Agenda 05/28/2019 Item #16K11 (CCHFA Grant Disbursement)05/28/2019
EXECUTIVE SUMMARY
Request that the Board of County Commissioners directs the Collier County Health Facilities
Authority to disburse grant funds to certain nonprofit health service agencies.
OBJECTIVE: For the Board of County Commissioners to direct and authorize the Collier County
Health Facilities Authority (the “Authority”) to disburse funds to certain health care agencies pursuant to
the recommendations of the Authority and consideration by the Board.
BACKGROUND: Chapter 154, Part III, Florida Statutes provides for the establishment of health
facilities authorities by counties, which have the power to issue tax-exempt bonds for qualifying nonprofit
health care facilities. Collier County established the Collier County Health Facilities Authority in 1979
by the adoption of Ordinance 79-95. Section 154.209 authorizes an authority to levy fees for its services,
and, after allowing for the administrative expenses of the authority, directs the authority to donate any
surplus funds that remain in its account to the Board of County Commissioners, which is then required by
the statute to disburse those funds to “nonprofit human health service agencies.” The Authority has
established a fee for its bond issuance services and has accumulated approximately $80,000 as a result of
bond issues it has authorized over the past three years. The Authority has determined that $30,000 will
cover its administrative expenses for the foreseeable future until further bond issuance revenues are
received, and therefore desires to turn over its surplus funds, in the amount of $50,000, to the BCC, for
the Board’s further disbursal of the funds to qualifying agencies, or, alternatively, the Authority will
disburse the funds directly to the agencies in accordance with the Board’s direction, which is the process
that has been used for previous distributions.
The process by which the Authority brings these recommendations to the Board is the process that was
used in 2011 and 2016, the last time the Authority made a funds distribution, and has been as follows:
1. The Authority advertised the availability of grants by notice in the Naples Daily News and direct
notice to agencies that had applied for grants in the past.
2. The Authority received grant applications from the following agencies, requesting funds for the
purposes briefly described:
a. CHS Healthcare (d/b/a Healthcare Network of Southwest Florida). Request
$50,000. The grant purpose is to assist in funding prenatal and postnatal oral healthcare
on board the agency’s mobile unit, the Health and Smiles Mobile.
b. Physician Led Access Network of Collier County (PLAN). Request $15,000. PLAN acts
as a referral resource where uninsured patients are treated by volunteer medical providers
and clinics. The grant request is for funding for a portion of the Program Manager's
salary.
c. Senior Friendship Centers’ Friendship Health Clinic Collier. Request $5,000. This
facility provides health and dental services to Collier residents over the age of 50 that live
at or below 300% of the federal poverty level. Most services are provided by volunteer
professionals.
d. David Lawrence Mental Health Center, Inc. Request $21,823.60. The grant request is to
purchase furniture and visual surveillance equipment for the Children's Crisis
Stabilization Unit expansion.
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3. The Authority held a public hearing on April 25, 2019 and heard presentations from each of the
applicants.
4. At the conclusion of the hearing, the Authority adopted a motion to recommend that the Board of
County Commissioners authorize grants as follows:
a. That CHS Healthcare receive a grant in the amount of $15,000 for the purposes set forth
in the application.
b. That PLAN receive a grant in the amount of $15,000 for the purposes set forth in the
application.
c. That Senior Friendship Center receive a grant in the amount of $5,000 for the purposes
set forth in the application.
d. That David Lawrence Mental Health Center, Inc. receive a grant in the amount of
$15,000 for the purposes set forth in the application.
Deciding among and reducing some of the requests to fit within the funds available, was a
difficult decision, and a careful evaluation of each request was made, which included an open dialog with
the applicants, all of whom acknowledge that their missions support and complement each other. All the
applicants have demonstrated success in serving the public health needs of the county over many years.
There is a true public need and public health benefit to be obtained from each of the requests.
FISCAL IMPACT: The Authority has accumulated approximately $80,000 as a result of bond issues it
has authorized over the past three years. After disbursing $50,000 in certain nonprofit health service
agency grants as recommended, sufficient operating funds will remain until additional funds are received
from future bond issues.
