Item F3
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date:
July 17, 2002
Division: Public Works
Bulk Item: Yes
No~
Department: Engineering/Construction Mgmt
AGENDA ITEM WORDING: Report on use of space in the Old Mariner's Hospital for a dental
lab for Rural Health.
ITEM BACKGROUND: See attached.
PREVIOUS REVELANT BOCC ACTION: On 6/19/02, the BOCC approved the conversion of
departed Commissioner Williams office in the Old Mariner's Hospital into a dental lab for Rural Health,
subject to a report and approval from the Rural Health Board.
CONTRACT I AGREEMENT CHANGES:
STAFF RECOMMENDATIONS: NI A
TOTAL COST N/A
BUDGETED: Yes
No X
COST TO COUNTY:
b:
Stephanie L. Coffe , Construction Manager
AMOUNT PER MONTH_ Year
DIVISION DIRECTOR APPROVAL:
DOCUMENTATION: Included ~
To Follow
Not Required_
DISPosmON:
AGENDA ITEM #~~
Revised 2/27/01
BOCC AGENDA JULY 17, 2002
ITEM BACKGROUND ATTACHMENT
ITEM BACKGROUND: The original estimated cost, including AlE
fees, was approximately $90,000.00, which included approximately
$40,000 of additional millwork. Rural Health has indicated that they
will purchase and install the required cabinetry and all equipment,
therefore the new estimated cost is $50,000.00. This cost includes a
separate Ale system as recommended by the architect, to alleviate
any potential air quality problems.
Also, included in this are provisions for installation of necessary
dental equipment and the revised space layout.
~
July 1, 2002
Bender & Associates
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Ms. Stephanie Coffer, Dir. of Planning & Constr.
Monroe County Construction Management
The Historic Gato Cigar Factory
1100 Simonton Street
Key West, FL 33040
MONROE COUNTY
CON6TRUCTlON MANAGEMENT
JU
liME:
RECfIWB~
RE: Mariner's Dental Office Modification
Dear Stephanie,
As discussed, we are proceeding with the modifications to convert the Commissioner Office space
to a dental clinic for Rural Health Network. In our professional opinion, this space requires a
separate air conditioning system to ensure proper indoor air quality. Therefore, our design
includes a separate system. My April 16, 2002 memorandum to you stated:
Henry Suarez of HNGS, has advised us that while using a separate Ale system for a
dental office may not be a code requirement, it is definitely good design practice. Dental
offices have odors that could be transmitted throughout other spaces of the building if it
does not have its own system, as well as other indoor air quality problems becoming an
issue during the system's life expectancy. Henry felt strongly, and I concur, that not
using a separate system was the wrong approach, but he would comply if he received a
written directive from the Owner. lfyou choose not to use a separate system, please
transmit your written directive through my office, as HNGS is my consultant, and I would
like to have documentation in my file.
Please call if you have any questions.
Sincerely,
A~
\
Bert L. Bender, Architect
BLB/ddk
cc:
Henry Suarez
Dave Koppel
Dent Pierce
Don Miner
Jim Roberts
410AngelaStreel
KeyWest, Florida33040
Telephone(30S) 296-1347
Facsimile (305) 296-2727
FloridlllicenseAA C002 02 2
sC-
MEMORANDUM
DATE:
July 3, 2002
~ONROE COUNTY
VC1l0N MANAGEME/{f
JUL . 2002
11'" "
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TO:
Stephanie Coffer
Construction Manager
Rob Wolfe cA1J
Chief Assistant County A ttornq(J\
FROM:
RE:
Dual AC system at Mariners
hhh~hhhhhhhhhh~hh
rf it is the architecfs professional opinion that Q dual AC system is needed for health
rea$ons, it is this Office's opinion that the recommendation should bi followed even
though the Standard Building Code does not require a dual system. The initial up front
cost will be a minor expense if Mariners, sans a dual AC ~stem, turned out to be a sick
building.
~NW/jeh
03 MONROE COUNTY SHERIFF DEP AR'Th1ENT - Discussion on a surcharge
on parking tickets to fund school crossing guards. The Board concurred with
Sheriff Roth's recommendation which will be brought forward to the Board.
P 1 MAYOR MCCOY - Approval of Resolution seeking support and passage of
House Bill 3878 and its counterpart in the U.S. Senate bulk approved.
