January 17, 2002

The Board of County Commissioners of Brevard County, Florida, met in special session on January 17, 2002, at 9:00 a.m. in the Government Center Florida Room, Building C, 2725 Judge Fran Jamieson Way, Viera, Florida. Present were: Chairman Truman Scarborough, Commissioners Randy O'Brien, Nancy Higgs, Susan Carlson, and Jackie Colon, County Manager Tom Jenkins, and County Attorney Scott Knox.

REPORT, RE: ATHLETIC PROGRAMS

Commissioner Carlson stated the Board requested she approach Dr. Gamble regarding the Brevard Community College (BCC) situation and athletic programs, and what it might mean in terms of community impact; and Dr. Gamble would like to give his perspective on the issue.

Dr. Thomas Gamble, President of Brevard Community College (BCC), stated there are a number of cutbacks that BCC is engaging in due to the hold back and anticipated cuts in its budget because of the recession and the September 11, 2001 disaster; he is sure the Board has had similar experiences and is having them now; but three areas that were of particular concern related to the Planetarium, the Cocoa High School pool, and the Intercollegiate Athletic Program; and some of these things are moving in a very positive aim. He noted BCC has no intention of closing the Planetarium, but has merely cut back in the number of public shows; everything else is still operating; the pool situation seems to be clarifying; and the Board most likely will have an address in the future from the YMCA, which is reviewing the issue, along with the BSA in terms of the potential of putting together a coalition to underwrite the costs of sustaining the pool. Dr. Gamble stated BCC has not used the pool for approximately the last six years; it lost its swim team at that time; there is only one competing intercollegiate swim team in the State, which is Indian River Community College; and in the case of intercollegiate athletics, this does not represent all of the athletic activities of the college. He noted it is only the competitive components that BCC is focusing on at the present time; BCC reviewed the budget and made major cuts in staffing, as well as operational costs; it is currently under a freeze for all new hires; and BCC feels the focus of the College needs to remain on teaching and learning at the first two years of college level. He stated the Intercollegiate Athletic Program came very quickly to the fore, largely because only about one half of the athletes are from Brevard County; the amount of money BCC has been spending on intercollegiate athletics is somewhat exorbitant as it relates to the rest of the College; and it is only dealing with about 100 students, as compared to the 20,000 students that attend BCC.

Dr. Gamble stated BCC looked hard and fast at potential alternatives for funding, and basically has offered to the booster organization and various athletic clubs in the community, to come forward with a plan to underwrite the continuing costs of those programs; and BCC will be addressing it at the Board of Trustees' workshop on January 28, 2002. He noted the only reason BCC is targeting this particular area is the relative cost and value of the current underwriting; it is important to recognize that by eliminating intercollegiate sports, BCC is not eliminating club sports or intramural sports; the plan on the table includes expanding those activities, along with increasing the scholarships for minorities so that, in effect, there is no loss of access by minorities of the community to a higher education; and BCC is an open door institution, which means it does not have any restrictions for people coming in. Dr. Gamble stated the fact that someone is not engaged in intercollegiate athletics is not in any way a barrier for them entering BCC; all of the facilities in the College for athletic purposes are going to remain; they will be available for the local Athletic Association for bringing in visitors for competitions; and BCC does not intend to change any of the funding mechanisms as it relates to the use of those facilities by that organization or by the community. He noted the issue has become very emotional; if the Board would review the data, the costs, and who is being benefited, it will find that even in the case of minorities, there are only 15 minorities from Brevard County who are engaged in intercollegiate athletic sports; and the rest of the minorities that are involved are from outside of Brevard County and, in some cases, outside the State of Florida.

Chairman Scarborough stated he is always concerned when the Board gets into things that it does not know enough about; and at this juncture, the Board should defer the issue to the wisdom of Mr. Gamble and his board to proceed as they deem appropriate, rather than the Board becoming involving. He expressed appreciation to Dr. Gamble for the update.

Commissioner Carlson stated Dr. Gamble has made it very clear that this will not affect Brevard County's sports as far as the sports commission; and that is what the Board needed clarification on.

DISCUSSION, RE: BREVARD COUNTY ELDER READY COMMUNITIES PLAN

Assistant County Manager Don Lusk introduced Paula Preston, Aging Services Planner with Housing and Human Services; stated Ms. Preston spent countless hours compiling the report and workshop materials; and expressed appreciation to Ms. Preston for her efforts.

