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From YouTube: Committee on Public Health and Human Services 11-20-2019
Description
The Committee on Public Health and Human Services of the Council of the City of Philadelphia held a Public Hearing on Wednesday, November 20, 2019, at 10:00 AM, in Room 400, City Hall, to hear testimony on the following items:
190715 An Ordinance amending Title 6 of The Philadelphia Code, entitled “Health Code,” by creating a new Chapter 6 1200, entitled “Prescription Data Collection,” to provide for submission of certain prescription data to the Department of Public Health solely for the purpose of administration and maintenance of the public health, in accordance with the Home Rule Charter, all under certain terms and conditions.
190788 An Ordinance amending Title 6 of The Philadelphia Code, the “Health Code,” to add a section establishing requirements for hospitals that anticipate closing, all under certain terms and conditions.
190804 An Ordinance amending Chapter 9 600 of The Philadelphia Code, entitled “Service and Other Businesses,” to add a new Section 9 638, entitled “Sale of Electronic Smoking Devices in Youth Accessible Establishments,” prohibiting selling and offering for sale certain electronic smoking devices in youth accessible establishments and fixing penalties; all under certain terms and conditions.
Immediately following the public hearing, a meeting of the Committee on Public Health and Human Services, open to the public, will be held to consider the action to be taken on the above listed items.
A
Good
morning,
this
hearing
is
called
to
order.
This
is
the
public
hearing
of
the
City
Council
Committee
on
Public
Health
and
Human
Services.
The
purpose
of
this
public
hearing
is
the
testimony
on
bills:
number
one:
nine
zero,
seven,
one:
five,
one:
nine
zero,
seven,
eight
eight
and
one
nine
zero
804.
We
have
a
quorum
of
members
and
attendance.
Besides
myself,
councilman
bass
is
chair.
I
want
to
recognize
the
presence
of
a
quorum
of
committee,
members
and
members
of
in
attendance,
our
councilman
bill,
Greenlee,
Councilwoman,
Helen,
gem
and
Councilman
al
tog
and
Berger.
A
B
You
very
much
madam
chairwoman,
and
welcome
everybody
to
this
hearing
today.
We're
gonna
hear
about
bill
number,
one:
nine,
zero,
seven,
eight,
eight,
a
bill
that
came
out
of
pain
and
struggles
from
this
past
summer
and
today
is
about
taking
a
stand.
It's
about
taking
a
stand
for
our
city,
for
public
goods,
for
people
and
for
health
care
is
a
human
right.
This
summer,
this
past
summer,
in
a
city
known
for
world-class
medicine,
we
learned
that
this
system
was
not
Fulcher
proof.
B
Over
the
summer,
a
for-profit
hedge
fund,
owner
of
Hahnemann
hospital,
rocked
this
city
with
the
abrupt
closure
of
a
vital
Philadelphia
institution
that
has
stood
since
the
Civil
War.
The
closure
announcement
was
made
in
mid-june
and
Hahnemann
hospital
was
effectively
shuttered
by
September.
So
today,
11
of
us
are
going
to
have
sponsored
a
bill
to
make
sure
that
Philadelphia
will
never
again
be
left
out
of
the
critical
decisions
that
impact
the
lives
of
our
neediest
residents
and
I
want
to
acknowledge
and
thank
my
council
sponsor
co-sponsors.
B
Kenan
Greenlee,
Parker
Johnson
Blackwell
college
owns
Tom
Green
and
talbin
Berger.
My
this
bill
will
require
hospitals
to
provide
the
city
with
notice
of
closure
six
months
in
advance
and
work
with
the
city
on
planning
that
ensures
the
appropriate
and
safe
transition
for
patients
and
help
staff
members
land
on
their
feet.
It's
important
to
know
that
Philadelphia
is
a
porous
large
city
in
the
nation.
Hahnemann
was
a
critical
safety
net
hospital
which
saw
50,000
patients
a
year
going
through
its
ER,
and
we
are
now
down
to
one
to
only
five
maternity
wards.
B
Hahnemann
had
six
there.
It
was
one
of
only
six
maternity
wards
in
a
city
that
twenty
years
ago
had
19
places
where
women
to
give
birth.
When
that
maternity
wards
shut
down
with
only
days
notice,
800
moms-to-be
had
precious
little
time
to
find
another
option.
Thousands
of
other
patients
had
to
find
had
to
find
other
care,
3500
employees,
some
of
whom
had
been
with
this
hospital
for
decades,
lost
their
jobs,
had
their
pension
sacrificed
and
hundreds
of
doctors
who
had
trained
for
years
for
a
placement
at
a
major
city
hospital
scrambled
to
find
other
options.
B
It
is
a
telling
sign
of
the
downward
spiral
of
health
care
that
this
hedge
fund
owner
Joel
Freedman
teamed
up
with
a
real
estate
company
to
buy
Hahnemann
and
then
drain
it
of
its
assets
as
it
extracted
every
ounce
of
profit
over
18
months.
While
we
are
left
to
pick
up
the
pieces,
Friedman's
bind
his
second
house
in
Los
Angeles
for
seven
million
dollars
that
says
it
all,
but
the
harsh
realities
and
the
destructive
practices
of
a
ruthless
for-profit
health
care
market
means
that
we
in
Philadelphia
are
going
to
step
up.
B
We
are
not
going
to
allow
this
to
happen
again
on
our
watch
and
I
want
to
thank
the
incredible
work
of
SEIU
healthcare.
Pa
1199
see
past
nap,
many
of
the
practitioners,
the
doctors
here
in
this
room
who
have
crafted
a
bill
that
shows
us
that,
as
a
city,
we
are
going
to
put
our
people
before
profits.
Today's
bill
is
about
supporting
all
of
us
and
I
look
forward
to
the
testimony
that
will
be
coming.
Thank
you.
Thank.
C
A
You
and
I'm
going
to
call
the
first
panel
to
testify
that
will
be
dr.
Thomas
Farley
health,
commissioner
Department
of
Public
Health
city
of
Philadelphia,
Regina
Franklin,
member
of
the
National
Union
of
hospital
and
healthcare
employees
from
1199,
C
and
Jared
Smith
representative
for
government
relations
with
SEIU
health
care.
Pennsylvania.
D
Is
this
working
now
good
morning
to
your
person,
bass
and
members
of
the
Public
Health
and
Human
Services
Committee
I'm,
dr.
Thomas
Farley
health
commissioner
for
Philadelphia
bill
number,
one,
nine,
zero!
Seven!
Eighty
eight
would
require
the
owners
of
hospitals
that
plan
to
close
those
hospitals
to
provide
a
written
closure
plan
to
the
Department
of
Public
Health
in
advance
of
that
closure.
We
support
this
bill
because
hospital
closures
are
potentially
risky
for
hospitals
patients
and
we
believe
hospital
owners
have
an
obligation
to
take
steps
to
assure
a
coordinated
transition
for
those
patients.
D
As
you
know,
in
early
July
of
this
year,
academic
health
systems,
the
owner
of
Ottoman
hospital,
declared
bankruptcy
and
announced
its
intention
to
close
the
hospital.
The
hospital's
emergency
department
was
closed
in
August
and
the
last
in
patients
were
discharged
in
early
September.
While
we
believe
that
there
are
sufficient
inpatient
hospital
beds
in
Philadelphia
to
care
for
the
city's
residents
who
need
inpatient
care
without
Hahnemann
Hospital.
This
abrupt
and
unplanned
closure
was
very
disruptive.
D
Hahnemann's
owners
had
made
no
plans
to
transfer
the
care
of
inpatients
our
outpatients
with
ongoing
medical
conditions
such
as
pregnancy
or
cancer
to
other
facilities.
It
had
no
plans
for
the
patient's
receiving
ongoing
care
in
clinics
that
were
closely
affiliated
with
the
hospital
and
had
no
plans
to
secure
and
store
its
medical
records
or
to
make
those
records
available
to
physicians,
accepting
former
Hahnemann
patients.
This
put
the
health
of
those
patients
at
risk
and
put
a
strain
on
the
other
medical
facilities
in
Philadelphia.
D
This
dangerous
situation
occurred
despite
the
fact
that
in
retrospect,
hyneman's
owners
must
have
known
for
months
before
their
announcement
that
they
intended
to
close
the
hospital
to
avoid
harm
to
hona
and
patients.
My
department
convened
a
series
of
meetings
during
July
and
August,
with
the
medical
leadership
of
other
health
systems
to
coordinate
the
transition
of
those
patients.
I
want
to
thank
publicly
the
chief
medical
officers
of
every
other
health
system
in
the
city
who
eagerly
stepped
up
to
help
and
the
many
staff
of
those
institutions
who
moved
quickly
to
accept
those
patients.
D
We
believe
those
meetings
and
the
actions
taken
by
the
participating
hospitals
were
very
beneficial
and
may
have
prevented
very
serious
harms
to
men,
patience,
but
the
process
was
rushed
and
not
optimal.
We
could
have
done
a
better
job,
protecting
patients
if
we
had
more
time
more
notice
and
more
responsible
planning
by
academic
health
systems.
I
want
to
be
clear
that
my
criticism
is
of
Hahnemann's
owners,
not
its
medical
staff,
the
medical,
nursing
and
local
leadership
of
Heineman
active,
extremely
responsibly
working
closely
with
us
and
the
other
hospitals
to
protect
their
patients
and
coordinate
their
care.
D
They
did
this
despite
the
fact
that
they
knew
that
they
were
being
laid
off
in
a
matter
of
days.
My
criticism
is
solely
of
Hahnemann's
out
of
town
owners
who
left
the
local
staff
in
a
difficult
situation
built
number
one:
nine
zero.
Seven
eight
eight
would
try
to
prevent
situations
like
this
in
the
future.
D
It
would
require
any
hospital
owner
to
file
a
closure
plan
with
the
Department
of
Public
Health
120
days
before
closing
a
hospital
that
closure
plan
would
have
to
address
many
crucial
issues,
important
to
the
smooth
transfer
of
patients
to
other
facilities,
including
written
agreements
with
other
facilities
to
accept
the
care
of
those
patients
and
access
to
medical
records.
All
hospitals
where
their
for-profit
or
nonprofit
are
community
resources,
funded
in
large
part,
with
public
monies
such
as
Medicare
and
Medicaid
reimbursement.
D
While
these
issues
are
certainly
important,
they're
not
directly
related
to
the
patient's
safety,
patient
of
Public
Health,
the
Department
of
Public
Health
does
not
have
the
expertise
in
these
issues
and
our
sole
focus
is
on
patient
safety
in
public
health.
For
this
reason,
the
Department
of
Public
Health
will
not
be
taking
these
elements
of
the
closure
into
account
in
determining
whether
to
approve
a
hospital
closure
plan.
Thank
you
for
the
opportunity
to
testify
I'm
happy
to
answer
questions.
E
Good
morning,
Regina
Franklin
first
I
would
like
to
thank
council
person,
Helen
Jim,
for
sponsoring
this
legislation
and
inviting
district
1199
C
to
participate.
In
today's
hearing,
I
was
a
Hahnemann
hospital
employee
for
28
years
as
an
administrative
associate
under
nursing
department.
During
my
28
years
at
hanaman
we
were
mult.
E
We
were
under
multiple
cells
of
hospitals,
with
each
cell
we
survived,
but
in
January
of
2018
American
academic,
Health,
System,
Board,
hahnemann
Hospital,
and
on
June
26,
2009
teen,
all
of
our
dreams
or
years
was
taken
away
from
over
2,500
workers
with
700
or
more
being
under
1199,
see
health
care
workers.
Union
June,
26,
2009
teen
was
just
an
ordinary
morning
for
some,
but
for
Hahnemann
that
morning
you
just
don't
know
how
it
changed
our
lives
and
now
seeing
the
hospital
was
closing
with
two
meetings
starting
at
7:00
a.m.
and
the
next
one
to
follow.
E
In
the
smallest
lecture
room
they
could
find
where
people
were
asking
where's
Joel
Friedman.
Why
isn't
he
here?
The
uncontrollable
sobbing
that
was
echo
through
alcohol's,
while
listening
to
management
tell
us
there
is
nothing
that
they
could
do.
The
hospital
will
be
closing
and
we
knew
looking
back
now
that
they
were
preparing
before
the
announcement
to
be
in
place
to
close
the
hospital
quick,
because
floors
were
starting
to
close,
we
merged
together
on
one
person,
one
two
or
three
floors
shortage
of
supplies.
E
E
It
was
so
unethical
they
did
not
care
they
locked
floors.
They
had
changed
on
the
doors.
How
could
this
even
happen
at
a
major
hospital
in
the
heart
of
Philadelphia?
How
could
your
Friedman
come
to
our
city,
the
City
of
Brotherly
Love
and
disrespect
our
community?
The
way
that
he
did
have
so
I'm
asking
you
to
please
support
this
Hospital
closure
legislation
bill.
E
C
Hello,
my
name
is
Jarrett
Smith
and
I
am
the
legislative
director
and
a
proud
member
of
SEIU
healthcare
Pennsylvania
representing
45,000
healthcare
workers
across
the
state,
in
hospitals,
nursing
homes
and
home
care,
and
we
stand
in
solidarity
with
district
11,
99c
and
paz
nap.
The
closure
of
the
hanaman
hospital
has
been
a
devastating
move
for
our
community
Hahnemann,
served
as
the
main
safety
net
for
downtown
Philadelphia's
neediest
residents,
who
viewed
the
hospital
not
only
as
their
treatment
center,
but
in
many
cases
as
their
home.
C
It
also
provided
a
livelihood
to
the
2572
staff
with
good
union
jobs,
all
of
whom
abruptly
lost
their
income,
their
own
healthcare
benefits
and
many
of
whom
lost
their
ability
to
stay
in
our
city.
Why
was
Hahnemann
closed?
The
story
we
are
given
is
that
the
hospital
was
losing
money
and
that
we
can't
expect
unsustainable
facilities
and
over
bed
in
markets
with
poor
payer
mixes
to
keep
their
doors
open.
But
we
call
BS
on
that.
C
The
people
of
Philadelphia
were
sacrificed
to
the
priorities
of
free
market
medicine
in
general,
a
venture
capital
medicine
in
particular,
and
that
is
what
is
unsustainable
in
the
case
of
hanaman
venture
capital.
Medicine
brought
us
Joel
Freeman,
the
california-based
owner
of
the
private
equity
group
that
bought
the
hospital
for
170
million
dollars
in
2018
and
filed
for
bankruptcy,
saying
that
he
can't
be
expected
to
prop
up
an
unsalvageable
situation,
and
now
he
and
his
partners
own
an
entire
city
blocks
worth
of
land.
C
That
was
underneath
the
hospital,
as
well
as
the
parking
garages
and
a
couple
of
other
buildings
that
Friedman
carefully
split
off
from
the
hospital
when
he
and
his
co
investors
acquired
Hahnemann.
The
same
central
role
of
patient
that
made
the
hospital
attractive
as
a
safety
net
provider
now
makes
the
land
incredibly
desirable
for
condos
or
hotel
walking
away
from
an
ailing
business,
while
profiting
from
the
real
estate
is
right
out
of
the
private
developments
playbook.
It's
the
story
of
toys-r-us
and
nursing
homes
throughout
our
state
and
across
the
country.
C
In
every
industry,
where
low
margin
businesses
sit
on
valuable
land,
but
in
the
case
of
health
care,
rich
investors
are
doing
more
than
driving
us
out
of
our
neighborhoods
and
taking
away
our
jobs,
they're
risking
our
lives.
We
should
not
make
the
mistake
of
thinking
that
only
for-profit
medicine
is
to
blame.
So-Called
nonprofit
health
systems
are
a
huge
part
of
our
landscape
in
Pennsylvania,
and
they
aren't
much
different.
They
are
rapidly
consolidating
spinning
off
for-profit
subsidiaries,
closing
unprofitable
facilities
and
communities
across
our
state
and
jacking
up
costs
for
us
all.
C
Guaranteeing
that
Medicaid
patients
like
those
at
hanaman
will
always
be
the
money
losers.
