►
Description
The Committee on People with Disabilities and Special Needs of the Council of the City of Philadelphia held a Public Hearing on Friday, October 23, 2020, at 9:30 AM, in a remote manner using Microsoft® Teams to hear testimony on the following items:
200527 Resolution authorizing the Committee on People with Disabilities & Special Needs to hold hearings regarding the consequences of potential additional cuts by the Commonwealth of Pennsylvania General Assembly to mental health services, especially those offered in the City of Philadelphia.
A
Good
morning,
good
morning,
it's
a
pleasure
to
have
this
committee
hearing
here
today.
This
is
a
committee
of
council
on
people
with
disabilities
and
special
needs,
and
we
will
begin
by
letting
people
know
that
under
state
law
currently
requires
that
the
following
announcement
be
made
at
the
beginning
of
every
remote
public
hearing
of
council
as
follows.
A
Due
to
the
current
public
health
emergency
city,
council
committees
are
currently
meeting
remotely,
we
are
using
microsoft
teams
to
make
these
remote
hearings
possible
instructions
for
how
the
public
may
view
and
offer
public
testimony
at
public
hearings
of
council
committees
are
included
in
the
public
hearing,
notices
that
are
published
in
the
daily
news,
enquirer
and
legal
intelligence
here
prior
to
the
hearings,
private
hearings
and
also
can
be
found
on
phl
counsel
dot
com.
I
will
know
that
the
hour
has
come
for
the
beginning
of
this
hearing.
A
Mr
inuzi,
will
you
please
call
the
role
to
take
attendance
members
that
are
in
attendance?
Will
you
please
indicate
that
you
are
present
when
your
name
is
called
also,
please
say
a
few
brief
words
or
paragraphs
depending
on
your
decision
today
when
responding,
so
that
your
image
will
be
displayed
on
screen
when
you
speak.
C
B
A
Derek
green:
I
am
present
I'm
going
to
call
this
meeting
this
public
hearing
of
the
committee
on
people
with
disabilities
special
needs
to
order.
A
qualm
of
this
committee
is
present,
and
this
is
a
hearing
regarding
resolution.
Number
two:
zero:
zero.
Five,
two
seven!
Mr
inuzi,
will
you
please
read
the
title
of
the
resolution.
E
Resolution
number
two:
zero:
zero.
Five:
two
seven
resolution
authorizing
the
committee
on
people
with
disabilities
and
special
needs
to
hold
hearings
regarding
the
consequences
of
potential
additional
cuts
by
the
commonwealth
of
pennsylvania
general
assembly
to
mental
health
services,
especially
those
offered
in
the
city
of
philadelphia.
A
Thank
you,
mr
inuzi,
before
we
begin
to
hear
testimony
from
the
witnesses
we
have
here
for
today,
everyone
who
has
been
invited
to
this
public
meeting,
that's
going
to
testify
should
be
aware
that
this
hearing
is
being
reported
because
the
hearing
is
public.
Participants
and
viewers
have
no
reasonable
expectation
of
privacy.
By
continuing
to
be
in
the
meeting,
you
are
consenting
to
being
reported
additionally
and
prior
to
recognizing
members
of
any
question
or
comments
it
may
have
for
any
of
our
witnesses.
Today.
A
I
will
note
for
the
record
at
this
time
that
we
will
use
the
chat
feature
that's
available
in
microsoft,
teams
to
allow
members
to
signify
that
they
wish
to
be
recognized
in
order
to
comply
with
the
sunshine
act.
The
chat
feature
must
only
be
used
for
this
purpose,
so
please,
only
members
of
council
provide
notes
in
the
chat
feature
before
we
call
for
the
first
panel.
I
want
to
thank
everyone.
That's
here
to
testify
and
they're
reviewing
this
hearing.
This
is
a
very
important
issue
in
so
many
ways.
A
A
A
In
particular,
during
the
corporate
administration,
we
saw
a
cut
of
about
84
million
dollars
that
occurred
from
the
budget,
and
those
dollars
were
not
replaced
now
that
time
period
when
we
had
the
great
recession,
we
had
a
deficit
at
the
commonwealth
level
of
close
to
about
700
million
dollars
going
into
next
year
is
anticipated
that
the
commonwealth
will
have
a
deficit
close
to
about
four
billion
dollars.
So
the
concern
is
what
will
happen
if
we
have
that
type
of
deficit
and
how
will
the
commonwealth
adapt
in
making
cuts?
A
We've
seen
how
cuts
were
made
in
the
past,
which
had
a
disproportionate
impact
on
this
population,
and
my
concern
is
as
we
go
into
the
next
year
and
as
we
as
a
council
go
into
our
next
fiscal
year
from
a
budgeting
perspective,
how
will
we
make
up
the
difference?
Traditionally,
the
city
has
budgeted
from
a
perspective
that
whatever
grant
dollars
we
receive
from
either
the
federal
government
or
the
state
government.
Those
are
the
dollars
that
we
use
for
the
provision
of
those
services.
A
So
if
there
is
a
scenario
where
significant
cuts
occur,
that
could
have
a
decimal,
very
decimating
impact
on
this
community
and
so
for.
From
my
perspective,
happiness
hearing
was
a
great
way
to
start
this
conversation
and
put
this
on
front
of
mind
not
only
for
the
city
administration,
but
also
members
of
council,
that,
as
we
go
into
our
budgeting
process,
starting
in
the
beginning
of
next
year,
that
we
have
an
understanding
what
type
of
impact
state
budget
cuts
may
have
to
this
population.
A
So
that's
why
I
think
it's
very
important
to
talk
about
this
conversation,
especially
in
context
of
the
coven
epidemic
and
pandemic.
That's
impacted,
so
many,
but
especially
this
population
of
people
that
have
a
physical
learning
difference
and
with
that,
mr
inuzi.
If
you
can
call
the
first
panel
of
witnesses
that
we
have
here
to
testify
this
morning,
dr.
A
A
I
would
like
to
thank
your
work
coming
in
as
the
acting
commission
for
the
department
of
general
health
and
intellectual
disabilities,
and
also
I
have
to
commend
the
work
of
your
staff
mcconnell,
as
well
as
the
outgoing
commissioner,
commissioner,
david
jones,
for
the
work
that
you
all
have
done
as
an
agency
in
trying
to
continue
to
provide
guidance
and
services
for
individuals
that
have
been
dealing
with
some
of
the
issues
we're
talking
about
today.
I
hope
you're
now
connected
and
ready
to
proceed
and
dr
bone.
B
D
Ideas,
thank
you
for
this
opportunity
to
testify
in
response
to
resolution
number
two:
zero
zero.
Five.
Two
seven
dbhids
is
responsible
for
oversight
of
a
provider
network
that
funds
services
for
children,
youth,
adults
and
families
in
philadelphia
with
behavioral
health
challenges
and
or
intellectual
disabilities.
D
Much
of
this
work
occurs
throughout
three
of
the
six
divisions
that
comprise
dbhids
intellectual
disability
services,
which
also
includes
the
birth
to
three
early
intervention
program.
The
division
of
behavioral
health
and
community
behavioral
health
or
cbh,
which
is
the
city-governed
non-profit,
managed
care
entity
that
authorizes
behavioral
health
services
for
individuals
eligible
for
medicaid.
D
D
A
D
We
understand
that
the
7
12,
the
7
months
of
funding,
will
not
be
made
available
until
the
general
assembly
passes.
The
remaining
state
budget,
the
uncertainty
of
the
time
frame
and
confirmation
of
the
fully
annualized
amount
is
of
concern.
The
potential
impact
on
the
budget
for
the
current
fiscal
year
is
unknown
at
this
time.
D
These
uncertainties,
coupled
with
the
current
economic
climate,
have
prompted
dbhids
to
proactively
explore
strategies
to
provide
service
continuity.
If
we
experience
reductions
now
or
in
the
future,
as
we
explore
the
impact
of
a
potential
budget
reduction
on
services,
it
is
essential
to
note
the
funding
structure
for
dbhids
services.
D
These
include
services
that
support
those
struggling
with
mental
health
and
substance
use
disorders
such
as
safe
havens,
recovery
houses,
long-term
structured
residences,
emergency
mobile
crisis
services
for
children
and
adults
and
employment
programs.
These
funds
also
cover
the
full
continuum
of
behavioral
health
treatment
services
for
the
uninsured
population,
including
inpatient
and
outpatient
levels
of
care.
D
In
fiscal
year,
19
through
state
award
funds
dbhids
served
nearly
45
000,
uninsured
individuals.
This
includes
those
who
are
not
eligible
for
medicaid,
which
also
encompasses
those
who
are
undocumented
immigrants.
In
the
future.
These
numbers
may
rise,
as
we
contend
with.
Multiple
traumas,
including
covet
19's,
prolonged
impact.
D
The
affordable
care
act
has
also
benefited
our
system
as
we
address
insurance
gaps
and
improve
linkages
to
long-term
sustainable
treatment
options.
Dbhids
plays
a
vital
role
in
addressing
the
social
determinants
of
health.
