiveness of the cluster-based truancy course, we have specific data by school and by cluster and by Council district, and we could provide that to you.

If you could provide that to the Chair, I would greatly 819 2/16/01 - FY '02 OPERATING BUDGET appreciate that. Tell me what happens in the -- I know a lot of attention is obviously focused on the young person who didn't go to school and why, and our first effort, naturally, is to get them back to school. Tell me a little bit about what goes on with the parents or guardian of these truant students. And what, if anything, do we do with them?

In those situations where there is the ability to do that, and most of the kids who are truant, by the way, are not report to Truancy Court and do not come to the attention of our system. But for those who do come to the attention of our system in those situations where the parent is having difficulties that are encouraging the truancy among the kid, we try to link that parent to the system of services that's available from the Behavioral Health System, from DHS, and from community-based supports. The evaluation that was done of the services provided in Truancy Court in the 1997-1998 school year, which is the latest version that we have, indicated that the vast majority of 820 2/16/01 - FY '02 OPERATING BUDGET the kids that we were successful in getting to go back to school were those who -- where we were also able to address the family needs. It's not usually done -- it's often not just the parents, it's also the siblings. My biggest difficulty right now, and Commissioner Martinez referred to this earlier, is that we really don't have a master plan on how we're approaching this stuff. And so we have often had situations where a child will show up in Truancy Court with virtually nobody knowing what it is that's going on in that child's life, and the master is then asked to make some recommendations or decisions about what to do. So we're working now on developing a much more coherent system of doing that in trying to put in touch with every child who is truant -- our current goal is 10 absences or more -- in touch with some kind of social worker or case manager or someone who can assess the family's needs as a whole and address them as a whole, because the evidence is absolutely clear that if you don't address the family's need, the kid does not go back to school. 821 2/16/01 - FY '02 OPERATING BUDGET

Okay. COMMISSIONER MARTINEZ: And, Councilman, I would like to add that truant children and youth come to the Department's attention also in another way, and that is through our intake in children and youth, because more and more, we are finding that judges place children from the bar of the court with the Department of Human Services in court-ordered supervision because a child is truant, and, you know, they've been trying to intervene, and so then they mandate DHS intervention. And that is yet another reason why we believe that we need to build a prevention system because, you know, we shouldn't wait for that. However, when that is the case and when we are court-ordered into a child and family's life, then we put services in the home, services to children in their own homes, trying to keep that family together and attack the truancy issues. But what we are doing to make that even more effective is that we are going to incorporate into the performance standards for the Department 822 2/16/01 - FY '02 OPERATING BUDGET of Human Services truancy as an issue of priority in every case. In every case, we're going to want to measure our success and the success of our provider agencies by how well the child is doing in school. So, for example, we're talking about when we go out and we monitor agencies, to have our monitors look at a report card and make sure that a report card of a child is in that file. We need to institutionalize as a practice the analysis and the review of how our children are doing in school, because we think that it's a window into many other things. And the other thing we need to recognize about truancy is that kids -- you know, what's behind truancy can be many, many different things. Sometimes it's a child just acting out and not, you know, responding to what parents want him to do; parents want him to go to school and they're not doing it. Sometimes it's fear of going to school; they're not having a good school experience. Sometimes it's that the parents are compromised by the use of drugs and are neglecting the children. You know, it's very complex. 823 2/16/01 - FY '02 OPERATING BUDGET I think an assessment is key in every case. You know, you can't generalize, but we know that there is generally a problem on the adult side, but there is not always an unwillingness of that adult to do the right thing.

Okay. In the same paragraph and then in the paragraph below, and I won't so much ask you questions, and if you could get us the information subsequent. Is there,, I guess, for the Department somewhat of a resource guide that any one of us could have that would not only give us information but locations and contact numbers for -- you have in your testimony, you make reference to the Parenting Collaborative. You talked about expansion and enhancement of after-school programs, the home visiting programs for new mothers, the expansion of the School Attendance Improvement Project, and a host of others. I mean, obviously, given the magnitude of your department, there are a whole host of programs and activities that you have. I don't know how you keep track of them all. But for us, is there something, I guess, that is a little smaller in terms of a 824 2/16/01 - FY '02 OPERATING BUDGET guide book that would tell us -- if someone were to call, and based on where my district as maybe compared to Councilman DiCicco's district, this is where you need to go, this is who you should talk to. You know, I mean, I'm not trying to run a social service agency out of the office; nor certainly would I even think that we could do it anywhere near at the level of DHS. On the other hand, sometimes people just need information. And, I mean, more in our preventive role, if someone reaches out, rather than sending them through the "Oh, you shouldn't talk to us, you should talk to the other one" or "Let me give you this number," or, you know, a runaround and send people all over the place, sometimes when you have them, I mean, you really have to try to provide an answer and a response right at the moment. Is there a that kind of document? COMMISSIONER MARTINEZ: Well, let me talk about a couple things really quickly. The first thing is that I asked for that guide when I first came to the Department of Human Services, and it was not available. And so we are right now 825 2/16/01 - FY '02 OPERATING BUDGET in the process of developing a guide to the Department of Human Services. The development of that is actually underway. We are going to issue a parenting resource guide the first time, and every year, we're going to reissue it to make sure it's updated and every year it's going to be better and better. So we're going to issue one specific to resources for parents and parents support and education. We will issue a guide to the Department of Human Services as soon as we complete it, and we are working on that, as I said, right now. And we're hoping not only to tell people how to access DHS services, but also the services of our unbelievable network of agencies. I mean, the Department of Human Services' budget is over $450 million, as you well know, and $71 million of those are in our staff, in our 1800 staff, and the rest is in services to the community. So we need to make sure that we're not talking only about what DHS does, but what our network of providers does. But the other we're thing doing, which 826 2/16/01 - FY '02 OPERATING BUDGET is, I think, even more significant, is that we're creating a strategy and an approach which is a customer-service approach, and we're working on a couple of things to break that problem once and for all or get rid of that problem, which is that people who need services have a really hard time connecting with them. And I'll tell you, this is being called for more than anything by my own staff, who often cannot find resources available or easily for our own clients. So we're going to do the guide and we're going to have a main number, which is now -- now being tested. We actually have a number, 683-4DHS, which gives people access to DHS through one single number, and we're working out the kinks of that system and we will advertise that number. We're going to develop an information and referral network that will connect callers to services as needed.

And we're going to develop a Web site, and the Web site is in development as well. So we hope to have a number of vehicles to give you, your constituents, my staff, and our clients access to information as quickly as 827 2/16/01 - FY '02 OPERATING BUDGET possible. We'll also hopefully be working with United Way in joint venturing around the development of a 211 number. I'm not sure if Council has heard about that, but it's a national concept, it's happening in Atlanta, where the 211 is used as an information and referral tool. And I've been speaking to Chris James (indiscernible) joint-venturing. We don't need two information and referral systems; we need one really good one.

Commissioner, at this moment, let me now commend you. You have obviously held your own very well up here and attracted the attention of the electronic media. COMMISSIONER MARTINEZ: Say some very nice things now, please.

Well, I will start being nice. Three last questions. One, in many instances, it is pretty much always taken as a given that all of these systems and programs and the bulk of the responsibility involving children, then naturally we talk about their mothers and what's going on with the mothers. It does occur 828 2/16/01 - FY '02 OPERATING BUDGET to me that there's only one woman in the history of the world who had a child and there wasn't technically a guy around. What are we doing with fathers and their role in this whole process involving their children? COMMISSIONER MARTINEZ: I'm inviting anyone from the Department -- (Laughter.) COMMISSIONER MARTINEZ: -- who can speak to that issue to join me. But I will answer that question from a conceptual standpoint, which is that, you know, when I think about family, and as I said, you know, I'm pretty new, but I'm driving my decisions based on some guiding principles. And certainly, one of my guiding principles is that when you look at family, you know, you look at it as broadly as possible, and you exclude no one. And certainly, under no circumstances, would I, you know, even think about developing programs or certainly continuing to invest in programs that do not take into account, you know, that kids generally have a mom and a dad. And 829 2/16/01 - FY '02 OPERATING BUDGET whether the dad is present at home or not, you know, the attempt to make that connection and the support really needs to be made. Moreover, Councilman, the law requires that. The law requires that the Department really work with both parents of a child or the caretakers of a child to make sure that they are an affirmative part of achieving safety and permanency for that child. So I assure you that as those issues come up, we will always fall on the side of inclusion in making sure that is taken very seriously, the role of men in raising children.

Thank you. COMMISSIONER RICHMAN: Councilman, it's an excellent question, and you will hear in the testimony, the Mayor's Office on Community Service, a new program they'll be instituting in Fiscal Year '02 called "Father Figure Initiatives" to address the fatherlessness in some of our communities. And I'm also reviewing a proposal that I have by the National Father -- I forget all of the names of it -- to be able to work with DHS and 830 2/16/01 - FY '02 OPERATING BUDGET other programs around how do we make sure fathers are included in all of the things we do, because so often, all anyone hears is about the mother. And we need to make sure that all of these children have fathers. And that the father initiatives are not only heard, but that they become more a part of our conversation. So those things are clearly on the agenda, and I hope by next year at this time, we're talking more mothers and fathers as opposed to references just about moms.

Great, thank you. Commissioner, in your Key Performance Measurements section of your testimony, the last page, I don't really know what this means; I know what it is. There's a line item that reads "Children Participating in Immunization Programs." FY '98 and '99 are listed as, I'm assuming, N/A, not applicable. There's 78 in Fiscal Year 2000, 165 in '01, and 200 in '02. Is this a new effort? I'm assuming that we work with or help to immunize more than a couple hundred of kids a year. COMMISSIONER MARTINEZ: It's not the 831 2/16/01 - FY '02 OPERATING BUDGET only immunization project in the City by any means. It's simply a reflection of an immunization initiative that was built by the family centers, so these are the children that have been immunized specifically through the network of family centers. 8

Okay. Last 9 question. Unfortunately yesterday, and 10 unfortunately probably earlier this year, and 11 unfortunately, it will probably occur in the 12 course of this year. Yesterday there was a rape 13 of a young woman, or a young lady, at Roxborough 14 High. There have been other instances of abuse of 15 young people, primarily young women of school age. 16 In that situation, does the Department 17 get involved at the level of any kind of 18 counseling, either for the victim, for the parents 19 and guardian, the rest of the school-aged population community at that locale that has obviously been affected at some level by this incident? And what happens with the perpetrators? COMMISSIONER MARTINEZ: Well, in the case -- in the case of a sexual abuse or a rape 832 2/16/01 - FY '02 OPERATING BUDGET incident, when the perpetrator is not a caretaker or a relative, DHS doesn't have a responsibility to investigate. We investigate sex crimes and sexual abuse when the perpetrator is a parent or a caretaker. However, that does not mean that the Department of Human Services does not play a role or does not have resources invested in a number of different places where we can touch that young woman's life and make it better. We fund, as I said before, over 300 agencies in the City nonprofit agencies, you know, that serve our clients that we refer, but also serve, you know, citizens all over Philadelphia when they need help. One of those institutions is the J.J. Peters Institute, which specializes in providing services to victims of sexual violence. They also treat perpetrators, as a matter of fact. We also fund the Philadelphia Children's Alliance, which specializes in intervening and supporting child victims of sexual abuse. Our family centers, I'm sure, could be places where kids connect. So, informally, although we do not have 833 2/16/01 - FY '02 OPERATING BUDGET an investigative role, DHS -- I certainly recognize that we have a responsibility to contribute to the network of support. And there are also organizations in the City, like Women Organized Against Rape, that are funded by the State and have a tremendous role in the City, and intervene affirmatively when those issues come to their attention. So my vision is that we are, and will continue to be, a part of a strong network of partners in the City, funding coming from many different places, and that when a child is hurt, that we all step up to the plate and offer whatever we have to make a difference. So I certainly accept responsibility and want to play a role anytime we're needed.