P2 MAYOR MCCOY - Approval of Resolution supporting an amendment to the
State Constitution to repeal the required development and operation of a
statewide high speed rail system bulk approved.
P3 MAYOR MCCOY - Approval of Resolution committing our full support to
the Jewish community and their efforts to restore their place of worship and
learning bulk approved.
P4 MAYOR MCCOY - Approval of Mayor's appointment of Nancy J. Klingener,
The Ocean Conservancy, to serve as District I representative, Monroe County
Tourist Development Council deleted.
P5 COMMISSIONER NEUGENT - Discussion regarding the S~eriff's Shared
Asset Fines and Forfeiture Fund, Byrne Grant, and Human SerVice Advisory
Board. Commissioner Spehar will send to the BOCC a justification sheet on
the recommendations from the Human Service Advisory Board. No action
taken.
GB.6 . COMMISSIONER NEUGENTIPUBLIC WORKS - Discussion of proposed
'\ , conversion of departed Commissioner Williams' office into a dental office 5-0
. ~ motion to approve the designation of departed Commissioner Williams' Upper
. Keys office' space for specific use of Rural Health dental lab, subject to a ~
and aQproval frQm the Rural Health Board:
P7 COMMISSIONER NEUGENT - Approval to petition the Florida Division of
Forestry to utilize the Hawkins Act whereas notices would be included in the
tax bill communicating the States interest in managing those lands to reduce
fire hazard bulk approved.
P8 COMMISSIONER NEUGENT/STAFF - Approval to appoint Bob Mock to
the Monroe County Parks and Recreation Advisory Board bulk approved.
Send appointment letter.
P9 COMMISSIONER SPEHAR - Approval to prohibit ceIlphone use by the
members of the Monroe County Board of County Commissioners while the
Commission meeting is in progress with the exception of any announced breaks
bulk approved.
9
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JUL 02 02
RURAL HEALTH NETWORK OF MONROE
COUNTY, FLORIDA, INC.
PO BOX 4966 lIME:
KEY WE 5 T, F LOR I D A 33041 - 4966 JIlECEWmB%
FAX: (305) 293-7573
PHONE: (305) 293-7570
FACSIMILE TRANSMITTAL SHEET
TO: STEPHANIE COFFER FROM: MARK L. SZUREK, PH.D
COMPANY: DIRECTOR; CONSTRUCTION/MC
FAX NUMBER: 305-295-4321 TOTAL NO. OF PAGES: 6
PHONE NUMBER:
RE: DRAFT - RHNMC EXEC. COMMIITTEE MTG MINUTES
URGENT 0 FOR REVIEW 0 PLEASE COMMENT
OPLEASE REPLY
o PLEASE RECYCLE
NOTES/COMMENTS:
Stephanie. . .
Please refer to page 2 of d1c minutc~, "IV, Old Business, part B".
Many thanks!
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RURAL HEALTH NETWORK OF MONROE COUNTY, FL, INC.
EXECUTIVE COMMITTEE RETREAT
CHEECA LODGE, J5LAMORADA, FL
Thursda y, June 27, 2002
MONROE COUNTY
CONGTRUCTlON MANAGEMENT
Minutes
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Officers in Attendance: Mr. Robert Luse, Chair ( CEO, Mariner's Hospital); Dr. Robert C. "Jake"
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Rutherford, Vice Chair (Director, Monroe Co. Health Deparbnent); Commissioner Dixie Spehar,
Secretary (rYf{,nroe Co. District 1); Ms. Debbie Premaza, Treasurer (Vice President, Lifelines Home
Health); Dr. Dave Rice, Officer-at-Large (CEO, Guidance Clinic of the Middle Keys).
Staff Members in Attendance: Dr. Mark Szurek, executive director; Ms. Sandy Higgs, community
outreach director; Mr. Rowland "Bud" Welch, finance director; Ms. Mary Dijkstra, office manager.
Staff Members Excused: Mr. John Pascucci, Jr, health services director; Mr. Keith Douglass, KidCare
director,
Guests: None
I. The meeting was called to order by Mr. Luse. All elected officers of the corporation were
present, constituting a quorum.