At
the
same
time,
they
collect
millions
of
our
taxpayer
dollars
through
Medicaid
and
Medicare
reimbursements,
while
paying
nothing
in
taxes
and
pilots
and
receiving
discounts
on
their
city
utilities.
It
has
to
stop.
We
spend
enough
money
on
health
care
in
this
country
to
be
able
to
ensure
and
entreat
everyone,
black
brown,
white,
rich
and
poor.
C
We
spend
more
per
capita
on
health
care
than
anyone
else
on
this
planet
by
a
factor
of
2
and
we
get
worse
outcomes
than
anyone
in
the
industrialized
world.
One
of
every
five
dollars
in
our
economy
is
funneled
through
health
care.
We
don't
have
a
resource
problem.
We
have
a
priorities
problem
for
decades
we
have
been
allowing
a
few
very
powerful,
very
rich
people,
most
of
them
white
men,
to
set
the
priorities
and
make
our
investment
decisions,
and
they
have
been
making
very,
very
bad
decisions.
C
They
have
created
instability
like
Hahnemann
or
the
chaos
caused
by
UPMC
when
it
gave
pink
slips
to
182,000
cancer
patients
and
seniors,
they
have
given
a
skyrocketing
costs,
cost
that
result
in
half
of
all
bankruptcies
and
mean
that
working
people
haven't
seen
a
raise.
In
decades
they
have
opened
up
a
chasm
between
the
health
haves
and
the
health
have-nots
and
as
the
largest
employers
of
non-union
low-wage
workers,
they
are
directly
responsible
for
growing
income
inequality
as
well.
C
We
were
never
asked
if
health
care
and
insurances
executives
should
make
millions
working
people,
poor
people
and
people
of
color
didn't
lobby
to
eliminate
the
certificate
of
need,
didn't,
engage
in
an
arms
race
to
gobble
up
physician
practices,
didn't
cut
patients
out
of
insurance
networks,
didn't
jack
up
pharmaceutical
prices
and
didn't
preside
over
decades
of
spiraling
costs
and
increasing
disparities.
All
the
while
trumpeting
their
tremendous
successes.
C
It
is
time
for
us
to
look
around
and
conclude
that
turning
over
our
health
system
to
unaccountable
private
sector
actors
has
been
a
disaster
in
a
city
where
we
measure
the
disparities,
disparity
in
life
expectancy
between
black
and
right,
rich
and
poor
in
decades.
It
is
time
for
the
people
to
come
together
and
demand
that
a
system
that
is
largely
funded
by
our
tax
dollars
and
our
premium
payments
be
responsive
to
our
needs.
C
A
To
thank
you
all
for
your
testimony
is
very
powerful,
particularly
miss
Franklin
and
your
experiences.
You
know
working
directly
on
the
nursing
floor
and
some
of
the
things
that
you
saw
that
most
of
us
had
no
idea
for
happening.
You
know
we
we
knew
it
was
bad,
but
I,
don't
think
that
anyone
knew
that
it
was
that
bad
and
so
I
really
want
to
say.
A
Thank
you
so
much
for
your
dedication
to
the
patient's
of
Philadelphia
to
the
patients
that
aren't
necessarily
the
quote/unquote
desirable
patients,
because
they
don't
have
private
health
insurance
and
they
don't
have
the
resources
and
means,
but
really
making
sure
that
they
receive
the
quality
and
a
level
of
health
care
that
any
and
all
of
us
should
receive,
regardless
of
your
economic
situation.
So
I
just
really
wanted
to
say
thank
you
for
that.
You
know
it's
and
again,
it's
really
just
shameful
in
terms
of
the
way
health
care
in
Philadelphia
is
playing
out.
A
You
know
we
see
that
or
we
call
ourselves
a
city
of
EDS
and
men,
and
yet
we
have
so
many
who
are
so
far
disconnected
from
the
healthcare
system
that
we
have
here
in
the
city
of
Philadelphia.
The
disconnect
is
real
and
you
see
it
in
the
results.
Short
of
life
expectancies,
high
blood
pressure,
diabetes,
heart
disease,
all
kinds
of
ailments
that
come
by
way
of
being.
You
know
living
in
poverty
living
in
particular,
neighborhoods
and
particulars.
A
If
codes
we
see
it
over
and
over
again,
and
yet,
while
the
healthcare
community
in
Philadelphia
overall
has
done
some
great
things,
they're
really
kind
of
missing
the
big
picture,
which
is
all
of
us
all
of
us
who
make
up
Philadelphia,
who
desperately
need
to
have
them,
connect
it
with
all
neighborhoods,
regardless
of
your
abilities.
So
I
just
really
wanted
to
say
that
and
to
say
thank
you
so
much
for
all
that
you
all
have
done
and
fighting
for
us.
Thank
you
to
all
three
of
you,
but
that
being
said,
Councilwoman
Kim,
yes,.
B
Just
a
brief
comment:
I
also
want
to
thank
the
panel
we're
glad
to
have
the
full
support
of
the
administration
behind
this
bill.
We
know
that
Pennsylvania
has
some
fairly
needs
a
lot
more
to
do
when
it
comes
to
hospital.
Closings.
New
Jersey,
for
example,
has
a
much
stronger
state
legislature
when
it's
taking
a
look
at
hospital
closings
and
right
now
there
are
dozens
of
hospitals
that
are
in
worse
financial
shape
across
the
state
of
Pennsylvania
than
Hahnemann
was
this
past
summer.
So
this
is
a
very
serious
issue
for
our
state
legislature.
B
We
appreciate
your
union's
advocacy,
not
only
here
in
the
city
of
Philadelphia,
but
also
at
the
state
level,
where
we
need
to
see
stronger
protections
in
place,
but
I
also
I
want
to
especially
thank
mr.
Smith
and
mr.
Anglin.
Thank
you
so
much
for
your
testimony
again.
You
know
your
passion,
compassion
for
your
patients
for
the
level
of
care
that
you
gave
up
until
the
very
last
day.
B
The
very
last
minute
is
demonstrable
about
why
this
matters,
and
we
want
you
to
know
that
we're
gonna
stand
with
you
with
your
union
and
with
your
non-union
brothers
and
sisters
here.
You
know
it
is
also
really
important
to
keep
in
mind
that
your
jobs
are
also
a
health
issue.
I
assume
that
when
these
jobs
were
lost
suddenly
that
people
were
left
without
any
indication
was
there
breaking
health
insurance
and
benefits,
and
all
of
that
as
well
in
terms
yes,.
E
With
$11.99
see,
it
was
based
on
whether
you
were
still
getting
your
unemployment
and
the
years
worked.
So
there
was
a
tear,
so
a
lot
of
us.
Yes,
we
still
kept
our
insurance
and
they
had
multiple
job
fairs.
For
us
outside
of
what
city
of
Philadelphia
gave
us,
they
still
I
mean,
even
as
of
last
month
in
October
they
had
another
job
fair
and
they
probably
will
still
be
running
more
and
more
Istanbul
when
you
know,
is
700
or
more
of
us.
B
E
So
anytime,
yes,
it
will
I
mean
it
seems
like
the
ball
was
off
as
soon
as
the
meetings
were
over,
we
felt
as
though
the
ball
was
rolling.
It
was
just
rolling
so
fast.
The
phone
call
over
the
phone,
letting
the
nursing
department
know
you
do
not
have
to
return
to
work
so
28
years,
and
that
was
it
over
the
phone.
You
don't
have
to
return
to
work
and
it
was
two
weeks
and
after
the
announcement.
E
B
Thank
you
very
much
for
bringing
that
forward
and
making
clear
like
for
us.
You
know.
Poverty
and
unemployment
is
also
also
a
health
crisis.
It's
a
health
crisis
when
people
lose
their
incomes
when
they,
when
they
have
to
be
forced
onto
a
job
market.
Unexpectedly,
so
I
appreciate
your
testimony
deeply
and
your
passion
for
your
patience
and
thank
you
for
being
here
to
testify.
Today.
Yeah.
F
E
F
E
F
E
E
You
know
those
hospitals
had
closed,
but
it's
just
Hahnemann
closing
like
it
just
was
unbelievable
to
think
that
that
hospital
with
closed
with
all
the
updates
that
1199
C
works
coming
in
and
letting
us
know
what
was
going
on
if
it
wasn't
for
them,
we
I
really
think
that
we
would
have
been
shut
down
long
before
the
thing
that
we
redid,
because
the
ball
was
just
rolling.
So
quick
and
thank
God
that
we
were
able
to
still
because
of
them,
get
our
pay.
That.
E
F
F
I
commend
you
for
what
you're
doing
your
leadership
of
your
Union
and
the
strength
of
it
and
helping
make
Philadelphia
a
better
place,
and
once
this
bill
was
introduced,
I
turned
to
Councilwoman
Ginn.
Who
was
that
hard
to
turn
to
her
cuz?
She
sits
next
to
me
and
said:
I
would
like
to
co-sponsor
because
something
like
that
I
think
is
terrible
for
the
workers,
terrible
for
the
city
and
I
stand
with
those
and
try
to
rectify
that
and
make
that
better,
so
I.
Thank
you
very
very
much.
Thank.
G
Good
morning
morning,
I
too
wanted
to
go
on
record
first
to
say
thank
you
for
your
very
compelling
honest
testimony
and
to
think
that
we
had
to
hear
your
stories
to
come
to
grips
with
the
what
I
believe
to
be
egregious
actions
by
well
compensated
healthcare
administrators,
so
kudos
to
the
sponsor
of
the
bill.
Councilwoman
again
and
all
of
our
members
of
City
Council.
Some
present
some
not
present,
who
paid
close
attention
to
this
debacle.
I
would
call
it,
but
secondly,
I
too
had
heard
whispers
from
girlfriends.
G
Quite
frankly,
who
were
in
this
health
care
space
and
was
dumbfounded
to
learn
of
the
surprise
that
the
employees
had
to
suffer
from
hats
off
to
the
partnership
that
you
a
form
of
$11.99
see.
We
know
that,
but
for
Henry,
Nikolas
and
Chris
Wood's
and
others
over
there
at
the
hospital
Workers
Union.
This
would
not
have
not
elevated
to
the
space
where
it
could
be
and
should
be.
G
Lastly,
I'm
pleased
to
hear
that
you
are
okay
with
the
extension
160
to
180
days,
because
it
takes
anybody,
small
and
large
institutions
to
figure
out
how
you
do
things
in
their
proper
order.
So
your
testimony
punctuates
why
this
bill
is
necessary
and
that
shouldn't
I
go
and
recognize.
Thank
you
very
much.
Thank
you.
A
Thank
You
Councilwoman
no
additional
comments.
Thank
you
very
much
to
the
panel
for
attending
today.
We
really
appreciate
your
support
for
our
health
care
system
here
in
the
city
of
Philadelphia
and
we're
gonna
call
I'm
gonna
call
the
next
panel
up
dr.
Kevin
D,
dr.
Kevin
de
Melo.
Forgive
me
for
mispronouncing
any
mispronouncing,
your
name
assistant,
professor
of
medicine,
division
of
general
internal
medicine
at
Drexel,
University,
Mary,
Carmen,
Farmer,
MSN,
Midwife
and
Women's
Health
Net
nurse
practitioner
with
Drexel
University.
H
Morning,
my
name
is
dr.
Kevin
de
Melo
and
I'm,
a
physician
who
serves
as
the
director
of
quality
improvement
and
patient
safety
for
the
Department
of
Medicine
at
Drexel,
University
College
of
Medicine
computing,
completing
my
residency
training
there
and
continuing
on
as
a
academic
hospital
I
stay
practice
at
conmen,
University
Hospital
for
a
total
of
nine
years.
Before
it
closed,
I
appreciate
you
allowing
me
the
time
to
appear
before
you
to
testify
in
support
of
bill
number
one:
nine
zero,
seven,
eight
eight
in
the
United
States.
H
We
currently
have
a
health
care
system
that
views
the
endurance
of
hospitals
as
the
survival
of
the
fittest,
but
there
are
tremendous
problems
with
how
we
define
fit.
The
fittest.
Institutions
receive
the
highest
reimbursement
rates
for
care
from
private
insurance
companies
to
achieve
that,
those
institutions
must
have
a
greater
hold
on
the
local
market,
typically
accomplished
by
buying
up
other
hospitals
to
create
large
health
systems.
This
gives
them
a
better
ability
to
negotiate
for
higher
payments
from
those
insurance
companies.
H
Considering
the
costs
involved
in
this
strategy,
these
institutions
must
have
significant
capital
to
achieve
those
higher
reimbursement
rates.
Thus,
the
well-funded
are
rewarded
with
additional
funds,
and
all
of
this
is
just
despite
the
fact
that
the
medical
literature
demonstrates
that
these
fit
hospitals
are
not
necessarily
providing
better
care
to
patients.
On
the
other
hand,
the
unfit
institutions
in
our
current
health
care
system
tend
to
be
located
in
rural
areas
or
care
for
predominantly
poor
patients.
H
Many
of
these
patients
are
either
uninsured
or
are
covered
by
Medicaid,
because
private
insurance
is
either
not
willing
to
cover
them
or
is
just
too
expensive
for
them
to
afford,
because
Medicaid
and
charity
care
reimbursements
to
hospitals
is
comparatively
low
in
order
to
survive.
These
institutions
need
to
somehow
offset
this
financial
burden
quote
unquote
of
treating
the
the
poor
with
caring
for
patients
with
private
insurance.
If
they
fail
to
do
so
or
do
not
get
substantial
funding
from
the
government,
these
hospitals
will
close.
H
Our
country
has
already
seen
a
significant
number
of
these
hospital
closures
over
the
past
several
decades.
Our
country
essentially
has
a
health
care
system
with
a
mix
of
private
public,
for-profit
and
nonprofit
organizations
that
inadvertently
divides
our
people
into
the
haves
of
the
have
nots.
The
care
of
the
have-nots
is
generally
not
seen
as
profitable
or
even
sustainable.
This
is
the
setting
in
which
Hana
and
University
Hospital
closed
the
171
year.
H
H
In
the
1990s
it
was
one
of
14
hospitals
bought
up
by
Allegheny
Health
Education
and
Research
Foundation
in
its
aggressive
strategy
to
build
a
large
Health
System,
a
strategy
that
led
to
it
filing
for
bankruptcy
within
just
a
few
years
of
those
acquisitions
becoming
America's
largest
nonprofit
healthcare
bankruptcy
at
the
time
from
their
tenant
health
care
owned
and
operated
the
hospital,
as
it
continued
to
have
significant
negative
operating
margins
over
the
next
20
years.
Over
this
time,
hahnemann
became
increasingly
a
safety
net
hospital,
serving
mostly
patients
with
Medicare,
Medicaid
and
charity
care.
H
In
this
setting,
Philadelphia
academic
health
system
and
affiliate
of
the
private
equity
firm,
paladin
health
care
capital
in
partnership
with
Chicago
based
health
care,
real
estate,
private
equity,
firm,
Harrison,
Street,
real
estate
capital
stepped
in
to
purchase
the
hospital
inherent
in
the
concept
of
a
private
equity
firm
is
the
need
to
turn
a
profit.
Considering
that
Hahnemann
is
zoned
to
see
mx5
the
most
permissive
tier
of
mixed-use
zoning
and
the
hospital,
and
that
the
hospital
lost
money
for
14
years
straight
under
tenant.
H
There
were
significant
suspicions
that
Philadelphia
academic
was
merely
interested
in
the
real
estate,
not
in
providing
health
care
for
the
people
of
Philadelphia.
Ultimately
Hahnemann
closed.
Most
troubling
issue
with
the
closure
was
the
method
in
which
it
was
closed,
while
the
Commonwealth
of
Pennsylvania
has
a
law
requiring
90
days
notice
of
a
hospital
closure,
Philadelphia
academic
closed
the
hospital
in
less
than
half
of
that
time.
Even
when
dr.
Rachel
Levine,
the
state's
Secretary
of
Health,
wrote
a
letter
to
mr.