We
work
to
improve
and
preserve
the
overall
behavioral
status
of
all
philadelphians
at
dbhids.
We
take
a
much
broader
view
of
improving
everyone's
health
in
a
community,
not
just
those
with
a
diagnosis.
D
We
support
wellness
and
resilience
so
that
over
time,
philadelphia
experiences
continuously
improving
behavioral
health
and
mitigates
the
effects
of
multi-layered
trauma.
There
will
always
be
a
need
for
access
to
high
quality,
clinical
care
supports
and
services.
We
are
also
focused
on
early
intervention
and
prevention,
which
includes
screening
for
and
preventing
the
onset
or
progression
of
conditions.
D
D
D
D
D
D
As
we
look
at
these
concerning
economic
conditions
and
face
uncertainty
regarding
potential
budget
cuts,
we
know
that
every
lost
dollar
directly
impacts
a
person
a
family
depending
on
us
for
survival
before
covet
19
philadelphia
was
significantly
impacted
by
multiple
layers
of
trauma.
We
were
combating
an
opioid
epidemic,
the
highest
poverty
rates
among
large
cities,
economic
insecurity,
systemic
racism,
community
violence
and
all
the
associated
traumas,
impacting,
of
course,
multiple
social
determinants
of
health.
D
A
A
A
D
So
to
to
be
clear,
the
amount
of
funding
that
is
impacted
by
the
512
specific
funding
stream
that
is
particular
to
state
based.
So
it's
not
the
whole
amount
that
was
at
risk
and
the
the
total
amount
of
the
that
award
was
for
mental
health,
145
million,
and
so
that
would
put
at
risk
approximately
84
million
and
then
another
just
about
5.7
million
of
oas
dollars.
So
the
majority
is
in
the
mental
health
base
where
we
received
5
12
of
the
funds.
D
D
So
the
amount
that
we
received,
the
5
12
amount
that
we
received
on
the
mental
health.
Just
to
be
clear.
We
received
approximately
60
million
on
the
oas
side,
approximately
4
million
on
the
ids
side,
approximately
10
million
and
on
the
ei
side,
approximately
8
million,
so
the
amount
that's
delayed
is
the
balance
of
the
annual
amount
that
we
would
anticipate.
A
Thank
you
in
some
of
the
conversation
I've
had
with
individuals
in
the
commonwealth.
In
anticipation
of
this
hearing,
my
understanding
is
that
federal
chaos
dollars
that
have
come
to
the
commonwealth
that
have
not
been
encumbered,
there's
an
anticipation.
Those
dollars
will
be
used
to
solve
the
budget
hole
for
this
fiscal
year
and
this
general
session
general
assembly
session
ends
on
november
30th.
Have
you
had
any
conversations
with
any
of
the
state
agents?
D
A
Okay,
thank
you,
and
so
my
other
concern
is
especially,
and
I
I
do
have
a
strong
sense.
Although
we
don't
know
what
may
happen
that
those
unencumbered
federal
care
styles
or
the
commons
received
will
be
used
to
fill
the
budget
hole
in
order
to
allow
your
organization
to
get
what
was
budgeted
for
the
entire
12
months.
A
D
Have
not
again
uncertainty,
I
think,
is
the
word
of
the
day
for
on
their
part,
as
well
as
on
our
part.
At
this
point
it
the
amount
for
this
year
is
with
the
legislature
and
it's
not
clear
what
the
following
year
holds
in
store,
which
is
again
why
we
are
grateful
for
an
opportunity
to
think
proactively
about
what
may
be
coming
down
the
pike
in
terms
of
risk
to
funding
sources
for
behavioral
health.
A
Generally,
during
this
time
of
year,
as
we
go
from
mid-fall
into
late
fall
and
early
winter,
various
departments
start
to
put
together
their
budgets
for
the
upcoming
fiscal
year,
which
will
start
july
1..
We
all
know
that
the
mayor
will
provide
his
budget
address
sometime
in
the
early
march
as
you're,
starting
to
put
together
that
information,
what
type
of
changes
with
all
the
uncertainty
that
we're
dealing
with?
D
D
The
types
of
services
that
support
wellness
as
a
focus
goes
in
on
ensuring
direct
care
for
those
who
are
struggling
with
those
types
of
challenges.
In
the
midst
of
substance
use
epidemic
and
the
impact,
the
national
trends
are
anticipating
an
uptick
in
mental
health,
behavioral
health
challenges,
given
the
impact
of
interrupted
routines,
isolation,
we're
looking
at
depression
and
anxiety
being
forecasted
as
people
try
to
re-engage
more
fully
in
their
environment.
D
D
You
look
at
again,
depression
risk
for
some
suicidal
ideation
increases,
so
the
focus
of
a
reduced
budget
would
be
on
addressing
these
direct
services,
which
are
often
more
costly
services,
and
the
concerns
would
also
be
in
delays
of
services.
If
there
are
reductions
in
the
number
of
hours
available,
clinicians
available
to
provide
the
services,
so
we
are
looking
at
steps
back.
We
are
looking
at
focused
services
and
we're
looking
at
what
kinds
of
reductions
again
unknown
in
the
unknown.
We
have
to
prepare
for
multiple
possibilities.
A
A
D
That's
one
of
the
areas
where
we've
seen
increases
it's
a
complex
picture.
There's
some
decreases
in
some
increases
and
in
the
drug
and
alcohol
world
services
are
more
in
demand
in
the
outpatient
and
residential
non-hospital
residential
areas.
So
we
are
concerned
that,
as
I
called
it,
a
hardship
multiplier,
it's
a
crisis
on
top
of
crisis
and
they
feed
into
each
other.
Those
with
substance
use
challenges
may
be
more
vulnerable
to
medical,
comorbidities
and
greater
illness
if
they
were
to
contract
covet
and
and
those
who
are
struggling
with.
A
E
No
problem,
thank
you
so
much,
mr
chairman,
and
I
appreciate
dr
bellen.
Thank
you.
So
much.
Could
you
talk
a
little
bit
about
services
to
young
people
and
how
they
were
impacted
in
the
last
in
the
last
crisis
that
we
faced
and
what
you
might
anticipate,
having
happening
to
young
people
and
the
services
that
you
currently
have.
D
D
Those
services
are
impacted
because
the
school
is
impacted
and
here's
we
go
back
to
the
theme
of
hardship
multipliers,
so
the
families
are
at
home
trying
the
best
that
they
can,
those
that
are
in
access
center,
so
the
the
impact
on
rolling
out
the
ibhs
fully,
although
they
are
out
there
and
doing
as
much
work
as
they
can.
It's
a
slower
role
because
of
all
of
the
challenges,
with
the
changes
to
the
expected
basic
structure
in
the
planning
for
an
ibhs
rollout.
E
One
of
the
you'll
have
to
forgive
me
because
I'm
not
I'm
not
entirely
clear
about
how
some
of
the
funding
worked,
but
one
of
the
partnerships
we
also
had
within
the
schools
was
paying
additionally
for
social
workers
and
high
needs
schools
to
service.
That
is
that
something
that
dbhids
was
part
of,
I
know
cbh
helped
use
some
of
their
money
for
it.
I
wasn't
sure
if
dbh
helped
do
that
as
well.
D
Yeah
so
there's
cbh
and
dbhids,
providing
some
supports
for
the
step
program
and
the
embedding.
So
any
of
the
services
that
are
embedding
in
the
schools
will
struggle
when
the
schools
are
are
in
a
different
mode.
I
think
there's
a
fair
amount
of
effort
to
provide
as
much
as
possible,
but
there's
no
question
of
impact
and
for
those
who
receive
who
are
uninsured
and
receive
services
that
are
as
much
as
possible,
paralleling
some
of
the
ibhs.
E
Mean
obviously,
with
schools
having
the
potential
to
not
be
fully
returned
until
september
of
2021?
Hopefully
you
know
one
of
the
things
that
we're
dealing
with
is,
of
course,
if
the
you
know,
as
the
financial
crisis
deepens,
both
for
municipalities
and
across
the
board.
Our
concern
is
that
when
schools
do
return
and
if
those
services
are
limited
or
pulled
back,
that's
going
to
be
an
even
bigger
issue,
because
those
young
people
will
have
will
will
will
definitely
need
those
support
services
in
the
classroom.
D
We
haven't
really
talked
yet
about
telesupports.
Patella
supports
are
incredibly
important
and
many
of
the
providers
have
pivoted
and
there's
a
fair
amount
of
satisfaction
with
telehealth
and
telesupports
and
I'll
just
take
this
opportunity
to
just
acknowledge
that
anywhere.
Where
there
remains
a
digital
divide,
will
impact
the
access
to
telesupports,
but
for
many
of
the
programs,
including
some
of
the
ones
for
children
they're
using
every
potential
innovative
approach
to
continue
to
provide
the
necessary
supports
for
the
kids
in
the
current
climate.