II. In a motion made by Dr. Rutherford and seconded by Comm. Spehar, the agenda was moved
for approval. Discussion: Dr. Szurek asked that the following items be included for consideration:
Under N. Old Business, D. Authorizations, part 2, add "Consideration of the FY 02-03 Work Plan";
under N. Old Business, D. Authorizations, add "#6. Approval for the executive director to sign a
contract with the state Attomey General's Office for a nutrition grant in the amount of $30,000.";
under V. New Business, add item "1. Report: Health Insurance Task Force" and item "J. Procedure
for reporting the aclions of the executive committee to the Board for ratification." The group
unanimously approved the agenda with the recommended additions.
III. Mid Calendar Year/Fiscal Year End Reports.
A. Health services. In the absence of Mr. Pascucci, Dr.Szurek subnmitted a report. This
past year, health services has performed over 21,000 services to 3,434 unduplicated
patients and experienced over 4,500 patient visits. When compared to the last fiscal
year, there were OVer three times as many services rendered to 300 more patients and
approximately 200 fewer visits. St. Clare's Clinic in Key West, targeting the homeless,
opened on June 1, 2002. Over $200,000 (retail) worth of medications were provided to
indigent patients this past year, coordinated by program efforts and provided by
pharmaceutical companies. Dr. Rutherford informed staff that new internet lines will
soon be available through the health department for use; this improvement may
expedite these indigent pharmaceutical services.
Administration, Community Outreach Director, Finance Director, or Health Services Director 1
vorCE 305-293-7570; FAX 305-293-7573
Referrals 1I8B8-381-SnO; Medi-Van 305-797-4104; Rural Health at Ruth Ivins Clinic 305-289-3748
Healthy Kids/KidCare Director-VOICE 305-517-9002; FAX 305-517-9004
www.ruralhealth-floridakeys.org
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B. Community outreach report: (Please see written report, attachment)
C. .", KidCare report: In the absence of Mr. Douglass, Dr. Szurek reported that a goal of 7%
(,...::growth per year was set in 2000. The number of enrollees in 2000 was 4,300. Mr.
- Douglass, and community partners, have exceeded their goal projections for
'.
",,' enrollment and now over 4,900 children are enrolled out of a potential 6,000 children.
Monroe County's achievement in this regard is perhaps one of the best in the state.
Finance report: Mr. Welch reported an error in accounting in his last report. A deficit
does not exist in the profit/loss for the Network due to a misallocation of income. Mr.
Welch reported a balance of $39K in the accounts, with all bills and liabilities paid for
fiscal year end.
Old Business.
A Minutes,3/21/02. In a motion made by Corom. Spehar and seconded by Dr. Rice, the
minutes of the meeting held on March 21,2002 were approved as written.
Oral Health Project Update. Dr. Szurek presented the final draft of the Oral Health
Care Project (OHCP) Plan for committee review. Dr. Szurekalso described the
presentation before the BOCC on June 19,2002 wherein a discussion was held about
space allocation and build-out costs at "old" Mariner's for a dental clinic for the
Upper Keys, as suggested in the plan. Dr. Szurek thanked Conun. Spehar for her
leadership in bringing the question before the Commission. In a motion made by
Ms. Premaza and seconded by Comm. Spehar, the plan (and petition for space at
"old" Mariner's) was accepted and approved by the committee.
HUD Grant (FL14B0-4001) Update. Dr. Szurek reported that in lieu of placing a
porhon of HUD grant FL14Boo-4001 out for an RFP to the community (for those
programs not currently not benefiting from HUD grant funds), he had elected to
withdraw $8,000 per year from FKOC and USFF, as allowed by HUD guidelines. This
total amount ($16,000) constitutes less than 10% of the yearly (HUD grant) budget.
Thi<; withdrawal will fund phannaceuticaI assistance for homeless clients served;
current budgeted amounts are inadequate to address demand. In addition, the impact
of this withdrawal is minimized as clients from FKOC and USFF are directed to
RHNMC primary care services at St. Clare's in Key West.
Authorizations. In a motion made by Dr. Rice and seconded by Dr. Rutherford, the
following authorizations were approved for appropriate execution by the executive
director:
1. To sign a contract with FKCC for nursing students in the next academic year.
2. To renew a contract "vith FL DOH:ORH (COR83, renewed) in the next fiscal
year and approval of the presented Work Plan for that period.
To renew a contract with MCHD for the next fiscal year for KidCare outreach.
To sign a contract for any Challenge Grant award through the DCF in the next
fiscal year.
To allow closure of RHNMC facilities on July 17,2002 to allow for a staff
retreat.
