BCC Minutes 01/17/1984 W
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:Ir,pl(!s, Florio,', Jðnu<.lry 17, 19!!4
LET IT bE REMEMBERED, that the Board of County Commissioner" in
and for the County of Collier met In WORKSHOP SESSION at th~ Courthouse
Complex, East Naples, Florida, lit 2:21 P.M. on this date with the
following members pres(!nt:
CIIAIRMM/:
DII V I 0 C. R r own
John A. f'lstor
f'rcùpr I ck J. V05S
I\lJS ¡:NT:
Vice Ch.,1 rm.1n Ilo11,ln"
~nry-~r~nccs Kruse
AL:W I'HE:>¡:NT:
Elinor M. :;klnnur, DupULy Cler}q 'ferry Vlrt{t,
Acting County M.Jn'''Jcr; ...no Actln'.J AssIDtnnt Count.y i1dn,1y"r Norton.
AGDi::JA
Prcaontdtlon by "epr~sontatlvcs of the Stntc of
F lor I d d II c .J! t tl Ml r "" tl:. b I I It" ti 0 n :; c r \' I e l' s con c o! r n-
Ing tholr proyrnm nno services
INTRODUCTION OF STATE HRS REPR[~ENT^TIVES
/,cting Assistant County '~"n,'qcr :Iorton Introduced MS. Mary Lou
fogle, Direct :';crvlcc ~;upcrvl:ior, Flurid.. 1I""ltl1 .1nd ;whilbllltDtlon
S"rvlces.
Ms. Fogle expl.1InL'ù th.lt sh" :.>upurvl:ic5 t./l'J loedl IIR~
office, ill1 chllaren Derv!ces progrdms "nd adult Gcrvlecs.
She said
that Mr. lIugh Gilmore supcrvls~s the unit of people who provide
survlcc!ò to ddul ts n tile comlllun 1 ty.
She 5<.110 hp would address
demographic data.
:';ho \Jxplaln"ò thdt Mrs. H"lon Fðl1crt work!! In the
CdpAcity of Progrüm SupervIsor for thu ^glnq .,ntl Adult Serviccs for
D is t r let ¡¡ w! ':. h t II \J II H ~ Pro g r <.1m () f [ ! <.: L' sou t 0 f t h Po D 1 s t r1 c tin Fo r t
M ye r s, Fl 0 rid a.
She sdid Mrs. fJll\Jrt would ~p~ðk to authorization and
monltorln~ the fðcll!ti~s.
REPR~SENT^TIVES' PRESENTATIONS
Ms. ~'o'Jlc s,lld thdt thu ¡::urpose of this .....orkstloµ i:.> to describe
the types of programs available for alternate living arrðngements for
adul ts.
She explained these refer to the v~rious types of placement
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,gD~ . 079 PACt 722 Janua ry 17, 1984
.ervic.. that aro available to adults. She s~id that placement reCer.
to actual rolocation in the various type. of setting. She .aid that
the adult. are eligible by either age and/or disability and that the
primary 90al of the program is to provent institutionalizing parsons
wherever possible. She said the program, olso, de-institutionalizes
persons who may have recouperated In order to re-enter a community,
rather than remain in an institution. She said that the objectives of
the program are to IIssist clients who are living independently in a
comlllunlty, to re-Iocate to a need Cor a particular setting for theml to
prevent the need for nursing hot:lt' care or stÐte institutionalization by
appropri a t.e placcment in alternatives, to facilit~t. moving clients
from nursing home. to their own homc~, whcrover possible, and to
Increas. community placemcnt from statu Instlt.utlons. She said an
attempt In made to match tho individual client to the type of setting
and sponsor or represcntative who runs the program, with regard to the
clients'. ability and age. She explained the following Cour types of
alternate care posslbllitlCts: Home Cðre for tho! Elderly, Adult
Congregate Living Facility; Adult fost~r Home and Institutional Care
Prog r ÐI\I.
Home Care for tho Elderly: Ms. Fogle explained this is a
situation where a person may not have to move because they are already
residing with Camily members, and it allows the person to stay in th.
family situation among the contacts and friends they have In the
community. She said t~CrQ is Ð range oC p~ymQnt8 offered to subsidize
the family for caring for the individual, from a minimum of $86.00 to a
~axlmum of $362.00 par ~~nth. She said there is an element of support
payment. to holp pay for sorvices not covered by other medical
insurance. which could rango from nothing to $134.~O.pcr month
. "
depending on the Individual'. .ituation.
