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Senior Advisory Committee Agenda 07/02/2018July 2, 2018 10:30 AM Senior Advisory Committee Meeting 3299 Tamiami Trl E Naples FL, 34112 Second Floor County Manager’s Front Conference Room 1. Call to Order 2. Pledge of Allegiance 3. Roll Call 4. Adoption of the Agenda 5. Public Comment 6. Adoption of Minutes from Previous Meeting 6.1. June 4, 2018 7. Staff Reports 8. New Business 8.1. Discussion with Assistant Chief Jorge Aguilera 8.1.1. EMS Issues 8.1.2. Identification of isolated seniors 8.1.3. EMS non-transport visits 8.2. Review of Executive Summary and Chairman Notes 9. Old Business 10. Announcements 11. Committee Member Discussion 12. Next Meeting Time, Date and Location 13. Adjournment Revised 9/15/2015 version 15.1 DRAFT EXECUTIVE SUMMARY Recommendation to approve the focus areas of the Senior Advisory Committee to the Board and provide additional guidance for the remainder of the Committee’s preliminary term of one-year. OBJECTIVE: To provide an update to the Board on the self-identified focus areas of the Senior Advisory Committee to ensure that they align with the desires of the Board. CONSIDERATIONS: The Board adopted resolution 2017-220 at the November 14, 2017 Board meeting that established the Senior Advisory Committee of Collier County. In the following months individuals applied for the new Committee. The Board appointed the initial membership at the February 27, 2018 filling all vacancies except the position for District 3. Since its initial April meeting, the Committee has convened 5 meetings where they considered information about seniors from reports and the activities other communities are taking to support seniors. Through this information the committee established the focus areas of the Committee. The Committee felt that communication should be the primary focus area since all other categories rely on effective communication with seniors. The following categories represent the current focus areas of the Committee. • Senior Communication – County services available as well as how to access services, and necessary information in the event of natural disaster • Information Access and Resource Awareness – A review of the information flow between the County government and the community to identify areas for possible improvement • Senior Isolation and Aging in place – how to address the effects of Senior isolation to ensure that seniors connected to their community • Senior Mobility and Transportation – how to improve the mobility of seniors within the community • Quality of Life Recognitions – what opportunities exist for Collier County to be recognized for the Quality of Life its residents enjoy and what steps can be made to improve the Quality of Life • Senior Center Development and Availability – how to improve access to senior centers and determine the need for more • Natural Disaster preparedness for Seniors – what can be done to mitigate the effects of a natural disaster on the senior population in general and isolated seniors in particular. The Committee will return to the Board at the conclusionend of the preliminary year with a report on its findings and recommendations to the Board. FISCAL IMPACT: There is no fiscal impact associated with this executive summary. GROWTH MANAGEMENT IMPACT: There are no Growth Management Impacts associated with this Executive Summary. LEGAL CONSIDERATIONS: Completed by the County Attorney’s Office RECOMMENDATION: To approve the list of focus areas of the Senior Advisory Committee and provide guidance for the Committee for the remainder of the preliminary term. Prepared by: Include the preparer’s name, title and department DRAFT 1 | Page Presentation Charles D. Hartman, Chair of the Senior Advisory Committee before BCC, July 10, 2018 Good morning, my name is Charles D Hartman. I am the Chair of the Senior Advisory Committee created by this commission late last year. It is my pleasure to make an interim report to the members of the Commission and to indicate the direction the Senior Advisory Committee has chosen to take during its first year of existence. As you are aware the mission of the senior advisory committee is “to review County plans and provide practical recommendations to the Board of County Commissioners to be more inclusive of senior needs by the leveraging the expertise and experience of seniors in the community”. The first four meetings of the committee were dedicated to organizing and selecting the area of focus for the committee during the initial year. We initially looked at five areas of possible concern. They were: 1. Information access and resource awareness, 2. Food security and hunger reduction, 3. Affordable housing and homeless prevention, 4. Affordable and accessible health care, and 5. Transportation and public safety. During our review, it became clear that food security, affordable housing, health care and transportation issues were primarily the concern of other advisory committees or of other elements in the private sector and that we could add little to their work through our efforts. However, the issue of information access and delivery of resource awareness was determined to be an area that could benefit from additional attention. When we say information access and resource awareness, we are talking about improving the visibility, understanding, and access by seniors who need guidance or assistance in order to identify locate or access needed services whether from the DRAFT 2 | Page private sector or government. it involves recommendations for development of general communication strategies, the creation of educational materials and information dissemination strategies. In reaching a decision to focus on information dissemination by the government, we reviewed several studies including the recent Collier County Needs Assessment funded by the Community Foundation of Collier County and the Schulze Family Foundation and the FGCU assessment of County needs created at the request of the Naples Senior