3.
4.
5.
Administration, Community Outreach Director, Finance Director, or Health Services Director 2
VOICE 305-293-7570; FAX 305-293-7573
Referrals 1/888-381-8770; Medi-Van 305-797-4104; Rural Health at Ruth Ivins Clinic 305-289-3748
Healthy Kids/KidCare Director-VOrCE 305-517-9002; FAX 305-517-9004
www.rurarhealth-floridakeys.org
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6. To sign a contract with the FL Attorney General's Office for a nutrition grant of
$30,000 in the next fiscal year.
V. New Business.
A. Policy & Procedures Revisions: In a motion made by Ms. Premaza and seconded by
Comm. Spehar, the revised policies and procedures were moved for approval. Discussion:
Conun. Spehar asked that the following changes be made to the document: on pp. 17-19 (and
throughout the document), reference to '"marital status", be changed to "familial status"; that
throughout the document, "handicap" be changed to" disabled"; that throughout the
document, "... or sexual preference..." foIIow the words" sexual orientation"; on p. 28,
(Employee Courtesy), that the words "... and will not discriminate on the basis of sex, race,
religion, natural origin, age, disability, sexual orientation or sexual preference..." be added at
the conclusion of the policy statement; on p. 36, in paragraph 3 of the policy, add" social
security number" after "grievance records" in sentence 2 of that paragraph; on p. 36, part 1.
tl:J.at the sentence "Reprimands may not be viewed by a third party..." be added;
p. 37, part r, add the phrase "...and outside of the presence of the supervisor..." at the end of
the last sentence; at the end of the paragraph pertaining to medical records on p. 37, add the
sentence "No release of medical records may occur without the written consent of the
employee or through court order."
Dr. Rice suggested that employee medical records be filed separately and in a section
not associated with employee files. Dr. Szurek agreed to execute that suggestion. Dr. Szurek
also asked that on p. 37, part v be added, allowing for a termination evaluation of a departing
employee, to include documentation of suitability for re-hire, election of COBRA coverage
and final comments by the supervisor.
The group unanimously approved all of the recommended changes.
B. Strategic Plan 2003-2005. In a motion made by Comm. Spehar and seconded by Dr.
Rice, the revised strategic plan as presented was unanimously approved by the
committee.
C. Budget: In a motion made by Dr. Rice and seconded by Comm. Spehar, the proposed
budget was moved for approval. Dr. Szurek highlighted the increase in funds
projected through fund-raising. The committee unanimously approved the proposed
budget for FY 02-03.
D. Management Information System: Dr. Szurek reported that Mr. Welch and Mr.
Pascucci have been asked to develop a MIS proposal lor presentation to the group at
the next meeting in September,
E. Future Funding Issues.
1. Rural Health Oinic. Dr. Szurek described the requirements of a "Rural Health
Clinic" under federal guidelines and suggested that it was "time" for RHNMC
to establish this designation for its service sites.
2, Medicare, Medicaid, KidCare, private insurance, Health Flex. Dr. Szurek
further stated that RHNMC was currently unable to obtain reimbursement for
costs associated for visits for patients who were currently enrolled under these
Administration, Community Outreach Director, Finance Director, or Health Services Director 3
VOICE 305-293-7570; FAX 305-293-7573
Referrals 1/888-381-8770: Medi-Van 305-797-4104; Rural Health at Ruth Ivins Clinic 305-289-3748
Healthy Kids/KidCare Director-VOICE 305-517-9002; FAX 305-517-9004
www.ruralhealth-floridakeys.org
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programs. In addition, RHNMC has a successful track record of referring, not
"stealing" patients, from the private sector.
3. HCH. Dr. Szurek described what was entailed in becoming a "Health Center
for the Homeless [HCH]) under federal guidelines and suggested that this
might be an attractive choice for future funding at St. Clare's, with the
cooperation of Catholic Charities and GCMK.
4. BOCC Line Items. Dr. Szurek reported that Mr. Douglass will be approaching
the BOCC for $150K in the next fiscal year for primary care.
5. HSAB. Dr. Szurek reported that RHNMC has been successful in securing
$100K from the HSAB. However, the HSAB Board had also made a unanimous
recorrunendation that RHNMC funding should become a direct line item under
the BOCC budget, since RHNMC performs essential services. Dr. Szurek
suggested that $50K of the $100K be given to the OHCP and the other $50K
returned to the HSAB, provided that BOCC will fund $150K as a recurring line
item for primary care.