Overview of Planning Process

Paula Preston stated on behalf of the Brevard Commission on Aging, she wants to thank the Board for allowing them to have the workshop to discuss the importance of aging issues in Brevard County; with the Board's support and the assistance of many of the people in the audience, the Brevard Commission on Aging, completed its first Elder Ready Communities Report this past October; the Report focuses on specific issues that are important and relevant to elder adults in the County; and the Commission on Aging is here today to discuss some of the top priority concerns with the Board and recommended strategies for implementing some changes that are needed. She noted the workshop has been structured to focus on the issues where the Commission on Aging feels the Board can have the greatest impact; these include caregiver and community support services necessary to help older adults live independently; protection of the most vulnerable older adults from abuse, neglect, and exploitation; the importance of information and referral to help families access services before a crisis situation develops; and both roadway and public transportation assistance that support independence and improve access to services. Ms. Preston stated during the course of the workshop, options will be discussed for implementing the recommendations contained in the report to address the service needs, including funding opportunities and advocacy efforts, as both the public education tool and the means to initiate Legislative change.

Introduction

J. B. Kenna, Housing and Human Services, thanked the Board for the opportunity to share the significant positive contributions the Commission on Aging brings before the Board and the community this morning; stated the Commission is an integral component of the multiple planning process the Board has initiated over the past few years; the Commission is able to showcase the Elder Ready Communities Report in the workshop today because, like other successful planning models, it adheres to four simple components of success; and it is partner oriented, data driven, research based, and outcome focused. He noted the Brevard Commission on Aging is partner oriented because it engages broad and diverse sectors of the local population; its report and recommendations have multi-level coordination and have been key factors in the development of regional aging plans and other local planning efforts; and the report will be a factor in the development of the Brevard County HOME Consortium Community Development Block Grant Consolidated Plan, and was a basis for the Brevard Tomorrow Report and Process. Mr. Kenna stated the Brevard Commission on Aging is data driven; the Elder Ready Community Report is based on needs and information that is both quantitative and qualitative; the data, which focused on the issues of aging, was provided to Brevard Tomorrow and served as a baseline for discussion and the development of a broad community-based report in the final Brevard Tomorrow report, which is due shortly; and the data was also used to assist the Housing and Human Services Department, along with the Affordable Housing Council, to develop a Request for Proposal that targeted $800,000 in SHIP and HOME dollars for housing for the elderly in Brevard County. He stated the Commission on Aging is research based because it uses the framework of processes that have been proven to work, such as the Older Americans 2000 Key Indicators of Well Being and the Principles of Successful Community Planning being partner oriented, data drive, research based, and outcome focused; the Brevard Commission on Aging is outcome focused; and it has looked at short and long-term goals and identified outcomes that are both measurable, realistic, attainable, and outcomes that create an element of change, such as changes in attitude, behavior, and quality of life. Mr. Kenna stated the report of the Brevard Commission on Aging will help efforts to prioritize needs and make informed funding and policy decisions in many sectors of the community, both public and private; and the Commission recommendations will be an integral part of the upcoming Community Development Block Grant and Community-Based Organization funding process this coming year; the ideas and options brought forth to the Board today will encourage healthy discussions; and introduced Melissa Otto, Chairman of the Brevard Commission on Aging.

Melissa Otto stated she was asked to come before the Board today to paint a picture of aging in Brevard County; aging in the County is as complex as the citizens are; large segments of the senior population are very active and vital members of the community; and seniors volunteer in the neighborhoods, drive on the roadways, and utilize the parks, libraries, and other services. She noted many aspects of the Elder Ready Communities Plan address these seniors, but it is the smaller segment of the senior population whose need is often greater; through her work with the Commission on Aging, TRIAD, and State Attorney's Office Elder Service Unit, she has had the opportunity to encounter many seniors and the services they need; and advised of various situations that occur every day, including the senior who makes a few dollars more than the federal poverty guidelines allow and does not qualify for needed home repair projects for their home to keep it safe and livable, the senior who has been victimized by a violent crime but does not immediately report it to the police or seek medical attention because he or she is not aware that they do not have to pay for those medical services and that there are programs that will pay for that, and the senior who is not ready for guardianship services and hires a caretaker on their own and that individual takes all the senior's money until they are penniless. Ms. Otto stated the list is long; as the senior population grows, the list gets longer; and staff hopes to give the Board insight into the specific problems identified in the planning process, some of the recommendations to solve the problems, and options for the Board to consider to take action.

