Loading...
Senior Advisory Committee Agenda 04/01/2019April 1, 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. March 4, 2018 7. Staff Reports 7.1. Collier 311 overview 8. New Business 9. Unfinished Business 9.1. Refine Report for Board of County Commissioners 10. Announcements 11. Committee Member Discussion 12. Next Meeting Time, Date and Location 13. Adjournment 38.A.2 Packet Pg. 1342 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) Commissioners, Since April 18, 2018 the Senior Advisory Committee has met 12 times to discuss Senior issues in the Community. The Committee has heard from several County Divisions and some external stakeholders about the services being delivered to seniors in the community and potential opportunities for the County. The Following list is comprised of several topics/areas that the Senior Advisory Committee feels the County should consider. The Senior Advisory Committee seeks your direction and looks forward to working with the County to further identify solutions to these issues. Senior Citizen Communication 1. Collate current County information sources 2. Collect and promulgate information (for profit, nonprofit, and public) about senior resources. While seniors are becoming adept at information technology, traditional avenues for informing seniors should be utilized (Newspaper & Radio) Senior Isolation 3. Drill down to a granular level. ‘Precinct captains’, from HOA’s, condo associations, etc., who could coordinate a system of contact with every senior for safety and quality of life. Housing, Health and Wellbeing 4. a complex issue that must be addressed – affordable housing, co-housing, home sharing – this is an issue that involves multiple organs of county government and attacking it may be a deferred priority for this committee. 5. The need for additional senior centers has been demonstrated by the huge success and the assistance to seniors offered by the Golden Gate Senior Center operated by CSR and the Naples Senior Center operated by Jewish Family Services. Similar centers are needed at a minimum in East Naples and in Immokalee. The county should work with nonprofits and its own excellent senior services operations to make this happen. 6. There is a need for Community paramedics who could follow up with repeat call users of their EMS services as well as with discharged hospital patients who also call and have limited ability to implement the discharge guidance provided by the hospitals. Many if not most of these users are seniors. The County should work with the hospitals to provide in home services that would reduce EMS usage for falls, etc. as well as reduce returns to the hospital largely for failing to follow discharge plans. General Design and Accessibility for Seniors 7. Universal Design options for new or existing construction – could this be incentivized by the county? 8. The need for additional bus stop shelters and a possible program (public/private Partnership to pay for them, 9. Senior mobility – this is most daunting of the tasks. Mass transportation is nodal, so getting the senior to the pickup site is a challenge. Also, mass transportation (e.g. – buses) can be intimidating and off-putting for people who have always led private, self-sufficient lives. An enormous challenge (Mini-buses, ‘Uber’ partnership with government?) 10. Pedestrian islands, countdown lights. With 12-lane city streets, it may be impossible for seniors to cross these byways in any amount of time (Ms. Berger). Perhaps the solution is overhead cross-bridges, but would seniors be able to use these (physically or psychologically)? 38.A.2 Packet Pg. 1343 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) Draft report discussion – • It appears that the overriding priority for the management of senior programs, whether or not the Senior Advisory committee remains Ad Hoc or becomes Standing, is to recommend the hiring of a Senior Issues Director or Coordinator (A ‘Seniors Czar’), who can initiate, implement, direct, and coordinate senior needs and resources between the public and private sector. • The current advisory committee could then become a resource for the Director, either as a standing committee of the county or as a non-governmental task force. Committee priorities: 1. Communication – collate current county information sources. 2. Communication2 - we recommend the collection and promulgation of information (for profit, nonprofit, and public) about senior resources. While seniors are becoming adept at information technology, traditional avenues for informing seniors should be utilized (NDN, WAVV [as suggested by Harriet Lancaster]). 3. Senior Isolation – drill down to a granular level. ‘Precinct captains’, from HOA’s, condo associations, etc., who could coordinate a system of contact with every senior for safety and quality of life. 4. Housing – a complex issue that must be addressed – affordable housing, co-housing, home sharing – this is an issue that involves multiple organs of county government, and attacking it may be a deferred priority for this committee. 5. Senior centers – at least one center should be developed for each county district. These may be public, private, or hybrid. Their activities should be coordinated by the office of Senior Issues Director (SID). 6. Coordination of EMS and hospital services to identify and follow repeat users of the emergency system (e.g. – frequent falls). The initiative of Chief Tabitha Butcher should be supported. 7. Universal Design options for new or existing construction – could this be incentivized by the county? 8. Bus stop shelters – Should be combined with #9 (senior mobility?) Shelters should not be advertising kiosks, but ‘naming opportunities’, and the concept should be considered and encouraged by the commissioners. 9. Senior mobility – this is most daunting of the tasks. Mass transportation is nodal, so getting the senior to the pickup site is a challenge. Also, mass transportation (e.g. – buses) can be intimidating and off-putting for people who have always led private, self- sufficient lives. An enormous challenge (Mini-buses, ‘Uber’ partnership with government?) 