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:
Monroe County Board of County Commissioners Meeting
July 31, 2001
The Monroe County Community Health Initiative
Presenters:
Liz Kern, HCSF Board of Directors and Executive Committee
Sonya R. Albury, Executive Director
Lourdes Gonzalez, Health Planner
I. Introduction
A. Health Council of South Florida, Inc.
B. Professional Health Planning Staff
C. Past Accomplishments/Contributions
II. Project Purpose
A. Regional Assessment
B. Community Engagement
C. Qualitative and Quantitative Data
D. Data Based Decision-making
III. Scope of Work
A. Community Task Force
B. Work Plan Development
C. Secondary Data Collection
D. Consumer and Provider Focus Groups, Community Meetings
E. Verification of Provider Data
F. Compilation and Analysis of Data
G. Report Development
H. Action Planning and Recommendations
IV. Principle Deliverables
A. Community Health Profile
B. Community Perspectives Report
C. Final Recommendations and Action Plan for Monroe County
V. Timelines
VI. Benefits/Outcomes
I. Insurance
2. Primary Care
3. Secondary Care
4. Transportation
5. Community Education
6. GrantlResource Development
VIII. Concluding Comments
STATEMENT OF QUALIFICATIONS
"Our mission is to improve health care in Miami-Dade and Monroe Counties. "
The Health Council of South Florida, Inc.
The Health Council of South Florida, Inc. is a non-profit organization dedicated to improving the
health of the 2.1 million residents of Miami-Dade and Monroe Counties. Its team of career
industry professionals - from management to planning personnel - combines expertise in
program evaluation, public health, medicine, health planning, social services, health care
administration, project management, education, management information systems, data analysis,
and social marketing. Its skills in community coalition building and collaboration are renowned,
as is its capacity to facilitate real changes within the health delivery system. Supported by
county and state governmental funds, as well as private philanthropies, the Health Council's
projects are recognized for their quality, validity, appropriateness, relevance and usefulness. The
Council is the only independent health planning body serving the communities of Miami-Dade
and Monroe counties, and one of a network of agencies serving the State of Florida.
General Capabilities
The Health Council is a full-service health consulting organization, offering a range of services
such as program evaluations, community health plans, health facilities utilization reports, needs
assessments, meta-analyses, and educational materials for consumers and health professionals.
Recent highlights of our work include the Central Miami-Dade Community Health Initiative
Health Prcjile and its companion documents: Final Report, Community Health Per5pectives and
Multimedia Education Packet. Other recent publications include A Managed Care Guide for
Consumers; The Medical Futility Guidelines for South Florida; New Arrivals' Access and
Utilization cf Health Care Resources in Miami-Dade County; Health Care Handbook for
Immigrants in Miami-Dade County; HIP/AiDS Cost Bemjit Analysis, and training videos and
CD-ROMS for physicians. The Health Council also produces educational brochures for the
public such as the Pharmacy Assistance Programs for Consumers. During last year alone, the
Council's work contributed to securing funds for a new, much-needed primary care center in
West Dade County, an area characterized by pockets of poverty and large numbers of newly
arrived immigrants. The Council also published the Comprehensive Health Plan for Miami-
Dade and Monroe Counties: 2000-2002 and maintains a website with links to government and
private health related sites.
The Health Council's Approach and Philosophy
The populations that are the primary focus for the Health Council include the uninsured and
underinsured, minority cohorts, persons with chronic diseases, newly arrived immigrants,
children, the elderly, and other groups of people that have difficulties in accessing the health care
delivery system. The Council is known for its capacity to join the community together and to
work collaboratively with other organizations that have similar missions.
Effective health planning requires expertise in several disciplines. Since 1965, the Health
Council of South Florida has recruited and retained a cadre of professionals from both the public
and private sectors, allowing for the unique capacity to "bridge" public health and private
delivery systems. The Council is unique in that it offers a tightly knit team of professionals to
provide comprehensive health planning.
Sonya R. Albury - Executive Director
Ms. Albury has been the Executive Director of the Health Council
of South Florida, Inc. for seven years. She oversees all activities in
the planning and development of health related projects for the
agency. Her primary areas of emphasis include a) increasing access
to health care for the uninsured and underinsured, b) disease
management, c) long term care and d) health care ethics. Under her
leadership, the Health Council has received awards for its
Transportation Disadvantaged Project in Monroe County and the
Attacking Asthma Initiative at Miami Children's Hospital. Ms.