Thank you very, very much, and I deeply appreciate your testimony this morning. Thank you. Thank you, Madam Chair.

You're welcome. Councilwoman Reynolds Brown, I see, is not in the room. She had some questions. 834 2/16/01 - FY '02 OPERATING BUDGET All right, we have other questions but I think maybe we'll move on. We certainly want to thank --

Madam Chair?

Yes, Councilman Nutter? (Councilman Nutter responds off-mic.)

Councilman Cohen, do you have questions?

Yes.

Please proceed.

Alba's been a favorite of the Cohen family for many, many years. There's a lot of talk about partnerships between faith-based groupings and governmental bodies with respect to services out in the community of all kinds. I'm wondering -- and there was a recent article in the last couple of days about Philadelphia being a leader in that, or at least being the home where the origin of that idea took hold, things of that sort. Are there steps being taken to make 835 2/16/01 - FY '02 OPERATING BUDGET sure, as that partnership grows, because there seems to be a big petition at the national level, that there is going to be watchful observations at both ends to make sure that the rights of the religious organizations are observed, and that there be no governmental interference with them? And at the same time, that the services given to the people are not tinged with the aspects of a particular religious group or idea? I'm just wondering, what is the (inaudible), because there may be good out of it and there may be dangers to both sides, because government tracks money when it's government money, and that tracking process may involve religious faith groups and problems that they're not aware of. And at the same time, the government has to observe the line of separation and demarcation between State and religion. I'm wondering whether there are any preparatory steps being taken to guarantee that the rights of both sides are, you know, rigidly obtained and maintained and observed. COMMISSIONER MARTINEZ: Well, I'd like to answer specific to DHS, and I'm sure that 836 2/16/01 - FY '02 OPERATING BUDGET Director Richman will have more to add from a citywide perspective. )(3)'s, and so they have to abide by all of the requirements of the law, but that are rooted in a faith-based, you know, community. For example Catholic Social Services is one of our largest providers; Jewish Family and Vocational Services is another one of our important providers. So there is a precedent for the faith community to step up and formally engage in relationships and obtain public funding to do community work. But when they do that and when they enter into a contract with the City of Philadelphia, they have to abide by all of the rules and regulations that every other provider has to abide by. So that has been the history in the Department, and it will continue to be the history, since anyone that we give public funding to, you know, has to abide by all of the laws and 837 2/16/01 - FY '02 OPERATING BUDGET regulations that apply to all of us. COMMISSIONER RICHMAN: I think one of the things we're all interested in seeing is, how are these dollars going to flow. Are they going to flow to cities to be able to distribute, are they going to flow directly to the religious organizations, and who is going to be in charge of doing the monitoring. I think, as Commissioner Martinez has indicated, this is not a new area for us. Almost all areas -- many of the areas within social service do some level of contracting now with organizations that have often very strong religious roots, but in the contract within the City, they have a work statement that determines exactly what that work will be. And we have program analyst as one category of worker, social workers and other people who go into these organizations to make sure they're doing the activity of our contract, as opposed to maybe the activity of what their original mission is. There have been some occasions where there have been contracts that -- where there have been grants of dollars to faith-based 838 2/16/01 - FY '02 OPERATING BUDGET organizations, where I've gotten a call from ACLU saying, Are you monitoring these people to make sure they aren't trying to work with people religiously? And when I've had those, we've followed up very closely to make sure that we know their mission.

Now, we can do that because it's money that flows through the City, and this is why we're very interested in how these dollars are going to flow. But almost regardless of how they flow, I'm sure if someone believes that the religious piece and the work statement piece have not been sufficiently separated, that we'll still get the phone calls. So we will work with those as they come.

Well, tell me, is there anything new in the ideas being promulgated or are they based on, say, the Philadelphia experiences or similar ones? COMMISSIONER RICHMAN: I think it crosses the gamut. Unfortunately, I was not able to be here during the testimony for the prisons, but one of the things I know they were going to 839 2/16/01 - FY '02 OPERATING BUDGET mention is the variety of faith-based initiatives that are happening right now with the Philadelphia prison system and the involvement of many of the City's ministers to can come and sort of adopt a prisoner, to be the support system when that person is released. One of those initiatives called "REST Philly" was funded by the Behavioral Health System and begins to work together with the prison system on how do we reduce the recidivism related to drug and alcohol as people get out of prison. That one's a little different than the kind that we have done before. So there are some differences coming up rather than the traditional work that I believe we need to watch very closely.

Well, I think both sides need to be protected, because religious groups have a right to be free of government interference, and the government has the right to be free on behalf of its people of religion coming to people at the same time that they're dealing with human services. So I think it's a difficult problem for 840 2/16/01 - FY '02 OPERATING BUDGET both. If it works out, the results can be fine, and that's what we want to see happen. But I just think that it requires vigilance on both sides, and each must know their own limitations. COMMISSIONER RICHMAN: Yes, and we will try to be very vigilant.

All right, good. Now while you're speaking, Secretary, how do we get hard figures on what's happening on welfare to work? Anecdotally, it seems to me that in a number of instance when fires have been reported, for example, the number of people in the household seems to have increased. There was a recent fire where there were 10 people in a small house that were threatened. I remember one not too long where there were 13. And I'm wondering whether when people talk about welfare rolls being reduced what the real impact is and whether there are any objective studies. I have a feeling that in my community, there's a great deal of double families coming together. I know of a young couple with four children living in a single-bedroom apartment, under absolutely deplorable conditions, where the 841 2/16/01 - FY '02 OPERATING BUDGET landlord doesn't take care of anything, people are worried and can't even report it to anybody 'cause they won't let us live, you know, in this kind of a situation, and we can't afford to pay a higher rent. And I'm just wondering, is there any governmental body or any private body that's making objective studies of what's really happening? Is it a fact that families are just, you know, grouping together in larger numbers? COMMISSIONER RICHMAN: The data coming across from welfare to work across the country continues to be coming in very slowly with analysis. I do believe that it's coming. We're completing about four years at a national level, and so they can do a look-back on the first couple of years, but I'm not sure that's always the kind of information you can make definitive statements on. There is data. I'm not sure you can analyze the data to make assumptions yet. I'd be very happy to try to get you as much of that information as we can. Much of it is coming from the State level and from the national level as opposed to the local level. What we have 842 2/16/01 - FY '02 OPERATING BUDGET now is basic information about who's going to be affected by some of the changes in deadlines that are coming up next March. And all of that information comes to us from the State. The impact of that -- I think the one piece that we are aware of is that no one has been sanctioned yet, but we are expecting sanctions to start happening possibly as early as next March, so that --

Well, I'm worried. For example, there seems to be some evidence that the longevity of a job, unrelated to economic conditions but related to the ability of people to do a basic job, you know, have enough work training, so that they come into work every day and come in on time, you know, and know that they're to perform work. That seems to be a skill that's kind of difficult yet to acquire. And I'm wondering if there are any studies on that. When we hear of people getting jobs, how do we know how long they last? Are there studies on that? And then what happens when the job doesn't last? Is there a return to welfare, or is 843 2/16/01 - FY '02 OPERATING BUDGET there this bundling up in just larger family groups? It's raised all kinds of problems for us with respect to quality of life, family safety, and so forth. COMMISSIONER RICHMAN: The initiative by Philadelphia Workforce Development, called Greater Philadelphia Works, actually has put out a couple of reports about what has happened within that framework around job retention and what happens to people if they don't hold a job. I'd be very glad to get you a copy of the report. Again, I would caution you, this is data as opposed to always analysis, but I think it can give you some feel around the challenges that folks are facing as they make that transaction from welfare to work and what happens next.

Could I ask you to give us your analysis. What are your conclusions as of now, knowing that the question's coming to you without you're knowing about it and you're not having all of the documentation available? What is the general feeling that you have as to what's happening with that program? COMMISSIONER RICHMAN: Depending on how 844 2/16/01 - FY '02 OPERATING BUDGET much support is given to a person making the transition determines to a large degree on how long they will hold that job. People are changing jobs, are moving between jobs fairly frequently with downtime in between. We know there are people who have been working, who, at the same time, are still approaching their 60-month point, which means they haven't worked for long enough to be able to stay off of that list for right now. It is an area that I am becoming much more knowledgeable of than I thought I would be at this point in time. Again, I would like to give you an analysis of how I view the data as opposed to talking too much off the top of my head.

Thank you very much. I'd appreciate very much receiving it. Thank you, Madam Chair.

You're welcome. Councilman Reynolds Brown, did you want to be recognized? (Councilwoman Reynolds Brown responds off-mic.) 845 2/16/01 - FY '02 OPERATING BUDGET

Thank you. I think there are a few more questions, but certainly, I think maybe we should move on today. Again, kudos for the great job you're doing. And certainly, Madam Secretary, we went to thank you for your leadership in many controversial areas in the City to help people in need and people with special problems. And, again, thank you all. Are there any other questions. (No further questions.)

Thank you very much. COMMISSIONER MARTINEZ: Thank you for your time and support.

Thank you. (Break taken.) - - - (Proceedings resume.)

Thank you very much. We're ready to resume our hearing. We'll now hear from the Health Department. Thank you very much for your patience as well. 846 2/16/01 - FY '02 OPERATING BUDGET (Witness comes forward.)

Please identify yourself for the record and begin, Commissioner Tsou.

Good morning, Councilwoman Blackwell and members of the Council. I'm Dr. Walter Tsou, Health Commissioner. Thank you for the opportunity to present the Health Department's budget request for Fiscal Year 2002. Joining me is Deputy Commissioner Michael Covone. 15 billion. 4 percent, comes from City tax-supported, up from 61 million in Fiscal Year '01. 7 million, or 86 percent, is for Behavioral Health and Mental Retardation Services. Today our testimony will be divided into these two areas. I will speak on new programs in Public Health, and Deputy Commissioner Mike Covone will speak on Behavioral Health and Mental Health and Retardation Services. " We are also working collaboratively with our fellow departments and Social Services to address the public health challenges presented by the Report Card 2000. In the area of children, Mayor Street has reaffirmed his commitment to the Year of the Child. Under the Director of Social Services, we are working with other agencies to promote a more integrated and coordinated delivery of children's services. For example, two of the Health Department goals, insuring a medical home and obtaining health insurance for every student, are also the two major health goals of the School District of Philadelphia. In working with the Department of Human Services, we plan to direct our Temporary Assistance for Needy Families (TANF funds) to implement a nationally-recognized, intensive, nurse home-visiting program for first-time mothers in areas of the City with high incidence of child abuse and neglect. Healthy Start, a public-private 848 2/16/01 - FY '02 OPERATING BUDGET partnership to reduce infant mortality, which began in West and Southwest Philadelphia, has now expanded to lower North Philadelphia, with an additional half million dollars in Fiscal Years '01 and '02. In the area of HIV and AIDS, the federal Ryan White Care Act is the major source of funds for AIDS treatment services in Philadelphia. million, an increase of million from last year's grant award. ) implemented the Philadelphia HIV Prevention Continuum, a redesigned continuum that offers a range of access points into the prevention system for every high-risk group across the City. 2 million community access program grant from the Health Resources Services Administration. This program, called "Health Right," will track uninsured residents in North Philadelphia to assure that they receive appropriate care. In the area of environmental health, the West Nile Virus, a recently-identified cause 849 2/16/01 - FY '02 OPERATING BUDGET of encephalitis in New York and New Jersey, was identified in mosquitos and birds in Philadelphia in late fall last year. We anticipate that this virus will survive this winter. 1 million statewide. A special challenge for our department will be the assumption of animal control services in Fiscal Year '03. And after many years, the SPCA has decided not to renew our animal control contract. In conclusion, we are very proud of the people who work in our Department of Public Health. Together, we are enthusiastic and optimistic about working to meet the public health needs of the City in the coming year. Thank you for the opportunity to give testimony today, and I will now turn to my colleague, Deputy Commissioner Mike Covone. And after his testimony, we would be both pleased to answer questions. DEPT. COMMISSIONER COVONE: Good morning. My name is Michael Covone, Deputy 850 2/16/01 - FY '02 OPERATING BUDGET Commissioner, and I'm here to present testimony on the Behavioral Health and Mental Retardation Services. I, too, will provide a brief overview of the full testimony, which has been provided to you. The Behavioral Health System consists of three major components that coordinate the City's treatment services for approximately 100,000 adults and children annually. The three components are: the Coordinating Office of Drug and Alcohol Abuse, the Office of Mental Health, and Community Behavioral Health.

