Senior Advisory Committee Agenda 01/07/2019January 7, 2019 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. November 5, 2018
7. Staff Reports
8. New Business
8.1. Refine Focus Areas and Ask to the Naples Daily News
8.2. Harriet Lancaster Second Report on Falls and EMS Calls by Seniors
9. Unfinished Business
10. Announcements
11. Committee Member Discussion
12. Next Meeting Time, Date and Location
12.1. February 4, 2018 10:30 a.m. County Manager’s Office Front Conference Room
13. Adjournment
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WilligGeoffrey
From:jacqlynpie@aol.com
Sent:Thursday, November 8, 2018 6:34 AM
To:WilligGeoffrey
Subject:Re: Senior Advisory Committee Meeting/Member Priorities
Geoff:
My three senior citizen priorities and suggestions are as follows:
1) Isolation
a. Identify individual senior households
b. Establish contact person in condos and/or neighborhoods
c. Make door-to-door contact
2) Poverty
a. If possible, identify those seniors in poverty by contacting social
security to determine those living off their monthly checks without any
other means of income
b. Offer food banks in churches, senior centers, and social services
agencies
3) Health Needs
a. Identify and create listing of home nurses and others who give
home care
b. Non profit organizations encouraged to underwrite and distribute
"emergency buttons" to seniors in need
Many thanks,
Jackie
Jacquelyn Pierce
239-293-3411
jacqlynpie@aol.com
-----Original Message-----
From: WilligGeoffrey <Geoffrey.Willig@colliercountyfl.gov>
To: Doug Hartman <charles.hartman2@gmail.com>; Harriet Lancaster <harrietllancaster@gmail.com>; Jacquelyn Pierce
<jacqlynpie@aol.com>; Joel Kessler <jkessler58@earthlink.net>; Larry Magel <lnmisles@gmail.com>; Litha Berger
<lithasberger@gmail.com>; Thomas Lansen (tlansenfl@gmail.com) <tlansenfl@gmail.com>; Victoria Tracy - Senior
Advisory Committee (vicki.tracy@comcast.net) <vicki.tracy@comcast.net>
Sent: Fri, Oct 26, 2018 11:21 am
Subject: Senior Advisory Committee Meeting #8
Good Morning,
At the last meeting I was asked to provide the list of priorities to the committee members ahead of the next meeting.
The attached is a letter that was discussed at the May 3rd meeting. At this meeting the consensus was that communication
was the main priority since it can address many of the topics included in the Chairman’s letter. The committee was also
interested in looking at ways to address senior isolation.
I have prepared the minutes from the previous meeting which can be accessed at
https://colliergov.box.com/s/jkttsqz4ssc7s5ofvrfoii5c183njysu. This folder will be where I will place the Agenda for the
meeting and any other backup material.
Respectfully,
Geoff Willig
Operations Analyst
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WilligGeoffrey
From:Charles Hartman <charles.hartman2@gmail.com>
Sent:Saturday, November 17, 2018 12:56 PM
To:WilligGeoffrey
Subject:Three primary goals for SAC
My thoughts on the three primary goals we can pursue for this year are:
Focus on improving communications between the CC Government and the more than 100,000 senior
citizens residing in the County. Sub‐components for this effort could include:
o Coordination with the Naples Daily News Staff and editorial board to highlight upcoming major meeting
of advisory committees, major policy development meetings on major issues in the county public
square, publication of articles and guest commentaries in the NDN, and notifications of upcoming major
events in the Geater Naples non‐profit calendar
o Assist United Ways of Collier County and Lee County and The Senior Blue Book staff to set up a central
web page covering all upcoming events affecting seniors. The web page could include a listing of all the
major resources that have been made available to assist seniors and how to reach them.
o Publication of periodic white papers outlining the impact on seniors of major policies instituted by the
BCC,22.
Identification of isolated seniors living the Collier County and make recommendations on how to maintain and
update the list for use during natural disasters and other emergencies in the future.
Assist County EMS in finding solutions for follow‐up on EMS calls for which transport to medical facilities.is
not indicated. This would particulary focus on EMS repeat visits which consume too many resources and
unnecessarily increase costs.
Geoff,
Could you send out a note to the Committee reminding them that their similar input is now due and that you will
consolidate the results into a single list you can send out prior to the next meeting?