H
joel
friedman,
owner
philadelphia,
academic
asking
for
a
cease-and-desist
of
the
hospital
closure
until
closure
plan
could
be
approved
by
city
and
state
officials,
he
moved
ahead
with
shutting
down
vital
hospital
services
such
as
trauma
and
cardiothoracic
surgery.
Consequently,
within
seven
days,
the
hospital
census
dropped
by
50%
and
continued
to
drop
until
it
reached
zero.
In
just
several
weeks.
The
effects
of
hominins
rapid
closure
have
yet
to
be
rigorously
evaluated.
I
worry
about
the
health
of
our
city's
people.
I
worry
about
having
one
last
level.
One
trauma
center
in
the
city.
H
I
worry
about
other
hospitals
being
overwhelmed.
Despite
what
possible
CEOs
may
report
in
the
media,
I
worry
about
the
570
graduate
medical
trainees,
whose
careers
might
be
adversely
affected
by
the
unexpected
change
in
educational
programs.
I
worry
about
the
trainees
who
incurred
unexpected
costs
and
having
to
relocate.
I
worry
about
the
trainees
having
to
pay
for
a
prohibitively
expensive
malpractice
insurance
covering
their
time
at
Hahnemann,
because
Philadelphia
academic
refuses
to
pay
for
it
despite
their
contractual
obligations.
I.
H
H
H
H
These
people,
these
health
care
workers,
need
the
support
of
the
city,
the
state
in
the
country,
decisions
on
increasing
or
decreasing
Philadelphia's
health
care
resources
need
to
be
collaboration
between
those
those
that
have
financial
and
organizational
interest,
ie,
the
private
or
public
institutions
and
those
that
protect
the
health
of
this
people.
Ie
the
community
and
the
government.
H
I
fully
support
bill
number
one:
nine,
zero,
seven,
eight,
eight
and
I
believe
that
that
it
will
give
the
city's
government
greater
strength
in
its
ability
to
protect
its
people
from
the
consequences
of
another
quick
Hospital
closure,
whether
that
the
winds
of
a
self-interested
venture
capitalists
or
not
ultimately,
I
hope
that
our
country
can
move
toward
a
health
care
system
that
strives
to
be
the
time
that
raises
the
both
of
all
people.
Thank
you.
A
Thank
you
so
much
for
your
testimony
and
we
can
tell
obviously
that
was
very
heartfelt
and
you
know
thank
you
for
being
here
for
really
speaking
truth
to
this
this
situation
and
what
has
happened
here
in
the
city
of
Philadelphia
and
all
of
our
concerns.
I
know
we
normally
save
comments
to
the
end,
but
I
really
just
wanted
to.
Thank
you
because
I
can
you
know.
A
Obviously
we
can
see
your
passion
and
your
concern
and
your
care
you
know
for
the
city
and
for
what
we
do
and
I
think
that
we've
all
been
pretty
much
up
here
on
this
panel,
we've
all
been
where
you
are
in
terms
of
really
feeling
frustrated
that
this
city
can
do
so
much
more.
We
all
believe
that
it
can
be
so
much
more
and
so
much
better
and
so
I
see
that
and
I
hear
that
in
the
words
that
you
spoke,
so
thank
you
so
much
I.
I
Morning,
my
name
is
muddy.
Gunman
farmer
and
I
am
a
certified
nurse.
Midwife
I've
lived
in
West
Philly
for
25
years
have
been
a
birth
worker
in
the
city
for
the
last
18
years
and
have
been
a
practicing
nurse
midwife
in
Philly
for
the
last
three
years,
I'm
also
the
current
president
of
the
Philly
metro
midwives,
which
is
the
local
chapter
of
the
PA
affiliate
of
the
American
College
of
nurse-midwives.
A
I
Made
wise,
we
have
been
educated
to
provide
reproductive
health
care
throughout
the
lifecycle,
including,
but
not
limited,
to
the
care
of
childbearing
people
throughout
the
course
of
their
pregnancies,
birth
and
the
postpartum
period.
We
provide
support,
offer
therapeutic
presence
and
create
an
environment
where
evidence-based
clinical
decisions
are
made.
I
They
understood
that
our
actions
as
clinicians
have
the
potential
to
harm
or
heal
far
beyond
just
the
physical
aspects
of
health
and
that
health
encompasses
wellness
and
mind/body/spirit
family
and
community.
This
model
created
an
environment
at
Hahnemann
that
yielded
low
seas,
action
rates,
high
rates
of
VBox,
which
are
vaginal
births
after
cesarean,
an
obstetric
unit
that
served
as
a
safe
and
welcoming
transfer
site
for
folks.
I
We
know
that
when
a
hospital
like
hahnemann
closes,
the
remaining
obstetric
units
go
into
survival
mode,
where
space
to
care
for
laboring
patients
is
extremely
limited.
Staff
to
patient
ratios
and
wait
times
increase
and
the
likelihood
that
mistakes
and
oversights
occur
goes
up
under
this
kinds
of
kind
of
stress.
Clinicians
find
that
they
must
compromise
practices
that
comprise
the
very
best
care
practices
that
ensure
that
patients
are
treated
with
their
full
humanity
and
minds
and
practices
that
help
eliminate
bias
and
address
more
subtle
forms
of
mistreatment.
I
Families
with
limited
financial
means
are
left
no
choice
but
to
go
to
hospitals
that
may
not
have
support
services
established
to
provide
optimal
individualized
care
that
they
deserve.
Our
practice
has
been
fortunate
to
partner
with
Thomas
Jefferson
University
Hospital,
to
continue
to
provide
prenatal
care
at
all
of
the
health
centers.
But
despite
our
best
efforts,
the
strain
on
our
patients
to
navigate
a
new
and
complicated
health
system
is
significant.
I
We
know
that
one
of
the
recommendations
found
in
the
literature
about
how
to
mitigate
the
adverse
effects
of
a
hospital
closure
is
to
increase
formal
communications
between
hospitals
in
the
region.
Although
serious
attempts
were
made
to
do
this,
when
hahnemann
was
closing
the
short
time
from
announcement
to
closure,
simply
didn't
allow
for
effective
implementation.
Had
this
bill
been
in
place,
the
approach
could
have
strengthened
the
city's
response.
I
The
bill
could
have
made
a
significant
difference
in
both
the
quality
of
the
experience
for
patients
and
providers
as
well
in
the
as
well
as
in
the
quantitative
effects
of
the
closure.
I
would
like
to
end
by
recounting
some
of
my
personal
experiences
and
sharing
in
the
grief
of
patients
who
continue
to
mourn
the
loss
of
their
home
hospital.
I
The
day
that
the
closure
was
announced,
I
found
out
from
the
news.
I
cried
with
my
patient
June,
who
was
32
weeks
pregnant
preparing
to
give
birth
to
her
fourth
and
last
child.
Who
looked
up
at
me
with
tears
in
her
eyes
and
said.
Do
you
know
that
four
generations
of
women
in
my
family
have
given
birth
to
their
babies?
At
hanaman,
do
you
mean
to
tell
me
that
I'm
about
to
give
birth
to
my
last
kid
and
I
won't
be
going
to
haunt
him
in
this
time?
I
Do
you
have
any
idea
what
this
means,
and
just
this
past
Thursday,
my
young
patient
Brielle,
came
into
the
hospital
for
a
scheduled
induction
of
labor.
At
41
weeks,
four
weeks,
she's
been
expressing
to
me
her
trepidation,
about
going
to
Jefferson
expressing
how
hard
it
has
cut.
It
is
to
come
to
trust
a
new
institution
after
years
of
going
to
hanaman
when
one
considers
the
extensive
history
of
mistreatment,
abuse
and
victimization
of
black
and
brown
people
in
the
u.s.
at
the
hands
of
the
medical
system.
I
It
is
easy
to
see
how
this
clothing
fits
into
the
same
troubling
narrative
for
those
communities
in
Philly.
In
trying
to
lay
her
fears,
I
struck
a
deal
with
Brielle.
She
would
come
to
give
birth
at
Jefferson
if
I
promise
to
show
up
dressed
in
my
hahnemann
jacket,
to
help
her
feel
more
at
ease.
I
did
just
that
much
to
the
amusement
of
my
Jefferson
colleagues
and
thankfully
she
went
on
to
have
an
uncomplicated
birth.
I
B
I
want
to
thank
dr.
de
Mello
and
this
farmer
for
your
incredibly
powerful
testimony.
I
think
that
so
often
the
hospital
closings
and
things
like
this
are
spoken
about
in
terms
of
weather.
You
know,
and
the
economy
can
absorb
something
it's
like
debt
leverage.
It
goes
into
the
language
of
you,
know,
courts
and
terminology.
That
means
nothing,
creditors
etc.
But
you
know
you
speak
to
a
lot
of
what
it
means
that
health
care
is
the
very
meaning
of
whether
life
continues,
how
it
continues
and
what
quality
of
care
that
people
have
assurances
that
it
continues.
B
And
so
we
can't
speak
that
language
anymore
and
dr.
de
Mille
I.
Think
you
more
than
you
know
during
the
fiasco
that
when
that
was
all
going
on,
you
put
two
words:
the
importance
of
us
not
being
so
confident
about
what
we
think.
We
know
that
we
can
absorb
these
patients.
They
can
go
elsewhere
here
and
there,
but
in
fact,
what
we
don't
know
is
the
most
worrisome
part
of
all
the
things
that
you
brought
up.
B
Who,
don't
you
know
a
man
was
shot
multiple
times
in
Center
City
and
walked
to
what
he
thought
would
be
an
ER
at
Hahnemann
Hospital
only
to
find
that
it
was
closed
a
few
weeks
ago.
What
we
don't
know
are
the
patients,
this
farmer,
that
you
serve,
who
are
approaching
care,
especially
when
they
don't
have
insurance,
especially
when
you
walk
in
to
some
of
the
fanciest
loveliest
places
and
aren't
sure
if
you're
gonna
be
treated
equally.
I
mean
I.
Think
that
those
questions
about
what
we
don't
know
is
what
we
are
so
callous
about.
B
We
are
disregarding
that
we
were
assuming
that
we
have
enough
hospitals,
we
can
absorb
them.
There's
too
many
ers,
there's
too
much
like
patient,
whatever
ratios
da-da-da-da-da,
and
we
didn't,
we
are
not
taking
into
account
people
who
have
traditionally
been
shut
out
of
the
system.
We
live
in
a
city
where
there's
a
20
year,
life
expectancy
difference
between
zip
codes,
less
than
a
half
a
mile.
Apart
and
in
those
instances
we
actually
have
to
do
a
lot
and
I
just
I
just
want
to
I
have
a
question
for
Miss
farmer,
but
dr.
de
Melo
I.
B
Just
wanted
to
like
read
the
quote
that
you
wrote
about
during
over
the
summer
and
I
think
you
wrote
whatever
happens
to
the
hospital,
let
that
city
block
forever
be
the
living
mirror.
That
reminds
us
that
we
will
never
fail
ourselves
again
in
this
way
and
that
the
health
of
this
city,
full
of
our
brothers
and
sisters,
is
more
important
than
money.
So
I
want
to
thank
you
for
that
and
miss
farmer.
B
You
know
one
of
the
things
that
I
think
you
brought
out
in
your
testimony
really
well
is
that
our
hospitals
need
help
in
dealing
with
many
a
part
of
the
patients
that
formerly
it
went
anuman
felt
at
home.
There
were
assured
that
they
could
get
quality
care.
There
would
feel
equal
there,
but
do
you
feel,
like
some
of
our
hospitals
currently
need
some
trainings
to
ensure
the
continuity
of
care
for
the
patients
who
formerly
went
to
hanaman,
especially
those
without
insurance,
especially
those
who
feel
a
lot
more
financially
and
secure
I?
Do.
I
I
think
that
one
of
the
things
that
Hahnemann
did
really
well
was
take
care
of
poor
people
and
they
knew
the
health
center
system
and
they
knew
how
to
integrate
those
patients
seamlessly
from
outpatient
to
inpatient
care
and
I.
Think
that
that
is
a
set
of
skills
that
needs
to
be
that
is
not
Universal
and
is
often
overlooked,
because
it's
not
really
it's
just
like.
Let's
just
do
the
clinical
work,
but
there's
a
lot
of
other
barriers
to
care,
and
we
who
work
in
the
health
centers.
I
We
really
see
what
those
barriers
are
and
hit
up
against
them
all
the
time
and
when
a
system
you
know
it
took
years
to
get
Hahnemann
to
the
point
where
the
system
was
seamless,
but
it
was
almost
seamless
and
now
being
in
a
new
system.
That's
trying
hard,
but
we've
run
up
against
those
barriers.
All
the
time,
so
I
think
that
training
would
be
great
and
I
think
just
a
continued
emphasis
on
how
to
integrate
the
care
of
people
with
lesser
financial
means
into
the
mainstream.
I
Like
you
said,
the
fancy
lovely
hospitals
that
that
would
be
excellent
because
I
think
it's
not
it's
not
just
about
the
clinical
outcomes.
You
know
there's
a
lot
more
about
the
quality
of
the
experience
that
gets
lost
in
the
stories
and
we
can
really
see
that
going
from
one
institution
to
another,
and
it's
not
that
people
aren't
trying
it's
it's
really
a
systemic
issue.
So
I
don't
know
you
know,
are
the
midwives.
Our
emphasis
was
not
to
lose
those
patients.
That
was
our
whole
focus
like
we
were
gonna
go
to
the
place
that
was
gonna.
I
B
I
want
to
thank
you.
The
chairwoman
had
a
fantastic
hearing
on
maternal
health
and
mortality
issues,
and
if
only
medicine
were
about
science,
we
be,
and
a
lot
may
be
sure
footing.
But
we
know
that
health
care
has
a
small
part
to
do
with
science
and
a
lot
to
do
with
how
we
treat
people,
how
people
feel
welcome
accessible
to
their
care,
whether
they
are
heard
and
whether
their
needs
are
are
met,
and
that
has
a
lot
more
to
do
than
a
bunch
of
machines
and
an
insurance
broker
behind
the
phone.
B
H
You
know
I,
think
my
my
support
for
this
bill.
I
think
I
think
giving
the
city
the
the
ability
to
have
that
power
to
kind
of
make
sure
you
know
to
be
able
to
take
care
of
its
own
healthcare
resources
right,
whereas
I
think
prior
to
this
bill
were
left
with
the
state
having
to
regulate
it.
And
you
know
in
this
situation
right
mr.
Friedman
did
what
he
wanted
and-
and
you
know,
I
think
our
it
felt
like
our
hands
were
tied
yep,
so
fully
support
this
boat.
Thank.
E
A
You
very
much
for
your
testimony.
Thank
you
for
being
here
and
for
our
last
panel
we
have
dr.
David,
Eisenberg
Drexel,
University
College
of
Medicine,
and
if
there
is
anyone
else
here
to
testify
on
bill
number
one,
nine
zero,
seven,
eight
eight
please
come
forward
now:
okay,
all
right!
Dr.
Eisenberg,
please
state
your
name:
Aysen,
Burke,
I'm!
Sorry,
please
state
your
name.
J
For
the
server
thank
you
very
much
David
Eisenberg
I'm,
an
associate
professor
of
medicine
at
Drexel
University
of
College
of
Medicine.
Thank
you
for
the
opportunity
to
express
my
support
for
this
bill.
I
am
the
former
internal
medicine
residency
program
director
and
I
apologize
that
I
don't
have
any
written
prepared
remarks,
because
the
issue
that
I'm
going
to
be
talking
about
is
relatively
rapidly
developing
or
at
least
we're
becoming
aware
of
it.
J
The
issue
is
the
malpractice
insurance
that
the
owners
of
hahnemann
have
actually
decided
not
to
pay
going
forward,
and
it
looks
like
that
this
decision
was
actually
made
back
in
2018
when
they
purchased
the
hospital,
despite
being
contractually
obligated
to
purchase
a
specific
type
of
malpractice
insurance
that
would
follow
employees
of
the
hospital
going
forward.
The
ownership
decided
to
purchase
him
out
practice
insurance
that
would
end
on
January
10th
2020.