Ms. Preston stated the Board has read the census reports that indicate Brevard County's population is aging; the graphs depict a dramatic visual of how the County's aging population is increasing; the age 65+ population increased 43% in the last 10 years; and what the proposed graph shows is the latest growth projections from the University of Florida, Bureau of Economic and Business Research, indicating that between now and the year 2020, Brevard County is going to see the growth increase another 53%. She noted as people age, their needs change; the aging of the County's population will bring increases in the number of people who require special services in housing, transportation, recreation, education, and health care; the number requiring informal care at home and formal care in a nursing home will also increase; at the Board's direction, the Elder Ready Communities Report is a first effort by the Commission on Aging to examine the population demographics of the County and to try and identify both current and future social and infrastructure needs; and this was a community-based planning process, with more than 250 individuals and 100 organizations participating. Ms. Preston stated in addition to the research that she conducted, service providers, older adults and caregivers were interviewed as part of the process; the Brevard Commission on Aging set up a focus group that consisted of elder advocates, health and human service professionals, and community leaders; these people were able to identify all of the issues that they felt should be addressed in the planning process; and the information that came out of the focus group was then used to establish a series of task force groups designed to look at a continuum of service needs for active older adults, as well as those with greater dependency needs. She stated the proposed graph depicts a continuum of care for older adults; the left side of the continuum represents the interest in needs of active older adults, which include opportunities for community involvement, continued employment, lifelong learning and leisure activities, and accessible and affordable health care; in the middle section, early intervention and maintenance care, there are services for those individuals who are still able to participate in most aspects of daily life, but may need some assistance to stay in their homes; this section includes home and community-based services, such as homemakers, personal care, guardianship, and respite and adult day care; and in some cases, community-based support services may not be enough to maintain an individual at home. Ms. Preston noted in those cases, residential care facilities provide a valuable service in caring for older adults with greater dependency needs; the bottom of the continuum shows supporting other services, including information and referral, transportation, and housing options that meet the needs of a population that is growing older; after much discussion and additional citizen input, the Commission established some priorities; and such priorities include to increase the local support services that enable older adults to live independently at home and prevent or delay nursing home placement, to protect older adults from abuse, neglect, and exploitation, whether in a community environment or a residential care setting; to promote a health care system that is acceptable and affordable that focuses on prevention and wellness, and encourages patient participation and the appropriate use of medical services; to increase the supply of affordable housing for low to moderate income older adults; to increase transportation options through roadway design that promote safe and responsible driving, pedestrian friendly community development, and expanding public transportation services; to increase awareness of and access to information about available community resources; to expand employment opportunities for older adults and provide assistance to individuals seeking employment; and to create a focus on the recreation and leisure needs of older adults. Ms. Preston stated improving the quality of life for Brevard's elder citizens is important to maintaining the overall quality of life in the County; paying attention to the community features and social service systems that contribute to creating a supportive environment for older citizens benefits everyone; and the conclusions and recommendations contained in the report support the County's vision of providing for the health and social needs of its citizens, and will help Brevard County meet the challenge of preparing for the future. She noted one of the overall planning objectives of the Commission on Aging is to help older adults remain in the least restricted living environment for as long as possible; for most people it is going to be their home; Brevard County has a large number of seniors who live alone, need assistance with activities of daily living, or are experiencing the debilitating effects of Alzheimer's disease or other forms of dementia; if community-based support services are not provided, these individuals are at risk of losing their independence and could be forced into residential facilities where the care is more expensive; and Bill Hoskinson will tell the Board about some of the services offered through his agency, and how the growth and number of older adults needing services is already being felt.

