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Ex-employees of Philly’s prominent needle exchange say they faced dangerous conditions treating people in addiction

The Inquirer has found that compounding issues at Prevention Point Philadelphia — a prominent shelter serving people in addiction — have jeopardized the health organization’s clients and employees.

Prevention Point.
Prevention Point.Read moreSTEVEN M. FALK / Staff Photographer

Raw sewage flooded the rooms used as health clinics inside a former church on Kensington Avenue that promised a safe haven in Philadelphia’s opioid addiction crisis.

Some employees worried about safety for themselves and their clients at a shelter with no locks on the front door. Others dealt with rodents in food prep areas.

And some say they faced sexual harassment that long went unpunished.

The Inquirer has found that Prevention Point Philadelphia, a prominent nonprofit serving people in addiction, has allowed these kinds of internal problems to jeopardize clients, employees, and the lifesaving mission that made it a leader in addiction treatment.

Prevention Point runs the oldest needle exchange program in the city and the only permanent site where drug users can trade in contaminated needles for clean ones. Providing this service means the nonprofit organization technically operates outside of state law, which bans such needle exchanges.

This has left Prevention Point facing little accountability since it pioneered in Philadelphia an approach to addiction called harm reduction, which seeks to keep drug users alive whether or not they’re ready to quit.

Its mission is combating an epidemic of addiction in a city that recorded 1,214 deaths in 2020 from drug overdoses. Prevention Point draws 24,000 people through its doors each year — from adjoining streets to the suburbs and beyond — as it works to fill a regional void in addiction health care by offering services that range from needle drops to HIV testing to housing assistance.

Eight former Prevention Point staffers have approached The Inquirer since last fall to talk about the environment at Prevention Point. Reporters corroborated their accounts in hours of interviews, spoke with the organization’s leaders, and reviewed the few public records available on its operations from the city and state health departments.

The investigation has found years of compounding problems at the health organization supported by $9.6 million a year in city funding, an investment that falls short of what many Kensington community members feel is needed to address the full scope of addiction-related social issues challenging the neighborhood.

» READ MORE: For years, Kensington residents have pleaded with Philadelphia officials for comprehensive solutions to a citywide addiction crisis that's most visible in their neighborhood.

Employees once had to use their coffee mugs to bail out a sewage spill in the main building. Meanwhile, the organization’s homeless shelters, at the time located in two former storefronts farther up the avenue, were infested with bedbugs and rats, and at one point had no locks on the doors.

There were shootings and stabbings outside the buildings, and employees said they felt unsupported by management when they raised concerns about the organization’s attention to security.

A culture of open sexual harassment of employees was detailed by five former staffers. Several say they and other coworkers felt ignored or dismissed by management when they tried to bring up problems.

In an interview, Prevention Point officials acknowledged many of the problems, but said they needed time to address them.

Nearly two years after the sewage backup, the organization relocated its homeless shelter to a newly renovated building at nearby Temple University Hospital — Episcopal Campus, but still runs health clinics at the old site. Officials said it has not flooded with raw sewage since 2021.

Recently, the organization also has investigated sexual harassment internally, overhauled its reporting system for complaints, and fired an employee found to have sexually harassed coworkers, officials said. The allegations of sexual harassment were first reported by Billy Penn.

Executive director Jose Benitez blamed some of the problems on Prevention Point’s rapid growth, but said clients were never exposed to serious health risks.

“We grew exponentially in the last four years and needed to build infrastructure. Being financially responsible, we figured out how to build infrastructure slowly so that we could streamline what we’re doing,” he said. He added: “To hear some of the allegations — it’s kind of like, they have kernels of truth, and in some cases, they’re being exaggerated, and in other cases, it’s just flat-out not true.”

Oversight is minimal. The state has no role in licensing or regulating the nonprofit. Prevention Point officials say they work closely with city agencies that handle addiction programming, and city officials say they regularly visit and monitor the organization.

However, city officials could not provide documentation of that oversight. The city appears to have taken few actions to address concerns despite being aware of employee complaints. City building inspectors also repeatedly flagged deteriorating conditions at its buildings, and independent financial audits have raised red flags over poor financial controls.

While acknowledging problems at the organization, the city’s Deputy Managing Director Eva Gladstein said in a statement that Prevention Point provides “highly effective, often lifesaving care.”

Former employees say that complex and compounding problems enabled unsafe conditions to fester: Prevention Point was a first-of-its-kind nonprofit that grew without guardrails, sufficient funding, or oversight. Management was unresponsive to employee complaints in a stressful workplace culture where harassment ran rampant. There also was the stigma of addressing drug use through harm reduction — and the pressure to succeed as one of the only groups doing so.