Mental Retardation Services is the office responsible for the development, coordination, and monitoring of services for over 11,000 children and adults with mental retardation. Approximately 98 percent of the resources dedicated to these services are State and federal resources. Over the last year, the Behavioral Health and Mental Retardation System, under the Director of Social Services, has established collaborative relationships with its sister social service agencies. Much of this effort has focused 851 2/16/01 - FY '02 OPERATING BUDGET on improving the effectiveness and efficiency of services. 's Office, of a multi-systemic therapy program aimed at reducing the number of children requiring out-of-state residential care; The establishment of a process to assure that eligible inmates leave the Philadelphia prison system with medical assistance in order to ensure access to court-ordered behavioral health treatment; The establishment of a multi- disciplinary team jointly developed by Mental Retardation Services and DHS, which will provide home visiting services to parents who need assistance in raising their children and managing a household due to their mental retardation. While many of the initiatives noted above are still in their early stages of implementation, the cross-system collaboration associated with these efforts has established a strong foundation for success in current and future initiatives. 852 2/16/01 - FY '02 OPERATING BUDGET During Fiscal Year '02, the Behavioral Health System and Mental Retardation Services will undertake additional initiatives aimed at streamlining access to and availability of services, while at the same time, taking measures to assure that those service result in positive outcomes for consumers. The Behavioral Health System is working to enhance community safety by reducing criminal recidivism due to substance abuse and mental illness. This effort will include the continued and expanded provision of behavioral health treatment and related services under criminal justice supervision as an alternative to incarceration. The increase in the Fiscal Year '01 State appropriation for Mental Retardation Services was the first of a five-year plan to reduce the statewide waiting list. Based on the Governor's budget for Fiscal Year '02, which continues this commitment, the Mental Retardation Program anticipates significant growth both next year and over the course of the next four years. Finally, over the course of the next 853 2/16/01 - FY '02 OPERATING BUDGET few years, Behavioral Health and Mental Retardation will implement a performance-driven system for contracted services. Payment will be tied directly to provider performance in key areas of effectiveness such as the number of people with disabilities that get and keep jobs and the reduction and recidivism rates for individuals receiving inpatient services. These indicators of quality will be developed with the involvement of consumers, families, advocates, and providers. The first year of this implementation will involve training and technical assistance to agencies as well as feedback on areas where they're doing well and areas where they need to improve. I too want to thank you for the opportunity to testify this morning, and will welcome any questions for Dr. Tsou or myself.

Thank you very much, Mr. Covone. Because Councilman Rizzo has to leave the room to make a presentation, we will call on him for questions. Can we have his mike on, please. Councilman Rizzo. 854 2/16/01 - FY '02 OPERATING BUDGET

Thank you, Madam Chair. Thank you, Sergeant-at-Arms. Commissioner, welcome. I believe this is your first budget?

My first.

The first question that I have is that we've learned that -- and you can explain the relationship that you will have with the methadone program in our prison system. DEPT. COMMISSIONER COVONE: Joining us at the table is Assistant Commissioner Mark Bencivengo, from the Coordinating Office of Drug and Alcohol. (Witness comes forward.) ASST. COMM. BENCIVENGO: The Coordinating Office is assisting the prison in developing the methadone detoxification program in the prison and is assisting the prison in getting the necessary licenses and approval in order to dispense methadone behind the walls.

Is this a Health Department program or a prison program? ASST. COMM. BENCIVENGO: This is a Behavioral Health Program, but it is being run by 855 2/16/01 - FY '02 OPERATING BUDGET the prison.

Could you tell us how much the prison system or your department have budgeted for this methadone program behind the walls? ASST. COMM. BENCIVENGO: We have not budgeted any funds from CODAAP for this particular project. Prison Health Services would be responsible for funding it, and we can make available to your office a break-out of that cost center, if you would like that.

I'd appreciate that information going to the President of City Council so we can discuss that. So you're telling me that we're -- SECRETARY RICHMAN: Let me jump in real quick, Councilman. The money to fund this program was in the $26 million that went into Philadelphia Health Services, and that was a contract that was basically let by the Social Services, the contract was drawn up, and we've been guiding on that. And it is a joint initiative between Health and prisons, but we're the ones basically driving that 856 2/16/01 - FY '02 OPERATING BUDGET in the Office of Social Services. We are currently for you getting the precise amount of money that is within that $26 million, and it's a fraction of that money, obviously. But we originally included it, and the operation of it will be within the contract for prison health services.

I think because of the possible controversy associated with the program, it might be very helpful to have a dollar amount associated with the support, the budgeted money, the process, and licensing it. I'd like to really know what this program's going to cost. And, Commissioner, for the record, and again I want to state it, that State prisons do not have a methadone program at this time, and I also checked with the feds, and there is no 19 methadone program in the federal institutions as of today. COMMISSIONER RICHMAN: That is correct, Councilman. And one of the reasons for that is, those are considered, quote, long-term programs. A City prison system is typically a short-term program, and it's only targeted at people who are 857 2/16/01 - FY '02 OPERATING BUDGET currently on methadone when they come in. And many of those folks are released fairly quickly because it isn't considered long-term program. So that when you have someone who has been on methadone, say, for ten years, and you know they're going to be in our prison for approximately a year, and you don't want them craving heroin when they get out, you want to maintain that treatment. The total amount of people -- and this is not for new people; this is for people currently on the program. And the number of folks that will probably involved in it is somewhere in the order of 15 out of the 7,000.

But I think it's safe to say that you just described a scenario in our City prison system that I believe we also have that same circumstance in the State facilities also, and they do not have a methadone program. There are short-term people incarcerated in State facilities. COMMISSIONER RICHMAN: I know you're right, but most of the time, we transfer people to the State prison after they've been in the City 858 2/16/01 - FY '02 OPERATING BUDGET prison for a year or two.

Okay, we'll be watching. The next question is this -- I think it should disturb us that the Pennsylvania SPCA has indicated that they're not going to renew the animal control contract with the City of Philadelphia. And I know that a lot of this is based on a decision on theirs and pitbull and other aggressive animals that we haven't dealt with here. They don't particularly like the fact that they are just asked to be the killers of dogs. Commissioner, do you think -- 'cause I want to ask you to be a little specific on how we can do, and I hear we've been looking at other agencies to do this, but if we undertake the animal control project that the SPCA presently administers, and I'm not talking about just going out and collecting stray dogs or aggressive dogs; I'm talking about all of the work that the SPCA does for the City. How much money would the Health Department need to construct an organization that would perform the services of 859 2/16/01 - FY '02 OPERATING BUDGET the SPCA if we had to do it in-house?

We're right now trying to explore all of our options in terms of trying to find either an alternative vendor who can substitute for the SPCA and/or studying doing it in-house. We estimate -- our current contract with the SPCA, I have to say, is $790,000. It's a very good contract for the City in the sense that the SPCA supplements that money with some of their own funds to help the animal control program. If we were to replace all of the animal control efforts that the SPCA does, we believe that it could easily exceed $1 million for the City.

Would you say that again?

We believe that it could exceed $1 million.

What million dollars you're saying?

It could exceed. And we would obviously need to discuss all of this with the Budget Bureau. We believe, however, that this is an issue for Fiscal Year '03. 860 2/16/01 - FY '02 OPERATING BUDGET

Commissioner, but I think -- I think we'd better start discussing it now.

Mm-hmm.

I think that that figure that you just threw out there, $1 million, is far from what it would take to replace the SPCA. We don't have a facility, we don't have any of the facilities. How could you build a facility? Could you just revisit that number one more time on how much it would cost the City to duplicate the services of the SPCA? Because I think I didn't hear you correctly.

Well, I understand your point. What I'm saying to you is that there are many aspects of trying to do animal control itself. In fairness, we believe that it will be difficult for us to fully replicate everything that the SPCA has been able to do. At a very minimum, I believe that we would have to spend at least a million dollars to try to do animal control services in the City. But I believe that the number could be higher. And what I'm saying to you is that we 861 2/16/01 - FY '02 OPERATING BUDGET have to explore all of the other possible options, including other vendors out there who may want to provide this service.

Could you give me a feel for other than SPCA, who these other vendors may be?

Well, we've been actually looking around to find other vendors who could do animal control. We have not been successful at this point, but we believe that over the course of the next months -- in fact, by September this 13 year, we will have a definite plan in terms of 14 what our plans are for the animal control plan in 15 the City. 16

Commissioner, this leads me to the point that the SPCA is pulling out of this contract. The fact that I think it's more politics at this point than anything. Do you think, Commissioner, that we could sit back down -- and I'd be willing to sit at that table -- sit back down with the SPCA and address the concerns of -- and I know one of their requests to us is to ban the pitbull from the streets of the City of Philadelphia, and I think they approached it in a 862 2/16/01 - FY '02 OPERATING BUDGET way where they weren't just asking for every pitbull to be put in a cage, that they wanted to phase the pitbull out because of the problems associated with the breed. Do you think we could sit back down -- and I'd be willing any day of the week, hours a 8 day, to sit down at the table talk to Eric 9 Hendricks, to talk to the executives at the SPCA, 10 because when you're saying to me it's a million 11 dollars to replicate the services that the -- 12

No, I said "at least a 13 million dollars." I didn't say that that's the 14 full amount. 15

Well, with all due 16 respect to that, I think that that's not even a 17 realistic figure to suggest that we could do this 18 even for $3 million. 19

Mm-hmm. 20

But my point being 21 is, do you believe we can salvage the relationship 22 and renew the interest of the Pennsylvania SPCA to 23 continue as the company that -- as the 24 organization that manages the animal issue in the City of Philadelphia? Have you tried to do that, 863 2/16/01 - FY '02 OPERATING BUDGET Commissioner?

We've had extensive discussions with them, including the issues --

Have you? COMMISSIONER TSOU: Yes, I have personally had discussions with Eric Hendricks on this issue. And we have discussed this whole issue, including the issues of what would it mean if we were to even ban pitbulls and whether that would be an incentive. This is beyond even one breed as an issue. They are philosophically moving toward a policy where they will move toward rescue and adoption as their only business and away from euthanasia for animals who are stray animals. And because of that, they are not interested actually in the animal control contract for Philadelphia.

Well, I was told that they would be certainly interested in the animal control contract for the City of Philadelphia, if the City of Philadelphia would make some changes to the way we deal with these aggressive breeds. I'm sure the SPCA would not have a problem of taking a dog down if the dog was 864 2/16/01 - FY '02 OPERATING BUDGET injured or needed that remedy. So, again, I would hope -- because I know -- I have a -- COMMISSIONER TSOU: I welcome --

I have a feeling, Commissioner, that the taxpayers of the City of Philadelphia are going to be the ones that have to pay the freight for this relationship -- this breakdown in a relationship between the City of Philadelphia, if it's the Health Department specifically. And I have a feeling this is going to be very, very expensive, because I don't know too many organizations -- maybe this would encourage somebody to get in the business of animal control, but I don't know any -- I don't know any today that would be able to step in. And, again, I think it's going to be very, very expensive. So I'd appreciate this being revisited. I'm going to call Eric Hendricks myself to see if he would be interested in meeting with us to discuss this issue to see if it can be salvaged.