E
So
when
you
say
I
mean,
can
you
already
see
the
gap
around
telehealth,
because
there
is
a
digital
divide
that
we're
pretty
clear
about?
The
city
has
made
a
significant
commitment
to
ending
the
digital
divide
in
philadelphia,
but
I
feel,
like
you,
would
you
already
have
clients
right,
you're,
moving
to
telehealth?
E
D
D
E
77,
you
said:
okay,
you
know
one
of
the
things
that
we
notice.
Certainly
when
schools
shut
down-
and
you
know
we
try
to
reach
families
and
children
in
particular.
One
of
the
darkest
and
harshest
realities
is
that
we
actually
lose
children
entirely.
We
we
don't
we're
not
able
to
find
them,
they
disappear
kind
of
off
the
books.
E
There
may
be
a
bad
address,
the
email
doesn't
work,
the
phone's
been
disconnected,
and
so
you
know
it's
it's
a
constant
reminder
of
how
important
it
is
and
how
fragile
families
are
and
that
our
connections
to
them
are
are
really
important
and
relationships
matter.
They'll.
They
can't
reconnect
based
on
basic
services,
but
they
can
find
people
if
the
relationship
is
strong.
Have
you
seen
some
of
that
with
some
of
the
clientele
that
you
serve
also
like
during
the
pandemic?
Have
people
like?
E
D
For
example,
inpatient
hospitalization
is
up
so
we're
seeing
some
more
people
there,
but
outpatient
is
down,
though
it's
up
with
the
substance
use
population
in
terms
of
outpatient.
So
we're
really
trying
to
understand
this
complex
picture
of
where
people
are
and
who's
coming
into
services,
who's
coming
into
services
that
maybe
hadn't
before
and
who's
coming
into
service.
D
Continuing,
there's
a
tremendous
effort
on
the
part
of
a
really
exceptional
provider
network
to
maintain
contact
with
people
who
have
been
in
treatment
and
again
the
telesupports
and
the
telehealth
is
really
a
critical
part
of
that.
We
also
pay
attention
to
crisis
lines,
and
you
know
there's
a
mixed
picture
there
as
well.
E
Yeah,
so
my
last
question,
thank
you
very
much
for
that.
So
my
last
question
is
that
you
know
I'm
trying
to
think
about
how
we
would
you
know
have
done
things
differently
and
how
we're
going
to
approach
this
new
financial
crisis,
which
is
you
know,
quite
honestly,
inevitable,
a
lot
differently
from
what
we
had
you
know
a
decade
ago.
I
know
that
in
our
school
system
we
took
out
nurses
and
counselors.
We
distribute
them.
E
One
to
two
to
three
thousand
nurses,
were
you
know
barely
in
place
in
a
huge
majority
of
schools?
I
think
it
had
a
lot
to
do
with
the
fact
that
there
weren't
pre-existing
quote
systems
or
I
don't
want
to
use
quotas.
What
do
I
say
student
ratios
that
would
have
protected
it.
So,
in
fact,
what
ended
up
happening
was
that
people
went
back
to
the
most
extreme
ratios
and
then
cut
back
from
there.
If
they
could
argue
that
you
know
there
was
any
kind
of
gap
or
opening.
E
So
in
this
particular
case,
legal
precedent
does
matter
ratios
any
types
of
things
that
ensure
or
guarantee
things
matter,
and
then
I
I
would
say
that
the
other
thing
that
we
lacked
really
was
in
especially
in
terms
of
mental
health
care
and
treatment,
and
our
institutions
and
I'll
I'll
definitely
get
to
you,
but
I
think
that
it
wasn't.
It
wasn't
considered
a
core
part
of
the
mission,
and
so
it
fell
to
the
wayside.
So
education
was
considered
a
full
part
of
the
mission
preserve
teachers
etc.
E
There
could
not
be
like
a
nuance
or
some
kind
of
balancing
or
another
kind
of
priority
system
that
came
in
place,
so
we
existed
back.
Then
we
closed
down
multiple
schools.
You
know
we
had
children
die
in
schools.
Without
nurses,
we
saw
our
graduation
rates
plummet
when
there
were
no
counselors
in
the
schools,
for
especially
in
that
first
year,
as
in
your
field,
and
you
know
we
went
through
those
devastating,
you
know
what
is
100
plus
millions,
and
you
know
like
it's
it's
you
know
it's
nine
figures
right.
E
It's
like
insane
amounts
of
money.
The
you
saw
kind
of
like
the
heavy
hand
that
came
through
as
how
would
you
have
done
things
differently
like
how
or
how
are
you
thinking
about
it
in
a
way
that
resets
our
priorities,
so
that
we
can
approach
any
future
financial
crisis
differently
in
a
way
that
values
mental
health
treatments?
And
what
would
you
have
uplifted
that
you
felt
did
not
get
uplifted
in
the
last
crisis?
E
D
D
So
if
you,
if
you
cut
into
schools,
you're
going
to
be
impacting
behavioral
health,
if
you
cut
behavioral
health
you're
going
to
be
impacting
the
schools,
I
think
it
has
to
be
looked
at
in
an
integrated
fashion.
These
are
we
have
great
awareness
of
the
social
determinants
of
health
and
the
impact
and
and
and
to
be
honest,
every
social
determinant
of
health
is
traumatized
right.
D
As
I
said,
acute
services
are
more
expensive,
so
there
has
to
be.
You
know
intentional
thoughtful
planful,
and
that's
a
really
it's
really
hard
to
do
that,
but
necessary
to
do
that.
So
the
idea
of
going
to
a
scenario
where
it's
you
know
remove
certain
people
based
on
ratios
is
concerning,
and
hopefully
we
have
learned
from
some
of
those
experiences
that
we
have
to
look
at
the
big
picture
and
the
small
picture
at
the
same
time.
E
Yeah,
thank
you
very
much.
Those
are
all
my
questions.
My
only
comment
would
be
that
I
do
think
that
things
that
weather
financial
crisis
crises
are,
as
you
said,
groups
that
have
figured
out
systems
in
which
there's
good
integration.
So
if
our
investment
right
now
in
kind
of
you
say,
like
you,
know,
fending
off,
you
know
what
we
we
know
likely
where
things
are
going
to
hit
and
who's
going
to
be
most
vulnerable.
B
B
D
D
I
think
every
opportunity
to
be
working
collaboratively
on
some
of
these
challenging
areas
are
is
needed
and
I
think
already
dbh
ideas
was
involved
in
that
kind
of
collaborative
work
along
with
the
you
know,
the
health
and
human
services
cluster,
and
so
I
have
every
expectation
that
that
will
continue
with
this
sort
of
focus
on
where
we
are
with
our
current
situation.
I
do
want
to
say
that
we
are
committed
to
school
services.
We
have
always
been
adding
services
and
improving
the
services.
D
The
ibhs
is
an
excellent
service
that
is
rolling
out.
It's
really
comprehensive
and
a
really
good
step
forward
with
excellent
providers
that
are
very
busy,
and
you
know,
receiving
supports
and
collaboration
meeting
regularly
with
cbh
leadership,
looking
at
their
funding
streams
and
what
is
needed
for
them.
So
all
of
that
is
very
much
underway.
B
D
B
Okay,
okay,
my
second
question
is
around
gun
violence
and
the
you
know
dramatic
spike
in
gun
violence
across
the
city,
but
particularly
in
in
many
areas
of
my
district.
How
has
the
gun
violence
epidemic
impacted
that
the
amount
of
services
that
you
are
providing
to
people
within
neighborhoods?
And
how
are
you
thinking
about
interacting
with
this
epidemic
as
the
numbers
around
shootings
and
homicides,
continue
to
rise.
D
So
our
trauma
and
support
services
are
well
in
place,
have
been
throughout
the
pandemic
and
support
along
with
our
partnership
with
nami
our
trauma
and
resilience
team.
There
were
customized
sessions
for
essential
workers
out
in
the
community,
with
network
of
neighbors
training,
trauma,
101
and
working
with
our
partners
and
fire
health
and
police
to
mitigate
impact
of
covet
19,
again,
hardship
multipliers,
multiple
traumas
and
the
supports
that
we
have
in
place
are
active
and
have
been.
Our
outreach
teams
are
out
there.
D
Our
community
wellness
engagement
units
we
have
been
building
even
before
the
bantamic.
We
have
been
building
teams
to
support,
strengthen
resilience
of
and
to
support,
communities
on
on
addressing
trauma
and
pre
and
working
with
the
office
of
violence,
prevention
and
other.
You
know
efforts.
I
think
dbhids
has
been
a
partner
with
the
criminal
justice
system
and
trying
to
work
on
innovative
approaches
to
some
of
our
biggest
challenges.
E
D
Yeah
we're
we're
out
there
with
the
communities
and
responding.
We
have
a
number
of
approaches.
We
have
already
been
looking
even
before
covid
with
awareness
of
the
the
traumatic
communities,
the
violence
we
support
programs
like
ceasefire,
so
we
have
been
steadily
increasing
and
even
through
the
pandemic
and
the
effects
and
impacts
we're
out
there,
we're
out
there
in
the
communities
and
we're
supporting
our
programs.