Priority Issues

Bill Hoskinson, President of Community Services Council (CSC), stated Brevard County has a good system of care for its elderly population; it has a number of quality agencies that provide care and cooperate with one another to avoid duplication of services and to maximize care for the frail elderly; the CSC is the lead agency for Community Care for the Elderly services, as well as services provided under the Older Americans Act; CSC is serving approximately 2,000 frail elderly persons each year through various programs; and it is about 2% of the senior population and the group that is the frailest and most at risk of institutionalization. He noted the average client is a women living alone in her late 70's or early 80's with a score in the highest rank on the needs test; assistance is needed with bathing, feeding themselves, walking, going to the bathroom, and basic needs of life; the CSC currently serves about 300 people a day in the Community Care for the Elderly Program and 600 people on Meals on Wheels; and there are 134 CSC clients who are not eligible for Medicaid waiver and receive services strictly from local and State dollars. Mr. Hoskinson stated the CSC provides case management for all of its clients; the case managers develop a care plan and supervise the care that is provided to clients; one of the services is adult day care; and the CSC contracts with the Alzheimer's Foundation, Senior Care, the Embers, Easter Seals, and the Pastoral Counseling Creative Care Center to provide adult day care for the clients. He noted the in-home services include respite, homemaking, personal care, assistance with bathing and shampooing, grocery shopping, and assistance with laundry; the CSC provides about one-fifth of the services through its own employees; and it contracts about four-fifths of the services out with other agencies in the community, such as Health First, TEHC, Health Care, Nurse World, Harborside, Granny Nannys, and whoever CSC can get to provide services for it. Mr. Hoskinson stated the case managers supervise the care for all the clients and monitor the contracts and the quality of care; it is the combination of the in-home services and home delivery meals that make it possible for these people to remain in their own homes; almost all of them score so highly on the needs test that they would not be able to remain at home without either of these services or the caregiver; there are about 400 people on a waiting list for services; and most of them are also high priority class who need services, but are not eligible for Medicare payment. He noted a second group of seniors who need assistance is the group of caregivers who are caring for their spouse or a family loved one; many of these people are frail themselves and also qualify for services; the County needs to continue to help the caregivers to provide care for their loved ones; and all of these people want to remain in their own homes. Mr. Hoskinson stated the County cannot afford the alternatives; it is the right thing to do; the third group is those seniors being cared for by one or more of their adult children or sometimes a neighbor or friend; and many adult couples in Brevard County are taking care of their parents at home. He noted the CSC also provides nutritious meals to 450 seniors who need them at 14 congregate dining sites through the Seniors at Lunch Program; it operates the Retired and Senior Volunteer Program with 1,200 volunteers and 200,000 hours of volunteer service in the County; it provides legal seminars, information, and referral in cooperation with the 211 service, home maintenance and repair, health fairs, and short-term respite and homemaker services to another 900 seniors through the Senior Assistance Program; and it manages Sunnyside Homes in Rockledge, an assisted living facility, and operates its own kitchen, which helps keep the meals affordable. Mr. Hoskinson stated in a few years when the baby boomers begin to need services for the frail elderly, the sheer number of them is going to force the senior services system to expand in home services, as well as institutional care; the crisis is coming; there are seniors in the community who need services now, but have not come to the delivery system for one reason or another; and the most cost effective way to provide the services is to provide them in the senior's own home, along with nutritious meals as needed. He noted the most expensive way is to wait until seniors need care in a nursing home or assisted living facility, and then pay four or five times as much as the cost to keep them at home; an additional $100,000 in funding to provide in-home services for Brevard's frail elderly would help keep more of them at home and would save several times that amount of money in long-term care costs; and $100,000 would purchase 44,444 delivered meals or 44,444 meals at a senior dining site, homemaking and personal care for 30 people with average service needs or 15 people with intensive service needs, adult day care for seven people five days a week or many more people at a day or two a week, the purchase of four beds in an assisted living facility for one year, or between two and three persons in a nursing home for one year. Mr. Hoskinson stated in-home services are not just the most preferred way to care for frail seniors, but the most cost-effective way.

Ms. Preston stated every year hundreds of elder adults in Brevard County are abused, neglected, or exploited; last year alone, there were 650 cases of reported abuse in the County; for every reported case, it is estimated that there are four to five cases that are not reported; many elder adults in the County lack the mental or physical capacity to manage their own affairs; and there are residents in long-term care facilities that are cognitively impaired and have no family or friends to make health care or residential placement decisions for them. She noted when an elderly person becomes physically or mentally incapacitated and is no longer able to make those decisions regarding their finances or personal care, a legal guardian may be appointed to represent and protect their interest; Brevard County, however, does not have a public guardian program; the need for guardianship services is growing and now exceeds the capacity of private case management agencies to provide pro bono services; and Barbara Whitley is present to tell the Board what role the public guardian plays in protecting older adults and the long-term savings to the State and County when the services are available.