Doug Hartman
8658 Mustang Drive
Naples, Florida 34113 USA
Cell: +1 703 582‐1855
Tel:+1 239 331 8662
charles.hartman2@gmail.com
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WilligGeoffrey
From:Harriet Lancaster <harrietllancaster@gmail.com>
Sent:Tuesday, November 20, 2018 11:37 AM
To:WilligGeoffrey
Subject:My Input for the Next Senior Advisory Committee Meeting
I thought we agreed to work on this at the next meeting in early December. I have a background that includes process
training and organizational development. I was planning on a simple design to help us come to consensus. However if
you prefer we give you focus areas in advance I will give you mine. There is a difference between what I think is feasible
and what I believe is most important and I wanted to deal with that in the meeting. But here are four foci for me.
1. Affordable Senior Housing (we are least likely to have any impact here)
2. Additional Senior Centers, in Immokalee, East Naples and Marco Island. ( these can be done with some pubic/private
non‐profit partnerships and so are very feasible).
3. Enhanced and Integrated Assessment and Services for Isolated and often home bound seniors. (This is also feasible
and I will have a report on this related to my falls follow up research).
4. More Visible and Effective Information and Referral ( this is not easy but ultimately doable).
Geoff, I am working on the report and input for a no cost RFP for assessment of 911 callers who ultimately do not get
hospital transport. Since the last meeting I have talked at some length with Dr. Hubaicca, Jorge Acquilera. (Both of whom
want to meet with me and Doug Hartman and I don’t know if that is feasible under Sunshine laws) and also to Dr. Gail
Casiola (about Parish nurses). I plan to write up another report to be discussed with the committee at our December
meeting as Acquilera and Hubaicca are working on this from a slightly different approach.
I will also work on input for a draft no cost RFP, as we discussed, for profit and non profit organizations to bid on a
rotating list of assessors to go in after more than one reported fall/call that doest not lead to hospital transport. This of
course will require a client release form designed and signed. I have at least four people that will review this for us and
give input, Mark Hahn, a social worker who does Medicare assessments, Cass Hubbard who is the case manager for the
Moorings and also does assessments, Mr Acquilera, and Mike Regean who hosted a workshop on this topic in a slighty
broader context. Since it is Thanksgiving week I would like to have them review it over the next weekend and get back
to me with their input. I will have it out to them hopefully by tomorrow afternoon. Therefore I would like your
agreement to get the draft RFP to you next week. I can send my additional report by Friday as you asked which would
allow you to get it out to our committee. I think any draft input I do for a no‐cost to the county RFP would be much
enhanced by some review from people on the ground in this issue. Please let. Me know by tomorrow if this is o.k with
you and if you want me to do any work on reaching consensus for top issues at the December meeting so I can prepare
in advance. Thank you, Harriet
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Senior Advisory Committee
Meeting December 3, 2018
Identifying Needy Seniors:
Isolation
Money
Language
Health
Poverty
Transportation
Communication
The committee is charged with identifying the isolated seniors and come up with
recommendations to provide a source of communication and location of
seniors in need.
The committee has discussed the difficulty of developing a system that identifies
seniors who are isolated and hard to locate and communicate to let them know
recourses are available. This is especially true during hurricanes, storms, fires,
emergency situations that call for evacuations.
My suggestion is to interview agencies that exist and are active in providing
services to the aging community such as;
Food Bank – which just marked the destruction of 200 million pounds of
food this past Tuesday,
Churches
Community Foundation of Collier County
The Boys & Girls Clubs
Schools
Fire Departments
Police Departments
Emergency Rooms at NCH and Physicians Regional
Senior Centers
Possibly there is a way of setting up a system connecting various centers,
churches that would be the recourse that has the location, name and specific
needs of seniors in a particular area. This could be connected to a senior high
school program using technology as the bank of information relating to the
location and specific needs of each individual.
Litha Berger
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Proposal for Interim Assistance to the Collier County EMS for Home-Based
Service /Assessments Follow Up
Recommendation from the Senior Advisory Committee to the BCC,
We propose a no cost to the county Request for Proposal for qualified
organizations who have the skills and interest to visit clients of EMS in their
homes and assess and refer, when appropriate, to prevent or reduce further
calls. EMS would make the referrals with a signed permission by the client. This
could be an interim measure until a community paramedics program or
equivalent could be funded.
Statement of Need—There were 313 calls to EMS in 2017 many of which did not
lead to transport to hospitals. There are often repeat calls for in home transfers
back to a chair, a bed, etc. EMS ambulances and fire fighters all respond to these
calls, which is costly and does not help with prevention or improvement of quality
of life over the long term for the clients who call. There were also 3,452 pubic
assist calls received by the dispatch center of which most are for lift assist.