D
D
C
D
Yeah,
so
nursing
homes
is,
is
not
particularly
specifically
under
dbhids,
but
I
would
like
to
talk
about
congregate
settings
and
our
our
role
in
supporting
folks
who
are
vulnerable
due
to
65
years
of
age.
Rover,
for
example,
or
those
who
have
medical
vulnerability.
Vulnerabilities
dbhids
was
instrumental
in
helping
to
stand
up,
quarantine
and
isolation
sites
and
integrated
supports
for
those
who
are
most
vulnerable
in
those
sites.
D
D
D
B
D
C
All
right
well,
thank
you.
Thank
you.
Can
you
talk
about
like
the
the
transition
into
the
community,
because
we
know
that,
particularly
in
light
of
covet,
there
are
a
lot
of
families
who
no
longer
want
to
do
the
traditional
care
settings
and
including
nursing.
You
know
nursing
facilities
and
are
there
transition
funds
or
resources
available?
C
D
D
You
know
telehealth
not
being
the
least
of
it
other
challenges
in
terms
of
let's
say
folks,
who
may
need
mat
access,
but
they're
in
isolation.
So
there
were
all
sorts
of
new
challenges.
We
were,
I
think,
incredibly
well,
positioned,
given
that
we
were
already
working
to
enhance
our
our
flexibility,
our
ability
to
provide
treatment
on
demand.
E
D
Work
to
improve
access
to
care
and
to
increase
mobile
presence,
so
that
allowed
us
to
kind
of
look
at
what
we
were
already
doing
and
see
what
needed
to
be
enhanced
and
adjusted,
and
so
much
of
that
has
you
know,
evolved
a
bit,
but
we're
still
pushing
to
further
that
effort.
Another
reason
to
take
us
back
to
the
concerns
about
cost
cuts,
because
these
types
of
efforts,
you
know
our
shift,
a
system
to
bring
services
where
people
are.
D
You
know
the
goal
is
to
bring
services
where
people
live
where
they
learn
where
they
pray
where
they
congregate.
You
know
this
is
what
what
the
goal
would
be,
and
so
a
more
mobile,
flexible,
responsive
system.
The
fact
that
we
had
already
been
moving
in
that
direction
was
an
advantage
as
we
needed
to
adapt
to
kovit.
D
C
How
do
we-
and
this
is
my
last
question,
mr
chairman-
how
do
we
make
sure
that
those
resources
are
known
and
out
there?
How
do
we
put
the
word
out?
I
have
someone
close
to
me
who
works
for
liberty,
resources
and
they
do
an
awesome
job
of
those
transitions
of
moving
people
into
the
community
with
various
disability
needs
and
that
need
to
be
met.
D
Yeah
so
there's
a
number
of
ways
in
which
we
bring
awareness
to
to
folks
that
they
know
what
the
resources
are
and
some
of
what
has
been
put
into
place
were
ideas
that
came
from
our
stakeholder
partners
from
community
directly
from
from
city
council
members,
and
some
of
that
includes
community-based
teams
that
are
out
there
interacting
and
bringing
the
knowledge
and
the
connections
making
the
linkages
we
launched,
mindful
together
as
a
partnership
with
independence
blue
cross.
That
is
still
up
and
active.
D
H
C
Thank
you
very
much.
The
only
thing
other
thing
that
I
would
like
to
add
is
that
I
I
would
encourage
mr
chairman,
in
in
your
role
and
also
as
the
chair
of
the
committee
on
health
and
human
services,
that
maybe
we
could
do
a
briefing
through
city
council
for
council
members,
because,
as
you
know,
we
get
a
lot
of
questions
and
don't
always
have
the
answers.
D
We're
very
very
happy
to
do
that.
We
did
do
one
last
year
and
happy
to
do,
and
especially
given
some
of
the
challenges
this
past
year
very
happy
to
do
to
schedule
that
to
upgrade
it,
and
we
also
are
aware
that
you
are
a
point
city
council
appropriately
for
folks
to
come
in
and
ask,
and
so
we
want
to
make
sure
that
you
have
all
the
information
that
you
need
and
the
connections
to
us
as
well.
C
C
A
You,
I
think,
that's
actually
a
great
idea
also
considering
that
dr
bowen,
you
are
new
into
this
position.
That
would
be
a
great
opportunity
to
introduce
you
to
members
of
council
by
having
that
type
of
briefing,
as
well
as
providing
information
on
how
members
of
council
and
our
offices
can
provide
services
to
constituents
who
are
dealing
with
some
of
these
issues,
especially
during
this
pandemic,
because
life
has
changed
so
much
dramatically
since
we
had
that
lamp
briefing.
A
C
C
A
So
we
will
end
with
that,
and
so
we
next
have
questions
from
the
council
member
brooks,
and
then
we
will
go
into
the
next
panel
if
there
are
no
other
questions
from
members
of
council
and
to
let
members
of
the
audience
know
and
members
of
council
that
the
next
panel
will
be
the
following:
sherry
rumman's,
dr
adriana
torres
o'connor
and
malcolm
musgrove,
and
that
will
be
the
next
panel.
If
there's
no
additional
questions
from
members
of
council
and
at
this
point
we'll
hear
from
council
member
brooks.
B
B
So
can
you
talk
more
about
the
plans
to
fund
supports
for
like
addictions,
mental
health
and
children
with
these
cuts
to
your
budget
and
are
there
future
opportunities
for
the
department
to
receive
increased
federal
grant
funding?
Because
we
know
without
you
know,
the
state's
allocation
it'll
be
hard
to
fill
those
budget
holes
moving
forward,
and
I
have
another
part
to
that
question.
But
you
want
to
answer
that
part
first
and
then
I
can.
D
D
Or
other
stimulus
type
of
money
that
may
be
under
consideration,
the
federal
funding
at
this
point
has
not
been
at
risk
for
this
year.
The
uncertainty
that
we're
focusing
on
is
the
state,
specific
funding
stream
and
there's
the
base
the
state
base
and
the
reason
that
the
concern
you
know
originally
came
forward
was
because
we
got
5
12
of
the
money
thus
far
this
year.
For
that
funding
stream,
the
federal
funding
stream
at
this
point
was
not
affected.
D
I
do
want
to
say
that
we
go
after
every
available
grant.
We
can.
That
is
a
focus
of
our
efforts,
and
so
we
look
for
we
and
we
apply,
for
any
other
supports
that
we
can.
That
is
a
part
of
our
overall
strategy.
I
think
that,
in
answer
to
your
question
about
substance
and
and
and
mental
health
and
children
services,
all
of
which
would
be
at
risk,
we
are
really
talking
proactively
here
thinking
forward
about
what
may
be
coming
down
the
road
I
think
appropriately.
D
So
those
are
the
concerns
and
why
we
are
so
I'm
grateful
to
have
this
opportunity
to
talk
about
this.
We
also
work
very
hard
to
and
want
to
just
emphasize
again
the
importance
of
the
aca
in
the
work
that
we
do.
We
work
very
hard
to
help
those
who
are
not
medicaid
enrolled,
but
are
medicaid
eligible
to
be
able
to
flip
them
onto
medicaid
dollar.
D
If
we
had
reduced
funding
it
would
be
difficult
to
continue
to
do
that.
If
there
were
challenges
to
the
aca
and
the
folks
who
are
served
through
medicaid,
we
would
have
additional
concerns.
So
I
think
again
we
go
back
to
the
word
uncertain
and
uncertainty
brings
with
it
a
certain
amount
of
anxiety
and
the
need
to
prepare
for
multiple
possible
scenarios.
B
D
So
the
network
is
able
to
serve
all
of
the
needs
of
the
folks.
At
this
point,
we
have
the
ability,
within
our
provider
network,
if
necessary,
and
if
we
had
funding,
we
can
expand
the
network.
We
always
cbh
in
particular,
focuses
on
network
adequacy
and
assesses
to
make
sure
that
we
have
capacity
in
the
event
that
we
began
to
exceed
our
capacity
or
we're
not
able
able
to
provide
timely
services.
D
B
Thank
you.
I
have
a
few
more.
I
wanted
to
talk
about
the
potential
layoffs
that
you
mentioned
in
your
testimony.
We
know
that
dbhis
is
a
leader
in
the
city's
workforce
as
it
relates
to
hiring
black
and
brown
workers.
So
I'm
really
concerned
that
the
budget
cuts
will
lead
to
deepening
poverty
for
working
people
throughout
the
city.
You
know,
while
also
fertility
neglecting
the
vulnerable
populations
that
they
serve.
B
D
D
D
B
Yeah,
thank
you
for
that,
because
my
concern
also
was
like,
as
a
former
mental
health
workers,
I
used
to
be
a
behavioral
specialist.
What
we
do
realize
is
that
with
staffing
shortages,
that
means
increased
workloads,
and
that
means
the
folks
that
are
most
in
need
will
get
limited
care
when
workers
are
stretched
of
everything,
and
I
just
wanted
to
make
sure
that
part
of
that
analysis
includes
what
would
increase
workloads
look
like,
because
what
we
do
realize.