Barbara Whitley, Director of Brevard Guardianship Services, stated there is a difference between a professional guardian and a public guardian; a professional guardian is an individual who cares for the people who are fortunate enough to have sufficient resources to pay for a private attorney; unfortunately, those individuals who take on indigent guardianships are met with people who have had limited finances all of their lives; and such guardians become the investigators. She noted she took care of one woman who had 34 different names and has taken care of people who each had five different social security numbers; there are different people needing guardianship who are incapacitated, but have nobody who will come forward; before services can be provided, the guardian has to prove who the person is, whether they were in the service, and if they have any income; and once the individual has been identified and it has been established that they are incapacitated, then the benefits process can begin.

*Assistant County Attorney Shannon Wilson's presence was noted at this time and County Attorney Scott Knox's absence was noted.

Ms. Whitley stated the process is interesting; there cannot be a guardianship without a lawyer; a legal person is needed to do the adjudication process; and they must supply the paperwork, including necessary pleadings. She noted the guardian has to do the financial management; the guardianship law requires that a documented certificate be provided of any assets found by the guardian, which includes real estate, bank accounts, cars, boats, and anything in the house; and the guardian must manage the ward personally. She stated the guardian sees the ward at least bi-monthly; he or she attends care plan meetings; the guardian has the medical responsibility for the ward; and the guardian's responsibilities are heavy. Ms. Whitley noted everything needs to be documented; guardianship is often compared to adopting a two-year old child; the guardian is constantly responsible for everything that individual does, including paying for a burial; and the guardian tries to provide for the client as much as possible. She stated her agency receives approximately 200 referrals a year; these are individuals who come from other agencies, including the police and other places; they fall into four groups--the mentally incapacitated elderly; the developmentally disabled; the mentally incapacitated younger person due to alcohol, drug abuse or mental illness; and a limited number of brain injured individuals. She noted guardians try to locate a person's family, friends, and any individual who will take over the responsibility; about 120 of the 200 referrals are solved by either family, friends, or by getting the medical services; this takes 12 to 18 hours per case for each of these individuals; and in about 12 cases out of 200 referrals there are financial problems. Ms. Whitley stated in some cases, guardians do power of attorney to keep the money safe; approximately 40 clients out of 200 go to guardianship; just because they are referred for a guardianship does not mean that guardianship will happen; and sometimes she has to explain that to referral agencies. She noted her agency does not take anybody to guardianship unless they are incapacitated and there is no other choice; currently the agency is carrying 102 on-going guardianships; nobody is giving them a dime to take care of them; and the agency has a staff of 15 and seven full-time care managers. She noted there are 60 paying clients; that is what has been carrying the agency for 14 years; but the referral base is increasing; and there have been 12 new referrals since the first of the year. Ms. Whitley advised there are only eight public guardian programs in the State serving approximately 1,400 individuals, using a combination of State, local, and charitable resources; four programs are funded through County general revenue, ranging from $42,000 to serve 60 clients to $2 million to serve 790 clients; three offices are funded from State general revenue funds with the Office of State Public Guardianship; and funding for these offices range from $120,000 to serve 63 clients to $319,000 to serve 118 clients. She noted only one program is funded from court filing fees; it is Osceola County, which receives $43,000 for 20 clients; Brevard County is providing $15,000 to serve at least 120 clients; and she does not know how many clients the other private guardianships are carrying, but most of the guardians in the County are also carrying non-paying clients. Ms. Whitley stated the Office of State Public Guardianship is looking for funding sources, but believes the funding for public guardians must come from not only State funds, but from other funds; the public guardian can only serve those who meet the Medicaid guidelines; the State is looking for Medicaid money to help pay for guardianship services; and it is going to be a hard road to prove and the federal guidelines will need to be changed. She noted her agency needs services to assist in advocating for funding for the development of a public guardian program to assist in the founding of a committee to explore resources available; the President of the Local Guardianship Association is present today; one of the recommendations is a bed tax on hospital, nursing home, and assisted living facility beds; and the Brevard Legislative Delegation and Florida Association of Counties also need to be approached for their assistance.