J
This,
as
I
said,
is
a
violation
of
the
contracts
that
our
residents
and
fellows,
signed
and
I
think
that
this
highlights
a
couple
of
things
number
one.
This
is
exposing
to
very
well
more
than
two,
but
I
want
to
focus
on
two
very
vulnerable
groups.
The
first
and
foremost,
are
the
patients
who
received
care
during
this
time.
Now
we
know
that
medicine
is
not
always
perfect
and
things
happen
and
patients
are
have
the
right
and
they
should
actually
be
able
to
bring
malpractice
lawsuits
and
actually
be
compensated
for
anything
that
may
have
happened.
J
That
was
not
right
during
their
hospitalization
or
with
offices
affiliated
with
Hahnemann,
and
these
patients
will
have
a
less
of
a
chance
to
be
adequately
compensated
because
our
trainees
won't
have
the
tale
malpractice
insurance
unless
they
purchase
it
themselves,
and
so
that
I
think
is
a
huge
deal
for
patients
who
are
already
underserved
and
would
require
that
compensation
to
actually
receive
future
care
that
they
need
either
at
either
at
rehab
facilities
or
home
care,
or
anything
like
that,
and
so
that's
the
first
vulnerable
population.
That
I
think
is
is
significant
to
point
out.
J
The
second
one
are
our
trainees,
and
so
this
doesn't
just
affect
the
570
that
were
orphaned,
it's
the
largest
orphan
or
it's-
the
largest
closure
of
a
academic
training
hospital
in
the
history
of
our
country.
But
this
also
affects
anyone
who
graduated
prior
to
that
who
actually
provided
care
during
the
time
of
AHS
as
ownership.
So
it's
just
around
a
thousand
trainees
that
are
affected
by
this,
and
you
can
imagine
all
of
the
patients
that
they
took
care
of
for
the
20
months
of
a
Jess's
ownership.
As
I
said,
these
trainees
are
already
in
debt.
J
They
will
be
opened
up
to
significant
liability.
Many
states
actually
have
requirements
to
have
uninterrupted
malpractice
insurance
to
actually
become
licensed
to
practice.
Medicine
and
many
jobs
actually
require
proof
of
continuous
malpractice
insurance
in
order
to
get
credentialed
at
hospitals
and
and
practices,
and
so
this
is
a
significant
issue.
J
I
also
think
that
this
will
actually
make
it
less
likely
for
these
980
trainees,
who
committed
to
coming
to
an
underserved
and
caring
for
an
underserved
population
to
do
this
in
the
future,
and
I
personally
feel
that
this
could
be
a
potential
brain
drain
from
our
city
and
then.
Finally,
the
cost
of
this
tale
is
prohibitive
for
many
of
our
trainees
already
in
debt.
J
But
I
also
ask
the
council
to
consider
if
there's
absolutely
anything,
we
can
do
to
help
this
situation
of
lack
of
tail
malpractice
insurance
for
the
people
who
are
currently
affected,
and
those
are
the
trainees
who
have
already
been
displaced
to
other
health
systems
and
also
the
patients
who
receive
their
care
at
Hahnemann
hospital.
Thank
you
very
much
for
the
opportunity.
Well,.
A
Thank
you
very
much
for
your
testimony.
I
think
you
brought
a
lot
of
things
to
light
that
someone
like
myself
is
not
a
physician
and
not
really
connected
in
that
way
to
the
medical
community,
wouldn't
have
no
idea
in
terms
of
the
interruptions
you
know
with
with
malpractice
insurance
and
just
all
of
the
other
things
that
really
go
into
what
this
disruption
to
healthcare
in
Philadelphia
will
mean
beyond
just
you
know,
sort
of
like
the
the
obvious
disruption
which
is
poor,
patient
care
and
displacement.
A
A
D
Morning,
chairperson
best
members
of
the
Public
Health
and
Human
Services,
Committee
I'm,
dr.
Thomas
Farley
health
commissioner
for
Philadelphia
bill
number,
one,
nine,
zero,
seven
one
five
would
require
pharmacies
in
Philadelphia
to
submit
data
to
the
Department
of
Public
Health
about
the
prescribing
and
dispensing
of
controlled
substances.
We
support
this
bill
because
having
this
data
would
help
the
Department
respond
to
the
opioid
crisis
and
prevent
future
problems
caused
by
the
inappropriate
prescribing
of
dangerous
drugs.
As
you
know,
Philadelphia
has
been
hit
particularly
hard
by
the
national
crisis
of
opioid
use,
addiction
and
overdose.
D
Approximately
1,200
people
have
died
or
drug
overdoses
in
each
of
the
last
two
years,
giving
Philadelphia
the
highest
overdose
mortality
rate
of
any
by
far
of
any
large
city
in
the
nation,
while
use
of
heroin
and
fentanyl
is
contributing
to
this
crisis.
The
over
prescribing
of
pharmaceutical
opioids,
like
oxycontin
and
vicodin
and
percocet
also
continues
to
be
a
major
cause
in
a
survey
conducted
by
our
department
in
2017
13
percent
of
adults
in
Philadelphia,
which
amounts
to
some
one
hundred
and
sixty
eight
thousand
people
reported
taking
prescription
opioids.
D
If
even
only
a
fraction
of
those
people
become
addicted
to
these
drugs,
it
still
represents
a
huge
number
of
addicted
people
at
high
risk
for
overdose.
Although
we
should
all
be
concerned
about
the
diversion
of
opioids
from
the
legal
to
the
illegal
market,
the
primary
source
of
for
pharmaceutical
opioids
in
the
city
today
is
the
legal
prescription
from
a
licensed
health
care
provider.
D
My
department
has
taken
many
steps
to
persuade
healthcare
providers
to
reduce
inappropriate
opioid
prescribing,
including
mailing
guidelines
to
16,000
physicians
in
the
metropolitan
area,
sending
staff
into
the
offices
of
1,300
medical
practices
to
deliver
very
direct
messages.
Still,
we
need
to
do
more
to
reduce
inappropriate
opioid
prescribing
based
on
de-identified
prescribed
prescription
data
that
my
department
has
analyzed.
The
prescribing
of
opioids
in
Philadelphia
is
extremely
skewed.
One
percent
of
prescribers
write
nearly
30
percent
of
the
prescriptions.
D
The
next
ten
percent
of
prescribers
write,
nearly
45
percent
of
prescriptions
and
more
than
half
of
prescribers
write
virtually
no
opioid
prescriptions
at
all.
Therefore,
our
outreach
and
education
to
prescribers
should
be
targeted
rather
than
one-size-fits-all
bill
number
one:
nine
zero.
Seven
one
five
would
require
pharmacies
to
submit
an
in
Philadelphia
to
submit
to
the
Department
on
a
quarterly
basis,
information
about
the
prescribing
of
controlled
substances.
This
would
include
information
about
the
health
care
provider
who
wrote
the
prescription,
including
his
or
her
name
and
specialty.
D
The
data
received
as
a
result
of
bill
number
one:
nine,
zero.
Seven
one
five
would
allow
the
department
to
target
our
education
to
high-volume
prescribers,
to
persuade
them
to
write
fewer
prescriptions
to
shape
those
educational
messages
according
to
the
Medical
Specialties,
and
prescribing
practices
of
these
high-volume
prescribers
to
create
prescriber
dashboards.
That
summarize,
the
prescribing
history,
including
a
comparison
to
the
average
prescriber
of
the
same
specialty,
to
evaluate
the
effects
of
these
steps
by
measuring
changes
in
providers
prescribing
patterns
and
working
in
coordination
with
law
enforcement
agencies.
D
On
the
small
number
of
irresponsible
pell-mell
prescribers
who
did
not
respond
to
education,
it
is
also
important
to
note
what
this
bill
does
not
do.
The
bill
does
not
require
the
reporting
of
any
information
that
identifies
patients.
The
bill
will
not
place
an
additional
burden
on
pharmacies.
The
data
to
be
shared
as
a
result
of
this
bill
are
identical
to
the
data
already
being
sent
daily
from
pharmacies
to
the
Pennsylvania
prescription.
Drug
monitoring
program,
also
known
as
the
PDMP.
D
All
that
would
be
required,
would
be
for
the
pharmacy
to
establish
a
separate,
secure
data
feed
to
my
department,
which
is
accustomed
to
receiving
and
analyzing
large
amounts
of
data.
You
may
question
the
need
for
a
local
reporting
requirement,
given
the
existence
of
the
state's
PDMP.
However,
the
state's
interpretation
of
the
state
law
that
established
the
PDMP
is
that,
while
the
state
health
department
has
full
access
to
the
PDMP
data,
local
health
department's,
do
not.
D
We
have
asked
legislators
in
Harrisburg
to
pass
legislation
allowing
local
health
departments
access
to
the
PDMP
data,
but
we
do
not
expect
legislation
on
this
to
pass
anytime
soon.
Given
the
magnitude
of
this
crisis,
we
do
do
not
believe
we
should
wait
any
longer
to
get
relief
from
the
state
on
this
issue.
Bill
number
one:
nine,
zero,
seven
one
five
would
allow
us
to
obtain
the
data
soon
to
take
appropriate
preventive
steps
that
I
just
described.
Thank
you
for
the
opportunity
to
testify
and
be
happy
to
answer
any
of
your
questions.
Thank.
A
You,
commissioner,
any
questions
from
the
panel
No.
Okay,
thank
you
very
much
for
your
testimony.
You
could
probably
stay
right
there
is
there.
Anyone
else
here
to
testify
on
bill
number
one:
nine,
zero,
seven,
one:
five!
No
okay!
If
we
could
have
the
clerk
now
read
the
title
of
bill
number
one:
nine,
zero,
eight,
zero,
four,
and
also
while
he's
preparing
to
do
that.
I
also
want
to
recognize
that
we
have
written
testimony.
A
One
bill
number,
one:
nine,
zero,
seven,
eight
eight,
which
was
the
first
fill
heard
by
public
citizens,
the
Women's
Medical
Fund
health
professionals
and
allied
employees
and
Cathy
dekosky,
former
Hahnemann
hospital
patient.
Thank
you
and
doctor
doctor
PJ
Brennan,
the
chief
medical
officer
and
senior
vice
president
of
the
University
of
Pennsylvania
Health
System.
Thank
you
bill.
C
Number
one:
nine
zero,
eight
zero
for
an
ordinance
amending
chapter;
nine,
six,
zero,
zero
of
the
Philadelphia
coal
and
titling
service
and
other
businesses
to
add
on
new
section,
9
6,
3
8,
entitled
sales
of
electronic
smoking
devices
and
youth
accessible
establishments
prohibiting
selling
and
offering
for
sale
certain
electronic
smoking
devices
and
youth,
accessible
establishments
and
fixing
penalties
all
under
certain
terms
and
conditions.
Thank.
A
K
Thank
you
very
much
Jim
I'm,
chair
I.
Don't
think
you
have
to
be
a
news
junkie
to
know
that
youth
raping
is
a
health
epidemic
and
the
majority
of
the
kids
that
that
get
addicted
use,
flavored
East
cigarettes,
this
bill
I,
think
addresses
the
only
real
way
to
address
it,
which
is
to
keep
kids
away
from
this
dangerous
product
and
not
have
the
product
where
the
kids
are
I.
K
Think
we'll
hear
from
a
representative
the
Youth
Advocacy
Institute
advocating
for
this
bill,
but
I've
wonder
if
I
know
a
number
over
here
only
ones
go
to
testify
so
drive
along,
but
I
wonder
if
they
could
all
stand.
The
ones
that
are
here
from
the
youth
advocacy
institute,
who
are
here
in
support
of
this
bill.
K
And
doctor,
thank
you
thank
you
all
and
dr.
Farley
will
give
the
all
the
reasons
why
this
is
a
good
bill,
but
I
want
to
just
address
one
other
thing
before
he
speaks
I
know
and
look
I'm,
always
looking
for
a
compromise.
I
would
argue
this
Bill's
already
a
compromise,
we're
not
banning
this
product.
We
are
regulating
it
and
we
are
regulating
it.
K
We're
the
high
nicotine
or
the
high
nicotine
and
the
flavor
products
can
be
sold
and
kept
away
from
young
people,
because
that's
the
issue
we're
trying
to
deal
with
here
we're
not
telling
stories.
They
can't
sell
certain
products,
but
I
think
when
you
balance
out
what
is
the
most
important
thing
is:
maybe
a
little
being
distorted
make
a
little
bit
more
money
and
kids
health
I.
Don't
think
that's
a
quick
I,
don't
think.
That's
a
tough
decision
to
make
so
I
hope
we
join
other
cities
and
states
who
have
put
in
these
reasonable
regulations.
G
Good
morning,
good
morning
morning,
I
want
to
echo
the
sponsor
of
the
bills
bottom
line,
which
is
that
we
have
to
be
smarter
and
how
we
find
reasonable
solutions
to
keeping
anything
that's
going
to
be
harmful
and
challenge
the
life
and
life
chances
of
young
people,
bringing
it
to
members
of
City
Council
in
a
way
that
we
can
deal
with
it.
So
first
I.
Thank
you
to
Councilman
green
lien
for
this
vital
legislation
that
continues
the
trajectory
of
this
council.
Doing
all
we
can
to
protect
the
lives
and
life
chances
of
Philadelphia's
children.
G
This
legislation
serves
as
another
preventive
measure
to
regulate
and
to
deter
our
children
from
the
negative
health
implications
of
spoke
of
smoking
or
doing
my
tenure.
As
a
member
of
this
council,
I've
made
it
clear
and
my
mission
and
a
number
of
ways
to
serve
as
an
advocate
for
women
families
and,
of
course,
our
city's
most
vulnerable.
Our
children
also
given
that,
as
is
the
practice
in
my
office,
we
do
not
operate
in
a
vacuum
or
with
a
myopic
vision.
G
We
seek
to
leave
no
stone
unturned
and
explore
every
Avenue
when
it
comes
to
introducing
meaningful
reasonable
legislation
that
is
equitable
across
all
sectors.
But
that
said,
the
record
should
reflect
that
I've
had
my
staff
pour
what
other
countries
are
doing
and
what
other
cities
might
be
doing
and
the
most
recent
information
I
have
that
I
want
to
put
on
the
record,
which
moves
moves
me
quite
frankly,
is
that
the
official
policy
of
the
United
Kingdom
and
His
Royal
College
of
Physicians
is
actually
to
promote
each
cigarettes
among
adults
for
people
trying
to
quit.
G
The
Royal
College
of
Physicians
explicitly
tell
doctors
to
promote
each
cigarettes
as
wildly
as
possible
to
people
trying
to
quit,
not
to
children,
but
to
adults
who
trying
to
quit,
because
they
think
carries
a
small
fraction
of
the
risk
of
smoking.
So
I
think
it's
important
as
we
proceed
with
this
conversation,
discussion
and
friendly
debate
that
we
focus
on
what
we
want
to
do
in
the
best
best
interest
of
children,
and
we
try
to
do
all
we
can
to
help
adults
who
want
to
stop
smoking
and
we're
always
possible.
G
A
D
Morning,
chairperson
bass
and
members
of
the
Public
Health
and
Human
Services
Committee
I'm,
dr.
Thomas,
Farley
health
commissioner
for
the
city
of
Philadelphia.
Thank
you
for
allowing
to
provide
testimony
on
build
number
one,
nine,
zero,
eight
zero
for
which,
if
enacted,
would
restrict
the
sale
of
flavored
and
high
nicotine
salt
vaping
devices
to
adults
only
establishments.
We
strongly
support
this
bill
nationally
use
of
e-cigarettes
and
other
vape
products.
D
My
teenagers
is
at
epidemic
levels
and
continuing
to
rise
use
among
every
age
group
of
young
people
from
middle
school
through
twelfth
grade
more
than
doubled
between
2017
and
2019.
The
change
from
2017
2018
alone
was
the
largest
increase
of
any
substance
use
among
the
nation's
youth
ever
recorded.
