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From YouTube: Committee on Public Health and Human Services 12-2-2019
Description
The Committee on Public Health and Human Services of the Council of the City of Philadelphia held a Public Hearing on Monday, December 2, 2019, at 9:00 AM, in Room 400, City Hall, to hear testimony on the following item:
190864 An Ordinance amending Title 6 of The Philadelphia Code, entitled “Health Code,” by amending Chapter 6 200, entitled “Preventive Medicine,” to require the reporting of information related to substance use treatment, drug overdose treatment, and related information, to the Department of Public Health, 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 item.
A
Good
morning
this
is
a
committee
hearing
on
the
Committee
on
Public,
Health
and
Human
Services.
The
purpose
of
this
hearing
is
to
hear
testimony
on
bill
number
one:
nine,
zero,
eight
six
four.
We
have
established
a
quorum
with
us
today,
our
councilmembers
Maria
quinones,
Sanchez
councilman
bill
Greenlee
and
Councilman
Alan
DOM,
and
if
we
could
have
the
clerk
now
read
the
title
of
the
bill
and
we'll
have
the
first
witnesses
come
forward.
A
B
A
C
You,
madam
chair
and
other
members
of
the
Public
Health
and
Human
Services
Committee,
for
discussing
this
bill
today.
As
we
all
know,
the
city
of
Philadelphia
has
been
combating
the
opioid
crisis
from
several
fronts.
Many
members
of
this
committee,
as
well
as
other
city
hall
colleagues,
have
provided
effective
solutions
that
have
helped
reduce
opioid
related
deaths
by
eight
percent
last
year
and,
as
we
all
know,
this
decline
is
nowhere
near
where
we
need
to
be,
and
there
is
still
much
more
work.
That
needs
to
be
done.
C
However,
in
order
for
us
to
understand
the
magnitude
of
what
we
are
truly
faced
with,
we
must
realize
the
full
scale
of
those
impacted
the
bill
I've
introduced
today
will
require
drug
overdose
reporting
to
the
city's
Health
Department.
It
includes
the
following
requires
each
emergency
room
or
department
that
treats
one
or
more
persons
for
a
drug
overdose
or
for
symptoms
of
withdrawal
as
a
result
of
drug
use.
It
provides
quarterly
reports
to
the
city's
Health
Department,
including
aggregated
information
on
all
such
occurrences,
and
the
description
of
substance
use
disorder,
treatment
resources.
C
The
emergency
department
provides
to
such
patients.
The
health
commissioner
cells
shall
submit
on
a
quarterly
basis
a
written
report
to
City
Council,
stated
a
number
of
emergency
rooms
and
departments
that
have
submitted
reports
to
the
health
department
and
any
emergency
room
or
department
that
violates
these
provisions
will
be
subject
to
applicable
penalties
imposed
under
the
city's
health
code.
I
want
to
thank
our
health
commissioner,
dr.
Farley
for
testifying
today,
as
well
as
the
work
he
has
put
into
combating
this
crisis
also
want
to
thank
dr.
C
D
This
is
fun
all
right.
Good
morning,
chairperson
bastion
members
of
the
Public
Health
and
Human
Services
Committee
I'm,
dr.
Thomas
Farley
health
commissioner
for
Philadelphia
bill
number,
one,
nine,
zero,
eight,
six,
four
sponsored
by
council
person
Tom,
would
require
hospitals
to
report
aggregate
data
to
the
Health
Department
on
how
they
manage
patients
seen
in
their
emergency
departments
who
experience
drug
overdose.
We
support
this
bill
because
having
this
data
has
the
potential
to
increase
the
number
of
people
with
opioid
addiction
who
begin
treatment
and
reduced
a
number
who
died
of
drug
overdoses.
D
As
you
know,
Philadelphia
has
been
hit
particularly
hard
by
the
national
crisis
of
opioid
use,
addiction
and
overdose.
More
than
1,100
people
have
died
of
drug
overdose
in
each
of
the
last
two
years,
giving
Philadelphia
the
highest
overdose
mortality
rate
by
far
of
any
large
city
in
the
nation.
In
addition,
the
city's
hospital
emergency
departments
have
had
more
than
8,000
patient
visits
for
non-fatal
drug
overdose
in
each
of
the
last
two
years.
If
these
patients
enter
drug
treatment,
particularly
medication
assisted
treatment,
their
risk
of
fatal
overdose
Falls
substantially.
D
That
means
that
each
of
these
overdose
visits
represents
an
opportunity
to
save
the
life
of
a
person
who's
at
very
high
risk
of
dying.
Several
initiatives
are
underway
to
help
patients
seen
in
emergency
departments
who
have
experienced
drug
overdoses.