Ms. Preston stated there are older adults and their families who know services exist to help them, but they do not know how to access the services; finding help can be difficult because the system in the County is so fragmented; for families that need help and do not know where to go for information and assistance, often situations escalate into a crisis situation; and the Board has supported the 2-1-1 system. She noted Libby Donoghue is present to bring the Board up to date on such system and how it and the senior helpline work together to meet the needs of citizens. Libby Donoghue, Director of Crisis Services, stated last July, her agency was notified that it had the 2-1-1 number dialing assignment for the Brevard County calling areas; it submitted its service request to BellSouth last September and began meeting with the Board members individually and collectively, the League of Cities, city managers, and other agencies that needed to know what was being worked on and to receive input about the design of the system; and the service was provisioned by BellSouth last April. She noted on May 1, 2001, the agency launched publicly the 2-1-1 system in Brevard County, with the support of the Board, United Way, Health Department, and several municipalities; among the municipalities, Melbourne is the only one that committed a full year's funding, but there was some support from other cities that are listed as well; and there were challenges in implementing the system.

*Commissioner Jackie Colon's absence was noted at this time.

Ms. Donoghue stated within about six weeks of starting the service, her agency found out that Barefoot Bay was not online; it started working on the problem in the summer; and as of December, 2001, the problem was finally resolved and the system is functioning from Barefoot Bay and throughout Brevard County. She noted the system is available 24 hours a day, seven days a week; incoming calls first go to an autoattendant; the first directive is if it is a medical emergency, to dial 9-1-1; there are a couple of other options, including a TDD, which is a communications device for people who are deaf or hard of hearing; there is the ability to transfer a caller to another program; and it is a big part of the relationship her agency has worked with Community Services Council. She noted the Council does some things differently than Crisis Services does, and specializes in seniors; the 2-1-1 system was not devised specifically for seniors or any other target population; it is a comprehensive program; and a big goal of Crisis Services is to work with the specialized programs and get people to the services in the most effective way. Ms. Donoghue stated in terms of the impact of the 2-1-1 system on the call volume, the chart shows the May through December, 2001 time period; the average was about 1,000 calls per month; the numbers have increased significantly; and the two peaks are directly related to the launch in May, 2001, and anthrax calls in October, 2001. She noted the calls compared to last year before the implementation of the 2-1-1 system have increased approximately 64%; Crisis Services is continuing to work on the awareness; it recognizes that still not enough people know about the system; and as word gets out and the system grows, both in Florida and nationally, those calls will continue to increase. Ms. Donoghue stated concerning the information and referral strategies and goals of the Board, there is 24-hour, seven-day availability and staffing by trained and qualified individuals; Crisis Services is certified by one national organization as a crisis center; it is in the process of accreditation by a national information and referral organization; and it anticipates having that accomplished this year. She noted there are several staff people who have individual accreditation, either as crisis specialists or information and referral specialists; it is Crisis Services' goal to increase the number of line staff who take exams and acquire certifications; her agency provides confidentiality to callers; and it offers a choice of services and providers. Ms. Donoghue stated the database has over 1,300 listings of health and human services programs that are offered both by public and private, for-profit and not-for-profit entities; Crisis Services tries whenever possible to give people multiple options and talk to them about some of the benefits of various options; but the final decision is up to the individual who is calling.

She noted cooperation and collaboration among providers is a goal that Crisis Services believes in very strongly; when the agency started moving toward 2-1-1, it met with the Child Care Association, which does specialized information and referral, Community Services Council, and other agencies to talk to them about how it would impact their systems; as the calls increase, the referrals that Crisis Services makes to other agencies increase; and they wanted to ensure it was going to be a good relationship on both sides. Ms. Donoghue stated her agency has also worked with groups that are not agencies, but coalitions or commissions, such as the Commission on Aging; and it has worked very closely with Together in Partnership, is involved with the Homeless Coalition, and anticipates working with the Commission on Mental Health as well. She noted Crisis Services recognizes that people being able to find these services is a first step into getting the help of human services across the system; it wants to do whatever it can to facilitate that; the seamless linkage is available with the phone system; and there is a future application that started in the homeless service area, but has broad implications across all systems, which is a shared information system for community case management. Ms. Donoghue stated Crisis Services is the lead agency in the development of it; it is working closely with Brevard County, United Way, and other providers on the service; in terms of access and awareness, her agency has developed, in cooperation with United Way, a strategic communications plan; and there is development of some common logos on the national level. She noted in terms of access information beyond dialing 2-1-1, Crisis Services has its database available from its website on line; it also sells it on a disk that people and agencies can load into their computers; she and Mr. Hoskinson have been meeting about working together on a printed directory that would be used primarily by professionals; and her agency is more than happy to work with any agencies or groups, as it has with Together in Partnership, on the maintenance of the resource data that is important to them. Ms. Donoghue stated there has been some language in a federal bill that is in committee right now for protecting children against terrorism, language in the Senate version of that bill supporting funding for 2-1-1 programs; there is also an effort in Florida to combine some of the State-funded health care services; and the task force that is reviewing that is looking at using 2-1-1 as a gateway into eligibility, screening, and information. She noted Brevard County is one of the communities that is being considered a pilot site for that project; and it is Crisis Services hope that if it is funded and proves successful, that it will be a demonstration beyond just the area of health care, but the usefulness of 2-1-1 as a community information utility.

