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(1) Since 1929 a variety of studies, starting with the Philadelphia Hospital and Health Survey, have called for the creation and maintenance of a network of neighborhood-based health centers to serve the citizens of Philadelphia.
(2) Responding to and acknowledging the need for such District Health Centers, the Philadelphia Home Rule Charter, Section 5-300, establishes the clear and ongoing responsibility of the City to "establish, maintain and operate District Health Centers, stations and clinics, laboratories and other health facilities."
(3) In the 1960's the City met this commitment by constructing District Health Centers in virtually every City Council District.
(4) These District Health Centers provide traditional public health services and comprehensive primary health care to all Philadelphians who seek these services. The District Health Centers guarantee to residents of Philadelphia that health care is a right and not a privilege reserved to those who can afford to pay. They have brought quality health care to all our neighborhoods and are the backbone of public health protection in Philadelphia.
(5) As of Fiscal Year 1990, one hundred thirteen thousand (113,000) individuals, seven percent (7%) of the population of Philadelphia, used services provided at the District Health Centers. These persons made over three hundred twenty-three thousand (323,000) patient visits to the District Health Centers.
(6) The District Health Centers welcome medically underserved persons into early, continuous and preventive health care, and provide such care in reference solely to medical criteria without reference to financial criteria. Persons using the District Health Centers are a vulnerable population. In Fiscal Year 1990, eighty-eight thousand three hundred (88,300) of the people who used the district health centers either had incomes at or below the poverty level. In that same year more than seventy-two thousand six hundred (72,600) of District Health Center patients had no health care insurance and an additional twenty-six thousand three hundred (26,300) rely on Medicare and/or Medicaid. The persons using the District Health Centers are poorer than most Philadelphians and have far less access to health services. They are six (6) times more likely to be uninsured than the rest of the Philadelphia population.
(7) The Family Medical Care Program in the District Health Centers not only saves lives, it saves Philadelphia considerable dollars. While the cost of providing primary pediatric and internal medicine services to sick and frail populations is high, the cost of not providing such services is much higher. Persons admitted into area hospitals through emergency rooms who have not received the type of services that are provided to patients in the Family Medical Care Program cost much more to the taxpayers and result in increasing uncompensated care costs to hospitals. Persons who do not have access to basic, comprehensive, primary medical care often require long hospital stays, followed by supervised convalescence.
(8) People with Acquired Immune Deficiency Syndrome (AIDS) or who are known to be infected with the Human Immunodeficiency Virus frequently have difficulty in obtaining medical and dental treatment and, therefore often turn to the District Health Centers for treatment.
(9) District Health Centers provide prenatal and family planning services throughout the City. These services are in short supply in many poor neighborhoods and are critical to Philadelphia's on going efforts to reduce its high infant mortality rate. Philadelphia would have an even higher rate of infant deaths without these services.
(10) District Health Centers provide preventive, primary dental health services to many persons who would not otherwise have them available for economic and non-economic reasons: children, pregnant women, persons with AIDS or Human Immunodeficiency Virus, or other non-economic reasons and other adults.
(11) District Health Centers have arrangements with other City services, programs and agencies to welcome persons with multiple health needs and other persons who historically have only limited access to doctors' offices and hospital outpatient programs: chronically mentally ill persons, persons with an intellectual disability, homeless persons, drug and alcohol using persons, persons with AIDS and persons with communicable diseases including sexually transmitted diseases and tuberculosis. 126
(12) The services provided by the District Health Centers are not only irreplaceable, they are life saving. The District Health Centers provide preventive and primary health care which reduces the number of costly and inappropriate visits to already overburdened hospital emergency rooms, again preventing an increase in the uncompensated care costs for hospitals.
(13) In view of the fact that the care rendered in the District Health Centers saves lives, saves money and promotes prolonged productive lives, the Council reasserts the City's basic commitment to provide comprehensive District Health Center services to all of its citizens who wish to use the services. The Council stands behind that commitment, and, in order to assure its restoration to full strength, enacts the following provisions specifying the District Health Center services that are to be available, mandating a flow of information permitting adequate Council and citizen monitoring of those services, and providing citizen input and redress that will enable citizens themselves to assure full implementation of all such mandated services.
(14) The Council possesses "complete powers of legislation ... in relation to (the City's) municipal functions...." Home Rule Charter, Section 1-100. Such legislative power necessarily includes the power to enact policies for the City that ensure the health, safety and welfare of its citizens, and that ensure that the mandates of the Home Rule Charter are carried out. In exercising its power, the Council is entitled "by ordinance ... (to) add new powers and new duties, not inconsistent with the scheme of this Charter to the powers and duties of the offices, departments, boards and commissions (of the City)...." (Home Rule Charter, Section 2-305.) In order to ensure that it has sufficient fiscal information with which to make its legislative decisions, the Charter further states that the "Mayor shall communicate to ... Council with such information on financial matters as the Council may from time to time request." (Home Rule Charter, subsection 4-101(a)).
Amended, Bill No. 130723 (approved January 20, 2014).