10. Intersections – Pedestrian islands, countdown lights. With 12-lane city streets, it may be impossible for seniors to cross these byways in any amount of time (Ms. Berger). Perhaps the solution is overhead cross-bridges, but would seniors be able to use these (physically or psychologically)? 38.A.2 Packet Pg. 1344 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) Chairman Hartman’s discussion of the development of mixed-use communities, with a bell- curve of central high-density affordable and conventional residential, green commons, commercial, and public (post office, police, fire, etc.) facilities, fanning out to reduced density, is excellent conceptually. This should be the cornerstone of future development of mid-income and affordable housing for seniors and working people in Collier County. 38.A.2 Packet Pg. 1345 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 1 | Page Final Report to Collier County Board of County Commissioners by the Senior Advisory Committee (ad hoc) April 2019 The Senior Advisory Committee was created by the Board of County Commissioners one year ago as an ad hoc advisory committee with a 12-month life. This report is a summation of the findings and recommendations of the Committee upon the completion of that term. The assigned 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 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 and delivery, 2. Food security and hunger reduction, 3. Affordable housing, 4. Affordable and accessible health care, and 5. Transportation and public safety. It was clear that food security, affordable housing, health care and transportation 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. 38.A.2 Packet Pg. 1346 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 2 | Page However, the issue of information access and resource awareness was determined to be an area that could benefit from additional attention. When we say information access and resource awareness, we are referring to 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 private sector or government. it involves recommendations for general communication strategies, the creation of educational material, and possible 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 attending Town Hall meetings organized by members of the Commission earlier last year added to our concerns. The citizens participating in these and other meetings demonstrated a low level of understanding of what the BCC and County government staff were proposing in the affordable housing area and why. Additionally, we have found that too many of the senior citizens in the County have questions about what government services are available and how to find them. We concluded that this issue indicated that a gap exists between the intentions of the County government and the understanding of the citizens on those subjects. 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 meetings and the principal subjects to be covered, 38.A.2 Packet Pg. 1347 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 3 | Page b. a listing of the main senior services available either from the government or the private sector with information on how to contact 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 the Community. 2. The opening of discussions with the Naples Daily News to publish weekly or by-monthly a ” Senior Page” containing the information listed above. AFFORDABLE SENIOR HOUSING We note that the following comments are made based on our assumption that all agree on the basic principles that our community should be organized to allow all our citizens to “Age in Place” and retain their independence for as long as possible and that we seek to treat all age groups, both the young and the old, equitably. The recent analysis done by ULI and the BCC appointed stake-holders committee 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. Collier County’s current demographic indicated that 31.4% of our population are over 65 and more than half are over 50. We expect that most of the newcomers will be retired millennials. By the time Collier County is built out, the majority of our citizens will probably be over 65. We need to build homes that are affordable for them as well as the added workforce needed to support them. It is not unreasonable to assume that four or five low income seniors will stand in line for affordable housing beside every worker. Our needed affordable housing has been vastly underestimated. UNIVERSAL DESIGN AS A HOUSE PURCHASE OPTION FOR SENIORS 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 38.A.2 Packet Pg. 1348 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 4 | Page 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 where 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. The new recommended lay-outs is being called “Universal Design”. We believe the Commission should direct the staff to evaluate a requirement that all new home developers 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 basic Universal Design modifications to a new home before it is built-out could be less than $300.00 USD. We emphasize that we are advocating requiring that new home developers offer a universal design option to buyers but 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 have low-cost fixes. If we are going to create an “Age-Friendly” “Livable” community, 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 need additional sidewalks and more streetlights, particularly in the Immokalee area. Older seniors find it difficult enough to walk with a cane or walker during daylight over smooth surfaces. It is all but impossible 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. 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 38.A.2 Packet Pg. 1349 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 5 | Page in mid-August 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 concerns about traffic flow, but it should also be dictated by concerns for seniors with lower mobility. 