GROWTH MANAGEMENT IMPACT: None
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney, is approved as to
form and legality, and requires majority vote for approval. -JAK
RECOMMENDATION: That the Board authorizes the Authority to disburse grant funds in accordance
with the above. All grants will be made pursuant to grant agreements that will require that the funds be
used as indicated and provide for appropriate certifications as to compliance.
Prepared by:
Donald A. Pickworth
Executive Director and General Counsel
Collier County Health Facilities Authority
ATTACHMENT(S)
1. Collier Health Services Application (PDF)
2. PLAN Application (PDF)
3. Senior Friendship Center Application (PDF)
4. David Lawrence Ctr Application (PDF)
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COLLIER COUNTY
Board of County Commissioners
Item Number: 16.K.11
Doc ID: 8886
Item Summary: Request that the Board of County Commissioners directs the Collier County
Health Facilities Authority to disburse grant funds to certain nonprofit health service agencies.
Meeting Date: 05/28/2019
Prepared by:
Title: Legal Assistant/Paralegal – County Attorney's Office
Name: Virginia Neet
05/07/2019 1:31 PM
Submitted by:
Title: County Attorney – County Attorney's Office
Name: Jeffrey A. Klatzkow
05/07/2019 1:31 PM
Approved By:
Review:
County Attorney's Office Jeffrey A. Klatzkow Level 3 County Attorney's Office Review Completed 05/07/2019 2:30 PM
Office of Management and Budget Valerie Fleming Level 3 OMB Gatekeeper Review Completed 05/08/2019 8:14 AM
Budget and Management Office Mark Isackson Additional Reviewer Completed 05/17/2019 11:39 AM
County Manager's Office Geoffrey Willig Level 4 County Manager Review Completed 05/20/2019 8:23 AM
Board of County Commissioners MaryJo Brock Meeting Pending 05/28/2019 9:00 AM
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Collier Health Services Inc., d.b.a
Healthcare Network of Southwest Florida
Prenatal Oral Healthcare
Table of Contents
Cover Page P. 1
Organization’s Information
Organization’s Board Members and
Leadership Team
Organization Narrative
Project Description and Narrative
P. 2
P. 2
P. 3, 4
P. 5, 6
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Packet Pg. 1527 Attachment: Collier Health Services Application (8886 : Collier County Health Facilities Authority)
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Organization’s Contact Information
Name: Collier Health Services, Inc. (d/b/a Healthcare Network of Southwest Florida)
Address: 1454 Madison Avenue Immokalee, Florida 34142
Contact’s Name: Stephen Wheeler
Contact’s Title: Vice President of Development
Phone: 239.658.3111
Email: SWheeler@healthcareswfl.org
Organization Type: 501 (c) 3 Non-profit as designated by the IRS
Healthcare Network Foundation Board Members
1. Chair: Fred Pezeshkan
2. Vice Chair: Adria Starkey
3. Treasurer: Dennis Brown
Board Members
4. Doug Campbell
5. Richard Craven
6. Haris Domond
7. Mike Ellis
8. Jeffrey Fridkin
9. Nina Gray
10. Charles Johns
11. Cee Cee Marinelle
12. Edward Morton
13. Pat Read Botthof
14. Gail Webster Patterson
Healthcare Network Leadership Team
Mike Ellis – President and CEO
Dr. Emily Ptaszek – Vice President of Operation / COO
Dr. Corin DeChirico – Vice President of Medical Staff / CMO
John “Trey” Fletcher – General Counsel
Sandy Steele – Vice President of Fiscal Services / CFO
Steve Wheeler – Vice President of Development
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Packet Pg. 1528 Attachment: Collier Health Services Application (8886 : Collier County Health Facilities Authority)
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Healthcare Network’s History and Financial Information
Introduction
Healthcare Network of Southwest Florida formerly known as Collier Health Services Inc., has been a
provider of healthcare in Collier County for over 42 years. Healthcare Network was started in 1977, with a
simple goal in challenging healthcare framework: to provide quality medical and dental care accessible to
all. With the help of collaborations with local partners and the continued support from our community,
Healthcare Network is finding unique solutions necessary to increase access to the primary medical,
dental, integrated behavioral healthcare and senior care for our community at 21 sites including 2 mobile
units. Our Ronald McDonald Care Mobile® and the Health and Smiles Mobile unit which provide oral health
care services throughout Collier County to children and adults. In 2017/2018 fiscal year, we provided
primary medical and dental care for nearly 60% of the children in Collier County and about 40% of the
adults (ages 18-64), and treated 2,757 seniors ages 65 and over living in Collier County.