Ms. Preston stated the County cannot have a community planning process without transportation; the Commission on Aging wanted to expand the concept of mobility planning beyond public transportation; and it wanted to look at other aspects of mobility planning, including pedestrian friendly communities and roadway design and usage. She stated 98% of citizens over the age of 60 still hold a drivers license in Brevard County; and almost 19,000 of those people are over the age of 80; and while they may not all still be driving, a good percentage of them are. She stated research shows that they are going to continue to drive for as long as they can; a loss of driving privileges is one of the leading causes of depression in older adults because it signals a loss of their independence; if the County is going to have people on the road and have them driving, it makes sense to do everything it can to make the individuals safe and responsible drivers; and Dick Thompson is present to discuss how the County can help older drivers through some basic roadway design features.

Traffic Engineering Director Dick Thompson stated the average driver 65 years of age and older requires eight times as much light to see the same object as a person 25 years of age or younger; the background for the proposed Elder Road User Program includes increasing needs of elder road users; research proves that age is a risk factor for drivers; aging affects vision, hearing, coordination, range of movement, strength, attentiveness, and reaction time; and enhanced visibility and reflectivity of traffic control devices provide greater safety and less stressful driving. He noted the objective of the Program is to provide highly visible signs, pavement markings, and traffic signals; increase the size of signs and lettering; increase the widths of pavement lane markings from four inches to six inches and eight inches; refurbish pavement markings more frequently to maintain maximum reflectivity; and increase use of reflective pavement markers to include all roadways with 35 m.p.h. or greater speed limit. Mr. Thompson stated the County has a recommended annual program with various features that could be used to enhance the driving for all drivers; there are some younger drivers who also have poor eyesight; and the program helps everybody who is on the road.

Ms. Preston stated some of these things are not only going to benefit the elder, but everyone; and one of the goals of this process is, as changes are made in the community to help the elderly, the County is focusing on the needs of the whole community. She noted research shows that people are going to drive as long as they can; if they have options to not driving, quite often they will take advantage of them; that is where the public transportation system comes in; and Brevard County has a good public transportation system. Ms. Preston stated Space Coast Area Transit (SCAT) has worked very hard to meet the needs of the elderly population; the Volunteers in Motion Program was developed specifically in response to transportation needs to the elderly; the County has reach a point, however, where the system needs to grow; and Jim Liesenfelt is present to explain the demands being placed on the County's public transit system, some of the current problems he is facing, and what an increasing number of older adults means for the future.

Transit Services Director Jim Liesenfelt stated SCAT is putting together its annual performance fiscal ridership review for the federal government; the County's vanpool system and fixed-route system last fiscal year have hit all-time record riderships; SCAT is moving ahead and trying to move more people; and this year looks better than last year. He explained transportation needs and demands, and how the County supplies transportation to senior citizens; stated as staff went through the last Transit Development Plan, it developed demands, estimates, and needs of the service; there are approximately 20,000 senior citizens over the age of 60 who are transportation disadvantaged; and those persons need assistance getting around either because they are disabled, low income, or unable to access other transportation needs. Mr. Liesenfelt stated of the 20,000 people, there is a demand for about 262,000 trips a year; SCAT supplies senior citizens three different ways-door-to-door transportation at about 40,000 trips a year, fixed-route transportation at about 105,000 trips a year, and Volunteers in Motion at about 8,000 trips a year; and based on the latest demand estimate, there is a shortfall of about 153,000 trips each year for senior citizens who need assistance for transportation. He noted current and future problems include the demand for non-medical subscription trips is increasing; there are more education and employment trips for the disabled; the number of dialysis chairs is increasing; the number of therapy, radiation and chemotherapy requests is increasing; the number of potential ADA required trips is increasing; and the peak service or time of day requests are increasing. Mr. Liesenfelt stated priorities to help the transportation for seniors include dialysis transportation, therapy subscription trips, employment trips, and general medical trips; the federal government has pulled out of daily operational funding for public transportation; the State's funding has been steady; over the future, the County cannot rely on the federal and State governments to help provide more money, with one exception; and Senate Bill 100 and House Bill 141 to close license tag fee loopholes will generate approximately $150,000 to $200,000 annually. He noted any other additional funding must be generated locally.