B
God
forbid,
that
if
we,
if
you
do
have
to
cut
staffing,
the
need
of
the
clients
already
served
will
not
be
reduced,
and
I
that
that's
just
a
major
concern
about
that.
I
have
unemployment,
how
it
affects
the
communities
and
also
how
it
affects
the
services
in
those
communities,
and
I
just
want
to
make
sure
that
the
potential
increase
in
workload
and
what
that
look
like
is
definitely
considered
from
a
worker's
perspective
and
also
from
a
family
and
caregivers
perspective.
D
Absolutely
agree,
and
again
these
are
inextricable
inextricably
tied.
I
do
want
to
also
just
be
clear
that
at
this
point
in
time,
we
do
not
have
a
reduction.
We
are
expecting
that
that
other
712s
to
be
considered
by
the
general
assembly,
but
the
economic
scenarios
must
be
considered
given
the
realities.
D
I
I
just
want
to
echo
how
important
it
is
for
direct
support
persons
to
be
to
be
present
and
serving
at
the
multiple
layer
of
levels
of
care
throughout
our
system.
Throughout
mental
health
substance
use
intellectual
disabilities,
early
intervention,
we
need
these
folks
in
place
and
providing
the
services
in
these
most
difficult
times.
D
A
D
So
about
90
percent
of
the
funding
goes
to
the
provider
network,
that's
what
the
funding
is
for.
It's
for
the
the
provision
of
behavioral
health
and
intellectual
disability
services
and
the
economic
impact
for
the
city
is
a
nine
to
one
for
every
one
dollar.
The
city
puts
them,
it's
nine
dollars
from
the
the
grant
funding
and
as
an
economic
impact
on
the
city,
it's
a
very
positive
economic
impact
for
the
city
and
the
loss.
This
is
not.
D
A
And
that's
why
raising
this
issue
is
important
now.
So
we
can
kind
of
think
what
we
need
to
do,
not
only
to
make
sure
that
we
can
continue
to
provide
all
the
services
that
we
need
to
do
for
our
constituents,
but
also
how
it's
going
to
impact
our
city
from
an
economic
perspective
as
well.
I'm,
dr
bowen,
thank
you
for
your
time.
A
A
F
F
I
thank
you
in
advance
for
the
opportunity
to
testify
before
you
today.
The
alliance
is
a
trade
association
that
represents
organizations
in
philadelphia
that
provide
services
and
supports
to
children
and
adults
who
struggle
with
mental
health
issues,
substance,
abuse
issues,
intellectual
disabilities
and
autism.
F
First,
it's
important
to
contextualize
my
testimony
today
by
reminding
you
of
what
you
probably
already
know.
Providers
of
critical
life-sustaining
human
services
are
operating
within
razor
thin
margins.
Unfortunately,
this
was
the
case
long
before
covet,
and
it
remains
true
now
and
probably
will
remain
true
in
the
future.
F
So
to
put
this
into
perspective,
and
recently
we
did
an
alliance
survey
and
we
found
that
nearly
90
percent
of
our
agencies
have
incurred
over
a
hundred
thousand
dollars
in
covid
related
expenses.
That's
a
hundred
thousand
dollars
that
is
not
reimbursed.
That
is
a
hundred
thousand
dollars
that
nobody
expected
prior
to
covid
and
over
55
percent
report
having
three
months
or
less
cash
on
hand.
F
It
should
come
as
no
surprise
that
securing
adequate
personal,
protective
equipment
or
ppe
has
been
both
difficult
and
quite
expensive,
while
the
supply
of
ppe
is
more
plentiful
than
it
was
at
the
start
of
the
pandemic
costs.
For
these
items
continue
to
be
sky
high,
these
costs
are
generally
not
reimbursed
and
our
providers
need
additional
funding
to
give
direct
services
workers
the
tools
they.
F
Themselves
and
their
families
and
those
entrusted
to
their
care
to
be
clear,
our
direct
carer
workers
require
the
team
safety
equipment
as
essential
hospital
workers.
They
are
indeed
essential
workers,
it's
unreasonable
to
ask
our
dsps
direct
support
professionals
or
essential
workers
to
take
on
the
same
risk
without
giving
them
the
same
resources.
F
F
Direct
care
workers
are
doing
very
risky,
difficult
jobs
for
substandard
pay,
which
leads
many
to
burnout
and,
ultimately,
to
a
decision
to
change
career
paths.
Substandard
pay
is
nothing
new
for
correct
care
workers.
We've
been
fighting
this
battle
for
a
very
long
time,
but
in
the
face
of
a
global
pandemic,
it
is
downright
inexcusable
that
we
cannot
afford
to
pay
them
a
living
wage.
F
Additionally,
there's
been
a
noticeable
increase
in
the
need
for
mental
health
treatment,
which
ultimately
results
in
providers
expanding
necessary
services
without
proper
funding
in
the
future.
These
providers
are
could
be
at
risk
of
closing,
laying
off
staff
for
significantly
decreasing
the
services
that
they
offer.
F
Alternative
payment
ratios
have
kept
many
of
our
behavioral
health
providers
above
water,
and
for
that
we
are
very
grateful,
but
that
option
is
slated
to
go
away
in
january,
and
at
this
point
we
believe
the
situation
will
become
even
more
dire
as
covid
gets
worse.
Throughout
the
winter
months,
state-funded
intellectual
disability
and
autism
day
program
closures
have
been
decimating,
many
providers
have
been
unable
to
continue
and
even
as
some
programs
have
safely
reopened,
it's
at
a
drastically
reduced
capacity.
F
F
F
We
have
a
responsibility
to
take
care
of
our
city's
most
vulnerable
citizens,
in
addition
to
significant
widespread
spread,
trauma,
violence,
systemic
racism
and
extreme
poverty.
I
believe
we
are
at
the
cusp
of
a
burgeoning
mental
health
crisis.
I
think
it's
safe
to
say
that
we
can
all
agree.
We
cannot
cut
funding
if
we
expect
things
to
improve.
F
F
F
A
G
Good
morning,
can
everyone
hear
me
wonderful?
Thank
you.
I
am
dr
adriana
torres
o'connor
president
and
ceo
of
mental
health
partnerships
good
morning
to
council
members.
I
would
like
to
thank
thank
you
for
this
opportunity
to
contribute
my
testimony
to
this
very
important
matter.
Special
thanks
to
chairman
derek
green
for
your
tireless
leadership
and
for
inviting
me
here
today.
G
Since
1951
mental
health
partnerships
has
been
providing
programs,
services
and
advocacy
to
thousands
of
philadelphians
and
their
families
struggling
with
mental
health
and
addiction
challenges.
We
have
pioneered
peer
support
as
a
way
of
recovery
for
those
experiencing
mental
health
and
addiction
challenges.
G
My
staff
have
walked
intimately
in
terms
of
the
journey
of
recovery
and
are
trained
to
use
their
lived
experience
in
partnership
with
individuals
and
families
with
mental
health
challenges
to
promote
recovery
and
resiliency,
like
the
thousands
of
mental
health
professionals.
Throughout
this
great
city
of
philadelphia,
our
staff
as
sherry
said,
are
front
line
and
essential
workers.
They
have
stepped
up
to
ensure
that
services
not
only
continue
to
support
those
in
need,
but
actually
increased
without
additional
funding
to
meet
the
increasing
demand
caused
by
this
pandemic.
G
The
numbers
speak
for
themselves
prior
to
covet
19.
Just
eight
months
ago,
one
in
five
adults-
that's
20
percent,
experienced
a
mental
health
challenge
in
their
lifetime.
That's
over
211,
000
philadelphians,
the
most
prevalent
diagnosis
were
anxiety
and
depression
and
the
diagnosis
of
depression
alone
costs
americans,
193.2
billion
dollars
a
year
in
lost
earnings.
This
is
a
compounding
effect
on
the
local
and
larger
economies.
Given
philadelphia
is
one
of
the
largest
economies
in
the
country
since
the
start
of
covet
19
only
eight
months
ago,
those
impacted
my
mental
health
and
addiction
challenges
have
skyrocketed.
G
Adults
experiencing
anxiety,
has
increased
by
30
percent
adults
experiencing
depression
has
increased
by
40
percent
adults
experiencing
trauma
and
stress.
Related
symptoms
has
increased
25
adults
who
started
or
increased
their
use
of
drugs
and
alcohol
to
cope
with
covid19
related
stress
has
increased
13
adults
who
have
seriously
considered
suicide
in
the
last
30
days,
has
increased
by
25
percent.
G
These
increases
in
the
number
of
people
impacted
by
mental
health
challenges
as
a
result
of
the
coven
19
pandemic
have
disproportionately
affected
young
adults,
black
and
brown
communities,
essential
workers,
which
includes
mental
health
workers.