The
Department
of
Behavioral,
Health
and
intellectual
disability
services
supports
peer
recovery
specialists
who
work
at
Temple
and
Episcopal
hospitals
to
counsel
these
patients
and
connect
them
to
care.
Dbh
is
also
considering
additional
support
to
other
hospital
emergency
departments
for
similar
warm
handoff
programs.
D
The
state
medical
assistance
office
provides
incentive
funding
to
hospitals
tied
to
the
in
part
to
the
percentage
of
these
patients
who
enter
drug
treatment.
After
that
emergency
department
visit
in
response
to
this
and
on
their
own
initiative,
hospitals
are
setting
up
systems
both
to
help
these
patients
enter
drug
treatment
and
to
initiate
treatment
with
buprenorphine
on-site.
D
Pennsylvania
law
regarding
confidentiality
of
drug
treatment
records
has
been
interpreted
as
prohibiting
the
reporting
of
the
names
of
people
experiencing
non-fatal
overdoses
to
the
Department
of
Public
Health,
we're
working
to
change
that
law,
but
we're
not
likely
to
accomplish
that
soon.
In
the
meantime,
it
would
still
be
valuable
to
us
to
have
aggregate
data
on
the
management
of
patients
seen
in
hospitals
for
drug
overdose,
billed
number
one
nine
zero.
Eight
six
four
would
require
hospital
emergency
departments
to
report
to
the
Department
of
Public
Health
on
a
quarterly
basis.
D
The
number
patients
seen
for
drug
overdoses,
the
number
of
those
who
are
assisted
for
the
drug
addiction,
while
in
the
hospital
the
number
scheduled
for
initial
appointments
with
substance
use,
treatment
providers
and
the
number
given
take-home
doses
of
naloxone.
This
information
will
be
very
useful
in
two
ways.
First,
it
would
enable
the
Department
of
Public
Health
to
monitor
progress
by
hospitals
in
helping
these
patients
so
that
we
can
direct
our
assistance
to
the
hospitals
who
need
it.
D
A
E
Morning,
chairman
bass
and
members
of
the
Committee
on
Public
Health
and
Human
Services,
my
name
is
dr.
Virginia,
colega
and
I'm.
The
vice
president
for
medical
affairs
at
independence,
Blue
Cross
I
appreciate
the
opportunity
to
testify,
in
support
of
bill
number
one:
nine
zero,
a
six
4
which
will
authorize
the
health
department
to
collect
additional
information
from
local
hospitals
regarding
the
interventions
and
outcomes
associated
with
non-fatal
opioid
overdoses
occurring
in
the
city.
E
Before
discussing
the
merits
of
the
bill
in
more
detail,
it
would
be
helpful,
I
think,
to
first
walk
through
some
of
the
proactive
actions
that
independence
has
taken
to
address.
This
crisis
will
focus
on
three
activities
that
independence
has
done
to
address.
The
opioid
crisis,
first
and
foremost,
is
changing
physician
prescribing
habits
working
with
our
providers
and
medical
partners.
Independence
has
seen
a
46
percent
reduction
and
the
number
of
members
prescribed
opioids
over
the
last
four
years.
E
Secondly,
we've
improved
treatment
options.
Independence
has
removed
cost-sharing
for
certain
forms
of
naloxone
and
has
lifted
prior
authorization
requirements
for
members
seeking
medication
assisted
therapy.
It's
not
only
the
right
thing
to
do,
but
getting
our
members
with
substance,
abuse
substance
use
disorder
into
evidence
based
treatment
is
a
sound
strategy
for
containing
health
care
costs.
We
have
done
analysis
and
know
that
an
independent
member
with
unaddressed,
untreated
substance
use
disorder,
con
utilizes
about
$10,000,
more
in
health
care
services
than
a
member
with
substance
use
disorder
who
receives
m80
such
as
buprenorphine
or
naltrexone.
E
And
thirdly,
we've
supported
our
community
efforts
on
awareness
and
education.
The
independence
Blue
Cross
Foundation
has
awarded
more
than
two
million
dollars
in
grants
to
national
and
local
nonprofits
that
provide
community-based
treatment
and
prevention
programs
throughout
Southeast
Pennsylvania.
This
has
included
our
regional
D
stigmatization
campaign
called
someone
you
know,
as
well
as
innovative
research
into
warm
Hospital
warm
handoff
best
practices,
which
is
the
subject
of
today's
hearing
bill
number
one:
nine,
zero.