Today,
more
than
a
quarter
of
and
I
got
to
correct
my
written
testimony,
here's
more
than
a
quarter
of
high
school
students,
not
just
12th
graders,
but
all
high
school
students
are
using
e-cigarettes
more
than
1/4.
D
This
increase
is
due
in
large
part
to
two
factors:
the
addition
to
vaping
products
of
solutions
of
fruit,
candy,
mint
and
menthol
menthol
flavorings
that
appeal
to
kids
and
the
introduction
of
nicotine
salt
products.
We
know
that
flavored
e-cigarettes,
which
smell
and
taste
like
candy
or
desserts,
motivate
children
to
start
vaping
97%
of
current
youth.
Each
cigarette
users
use
flavored
cigarettes
and
70%
cite
flavors
as
a
key
reason
for
their
each
cigarette.
Use.
I've
got
a
couple
of
examples
here.
I
thought,
I
might
just
show
you.
This
is
product.
D
D
This
is
pods
that
are
mixed
berry
and
this
one
is
called
a
loss.
It's
called
peachy
mango.
Excuse
me,
peachy
mango
this
by
the
way
advertises
which
one
six
percent
nicotine
and
I'll
get
to
the
nicotine
levels
in
a
bit
sure
one
flavor
menthol
is
one
of
the
most
popular
flavors
by
e-cigarette
used
by
teens.
We
know
that
teens
are
smart
start
smoking
with
menthol
products
are
twice
as
likely
to
become
regular
smokers.
We
know
the
teens
who
start
with
e
cigarettes
are
more
likely
to
later
use
combustible
cigarettes.
D
Restricting
the
sales
of
flavored
products
would
be
a
major
step
forward
in
reducing
the
number
of
children
who
become
addicted
to
nicotine.
We
also
know
that
East
cigarettes,
like
Joule,
that
use
nicotine
salts
deliver
high
levels
of
nicotine
and
users
are
especially
risky.
Nicotine
is
a
drug
that
is
as
addictive
as
heroin.
Older
cigarette
devices
generally
used
nicotine
in
freebase
form
these
devices
contained
at
less
than
twenty
milligrams
of
nicotine
per
milliliter
of
fluid,
but
Jewell
and
new
Joule
look-alike
devices
typically
contain
much
higher
levels
of
nicotine.
D
Jool
has
complied
with
this
rule
by
marketing
in
Europe
a
product
with
less
than
20
milligrams
per
milliliter
of
nicotine
about
a
third
of
the
nicotine
levels
of
jewell
sold
in
the
United
States.
The
manufacturers
adopted
to
the
regulations
put
in
place
there.
This
epidemic
of
youth
vaping
set
the
stage
for
a
second
epidemic
east
cigarette
or
vaping
related
lung
injury.
As
of
November
5th
2019.
D
Over
2000
cases
in
dozens
of
deaths
have
been
reported,
including
multiple
cases
in
Pennsylvania
and
one
death
in
Pennsylvania,
approximately
80
percent
of
patients
were
under
35
years,
a
years
old.
The
Centers
for
Disease
Control
Prevention's
current
belief
is
that
most
of
these
cases
have
been
caused
by
users,
vaping
liquids
containing
THC,
the
active
ingredient
in
marijuana
and
vitamin
E
acetate,
but
the
agency's
investigation
is
ongoing
and
much
of
this
epidemic
is
not
yet
understood.
There's
no
question
that
the
widespread
availability
and
use
of
e-cigarettes
and
young
adults
has
enabled
this
epidemic
to
occur.
D
The
FDA
has
had
the
authority
to
regulate
vaping
devices
meaningfully
since
2009,
and
it
has
announced
plans
to
regulate
them
multiple
times,
but
each
time
it
has
failed
to
act.
Most
recently
the
president
announced
it
said
that
he
was
not
going
to
be
acting
on
e-cigarettes,
although
they
had
promised
through
that
very
recently.
As
a
result,
no
one
knows
what
ingredients
are
any
cigarettes,
because
the
FDA
has
not
required
manufacturers
to
disclose
this
information.
If
no
one
knows
what's
in
them.
D
Certainly
no
one
could
truthfully
say
that
any
of
these
products
are
safe,
especially
if
they
are
used
daily
for
many
years
as
more
and
more
young
people
become
dependent
on
these
highly
addictive
devices,
states
and
cities
across
the
country
are
stepping
up
to
protect
their
young
people.
Some
are
banning
flavorings.
Some
are
banning
e-cigarette
sales
entirely.
I
should
point
out
that
yesterday
the
American
Medical
Association
voted
to
recommend
a
ban
of
e-cigarettes
entirely.
D
This
bill
takes
a
more
balanced
approach.
It
would
restrict
the
sale
of
e-cigarettes
that
contain
flavorings
or
high
nicotine
levels
and
salt
forms
to
stores
that
do
not
allow
children
to
enter
jool
and
other
similar
products
will
continue
to
be
available
in
qualifying
adult
only
stores,
lower
nicotine
tobacco
flavored
cigarettes
will
remain
broadly
available
in
stores
that
have
tobacco
sales
permits.
I
have
here
a
list
of
e-cigarette
products
that
stores
that
have
forged
tobacco
sales
permits
would
be
able
to
sell
under
this
bill.
D
You
may
hear
opposition
to
this
bill
from
the
owners
of
convenience
stores
who
would
like
to
continue
to
sell
flavored
and
high
nicotine
salty
cigarettes.
They
may
claim
that
they
have
a
record
of
never
selling
tobacco
to
youth
or
that
they
have
their
own
robust
youth,
tobacco
compliance
programs,
but
data
from
the
city's
youth
compliance
program
shows
that
convenience
stores
very
frequently
sell
tobacco
products
to
children,
even
though
this
is
against
the
law.
D
For
example,
34
percent
of
youth
compliance
checks
done
at
7-elevens
in
Philadelphia
over
a
three-year
period,
resulted
in
an
illegal
sale
of
tobacco
to
a
minor.
This
is
the
same
high
rate
of
non-compliance
for
all
tobacco
outlets
citywide.
This
means
that
if
we
want
to
prevent
our
children
from
purchasing
the
most
unsafe
each
cigarette
products,
we
need
further
restrictions
on
the
stores
that
can
sell
them.
D
Overall,
we
believe
this
bill
would
help
protect
Philadelphia's
children
from
e-cigarette
marketing
reduce
the
number
of
teens
who
become
addicted
to
e-cigarettes
and
help
limit
the
adverse
health
effects
of
vaping,
while
still
allowing
adult
smokers
who
want
to
use
these
cigarettes
to
quit
smoking
to
do
so.
Thank
you
for
the
opportunity
to
testify
I'm
happy
to
answer
any
of
your
questions.
K
K
K
Don't
know,
maybe
somebody
would,
but
you
know
I,
wouldn't
think
so
so
so,
as
you
pointed
out
in
your
testimony,
ninety-seven
percent
of
children,
young
people
use
flavored
cigarettes
right,
correct,
flavored,
e-cigarettes,
I'm,
sorry,
yeah,
so
so
they're
clearly
geared
towards
young
people
right
I
mean.
Is
there
any
doubt
about
that?.
D
D
My
mind:
okay,
all
right
and
even
you
know,
dual
has
acknowledged
that
in
is
claiming
that
they
will
not
be
marketing
the
flavored
e-cigarettes
in
the
future.
But
let
me
point
out
that
those
products
there
are
not
jule.
Okay.
Now
there
are
now
an
entire
category
of
what
I
would
call
jewel
knock-offs
and
make
these
flavored
products.
So
there's
still
widespread
availability
of
these
flavored
products
in
convenience
stores
and
bodegas
across
the
city
and.
K
D
D
K
D
No
jewel
has
said
for
four
years
that
we
don't
market
to
children.
Nonetheless,
we've
seen
this
huge
run-up
to
about
25
percent
of
teenagers
are
using
these
products.
The
point
of
those
25
percent
of
teenagers
are
not
smokers.
Trying
to
quit.
These
are
kids,
who've,
never
smoked.
They
took
up
what
is
now
essentially
a
new
drug
delivery
device,
a
new
drug
because
it's
unregulated
and
the
industry
can
market
it
without
restrictions
and.
K
I
K
D
D
Mean
you
could
argue
that
the
FDA
should
ban
flavored
products
and
should
ban
products
with
nicotine
levels
above
the
threshold,
as
they
did
in
the
European
Union
right.
This
doesn't
ban
those
it
allows
them,
but
allows
them
only
specialized
places
where
we
know
kids
are
not
going
to
be,
and
then
the
products
that
we
hope,
although
we're
not
proven,
are
safer,
would
be
still
widely
available
at
any
place.
That
has
a
permit
to
sell
tobacco
products.
Okay,.
D
Believe
this,
you
know,
achieves
the
correct
balance.
I
actually
say
that
there's
a
fair
amount
of
uncertainty
around
cigarettes,
no
one
knows
how
safe
they
are
over
the
long
term.
There
may
be
some
value
to
current
smokers
who
want
to
quit,
but
we
definitely
don't
want
teenagers
who've,
never
smoked,
to
use
these
products.
So
we
think
that
this
strikes
that
that
right,
balance
and
and.
K
Just
I
mean
we've
again
seen
in
the
news
how
many
young
people
have
gotten
seriously
ill
or
even
died
from
and
I
know.
Some
of
these
are
things
that
they,
what
you
call
kind
of
break
down
and
use
other
products
in
them,
but
I
mean
that's.
This
isn't
just
kids
could
be
getting
hooked
on
cigarettes,
kids
or
kids
could
be
dying
from
this
stuff
right
right.
D
So
so
kids
can
buy
products
that
you
know
over
the
internet
that
was
made
in
somebody's
basement
that
may
be
sold,
has
got
THC
and
who
knows
what
else
they
threw
in
there
in
this
case?
Maybe
vitamin
D
acetate,
and
sometimes
it
could
be
one
used.
It
ends
up
being
fatal.
We
were
once
told
that
jewel
was
actually
hard
to
break
into
and
just
change
out
the
liquids,
but
we
put
that
to
a
test
and
our
tobacco
staffer
was
able
to
break
into
a
jewel
pod
in
about
30
seconds
with
a
paperclip.
So.
D
K
And
just
a
couple
things
on
on
what
we
might
hear
from
other
witnesses.
I
know
the
issue,
a
menthol
comes
up
and
it
comes
up
a
lot.
When
we
talk
about
cigarette,
you
know
regular
cigarettes
too.
What
is
your
feeling
I
mean
some
people
might
advocate
taking
menthol
out
of
the
regulated
taken
out
of
this
bill?
What
will
be
your
opinion
on.
D
So
you
know
the
amongst
of
favorite
flavors
among
teenagers,
menthols
number
two
man
and
and
I-
don't
particularly
see
why
adults
need
menthol
any
more
than
tobacco
flavor.
What
they're
used
to
smoking
is
probably
more
tobacco
flavor
than
anything
else.
So
I
don't
see
any
particular
value
to
adults.
Trying
to
quit.
I
should
also
point
out.
There
are
many
proven
medicines
to
help
adult
smokers.
Quit
proven
me
safe
and
effective,
licensed
by
the
FDA.
For
this
purpose,
our
first
recommendation
any
smoker
who
wanted
to
quit
us
two
first
tried
those
medications.
You
know.
D
If
they
can't,
then
these
cigarettes
are
available.
They
are
unproven.
The
companies
who
made
these
cigarettes
have
never
done
the
studies
to
demonstrate
their
effectiveness.
They
have
never
done
the
studies
to
demonstrate
their
safety
nests
they've,
never
disclosed
their
ingredients,
so
it's
out
there,
but
I
am
reluctant
to
encourage
a
belt
smokers
to
use
this
product.
In
view
of
all
that,
uncertainty
because.
D
Yeah
regular
cigarettes,
we
know
what's
in
there,
those
are
unregulated
wheat
there's,
you
know.
Probably
these
cigarettes
are
safer
than
regular
cigarettes
and
a
Hufflepuff
basis.
However,
we
certainly
don't
want
people
who
were
not
using
regular
cigarettes
to
take
up
these
cigarettes.
No
one
knows
what
happens
to
your
lungs
if
you
use
e-cigarettes
for
decades,
never
been
around
that
long
and
their
lungs
are
different
from
your
skin.
These
are
delicate
tissues
that
even
chemicals
that
may
we
may
feel
are
safe,
could
really
damage
over
a
period
of
years
and
when.
K
D
So,
and
in
the
FDA-
and
now
it's
very
recently
that
they
were
going
to
take
action
and
right,
my
understanding
was
that
they
were
going
to
ban
all
flavors
or
almost
all
flavors,
and
they
were
ready
to
do
it.
In
a
matter
of
days,
then
President
Trump
said
a
few
days
ago.
That
know
he
was
going
to
reconsider
that
and
the
FDA,
unfortunately,
is
brought
under
too
much
political
pressure
from
the
industry
these
days.
This
is,
it
would
be
our
preference
for
the
FDA
to
be
acting
on,
regulate
these
products,
but.
K
Editorial
comment:
you'll
have
to
respond
to
this,
but
if
that
the
man
that's
temporarily
residing
in
the
white
house,
if
he
has
influence
on
something
I,
don't
trust
a
darn
thing
so
I'll
just
leave
it
at
that.
Just
real
quick
to
two
other
things
that
might
come
up.
I
think
definitely
welcome
on
the
issue,
the
age
making
21
what
you're
feeling
about
we.
D
Support
raising
the
age
of
the
sale
of
all
tobacco
products
from
18
to
21.
There
is
a
bill
in
the
legislature
in
Harrisburg
that
has
made
a
lot
of
progress.
I
I
forget
exactly
where
dishonest
but
stay
feel
I
think
it's
likely
to
go
through,
and
we
certainly
think
when
that
that
would
be
a
step
forward.
However,
as
I
pointed
out,
there's
it's
very
common
for
stores
now
to
sell
to
children
who
are
underage,
who
are
under
age.
D
But
I
can
tell
you
that
we
certainly
have
clear
examples
of
where
our
teenage
testers
have
gone
in
and
there's
a
scanner
there
and
they
will
to
buy
tobacco
products
either
because
they
don't
ask
for
the
teens
ID,
where
they
ask
for
they
scan
it
and
they
still
sell
the
product.
Now.
I
understand
from
our
conversation.
Just
before
the
hearing
began,
that
the
industries
claiming
that
there
is
a
some
sort
of
new
technology
that
would
not
permit
the
clerk
to
do
that.
D
K
D
K
A
A
You
know,
retailers,
saying:
oh,
we
don't
sell
to
anyone
under
18
on
anyone
under
21.
You
have
to
show
identification.
You
have
to
do
you
know
this
and
the
other
thing,
and
we
know
for
a
fact
that
that
doesn't
happen.
As
a
matter
of
fact,
one
of
my
staffers,
we
were
at
an
event
at
a
store
in
Nice
town
and
they
were
sold.
You
know
a
prize,
a
cigarette.
You
know
a
Lucy
right
right
in
front
of
us
to
someone
who
was
clearly
underage,
but
so
we
know
that
it
happens.
A
D
A
No
case
it's
not
across
the
board,
so
we
don't.
So
if
we
relied
on
the
scanners,
we'd
only
be
relying
really
on
a
small
portion
or
a
portion.
I,
don't
know
if
it's
smaller
but
a
portion
of
the
retailers
who
would
be
selling
these
products
correctly.
Okay,
all
right,
Councilwoman,
Kim
and
then
brown
and
then
talking
burger.
B
B
B
A
lot
of
my
concern
is
that
they've
been
pitched
this
as
if
it's
safer,
somehow
because
it's
not
cigarettes
and
to
me
one
of
the
biggest
concerns
is
that
this
industry
is
manipulating
perceptions
and
marketing
in
the
same
way
that
they
do
with
sugar
in
the
same
way
that
they
do
with
soda
and
other
kinds
of
products
and
that
young
people
aren't
taking,
aren't
making
that
distinction.
They're
not
hearing
that
it's
for
adults,
they're,
hearing
that
it's
safer
than
cigarettes
and
then
they're,
seeing
the
packaging
and
I
guess
you
know.