Among the other health services Healthcare Network offers, our dental team provides preventative services
(sealants), examinations, gum evaluation and treatment, cleaning and Fluoride treatments, x-ray services
and education in preventive care. These services can include but are not limited to: routine examinations
and x-rays, teeth cleanings and fluoride treatments, sealants, fillings, pulpotomies and stainless steel
crowns, tooth extractions, nitrous oxide analgesia, space maintainers and limited orthodontics. In
2017/2018 fiscal year alone we provided 20,984 unique individuals with dental services.
Healthcare Network’s main facility is the Marion E. Fether Center located in Immokalee, Florida. This rural,
predominantly agricultural community is roughly forty miles from the county seat of Naples and is home to
a large migrant community. The area’s population fluctuates seasonally, swelling by more than 40,000
individuals as migrant and seasonal farmworkers move into the area during times of crop production and
processing. The total Hispanic population of Immokalee (CDP) is 75.6% and in Collier County 25.9% of the
total population; higher than the state average at 22.5%. In addition, 23.1% of Collier County are foreign
born; almost 4% higher than the state average and 31.4% speak a language other than English at home for
individuals aged 5 and over.
As discussed above a large portion of the Immokalee area is of Hispanic descent and born in foreign
countries; specifically, Mexico. With this demographic, Healthcare Network has encountered unique
barriers to care for treating patients in Collier County.
Regular health screening, preventive care, oral health care, adherence to medication regimens, and follow-
up protocols are impacted by:
Language and culture;
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Packet Pg. 1529 Attachment: Collier Health Services Application (8886 : Collier County Health Facilities Authority)
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Lack of knowledge of the health benefits of oral healthcare during pregnancy
Access to prescriptions, both due to financial influences and, for migrant patients, while moving to
and from areas of crop production;
Time away from job sites for medical and supportive services appointments;
Lack of income for nutritional and supplemental care;
Transportation to care;
Lack of health insurance;
High rates of poverty and unemployment; and
Low rates of health literacy.
In providing a continuum of care, Healthcare Network has established long term collaborations with a variety
of providers, universities and local community organizations. These include local hospitals such as NCH and
Lee Health System, and community institutions including Florida State University College of Medicine
(FSUCM), and Naples Children and Education Foundation (NCEF). Others include the YMCA and the
Community Foundation of Collier County.
Healthcare Network has policies and procedures in place to provide accounting controls over assets,
liabilities, revenues, and expenses. The finance department utilizes the Blackbaud Financial Edge
Accounting Software. All Financial policies are reviewed, updated and sent to the Board of Directors each
year for approval. An annual independent audit of financial statements is performed and approved by the
Governing Body.
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Packet Pg. 1530 Attachment: Collier Health Services Application (8886 : Collier County Health Facilities Authority)
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Project Description and Narrative
Healthcare Network is a leading provider of prenatal care in Collier County. In 2016 we took over control of
Total Women’s Care and since 2016 we have continued to expand our pre- and post-natal health services
throughout Collier County. In 2017, we saw 2365 expectant mothers. We are requesting $50,000.00 in
funding to provide oral healthcare onboard our mobile unit, the Health & Smiles Mobile to approximately
105 women who are underinsured and uninsured. While we can’t give an exact number of patients to be
treated since treatment plans are so varied based on our previous grant we used an average of $475 per
patient. That number can vary depending on the extent of work a patient may need. Our program will offer
a variety of services including: oral exams, radiographs as needed, teeth cleanings, fluoride treatments,
fillings, and extractions. If patients require additional comprehensive services, they will be referred to our
land-based dental clinics.