Like
my
staff
at
mental
health
partnerships
and
those
with
pre-existing
mental
health
conditions,
these
increases
are
not
just
numbers:
they're
people
they're
the
citizens
of
philadelphia.
G
The
reality
is
clear:
coven
19
and
its
effects
are
not
going
away
anytime
soon.
It
is
also
clear
that
mental
health
funding
is
more
critical
now
than
ever
any
cut
to
mental
health
funding
will
compound
the
increased
trauma
and
mental
health
challenges
that
people
are
experiencing
now,
which
has
already
resulted
in
an
increase
upwards
of
40
percent
of
people
experiencing
mental
health
challenges.
G
A
cut
to
mental
health
funding
will
further
compound
the
lost
earnings
experienced
by
those
with
mental
health
challenges,
to
the
extent
that
the
193.2
billion
dollars
in
lost
wages
will
look
like
a
drop
in
the
bucket
when
compounded
with
the
increase
in
mental
health
incidents
and
current
job
loss
caused
by
this
contempt.
This
pandemic,
which
itself
is
triggering
mental
health
challenges.
G
It
is
clear
that
this
pandemic
has
created
budget
shortfalls
at
all
levels
of
government.
It
has
caused
great
strains
on
small
and
big
business
alike.
However,
non-profit
mental
health
organizations
like
mental
health
partnerships
will
be
especially
hit
hard
by
decreases
in
government
funding
just
when
they
are
needed
the
most,
and
this
will
not
only
have
short-term
consequences
for
the
mental
health
of
philadelphia's
residents,
but
will
have
long-term
consequences
to
the
health
and
stability
of
citizens
that
result
from
increased
costs
to
the
overall
economy.
G
H
Access
to
adequate
behavioral
health
care
is
critical
to
create
healthy
communities.
Before
the
start
of
the
covet
19
pandemic
and
accompanying
economic
anxieties,
we
face
significant
challenges
in
caring
for
philadelphians,
the
opiate
epidemic,
rising
suicide
rates
and
significant
access
issues
prevented
people
from
receiving
the
services
they
need.
The
southeast
pennsylvania
community
health
needs
assessment,
ranks,
substance,
use
and
mental
health
care
as
the
most
important
community
health
priority
for
our
region
and
notes
that
our
most
vulnerable
community
members
are
those
are
those
most
in
need
of
behavioral
health
services.
H
This
includes
those
living
in
poverty,
racial
and
ethnic
minorities,
immigrants
and
refugees,
lgbtq
plus
community
youth
and
older
adults.
The
current
crisis
only
amplifies
the
need
for
mental
health
and
substance
abuse
disorder,
services
increase
and
increases
barriers
to
individuals
seeking
treatment.
People
suffering
with
mental
health
and
substance
use
issues
are
more
likely
to
rely
on
medicaid
and
public
health
programs
for
support.
H
Reducing
funding
to
this
vulnerable
population
will
not
only
have
a
devastating
effect
on
the
individuals
who
rely
on
the
use
of
services
and
their
families,
but
also
to
the
community
in
the
city
as
a
whole.
Access
to
behavioral
health
care
not
only
improves
the
lives
of
individual
citizens,
but
it
also
improves
the
quality
of
life
within
our
communities.
H
Access
to
care
for
individuals
in
need
reduce
the
likelihood
of
criminal
activity,
homelessness,
overdose
deaths
and
spread
of
disease
or
illness.
It
also
increases
the
overall
productivity
of
philadelphians
by
increasing
participation
in
work,
education,
volunteer
activities
and
reducing
involvement
with
the
criminal
justice
system.
H
Behavioral
health
care
can
improve
an
individual's
overall
health
and
well-being
and
reduce
total
health
care
costs.
Individuals
with
severe
and
persistent
mental
illness
have
shorter
life
spans
and
more
medical
conditions
than
the
general
population.
Social,
economic
anxiety,
food,
insecurities.
Lack
of
housing
and
employment
issues
go
hand
in
hand
with
mental
illness
and
addiction
issues.
Untreated
mental
health
and
substance
use
issues
result
in
higher
utilization
of
emergency
room
department,
visits,
increased
hospitalizations
and
greater
health
care
expenditures
by
entering
by
addressing
individuals
basic
needs.
H
It
is
up
to
all
of
us
legislators,
community
members,
provider,
organizations
and
provider
organizations
to
ensure
that
we
are
providing
access
to
community-based
services
and
supports
that
our
neighbors
need
access
to
care
does
not
simply
mean
having
provider
organizations
operate
within
the
system.
It
requires
provider,
organizations
that
are
able
to
meet
people
where
they
are
physically,
culturally,
economically
and
where
they
are
in
terms
of
their
treatment.
H
Mental
health
providers
need
adequate
funding
to
deliver
high
quality
care
that
philadelphia
communities
deserve
funding
that
will
enable
us
to
hire
qualified
staff,
implement
telehealth
and
other
new
technologies,
usually
utilize,
evidence-based
practices
and
to
better
coordinate
care
with
physical
health
providers
and
social
service
supports
mental
health
care
is
an
essential
component
to
the
city's
public
health.
The
funding
of
mental
health
services
is
not
only
investing
in
the
individual
philadelphians.
B
While
relatively
new
in
the
role
of
chief
educational
services
officer,
I've
had
the
privilege
of
working
in
the
public
health
community
for
nearly
30
years,
specializing
in
the
needs
of
children,
with
developmental
delays
through
our
childline
program
and
individuals
with
intellectual
and
developmental
disabilities.
Through
our
personal
program,
this
work
has
placed
me
and
my
team
front
and
center
in
the
lives
of
families,
pays
vacantly
searching
for
critical
resources
for
their
children
and
for
their
family
members
with
special
needs
getting
the
case
with
nearly
all
of
the
people
touched
by
phmc,
subsidiaries
and
programs.
B
The
children
and
individuals
served
by
child
lincoln
personally
have
complex
needs.
In
fact,
we
estimate
that
85
percent
of
participants
in
phmc's
behavioral
health
services
are
duly
diagnosed,
with
both
mental
health
and
substance
use
disorders,
and,
while
my
teams
are
not
directly
delivering
mental
health
resources
to
the
individuals
and
families
we
serve,
we
are
keenly
aware
of
how
vital
these
services
are
in
the
lives
of
our
participants
and
their
families.
B
Their
relief
must
have
quickly
faded
into
frustration
within
the
only
program
offering
the
appropriate
level
of
mental
health
services
wasn't
able
to
accommodate
their
child
due
to
a
lack
of
staff
resulting
from
decreased
funding
to
struggle
with
these
families
is
all
too
real.
The
resources
are
already
far
too
few,
and
the
current
environment
of
an
ongoing
pandemic
has
only
intensified
the
importance
of
good
mental
health
for
all
individuals.
B
I
respectfully
make
two
specific
requests:
please
reach
out
to
your
colleagues
at
the
state
level
and
implore
them
to
maintain
better
yet
to
improve
funding
for
mental
health
services
in
philadelphia,
and
please
consider
city-specific
funding
and
support
for
mental
health
providers
for
nearly
50
years.
Phmc
has
been
a
safety
net
for
the
populations
we
serve
across
our
city
and
region.
B
We
are
committed
to
continuing
this
work.
We
will
continue
to
advocate
on
their
behalf
and
work
in
collaboration
for
our
fun
with
our
funders
partners,
elected
officials,
to
shine
light
on
the
impact
these
budget
decisions
have
on
individuals,
families
and
communities
we
serve.
Thank
you
again
for
the
opportunity
to
speak
with
all
of
you
today.
I
look
forward
to
our
continued
partnership
in
improving
the
lives
of
the
people
of.
A
Philadelphia,
thank
you.
Thank
you
for
your
technical
for
the
record.
The
councilmember
alan
diamond,
also
here
and
also
councilman
catherine
gilmer
richton,
was
here
earlier
and
we
look
forward
for
her,
hopefully
being
able
to
return
back
to
this
hearing.
I
have
a
couple
questions
I
would
like
to
ask
and
if
any
other
members
of
council
have
questions,
feel
free
to
make
reference
to
that
or
indicate
that
in
the
chat
feature
first
question
is
for
mr
brummons:
can
you
give
the
perspective
of
the
alliance?
F
Oh,
that's
a
good
question,
one
that
I
don't
know
I'm
prepared
to
answer,
although
right
this
moment,
but
I
can
get
an
answer
for
you.
I
would
say
we
we
do
run
the
gamut.
We
have
very
small
organizations
that
have
less
than
a
million
dollar
budget
and
other
organizations
that
have
two
300
million
dollar
budgets.
F
F
You
know,
because
we're
not
we're
not
just
thinking
about
the
the
provision
of
services
in
in
isolation,
we're
thinking
about
the
the
unspoken
contract
that
you
will
have
an
employee
who
you're
paying
right
to
show
up
to
work
and
and
come
and
do
that
work
who
is
going
to
serve
someone
who
is
is
in
need
of
those
services,
and
so
when
a
larger
organization
has
to
lay
people
off
in
a
lot.
