Board of health delays vote on Kensington mobile service rules amid legal, equity concerns

The Philadelphia Board of Health delayed an expected Thursday vote on regulations tied to Councilmember Quetcy Lozada’s mobile services ban, citing legal and equity concerns over its restriction to the 7th Councilmanic District. 

The regulations would let the city’s Department of Public Health create and manage a permitting system specifically for mobile medical providers operating in the 7th District, which includes most of Kensington. 

The process would enable the health department to verify medical licenses, ensure a “consistent standard of care,” and require the “necessary materials” to provide those services, said Ben Hartung, public policy advisor for the health department. 

Enforcement of the law, signed by Mayor Cherelle Parker in May, has already been delayed due to the absence of a permitting process. 

This was the board’s first public discussion of the bill. Members, who meet quarterly, said they needed more time to deliberate and raised concerns about how the permitting system would be implemented and how the law would be enforced.

“It is upsetting to me that most of what I know about this bill was not through deliberation or discussions we had as a Board of Health, but was through the media and me following it outside of that realm,” said board member Dr. Scott McNeal, president and CEO of Delaware Valley Community Health Inc. “Now we are meeting for the first time to discuss it and put some type of seal on it.”

If the board does not pass the regulations, the city will move forward with permitting and enforcement measures without the health department’s oversight, said Health Commissioner Palak Raval-Nelson. Still, she said the city ideally wants the health department involved. 

Raval-Nelson said the city has asked its law department whether the legislation can be applied citywide and is awaiting an answer. 

Board member Dr. Marla Gold, a former professor of health management and policy at Drexel University and senior vice provost for Community Health, said she wished the board had been more involved from the start and refused to vote without legal input.  

“I object to any process where the tail wags the dog when it comes to public health, and that we're now running to vote on something, a regulation that perhaps, had we had a chance ... to work on this, we would have perhaps informed this differently at the gate,” she said. 

Gold urged her fellow board members to read the legislation and by the end of the meeting, asked the city to share the final approved legislation with the board. 

Gold acknowledged the challenge of balancing residents’ quality-of-life concerns with the need to coordinate and provide care for people with substance use disorder. 

As part of its presentation, the city highlighted a community engagement process led by Lozada and included a quote from Kensington resident Sonja Bingham, who said she was grateful that the community had been involved.  

“But that said, voting for something that's Councilmanic specific, I will not do it. I won't do it,” she said. “Being promised that we'll vote on this, and then legal will look, I at least cannot do, it goes against everything that I believe in.” 

Gold also said the health department – not the Department of Licenses and Inspections – should oversee all permitting, including for mobile providers of food and other basic necessities.

Dr. Usama Bilal, assistant professor of epidemiology and co-director of the Urban Health Collaborative at Drexel University, expressed concern about gaps in access before permits are issued. 

“There is a population that needs access to this. There is a permitting process that will limit that access, at least in the short term,” Bilal said. “I want to understand what the PPH or the city's plans are to cover those gaps.” 

Raval-Nelson said the law won’t be enforced until the permitting process is in place and providers have had a chance to apply. 

“Services will just continue as we work to get everybody permitted,” she said. 

Several city officials echoed Lozada’s description of the policy as a way to coordinate services. 

But board member Dr. Amid Ismail, dean of Temple University’s Kornberg School of Dentistry, said the law appeared more focused on restricting services than coordinating care.

“To limit the provision of service to a certain area of Kensington, squeeze the population out of Kensington, and to allow them only to work — maybe I'm not reading it right — between 11 p.m. and 6 a.m., is not a good public health policy,” Ismail said.

About 20 community members joined the virtual meeting, along with other city and health officials. 

All public commenters voiced dissent, with some sending messages in the Zoom chat during the two-hour meeting. 

They reiterated that the bill would limit access to medical services to people with substance use disorder in acute need. They urged the board to oppose limits on providers. Some reminded the medical professionals of their oath to “do no harm.” 

“This legislation reflects what the Trump administration is doing. How can you all ring the alarm? You don’t need to be complicit,” wrote Samm Pheiffer of the Positive Women's Network. 

Billy Ray Boyer, who has done mobile outreach in Kensington for seven years, asked for evidence that unhoused residents’ input was considered while drafting the legislation. Boyer said, as far as they knew, there was an “absolute absence of participation” and invitation to unhoused neighbors for any community meetings. 

“When I go out with my organization on Sundays, we have a line around the block and can never serve everyone and we come out with enough supplies for 200 people,” Boyer wrote in a Zoom message. “Who is going to even fill that small gap if we get regulated and criminalized out of being there?” 

Dr. Sam Stern of Temple Health said the location for Temple’s mobile provider site was chosen based on city overdose data. 

“I want to just urge that if this board ends up regulating the permit process, you consider liberalizing the location and time restrictions from the process to ensure that access to life-saving medical care can continue uninterrupted,” Stern said. 

Board members are awaiting a response from the law department and will reconvene to discuss the regulations at a later date, yet to be determined as of Thursday.

“Those of you who've joined us, you are clearly being heard tonight,” said Dr. Gold. 

Community members were encouraged to email the board via Hartung at benjamin.hartung@phila.gov. 

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