Urban Warrior | Health cuts show where priorities are

HERE'S A DISTURBING but sadly unsurprising diagnosis: Two out of three former public health commissioners say funding city health centers is not a priority for Mayor Street.

Dr. Walter Tsou, who headed the Department of Public Health when Street took office in 2000, and Dr. Joanne Godley, who ran it for six months in 2005 and 2006, said last week that they never got a chance to ask the mayor to add health center staff to cure chronic problems of long waits for patients to get appointments.

Street, they said, didn't speak with them about their work.

"Public health is not a priority for this administration," said Godley, a former health-center doctor who quit soon after being promoted because of the lack of resources. "I thought my continued presence there was rubber-stamping what was happening."

Tsou noted it's been almost two decades since the city has built a new health center. "We have built other things like stadiums," Tsou added. "I guess people feel like that's important."

The commissioner after Tsou and before Godley, John Domzalski, has a different take. He says funding has been a problem since the health centers, which were opened to treat public-health problems like tuberculosis and sexually transmitted diseases, started providing care normally handled by family doctors.

"I don't think there was ever a time when it wasn't a priority," Domzalski said of funding.

I decided to get a second, third and fourth opinion on health-center staffing after watching the mayor's current acting public-health chief, Carmen Paris, take a verbal beating at a City Council budget hearing last week.

Council is ticked off because the mayor pulled a double-cross on health-center funding.

Street, needing Council's approval for his budget last year, promised to spend $1.6 million to hire more center staffers. That money was never spent and now Street wants to slice it from the department's budget.

Council members grilled Paris for more than an hour but she refused to take the bait and blame long-standing health-center problems on a lack of staffing.

This is as close as she came: "My job is to do the best I can with the resources I have available. That's what I'm doing."

Speaking of resources, Godley told me something that rarely comes up in the long-running debate about staffing the health centers: They make money.

In her last fiscal year on the job, it cost $17 million to run the centers, which took in $22 million in reimbursements for services from public programs and private insurance companies.

"We're not putting the resources gained back into the health centers," Godley said.

The profit goes into the city's general fund, where it gets spent on things the mayor and City Council consider important.

Except, of course, when the mayor promises to spend the money and then sits on it.

Godley said even when there was money in her budget to hire staff members, she had to get "special permission" from the managing director's office and the mayor's office to do so. And the answer was often a swift no-can-do.

Paris told Council last week that the mayor's cuts would mean a loss of 38 health-center jobs.

Council President Anna Verna almost sputtered with outrage, noting that Street wants to spend $4 million in the fiscal year that starts in July on "Philadelphia Green" to spruce up open spaces.

"I just don't know where our priorities are," Verna told Paris and Diane Reed, the mayor's budget director. "I really don't."

Council has the power of the city's purse. The mayor needs his final city budget approved before he can head off into retirement.

We have one last chance to teach him how to keep his word.*

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