Albury oversees the administration of a statewide insurance program for persons living
with HIV/AIDS which has increased access to underserved populations by more than 75
percent for both Blacks and Hispanics and has saved the State over $25 million in care
and treatment dollars during FY2000-0 1. Ms. Albury has undertaken research in the
areas of children's health insurance, health care financing models and disease
management, utilizing the most recent technological advances in CD-ROM applications.
Under her guidance and planning support, the Council helped launch the Florida Keep
Healthy Start Coalition in Monroe County. Most recently, she spearheaded the Hospice
Medicaid Education Project with the nationally acclaimed Hospice Foundation of
America.
Ms. Albury also serves on the Executive Committee and Board of Directors of the
American Health Planning Association and was recently named President-elect of the
national organization. Ms. Albury also serves on various local and state boards and
committees, including the Board of Directors for the DadeIMonroe division of the March
of Dimes; Steering Committee Member of the Growing Healthy Task Force; former Co-
Chair of the Education Committee and recently named Co-chair of the newly appointed
Strategic Planning Review Committee, Greater Miami Chamber of Commerce; Policy
Oversight Committee Member, Florida's Agency for Health Care Administration; and
Special Advisor on Medical Futility to the Statewide Panel for the Study of End-of-Life
Care in Florida.
Prior to joining the Health Council, Ms. Albury was a health care consultant with Nancy
Persily Associates and developed marketing plans for hospitals, nursing homes, adult
congregate living facilities (ACLF's), rehabilitation facilities and related health care
organizations. She helped establish the Southeast Florida Center on Aging at Florida
International University. Ms. Albury also co-authored several chapters in the book
El derc are: Positioning Your Hospital for the Future and is a contributing co-author to
numerous health reports and publications.
Ms. Albury earned her Bachelor of Science from Taylor University in Indiana and her
Masters of Social Work degree from Florida International University with a
specialization in Community Development and Administration in 1981. She is a former
resident of Key Largo, Florida.
Lourdes Gonzalez - Health Planner
Lourdes Gonzalez has been a Health Planner with the Health
Council of South Florida, Inc. for the past three years. Ms.
Gonzalez currently staffs and coordinates the Local
Coordinating Board for the Transportation Disadvantaged in
Monroe County. During her tenure with the Health Council,
she has worked on various projects compiling and analyzing
data for different sectors of Miami-Dade and Monroe
Counties, including a meta-analysis relevant to the assessment
of health care needs and the identification of system
deficiencies.
Ms. Gonzalez was also a major staff liaison to the South Miami-Dade, West Miami-Dade
and Central Miami-Dade Community Health Initiatives conducted in Miami-Dade
County. These Initiatives have provided an action-oriented approach to coordinating and
enhancing the health care delivery system by conducting focus groups for consumers and
providers, holding community forums and/or public hearings and performing personal
interviews in the neighborhood churches, primary health care centers and other sites
throughout the community.
Ms. Gonzalez has experience conducting focus groups and developing survey
instruments related to variety of health topics, such as diabetes and mY/AIDS and the
trauma system. A consumer video on mY/AIDS was also developed under her
coordination and supervision for the Agency for Health Care Administration.
Ms. Gonzalez was on the Board of the Women's Healthcare Executive Network of South
Florida and a member of the March of Dimes Program Services Committee. She has
received Certificates of Appreciation and Recognition from the American Heart
Association and recognition from various community groups.
Lourdes Gonzalez holds a Bachelor of Science degree in Health Services Administration
from Florida International University and has a Medical Assistant degree. Ms. Gonzalez
is fluent in English and Spanish, both written and spoken.
Troy Johnson - Health Planner
Troy Johnson is a Heath Planner with the Health Council of
South Florida, Inc. He facilitated the Central Miami-Dade
Community Health Initiative (CMDCHI). Through this
project, the Task Force developed recommendations for
addressing health care needs and gaps in the Central Miami-
Dade area and has produced a set of CMDCHI planning
documents such as the Central Miami-Dade Health Initiative
Health Profile, the Community Perspectives Report, the
Multimedia Education Packet and the Final Report. He is
assisting the Miami-Dade County Trauma Advisory Committee (T AC) identify system
wide issues in the county's trauma system and has managed the update of the local
county trauma plan. Mr. Johnson is also currently supporting the TAC's efforts in re-
designating a county Trauma Agency.