B
D
B
If
you
want
those
folks
who
are
on
cigarettes
to
quit,
smoking
then
put
them
in
an
adult
shop
where
they're
up
over
18
anyway,
and
they
can
buy
their
PG
mangoes
and
their
frothy
lemonade's
and
their
candy
cane
stripes
or
whatever
flavored
kind
of
products
that
they
want.
But
it
doesn't
seem
to
make
sense
to
me
so
I'm
wondering
if
you
can
talk
a
little
bit
about
you
know
what
I
mean.
B
What
is
the
city
doing
in
terms
of
looking
at
the
impact
of
the
expansion
of
nicotine
marketing,
particularly
to
young
people
in
any
format,
I'm,
not
distinguishing
whether
it's
a
cigarette
or
dual
or
whatever?
It
is,
but
that
or
vaping
products
that,
but
the
nicotine
marketing
feels
like
it
has
gone
off
the
rails
again
in
a
way
that
we
were
able
to
control
it
moderate
it
manage
it,
regulate
it.
B
D
I
couldn't
agree
more
there's
a
widespread
perception
among
teenagers
that
these
products
are
and
not
just
safer,
but
that
they
are
safe
period.
There's
nothing
wrong
with
them
that
doesn't
come
from.
Nowhere
comes
from
somewhere
and
certainly
there's
a
lot
of
marketing
takes
place
over
social
media
in
particular,
because
that's
where
you
reach
teens
jewel
is
marketed
and
social
meeting
the
past,
and
they
now
claim
they're
not
going
to
do
that
anymore,
but
they've.
Now
many
other
companies
that
are
producing
the
same
products.
We
unfortunately
don't
have
the
ability
to
regulate
that
marketing.
D
However,
we
can
try
to
counteract
them
Marketing.
So
while
we
are
supporting
this
bill,
we
also
are
currently
running
a
campaign
on
social
media
called
behind
the
haze,
which
is
targeted
specifically
teenagers
and
lets
them
know
about
the
risks
and
the
unknown
risks
of
these
cigarettes
and
points
out
that
really.
This
is
just
coming
from
an
industry
that
wants
to
get
them
addicted
to
nicotine.
That
campaign
may
still
be
overwhelmed
by
the
marketing
of
the
industry,
but
that's
what
we're
doing
what
we
can.
D
I
should
say:
I
had
a
meeting
with
the
Centers
for
Disease
Control
people
who
were
in
charge
of
the
investigation
for
over
the
lung
injury,
and
he
said
as
far
as
cigarettes.
He
said
the
marketing
is
what
brings
a
horse
to
water?
The
flavoring
is
what
gets
them
to
drink
and
the
nicotine
is
what
keeps
them
drinking.
So
these
are
three
elements
that
really
are
driving
the
e-cigarette
problem
and.
D
Think
industry
is
looking
for
profit
and
they'll
go
wherever
they
can.
Their
initial
work
was
over
the
internet
and
then
it
was
more
in
high
income
neighborhoods,
but
it's
moving
into
lower-income
neighborhoods
now
and
so
in
the
end,
the
neighborhoods
and
the
communities,
where
there's
less
oversight
where
there's
less
government
presence
are
where
they
can
make
the
greatest
headway.
So
we
know
it
for
combustible
tobacco
products.
It's
much
more
common
among
low-income
folks
and
minority
folks.
Well,.
B
Your
lives
are
about
policy
that
there's
a
market,
that's
being
built
off
of
your
lives,
that
your
health
and
your
money
and
your
neighborhoods
are
in
play,
and
what
I
want
to
make
sure
is
that
we
don't
allow
that
to
happen
without
your
presence.
So
I
really
just
really
want
to
thank
the
young
people
who
came
out
here
today
with
organizations
and
groups
and
advocates
as
well,
but
especially
because,
if
we
don't
hear
from
from
folks
we're
gonna
make
policy
absent
your
voices
and
that's
never
gonna
be
a
good
thing.
So.
D
G
Councilman
Brown
good,
more
I
want
to
echo
councilman
gimmes
salute
to
the
young
people
here
who
have
shown
up
to
register
your
your
voice,
your
presence
around
policies
that
ultimately
impact
you.
Let
me
say
for
the
record
that
councilman
alt
Alton
Berger
Councilwoman
game
Councilman,
sponsor
of
this
bill.
Greenlee,
chair
of
this
committee
of
myself
all
agree
mm
that
products
like
this
are
unacceptable
for
children
period.
So
there's
no
dispute
about
the
principle
of
the
bill.
G
Let
me
repeat
that
there's
no
dispute
about
the
fact
that
these
products
are
unacceptable
and
we,
as
policy
makers,
have
to
be
prudent,
smart,
responsible
and
reasonable
when
it
comes
to
making
sure
we're
protecting
children.
That
needs
to
be
stated
for
the
record.
So
with
that
said,
please
speak
again
to
menthol
and
how
that
has
great
lines.
When
it
comes
to
protecting
children
and
having
it
available
for
adults,
we
tried
to
quit
smoking
so.
D
Surveys
of
teenagers
who
are
using
e-cigarettes
when
they're
listed
what
what
flavors
you
use
the
number
one
flavor
our
fruit
flavors,
like
those
number
two,
are
our
menthol,
and
so
so
these
are
a
very
common
driver
for
children
to
start
using
e-cigarettes,
but
the
what
the
menthol
does
is.
It
has
a
numbing
effect
on
the
mouth
and
the
throat
and
so
you're
less
likely
to
feel
the
liquid
in.
D
There
is
being
harsh
when
you
take
it
in
so
you
are
more
likely
to
use
a
product
at
all
and
are
more
likely
to
use
a
product
that
has
high
nicotine
levels,
which
can
be
harsh
in
its
own
right.
Okay,
and
so
you
know
there
may
be
adults
who
use
this,
but
I
think
on
balance,
there's
no
reason
to
make
exception
of
that
flavor
over
any
other
flavor.
Okay,.
G
In
certain
municipalities,
I
know
for
sure
in
Delaware
to
follow
up
on
councilman
Greenlees
question
with
regards
to
raising
the
age
to
21
as
a
measure
by
which
we
further
protect
children,
who
are
smart
enough
for
strategic
enough
to
to
approach
others
to
represent
them
with
the
purchase
of
certain
types
of
products.
What
is
your
view
again
with
regards
to
raising
the
age
to
21
yeah.
D
So
we
are
strong
supporters
of
raising
the
sales
page
for
tobacco
products
and
and
e-cigarettes
are
classified
in
law
as
tobacco
products,
raising
it
from
18
to
21
the
the
reason
we
did
not
bring
this
idea
in
front
of
the
City
Council
the
past
is
that
the
city
is
preempted
from
taking
that
action.
Only.
C
D
G
D
Are
not
required
to
be
a
tobacco
permit
T,
so
you
know
some.
Some
of
the
convenience
store
chains
have
voluntarily
started
using
scanners,
which,
on
the
surface,
sounds
like
not
a
bad
thing,
but
again,
our
experience
is
that
convenience
store
chains
here
are
selling
tobacco
products
to
children
just
as
much
as
independent
bodegas,
our
I'm.
D
G
And
so
forth,
the
story
I
like
to
tell
is
that
I
was
the
oldest
of
seven.
My
mother
told
me
if
I
picked
up
a
cigarette
and
she
would
do
something
that
was
probably
not
lawful,
because
I
had
six
other
siblings
behind
me
all
of
my
siblings
smoked
at
one
point:
I
never
picked
up
a
cigarette
so
trying
to
lead
by
example,
didn't
matter
in
that
particular
circumstance.
G
So
for
those
who
fall
upon
the
the
crutch,
some
might
argue
I
would
not,
because
you
know
folks
figure
out
ways
to
handle
their
own
stress
for
those
who
fall
in
that
space,
where
they
have
to
rely
on
e-cigarettes
and
and
given
your
view,
you
respect
a
data
research
as
do
I
when
I
look
to
hear
and
read
that
the
Royal
College
of
Physicians
promote
each
cigarettes
as
wildly
as
possible
to
put
two
people
trying
to
smoke
by
banning
stores
from
selling
these
cigarettes.
We
simply
encourage
the
use
of
more
dangerous
alternative
for
adults.
D
D
Product
is
safer,
as
I
said
that
you
can't
sell
e-cigarettes
with
more
than
twenty
milligrams
per
milliliter.
That's
about
a
third
of
the
nicotine
levels
of
jewell
I,
don't
know
what
their
regulations
are
with
regards
to
flavours
and
I
I'm,
not
sure
what
their
actions
are
about.
Youth
access,
but
I
do
know
that
this
epidemic
of
the
vape
lung-
that's
happened
in
the
past
few
months-
did
not
happen
in
Europe.
So
if
you
have
a
much
safer
regulatory
environment,
then
there
might
be
some
logic
in
promoting
some
of
these
products
for
smokers.
D
I
can
tell
you
around
the
world
that
there
are
there's
a
diversity
of
opinion
among
public
health.
People
about
this
and
I
can
tell
you
that
there
are
many
other
that
the
value
of
e-cigarettes
to
help
smokers
quit
is
unproven
and
we
have
many
other
forms
of
treatment
that
are
proven
to
be
safe
and
effective,
and
so
stop
right
there
for.
G
For
for
those
who
fall
upon
a
space,
because
that
was
a
part
of
your
earlier
testimony
fall
in
a
space
where
they're
trying
to
get
off
drugs
or
stop
drinking.
It's
easy
for
us
to
say
what
they
can
do
and
should
do.
But
for
those
persons
who
are
in
the
struggle
themselves,
they
ultimately
have
to
decide
what
works
best
for
them.
So
I
reject
the
notion
that
we
can
we
consist.
We
can
prescribe
what
we
think
is
good
for
somebody.
G
D
I
couldn't
agree
more,
we
we
love
smokers.
We
want
to
help
them
quit.
There
are
many
options
available
to
them.
There
are
nicotine
patches
and
gums.
There
are
medications
and
I
should
also
point
the
same
type
of
e-cigarettes
that
is
available
to
them
in
the
United.
Kingdom
would
be
available
in
convenience
stores
in
bodegas
across
Philadelphia.
Under
this
bill,
this
bill
would
not
prohibit
the
lower
nicotine
level
these
cigarettes
from
being
available
in
Philadelphia,
okay,.
D
A
F
Want
to
commend
also
all
the
young
people
that
are
here,
because
they
have
an
interest
in
this
and
I
would
urge
them
to
continue
this
all
through
their
lives,
even
when
they're
no
longer
young,
if
you
have
something
of
an
interest
to
you,
I
think
you
had
a
lot
of
elected
officials
now
and
if
you're
so
motivated,
you
ought
to
consider
at
some
point
being
part
of
that
process
and
running
for
office
yourself
and
I
could
nurture
more
because
that's
what
democracy
is
all
about.
Dr.
F
D
F
D
F
D
F
But
then
again
we're
gonna
cite
data
I,
think
you
know,
and
and
and
having
violations
of
this
nature
is
serious,
but
also
these
the
ID
scanners
of
a
hundred
percent
in
7-elevens
I,
think
that
ought
to
be
looked
at
as
well
and
see
how
many
violations
are
since
they
went
to
this
hundred
percent
grouping.
You.
D
Know
the
first
I've
heard
about
there
was
a
claim
made
before
the
hearing
that
there
was
some
sort
of
new
technology
that
had
been
in
place
in
the
past
couple
of
weeks.
I,
don't
understand
how
that's
different
from
what
was
there
before
I
would
be
interested
in
knowing
more
about
that.
I
can
only
tell
you
what
we
you
know
done.
Our
data
based
on
what's
been
there
before
so.
F
M
Thank
you,
madam
chair,
and
thank
you
members
of
the
committee.
Thank
you
dr.
Farley.
It's
not
your
first
rodeo
attempt
to
do
something
that
might
face
preemption
by
the
Commonwealth
of
Pennsylvania.
As
we
look
at
the
flavored
tobacco
issue
in
rap
paper.
Let
me
just
say
it
for
my
chairwoman:
Councilwoman
bass
I
applaud
your
courage
in
a
sense.
This
is
when
this
reminds
me
of
liquor
bottle
Drake
when
you
stood
up
for
that
and
faced
a
lot
of
criticism
for
that
but
understood
it
was
not
only
a
health
hazard
at
7
a.m.
M
people
lining
up
to
get
drinks
and
feed
their
alcoholism,
and
things
like
that
that
you
stood
up
for
that.
So
this,
in
my
mind,
is
a
continuation
of
those
kinds
of
efforts,
because
we
are
disproportionately
impacted
by
these
negative
things.
So
here's
what
I
got
to
say
about
preemption.
They
didn't
preempt
bullets
in
our
neighborhoods.
M
When
our
children
died
disproportionately
from
gun
violence,
they
could
stand
up
and
preempt
that
they
could
help
us
by
pre-empting
the
prison
school
to
Prison
Pipeline
and
adding
a
little
more
funding
to
the
stream
so
that
they
could
properly
educate
our
kids,
particularly
in
conflict
resolution.
I
would
love
preemption
of
that.
When
we
look
at
this
issue
of
flavored
tobacco
and
as
well
as
east
cigarettes,
it
is
purposefully
marketed
to
our
children.
It
is
we
we
had
a
hearing
right
here.
M
We
laid
on
that
table
skittles
right
next
to
one
of
the
flavors
we
did
M&Ms
and
all
of
them
were
so
very
similar
that
to
the
naked
eye,
if
you
just
grab,
you
might
want
up
grabbing
the
tobacco
product.
Second
thing
in
the
displays
and
a
lot
of
these
corner
stores.
They
are
particularly
placed
right
next
to
our
children's
can
as
to
create
a
psychological
attraction
to
these
colors
and
flavors
that
they
suggest.
M
You
asked
the
question
of:
did
you
ever
smoke?
Well,
I'm,
a
smoker,
but
more
than
that
I'm
second
generation,
my
father
died
of
lung
cancer.
My
less
meals
with
him
were
through
an
oxygen
mass
where
he
had
to
time
it,
so
he
could
eat
and
then
go
back
to
breathing.
My
mother
died
of
an
aneurysm
which
a
lot
of
people
you're
the
doctor
in
the
house
associated
with
smoking
and
the
thinning
of
membranes
and
things
like
that.
What
I
remember
is
on
a
worst
snowstorm.
M
M
So
what
I
have
to
say
about
preemption
is
bring
it,
but
we
have
a
responsibility
to
these
young
people
to
try
to
save
them
from
themselves,
save
them
from
the
industry
of
tobacco,
because
we're
not
fooled
tobacco
is
big
business
Pennsylvania,
believe
it
or
not
other
than
Pittsburgh
and
Philadelphia
in
the
tea
is
an
agricultural
state.
So
there
are
forces
that
are
aligned,
whether
you
talk
about
the
small
corner
store
to
7-eleven
or
whether
you
talk
about
the
farmer
in
York
County
that
wants
to
benefit
from
their
addictions.
M
So
we
have
a
responsibility
to
stand
up
and
be
counted
about,
discover
and
if
we
get
struck
down
in
court,
so
future
generations
will
say
we
tried
at
least
to
defend
them.
So
when
I
heard
about
this
I
had
to
come
in
and
let
you
know
that
I'm
proud
of
this,
this
panel
I'm
proud
of
this
committee
for
doing
the
right
thing.
First,
thank
you.
Miss
miss
chairman.
A
Thank
you
and
I.
You
know
the
the
story
you
just
mentioned
about
your
mother
brings
to
mind
something
similar
with
my
mother
who
passed
away
from
cancer
as
well
and
who
was
a
lifelong
smoker
and
when
she
was
in
the
hospital
just
days
from
passing
away,
she
had
a
roommate
in
the
hospital
room
with
her
who
lit
up
a
cigarette,
and
this
woman
was
also
critically
ill.
A
A
You
know
just
Bibles
my
mind
that
in
one
Airlines,
when
the
airplanes,
there
was
a
smoking
and
a
non-smoking
section,
I,
don't
even
know
how
that
how
that
worked
out
I
mean
just
sounds
crazy
now,
but
smoking
was
just
so
accepted
and
so
much
of
a
part
of
our
culture
as
Americans,
and
now
we
know
better
and
now
that
we
know
better.