I would welcome your help 865 2/16/01 - FY '02 OPERATING BUDGET with this issue.

My next question is --

Excuse me, Councilman, may I piggyback on that?

Yes, ma'am.

I think the SPCA had a real high budget, not just for Philadelphia. It may be something like 44 million, some real high number. And as the Commissioner knows, we did pass legislation here that would do four things. The State doesn't allow us to regulate breed-specific legislation. That was the problem. Councilwoman Miller is working on a resolution asking the State to rescind that law that does not allow us to deal with breed-specific animals or dogs. What we did however, was pass legislation that dealt with vicious dogs that would permit -- provide for four things: One, it would up the fine; two, it would enact penalties for those training dogs to be attack dogs; three, it would certainly penalize the place being used, if a person would allow their home or a place to 866 2/16/01 - FY '02 OPERATING BUDGET be used to deal with vicious dogs; and, four, it allow for immediate temporary seizure of dogs that could be returned if, in fact, they were not being trained to be attack dogs. So this City Council has done some things, which we tried to tell the head of the SPCA, who decided that he wanted to run City Council and the whole universe when it came to dogs. We found him extremely offensive. I will say to you, Commissioner, that I have had some dealings with individual who have been working on putting together a company, some people who did, Councilman, work for the SPCA, who are now interested in trying to put together something. They are at the point -- we have not come to you because the package isn't all together, but they're at the tail-end of a place certainly large enough, and they've been dealing with some people that could have such a facility, and to decide what in fact what in fact the budget would be to do all of that. It's a massive undertaking. But I've said all of that to say that we do have some people who are interested. And, 867 2/16/01 - FY '02 OPERATING BUDGET you know, if you feel it would be helpful to involve you in these preliminary discussions, we'll be glad to do that because they've been talking about it since we had our last budget with the SPCA. Certainly, we find it offensive. You know, I don't think you have to fight people and pay them too. We found their attitude extremely offensive, as if we wanted to turn our heads and as if this Council certainly wanted to support attack dogs or pitbulls attacking people. And so we found them extremely offensive, because the SPCA director did not want to hear that we don't control by law breed-specific dogs. If we could say outlaw them all tomorrow, we would have been glad to do that, but we don't control that; that is a State mandate. Councilman, certainly we want to thank Councilman Rizzo for his interest then and now in seeing that we do something about this. But, Commissioner, we'll be to you in short order, as soon as the organization has finalized this package to see what the City and your department, what part you might be willing to 868 2/16/01 - FY '02 OPERATING BUDGET play and what they think able to do on their own.

Thank you very much, Madam Chair. That gives me some comfort to know that there's something being developed.

Thank you.

That could replace this organization.

Excuse me, one moment before you continue, and I know we said you could go first. Councilwoman Blondell Reynolds Brown wanted to introduce some of the students here. Before she does, I will take the initiative to introduce our leader Greg and some Friends of Malcolm X Park, who are here, and there he is in the back. Greg, raise your hand so people can see who works so hard in my district. (Applause.)

And that is Friends of Malcolm X Park. Many of you know it as the old (indiscernible), but it's Friends at Malcolm X Park, across the street from Huey School, at 52nd and Pine. Councilwoman Blondell Reynolds Brown, 869 2/16/01 - FY '02 OPERATING BUDGET you wanted to do introduction? There are other schools here.

Sure. Thank you very, very much. Because the time is sensitive for the young people who are here, and they're here to be strong advocates with regards to Friends of Philadelphia Parks we want to salute, welcome, and celebrate the presence students from the Huey School and the Elmwood Elementary School. (Applause.)

And let the record show that they are in your district, Councilwoman Blackwell, and we know that you know very much about the good work they are doing as public policy-makers for tomorrow. Thank you very much.

Thank you. We also understand that some students are here from Cassidy School. And let me say to all of you at Huey School. In fact, I have big posters, but now is not the time, I suppose. We are really trying to make Malcolm X Park a model for the City. We have prevailed upon Children's Hospital and they have committed $200,000. We've already -- the City has already invested another $245,000. So I 870 2/16/01 - FY '02 OPERATING BUDGET say to everybody and all of my colleagues around the City, this will be a model for the City. It's a special place, the Friends group works well, and we're looking forward to having puppet shows, we're going to have a gazebo in the center of the park. At night, we hope to have jazz shows there for the adults in the community. We're doing a public-private institutional partnership there, where a developer is going to -- a private developer going to invest private funds in 75 houses on the periphery. As I said, we have Children's Hospital who's invested $200,000 in addition to the City's $245,000 for Children's Hospital for playground equipment. And Huey School is across the street and the church, a faith-based organization across the street. So we will show you what public-private institutional faith-based school partnerships can be. Thank you. (Applause.) - - - 871 2/16/01 - FY '02 OPERATING BUDGET (Recorded by Lisa C. Bradley, RPR.)

Good afternoon. My name is Louis Rossman. I'm an Assistant City Solicitor in the Law Department. Councilman, I'm not going to prepare to give you a definitive statement on legal issues surrounding the needle exchange program, but if you you'd like, I am prepared to give you a brief outline of what I think are the legal issues surrounding the program. First of all, in addition to the executive order about which you're aware, I believe that the Health Department has authority to develope something like the needle exchange program under its general charter authority which is under section 17 5-300B of the charter to conduct public health programs. In addition, I note that under state law, 35PS Section 521.5 local boards of health and departments of health may, based upon a report of a disease that is subject to a particular type of control measure, the local body is authorized to carry out that measure in such manner as they may prescribe by rule or regulation. And I note that 872 2/16/01 - FY '02 OPERATING BUDGET prior to the executive order that was issued in June of 1992, the Board of Health adopted a resolution 4 endorsing a needle exchange program as an emergency public health measure to control the spread of HIV and AIDS in the City. The question about how the needle distribution program -- needle exchange program might be prohibited under law is a question of whether state criminal law regarding the distribution of drug paraphernalia would apply. I think there's two issues that are raised there. The first is whether under that criminal statute you would have, when public health officials are contracting for this service, you would have the requisite criminal intent that the legislature meant to instill in that criminal statute when they distribute needles in exchange program for public health measure. The other issue, I believe, is that given that there is a state authorization, a particular authorization for local boards of health and departments of health to adopt particular control measures to control the spread of disease in the local area that you have to consider how that specific authorization to the local Health 873 2/16/01 - FY '02 OPERATING BUDGET Department, how that would play into an interpretation of the criminal statute and whether that might in the case of a local a health department in some affect the drug paraphernalia statute. I also note, as you noted, that the program has been in effect for nine years. The law enforcement agencies that are responsible for enforcing the criminal statutes in Philadelphia, the DA's Office and the Attorney General's Office of the Commonwealth have not, as far as I'm aware, ever sought to challenge the program or prohibit the program. In fact, I think at the inception of the program there were discussions with the DA's Office about the program, and they were not opposed to the City's participation in the program. So the particular enforcement agencies involved have, I think, over the course of nine years demonstrated that they do not believe at the least even if there is -- they have not demonstrated that they believe that there is a violation of law or that they feel that there is an enforcement action they should take.

Counselor, I know 874 2/16/01 - FY '02 OPERATING BUDGET you're a busy attorney in the Law Department, but I would appreciate that opinion to the Chair. And again, I made my statement earlier that maybe the DA, maybe the State Attorney General at the time overlooked the law based on the need. But I've been asked by my constituents that live in the area of the distribution of the needles that they have obviously a probably with it and there's concern about the program. And the question is constantly asked of me, is it legal or is it not. And once you're able to tell me, sir, in that opinion that it is -- and I hear what you told me today, that it is a legal program and it is not just a program that is being -- an issue that is just avoided by law enforcement. I would have no problem telling my constituents that we are administering a program that conforms to the law. I thank you.

Thank you, Councilman. We'll work on that and we'll get that opinion to you.

Thank you. Thank you, Madam Chair.

Thank you, Councilman. Might I note that in my area, I 875 2/16/01 - FY '02 OPERATING BUDGET neglected to ask the DA earlier, but in the same area where we have the highest rate of infant mortality and we're focussing on the Mayor's blight program, we had the trucks out there to give out the needle exchange program and we think it's a great program and we're glad to have it and glad to have the opportunity to try to protect people and prevent more death than already exist. That's my personal opinion. Commissioner Tsou, let me thank you for helping us with helping us with an immunization program. Two years ago, maybe three now. Time, as Councilman Cohen knows, time moves very quickly. But we had a youngster die, a seven-year-old. His name was Kylon Tyler (ph) from McMichaels School due to bacterial meningitis and it just motivated us to get involved in immunization. We started that one school two years ago. Of course, this year, thanks to your help, just yesterday we had an immunization school. We try to do three clusters and increase it. And next year, we want to increase it more. I know there's some debate about where we immunize kids. And I know that the recreation commissioner is talking about doing. I think the more, the 876 2/16/01 - FY '02 OPERATING BUDGET better, especially since we have this HIV serum that has to be given to students by the time they're in the sixth grade. And I wondered if you have any particular strategy or if you see any particular need that we should be aware of in trying to help this program, the immunization program, be all that it can be. COMMISSIONER TSOU: Let me briefly say that we appreciate all the efforts of our fellow agencies who want to help promote immunizations. Clearly, childhood immunizations is one of the most cost-effective things we can do in public health. And by expanding our sort of domain of people who can speak on this issue, I think it helps us. And we're also proud of the fact that the State of Pennsylvania has taken some initiatives in making school-based vaccines. Barb, you want to say anything about our special immunization efforts we're doing in the Philadelphia that maybe the councilwoman might be interested in hearing about.

Thank you, Councilwoman Blackwell and Walter Tsou.

Please identify 877 2/16/01 - FY '02 OPERATING BUDGET yourself for the record.

Dr. Barbara Watson, advisor to the immunization program for the Philadelphia Department of Public Health. There are several aspects. We are trying along with maternal and child health and DHS of having every child have medical home, and we really see that as one the key points. So in working with the Academy of Family Practice and the Academy of Pediatrics is to facilitate each child getting into an office on time. The early childhood welcome home visit and the kids immunization registry has turned out to be the most important factor over the last seven years of increasing our immunization rates which have prevented the measles outbreaks that we had in early '90s and have prevented a number of other diseases. But we continue to need to do more work with that because a lot of children go from one provider to another provider up to five times in any year. And the constant question that comes back is, well, what did they have, what do they need? At this point, the registry is fully populated and providers are finding that it's very much more helpful than it was when we first developed it. So the work that Walter 878 2/16/01 - FY '02 OPERATING BUDGET Tsou has done for getting funding for that registry has been a great success. Obviously, once you get levels up into the 90 percents, there does tend to be complacency. Addressing the issue about meningitis, there is now a new vaccine to prevent pneumonococcal meningitis and hopefully in the children under 5 we will start to see impact of that as we've seen in impact on all the vaccine-preventable diseases. At this point in time, there's some issues with various insurances not covering it. Again, working with the pharmaceutical agencies as well as the Academy and Department of Health, all of those kinks hopefully will be decreased.

I think we're doing a lot better job. When this initially happen, everybody panicked. The School District panicked and the City panicked and we handled it badly. But now we have an organized, and the Deputy Commissioner was very, very helpful during that period. And we have a much more organized way we deal with diseases. And I think that sometimes we have to remember that none of us created it, but it is our job to try to help organize it and resolve it 879 2/16/01 - FY '02 OPERATING BUDGET and make life better for students and the citizens of our City. So we're committed to working with you toward that end.

And just to recognize the out reach as well. They do an enormous job of educating in the homes as well as the child care. So we're trying to be in all places.