You
know
in
a
bigger
way:
that's
more
people
who
are
now
without
jobs.
F
A
Well,
I
just
wanted
to
kind
of
give
for
members
of
the
committee
and
those
watching
a
kind
of
flavor
of
the
nature
of
organizations
that
are
part
of
the
alliance.
But
I'll
ask
this
follow-up
question
and
I
try
not
to
make
assumptions
what
is
the
vast
majority
of
organizations
that
are
part
of
the
alliance
non-profit
organizations
who
receive
the
significant
amount
of
the
resources
that
they
use
to
deliver
services
from
federal
state
and
local
governments.
F
Yes,
they
are
mostly
non-profit
to
be
clear.
The
alliance
of
community
service
providers
is
not
the
only
trade
association
in
the
city
of
philadelphia.
We
are
the
largest,
but
we
don't
our
work,
and
you
know
when
I
quoted
statistics
to
you
earlier
this
morning.
They
they
are
around
alliance
providers
and
so
just
to
you
know,
really
highlight
the
point
that
the
problem
is
even
worse
than
what
I
said
this
morning,
because
there
are
other
providers
that
don't
belong
to
the
alliance
of
community
service
providers.
F
A
And
thank
you
for
that,
and
I
just
want
to
because
not
everyone
knows
all
of
the
acronyms.
So
when
you
say
id
you're
talking
about
intellectual
disability
in
this
space
and
having
been
a
member
of
a
lot
of
different
non-profit
boards,
having
you
know,
served
as
a
stanford
city
council
to
former
council
member
marin
tasco,
who
chaired
the
public
health
and
human
services
committee
and
also
based
my
own
experience
with
a
son
on
the
autism
spectrum.
A
I've
got
to
know
the
various
acronyms
quite
well,
but
you
know
for
the
services
that
are
coming
to
the
city
from
the
commonwealth,
for
the
department
of
behavioral
health
and
intellectual
disabilities,
the
acronym
and
dbh
ids,
and
they
also
provide
contract
services
to
organizations
like
cbh
or
community
behavioral
health
and
there's
a
whole
host
of
acronyms.
But
for
the
most
part,
the
dials.
We're
talking
about
that.
A
A
A
lot
of
time
and
energy
is
spent
on
the
general
fund
dollars
and
those
are
dollars
that
come.
You
know
to
the
city
by
way
of
resident
and
non-resident
wage
taxes,
the
business
income,
receipt
tax,
real
estate
tax
or
real
estate,
transfer,
tax
sales,
tax
or
amusement
tax,
and
a
lot
of
that
energy
in
our
budget.
Conversation
is
spent
on
those
areas
that
come
into
our
general
funds.
But,
as
dr
bowen
talked
about,
we
receive
a
significant
amount
of
money
and
she
just
made
reference
to
her
area.
A
We
also
have
the
health
department
as
well
receive
significant
dollars
at
the
federal
and
state
level,
but
also
come
into
the
city
of
philadelphia,
and
those
issues
are
not
addressed
as
much
and
that's
why
I
want
to
have
this
conversation,
because
if
we
receive
significant
cuts
at
the
state
level,
that
will
dramatically
impact
the
organization
represented
here
and
the
constituents
that
we
serve
as
members
of
council
not
only
from
services
but
also
from
employment,
as
well
as
other
economic
impacts.
So
just
for
once
again
for
the
record.
F
It's
often
the
case
that
individuals
are
duly
diagnosed
and
they
may
have
co-occurring
drug
and
alcohol
and
behavioral
health
as
well
as
co-occurring,
behavioral,
health
and
intellectual
disabilities
and
autism.
So
it's
complicated
and
it's
not
two
clear
paths
that
are
parallel:
they
they
often
intersect
so.
A
Thank
you,
and
also
I
just
want
to
state
as
well.
Thank
you
for
your
advocacy
regarding
direct
service
professionals
factors.
Earlier
today
I
saw
an
email
from
ask
me.
District
accounts
1199c
during
a
work
with
philadelphia
works
to
try
to
hire
and
get
more
people
into
the
dsp
or
direct
service
professional
area.
That
is
a
great
need,
a
special
need
to
increase
their
salaries,
even
when
we
were
in
a
more
robust
economy
prior
to
covet.
A
A
I
have
a
question
for
dr
adrian
torres
o'connor
as
weird,
and
you
touched
on
this
in
your
testimony.
I
want
to
get
some
more
perspective
on
the
issues
of
mental
health
and
homeless
and
the
homelessness
issue
we've
had
in
our
city.
We've
had
you
may
reference
to
a
number
of
statistics
and
information
that
the
pandemic
has
started
to
increase
those
issues,
and
I
know
your
organization's
been
doing
a
lot
of
work
in
a
number
of
areas.
A
I
know
we've
had
direct
conversations
regarding
your
advocacy
and
support
for
the
increase
of
homeless
individuals
that
were
at
the
airport
and
trying
to
resolve
that
issue,
working
with
delaware,
county
and
and
your
organization
providing
services
for
people
who
are
homeless.
But
if
you
can
give
some
more
perspective
on
how
covet
and
a
possible
loss
of
state
dollars,
could
impact
and
increase
this
concern
in
our
city.
G
Thank
you.
So,
yes,
in
terms
of
the
homeless,
our
homeless
services
and
what
we
have
been
seeing
and
in
the
trends
because
of
coven
19
and
the
subsequent
job
losses
throughout
the
city,
the
number
of
people
who
are
experiencing
homelessness
has
gone
up
because
of
that
and
we're
seeing
a
lot
more
women
and
families.
G
In
addition,
what's
compounding
the
issue?
Is
the
shelters
are
full
they're
full?
They
cannot
take
any
more
individuals.
There
are
more
individuals
who
are
in
need
and,
in
addition,
because
of
the
safety
precautions
from
the
cdc
and
on
our
own
health
department
regarding
six
feet,
spacing
there
are
more
people
in
need.
The
shelters
are
full
and
the
shelters
because
they
have
to
increase
people's
safety.
They
have
to
space
people.
So
then
there's
less
room
on
top
of
that.
G
So
it
really
is
an
ongoing
compounding
factor,
and
dr
bowen
also
indicated
that
inpatient
facilities
are
also
experiencing
an
increase
in
admissions,
and
that
can
also
be
contributed
to
individuals
who
are
recently
recently
in
in
the
homeless.
Experience
because
they've
lost
their
jobs,
they've
lost
their
insurance.
They've
lost
their
ability
to
take
the
psychiatric
medication
that
has
helped
to
support
their
mental
health
recovery.
G
So
there
is
a
lot
of
decompensation
that
my
staff
is
experiencing
a
lot
more
crises
than
my
outreach
teams
are
intervening
with.
So
this
is
really
having
a
trickle
effect
that
sarah,
malcolm
and
sherry,
have
also
highlighted
in
terms
of
where
we
are
with
with
the
homeless
populations,
and
I
I'm
not.
I
don't
feel
that
the
answer
is
more
shelters.
We,
I
think
we
need
to
come
up
with
a
systemic
kind
of
short,
medium
and
long-term
solutions.
I
think
there
is
that's
possible,
but
that
that
is
going
to
take
funding
as
well.
A
A
A
An
analogy
I
use
is
that
the
resolve
is
imagine
if
you're
walking
down
broad
street
and
you
tripped
and
fell
and
all
your
papers
and
your
books
and
your
things
you
had
on
you
were
scattered
all
over,
and
you
know
that's
how
the
pandemic
hit
us
like
all
of
a
sudden.
In
march,
we
got
slammed
with
this
issue
that
just
kind
of
knocked
us
off
our
feet,
and
so
just
like
it
took
us
some
time
to
kind
of
get
our
perspective
on
how
we
deal
with
this
virus.
A
That's
similar,
if
you
were
to
trip
and
fall
on
broad
street
at
12
o'clock
in
the
afternoon,
and
so
the
resolve
is
the
first
step
of
okay.
This
just
happened.
Let
me
get
understanding
of
where
my
papers
are
or
my
notes
did
I
scuff
my
pump.
Did
I
scuff
my
shoes
and
just
got
a
sense
of
what
happened.
That
next
step
is
resilience.
Resilience
is
that
you
know
you
understand
what
just
happened,
which
is
similar
to
what
happened
in
covet
and
now
we're
trying
to
get
some
perspective
of.
A
How
do
we
get
back
up
similar
to
if
you
tripped
on
broad
street
resilience
like
okay,
I
gotta
get
back
up,
and
now
I
got
a
sense
of
what
just
happened.
The
return
is
okay.
How
do
I
get
myself
to
where
I
was
before
I
tripped
on
broad
street?
That's
the
same
thing:
that's
happening
with
us
with
covet.
How
do
we
get
back
to
where
we
were
before
cobra
struck
in
march,
but
the
last
two
parts
of
this
5r
approach
are
reimagination
and
reform.
A
How
do
we
see
to
do
things
differently
and
using
this
kind
of
situation
of
kovit
to
get
us
to
reform
the
way
we
provide
services
and
do
things?