Mr. Johnson holds a Master's Degree from the University of South Florida-College of
Public Health. He has worked with the Department of Health in Tampa, Florida in
developing, implementing, and evaluating health promotion and education programs
addressing chronic illnesses; and coordinating community and staff training in Basic Life
Support, health screenings and mass vaccination events. He has also been involved in
research projects conducted by the University of South Florida-College of Internal
Medicine and the H. Lee Moffitt Cancer Center.
Mr. Johnson is a member of the American Public Health Association and brings 10 years
of experience in data collection, data evaluation/analysis, knowledge in research
methodologies, and health intervention planning.
Rob Harris - Data Manager
Rob Harris has been the Information Technology and Data
Manager at The Health Council of South Florida, Inc. since
1993. His responsibilities include management and planning
for information technology systems, deployment and security,
database design and oversight, data analysis, survey form
design, geographic information systems, and website design
and maintenance. Mr. Harris is also responsible for and
oversees the Certificate of Need Program (CON) including site
visitations, conducting public hearings, data collection and reports to the State for the
South Florida area.
Prior to joining the Health Council, Mr. Harris was Vice President, Director of MIS of
MD Resources, a physician recruitment and hospital consulting firm. He was Senior
Marketing Research Analyst with the News and Sun-Sentinel Company, and Senior
Consultant with The Concept Group, a management consulting firm specializing in the
guaranteed solution of difficult business issues.
Mr. Harris received his B.A. degree in Government from Rutgers University in 1966, his
M.A. degree in Sociological Research from Michigan State University in 1967, and his
M.S. in Computer Information Systems from the University of Miami in 1990. He has
received certificates in ArcView GIS 3.1 and ArcView GIS 8.1 from Environmental
Systems Research Institute (ESRI).
He has been elected to the National Political Science Honor Society, Pi Sigma Alpha, the
National Honor Society of Phi Sigma Alpha, and served as an advisor to the National
Academy of Sciences.
Draft copy - not yet approved by Human Services Advisory Board
MONROE COUNTY HUMAN SERVICES ADVISORY BOARD
MINUTES OF MEETING HELD ON
June 26, 2001
Conference Room
Monroe County Public Library
9:00 AM
Marathon, FL
Board Members Present:
John Rolli
Alexsandra Leto
Tricia Hynes
Kirk Bondurant
Staff present:
David Owens
Louis LaTorre
Board Member Absent:
None (one position is currently vacant)
At approximately 9: lOAM, Chair Alexsandra Leto noted the existence of a quorum and called the
meeting to order. Human Services Advisory Board members introduced themselves.
John Rolli made a motion, seconded by Kirk Bondurant, to approve the minutes of the May 2, 200 I
meeting. Motion passed unanimously.
John Rolli said that the Board should discuss and arrive at a strategy to follow regarding its funding
recommendations, since the total requested far exceeded the amount available. Alexsandra Leto asked
for suggestions from Board members. John Rolli discussed the direction given by the Board of County
Commissioners and suggested that the Board consider each applicant's request, vote on an amount to
recommend for each, and then apply a percentage reduction to each to bring the total down to the limit of
$289,194.00 imposed by the Commission. John Rolli made a motion to this effect, seconded by Kirk
Bondurant, which was approved unanimously.
Louis LaTorre arrived at approximately 9: 17 AM.
John Rolli discussed new agencies and the difficulties involved in evaluating them because of the lack of
a financial audit, client history, and so on. John Rolli made a motion, seconded by Tricia Hynes, to deny
Rodriguez Home Away from Home, Red Ribbon Kids, and Womankind funding due to lack of history
without regard to merit of their programs. Discussion followed regarding the requirement of 501(c)(3)
status. Louis LaTorre discussed proper licensing and 50 1 (c)(3) status. John Rolli discussed the value of
more track record in evaluating applicants, noting that this does not exist with new agencies. Kirk
Bondurant mentioned the need of the new programs for the funding. Alexsandra Leto questioned
Rodriguez Home Away from Home and Red Ribbon Kids regarding their 501(c)(3) status. Dottie
Rodriguez, on behalf of Home Away from Home, and Anthony Swain, on behalf of Red Ribbon Kids,
responded. John Rolli amended his motion so that it would deny funding only to Rodriguez Home Away
from Home; Tricia Hynes amended her second, and the motion passed unanimously.