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~·~·..ld·.~~1a1 '.tt-.ltng, 'but' who 'lIay not have family'of his own"within ta ,·,.t.'¡
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·~~'.·è~~~ni~Y with whom to r..id~~, She uid it is designed to r..embl~ the ..' ",~
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I fa.ily llving sltuation and li~its the number of residents to three.
She .lIid that the residents must be 65 yeðrs old or 11 disabled adult,
18 years old or older.
She sllid that placemont must be agreeable to
the sponsor and client being p1ace4. She said :hllt a physician's
.tate~ent is needed from the client's doctor indicntinq that It this
type ot care was not available the person may be hospitalized or
institutionallxed. She .lIid that the client's Incomo is added to an
optional atate suppl(!mentation which would yield $)52.00 per month to
care for roo~ and board requirements IInd 038.00 per month to cover the
clIent'. personal needs.
Adult Congregðte Living 'acility: Ms. fog Ie Bðid this fllcility
.trlves to create a home-like environment, however, there are a larger
number of residents than In a private fostor Home.
She said the
eligibility requirements are the same as the Foster Home and the room
and board rates allows the aponsor to be paid $400 per month Cor room
and board and costs.
Institutional ClIre Progrllm: Ms. fogle said thi~ is the nursing
ho~e placement.
She explllinod thðt th(! eligibility to receive govern-
1
~·.ent oaslatði,ce
would requiro the sum of $800.06 or less s month and
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that the person's resources not exceed a maximum oC $1,500. She said
that a physician's statement Is definitely required indicating that
this type of care is what is necesslIry.
Ms. fogle said that the Individual must participate In their
planning and placements in IIny of these situations. She explained that
'
.....the exception 16 in the event that a guardian is appointed due to a
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it 'colllpetency ruling. She slIid for those instances nur¡;ing home
f placemen'ts would probðbly be made.
" .
~~. Mr. Gilmore expl~ined he WIIS present to talk about the -greying of
.I.lIIer ic a-.
lie slIid thllt Florida will continuo to be the crucible that
the r(!ßt of the United Stlltes will continuo to watch because of the
population shifts. lie reviewed demographics which included the
projection from Senator MIInn, three weeks IIgO, that 6,000 people will
move into the Stllte of Floridll on a weckly basis. lie referred to a
Fort Myers Ncwß Press article that Indicated by the year 2000 one in
every Cive citizens In Florida will be 65 IInd older. He 3aid this fact
will not be true in the Unitcd StðtC9 until the yellr 2050. He slIid
thðt the IIrtic1e indicated that 1(3 of the population In the west coast
counties is 65 yeðrs old or ~bove.
H., sðid this section of the populð-
tion Dwelled by ovcr 70\ during the last decllde IInd thllt the population
of plH:Jons 85 yeèHs /lnd over, 104'"
He said figures Indlcðte that in
1980 thcre were 1.8 million people 60 years old and ove~ In Floridð IInd
I: the projection for 2000 indlcðte thcre wil bð a population of 3.4
" million.
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Mr. Gilmore said there will be an increðD~d demand for the
aforemen~ioned servlc9s. He slIid that the best estimates is thðt 4\ of
\
any population, 65 years old or above, will neðd some tYPð of
t
alternative living ðrrangement. He explained his projections using the
1980 cðnsus figures for Collier, Lee IInd Chðrlotte Counties.
He 8a id
if all the availðble beds in thesð counties are combined ðnJ 4\ of the
above 65 years of age in each of the counties are juxtaposed
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beside the number o! ðvailllble bed~, the result
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for
and in Lee
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Januaiy 17, 1984
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fte uid that the concern i~.for the YU'~"~?!.?";r~~~:~'."':"
of pr...ure that will bo brought to bear on the 'Stat. ~"'~:.. .
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Fallert explained thllt she is tho Program Supervisor for t.h..·· ',J P'
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co~munitles t.O ~e.t the needs.
Adult 6ervices for District 8, that encompasses seven
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counties Including Collier County. She stressed that this presentation
is discussing fllclllties not just for HRS clients but for all older
people who ~ay need a typo of. living .srrangement. Sho exp1.1ined the
~anner in which the HRS Department approaches thesc kinds of facilltios
'.
~': and the regulatory proces8 with each 8ituation. She I1lIid the Home Care
..;~:>
and the Adult FOllter Home facilities lire not governed by II Statute.