Thank you very much. Commissioner, you mentioned elevated blood levels and lead levels. I see Bernard Johnson here. It's his issue since I've known him. In fact, you mentioned elevated blood levels will be fewer than 900. Could you explain the significance of elevated blood levels and what you found this year and how do you see us attacking this problem? COMMISSIONER TSOU: Well, we have to begin by saying that we have a naturally recognized success story in lead poisoning in Philadelphia. And over the course of the last six or seven years, the incidence and prevalence of lead poison children has dropped dramatically. To give you some sense about this, an action level of over 20 micrograms per deciliter would be -- in 1998 we had approximately 5.8 percent of the kids that were 880 2/16/01 - FY '02 OPERATING BUDGET screened who had levels over 20. Just two years later in 2000, that number is down to 2.1 percent. So we've actually cut it in half. And those who have very high lead levels despite the fact that we've greatly increased screenings for lead. I think it's a really a tribute to many of the people who work in our lead program that we've done so well. We, obviously, don't want to rest on our laurels and we want to continue our efforts to try to reduce the number of children who might be lead poisoning. The month most serious complication of lead poisoning, as you are probably aware, is the problem of learning disabilities and its effect on school readiness. So we do see this as an important issue for us and for our children.

You may not know, and maybe we'll have to ask the School District, but we still get complaints that in schools where clean drinking water is supposed to be brought up that it is not happening in all schools. Are you aware of any of that. COMMISSIONER TSOU: We're aware that, as you know, we've had about 20 percent of the drinking water supplies in the School District had detectable 881 2/16/01 - FY '02 OPERATING BUDGET levels greater than parts per billion of lead. And we have actually ordered those drinking fountains to be shut off and that bottled water be brought in in its place. We've now extensively been able to assure ourselves that school kids are not drinking water that has lead contamination in it and we're working on a biweekly basis with the School District and EPA and the Health Department and Water Department to assure that a remediation plan is in action.

I will ask Mr. Johnson if he would refer to me or the Commissioner because he has heard that there are some schools where it's not happening. We'll ask him if he'll get that information to us so that we can pass it on since you're dealing with it biweekly. COMMISSIONER TSOU: We can.

Thank you very much. In terms of infant mortality, as you know I have one of highest -- in my district we've had many problems. I see Virginia Brown and others who have worked with us in Mantua. Where do we stand in terms of our success rate? I know we've done a lot in the past and in terms of your testimony on 2/16/01 - FY '02 OPERATING BUDGET 5, in decreasing in this area, infant mortality? COMMISSIONER TSOU: Well, again, the good trend is that our infant mortality rate is in fact decreasing. Our rate of approximately five years ago was around infant deaths per thousand 7 life births. We're down to the most recent 8 statistics n 1998 of 12.3 infant deaths per thousand 9 live births. 10

Do you have any 11 more recent data than 1998? We'd certainly like to 12 have it for Mantua if we can get it and Kingsessing. 13 COMMISSIONER TSOU: We don't have more 14 recent data yet. We are dependent on the state to 15 give us the statistics, so we're waiting for the 16 state data sets to come in.

Do you have any idea when that would be, Commissioner. COMMISSIONER TSOU: When that would happen? We don't know when that would happen, but it should happen sometime this year. Beyond that, I can't say.

All right. Thank you. There have been some changes with our overall City organization of HIV programs. I don't 883 2/16/01 - FY '02 OPERATING BUDGET quite know why. I've always thought that we were a leader in this country with all the programs. I've never had a person referred to my office or who has called and we haven't been able to try to secure them help within the City system which is why I always support community base health in any other program where we can be tied -- where our constituents can be tied to government because it always gives us referral systems. Where are we with regard to AIDS programs. And I suppose that reorganization started before you came in. And why was there a need to reorganize? And do you fund some agencies, changed things around, and that's about all I know about it other than I realize there has been some changes. COMMISSIONER TSOU: Well, we also have a naturally recognized AIDS program in Philadelphia. And the good news, I think, is actually in terms of dollars because between last year's Brian White Care Act which came into this Philadelphia and this year we've had an increase of $4 million which is actually one of the highest of any City in the country. That's a recognition I think on the federal of success that we've had. 884 2/16/01 - FY '02 OPERATING BUDGET What is part of the success, I think, is the fact that is the fact that we actually have a very intensive community based program effort to try to make sure that our programs are focussed in terms of HIV prevention and minority communities and to those people at the highest risk for HIV and also to provide services and treatment services in those areas. Joining me up here right now is Pat Bass who could perhaps speak a little bit about our programs.

Good afternoon. My name is Pat Bass. Councilwoman, I think you might be talking about the fact that we have just procured a great deal of our dollars in case management and outreach. We have restructured outreach only in that we are now asking our outreach workers to really collaborate with both primary care and also with counseling and testing so that we have now gone through a training program. And so that while it might look like it's been a change, certainly it's been our effort to make sure that we are unifying folks who know thier diagnoses who are not in care, those who are newly diagnosed, and those who are 885 2/16/01 - FY '02 OPERATING BUDGET engaged or who live in risk-based communities. And so that the change, I think, really has been a change in just how we are providing the services. But, yes, we have actually just gone through a procurement. It has always been our intent that when new monies come into the City that we do this. We've always outreached minority providers in particular. And to be sure that when we do the out reach for procurement that we engage minorities providers, the small CVOs in the process. We give them the technical assistance so that they can effectively apply for the dollars. And once the awards are made, we give them the kind of technical assistance that they need to build their infrastructure so they can be successful in providing the services.

Thank you. Might you know, Ms. Bass or any of you, I understand that on you mentioned prison health services offer three days of HIV medications to released inmates. Is this really enough time to even to get an appointment at a health center? Psychotropic drugs also for the mentally ill are available for three days. How can this be helpful given the 886 2/16/01 - FY '02 OPERATING BUDGET nature of these illnesses?

We have focussed on case management sort of discharge planning in the prisons. And the idea is that we would give folks -- we would begin to engage them before they're discharged and we would give them the medications and then they can get an appointment with the community health centers and so that there is no 10 wait for that. So that once the case manager knows the person is being released, we can outreach this person and we can get them an appointment so that we are able to put them into ambulatory care. The issue is if let them go longer than the three days without engaging them, then we worry about them being lost to care.

I see, so you try to control it. Incidentally, in fact, Councilman Rizzo mentioned it on his way out. But if my memory serves me right, just as an aside on the SPCA, I think our figure was something like $8 million. I think it was $8 million we give SPCA, if my memory serves me right because we spent a lot of time with the director telling us off and blaming us for pit bulls. That's just an aside. He's one of 887 2/16/01 - FY '02 OPERATING BUDGET my favorite people. I'll be waiting for him when he comes back. On and 9, you mentioned the rising costs of prescription costs. Have we been in touch with Harrisburg regarding the plight to maybe use some of the tobacco settlement money or other funding sources to help this cost? Are you involved in that aspect of care? COMMISSIONER TSOU: Councilwoman, you are correct that we are very hopeful that the tobacco settlement money can help offset some of our prescription costs. And there is discussion in the Pennsylvania House that some of the money will be used for this purpose. It will be primarily aimed at senior citizens to supplement the Pace Net program that is currently in place. Of course, we have a wider audience because we serve all individuals regardless of their age and we do have a large number of uninsured individuals who come to our health centers who do need support for their prescription drugs. But we do believe that tobacco settlement can be of some benefit to us.

Thank you. Are there questions? Councilman Cohen, you're next. 888 2/16/01 - FY '02 OPERATING BUDGET

Thank you, Madam Chair. A number of years ago the City Council passed an ordinance dealing with the waiting period that occurs at the City 's health centers. At that time, the goal was to have no more than a two-week waiting period. And we're getting many complaints that the waiting period runs from three to five weeks. I wondered, Dr. Tsou, if you could comment on that and tell us what our goal is because I know in the business world if somebody had to wait a day, it is a crisis. And we think human health is pretty important and the health centers ought to be much more available. Go ahead, sir. COMMISSIONER TSOU: Let me start by saying that there is some differences in terms of adult versus children. For adult visits, there are more difficulties in getting the first appointment. And part of the problem actually deals with having the full staffing that we would like in all the centers. But in the areas of pediatrics, most pediatricians can be seen within three weeks and frequently they can be seen even within a few days. So we believe that at least for our most vulnerable 889 2/16/01 - FY '02 OPERATING BUDGET citizens, our children, they are able to easily get access to pediatric care. All of our health centers have walk-in capabilities and those who really do need help always have the right to come in and walk into our health centers. But we are concerned also about trying to see our patients more expeditiously and we are working on management issues internally to try to improve so that people don't have such a long wait time.

Well, is there any way of developing a plan in the Health Department that would achieve that goal that appointments should always be within the two-week period, preferably much shorter, but no longer than the two-week period. What would it take to do that? Could I ask that the department come up with a proposal for that, because it just seem wrong that the population that needs most care and is least capable of getting it, we indicate to them, you know, it's really not an emergency, whatever your health problem is. COMMISSIONER TSOU: Well, we will work on this issue. I'm going to ask Assistant 890 2/16/01 - FY '02 OPERATING BUDGET Commissioner Mike Lucas if he could make a comment about that.

Hello. My name is Mike Lucas. I'm an Assistant Health Commissioner.

You're going to have to speak into the microphone. The acoustics here is awful. And I won't accept the fact of my age being difficulty in hearing because I hear as well as anybody else if the voice comes through, so please speak into the microphone.

My name is Mike Lucas, Assistant Health Commissioner in the Department of Public Health. As Dr. Tsou said, we measure appointment availability in the health care centers by looking at different populations. If we look family planning -- we look at family planning, prenatal, dental, adult care, and pediatric care. The good news is that for prenatal care and for pediatric care, there's almost a hundred percent, if not a hundred percent chance you're going to get an appointment within a couple of days, not just three weeks, within a couple of days. For dental care, for the most part, except for two of our health care 891 2/16/01 - FY '02 OPERATING BUDGET centers, you can get an appointment within a couple of days. Pediatric care, as I said, it's easy access, as Dr. Tsou said. Adult care is slightly different. In five of our eight health care centers, you can get an appointment within the three-week period of time. It's the other three health care centers that we operate in which it varies. It goes anywhere from three weeks to five weeks as you suggested. Part of the issue is one of the health centers, Health Center No. 4, is currently under renovations. With the renovations, we did have to curtail the number of new appointments to patients to accommodate the renovations. As a result of that, we believe many of the individuals in West Philly are overflowing to Health Center 3, which is the second health center which has been having a problem for adult care and that's why it ends up being over the three weeks. The last center is Health Center 10 which does have appointments that take longer than three weeks. What we can provide you, if you wish, is what it would take us, some kind of plan, including a budgetary plan of getting us to a level which is deemed satisfactory by everyone. 892 2/16/01 - FY '02 OPERATING BUDGET

We would like that because there's nothing City Council can do unless you present us with a plan. We appreciate the fiscal needs of the City, but we think we ought to have the right to make a policy decision as to whether a bundle of money goes in one direction or another and we really can't think of anything more human health, particularly to that portion of the population that's least capable providing it for itself. So we'd like you to have a plan then we'll have a decision to make and we'll do it hopefully in cooperation with the Mayor's office. But Council will have a chance to express its opinion on a policy. I think a policy of three to five weeks is not an acceptable policy for the provision of health care for the neediest of Philadelphians. So could we set a time period? We'd like to get it so that if there is agreement in City Council and there are discussions with the Mayor, we would have an opportunity possibly to make the revision in the budget or to provide additional funding. What would be the time period required to provide a plan? We know that you don't make the ultimate decisions. We know that commissioners have to report to a higher 893 2/16/01 - FY '02 OPERATING BUDGET authority, secretaries, managing directors, finance directors, ultimately the Mayor. But at least Council would have the information so we can have an intelligible conversation with the officials we would have to deal with to make changes in the budget. Could we have a preliminary program within a week? Because our budget moves on a pretty fast schedule. COMMISSIONER TSOU: How about within two weeks.

