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January 10, 2013 Zoning Board of Adjustment 1401 John F. Kennedy Boulevard Municipal Services Building, 11th Floor Philadelphia, PA 19102-1687 F: (215) 686-2565 Philadelphia City Planning Commission ATTN: Alan Greenberger, Chairman One Parkway, 13th Floor 1515 Arch Street Philadelphia, PA 19102 F: (215) 683-4630

RE:

Appeal #21324 Permit #492205 Calendar: Jan 22 2013 12:00 2100 N FRONT STREET Applicant: KENSINGTON HOSPITAL Type: SPECIAL EXCEPTION ZONING VARIANCE

To The Zoning Board of Adjustment and PCPC:

In the near future you will be hearing case 21324, a request by Kensington Hospital to relocate an existing methadone clinic operation currently operating inside 136 W DIAMOND, approximately 0.1 miles to the subject parcel as part of a MAT clinic expansion. Kensington Hospital wishes to relocate this clinic so it can conduct an expansion project of its methadone dispensary operation. Its present space and capacity currently presents negligible patient volume. The MAT clinic presently operates within the main building of Kensington Hospital on an upper floor and has historically not posed a disruptive influence upon the community in which it serves. All this is about to change.

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Kensington Hospital has acquired a significantly sized corner property directly underneath the SEPTA Market-Frankford Line at 2100 North Front Street with the intention to shunt its methadone dispensary program out of the main hospital building. Likewise, it has proposed an undertaking of the existing improvements: a three-story commercial property, which it will expand with an addition in order to fulfill state licensing and local occupancy requirements to serve more patients and increase its capacity. I already know ahead of time that the Zoning Board of Adjustment will grant this application without reservation, and the Philadelphia City Planning Commission will also give a positive recommendation for the same. Im quite certain theres been prior discussion about this Applicant off the record. The district Councilperson for this subject parcel has already expressed her support for this project; thats more than enough information to conclude how the proceeding on January 22nd will go. So, instead of wasting my breath arguing against a foregone conclusion, I would like to enter several matters into the Record into this Applicants file and I will also share this letter with the community, which Kensington Hospital serves. Kensington Hospital is undertaking this daring expansion project at a time when its financial health appears in jeopardy. Program Service Revenue according to their FY2011 IRS Form 990 indicates a drop from $6.7MM to $6.4MM <-$329,605>. Liabilities increased during a single year by half a million dollars at the same time. Kensington Hospital indicates $5.8MM of its revenue is from Medicaid receipts [Schedule H Part 1, line (7)(b)(c)]. Short of donor financing, its not plausible that the Hospital has turned its primary moneymaker around: namely its Medicaid billings. During the public joint community meeting held between residents of Norris Square Civic Association and East Kensington Neighbors Association, counsel for Kensington Hospital indicated that the expansion was needed for Kensington Hospital to survive. I fully anticipate when Kensington Hospital has successfully relocated its methadone dispensary program under the Market-Frankford Line, the Hospital will immediately ramp up its dispensary program and increase its patient load. This is not dissimilar from an ongoing expansion trend in Philadelphia of dispensaries in for-profit and non-profit opioid maintenance programs, also known within the industry as medication-assisted therapy (MAT). The City Planning Commission has utterly failed to recommend the best way forward for MAT clinic expansion to co-exist peacefully with dense, urban residential environments. A nearby MAT clinic at 8th and Girard Avenue serves a confirmed 800-patient-a-day caseload. Given that patients do not all arrive at the same time for their appointments, clinics can and often do overschedule their appointment books far beyond the capacity of their patient waiting rooms. Opioid withdrawal symptoms comingled with the needs of