Center. In addition, we drew upon the experience over the last 10 to 20 years of various members of the committee in evaluating whether this was the area we wanted to focus on. Our experience in participating in the Town Hall meetings organized by Commissioner Taylor and Commissioner Fiala earlier this year added to our concerns. The citizens participating in these and other Town Hall type meetings demonstrate a very low level of understanding of what the government was proposing in the affordable housing area and why. Additionally, we have found that too many of the citizens in the County have questions about what government services are available and more importantly how to find them. When viewed as a whole, the issue of information access and resource awareness indicated that a gap exists between the intentions of the County government and the understanding of the citizens on those subjects. I will return to the issue of public information in a moment but first let me mention a few of the items that arose during our review of the studies and that we feel will need eventual attention by the Commission on behalf of the senior community. For ease of review, I will note those items we believe should be brought to the attention of the Commissioners broken down into the categories used in the needs studies. We have restricted ourselves to issues that can be resolved in the short term and that can be addressed without significant cost or organizational change. I must note that the following comments are made based on the assumption that all agree on the basic principle that our community should be organized to allow all our citizens to “Age in Place” and retain their independence for as long as possible. We seek to treat all age groups, both the young and the old the same. DRAFT 3 | Page AFFORDABLE HOUSING Let us start with the issue of affordable housing for seniors. The recent analysis done by ULI and the appointed stake-holders committees focused on the need for workforce housing. It is clearly a growing crisis. But little was said about senior housing needs which parallel those of the workforce and require basically the same solution. In addition to the need for more senior housing units there is the issue of redesigning our new homes to better fit senior needs. There are new home designs created by organizations such as the National Home Builders Association and the AARP that detail changes to the interior construction of homes that make them “age friendly” for residents throughout their life cycle. The life-cycle extends from their first home purchase when they were younger and physically active to the final period in their lives were many are limited in mobility and find it difficult to live in a home with a conventional layout. Conventional in the sense that they are often multi-level and have high cabinets and narrow doorways among other things. This new recommended lay-outs has been defined as “Universal Design”. We believe the Commission should consider requiring all new home developers to offer a Universal Design option to all new home buyers. Making the modifications involved in Universal Design are low cost when included before the unit is built out but far more expensive if made to an existing structure. The National Home Builders Association estimates that the cost of Universal Design modifications to a new home before it is built-out would be less than $300.00 USD. We are advocating requiring that new home developers offer a universal design option to buyers and not mandating that anyone use it. TRANSPORTATION AND SAFETY There are four issues of interest in the transportation and safety area that are short term and low-cost fixes. If we are going to create an “Age-Friendly” “Livable” community in which almost half the residents are seniors, we need to concern ourselves with issues of senior mobility. In other words, we need to focus on making our public and commercial spaces friendly to residents of all ages. 1. There are areas of the County that are in need of additional sidewalks and more streetlights. Older seniors find it difficult enough to walk with a cane or walker during daylight over smooth surfaces. It is all but impossible DRAFT 4 | Page when lighting is limited or the surface is unimproved. The lack of both in some areas results in many seniors being effectively locked into their homes after dusk. Taking advantages of our restaurants and theaters in the evening or just going for a walk is out of the question. Maybe some of the funds used to improve soccer fields can be used to address this more important public safety need. 2. There is a clear need for more bus stop shelters and benches for the CAT system. Seeing an older senior sitting on the curb in the sun at a bus stop in mid-July is an absurdity in a county as wealthy as Collier. If money cannot be found in the County Budget, we should explore allowing private sector entities to pay for the shelters and benches and being acknowledged by placing their name or ad on them. This can be done with dignity and without crass or offensive signs we all seek to avoid. Your staff has estimated that this can be done at a cost of only $35,000 per shelter. 3. We need to examine the feasibility of placing pedestrian islands halfway across some of our large and high traffic roads particularly those that are six lanes and more in width. Low mobility seniors are afraid to attempt to cross in the time allocated before the light changes. We understand that light timing is dictated by traffic flow concerns but it should also be dictated by concerns for seniors with low mobility. 