An outline indicating the budgetary needs. And including in that was another question I had, there seems to be a special prime in the pharmacy department. The pharmacy seem to be especially overburdened. It may have something to do with what's happening in the area where payments are made that may be driving a larger portion of the population into pharmacies. I don't know whether that's the case or not, but the reports we get is that it's often impossible for the pharmacists and the clerk that some pharmacies seem to have and some don't seem to have. I don't know what drives that, but we think that there's got to be a provision for increased assistance in the 894 2/16/01 - FY '02 OPERATING BUDGET pharmacies that are not able to handle the flow. The third question I'd like you to incorporate in all of that would be the question of filling of vacancies. It seems to take an uncommonly large amount of time for a vacancy to get filled. I know there's a general personnel policy that says don't bring anybody on board until you've completed the payments, including vacation time and sick leave time sometimes for people that have left. But we think in your department there ought to be very special consideration as there appears in the police and fire department, all have to do with saving lives and you had the same problem of saving lives as the police and the fire people do. You were in the non-uniform category, and I think the urgency is just as great. So if you could prepare such a plan, I'd be appreciative. COMMISSIONER TSOU: We feel we can do that.

Thank you. And one other question. I don't know where the questions, you know, what their based on or what the origin is that Councilman Rizzo raised with respect to methadone and point of prevention and other things, 895 2/16/01 - FY '02 OPERATING BUDGET but I think there is common agreement -- and please disagree with me if you think I'm wrong. As I understand it, there's common agreement by all professionals in the field overwhelmingly that the so-called war on drugs as being waged in the United States has pretty much been a failure. And if prison population has anything to do with it, that seems to be direct proof because the budget at the state level on cost of prisons have risen, I think, by 10 fold over the last 20 years. And it's also generally considered that the use of drugs and drug addiction is a very major cause of that cost inflation and the numbers of people who are in our prisons. We're the most uncivilized country in the world if we were to judge civilization by percentage of people in jail. And it seems to be as a result of the drugs. I think we have close to two million Americans in jail or on probation or parole at any given time. It's an unbelievable figure. And I think drugs plays a large role in it. And I would like to see, and help me if you can, is there a comparison of a cost? I think the cost to taxpayers throughout the whole country for the inflated number of prisoners coming into jails because of drug 896 2/16/01 - FY '02 OPERATING BUDGET addiction as against the cost of attempting to bring about some cures or relieve some people from the pressures of addiction which apparently tend to create much greater crime. Is there any kind of analysis like that? Because it seems to me totally lopsided. Seems to me we're hardly spending anything on drug rehabilitation, drug prevention, you know, addiction prevention, and we're paying hundreds of millions of dollars in taxpayer funds to support not only building of new jails, but the staffing of them and so forth. It seems to me we maybe going in the wrong direction. Did you have any thoughts, professionally? You're all professionally in this area.

There is some information we can provide you on some of the initiatives that are currently going on relative to prison and drug and alcohol treatment. Forensic Intensive Recovery Program is one area that we can provide you some information on the success rate of that particular initiative which is really linking individuals to leave the prison system to services in the community by tying in the criminal justice system with them and actually having folks ordered to those services. 897 2/16/01 - FY '02 OPERATING BUDGET

It seems to me the explosion in cost at the state level of the prisons and the staffing of them is what causes the Governor to kind of mete out in very few numbers the dollars for the school system because of the demands of the cost of the prisons. And that seems to me just the wrong direction we ought to go. We ought to spending much more money on our kids and much less in prison confinement, certainly, if there's any other way of dealing with a population which causes crime largely because of drug addiction. So we're so happy when we get a few extra million dollars from the state for schools and the need is so much greater. Yet hundreds -- I think the state budget used to cost around a hundred million. I think it's into a billion, maybe two billion on maintaining prisons. I would appreciate if you could furnish the Councilmembers with whatever exists in the field of professional opinions about how you deal with drugs and the results of building more prisons as against drug prevention. Maybe in the prisons system it seems to me that maybe that is a good place to begin with because most prisoners ultimately come out, and it would be great if they 898 2/16/01 - FY '02 OPERATING BUDGET come out free of drug addiction. Otherwise, we're going to have that revolving door. So whatever you can furnish us I think would be very helpful to us in developing our policy in the City of Philadelphia. Thank you very much.

Could I ask for an a yield for a moment?

Yes.

Councilman Rizzo.

Thank you, Madam Chair for this opportunity. Based on data, I talked some folks also that have indicated that the rehabilitation program is, A, very costly and it has not been as effective as it could be or where we would want it to be. Is there a report or data that could indicate the performance of the programs that we spend a tremendous amount of money on so we can see how successful we are? Is there anything at all that we can read to help us better understand where the taxpayers' money is going and how well it's being handled? I'd appreciate a report like that be sent to the Chair because I'm not sure whether we do a 899 2/16/01 - FY '02 OPERATING BUDGET good job, whether we're doing poorly. Could you just comment briefly on the performance of these various programs and what we can read to substantiate your comments?

Mark Bencivengo. We have an initiative that Michael Covone referenced called the Forensic Intensive Recovery Program where we arrange in conjunctions with the District Attorney's Office and the Public Defender where we arrange for early release for people from the county jails. We've now completed a 48-month study of people post Forensic Intensive Recovery Program. That is, people who came out and were placed into substance abuse treatment programs and then we followed them for a total of 48 months. The first time we did the study, we followed them for about 18 months. And we did it a second time and followed them for 48 months. And the measure that we looked at specifically was reconviction, people who had gone through or program and whether or not they were reconvicted of a subsequent crime versus people who had not gone through the program and whether or not they were reconvicted. We can make those reports available. They are very positive in terms of the 900 2/16/01 - FY '02 OPERATING BUDGET affect of the Forensic Intensive Recovery Program, and you'd really need to look over the long term. I mean, what is the cost of crime in a variety of ways and in terms of its impact on the quality of life. We will be glad to make those available Council President.

Correct me if I'm wrong. You're pointing out one specific program. I'd like to see the results of the entire universe of money spent on all of the programs and understand how successful all of this money that is being sent -- I mean, if we have to look at each program, that's fine. But I'd like to better understand of all the monies spent how effectively is it being spent? Is that possible?

That would be a much taller order. I'd also mention it's quite important that the amount of general fund City dollars that are spent on this program is actually quite small. There's a much larger amount of Medicaid dollars spent on this program because the services that the programs provide are Medicaid-eligible services and they're able to seek reimbursement for providing those services. So one would have to look at. 901 2/16/01 - FY '02 OPERATING BUDGET

It skews the --

There's multiple sources of money coming in, and as I said, the City dollars are very, very modest in terms of supporting substance abuse programs.

Would the feds have -- would they have looked at the performance of the programs? I can't imagine them not.

The federal government, and particularly the Center for Substance Abuse Treatment has funded a number of much more limited evaluation similar to what we funded around the Forensic Intensive Recovery program. So there are slices of the substance abuse rehabilitation program that have been looked at in various research projects. We are constantly reviewing the literature that comes out in an effort to let our decisions be guided by data and best practices in establishing programs in Philadelphia. So while we have a number of studies, they may not be specific to Philadelphia; they are specific to substance abuse rehabilitation efforts in general.

Thank you. Thank you Madam Chair for allowing me to 902 2/16/01 - FY '02 OPERATING BUDGET have Councilman Cohen yield to me. Thank you.

You're welcome. Councilman Nutter.

Thank you, Madam Chair. There's been a lot of discussion about this and I know this is an issue that Councilman Rizzo cares very deeply about. He's asked a lot of questions about, he has a right to ask questions about and try to get answers to his questions. I wanted to try to get a sense of where we are with all of this and where we're trying to go, but the first think I'd like to understand, I think it's sometime important that we know, quite honestly, who we're talking to. Now, Mr. Bencivengo, how long have you been with the City.

Twenty-eight years.

And always in the CODAAP area?

Always in the substance abuse CODAAP area.

What's your back ground and training in this area? 903 2/16/01 - FY '02 OPERATING BUDGET

My academic background is graduate degree in sociology, particularly criminology and deviant behavior.

And you've worked for the City for 28 years and you've been in the drug abuse substance abuse area all of that time?

All of that time. I'd also mentioned that I'm on a number of national groups that look at the substance abuse problem from a national perspective.

So you've been working in an area for a while and I think under any set of criteria you would be a considered a practicing professional in this area?

I would say so, yes.

At least from your perspective, you know what you're talking about. Mr. Covone, what particular area for you.

I've been in the mental health and mental retardation area for 17 years.

What's your background and training.

Actually, a degree in 904 2/16/01 - FY '02 OPERATING BUDGET accounting and I've worked in various aspects in both program areas, mental health and mental retardation and administrative areas.

Dr. Tsou, MPH, what is that, a master's in publish health. COMMISSIONER TSOU: That's correct.

Let me try to understand this. Is the current research and literature in drug abuse/subtance abuse area now determined that drug abuse and substance, is that something that people engage in just because they want to or because they like it, or is it now considered in the medical profession to be virtually a disease?

Increasingly there's recognition that substance abuse is a disease, and in fact, Dr. Alan Leshner (ph) of the National Institute on Drug Abuse in his presentations, and he is an M.D., presents scientific evidence pointing to the disease concept of substance abuse.

If we stay along that particular path, do we provide any other medicines to treat disease of people who are either in prisons, on probation, not in prison but have 905 2/16/01 - FY '02 OPERATING BUDGET other medical needs? Do we help people who people who have diabetes? Do we help people who have heart disease, liver problems? Do you deliver any other medicines to people who have disease? COMMISSIONER TSOU: We do provide medications for other people with other physical illnesses.

Do we have contracts with providers? The other issue that was raised was with regard to the methadone. What would happen if the person came into the criminal justice system and they had been however they were doing it, but had been in a methadone treatment program prior to there incarceration? And I think the Prisons Commissioner testified the other day that our average length of stay, I believe, for an adult male is 54 days or maybe 74 days. I don't have those notes in front of me at the moment. What would happen if the person came in and we stopped providing methadone, although they had been in a program prior to their incarceration? What do you think would happen with that individual?

They would experience the discomfort of withdrawal from the methadone. 906 2/16/01 - FY '02 OPERATING BUDGET

And does that have any behavioral ramifications? Will it affect how they act while they're in our care? And what happens when they leave?

I would posit that it would very definitely impact on their behavior in the prison. Obviously, they're uncomfortable, they're feeling sick and they may find it difficult to adhere to prison rules feeling that way, yes.

Do we have any contracts with providers involving the provision of methadone for people in a non-incarcerated situation?

Yes, we have approximately 10 methadone programs in the City of Philadelphia. The first one, I believe, was licensed in the late 1960s.

And why do we do this?

I happen to believe, and other people in substance abuse also believe that in areas where there are high levels of open addiction, that you'd want to have full array of treatment responses. And methadone is very 907 2/16/01 - FY '02 OPERATING BUDGET definitely a legitimate treatment response. I'd also mention that in 1998, I believe it is, 43 states, including the District of Columbia, had methadone programs, including 58 in the State of Texas. Pennsylvania has 28 methadone programs; and I believe that approximately of them are here in 8 Philadelphia. 9

And methadone is 10 recognized as one of the leading treatments to deal with heroine addition?

It's one of the leading treatments in dealing with opiate addiction, in this case it happens to be heroin addition.

Is Philadelphia considered one of top centers on the East Coast for both heroine use, heroin transportation and heroin purity?

There's a program called the Domestic Monitor Program which is run by the drug enforcement administration. The Domestic Monitor Program makes street-level purchases of heroine in approximately 22 cities across the United States. In the most recent Domestic Monitor Bulletin that I saw, Philadelphia ranked No. 2 in 908 2/16/01 - FY '02 OPERATING BUDGET terms of the quality of the heroine available at a street level and the price per milligram pure. So the answer to your question is yes. There is a fair amount heroin, a large amount of heroine in Philadelphia. It's very high quality heroine, and the price is very reasonable.