The Health & Smiles Mobile is a 40-foot-long, 8-foot-wide, state-of-the-art dental mobile office that delivers
primary dental care to all patient populations in Southwest Florida. The mission of the Health & Smiles
Mobile Unit is to improve the dental health status of the underserved and underinsured populations in
Collier County. Pregnant women and children are particularly vulnerable and we strive to provide
continuous access to quality oral healthcare services. With this grant request, the Health & Smiles Mobile
will travel throughout Collier County to various locations, including Women’s Care Immokalee, Collier
County Health Department, Grace Place for Women and Children, Guadalupe Center and migrant
communities. We will provide specific dental treatment needed for the pre- and post-natal patients by our
full-time dentist aboard the Health & Smiles Mobile Unit. Many of our patients do not have access to
transportation and this will eliminate one of their barriers to care. These grant dollars can provide the
financial assistance to this high-risk population and eliminate another barrier to receiving care.
Another barrier to access of care is a person’s socio-economic status. For instance, persons with higher
annual incomes reported significantly higher rates of dental visits in Collier County according to the 2016
Collier County Florida Health Assessment. In fact, in this Community Health Assessment, it was reported
that Collier has pockets of significant poverty ranging from $10,029 to $22,416 in income per year. The four
communities which account for this are: Immokalee, Naples Manor, Golden Gate City and Naples Park.
These are all areas which we serve the patient population. In addition, the Assessment also reported that
in 2010 only 36.3% of those who are living below the poverty level had access to oral healthcare services;
leaving 63.7% who did not have access to adequate oral health services.
Furthermore, the Collier County Health Assessment determined that in 2014, Collier County residents
made 628 emergency room visits for dental conditions. These dental “emergencies” were categorized as
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Packet Pg. 1531 Attachment: Collier Health Services Application (8886 : Collier County Health Facilities Authority)
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avoidable had these patients had access to preventative care. The charges for these avoidable visits
totaled $833,256. Between 2012 and 2014 dental emergency room visits decreased by 7.5% while the cost
associated with these visits increased by 40%. The highest number of those among these emergency room
visits ranged from ages 20 to 34 with more than 500 visits per year.
According to Prenatal Dental Care: A Review by Dr. Homa Amini, the most common oral disease is
gingivitis, which has been reported in 30-100% of pregnancies. In addition, the Center for Oral Health
states that “controlling the oral disease of a pregnant woman can potentially reduce the transmission of
pathogenic bacteria from the mother to her baby and recommends encouraging all women at the first
prenatal visit to schedule a dental examination if one has not been performed in the past six months.”
These funds will help provide pre-natal and post-natal women with these much needed dental services to
help treat and prevent oral health complications during their pregnancy. The Health and Smiles Mobile Unit
will allow our staff to treat a variety of conditions and provide routine oral health care services such as oral
exams, cleanings, fluoride treatments, fillings and other needed procedures.
These exams are paramount in ensuring both the health of the mother and baby during the pregnancy and
enables our staff to diagnose any complications early and safely treat them with no risk to the mother or
baby. Prenatal oral healthcare has often been neglected during a woman’s pregnancy and most women
are not advised to see an oral health professional as part of their prenatal care; making this program a
unique facet of HCN’s health services. These patients often have little or no medical insurance coverage
and pay on a sliding fee scale or have third party insurers who do not adequately provide coverage for their
dental needs. Without the generosity of the community, our patients would often be unable to afford these
preventative oral services, which are so vital to their health and their unborn child’s health.