E
Eight
six
four
will
ensure
that
the
Health
Department
has
greater
insights
into
warm
handoff
programs
in
the
city,
providing
more
information
on
a
continuous
basis
regarding
how
well
local
hospitals
are
transitioning
overdose
survivors
into
treatment.
This
will
provide
the
department
and
other
city
agencies
with
actionable
information
regarding
how
best
to
allocate
treatment
funding
related
to
these
protocols.
E
Our
Foundation
has
seen
this
type
of
collaborative
work
firsthand
in
Bucks
County
in
2017.
The
Foundation
commissioned
a
study
with
the
Bucks
County
Health
improvement
partnership
to
examine
emergency
department,
warm
handoff
outcomes
in
local
hospitals,
which
included
the
same
types
of
data
sharing
contemplated
in
bill
number
one:
nine,
zero,
eight
six,
four:
the
report
identified
high
performing
facilities
and
a
series
of
best
practice
recommendations
based
on
qualitative
research.
Many
of
these
recommendations
are
now
being
implemented
thanks
to
a
six
hundred
and
fifty
thousand
dollar
grant
awarded
by
the
pennsylvania
department
of
drug
and
alcohol
programs.
E
In
july
of
this
year,
the
foundation
is
now
funding
a
second
study
to
determine
the
impact
of
the
best
practices
being
implemented,
and
we
are
optimistic
that
we
will
see
even
greater
results.
This
type
of
coordination
is
needed
in
the
city
because
we
know
that
many
local
health
systems
are
already
doing
great
work.
For
example,
Penn
Center
for
opioid
recovery
and
engagement
is
showing
great
promise
using
an
app-based
machine
learning
technology
to
enable
more
timely
interventions
by
clinicians.
E
They
are
seeing
marked
improvements
in
getting
patients,
immediate
access
to
ma
T
in
the
emergency
department
and
a
considerable
reduction
readmissions
in
total
they
calculate
that
they
may
have
prevented
as
many
as
a
hundred
and
eighty
seven
overdoses
since
the
program
to
start
disseminating
best
practices
in
building
on
these
successes
can
help
the
city
leverage,
additional
federal
and
state
funds
that
remain
available
for
deployment.
In
short,
we
can
save
more
lives
if
we
continue
to
work
together.
E
A
You
for
your
testimony,
thank
you.
Both
come
Oni
and
the
one
question
I
had
was
that
you
know
this
is
a
good
thing.
You
know
I
thank
the
sponsor
of
the
bill.
I
think
that
this
is
something
that's
you
know
very
obvious,
but
also
a
bit
disconcerting
that
we
aren't
already.
We
don't
already
have
this
process
or
this
policy
in
place
at
our
local
hospitals
that
these
kind
of
measures
aren't
already
being
taken.
Can
you
tell
us
what
are
the
reporting
requirements
now
from
hospitals
here
in
Philadelphia
the.
D
We
would
like
the
hospital
to
report
by
name
people
who
come
in
with
non
fatal
overdoses,
but
again
the
state
law
that
requiring
the
confidentiality
subsidies
treatment
records
has
been
interpreted,
that
we
can't
get
that
reporting.
So
we
get
data
a
daily
basis
of
everything
everything
seen
in
the
emergency
department.
That's
de-identified,
so
I
can
tell
you
how
many
people
came
in
in
the
last
24
hours
for
non
fatal
drug
overdose,
I,
don't
anything
else
about
them.
D
Besides
that,
just
that
that
raw
number
and
most
important
for
this
bill,
we
don't
know
what
happens
after
that,
Frank
and
and
we
we
have
been
working
with
hospitals
as
independence.
Blue
Cross
has
to
try
to
improve
their
warm
handoff
programs
and
we
hear
a
lot
of
individual
cases
where
they're
really
making
progress,
but
we
don't
have
any
hard
data
on
how
extensive
that
progress
is,
and
we
feel
like
there's
more
ways
to
go
so
having
some
hard
numbers
and
that
would
really
be
helpful.
Okay,
very.
A
Good
yeah
I
think
that
there
was
always
the
assumption,
but
we
shouldn't
assume
all,
but
always
the
assumption
that
someone
comes
in
with
a
non
fatal
overdose
and
they
are
then
you
know,
recommended
or
referred
or
transferred
to
some
sort
of
a
treatment
program
or
some
some
opportunity
to
be
able
to
get
themselves
clean
and
to
not
really
have
that
information
or
to
not
know
if
that's
actually
happening.
You
know
it's
just
a
glaring
omission.
You
know
that
that's
been
happening
for
quite
some
time
so
again,
I.
F
Good
morning,
thank
you,
madam
chair,
and
thank
you
to
the
bill.