It's
really
incumbent
upon
us
to
do
better,
particularly
when
we
think
about
the
next
generation
so
I.
Thank
you.
Councilman
Thank,
You,
councilman,.
K
A
K
Very
quickly,
I'm
councilman
Jones
came
down
because
he's
been
a
leader
on
this
whole
issue,
bringing
up
the
the
issue
under
flavored
tobacco
products,
so
I,
and
it's
really
that
effort
that
brought
on
this
issue
too.
So
thank
and
I
should
just
mention
for
the
record
that
well
I
introduced
the
bill.
You,
madam
chair
councilman,
Jones
and
council
president
Clark
or
co-sponsors
of
the
bill
and
just
as
you
brought
up
family
members,
I
always
think
about
my
aunt
who
got
me
started
on
the
Phillies.
K
While
she
used
to
sit
there
with
a
rosary
watching
the
Phillies
smoking
his
cigarette,
she
used
to
say
give
me
my
one:
vice
I,
don't
do
anything
else
wrong,
but
that
one
thing
wrong
killed
her
it's
70
years
old.
So
we
all
know
what
this
does
and
we
all
know,
I'm
I
think
we
have
moved
forward
as
Councilwoman
Bassett
said,
but
we
need
to
keep
moving
look
more
forward
and
this
is
a
forward-looking
bill
and
I
think
it
will
help
these
people
these
young
people,
sitting
image
in
the
audience
today.
Thank
you,
madam
chair
Thank.
A
You
Thank
You
councilman,
okay,
with
no
other
questions
from
the
panel
Thank
You,
commissioner,
and
if
we
could
now
I
have
come
forward
to
testify
on
bill
number
one:
nine,
zero,
eight,
zero,
four
dr.
Michael
Madden
and
Neil
Meg
mech
huge'
Makaha
from
Penn
law,
and
we
are
going
to
ask
in
the
interest
of
time
if
you
could
summarize
your
testimony
to
the
best
of
your
ability.
Okay,.
L
A
L
L
Madam
chair,
madam
vice
chair
and
members
of
the
committee
I'm
dr.
Michael,
Madden
I'm,
a
family
physician
I
am
currently
president
of
the
board
of
allies
for
health
and
well-being,
Southwest
Pennsylvania's
largest
provider
of
services
for
people
with
HIV
HIV,
and
to
prevent
to
prevent
it.
I
also
am
recently
retired,
as
chief
medical
officer
of
Gateway
health
plan,
which
has
been
a
provider
of
Medicaid
of
healthcare
services
for
Medicaid
and
Medicare
recipients
in
Philadelphia,
and
the
rest
of
Pennsylvania
I
am
committed
to
harm
reduction
in
many
many
areas,
and
this
is
one
of
them.
L
L
Summarising
I
guess
the
the
key
points
that
I
would
like
to
make
is
that,
while
this
is
a
good
bill,
we
would
encourage
you
to
amend
it
in
two
very
specific
ways.
Those
are
allowing
the
sale
of
tobacco
and
menthol
flavored
products,
regardless
of
nicotine
content
that
do
not
primarily
appeal
to
youth
and
I,
will
give
you
data
about
that
and
allowing
the
sale
of
vapor
products
that
have
received
pre-market
approval
from
the
Food
and
Drug
Administration.
L
The
voice
of
the
people
that
have
not
really
been
heard
here
are
the
current
smoke
adult
smokers
who
are
looking
for
ways
to
help
them
deal
with
their
addiction
I
fully
and
completely.
As
does
Reynolds
share
your
concern
about
youth
vaping.
No
youth
should
use
tobacco
products,
including
vaping
products,
but
these
two
very
modest
exceptions
to
this
ordinance
will
I
think
not
impair
the
activity
of
avoiding
youth
uptake
of
vaping
products.
L
Let
me
first
talk
to
the
menthol
issue.
National
data
confirms
that
youth
do
not
use
tobacco
or
menthol
vaping
flavors.
There
is
a
well-known
study
called
monitoring
the
future
that
tracks
this
over
time.
If
you
have
a
copy
of
my
printed
testimony,
you
will
see
a
chart
on
page
two
that
looks
at
the
flavor
choices
of
children.
You
will
note
that
a
very
miniscule
percentage
choose
to
use
menthol
Virginia
tobacco
or
tobacco
flavors.
These
are
reasonable
exceptions.
These
are
not
flavors
that
appeal
to
youth
and
we
certainly
endorse
your
activities
against
other
flavors
and
youth.
L
The
second
one
is
to
address
real
carefully
the
point
of
tobacco
harm
reduction,
being
sure
that
we
have
good
availability
of
these
products
for
current
smokers
to
move
from
cigarettes.
There
is
good
evidence
that
this
works.
The
the
National
Academy
of
Sciences
adore
TSA's,
this
concept,
public
health
England,
has,
as
as
previously
been
stated,
endorses
it.
The
FDA
endorses
this
as
an
opportunity
to
move
people
from
combustible
tobacco
to
a
safer
product,
not
completely
safe,
but
much
safer
product.
I
encourage
the
committee
to
to
consider
that
point
and
consider
the
needs
of
current
smokers.
L
The
other
one
that
I
want
to
address
is
the
the
concern
raised
about
lack
of
action
at
the
federal
level.
In
fact,
there
is
a
good
bit
of
action
going
on
right
now.
At
the
federal
level,
the
pre-market
approval
process,
known
as
pmta
is
alive
and
real.
All
current
vaping
products
that
are
on
the
market
must
submit
their
product
for
review
by
the
FDA
by
May
of
next
year.
A
scant
six
months
away.
L
Reynolds
has
already
submitted
that
for
our
product
and
despite
the
comment
that
there
is
no
evidence
to
support
this,
Reynolds
has
submitted
one
hundred
and
fifty
thousand
pages
of
testimony
studies
and
information
to
support
the
safety
of
this
product.
What
is
the
FDA
looking
at
specifically
to
achieve
this
approval?
Manufacturers
have
to
provide
extensive
and
persuasive
evidence
that
their
products
will
provide
a
harm
reduction
benefit
for
existing
smokers,
while
limiting
their
appeal
to
and
access
by,
youth.
The
exact
combination
of
policy
you're
looking
to
achieve.
L
So,
in
short,
I
would
ask
you
to
make
two
minor
modifications
to
this
otherwise
good
bill
and
allow
for
menthol
to
be
sold
at
retail,
where
it
is
where
they
are
checking
for
for
age
of
the
person
and
to
allow
that
that
products
that
are
approved
by
the
FDA
in
the
pre-market
process
continued
to
be
sold
at
retail
I'll.
Stop
there
and
sorry,
if
that
was
too
rushed,
but
I
tried
to
meet
your
request.
L
A
A
N
Since
then,
I've
been
pursuing
academic
research
on
the
issue
through
public
records
in
FOIA,
requests
and
I.
Think
it's
incredibly
important
to
question
how
we
got
to
this
situation
and
whether
or
not
this
legislation
can
completely
address
the
problem,
or
at
least
do
the
most-
that
the
Philadelphia
City
Council
is
able
to
with
it
within
your
power.
N
N
So
this
month
the
FDA
was
expected
to
introduce
a
federal
ban
on
flavored
e-cigarettes.
They
failed
to
do
so.
A
recent
Politico
article
said
it
was
because
President
president
Trump's
advisors
thought
it
was
going
to
harm
them
politically
and
it
had
nothing
to
do
with
public
health.
So,
at
a
moment
like
this,
it's
in
credit
important
that
the
Philadelphia
City,
Council
and
other
legislative
bodies
throughout
the
country
step
up
and
do
what
they
can
to
protect
the
nation's
children.
So
the
in
order
to
understand
this,
you
have
to
look
at
jewel.
N
Jewel
is
one
of
the
fastest
growing
companies
in
American
history.
It
reached
a
ten
billion
dollar
valuation
faster
than
Facebook,
and
in
2018
was
valued
at
thirty
eight
billion
dollars
after
Altria,
the
parent
company
of
Philip
Morris
invested
to
buy
a
third
of
the
company
and
during
that
period
of
time,
is
when
we
went
from
1.5
million
kids
to
more
than
5
million
former
FDA
Commissioner
Scott
Gottlieb
says
that
the
youth
vaping
epidemic
is
almost
entirely
attributed
to
Joule
and
their
flavored
products
tools.
N
Success
came
from
its
chief
innovation,
which
was
to
make
nicotine
more
potent
and
palatable
for
children.
If
you
look
at
joules
patent
literature,
you
can
see
that
the
product,
potentially
at
least
in
this
patent
it
hits
users
more
quickly
and
more
effectively
than
regular,
combustible
cigarettes
which
would
indicate
that
it's
more
addictive
in
one
study.
Sixty-Three
percent
of
kids
did
not
even
know
Joule
head
nicotine
in
it
in
all
flavors,
so
there
are
a
lot
of
kids
out
there
who
think
that
they're
just
inhaling
mango
vapor
and
that's
part
of
the
problem.
N
When
Joule
first
went
on
the
market,
they
didn't
even
have
nicotine
warnings.
Fda
Commissioner,
David
Kessler,
who,
in
the
90s
took
on
the
tobacco
industry,
has
written
that
tool
took
a
page
out
of
big
tobacco's
playbook.
For
example,
in
1972
Brown
&
Williamson
wrote
an
internal
memorandum
titled
youth
cigarette
new
concepts
in
which
they
found.
N
Having
stated
the
CEO,
particularly
James
Mon
sees
the
former
CEO
that
they
wanted
to
recreate
the
magic
and
luxury
of
the
tobacco
industry,
which
created
the
cigarette,
the
most
successful
consumer
product
of
all
time
in
the
eyes
of
mr.
Muncey's,
but
beyond
mere
words.
Big
Tobacco,
as
the
saying
goes,
Jules
imitation
of
big
tobacco
was
its
highest
form
of
flattery
beyond
those
words.
So
originally
speaking
of
Reynolds,
if
you
look
at
where
Jule
came
up
with
their
nicotine
salt
formulation,
it
was
from
tobacco
industry
documents
from
r.j.
N
Reynolds
from
1979,
so
the
founders
of
jewell
have
on
record
stated
that
they
were
digging
through
the
trove
of
tobacco
documents
that
came
out
of
the
master
settlement
agreement
when
they
came
up
with
the
product.
One
of
those
documents
that
came
out
of
an
FDA
FOIA
request
and
was
recently
reported
reported
in
FOIA
in
Reuters,
was
a
document
from
r.j.
Reynolds
showing
the
efficacy
of
nicotine
salts.
N
Jool
is
also
so
similar
to
Marlboro
or
was
system
their
marketing
and
branding
tomorrow,
bro
that
that
Philip
Morris
actually
sued
Joule
in
2015
for
trademark
infringement,
because
of
how
similar
their
design
was
even
the
name
jewel
resembles
cool
the
number-1
menthol
cigarette.
There's
no
question
that
this
company
was
trying
to
recreate
what
they
said
was
the
magic
and
luxury
of
big
tobacco,
but
there's
no
luxury
in
smoking.
Smoking
inflicts
addiction.
Addiction
is
the
opposite
of
choice
and
it's
a
disease.
N
What
I
would
like
to
raise
to
you
and
to
at
least
address,
are
the
arguments
for
harm
reduction
now
in
Philadelphia
we're
one
of
the
first
cities
in
the
nation
that
is,
that
is
considering
supervised
injection
sites
and,
and
we
recognize
that
harm
reduction
is,
is
an
area
of
policy
that
we
should
pursue
in
in
any
number
of
settings.
But
here's
the
problem.
N
Those
settings
are
not
driven
by
profit.
Tool
is
driven
by
profit
and
we
must
be
very
skeptical
of
any
proponents
of
harm-reduction
who
are
based
on
the
original
business
model
of
the
tobacco
industry,
which
was
addicting
children
and
hooking
them
for
life.
So,
if
we're
going
to
talk
about
harm
reduction,
it
has
to
be
in
a
different
framework.
It
can't
be
through
supporting
industry
policies
that
are
pushed
by
lobbyists,
I
really.
A
N
Think
Commissioner
Farley
did
a
great
job
at
covering
many
of
the
issues
related
to
the
regulation.
Last
point
that
I
would
make
is
that
the
FDA,
as
as
he
has
mentioned,
has
not
ruled
on
whether
or
not
these
these
products
are
appropriate
for
the
protection
of
public
health.
That
will
happen
after
May
20-22.
N
To
ban
these
products,
the
way
that
San,
Francisco
and
other
other
states
have
Montana
has
implemented
a
ban.
At
least
a
moratorium.
Massachusetts
has
done
so
this
very
much
to
me
does
feel
like
a
compromise
bill
and
it's
not
an
overstepping
any
boundaries
and
I'll
leave
it
at
that
and
take
questions.
Okay,.
B
L
B
B
L
Require
prescription
but
physicians,
the
council
patients
dealing
with
addictions
know
that
harm
reduction
is
a
not
as
an
alternative.
A
number
of
national
medical
bodies
have
supported
the
concept
that,
if
people
are
not
able
to
quit
either
on
their
own
or
with
traditional
nicotine
replacement
products,
the
tobacco
harm
reduction
is
a
reasonable
strategy
for
those
people
to
try,
as
is
a
safer
alternative
to
combustible.
B
A
A
A
O
Please
my
name
is
DEA
Joe,
Wilson,
hello.
Everybody
I
would
first
like
to
thank
chairman
best
and
members
of
the
committee
for
allowing
me
to
speak
today.
My
name
is
Diaz
Olson
and
I'm.
17
years
old
and
I
am
part
of
the
advocacy
Institute's
realtalk
tobacco
program
I'm.
Currently
in
the
12th
grade
and
over
my
years,
a
high
school
I've,
seen
such
a
difference
in
the
kids
I
think
when
I
first
started
off
as
a
freshman
I
had
never
even
heard
of
a
vape
pen.
O
Now
students
are
comfortable
enough
to
pull
out
their
jewel
as
soon
as
teachers
turn
their
heads,
I
can
remember
walking
into
the
bathroom
and
the
beginning
of
my
first
grade
and
I
would
have
thought
there
was
a
party
girl
or
something
there
was
a
fruity
fog
filling
the
air.
While
girls
sat
on
the
floor,
gossiping
and
trading
jewels,
there
were
so
many
people
in
the
bathroom
I
couldn't
even
get
to
a
stall.
Other
hanging
out
in
the
bathrooms
has
caused
people
to
struggle
academically.
O
She
is
16
and
addicted
to
something
she
thought
was
harmless,
not
only
that,
but
she
has
felt
almost
every
class
in
her
first
marking
period.
Some
schools
think
that
locking
the
bathrooms
would
be
the
best
thing
to
get
students
back
on
track,
but
what?
What
about
the
kids
that
simply
just
have
to
use
the
bathroom?
There
was
one
time
I'd
used
the
bathroom
to
change
my
tampon
and
I
couldn't
even
get
in,
because
my
school
doesn't
want
kids
to
go.
O
They
stand
out
to
the
youth
I
feel
like
there
won't
be
many
youth
tempted
to
use
these
products.
Nobody
wants
to
smoke
a
tobacco
flavor
vain
because
it
takes
the
curiosity
out
of
vaping.
Everybody
knows
that
cigarettes
or
tobacco
is
bad
for
you.
The
word
vape
is
an
allusion
to
the
harm
that
comes
from
using
the
products
and
all
the
different
flavors.
But
the
icing
on
the
cake,
one
jewel
pod,
has
just
just
as
much
nicotine
as
a
full
box
of
cigarettes.
O
P
Name
is
Nancy
Kurtz
I
am
the
assistant
superintendent
for
the
archdiocese
in
high
schools
as
educators.
Our
role
is
to
attend
to
the
whole
child.
We
concern
ourselves
with
the
person's
intellectual,
social
and
physical
development.
We
understand
the
deep
connection
among
the
three
the
programming
and
curriculum
in
both
elementary
and
secondary
schools.