4. The issue of placing cement curbs at the end of parking spaces in our public parking lots needs 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. An informal survey of lots that do not include the curbs indicate no increase in disarray or neatness. In many locations, 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 are 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 problem is beyond the scope of the Senior Advisory Committee. We can only acknowledge that it exists and tha,t for those affected, represents a serious problem. EDUCATION AND SOCIAL SERVICES Education is an area outside of the scope of the Committee’s charter. 38.A.2 Packet Pg. 1350 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 6 | Page 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 is around 200+ and that there is a waiting list of more than 700 qualified needy residents. The county 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 a specific 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 or affordable housing. They are not friendly to older seniors, working poor or beginning professionals. We need to look at how we plan our new communities as we grow to the East. Since WW II, we have developed our road systems and our suburban housing areas on the assumption that almost all citizens have access to an automobile. As our average life expectancy has extended well into the 80s and is headed for the 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 38.A.2 Packet Pg. 1351 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 7 | Page the need of the growing and aging population. Among these are AARP with it’s “Livability” programs and the National Association of Home Builders with its “Universal Design Program” mentioned earlier. We believe the Commissioners would benefit from a review of these programs. ISOLATED SENIORS 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 confirmed that there are numerous seniors living alone that were not accounted for when most were evacuated before Irma arrived. Seniors that are isolated either due to physical isolation or loss of their social support networks are a growing concern. There is no centralized list 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 annual 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 that otherwise would spend many hours responding to out of County calls from relatives and friends checking up on these seniors when they cannot contact them. 38.A.2 Packet Pg. 1352 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 8 | Page One idea would be for the BCC to declare a Senior Day on a Saturday in late Spring and in conjunction with Collier County School District and the Sherriff’s Office to form teams that could do a door to door survey of each CERT area. The school district could encourage and organize volunteer high school juniors and seniors to fill out the teams as part of a county wide “Civic Day”, not dissimilar from “Earth Day” programs In sum, the Committee has found several issues affecting seniors that we think are deserving of the Commissioner’s attention. Most require a programmatic approach to solve the problem. The restrictions imposed by Florida’s Sunshine laws make it difficult for an advisory committee such as ours to organize solutions for the problems identified. CREATION OF PARAMEDICS CORPS IN COLLIER COUNTY A final problem identified by the Committee involves follow-up on patients discharged from our hospitals without suitable support in their homes to ensure that the patients follow discharge instructions on medications and physical therapy. A similar problem exists for the Fire and EMS services when they make an emergency call on a patient requesting assistance and determine that the patient is not sufficiently injured to require transport to the Emergency Room. Many of these calls are repeat calls for patients that have fallen repeatedly or who are mismanaging their prescribed drugs. There is no organized follow-up to ensure that their primary care physicians are notified, or other remedial action is taken. This problem is not unique to Collier County. It has been reported in many communities throughout the United States. The recommended solution is the creation of a County paramedic Corps of a few individuals trained to conduct follow-ups. This would save the expense and unnecessary dispatching of Fire and EMS assets and would likely pay for itself in saved trips and avoidable readmissions to our hospital system. We recommend that the Commission instruct the staff to evaluate this option and develop recommendations for action. 38.A.2 Packet Pg. 1353 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019) DRAFT 9 | Page FINAL DISPOSITION OF THE COMMITTEE It is now time for the Commission to decide the future of the Committee. We believe there are three options: 1. Establish the Senior Advisory Committee as a standing and permanent Advisory Committee to the Commission. 2. Disband the Ad Hoc Committee. 3. Create a senior position of” Senior Affairs Coordinator“ responding directly to the County Manager or Deputy County Manager and responsible for coordinating the aspects of county programs affecting seniors in all departments and agencies and acting as a singe point of contact for private sector organizations with the County government. This individual would have no operational authority but rather act as a coordinator for the County Manager. This would allow the private sector to organize an umbrella coordinating Committee formed outside of the Sunshine Laws to work closely with the Senior Affairs Coordinator. The Senior Affairs Coordinator also could act as the supervisor for the weekly or bi-weekly “Senior Page” in the local media We recommend option #___ (To be determined) Charles D. Hartman Chair 38.A.2 Packet Pg. 1354 Attachment: Agenda and Backup Documents - April 1, 2019 (8821 : Senior Advisory Committee - April 1, 2019)