6he said that anybody who IIpp1iu9 to oppr~te II foster Home or to
receive a subsidy, under Home CIne for the Elderly, goes through an
approval proces8 tó~etermine the eligibility or that tho adequate,
appropriate care can be provided.
She said that IIRS personncl are in
those facilities regularly for monitoring ðnd that a routine annual
approv1l1 is done.
She said, in the (!vcnl of II complaint, tho HRS
personnel immediately go to the facility.
Mrs. Fallert said that the Adult Congregate Living FlIcillty (ACLF)
will come to thQ attention of the BCC more th...n the oth(!r fllcilities,
because people will come beforo the Board to request zoning changes In
,
ord-r t.o 'dev(!lop these facilities.
She expl~incd these facilities are
licensed by the HRS Department under Stlltute lind, until 1/13/84, it was
her officc's responsibility for thðt license. ~he polntod out the
function now rests with the HRS Office of Licen~ure and Certification,
the same office thllt licenses nursing homps. Sho explained the sct of
rules that governs the liconsing procüss that rango from the quality of
car. an individual would rcceive to the type of sink and fire ext.in-
9ulaher that are necessary. She said the rules are to provide
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~~ 079 ~A~t 726 JlInUI!fY 17, 1984 ,.I·t~'~~;
I ~~~·.~~.urð~c'; thðt ~n individual going into these facilities will rcceive\. . ;;.
~,~OOd and slife ClIre, which is the HRS Dcpðrtment's mlljor conc(!rn. She
.ðid these facilities lire licensed annudlly ðnd monitored between
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t'llcenølng.
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She aaid any type of complaint Is investigated Immediately,
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to ensure there Is no ðbusc of individual or inadequacy of care.
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She said thllt thoy ~crve people othor thlln HRS
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^ discussion wa3 held rogarding the projected numbcr of beds In
Collier County ðnd CommlBslon~r plstor requ<,~tod c1arlficbtion. He
referr~d to future fllcillties, such as Luly PlIlms, which will be II
rcntal fDclllty with a nursing home atLlched dnd IIsked if the figures
are conaldcred II part of congrogato living for pcop1e ovcr 65 years of
age.
Mr. Gi1moro s...ld thðt [lIcilit!(!s such dB Moorings P"rk are
considored lit. Cðre facllitlos where a porson purchases or rents ð
unl.. 'He sdid theDe dre fnr different than the ACLP ðrrangement
discussod.
lie slIid it is his impression that Moorings Park should not
b. considered an ACLP, as it currently is, since it involves ownership.
He said when he WðS doing his statistical bna1ysis, he oliminated Ilf.
.,
I (. care centers in overy county.
Commissioner Plstor reforr(!d to his
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I pertlclpðtlon on the lIelllth and Mcntal Health Council IInd tho
il\pression thðt he recoivcd that Collier Cour,ty had moro nursing home.
beds than w~re required.
He 611id he did not agree wlth thllt sentiment.
'.
Ha reforred to an example of ð situllt!on where a person Is hesitatlng
to apply for a Certificate of Noed for a ACLf because of the
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facility may do ~o it tho requirement. ðr~ lD~t. ""'~' '
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that the reguest will te denied.
Mrs. Fallert soid that
home does not hðva to be part.,?! an .a.CL1".
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",. ¡lid In "'CLF . d.!1ned by law a. any facility thllt provides room
·~h1t~.1l·'~¡~~ per.onal care for I twent.y-four hour period for four or lIIod.
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~unr.lat.d Individual.. She aald the facilities range from t.ho.e t.hllt
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~provide 'care for four perlons to facilities thllt hllve 300 or 400 beds.
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She pointed OUt tha't. .ome fllcUtl.. have apartments and noted that
Moorings Pork is at one end of the spectrum. Sh(! said the~e IIr. all
expected t.o ~eet the sam. regulat.ions whic~ somotimes crelltos problems.
Tape '9
Mrs. f1l1lert exploin(!d that, by la~, IIn ACLF cannot provide
.killed nursing c~r~ or administer medIclItions and thllt they may
.upervise the taking of mr.dication.
~he said th~t II nursing home is
the only facility that can do 80 and that a Certificate of Need is
required for a license. Acting County Kðnager Virta pointed out that
there ~re two provislonöl use petitIons before the ßCC for ADCL
facilities, recently". lie Di11d onc WdB In Golden GlIte Estlltes, for four
people, and one off Kelly ROðd.
Thcro being no furthcr bUHIncB8 to come be[ore tho: Board, tho
Workshop was adjourned lit .3: 15 P.M.
~OD' 079 mt 727
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