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regular life often mean patients tend to prefer early periods in the day to receive their on-site treatment; those who do hold jobs and/or have obligations or are suffering pain are highly motivated to appear early. This is why many of the undermanaged MAT clinics in Philadelphia have long waiting lines outside their buildings early in the morning. For some clinics, such as Parkside Recovery [5000 Parkside Avenue, Philadelphia, 19131], the overbooking presents a problem throughout the entire period when the clinic is open for business. Therefore the outdoor areas surrounding the clinic serve as the patient waiting room. It is this situation along with a lack of security that led to incidents of confirmed drug dealing occurring no less than 3 feet from the front door of the clinic. Neighborhood residents surrounding 2100 North Front Street do not believe that Kensington Hospital will gracefully manage their expansion plans, given the instant need to grow revenue. To that end, the following ills are likely to pose problems: Lack of security expansion at the new facility will make the new MAT clinic attractive to more drug activity along the Front/Kensington Avenue corridor The building and property will not be appropriately supervised and maintained to protect patient safety Kensington Hospital will not create enough indoor patient waiting space for their expansion, which will lead to at-risk patients loitering outside. This will leave these patients with targets on their backs for area drug sealers looking to close sales. Previous MAT clinic operators did not care about this until state regulators in Harrisburg were appalled at videos capturing these transactions occurring outside MAT clinics in Pennsylvania.

Residents of Hope Street Neighbors For Better Living, NSCA and East Kensington Neighbors Association exist for one reason: to further the betterment of their neighborhoods. They were asked to participate in the zoning process and they will be present on January 22nd to render their concerns to you, which will be in the negative. That is of course presuming Applicant does not postpone this zoning case yet again, as nettlesome zoning applicants often do to frustrate those seeking to enter testimony into the record should parties wish to appeal your decision to the Court of Common Pleas. In the past I have witnessed prior zoning controversies surrounding MAT clinics before the Zoning Board of Adjustment; Ive also witnessed the last 5 years of the Planning Commission purposely staying silent about this issue. That is why it comes as no surprise to me that Councilman Bobby Henon and Councilman Brian ONeil passed Bill No. 12-077000 which removes medical offices from all but the most remote zoning parcel classifications. This bill was passed over Mayor Nutters veto with only a single dissident: Councilman Greenlee. Given prior litigation

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from profit-fueled MAT operators using the Americans with Disabilities Act as a defense against zoning control, District 6 and District 10 had to reach for this non-discriminatory measure to ensure that all MAT clinic operators at least meet with the community (something that did NOT occur with the Healing Way case, as L&I had granted permits assuming by-right status applied). I am sure PCPCs opinion over 12-077000 was negative insofar that the new Zoning Code has been poisoned by one-off zoning regulations that are not streamlined into the Zoning Code. That is because PCPC has not come up with any recommendations for severing the issues MAT clinics cause with nearby residential neighbors. Since I dont anticipate PCPC to ever address this issue, and everyone at City Hall also seems quite scared to approach it, I welcome further bills by district members of City Council to replicate 12-077000 into their own districts. I live in District 1 and Councilman Squilla has already publicly indicated that he will expand medical office controls into his own district. I will grant Kensington Hospital the benefit of meeting with the neighboring community to disclose their plans. Thats rarely happened in Philadelphia with this type of commercial business. That did not occur prior to the beginning of site preparation activity at the start, but at least it did happen. I would love for Kensington Hospital to prove me wrong and a fool. Their current clinic has a negligible patient load, it sits in the same building as the Hospital administration, its continuously under observation and waiting capacity is available for its current operation. Every single one of those variables will be changing in this project up for your consideration. Given the financial pressure for Kensington Hospital to increase its Medicaid billings to steer its balance sheet back into the black, I foresee that financial pressure overriding the need to provide reasonable patient services in an environment that can cohabitate peacefully with its neighbors. If and when those problems arise in the future, I will point all Philadelphia residents back to this letter that you are reading today. Sincerely Yours,

Christopher Sawyer Owner, Philadelinquency.com cc: Councilwoman Mara Quiones-Snchez Councilman Mark Squilla East Kensington Neighborhood Association Hope Street Neighbors for Better Living Norris Square Civic Association New Kensington Community Development Corporation

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