4. The issue of placing cement curbs at the end of parking spaces in our public parking lots need to be reexamined. The list of complaints by residents, both older and younger, who trip over them when walking between parked cars is too large. A review of lots that do not include the curbs indicate no increase in disarray or neatness. They may be more dangerous than beneficial. HEALTHCARE The principal concern expressed by seniors in the health care area is the growing shortage of primary care physicians who willing to accept Medicare and Medicaid patients. Even if they can find a willing physician, they are faced with long delays before they can be seen. This is a national problem and probably cannot be solved locally. It reflects the turmoil that exists in the private sector and government medical insurance programs. In any event, the solution to this DRAFT 5 | Page problem is beyond the scope of the Senior Advisory Committee. We can only acknowledge that it exists and that for those affected, represents a serious problem. EDUCATION AND SOCIAL SERVICES Education is an area outside of the scope of the Committee’s charter. Collier County operates a small social services division. Its primary purpose is to operate several state and federal programs in access to housing, transport assistance and food distribution. The staff has advised the Committee that its active client list currently around 200+ and that it has a waiting list of more than 700 qualified needy residents. The staff indicated that they take a passive approach to identifying needy citizens in that they wait for them to come to the county offices and sign up for services. In a county with more than 125,000 senior citizens, serving 200 needy is miniscule. Moreover, the needs studies found that many needy citizens do not know what services are available or how to find them. This is another area in which information dissemination is wanting. CITIZEN WELLBEING AND COMMUNITY COHESION Most seniors are very satisfied with the level of community wellbeing and are proud of the awards given to Naples by groups like Blue Zones and others. However, there is a continuing concern about how we're handling new construction and growth. We continue to build our new neighborhoods based on the availability and use of the automobile. We are building sprawl of the worst kind, The new neighborhoods are not walkable or bikeable. They are isolated from the commercial services and social centers that seniors need and want. They do not contain enough mixed housing. They are not friendly to older seniors, working poor or beginning professionals. We need to look at how we plan our new communities. Since WW II, we have developed our road systems and our suburban housing areas on the assumption that almost all citizens had access to an automobile. As our average life expectancy has extended well into the 80s and is headed for the DRAFT 6 | Page 90s, seniors are outliving their ability to drive safely. We need to rethink the layout of our neighborhoods. Numerous organizations have begun to address this problem and have come up with plans to redesign neighborhoods and commercial centers to accommodate the need of the growing and aging population. Among these are AARP with it “Livability” programs and the National Association of Home Builders with its “Universal Design Program” We believe the Commissioners would benefit from a review of these programs. There is one issue that probably should fall under this category and that is the identification of isolated seniors prior to any emergency such as a hurricane. The experience with IRMA indicates that there are numerous seniors living alone areas that were not accounted for when most evacuated before Irma arrived. Seniors that are isolated either due to physical location or loss of their social support networks are a growing concern. There is no centralized lists identifying them. Many separate groups such as churches, food distribution charities and Government operated social services have partial lists but there is no central clearing house or list that can be made available to police or EMS personnel during an emergency. The committee looked at several options and following discussions with EMS personnel, it was determined that the use of the of the CERT teams would be the ideal, low cost solution. Since these team will be given specific geographical areas of responsibility and be responsible for reporting back through the EMS network the level of damage and emergency needs in their zone, it would be a simple add on to require them to identify those isolated seniors in their areas of responsibility. This could be done as part of any routine exercise of the network scheduled before an emergency occurs. Since these teams will be the first trained responders with individual portable communication to enter their zones, they are the ideal organization to assume responsibility for this requirement. This could take a significant burden off the Emergency Centers who otherwise would spend many hours responding to out County calls by relatives and friends checking up on these seniors when they cannot contact them. DRAFT 7 | Page BACK TO INFORMATION ACCESS AND RESOURCE AWARENESS Based upon our initial reviews, we believe there are two steps that can be taken immediately that will improve citizen awareness of the services and resources available. They are: 1. The creation of a joint government / private sector “Senior Web Page” that will contain, among other things, information and/or links on the following: a. the schedule of Government open meeting and the principal subjects to be covered, b. a listing of the main senior services available either from the government or the private sector with information on how to find them, c. a listing of the major civic events and private sector meetings that may interest seniors, d. lists of community events of interest to seniors. This web page can be paid for and operated by one of the non-profits serving seniors. 2. The opening of discussions with the Naples Daily News to publish weekly or by-monthly a” Senior Page” containing the information listed above. SUMMARY In sum, the Senior Advisory Committee is organized and on the move. We are focusing in information resource primarily but are also reviewing the senior components of the needs studies. If the commission thinks we should change our direction or focus, we ask for your guidance.