Sponsor
I
appreciate,
councilman
Dom's
work
in
this
area
and
all
the
time
that
he
has
spent
with
us
in
Kensington
and
some
of
the
work
that
we're
doing
citywide
we're
for
dr.
Farley.
Can
you
walk
me
through
because
one
of
the
things
is
we
do
have
some
of
the
emergency
room,
hospitals
and
hospitals
per
se
who
have
internal
treatment
programs?
How
will
this
reporting
help
us
determine
who
they
referring
to
for
the
purposes
of
what
you're
saying
the
continuum
care
piece?
D
This
is
written
right
now.
My
understanding
is,
it
would
just
say
whether
they've
gone
to
a
treatment
provider.
We
wouldn't
say
what
treatment
provider
they
went
to
now.
The
hospitals
that
have
their
own
treatment
programs
is
going
to
be
easier
for
them
to
get
into
that
treatment,
but
the
sheer
number
of
people
coming
into
the
emergency
departments
means
they're.
Gonna
have
to
use
other
treatment
providers
as
well.
So
this
will
I
hope,
push
them
to
developing
closer
relationships
with
these
external
treatment
providers
so
that
they
could
use
all
those
resources
in.
F
D
The
reimbursement
would
come
from
the
Medicaid
program,
which
is
that
actually
Medicaid
managed
care
organizations,
I
I,
don't
know
additional
requirements,
you'd
be
interested
in
I,
know
the
and
the
substance
use
treatment.
Confidentiality
law
is
a
big
barrier
to
the
sharing
of
information.
Here.
The
opioid
crisis
has
brought
to
light
the
fact
that,
because
of
that,
regular
medical
providers
and
substitutes
treatment
providers
really
can't
coordinate
care.
It's
a
big
problem
on
from
my
perspective,
so
I'm
not
sure
what
else
we
could
do.
F
I'm
just
thinking
if
the
hospital
is
requesting
reimbursement
or
if
the
treatment
provider
is
requesting
reimbursement
from
our
managed
care
from
someone,
is
there
a
additional
way
that
we
can
track?
Some
of
that,
while
you
work
what
is
happening
at
the
state
with
the
amendments
of
those
laws,
I
mean
you
know,
we
hear
that
they
are
committed
to
this
way
through
a
challenge.
F
D
Know
I
have
not
heard
opposition
to
these.
You
know
law
changing
laws.
It
would
allow
us
to
get
some
of
this
information.
I.
Take
it
back.
There
was
opposition
from
people
who
care
a
lot
about
confidentiality,
substance
use
treatment.
We
all
know
where
that
comes
from.
We,
nobody
wants
their
information,
they
have
a
drug
use
problem
to
become
public.
On
the
other
hand,
the
state
law
is
so
restrictive
that
it
has
really
prevented
people
from
helping
those
in
need.
F
It
for
IBC
I
want
to
thank
you
for
the
someone
you
know
campaign
I
was
there
at
the
launch
and
really
appreciated
the
faces
behind
the
numbers.
I
talk
about
that
a
lot
right
and
how
many
funerals
have
we
gone
to
and
how
many
people
we
know
that
our
impact
is
so
I
appreciate
that
from
the
insurance
perspective,
as
we
work
through
some
of
these
modifications
at
the
state
law,
where,
whereas
IBC
going
to
be
on
it,
are
we
gonna
get
support
from
the
insurance
industry
around
some
of
this
hit
book
changes
so.
E
Thank
you
for
the
question.
Yes,
we
are
supportive
because
the
current
state
laws
are
actually
more
restrictive
even
than
HIPAA,
so
we
have
been
speaking
to
folks
in
Harrisburg
legislators
and
others
about
the
need
for
the
change
to
the
state
laws
as
well
as
what
would
be
important.
Also
I
think
for
insurers
would
be
access
to
information
in
the
PDMP.
E
So
knowing
you
know
so
what
happens
sometimes
is
people
will
pay
cash
or
opioids,
and
we
have
that
in
our
claim
system,
and
so
we
can't
always
understand
who
is
at
risk
and
who
might
benefit
from
outreach
and
treatment.
So
one
of
our
other
areas
that
we
are
focused
on
is
trying
to
level
the
playing
field
so
to
speak
and
to
have
access
to
the
p.m.
PDMP
as
well.
A
questioning.
F
Yeah,
we
all
are
anxiously
a
wait
for
that
system
to
really
work
at
the
state
level
and
I
know
it's
had
some
leadership
challenges
and
they're
going
through
some
modifications.
What
have
you
done
around
the
third-party
billing,
which
has
become
another
loophole
that
people
use
to
access
opioids?
So
do
you,
as
as
a
main
insurer
allowed
their
party
billing
for
patients
in
your
plan?