“Much like the pandemic is highlighting a lot of issues that have existed, Prevention Point’s rapid growth has been fuel to the fire — and they’ve never built a solid foundation for themselves,” said Tiff Rodriguez, a former case manager at the organization and Kensington resident who’s been vocal about issues she encountered there.

Despite the recent changes, those who have worked at Prevention Point remain alarmed. Many don’t know what worries them more — the dangerous conditions they say they worked through, or that discussing them publicly could undermine the city’s main source of help for people with nowhere else to turn.

“I don’t hate Prevention Point,” said Eva Fitch, a former employee who left the organization in September 2021. “I believe in its mission more than anything else. But it doesn’t feel like you can treat people this way and uphold that mission.”

An outlawed mission

Since its inception at the height of the AIDS epidemic, Prevention Point has occupied a unique position in Philadelphia’s health-care infrastructure.

In the 1980s, drug users came to Philadelphia for its cheap, pure heroin providing a high that would last for hours. Kensington rapidly became the epicenter of the trade, at one point earning a reputation as one of the East Coast’s largest open-air drug markets. But each injection also put drug users at risk of diseases such as HIV and hepatitis, especially when they shared needles.

Increasingly concerned AIDS activists launched what would become Prevention Point by handing out clean syringes in Kensington.

State officials threatened to arrest them, but in 1992, then-Mayor Ed Rendell told state authorities to arrest him first. He used an executive order to allow Prevention Point to operate in defiance of the state’s syringe exchange ban.

By the mid-2010s, Prevention Point would be credited with preventing more than 10,000 HIV infections from injection drug use. It also courted controversy in the community — where many residents feel that the city has not done enough to curb drug use and sales, burdening Kensington with social problems that wouldn’t be accepted in other neighborhoods.

Today, dozens of states have passed laws legalizing such exchanges — but not Pennsylvania.

In most states where syringe exchanges are legal, they are overseen by state health departments. But Pennsylvania’s ban leaves syringe exchanges across the state operating largely with the blessing of local municipalities. The state’s Department of Health does not license or oversee the operation, nor does its Department of Drug and Alcohol Programs.

And when a pandemic arrived, making delivering health care safely even more challenging, existing issues at Prevention Point reached a crisis point.

Shoddy conditions, little oversight

Inside the church building and two converted storefronts that housed Prevention Point’s programs, conditions were deteriorating while the needs of people in addiction surged during the pandemic. Shelter spaces that were never especially clean became downright unsanitary, employees say.

Chyna Parker, a former staffer at one of the respite centers who left in January 2020, remembers rats and mice scurrying out of the refrigerator where guests’ food was prepared, or running across her feet in the kitchen.

One time, a guest called her over to their cot, screaming, when a mouse was swimming at the bottom of their coffee cup.

Eventually, a staff member brought in a stray cat off the street to help hunt the rodents in the building. “It was completely disgusting,” Parker recalled.

When bedbugs swarmed cots and furniture, management gave staffers bottles of rubbing alcohol to spray on themselves before and after shifts, Parker said.

And there was the sewage.

Parker recalled a handful of instances where she turned on the kitchen sink to clean a dish, and the tap water was brown and smelly. The same happened in the bathroom, where solid pieces of sewage ran from the brown sink water when she tried to wash her hands.

The response when she raised concerns to management: silence.

At the shelters, most of the residents were still in active addiction — and afraid of being caught using drugs. So they shoved needles down sinks and in toilets, clogging the plumbing and causing backups.

Courtney Lane, a former housing case manager at Prevention Point, said that for the majority of her three and a half years there — ending in August 2021 — the shelters didn’t consistently have containers to dispose of used needles, because Prevention Point thought it would encourage drug use. She watched sewage overflowing into shelter bathrooms.

“I remember one time getting like a Roto-Rooter, like an industrial-sized one, and there just being hundreds and hundreds of syringes coming up. It was just like the craziest thing I’ve ever seen,” Lane said.

Used needles discarded in plastic trash bags poked workers — who were not trained to handle needles — emptying the garbage, she said. Fitch said workers weren’t given protective gloves to prevent needle sticks.

Prevention Point officials said all buildings were equipped with syringe disposal containers, and the employees who told The Inquirer otherwise were wrong.

Records from the city’s Department of Licenses and Inspections show that since 2019, officials conducted 11 investigations into conditions at the main church building, nine at its shelter across the street, and two at another shelter farther up Kensington Avenue.