Alexsandra Leto discussed the application of Red Ribbon Kids. Louis LaTorre mentioned the lack of a
Department of Children and Families license at this time. Rita Swain addressed the Board regarding the
need for their program. John Rolli noted that Red Ribbon Kids was not sufficiently developed at this
time and moved to deny funding to them. The motion was seconded by Tricia Hynes, and passed 3 - 1,
with Kirk Bondurant dissenting. Alexsandra Leto briefly discussed licensing and other requirements
with representatives of Red Ribbon Kids.
Draft copy - not yet approved by Human Services Advisory Board
Representatives of and student participants in Monroe Youth Challenge addressed the Board at great
length regarding their program and its benefits. They summarized activities to-date of the program. Judy
Greenman responded to questions of the Board. John Rolli asked about funding by the Monroe County
School Board. Judy Greenman replied that there had been cuts in School Board funding. Louis LaTorre'
addressed the issue of Monroe Youth Challenge and its lack of501(c)(3) status, noting that the Monroe
County Education Foundation, which was mentioned on the application, had 501(c)(3) status, but the
Monroe Youth Challenge did not. Alexsandra Leto replied that the Education Foundation had completed
and signed the application, so it was not a problem if Monroe Youth Challenge did not have 50 1 (c)(3)
status. Tricia Hynes mentioned the benefits of a similar Youth Challenge program in a community in
which she had previously lived. John Rolli made a motion, seconded by Tricia Hynes, to approve up to
$20,000.00 in funding to Monroe youth Challenge, contingent to an equivalent amount of funding being
given to Monroe Youth Challenge by the Monroe County School Board, and subject to later
proportionate reduction to meet the Commission's total funding limit. Discussion followed, and the
motion was approved unanimously.
The application of Samuel's House was discussed next. John Rolli noted much improvement in the
format and contents of their application. John Rolli made a motion, seconded by Kirk Bondurant, to fund
Samuel's House in the amount of $25,000.00, subject to later proportionate reduction to meet the
Commission's total funding limit. Motion passed unanimously.
Rene Grier, representing Womankind, addressed the Board, answering questions regarding the purpose
of the funding and the need for the program. David Owens and Louis LaTorre mentioned that this
funding typically was not used for the purchase of equipment, because of inventory and possession
issues. John Rolli addressed the lack of an audit and IRS Form 990. Tricia Hynes made a motion,
seconded by Kirk Bondurant, to approve funding in the amount of$12,750.00 (reflecting a decrease of
the equipment purchase amount), subject to later proportionate reduction to meet the Commission's total
funding limit.
Sylvia Ann Godfrey, representing Florida Keys Juvenile Services, addressed the Board and responded to
numerous questions from the Board and Staff related to information in her application and an addendum
to her application which had been given to Board members just prior to the meeting. David Owens
mentioned that the County occupational license noted that it was for a retail business. Louis LaTorre
commented regarding the lack oflicenses and questioned Ms. Godfrey about services provided, client
counts, referrals, working arrangements with other agencies, and so on. Ms. Godfrey mentioned that she
had removed funding for Island Home from her request. John Rolli made a motion, which failed for lack
ofa second, to fund Florida Keys Juvenile Services in the amount of $10,000.00. David Owens noted
that of the remaining programs for which funding was requested (Fishing for Food, Self-Defense, and
used clothing distribution), two seemed to be more recreational than human service-related. Tricia Hynes
questioned Ms. Godfrey regarding program-related expenses for the programs, used clothing in
particular, and the expenses related to each. Ms. Godfrey described expenses related to the used clothing
program, such as laundering them, and picking up and delivering them. David Owens questioned lease
expenses, saying that most of the activities of these programs would seem to take place off-premise.
Tricia Hynes made a motion, seconded by Kirk Bondurant, to fund Florida Keys Juvenile Services in the
amount of $5,000.00, subject to later proportionate reduction to meet the Commission's total funding
limit. Motion passed unanimously. David Owens and Louis LaTorre voiced their objections to this
funding, and repeated their concerns.
Bert Loudenslager, representing Habitat for Humanity, addressed the Board. She described the program
and the services it provides, and answered questions from the Board concerning the area served, which is
primarily the lower keys. She assured the Board of their commitment to assist all areas of the Keys in the
event of an emergency. John Rolli discussed the lack of an audit by a CPA, and discussed the work done
Draft copy - not yet approved by Human Services Advisory Board
by Habitat for Humanity, noting that affordable housing was a priority for the County Commission. John
Rolli moved to fund Habitat for Humanity in the amount of $40,000.00, subject to later proportionate
reduction to meet the Commission's total funding limit, and requested a CPA audit and a commitment of
services keys-wide in a disaster. Ms. Loudenslager agreed to these conditions, and agreed to match in
community outreach the amount ultimately awarded. Kirk Bondurant seconded the motion, and the
motion passed unanimously.