F
F
Oh
I
have
doctors
that
setup
we're
not
direct
bill
bill
to
you,
but
may
be
working
through
another
doctor
or
another
healthcare
provider,
and
they
provide
the
opioids
in
that
and
then
bill
to
a
main
medical
facility
or
for
something.
Are
you
aware
around
some
of
that
and
what,
if
anything,
has
has
IBC
done
to
close
that
loop?
So.
E
We
would
look
for,
through
our
claims,
to
the
extent
that
claims
are
being
filed.
We
would
look
for
aberrant
patterns
in
our
pharmacy
claims,
predominantly
there
and
work
with
our
our
CF
ID
our
fraud
unit
to
look
and
investigate
further
if
there
are
a
baron
patterns
and
what
the
cause
of
those
aberrant
patterns
are,
and
we
have
a
very
active
group
that
works
both
with
law
enforcement
regionally
as
well
as
federally.
If
we
see
aberrant
patterns.
Thank.
C
You,
madam
chair,
and
thank
you
both
for
your
testimony
today,
thanks
for
your
assistance
and
I
also
wanted
to
acknowledge
councilman
Greenlee
who's,
a
co-sponsor
of
this
bill,
and
it's
really
the
idea
of
this
came
from
Councilman
Greenlee.
He
gave
a
very
and
passion
speech
in
the
spring
on
the
floor
of
this
council.
That
drove
me
to
try
to
find
a
way
to
maybe
help
this
situation.
I
know
he
had
a
stronger
bill.
That
well
did
not
pass,
but
this
is
really
because
of
his
speech.
His
mentorship
on
this
and
I
hope
him.
C
A
lot
of
credit
for
this,
so
I
just
want
them
publicly
acknowledge
that.
Secondly,
I
had
another
thought
is
one
of
the
ask
dr.
Cole
ago.
You
know
we
have
we're
number
one
in
the
world
in
gene
therapy,
Muniz
ation
and
gene
therapy
at
the
University
of
Penn
and
we've
come
up
with
several
cures
that
no
one
else
in
the
world
has
come
up
with
whether
it's
pediatric
leukemia
cure
dr.
Cole,
June
and
Penn's.
C
E
So
that's
a
great
question.
I
am
not
personally
aware
if
Penn
is
working
on
that,
but
that
does
not
mean
that
they
could
not
be
working
on
it
and
I.
Think
given
recent
advances
with
CRISPR
technology,
that
the
sky
is
the
limit
at
this
point
in
time,
but
I
am
not
personally
aware
of
anything
that
Penn
is
doing
because
in.
E
That's
that's
a
very
interesting
concept.
I
think
it
gets
to
the
biology
of
addiction.
There
are
other
multifactorial
issues,
especially
when
you
talked
about
social
determinants
of
health
that
may
also
impact
in
underlying
mental
health
conditions.
That
would
also
need
to
be
treated
in
addition
to
the
substance,
abuse
disorder,
okay,.
A
Thank
you
very
much.
Is
there
anyone
else
here
to
testify?
There's
no
other
questions
from
the
panel.
So
thank
you
so
much
for
being
here
for
your
testimony
and
is
there
anyone
else
in
the
audience
here
to
testify
Arina,
maybe
okay,
so
if
there's
no
one
else
to
testify.
That
concludes
this
hearing
or
bill
number
one:
nine,
zero.
Eight
six
four
well
now
go
out
to
a
public
hearing
public
public
meeting
on
bill
number
one:
nine,
zero,
eight,
six,
four
and
I
want
to
recognize
councilman
bill,
green
leaf
or
motion.
G
A
Been
moved
and
properly
seconded
the
bill
be
moved
out
of
Council
out
out
of
this
committee
with
a
favorable
recommendation
all
in
favor
any
opposed,
and
that
we
would
have
a
suspension
of
the
rules
bill
number
one:
nine,
zero.
Eight
six
four
would
be
approved
with
a
suspension
of
the
rules
and
reported
from
this
committee
with
a
favorable
recommendation.
Actually,
let's
do
that
again.
Let's
do
that
one
more
time.
Yes,
he
would
just
do
that.
One
more
time,
Adam
chair.
G
A
Been
moved
and
properly
seconded
that
bill
number
bill
number
one:
nine,
zero,
eight
six
four
be
reported
from
this
committee
with
a
favorable
recommendation
and
a
rule
suspension,
and
it
will
be
read
into
the
record
at
the
next
session
of
council,
and
that
being
said,
that
concludes
the
business
of
this
committee.
Thank
you.
Thank
you.
Thank
you.
Everyone
for
attending.