You said we were No. 9 2 out of 22 cities?

I believe it was 22 cities, yes.

Do you know what the No. 1 City was?

I think it was either Baltimore or Newark.

Also on the eastern seaboard corridor. Okay, thank you for that information in that area. I want to go back to two areas where my colleagues have been. First, the comments that the Chair made with regard to the SPCA. I have not been that actively involved in the on whole SPCA issue. I can say, though, as a person who has attempted on a couple of occasions to access their services based on complaints by my constituents -- and I don't know 909 2/16/01 - FY '02 OPERATING BUDGET this individual, Dr. Tsou, that you've been dealing with. I have not high level discussions with anyone from SPCA, but I can say that on most occasions, they have been non-responsive to anything that I've asked them to do or that my office has asked them to do. We didn't get into who's who or who's calling or anything. It was a problem. There was an issue. It's my understanding we had a contract with them, and I have this quirky little thing about me that if I have a contract or the City has a contract with someone, I actually expect them to perform according to the contract terms and conditions. And I have had tremendous negative response from the SPCA. I do not know all the particulars. I don't know whether it's substantive issues, personality issues, or what the problem is, and quite frankly, I don't care at this point. If it gets worked out, that's wonderful. If not, we'll find somebody else to do the work. But on a personal level, representing a specific area, they have been nowhere in terms of responding to the constituents that I call on behalf of. With regard to lead abatement, I think it's on or 4. of the testimony. The 910 2/16/01 - FY '02 OPERATING BUDGET one thing I never really understood about what we do in the lead abatement area, and you're certainly to be commended for the statistical information that you laid out. Who gets tested or who gets screened? What's the population of children who get the screening? You know, it's kind of like one of those situations where, you know, who do pollsters talk to? I've never met anyone who was ever polled by a pollster. I don't know anybody whose child has ever be screened. And I'm not saying you're not doing the work. I don't understand how it happens. COMMISSIONER TSOU: Dick Tobin will speak on this issue.

My name is richard Tobin. I'm director of the Childhood Lead Poisoning Prevention Program. Last year there over 40,000 children screened in Philadelphia. They screen primarily in hospitals, doctor's offices, clinics across the City. We do some limited screening with our community outreach workers. When we find an area where we feel it's being underserved or we feel there's particular problem. The greatest concentration of children is in North and Central and West Philadelphia in the highest risk areas, but 911 2/16/01 - FY '02 OPERATING BUDGET screening is now spreading out throughout the City in a number of areas and particularly in terms of children who are on MA. That's a requirement under the EPSTT Program that the doctors do the screening. We get recording on the screenings through the City's public health lab and also through laboratory reporting from private labs across the state.

Forty thousand kids out of an estimated population of how many?

It's probably somewhere around a little over a hundred thousand in that age range.

What's the age ranger that you're primarily concerned about?

One through six.

One through six?

One through six years of age.

And you're saying that the City does 40,000 on our own?

No, there's 40,000 screened in the City. We do only a very limited amount of screening ourselves.

Well, what happens 912 2/16/01 - FY '02 OPERATING BUDGET with the other 60,000 kids?

I wish they would get screened.

What are we doing to help them get screened?

We are educating doctors and parents to ask for screening. And many of those children do get screened within that age range. In other words, if I were to look at a five-year spread in that age range, there's substantially more tan the 40,000 that we just screen last year. Some kids get screened each and every year for the first six years of their life. Some kids get screened each as the department recommends at least each year for the first three years of age of life which is the highest risk time. Some kids get screen once in that whole period.

Tell me a little bit about any affirmative steps that we take to encourage screening. And for instance -- and maybe you already do this. What particular steps have we taken, for instance, to encourage all public employees to make sure that their kids, their grandchildren, their nieces, nephews, or anybody 913 2/16/01 - FY '02 OPERATING BUDGET else get screened? Do we send material out to all the public employees? Do we stuff anything in the pay envelopes? Do we have anything on the web site? Does stuff go around?

We do have information on the web site. We have sent mailers out with Water Department bills. We've also had some public service announcements on. We concentrate a great deal on the medical community. We hold provider meetings and conferences periodically and try and push it because even if parents don't remember to ask to have their child screened, the doctor should know that this is something that they need to do.

Do we need to do more outreach?

We always need to do more outreach. We have concentrated outreach programs. We have community health workers who do presentations on a City-wide basis to parents groups, to day care groups and to basically anyone who will sit down and listen. Be more than glad to give one here.

Maybe we should. Councilman DiCicco has, quite frankly, lead the 914 2/16/01 - FY '02 OPERATING BUDGET effort here in City Council, for instance, on giving blood. I mean, it's one of a number of things that we could probably shine some additional light on. As a result of his efforts, I have, for instance, become much more sensitive and will now on a regular basis give blood to the American Red Cross. I think to the extent that either public employees are being asked and encouraged to look after little ones in that situation and then the general employer population, working through whether it's Greater Philadelphia First and partnering with those organizations to provide some emphasis to their workers. I mean, that's the kind of thing that really should be promoted and encouraged throughout our entire community to the extent that people are thinking about this. I understand your emphasis on the doctor because at least at that point they kind of have the kids. But apparently -- would you agree that a fair number of young people do not get this kind of screening which then has tremendous implications later on in their lives?

There are a fair number of young people who aren't screened. However, they tend also to be concentrated in the lower risk areas 915 2/16/01 - FY '02 OPERATING BUDGET of the City. As we've increased screening, for instance, going out to the newer housing in the Northeast, we found very low incidences in those areas. There's very little incidence for the number of kids who were getting screened. In the highest risk areas with the oldest most deteriorated housing in City, we find a very great penetration in those areas because historically that's where we've concentrated our efforts.

Well, what I would ask you to do, if you forward to the Chair, one, I would like -- and it's been dangerous around here the past couple days to ask for any maps, but I will ask you if you could get us some maps that show the gradations of these concentration levels as well as where you think the population is throughout the City of Philadelphia. If you could forward that to the Chair and then in some reasonable period of time maybe share with us what you think an ungraded outreach program might look like and what City Council can do both directly and potentially from a funding standpoint to help support that.

Absolutely.

Thank you. 916 2/16/01 - FY '02 OPERATING BUDGET

Councilman, I'm Susan Lieberman and I'm Director of Division of Early childhood, Youth, and Women's health. I'd just to add a little bit to Mr. Tobin's testimony. In all of the outreach programs that we do, which include Welcome New Families which is a program for all new parents with information packets, for our Home Visiting which is nurse home visiting and lay home visiting, and outreach programs for a Healthy Start. We include information about the importance of lead screening so that we're trying very hard. We work with community organizations who actually do an excellent job of getting the word out about lead screening, nutrition, all kinds of activities which improve mothers and babies' health.

Thank you, Madam Chair.

Councilwoman Miller, you're next.

Thank you. Just as a follow-up.

I'm sorry, Councilwoman. You'll have your follow-up. 917 2/16/01 - FY '02 OPERATING BUDGET Councilwoman Brown was next. Sorry.

I just wanted to do a point of order.

Certainly.

In regards to lead base paint, I just wanted to ask a question regarded removal. How many do you remove -- lead base paint removal from homes, particularly in the areas you just identified, how many homes did you do last year? How many do you expect to do this year? If there's a backlog, what are the plans to address the backlog because that's important, too. The education and whatnot is really good, and the testing. But also removal is key to us addressing the problem of lead base paint.

Lead paint removal, at one time we did lead paint removal with blow torches and scraped it off and it was a fairly quick job to do. And unfortunately, that was wasn't right way to do it. Doing it properly is a very expensive and tedious process. We don't always get houses into compliance. Now, we get -- I don't remember the number right off the top of my head. But there are about a thousand houses that have come into 918 2/16/01 - FY '02 OPERATING BUDGET compliance within our open case load right now. That doesn't mean nothing's been done in them. We outreach workers speak to the parents and the parents very often will do what they can in those situations. Many of those houses, more than half are owner-occupied or low-income owner occupants. In many cases, they don't have the resources to safely do that removal. We try and qualify them for HUD grants. We try and get these jobs done, but there are probably a thousand houses out there where we have found lead base paint and hasn't been completely removed.

Well, if they qualify for a HUD grant, then they can get it removed?

If they qualify for a HUD grant, we work for the Office of Housing for the HUD grants. If they meet all the qualifications in there, they can get a contractor which is a certified contractor under the Commonwealth certification laws, come in and do the paint removal work and do the necessary work that need to be done to make the house safe. Very often, people can't qualify because of problems with title and things of 919 2/16/01 - FY '02 OPERATING BUDGET this nature. And what we try to do in those cases is help them to get it in the safest condition possible. The one thing I will say is during the last quarter, none of the children who received follow-up testing for lead had an increase in their blood lead level. I think we've been very successful in terms of teaching parents what to do, even in an environment that does contain lead.

It's really important because I know in my district there are lots of old homes. Lots of us aren't fortunate enough to live in areas where they have a lot of new homes. I just think that -- I just wondered if there's anything that we can do at the City level to help people get this hazardous material out of their homes. And maybe we can talk about that at some other time. Thank you. Thank you, Madam Chair.

You're welcome, Councilwoman. It appears to me that I've learned from this hearing that we don't have a handle on this problem. Maybe if there could be some added focus on assessing where the problems are and what the needs are and then you can make budget requests, 920 2/16/01 - FY '02 OPERATING BUDGET then we can be of more assistance to you. But we need you to direct us. And certainly, when you have people -- I already mentioned Mr. Johnson. He is in here screaming all the time. And, in fact, we're getting a new school because of the screaming that we started on lead paint. And anybody who knows him, knows that's his issue. But I understand his concerns because we really, really don't have a handle around the extent of this obviously enormous problem. So if you help us to make those assessments, then we can try to help you to petition the Administration for the money, okay?

Thank you.

We will wait for a new minutes so the stenographer can reset her machine. Thank you. Just momentarily. (Brief recess.)

Thank you for your patience. I have Councilwoman Reynolds-Brown, you're next.

Thank you very much. I want to follow-up concerns raised by colleagues around the lead issue and underscore Councilwoman Blackwell's remarks that it really is 921 2/16/01 - FY '02 OPERATING BUDGET indeed an enormous problem. So let me attempt to get some additional facts. You mentioned that currently 40,000 young people have been screened; is that correct, lead poisoning expert?

During the last year there were 40,000 children screened, yes.

And approximately 60,000 remain to receive that service.

A number of those 60,000 kids may have been screened in the year prior to that also. In other words, you have a five-year period when the child can be screened or should be screened for lead.

Would it be fair to draw the conclusion then that if there are approximately 60,000 young people left to be screened or either re-screened, that equals the 1100 homes on the waiting list? Is it a conclusion arrive? I mean, you mentioned that there are 1100 homes on a waiting list.

The 1100 homes are related to children that were found with confirmed elevations. Not necessarily -- they're all children who were screened, but there were a lot of 922 2/16/01 - FY '02 OPERATING BUDGET kids who were screened who don't have the confirmed elevations.

What happens in cases where lead has been determined to be in a child, they receive the treatment, and they go back home where lead may still be present? What happens in an instance like that? What do you do? Is that not a potential reality?

That is a potential reality. Lead exists in probably about 95 percent of the houses in Philadelphia -- well, about 80 percent total Philadelphia; 95 percent of the older housing in Philadelphia. Children do go back and in some cases we do have teams we can send out to do housing reduction work. In other cases, that work is done by the owner or by the occupants. But we also have outreach workers and the inspectors are also trained to work with the parents to show them where the greatest hazard is in trying to eliminate that hazard. In some cases, you may still have a lead hazard present in the house. If you teach the mother to wash the child's hands repeatedly and continuously and keep them away from that area, he won't have as much exposure as he had when he was 923 2/16/01 - FY '02 OPERATING BUDGET going there. The children can come back and come back with high elevations after a treatment if they are continuing to be exposed.