John Rolli addressed Helpline and made a motion to fund them in the amount of $20,000.00, subject to
later proportionate reduction to meet the Commission's total funding limit. Kirk Bondurant seconded the
motion, and the motion passed unanimously.
Barbara Fike, of Caring Friends for Seniors, addressed the Board, and answered questions asked by Louis
LaTorre regarding services provided and the area served.
John Rolli made a motion to approve the remaining applications in the same amounts that they had been
awarded in fiscal year 2001, and then apply an equal percentage reduction to each applicant, including
those already approved, to bring the total down to match the total funding limit set by the Commission.
Kirk Bondurant seconded the motion. Tricia Hynes proposed an opportunity for those requesting large
increases to address the Board. Tricia Hynes made a motion to amend the motion already on the floor to
recommend funding Monroe Association for Retarded Citizens (MARC) in the amount of$56,873.00,
instead of the amount they received last year, since MARC was planning to expand operations into the
upper keys area. John Rolli seconded the motion, and the motion to amend passed unanimously.
Discussion followed, during which Diana Flenard-Moore described the expansion of services into the
upper keys and mentioned that funding in the amount of $30,000.00 would prohibit that expansion.
Carmen Turner of Big Brothers/Big Sisters discussed expansion of that agency's services. A vote was
held on the amended motion, and it passed unanimously.
David Owens entered funding amounts equal to fiscal year 200 I funding for all remaining agencies,
leaving MARC at $56,873.00 and not changing the amounts approved for the agencies already voted
upon, but still subject to reduction to meet the total limit. He announced that the total at that point
exceeded the limit by $149,623.00, and a 34% reduction to all agencies would be needed to meet the goal
of$289,194.00. Brief discussion on this topic followed. Joe Barker of Wesley House addressed the
Board, and suggested that a percentage reduction applied to all agencies would be the most equitable way
to proceed. John Rolli made a motion to apply a 34% reduction to all amounts. Tricia Hynes seconded
the motion, and it passed unanimously.
David Owens applied the percentage reduction to all amounts, and read aloud the new funding amount
for each agency. John Rolli made a motion, seconded by Kirk Bondurant, to fund each agency in these
amounts. Motion passed unanimously.
John Rolli made a motion, seconded by Kirk Bondurant, that if the Commission should allocate
additional funding for human service organizations, the amount of the increase should be applied
proportionately among all agencies. David Owens noted that his understanding was that if an agency had
been approved for an amount equal to 10% of the total, then that agency would receive 10% of the
amount of the increase approved by the Commission. This would eliminate the need for the Human
Service Advisory Board to meet again to make further recommendations regarding a possible increase in
total funding. A vote was held, and the motion passed unanimously.
Discussion followed regarding the total funding for this year and in recent years. Most agencies noted a
need for increased funding, and argued that the services they provide are essential to Monroe County.
Draft copy - not yet approved by Human Services Advisory Board
Diana Flenard-Moore of MARC offered to have their funding reduced to $30,000.00 and have the
difference between that and the amount just approved applied proportionately to the other agencies. John
Rolli made a motion, seconded by Tricia Hynes, to accept MARC'S offer and apply the amount of
$7,481.00 proportionately to the other agencies. Motion passed unanimously. David Owens agreed to
apply this formula and advise each applicant of the funding amounts, which would be recommended to
the County Commission.
There being no further business to discuss, the meeting was adjourned at approximately 12: 15 PM.
Frederick-Debbie
From:
Sent:
To:
Cc:
Subject:
Hanson-Donna
Friday, July 27, 2001 3:50 PM
Roberts-Jim
Frederick-Debbie
HSAB
Comm. Nelson asked me to send you this note:
Mr. Roberts,
As I will be out of town for the next budget meeting on the 31 st, I would like to share my thoughts on funding
for the Human Services Advisory Board.
Amounts should be made to offset inflation and the higher cost of doing business in Monroe County.
Since the Rural Health Network is providing services at a higher level, we might fund for one year and try to
obtain a permanent solution by adopting H.B. 509.
Murray Nelson
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