Help
students
not
only
develop
their
intellectual
skills.
It
helps
them
develop
a
deep
appreciation
for
their
body,
mind
and
spirit.
P
At
one
time,
the
use
of
cigarettes
by
students
in
schools
throughout
the
archdiocese
was
a
persistent
problem
which
impacted
the
health
and
well-being
of
our
students
and
required
the
allocation
of
time
and
financial
resources
to
address
its
impact.
The
problem
was
all
but
eradicated
in
our
schools
due
to
a
combined
effort
that
included
education,
outreach,
community
support
and
legislation.
In
the
past
couple
of
years,
instances
of
student
vaping
in
schools
across
the
archdiocese
have
grown
exponentially.
P
We
at
the
Office
of
Catholic
education
first
became
aware
of
this
issue
in
March
of
2018.
When
students
were
caught
in
a
school
vaping
in
a
bathroom,
it
quickly
became
apparent
that
this
was
not
a
one
student
one
school
problem.
Although
the
prevalence
of
these
products
varies
throughout
the
Archdiocese,
there
is
not
one
school
whose
students
are
not
impacted
in
some
way.
We
once
again
find
ourselves
faced
with
a
nicotine
crisis
in
our
schools.
That
in
many
ways,
is
more
insidious
than
that
we
overcame
previously
with
cigarette
use.
P
The
design
and
concealability
of
the
e-cigarette
makes
them
difficult
to
detect.
Packaging
is
not
as
clearly
labeled.
Flavors
used
in
pods
are
highly
appealing
to
young
people.
The
sweet
candy
like
flavors
confuse
parents
and
students
about
what
is
actually
in
the
pods
they
are
buying.
Students
and
parents
are
often
unaware
of
the
presence
of
nicotine
or
of
the
true
amount
of
nicotine
present
in
the
pods
being
used.
Students
have
reported
becoming
addicted
to
vaping
without
awareness
that
they
are
even
consuming
an
addictive
substance.
One
such
student
attends
our
high
schools.
P
He
spent
almost
two
weeks
in
the
pediatric
intensive
care
unit
at
a
Titan
Hospital
for
children.
He
was
diagnosed
with
Numa
notice,
which
his
doctor
has
attributed
to
his
regular
use
of
a
vape
for
over
a
year.
This
healthy
athletic
teenager
believed
that
the
products
he
used,
mainly
fruit,
flavored,
were
not
harmful
and
his
life
was
forever
changed
because
of
it
once
again,
Kees
school
resources
are
being
diverted
to
combat
this
issue,
which
is
directly
impacting
the
health
and
well-being
of
our
students.
P
Schools
are
engaging
in
programs
from
Cora
and
Karen
to
offer
cessation
programs
and
other
support
for
students
who
are
already
engaging
in
e-cigarette
use
programs
through
the
Philadelphia
Department
of
Public
Health
and
other
entities
are
being
instituted
by
leaders
from
the
office
of
Catholic
education
to
local
school
principals,
to
educate
parents,
students
and
other
stakeholder
groups
on
the
dangers
of
the
use
of
e-cigarettes
by
children
and
teenagers
time.
Resources
are
being
dedicated
in
schools
to
monitor
student
behavior
in
an
effort
to
prevent
the
use
of
e-cigarettes
on
campuses.
P
Q
Hi
I'm
dr.
Brian
Jensen
I'm
a
practicing
primary
care
pediatrician
at
Children's,
Hospital,
Philadelphia
I'm,
also
a
researcher
based
at
University
of
Pennsylvania
I'm,
also
a
tobacco
treatment
experts
and
I.
Don't
work
for
a
tobacco
company,
so
I'm
here,
we've
had
great
testimony
from
my
colleagues
hearing
what's
happening
in
the
school
settings.
Let
me
kind
of
talk
about
what
we're
seeing
in
the
office
in
the
clinical
and
the
patient.
Experience
setting
and
I'll
be
brief.
Q
A
lot
of
people
have
already
hit
up
the
key
points
here
so
I'm
here
today
in
my
official
capacity
as
a
doctor
to
offer
my
expert
insight
as
someone
who
takes
care
of
children,
adolescents
and
young
adults
in
our
city.
So
this
group
can
have
the
best
evidence
available
to
them
on
this
critical
health
issue
of
the
epidemic
of
adolescent
vaping
in
the
East
cigarette
use.
Children,
as
we
all
know,
or
a
vulnerable
population,
and
my
job
as
a
pediatrician
is
to
protect
them
from
harm
and
dangerous
products.
These
cigarettes
are
clearly
dangerous.
Q
Their
use
puts
children
and
teenagers
at
risk
for
significant
harm
and
a
lifelong
struggle
with
nicotine
addiction
as
a
patrician
who
works
to
keep
kids
healthy
and
safe
I
find
the
details
of
e-cigarette
use.
Incredibly
disturbing
I
see
patients
who
are
so
addicted
to
these
products
that
they
can't
pay
attention
in
school.
Further.
This
addiction
is
limiting
their
ability
to
participate
in
sports
and
concentrate
on
other
activities.
This
addiction
causes
dramatic
changes
in
teenagers,
moods,
impacting
their
relationships
with
their
family
and
friends.
Q
Almost
daily
I
receive
questions
from
parents,
teachers,
school
nurses,
pediatricians
and
patients
about
how
can
we
best
help
teens
that
are
addicted
to
nicotine
and
help
protect
teens
from
these
essentially
unregulated
products?
So
we've
talked
on
some
of
these
points
before
originally
market
to
help
adults
quit
smoking
a
claim
with
actual
little
evidence
to
back
it
up.
These
cigarettes
have
been
particularly
appealing
to
youth
because
of
their
discreet
designs
and
sweet
and
fruity
flavors.
Q
In
fact,
almost
all
youth
who
they
abuse,
flavored
cigarettes
and
here's
an
important
point,
and
while
more
than
25%
of
high
school
students,
regular
use
e-cigarettes
fewer
than
5%
of
adults
actually
use.
These
products-
this
is
a
teenage
use
issue.
Teen
patients
often
tell
me
they're
only
vaping
flavors,
not
realizing
that
they're
being
misled
as
to
actually
what
is
in
the
products
in
reality,
ease
cigarettes.
Solutions
contain
numerous
harmful
toxicants
and
cancer-causing
chemicals.
Just
like
traditional
cigarette.
Also,
the
nicotine
concentration.
Q
Some
products
is
incredibly
high,
with
Venu
VAE
pods
continuing
the
same
amount
of
nicotine
as
an
entire
pack
of
cigarettes,
as
we've
already
heard
from
more
importantly,
the
teenage
patient
that
I
see
my
practice
they're
telling
me
they're
using
multiple
pots
a
day
they're
coming
into
the
office
with
signs
of
acute
nicotine
toxicity
shaking
their
hands.
All
this
nicotine
exposure
by
teens
rewires
they're,
developing
brain
increasing
the
risk
of
addiction
to
other
nicotine
products.
Q
That's
why
so
many
studies
keep
finding
the
same
results
adolescence
and
young
adults
who
use
e-cigarettes
are
at
four
times
increased
risk
of
becoming
traditional
cigarette
smokers.
The
SI
saket
use
makes
it
easier
for
teenagers
to
develop
a
lifelong
addiction
that
we
know
kills
half
its
long-term
users.
You
have
even
the
face
of
a
growing
epidemic.
These
products
lack
the
regulation
needed
to
adequately
protect
children
teens.
Currently,
u.s.
Q
federal
laws
and
regulations
do
not
restrict
the
advertising
of
e-cigarettes
to
consumers,
nor
do
they
address
the
need
for
the
safety
testing
these
products
without
a
ban
on
all
flavored
e-cigarettes
flavors
that
we
know
lead
to
youth
experimentation
and
addiction
are
available
in
market
to
youth.
In
the
absence
of
strong
and
effective
federal
regulation,
local
action
is
needed.
We
must
take
action
now
to
protect
the
gains
we
have
made
in
reducing
youth.
Nicotine
use
and
coordination
is
the
key
to
our
success.
Q
In
the
1970s
80s,
potentially
up
to
40%
of
high
school
students
were
regularly
using
cigarettes
were
down
to
fewer
than
10%,
but
we've
seen
a
dramatic
rise
in
e-cigarettes
during
my
time
in
clinical
practice.
Over
the
last
15
years.
With
the
recent
legislation
introduced
by
City
Council,
we
have
the
opportunity
to
take
action
to
ban
flavors
in
cigarettes
and
restrict
sales
of
high
nicotine
products
in
Philadelphia.
We
need
more
research
to
help
teen
e-cigarette
users
quit,
but
preventing
youth
use
in
the
first
place
should
be
our
primary
goal.
Q
Prevention
works
the
country's
leading
medical
health
and
abbacy
groups
from
the
American
Academy
of
Pediatrics,
of
which
I'm
a
member
to
the
American
Cancer
Society
all
agree
that
flavored
East
cigarette
and
tobacco
products
are
made
for
the
purpose
of
attracting
kids
and
few
in
the
addiction
of
a
new
generation
of
lifelong
nicotine
users.
We
can
no
longer
afford
to
wait
as
children
and
adolescents
pay
the
ultimate
price.
Again.
Thank
you
for
opportunity
to
speak
with
you
today,
I'm
happy
to
answer
any
questions.
After.
R
R
So
in
a
products,
although
not
as
much
as
we
used
to
that
goes
across
the
border.
That's
a
black
market
in
Philadelphia
now,
as
well
as
a
lot
of
cigarette
products
that
are
a
black
market,
because
the
taxes
that
we
imposed
about
five
years
ago,
so
a
merely
here
to
say
that
I
do
support
my
community
I
believe
in
legal
products.
R
I
know
for
Philadelphia
County
to
come
up
with
more
money
to
help
the
city
I'm
in
the
25th
district
in
Philadelphia
County,
through
a
lot
of
work
with
the
police
in
25th
district
do
a
lot
of
fundraisers
for
them.
We
just
did
their
Halloween
party
at
lighthouse.
Lighthouse
field
gave
out
tons
of
candy
to
the
kids
in
the
community.
We
also
do
their
carnival,
which
is
done,
which
has
gotten
big,
which
is
done
in
the
largest
heroin.
R
You
know,
drug
part
of
the
city
and
I
commend
them
on
the
work
they
do,
but
what
I
also
see
in
Philadelphia
is
blocks
and
blocks
and
neighborhoods
that
have
no
stores
left,
because
they
have
no
products
to
sell
everything's,
regulated
and
I
guess
what
gets
me
is
I
know
the
products
are
being
bought
in
other
counties
or
shipped
to
other
counties
or
brought
in
to
other
states
and
I.
Think
that
all
we're
proposing
here
today
and
I
don't
want
to
take
up
too
much
more
time,
because
you
guys
have
been
very
patient.
R
We
believe
in
21
for
this
vape
product.
We
don't
want
it
in
the
hands
of
children.
We've
we've
made
a
amendment
to
have
the
product
be
a
scannable
product
and
I,
get
that
there's
been
a
lot
of
talk
about
the
retail
community
and
listen
these
people.
These
stores,
these
supermarkets,
these
bodegas,
these
convenience
stores
gas
and
goes
I,
mean
they
supply
products
that
people
buy
and
they
have
a
right
to
supply
them
properly.
You
know,
and
the
city
or
the
state
has
the
right,
and
the
federal
government
has
a
right
to
police
them.
R
If
they
don't
do
the
job
properly,
I
mean
I,
can't
defend
a
retail
store
that
sells
a
product
to
an
underage
youth,
I
mean
I,
think
it's
crazy,
I,
don't
understand
it,
but
I
also
think
the
city
should
allow
that
to
happen,
or
the
state
should
allow
that
to
happen.
So
we've
put
in
amendment
that
doesn't
call
for
a
bit
and
flavors
get
rid
of
them.
I
mean
mango
cherry
banana.
R
Whatever
it
is
tobacco
and
menthol,
or
products
that
adults
use,
we
can
all
say
that
they
don't
and
I
can
the
doctors
and
lawyers
state
facts.
I,
don't
agree
with
all
those
facts
have
been
in
this.
This
consumer
goods
business
for
a
long
time
so
I've
heard
a
lot
of
things
thrown
out
that
that
I
I
know
aren't
true.
So
a
lot
of
a
lot
of
adults
use
menthol
products
and
tobacco
products,
and,
quite
honestly,
if
an
adult
is
a
vapor,
you
know
and
he's
getting
off
of
combustible
cigarettes.
R
R
K
K
K
A
The
bill
has
been
moved
and
properly
seconded
that
bill
number
one:
nine
zero,
seven
one
five
be
reported
from
this
committee
with
a
favorable
recommendation
and
further
move
that
the
rules
of
council
be
suspended
to
permit
first
reading
of
this
bill
at
the
next
session
of
council.
All
a
favor
will
of
this
motion
will
signify
by
saying
aye
hi
any
opposed.
Okay,
the
eyes
have
it,
and
the
motion
carries
and
bill
number
one:
nine
zero.
A
K
G
K
A
Second,
it
has
been
moved
and
properly
seconded
that
the
amendment
to
bill
number
one,
nine,
zero,
seven,
eight
eight
be
approved.
All
those
in
favor
of
the
motion
will
signify
by
saying
aye
any
opposed,
no
okay,
the
eyes
have
it
and
the
motion
carries
and
the
amendment
to
bill
number
one:
nine
zero,
seven
eight
eight
has
been
approved
and
I
want
to
recognize
council
member
Greenlee
for
a
motion
on
bill
number,
one:
nine,
zero,
seven,
eight
eight
as
amended.
Thank.
K
A
Okay,
it's
been
moved
and
properly
seconded
that
bill
number
one:
nine
zero,
seven
eight
eight
as
amended,
be
reported
from
this
committee
with
a
favorable
recommendation
and
for
further
move
that
the
rules
of
council
be
suspended
to
permit
first
reading
of
this
bill
at
the
next
session
of
council.
All
those
in
favor
of
the
motion
will
signify
by
saying
aye
aye
any
opposed,
no
okay,
the
eyes
have
it
and
the
motion
carries
and
bill
number
one.
A
A
K
You
ma'am
chair,
I,
appreciate,
counsel
and
Reynolds
Brown
offer
an
amendment
try
to
find
a
compromise
here,
as
I
see
it
earlier,
I
believe
dis
bill
as
it
states.
It's
a
compromise,
I
think
the
best
solution
to
this
problem
and
is
a
serious
problem,
is
to
keep
kids
away
from
this
product
and
keep
the
product
away
from
the
kids
and
I
think
this
bill
has
been
well
thought
out
and
I
think
it
should
remain
in
its
present
form
and
with
all
so
I
respectfully
would
ask
that
this.
The
amendment
that
was
offered
be
declined.
A
Thank
You
councilman,
okay,
so
the
bill
has
been
or
the
the
amendment
has
been
offered
and
seconded
all
in
favor
of
the
amendment,
please
say:
aye
those
opposed
no
okay.
The
motion
has
not
been
approved
and
so
I
want
to
recognize
councilman
Greenlee
for
a
motion
on
the
bill
as
presented
one
nine,
zero,
eight,
zero.
Four
thank.
K
A
The
it's
been
moved
and
properly
seconded
that
bill
number
one:
nine
zero,
eight
zero.
Four.
We
reported
from
this
committee
with
a
favorable
recommendation
and
further
move
that
the
rules
of
Kemp
Council
be
suspended
to
permit
first
reading
of
this
bill
at
the
next
session
of
council.
All
those
in
favor
of
the
motion
will
signify
by
saying
aye
aye
those
opposed
the
eyes
have
it
in
the
motion
carries
bill
number
one:
nine,
zero.
A
Eight
zero
four
will
be
reported
from
this
committee
with
a
favorable
recommendation,
with
a
request
that
the
rules
of
council
be
suspended
to
permit
first
reading
at
the
next
session
of
council.
That
concludes
the
business
of
this
Committee
on
Public,
Health
and
Human
Services
for
today.
Thank
you
all
very
much
for
your
attendance
and
patience.
Thank
you.