How many homes do you clean up each year, approximately?

With all of our inspections, there are a couple hundred homes that do come into compliance. Our own crew only did 30 years homes in the past year because of limited resources and the fact that we didn't have full staffing during that time.

So if you did 30 this past year and there are conceivably 1100 on the waiting list, that simply underscores Councilwoman Blackwell's remarks that it's enormous and we'll never get ahead of the curve because we're always catching up. So I, too, will look forward to the data that Councilman Nutter has requested which can give City Councilmembers of Council an idea on where the bad marks are so that data and best practices can then drive a strategy that moves towards eliminating that 1100 homes that are still waiting to be addressed. What's the relationship with the School 924 2/16/01 - FY '02 OPERATING BUDGET District? You mentioned a number of partners. I did not hear the School District. You do mention on of your testimony, and I quote, "We also work closely with the School District to support our current lead prevention efforts." Please elaborate on that.

Right now the School District is a process of testing the drinking water in all the schools. They're almost completed the testing. They've run over 18,000 tests on over 16,000 water outlets. They've turned off all of the outlets, to the best of our knowledge, that were found to be elevated or that hadn't been tested yet. We have a couple of people on staff who full time are monitoring the School District's efforts in this regard and will continue to work with them through the process of remediation. We don't work very really strongly with School District in terms of screening primarily because of the age of greatest interest for lead screening is actually --

One through six?

The age we cover is one 925 2/16/01 - FY '02 OPERATING BUDGET through six, and the greatest interest is actually one through three, and they just don't have those kids for most part at that point. Also, the head start programs and things of that nature are also doing -- they do do some screening in conjunction with some other agencies and we don't really do that.

I hear what you're saying and recognize that the School District for the most part begins to touch children lives around three or four years old. But implicit in that may be an opportunity since the School District begins to touch young people between the ages of three and six and because your data say that you deal with young people one to six, that an opportunity might to exist to do some kind of linkages prevention types of things to get to parents who have children between the ages of three and six. I would suggest that you look at that and consider that is an opportunity.

And as a part of our outreach efforts, we do do those sort of things. We do have our community health workers making presentations at schools, at head start centers, at 926 2/16/01 - FY '02 OPERATING BUDGET day care center and things in association with the School District. There just isn't a big formal plan that sets it out as a part of the School District activity.

Very well. Your answers are well taken, but again I underscore Councilwoman Blackwell's remarks; it is an enormous issue. And to the extent that you all enlighten us and raise our antenna, it gives us the ammunition we need to put this as priority funding matter on the front burner when it comes to this time of year, budget time. So we'll look forward to the date that Councilman Nutter has requested so we can work with you in making this a front burner funding priority. Thank you very much. I have question now that I need see the leader of CODAAP. If I could ask him to please come forward. I simply want to follow-up on what Councilman Cohen eloquently touched on. I noticed in the testimony and I looked at the charts and, there are charts that speak to what's happening around disease control, AIDS prevention and early childhood. Currently $45.5 million are spent by CODAAP for a range of services. A lot of discussion 927 2/16/01 - FY '02 OPERATING BUDGET on this floor was given TO one side of the equation, which is what we do with young people, what we do with City residents after they've been touched by that disease. Let's look to the flip side of that equation, the prevention side. I need to hear what's happening, I need to hear what amount of dollars are being devoted to prevention, and I need to hear what's happening in the School District as relates to prevention so young people are at least enlightened because we know that when we look at the explosion of what's happening in prisons, if you track it, most of that is related to drug abuse. So what are we doing in the area of prevention and what percentage of this 45 million is devoted to prevention?

That's a very good question, but I would also like to say that when one does treatment and one treats, let's say, moms who have children or the dads, when you have a recovering person going back to a household, very often those households are reunited and those folks act as very positive role models for their children. Every spring I go to a number of graduations of treatment programs and I'm always very pleased to 928 2/16/01 - FY '02 OPERATING BUDGET see the numbers of children at those programs that are being reunited with their mothers and fathers who are now in recover. So while one can focus on prevention, you can also look at the impact of treatment with the adults in bringing those families together and, in fact, conveying a prevention message. But with regard to the specifically to your question, there are three programs which CODAAP funds that work within the public and parochial schools and they work in a variety of schools, a number of schools. Also, there are, I believe, 12 community-based organizations that do preliminarily after-school prevention programs in the neighborhoods. We call it our Youth Risk Reduction Project. There are three programs that work with -- specifically new programs that we just started that work with adolescence. One does outreach in case management with adolescence who are not yet really involved with substance abuse but are at high risk for substance abuse. In terms of what percentage of the 45 million that goes into prevention activities, I would say probably in the neighborhood about 20 929 2/16/01 - FY '02 OPERATING BUDGET percent of the monies that come into us from the state goes into prevention programs.

The programs you mentioned, you said that there three programs in the schools, or did I mis-hear you, including the Youth Reduction Project?

There are three projects that work in the school. The Corporate Alliance for Drug Education works in a number of schools. Shalom works in a number of schools. And Jewish Family and Children Services Project Pride works in a number of schools. And then there are the Youth Risk Reduction Programs which are community-based organization that do primarily after-school and weekend activities.

And they're funded by the percent you get from the 19 State? 20

They are funded within that 20 percent, yes.

Councilwoman, I just wanted to add one point to that also. There's also 60 consultation and education specialists that are funded in a variety schools throughout the City in 930 2/16/01 - FY '02 OPERATING BUDGET each of the clusters, clusters throughout the City. They're basically a frontline resource to the school administration and to children who may be experiencing some type of behavorial health, not only drug and alcohol, but potentially behavorial health services and then link back to a variety of resources. So that's in addition to what Mark testified on the drug and alcohol front.

I think it's very 11 important to note that while within the pages that 12 you have, there's a budget for CODAAP and a budget 13 for OMH and so forth, that these offices within the 14 behavorial health system work very closely together 15 so youngsters who are at risk of, say, substance 16 abuse which are very many young people, are touched 17 by the entire constellation of monies that are 18 within the behavorial health system. CODAAP has an allocation, and we're accountable to the State Department of Health for that allocation. But there's more money in the behavioral health system that touch kids.

Thank you. Thank you very much.

As you know, Safe and 931 2/16/01 - FY '02 OPERATING BUDGET Sound has one of its initiatives to look at drug and alcohol prevention among children in Philadelphia I'm not sure Mark said it, but I know he knows it very well. Substance abuse for our kids is a very, very difficulty area. And one of the reasons we made an initiative of Safe and Sound is to try to determine what's the best way to effect that change rather than just putting money in it and not getting a return on it, what is the way to approach it. Safe and Sound is about to come out with a concept paper. They have spent the last year and a half, I believe, or year beginning to work with the professionals in the field who work with adolescence who have a that training for children who know prevention to try to figure out what is our best approach to do this. And at the point that we can begin to sort that out, we will then be prepared to begin to look for the significant dollars I think it's going to effect a prevention program. But I want to be very caution that we no longer just put money out there and hope we get better results and don't have a way of, one, measuring it and making sure we're going to bring down the probability that youngsters actually get engaged in the substance 932 2/16/01 - FY '02 OPERATING BUDGET abuse lifestyle.

I thank you for that. Again, as you move down the road of exploration and gathering data, I think it's imperative that the School District be involved at every -- and that is not to say that the School District is already at the table, but I do believe they have a responsibility in the prevention education of this not at grade 9, but at grade 1. And so as you gather the data, if they are not already, please encourage them, and I will certainly make it clear during budget hearings when they come before this body, that they be at the table.

Let me just have Dr. Dogan come up who's the medical director of the behavorial system. She's been involved in this past year and can tell you whose been involved.

Please. Good morning. Before you start, please let me put on the record that I would forwarded to the Chair the information on the programs that are currently in the school and which schools are participating so we see where we are and where we need to go to make it a system-wide initiative. 933 2/16/01 - FY '02 OPERATING BUDGET

Hello. I'm Judith Dogan. I'm both a general psychiatrist --

Excuse me. Can you pull the mike closer. We absolutely can't hear you. It's not a great system.

I'm Judith Dogan. I'm a general psychiatrist and child and adolescence psychiatrist functioning within the behavioral healthy system. I want to look at you and still use the mike. I had the privilege of being part of an adolescent work group on substance abuse which was actually charged as a work group that is part of the Safe and Sound initiative at the Mayor's request. When convened last January. There were about 50 individuals who are connected with all aspects of the school system, juvenile justice, behavorial health providers both on the mental health and the substance abuse side. There were community representatives and a large group of individuals who are involved in both preventative research as well as substance abuse research. We are in the final stages of crafting a report that will provide recommendations around prevention services, early 934 2/16/01 - FY '02 OPERATING BUDGET intervention services, and treatment services that we feel will best meet the needs of this community.

Thank you very much. We'll look forward to that information as we go down the road. I thank you for that. I have two more questions, Madam Chair. Please tell us, elaborate on your testimony, the asthma bus. We know that in our community asthma among little people is on the rise, and just enlighten us a little on what that is a what it's doing. COMMISSIONER TSOU: The Thomas Jefferson University has in cooperation with various other groups, including a special grant, a two-decker bus, sort of the British style bus, which is an education bus that is available elementary school kids to teach them about a variety respiratory illness, asthma being the most prominent one. And there are panels in the bus which sort tell a cartoon story about how asthma comes about and what you can do about preventing or controlling asthma. The panels are themselves switchable so that you could actually do a discussion about tobacco use, for example, also in that bus. We have the only bus of its kind in 935 2/16/01 - FY '02 OPERATING BUDGET Philadelphia in the nation, and we hope to use this as an educational tool.

It's a novel approach and hopefully it will get the attention of parents who have children with asthma. My final question is around what the Health Department is doing in the area of sudden infant death syndrome. I know at one time the Health Department provided counseling services to those families. You may still be doing that. I'm just interested in an update. And what services are being rendered to families who lose children due to death other than sudden infant death syndrome, homicide and those kinds of things. COMMISSIONER TSOU: We are very concerned about sudden infant death syndrome, SIDS, and in particular your concern, I'm sure, is related to the of the grief counseling that goes with that. I wonder, actually if Sue Lieberman would like to speak with you about this issue.

Hi. I'm he Susan Lieberman, director of the Division of Early Childhood, Youth, and Women's Health. The SIDS program provides culturally 936 2/16/01 - FY '02 OPERATING BUDGET competent bereavement counseling, group sessions, education programs around unexpected or death for children up to age two. And they serve about 250 families a year. There is also a program out of medical examiners office called the grief assistance program --

It's called what?

The grief assistance program, which provides counseling to families who have lost relatives to homicide and other kinds of deaths that are unexpected.

So for parents who lose their little people after the age of two, the City has a service in place where that counseling service can be continued in spite of the Health Department not providing that, correct?

Yes. Yes, ma'am.

I should wait until the next round for additional questions.

Thank you. Councilman Clarke. While he's coming, let me ask you, PHMC collects data for the Health Department. What kind 937 2/16/01 - FY '02 OPERATING BUDGET of data do they collect for you? COMMISSIONER TSOU: Philadelphia Health and Management Corporation has probably the nation's most extensive longitudinal study on behavioral risk factor surveys, things like smoking prevalence, overweight, access to health care. It's called the community health data base, and their most recent statistics were recently made available for the Year 2000. It's something that's actually is mostly used as a research tool, but it's also of some use to policymakers on what's going on in Philadelphia.

Could you send us a list of data you might have and then we can request any specific information that we might want. COMMISSIONER TSOU: Certainly.