Collectively, L&I cited Prevention Point for 64 code violations across those three properties over the same time period, for everything from trash to serious fire code violations. In its most recent visits to the church building this year, inspectors repeatedly flagged multiple fire hazards that have persisted for months, including a lack of extinguishers, obstructed exits, and fuel canisters being stored indoors. Prevention Point spokesperson Cari Feiler Bender said issues with L&I have been addressed.

In the summer of 2021, the main church building experienced a massive sewage backup while management was out on a staff retreat.

Former staffer Corey Nedev immediately worried about the sewage causing infections in his immunocompromised patients in the HIV treatment division, and other patients in the clinic with open wounds — a common side effect of injection drug use.

“In our HIV clinic, we can’t sit there drawing your blood in a room that can put you into sepsis,” Nedev said.

A maintenance manager told Nedev to scoop raw sewage out of his clinic room with a coffee mug. Meanwhile, others tried to contact leadership. Weak and vulnerable patients were directed upstairs into a former sanctuary without electricity. It was almost unbearably hot, but there was no sewage.

Eventually, Nedev said, a cleaning crew came in to clean up the sewage. Yet staffers noticed feces on chairs and in sinks when they returned to the building. Rodriguez said she called the federal Occupational Safety and Health Administration. Nedev said a maintenance manager slammed a door on him when he raised concerns about the feces in his clinic offices. Frustrated and feeling unheard by management, Nedev resigned shortly after the incident.

Benitez, the organization’s executive director, blamed the sewage spillover on construction on another lot, and noted that the building was cleaned within two days.

Late last year, the organization closed its Kensington Avenue shelters and moved them both to a building on the Episcopal campus. Current employees, who spoke with The Inquirer at their employers’ direction, said the improvements include more space for clients and staff and a building renovated around Prevention Point’s needs.

City officials said they had learned of the sewage incident in the main building after the OSHA complaint was filed. They inspected the facility and determined that Prevention Point “had appropriately addressed the issue.”

Violence inside and out

Prevention Point staffers said leadership brushed aside their concerns about routine exposure to violence and trauma in a neighborhood where shootings and violence related to the drug trade are common. The police unit that patrols the surrounding neighborhood has recorded 273 shooting victims over the past year — or about 10% of all those shot citywide.

Two of the former staffers who detailed concerns about safety inside also lived in the community, a former industrial hub that’s long been home to working-class families with a fierce devotion to the neighborhood, which they have felt is neglected, underserved and underfunded by the city.

» READ MORE: This Kensington outreach worker saved dozens from overdose. Then the trauma became too much.

At one of the old shelters on Kensington Avenue, the locks on the building didn’t work, a problem particularly during understaffed evening hours. It wasn’t unusual for guests to bring in friends from outside, sneaking them by the evening workers, Parker said.

One night in 2019, a drug dealer burst through the unlocked door of the shelter, with a gun drawn, pointing in staffers’ faces and moving toward guests, looking for someone who owed them money, according to Parker, the former homeless shelter staffer.

Prevention Point officials deny this incident happened. “There was trouble with a lock. We tried to get the landlord to fix it. And eventually it got fixed. That did take a tiny bit of time,” said Bender.

In 2020, one of Prevention Point’s clients fatally stabbed a man outside one of the organization’s shelters. Lane, the former housing case manager, said she had spoken to her supervisor for weeks about the client’s mental health.

Deeply distressed by the stabbing, Lane said she asked her supervisor for time off, which was refused.

“They kept being like, ‘People die, it’s just how it’s gonna be.’”

“They kept being like, ‘People die, it’s just how it’s gonna be.’”

Courtney Lane, a former housing case manager at Prevention Point

Benitez said the organization was in the process of getting the man a mental health evaluation — although not because his behavior struck anyone else at the organization as unusual. “The reason the person was being evaluated was because we needed it for the next step in his housing placement,” he said.

This February, a client was shot outside the main building. Krystal Perea, who worked as a case manager, happened to be outside at the time, and helped the injured man on the sidewalk, offering emergency first aid.

Two days later, a panicked coworker ran up to Perea’s desk in the main building, saying the shooter was inside and looking for her, Perea said. The alleged shooter believed, falsely, that Perea had called the police.

Security staff, she said, laughed at her terror. “The head of security was saying he knows the shooter, and he’s not going to do anything, he just wants to have a conversation,” she said. “They were joking about my situation.”

Perea managed to slip out a back exit. She had planned to quit the job anyway, and spent her last few days at Prevention Point working from home.