Discussion: Ms. Premaza expressed her fears that RHNMC may be too competitive for
the private practice market and feared further reductions in medical staff inventory in
the community. Dr. Rice stated that RHNMC has made its presence known and has
taken only those patient,> who most other MD's will not see. Mr. Luse agreed with Dr.
Szurek, that RHNMC's "track record to date" allows for an open forum to discuss
patient referrals and RHNMC has honored its pledge to refrain from aggressive
competition. Dr. Rutherford also concurred with Mr. Luse. Comm. Spehar agreed
that the county must not be the only source of sustaining funds for RHNMC projects.
The group unanimously agreed to allow staff to pursue these funding streams with the
provision that routine reports of progress and implications be given to the committee.
F. Reports to/from the HCSF. Ms. Premaza agreed to report to the RHNMC Board on a
regular basis, and to report to the HCSF Board, the activities of the RHNMC Board.
Dr. Szurek stated that Ms. Premaza will be regularly added to the RHNMC Board
agenda.
G. Change of DCF sub-District. After some discussion, the group stated that no
recommendations for a possible change in DCF sub-district status would be
entertained by the RHNMC
H. Employee Leasing. Dr. Szurek asked that he pursue employee leasing, its costs and
potential for positive impact for RHNMC over the next six months. In a motion made
by Comm. Spehar and seconded by Ms. Premaza, the executive director was approved
to investigate the advantages of employee leasing and report back to the group.
1. Health lnsmance Task Force. Dr. Szurek reported on the work of the ad hoc
committee under the direction of Comm. Spehar, and the support of Dr. Rutherford
and Mr. Luse. Dr. Szurek reported on the first meeting held on May 30, with a second
planned for July2. There is conflicting information about the proposed "Health Flex"
program approved by the legislature and its applicability to Monroe County.
Administration, Community Outreach Director, Finance Director, or Health Services Director 4
VOICE 305-293-7570; FAX 305-293-7573
Referrals 1/888-381-8770; Medi-Van 305-797-4104; Rural Health at Ruth Ivins Clinic 305-289-3748
Healthy Kids/KidCare Director-VOICE 305-517-9002; FAX 305-517-9004
www.ruralhealth-floridakeys.org
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However, Deputy Commissioner Kenney Shipley of the Dept of Insurance a has
agreed to appear and report to the task force about "Health Flex" on 7/2, thanks to
intervention of Rep. Sorensen. Dr. Szurek thanked Comm. Spehar for her leadership,
and to Mr. Luse and Dr. Rutherford for their time and support as members of this ad
hoc committee.
J. Reporting the Activities of the Executive Committee to the Board for Ratification. Dr.
Szurek suggested that minutes of the executive committee be mailed to the Board and
that additional draft copies of the minutes be made available to members prior to
Board meeting times. This might alleviate the concern of some Board members that
"too much detail" is presented in Board meetings, willie still providing to other Board
members sufficient detail for those requiring it, before ratification of this committee's
activities. The group agreed to the procedure suggested.
VI. Conununity Input. Ms. Higgs announced a series of meetings that will occur on July 17th
to speak with various pediatricians about MCH's outreach for indigent children. MCH
would like to Ie-introduce their mobile van to the community to address serious illness
among children currently not addressed.
VII. Announcements.
A. The next meeting of the Board is scheduled for Monday, July 8, 2002, at 9:00 a.m.,
at the Marathon County Govenunent Center.
B. ll1e next meeting of the executive committee is scheduled for Thursday, September
26, 2002, at Mariner' 5 Hospital at 1:30 p.m. Members may be accommodated by
conference call-in.
VIII. There being no further business before the committee. the committee meeting was
adjourned by acclamation. .
Respectfully recorded,
Mark L.Szurek, Ph.D.
Executive Director
Administration. Community Outreach Director. Finance Director. or Health Services Director 5
VOICE 305-293-7570; FAX 305-293-7573
Referrals 1/888-381-8770; Medi-Van 305-797-4104: Rural Health at Ruth Ivins Clinic 305-289-3748
Healthy Kids!KidCare Director-VOrCE 305-517-9002; FAX 305-517-9004
www.ruralhealth-floridakeys.org
.