And
so,
when
you
talked
about
beyond
just
the
shelter
approach,
can
you
give
a
little
perspective
on
how
we
would
reimagine
and
reform
how
we
provide
homeless
services,
especially
when
we
may
have
some
reductions
at
the
state
level
and
may
have
to
do
things
differently?
G
People
are
impacted
when
they've
lost
jobs
in
the
food
service
industry
at
the
airport,
it
is
a
trickle-down
effect
being
able
to
just
kind
of
walk
past
somebody
who's
experiencing
homelessness.
You
know
outside
of
it
the
industry
that
is
social
services,
human
services
or
behavioral
health
and
saying
it's
not
my
problem.
It
is
because
that
person
very
well
could
have
worked
in
your
industry.
I
I
can't
tell
you
in
my
20-year
career
how
many
individuals
who
worked
in
in
white
collar
classified
jobs
were
now
coming
to
my
organization
for
homeless
services.
G
It
is
not
a
far
fall
for
people
who
are
in
the
for-profit
or
commercial
industries,
so
I
think,
starting
to
have
those
conversations
is
really
going
to
be
pivotal
to
be
able
to
help
solve
and
support
a
successful
solution
to
the
experience
of
homelessness,
because
housing
is
a
right,
safe,
affordable
housing
is
a
right.
It
is
not
a
privilege,
and
it
is
a
right
that
everybody
should
be
entitled
to.
A
Thank
you,
dr
torres
o'connor,
for
your
comments.
I
guess
I
want
to
also
note
that
councilman
isaiah
thomas
is
also
here
and
present
for
this
hearing.
Any
members
of
council
have
any
questions.
Please
indicate
that
in
the
chat
feature
I
have
questions
for
mr
musgrove
and
ms
molina
robinson
from
meraki
and
phmc.
H
I
I
think
the
challenges
that
we're
facing
here
in
philadelphia
are
challenges
that
that
we're
facing
across
the
state
of
pennsylvania
the
pandemic
is,
in
some
cases,
is
reduce
access
to
treatment.
I'm
not
only
seeing
that
in
in
philadelphia,
but
seeing
it
in
our
surrounding
counties.
Montgomery,
bus,
delaware
and
chester.
We're
grateful
that
all
the
mceos
have
managed
to
put
in
place
an
apa
that
is
helping
us
stay
afloat.
H
H
H
So
we've
reduced
that
to
30
minutes
and
in
some
cases,
15
minutes.
But
access
to
treatment
is
up,
which
is
which
is
a
plus,
and,
I
think
is
a
positive
coming
out.
Hopefully,
at
some
point,
when
we
come
out
of
this
pandemic,
that
we
will
have
the
ability
to
see
consumers
face
to
face
and
see
consumers
through
telehealth,
because
I
think
it
is
a
resource
that
most
certainly
will
help
the
communities
that
we
serve.
B
I
just
wanted
to
add
it.
We
similarly
have
seen
the
in
with
our
partners
in
the
surrounding
counties
and
the
work
that
we
do
in
philadelphia,
an
increase
in
having
to
respond
to
families
needs
you
know,
there's
an
increased
need
for
services,
families
need
resources,
and
so
our
our
staff
are
working
very
hard
to
respond
to
all
those
needs
and,
at
the
same
time,
we're
seeing
the
impact
and
responding
to
individuals
that
have
behavioral
health
needs
and
didn't
have
behavioral
intelligence
before.
B
But
the
impact
of
pandemic
really
is
requiring
more
additional
services,
and
so
one
of
the
things
that
we're
really
concerned
about
is
we're.
Looking
at
these
budget
implications
is
more
supports
and
services
specifically
for
our
populations
in
the
home,
because
what
we're
trying
to
do
is
families
really
want
to
support
their
family
members
at
home
and
in
the
community?
But
if
there's
no
services
there's
a
lack
of
staff,
then
we're
looking
at
increased
hospitalizations.
B
It
might
be
residential
placements
and
we
see
the
struggle
with
families
having
to
make
the
decision
about.
I
want
to
keep
my
family
member
at
home,
but
I
don't
have
the
resources
and
the
services
to
do
that,
and
so
now
I'm
thinking
about
residential
care.
So
that's
a
lot
of
the
dialogue
that
we
are
we're
hearing
and
we're
experiencing
in
our
programs.
A
And
if
I
can
follow
both
of
you
regarding
this
point,
I
know
in
the
beginning
part
of
this
pandemic.
I
was
talking
with
a
number
of
providers
in
a
space
about
the
challenges
on
because
of
covid.
They
could
not
provide
the
same
type
of
care
they
provide
in
the
past
where
they
were
coming
into
the
home
and
providing
services
and
then
based
on
the
number
of
hours
per
week,
then
that
direct
service
professional
as
part
of
their
organization
were
being
paid
from
various
entities
on
that
type
of
service
unit
delivery.
A
But
because
people
could
not
go
into
the
home,
they
had
to
find
alternative
ways
of
providing
services
and
that
led
to
an
increase
in
telehealth,
but
also
going
back
to
what
you
both
were
talking
about
an
alternative
payment
arrangement.
And
so
my
understanding
is
that,
based
on
that
alternative
payment
arrangement,
you,
your
organizations
and
others
were
able
to
continue
to
receive
payment
for
the
services
that
you're
providing.
A
F
F
Now
it
happened
pretty,
and
so,
when
you
talk
about
policy
changes,
one
of
the
things
that
we're
very
concerned
about
is
you
know
we
can't
go
backwards.
In
terms
of
that,
we
may
pull
back
some
of
the
telehealth,
because
I
think
you
know
obviously
it's
great
to
be
in
each
other's
presence
and
and
sense
of
community.
F
G
I
just
this
is
dr
adriana
torres
o'connor.
I
just
want
to
kind
of
add
malcolm
had
said
that
they're
experiencing
a
decline
in
their
participation,
so
from
behavioral
health
standpoint.
Traditionally
there
is
an
approximate
25
percent,
drop-off
rate.
That
traditionally
happens
that
can
be
expected
when
services
move
from
in
person
to
telehealth.
G
So
I
know
that
mental
health
partnerships,
our
drop-off,
followed
that
traditional
trend,
which
happens,
which
I
believe
malcolm
was
referring
to.
But
for
us
it
has
recently
increased
further
to
closer
to
30
percent,
because
the
free
minutes
that
were
originally
offered
by
a
lot
of
these
phone
companies
have
stopped
and
our
participants
don't
have
the
funds
to
pay
for
minutes.
G
There
is
provider
fatigue
which
malcolm
alluded
to
a
normal
session
would
have
been
45
or
60
minutes
and
if
you're
supposed
to
see
or
check
in
with
three
different
providers
in
a
day.
Not
only
do
you
not
want
to
be
on
the
phone
for
three
hours,
I
mean
I
don't
want
to
do
that.
I
can't
imagine
what
our
participants
wanting
to
do
that
when
they
have
all
these
other
demands,
but
they
also
have
limited
minutes
and
then
you've
also
experienced
the
drop-off
of
people
where
telehealth
is
just
not
a
fit.
G
A
Thank
you
for
your
comments.
If
any
other
members
of
council
have
any
questions
or
would
like
to
ask
a
question,
please
indicate
that
in
the
chat
feature,
I
think
it's
been
so
interesting.
This
whole
conversation
when
you
make
reference
telehealth
for
some
of
the
people
that
work
in
this
body
know
that
my
wife
has
worked
in
health
care
for
a
number
of
years
from
an
information
technology
standpoint
telehealth
has
been
something
that's
been
coming
for
a
long
time.
A
With
that,
I
don't
see
any
additional
questions
or
comments
from
members
of
this
committee.
I
want
to
thank
and
there's
also
make
one
last
statement:
are
there
any
members
of
the
public
that
are
here
that
would
like
to
testify
saying
none?
I
want
to
thank
all
of
you
from
being
here
for
this
hearing.
A
I
would
also
think
that
an
additional
advocacy
that
you
would
need
from
this
body,
especially
in
reference
to
the
issue
that
was
brought
forth
today
regarding
concerns
of
cuts
at
the
state
level.
Let
us
know
definitely
willing
to
work
and
advocate
in
the
commonwealth
on
the
challenges
we
need
to
make
in
reference
to
those
issues,
and
we
stand
ready,
because
we
know
that
if
those
cuts
were
to
occur,
we
have
some
significant
challenges
here
in
the
city
of
philadelphia,
based
on
all
of
the
things
that
have
been
identified
this
morning.
A
So
with
that,
I
want
to
thank
you
all,
especially
my
colleagues
for
listening
and
being
here
and
asking
questions
for
this
hearing
and
seeing
no
other
additional
comments
or
perspectives
at
this
point.
This
concludes
the
public
hearing
of
this
public
hearing
of
this
committee,
people
with
disabilities
and
special
needs.
We
will
recess
this
hearing
until
the
call
of
the
chair.
I
want
to
thank
all
of
you
for
your
participation
and
information
this
morning.