After the shooting, she was told not to come back even on a part-time basis. “A close friend of mine who is in leadership broke it down and said, ‘It’s because you’re a liability,” she said.

Benitez said the alleged shooter never came into the building. Perea also disobeyed a lockdown order to help the man wounded in the shooting, he said.

“We took appropriate measures,” he said. Staffers also spread word to the security team to keep an eye out for the suspected shooter.

Prevention Point spokesperson Bender said that Perea was not asked to stay away from the organization. She added: “Kensington is a difficult place. There’s a lot of people dealing with trauma, there’s a lot of participants dealing with many, many things in their lives. And Prevention Point can only control so much in the world, right? They can’t control what happens on the street.”

Sexual harassment and silence

Sexual harassment happened all around Prevention Point, from stairwells to stockrooms, five employees told The Inquirer, providing detailed accounts that in many cases they also reported to managers, they said.

Rodriguez, the former case manager, said she witnessed fellow staffers enduring sexual harassment and assault, including a male staffer kissing a female staffer without her consent. Several staffers had restraining orders against other staffers, she said.

Nedev, who worked in the HIV clinic, recalled staffers commenting on their coworkers’ bodies as they walked up and down stairs.

A manager who has since left the organization but is concerned even now about retaliation, said that after a coworker reported being sexually harassed, someone in the two-person human resources department called the coworker a “whore” and a “home wrecker.” As it turned out, the accused harasser was dating an HR employee, said the manager, who asked not to be named for fear of reprisal.

In November 2018, Parker, who worked in Prevention Point’s low-barrier shelter, reported for an afternoon shift to prepare dinner for her guests. From the stockroom, Parker heard another line staff worker call her frantically, pointing to something on the ground.

When Parker bent over to look, the staffer pushed himself behind her, groping her and smiling. Shaken, Parker called her friend Tatyana Woodard — a fellow line staff worker and, like Parker, a Black trans woman — and heard her story repeated back to her. The same staffer had harassed Woodard the year before, and had also made transphobic comments toward her in front of the guests they were serving.

Later, Parker learned that other Prevention Point residents had also reported her harasser to management in separate, previous incidents — and said he was moved from other shelters after past incidents of harassment. The staffer was fired two weeks after Parker’s report.

Several employees said that it was widely known that members of a security team hired by the city to guard Prevention Point’s main building were soliciting sex from female clients, many of whom engaged in sex work to survive on the streets in Kensington. Fitch said she heard directly from clients who had been solicited by members of the security team.

The security guards would refuse to pay the women after sexual encounters in security offices and the basement of the main building — and then refuse to protect them while they were seeking services at Prevention Point, staffers said. The security team was eventually replaced.

Benitez said rumors of sexual misconduct by the security team had been investigated by the security company that employed them and were deemed unfounded. City officials said they had not been informed of these allegations.

In 2021, a group of employees successfully lobbied management to conduct an investigation into serial sexual harassment claims.

No staffers interviewed by The Inquirer ever saw the report or learned what was in it. Benitez said Prevention Point is not legally allowed to share details of the report because of employee confidentiality rules.

The organization has since overhauled its sexual harassment protocol, he said, making it easier to report incidents of harassment and holding trainings for employees.

Mission at risk

Employees who have left Prevention Point say they’re still deeply committed to the organization’s core mission: helping people in addiction stay alive. But they no longer trust that it is acting in the best interests of employees and clients.

Rodriguez, who said she was fired last fall after a dispute with a superior, still struggles with the guilt she feels when former clients call her asking for help — or just to tell her they miss her.

“On the street, there aren’t many people you can trust — and so many of us have built those relationships with clients. To be torn apart from them with no transition time, no warning — now they’re completely unstable emotionally,” Rodriguez said. “I had one client break down crying, saying, ‘I’ll never forgive you for leaving me like this.’”

“I had one client break down crying, saying, ‘I’ll never forgive you for leaving me like this.’”

Tiff Rodriguez, a former case manager at Prevention Point

Other staffers who spoke with The Inquirer said they left Prevention Point to protect their own mental health — and remain worried about the clients they left behind.

Lane said she watched the stress of the job and lack of support from higher-ups eat away at coworkers, some of whom were in recovery themselves. Over her time at the center, she said, she watched several colleagues relapse or become homeless on the streets of Kensington, “basically discarded.”

“People are trying to help but they’re also dealing with a lot from being in recovery themselves, and then the stress of being in a working environment that’s unsupportive, super chaotic and toxic,” Lane said. “No one’s checking on us, you know?”

This article has been updated to amend the date of a fatal stabbing outside Prevention Point.