This is paramount to ensure both the health of the mother and baby during the pregnancy and will also
provide an opportunity to properly educate the expectant mother on proper oral hygiene during and after
pregnancy, which will lead to better dental hygiene for her unborn child. Dental care can and should be
rendered during all trimesters of pregnancy and can help to establish optimal oral hygiene during and after
pregnancy to reduce the risk of transmission of pathologic bacteria from mother to child.
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Packet Pg. 1532 Attachment: Collier Health Services Application (8886 : Collier County Health Facilities Authority)
Application for Collier County Health Facilities Authority Grant
1. Name, address, phone and email address, and contact person’s name and title:
Physician Led Access Network of Collier County (PLAN)
2671 Airport Road South
Suite 202
Naples, FL 34112
Contact Person: Dr. Bill Kuzbyt, Board Chairperson
239-898-7099
drkuzbyt@bhsfl.com
2. Applicant’s form of organization:
PLAN is a Florida not-for-profit, 501(c)(3) corporation.
3. Officer Names:
Chairperson: Bill Kuzbyt, Psy.D., J.D.
Treasurer: Kelly Daly
Secretary: David Whalley, MD
4. Description of activities of the organization, including history of the organization and
information on budget:
PLAN has been serving Collier County for over 15 years. The mission and
purpose of the organization is to provide the coordination of medical care for
residents of Collier County, ages 18 to 62 years, who need specialty medical care
and who are indigent or qualify with incomes at or below 200% of the Federal
Poverty Guidelines.
Our team of approximately 200 volunteer medical providers offer their services to
qualified patients. The current annual budget of PLAN is approximately
$180,000. The Board of Directors of PLAN are all volunteers. There are two
full-time employees who recruit physicians to become members of PLAN. These
employees also complete the qualification process on patients, to be sure that they
do not have insurance coverage or other ways to pay for the needed specialty care.
This system ensures that PLAN helps the neediest of residents.
In February 2019, PLAN took a significant step in its Strategic Plan by hiring a
part-time Program Manager to manage the day-to-day operations of the
organization and to assist the Board in ensuring that other key initiatives are met.
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Packet Pg. 1533 Attachment: PLAN Application (8886 : Collier County Health Facilities Authority)
5. Description of the uses for the requested grant monies:
For the past few years, PLAN has been working on finding the best way to staff and
run the daily oversight of the office. The Board had decided that the best fit would be
to return to a previous model of having a Program Manager.
The role of the Program Manager has three distinct functions. The first is to liaison
with the Board, overseeing the day-to-day operations to ensure the mission of PLAN
is achieved. The second is to recruit physicians and partners, as well as retain the 200
physicians and partners in the network who are responsible for providing the charity
care to the citizens of Collier county. The third function is to spearhead fundraising
efforts in order to ensure PLAN can continue its work.
In February 2019, PLAN hired Ms. Yvonne Hill as our Program Manager. She was
head and shoulders above the other candidates and has already proven to be a
valuable asset to our organization. The decision regarding hiring a Program Manager
was not a difficult one in terms of needed leadership and having a skilled and
polished professional represent PLAN in the community. The difficulty lies in
ensuring adequate funding for the position.
We are extremely grateful to the Authority for this opportunity. One of the most
challenging aspects for a small not-for-profit is finding funds which can be utilized
for general operations. We have received several grants that help offset the cost of
medications, labs, and needed medical procedures; it is a challenge, however, to find
grants that are permitted to be used for staff salaries.
Since the Authority permits such use of funds, the Board of Directors of PLAN
respectfully requests $15,000 which would cover 25% of the Program Manager’s
salary. We recognize that this is not a recurring opportunity and wanted to let the
Authority know that PLAN will sustain the Program Manager position through a
number of other funding sources.
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Packet Pg. 1534 Attachment: PLAN Application (8886 : Collier County Health Facilities Authority)
16.K.11.cPacket Pg. 1535Attachment: Senior Friendship Center Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1538 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1539 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1540 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1541 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1542 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1543 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1544 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1545 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)
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Packet Pg. 1546 Attachment: David Lawrence Ctr Application (8886 : Collier County Health Facilities Authority)