Background of Issue. from Community Medicine Roundtable report of Feb. 2017
provided by Dr. Michael Reagen, convener
The summary points out that over the past two decades there have been
marvelous advancements in EMS/Fire and Rescue agencies that intersect to
provide timely care for stroke, heart attack and trauma emergency management.
It summarizes the many chronic illnesses that Collier County residents suffer from
and then suggests moving to providing preventative primary care to patient
populations with chronic conditions that lead to acute conditions. To deal with
this it describes Community Paramedicine programs, an evolving model being
piloted in at least a half dozen states. Community Paramedics with advanced
medical training beyond the standard EMS training would provide in home
preventative visits which helps primary care providers monitor patients, especially
those with a chronic disease, and also spots hazards that might lead to a problem
and an emergency call later. This model requires funding by grant or permanent
source and has not yet been pursued in Collier County. The North Naples Fire
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Department is looking at least two other Florida jurisdictions for another model
for its fire fighters currently to provide in home follow ups and preventative care.
Proposal for an Interim Approach which Could Also Test Reduction of EMS usage
when not appropriate.
What led to this Proposal? At the direction of the Chair of the Senior Advisory
Committee to the BCC conversations were held by a Senior Advisory Committee
Member, Harriet Lancaster, with a number of individuals including non-profit
groups like Bruce Lopez at CARE PATROL and at least one profit making home care
agency, Almost Family’s local director Velma Delgado and other care providers.
These conversations indicate that there is an interest in helping the EMS and the
repeat call clients by doing in home assessments and referrals when necessary at
no cost to the county’s EMS. Care Patrol receives its funding from organizations to
which they often refer. If referrals are required Care Patrol can help with
identifying Medicare and Veterans and Veterans’ surviving spouse resources.
Almost Homes Delgado said she is willing to do the assessments at no cost and
often can line up resources. Those who have no resources and no possible access
would also be identified which is important statistical information for future
program development. Note that there are two kinds of home health agencies,
Certified Home Health agencies that get their funding from Medicare as well as
private insurance and private pay and the second group that are private pay
home care agencies who get their funding primarily from Medicaid, the State or
private pay. The first tends to have nurses and therapists as well as medical social
workers and the second group most often have nursing aides overseen by an RN.
How many agencies would be interested in doing assessments is unknown.
Mike Reagen feels that we could establish a “closet” of transfer equipment for
needy clients through generous business donors. Please note that Louise Pelletier
of the county’s senior services indicates her clients who have case managers and
receive transfer equipment rarely call EMS.
Since EMS needs to be sure they are legally protected for any referrals to
nonprofit or profit-making agencies for assessments we are proposing a no cost
to the county RFP which would have appropriate selection standards and a
common protocol for any organization on an EMS list. EMS would also have to
obtain a signed permission form from the referred client.
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RFP Requirements. -we are proposing an RFP calling for qualified organizations
interested in providing assessment and referral to clients identified by the
County’s EMS. We are suggesting that this RFP be drafted with committee input
from the following by an appropriate county staff person.
Suggestions for the committee membership:
Louise Pelletier from the County’s Senior Programs or her representative; Chief
Tabatha Butcher, Collier County EMS or her representative; Dr. Gail Casiola,
Coordinator of Parish Nurses in Collier Count who offered to help with a protocol
as they work only with four defined parish groups and would not be able to
respond to the RFP; Dr. Paul Hobaica, who works with North Naples Fire
Department’s Jorge Acquilera on a preventative clinic at an Assisted Living facility;
Other community possibilities to work on this are: Kass Hubbard an experienced
health professional who is the current Case Manager for Moorings’ Park. Another
suggestion is: Mark Hahn, a social worker who does home assessments for
Medicare agencies and works with home bound seniors. He is also on the Collier
Senior Resource Board of Directors. No doubt there are others from the county
staff including a representative from the Legal Office who might be included.
There are four desirable tasks for this working group:
(1) an EMS follow up assessment protocol,
(2) a release form for the EMS client,
(3) a no cost to the county Request for Proposal, and
(4) a data form to indicate demographics of each client and referrals made as
well as the in-home prevention recommendations.
A key element of this approach would be a chance to collect and analyze the
data about a non -medical approach to follow up assessment and referral: who
actually participates, their demographics and does it reduce repeat calls. Also, it
can identify medical tasks that would be most useful in further efforts by
medical trained follow up staff to prevent repeat calls and improve client care
and quality of life.
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