Category: Health

Philadelphia lawmakers voted Thursday to ban mobile outreach groups that provide medical care and support services to people in addiction across a swath of Kensington, the epicenter of the city’s drug crisis.

The vote came just days after the city began enforcing controversial new regulations in a different part of the neighborhood, where the same providers may operate only if they have a permit to do so and park in areas designated by the city.

Taken together, the actions spearheaded by City Council members who represent Kensington and Mayor Cherelle L. Parker’s administration amount to a major shift in how transient people who use drugs obtain medical care and basic needs like food, water, and clothing.

Many have long relied on mobile outreach services that met them on the street. Those same providers can now park only in designated areas or serve people for limited amounts of time.

Council members who support the legislation say residents in the neighborhood do not want people in addiction lining up for medical care or support services near their homes.

Councilmember Mike Driscoll authored the bill banning mobile service providers entirely from his 6th District, which includes parts of the neighborhood that are northeast of the infamous open-air drug market at the intersection of Kensington and Allegheny Avenues.

Driscoll said his bill, which passed Council 14-3 on Thursday, is not aimed at punishing providers. He said he is open to finding a location in his district where they can operate with the city’s permission.

“I just don’t want the service providers picking where they want to go at the expense of the kids and the neighbors,” he said.

But advocates for people who use drugs slammed the bill, and said reducing access to care will not help people in addiction.

“Restrictions like these will not end the opioid crisis. They will not make anyone in Kensington or District 6 safer,” said Katie Glick, a nurse who treats people in addiction and lives in the neighborhood. “These restrictions will disable and kill people.”

In Kensington, inconsistent rules for providers

If Parker — who has never issued a veto — signs Driscoll’s bill, it would result in a patchwork of rules for mobile service providers in Kensington, which is represented by three different Council members.

The western side of Kensington is in the 7th District, where Councilmember Quetcy Lozada’s legislation that required the permitting system applies. Organizations that do everything from handing out water to providing medical care now face a $1,000 fine for operating without a permit.

The city began enforcing those new rules on Dec. 1. No citations had been issued as of Wednesday, police said.

In the southern parts of Kensington that fall in the 1st District, represented by Councilmember Mark Squilla, no legislation applies to mobile providers.

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The inconsistency is the result of councilmanic prerogative, the unwritten rule that gives Council members who represent geographic areas a large amount of sway over what happens in their districts. Lawmakers largely approve legislation offered by a district Council member when it affects only that member’s district.

Some of Council’s progressive members who represent the city at-large have bucked that practice several times on matters related to Kensington, where Parker and her allies in Council have placed an intense focus on improving quality of life.

The progressives — who favor an approach to the crisis called harm reduction that aims to keep people alive until they are ready to enter treatment — argue that placing restrictions on mobile service providers will make it harder for them to reach vulnerable people in addiction and ultimately reduce the number of providers on the street.

“When human beings are trying to provide help,” said Councilmember Nicolas O’Rourke, “the attitude should never be ‘how can we limit them.’”

O’Rourke and Councilmember Kendra Brooks, both of the Working Families Party, and Democrat Rue Landau voted against Driscoll’s measure.

But Lozada said implementing new regulations was not about restricting care.

“We’re hoping that services continue,” she said. “People have just moved to other spaces to find a way to be able to continue to provide the services that people need.”

And Parker administration officials said the goal is not to reduce the number of providers, but to better coordinate them and ensure safety, especially for people receiving medical services.

Kensington has been a key issue for the Parker administration and Council members who have pushed for more law enforcement in the neighborhood, where sprawling homelessness, open drug use, and violent crime have been commonplace for years. There have been some signs of progress, including a reduction in the number of people living on the street.

The city has tried new tactics, including opening its own recovery house and expanding police foot patrols. The local government has also at times operated its own mobile medical services and contracts with organizations that do so.

So far, the city has issued nine permits to providers who perform mobile medical services and 40 to organizations considered “nonmedical,” like those that distribute food. Some of those organizations also operate in other neighborhoods.

“We don’t have a problem if there’s five or 500 providers,” said Crystal Yates-Gale, deputy managing director for health and human services. “As long as they’re qualified to provide the care, and as long as we can help coordinate the care.”

Despite the changes, city says ‘people are still coming’

Under the new rules, nonmedical providers are prohibited from staying in one place for more than 45 minutes. Medical providers can station on a two-block stretch of Allegheny Avenue at nighttime or at a designated parking lot at 265 E. Lehigh Ave. during the day.

That lot, which is managed by the city and addiction service provider Merakey, is connected to the city’s Wellness Support Center.

Inside, people can access first aid, showers, and food, as well as get directed to treatment, legal aid, housing assistance, and other services.

In the parking lot, two mobile medical service providers run by Merakey and Kensington Hospital are currently stationed, according to Kurt August, executive director of the Philadelphia Office of Public Safety’s Criminal Justice Division. He said officials are looking to expand the number of providers that operate there.

In late October, Merakey began dispensing methadone out of an RV parked in the lot. The tightly regulated opioid medication is a popular treatment for people experiencing withdrawal because it helps stave off cravings.

Raymond Bobb, a medical director at Merakey, said he has seen promising results in just a few weeks, including starting people on methadone and getting them stable enough to transition to inpatient drug treatment. Merakey offers to transport people on the street to the RV to enroll them in medication-assisted treatment.

“We’ve been able to take everything right to the heart of the epidemic and engage people the way you would treat your brother, or your sister, or your family,” said Bobb, who is also in recovery and became emotional when speaking about the program.

“Our goal,” he added, “is to build people up and motivate them to want treatment for themselves.”

August said retention has been high, despite the police presence at the support center. The officers, he said, were “handpicked” to be stationed alongside behavioral health professionals.

“It’s not a secret that police are on site, and people are still coming,” August said.

Still, other providers have expressed concern that requiring people to travel to the lot adds an additional barrier to care, especially for those who were used to mobile services coming to them.

Sarah Laurel, who runs the addiction outreach program Savage Sisters and has a nonmedical permit, said she fears that providers who offered medication-assisted treatment on the street will now be less accessible.

However, she said, some clients greeted the news of service limits with a shrug.

“The friends we serve are so used to not being heard that when they realize that services are going away, they adjust quickly to not having things,” Laurel said. “They just say, ‘No one cares about us. They hate us anyway.’ That is how people feel seen in this city.”

Staff writer Ellie Rushing contributed to this article.