The meeting recessed at 10:25 a.m. and reconvened at 10:45 a.m.

Advocacy

Ms. Preston stated Fran Carlin-Rogers is present to talk about the importance of advocacy efforts and how developing partnerships can enhance the effectiveness of those efforts.

Fran Carlin-Rogers, Senior Resource Alliance Consultant, stated the Senior Resource Alliance (SRA) is the area agency on aging that covers Planning and Service Area 7, which includes Brevard County, Orange, Osceola, and Seminole Counties; one of the mandates of the area agency comes from the Older Americans Act, which is to advocate for seniors; the SRA has been working on the Senior Resource Alliance Advocacy Program since early 2000 to establish a coordinated advocacy program in each of the four counties; and in that effort, the SRA was given clear orders by its board and the Advisory Council that has been working on the Program. She noted the priorities established for the Advocacy Program include that they be very tangible, County specific, and partnership driven; the mission statement is to create an elder ready Florida by increasing awareness of senior issues and of the political and economic powers of the elders; and the Advocacy Program volunteers will provide specific information on senior issues and needs, build community relationships, be knowledgeable and comfortable with the legislative process, focus efforts on SRA and Commission on Aging selected issues, work with the agenda of partnership organizations, and extend the visibility of SRA and Commission on Aging as the voice of all seniors in the community. Ms. Carlin-Rogers stated the SRA advocacy issues for 2002 include three areas-publicize results of 2001 needs assessment, discuss impact of service-related issues, and education regarding the caregiver program and needs and opportunities; the partner organizations include the AARP, RSVP, Osceola Council on Aging, Commissions on Aging: Brevard and Orange Counties, and others; the recruitment and training of volunteers include appointing a volunteer coordinator in each county, SRA staff to provide ongoing support, and training sessions in grassroots advocacy to be held in each county.

Ms. Carlin-Rogers stated the SRA is very excited about the Advocacy Program because it is the right issue at the right time; it focuses on county level of concerns, is driven by partnerships, and provides a stronger voice for seniors.

Funding and Resources

Ms. Preston stated in the current budget environment, funding issues are coming to the forefront; how to expand existing funding sources, develop new funding sources, and better utilize existing community resources was an integral part of the planning process; Dr. Douglas Beach is going to give a brief overview of how the federal and State dollars for elder services flow to the local level in Brevard County.

Dr. Douglas Beach, Chief Executive Officer of Senior Resource Alliance, stated the 1965 Older Americans Act sets up the template for aging services throughout the United States; and explained a chart on the national aging services network. He noted currently there are 650 Area Agencies on Aging nationwide; of the 650, the SRA is one of those and represents Brevard, Orange, Osceola and Seminole Counties; the nationwide area agencies contract with 27,000 service providers; and such service providers access services, such as information and referral, outreach, case management, transportation, in-home services, community services, and caregiver services. Dr. Beach stated the role of the Area Agencies on Aging, as mandated by the Older Americans Act, is to develop an area plan to provide a comprehensive and coordinated system of services with special attention to older individuals with low incomes, those who have the greatest economic need, and those who have low-income minority status; and the second mandate of the Older Americans Act is to serve as the advocate and focal point for older individuals within the community by monitoring, evaluating, and commenting on all policies, programs, hearings, levies, and community actions, which will affect older individuals. Dr. Beach stated the SRA satisfies its role through planning, contract management, and needs assessment; and explained a chart showing how the funding comes through the SRA to the various counties. He noted the SRA is approximately a $20 million non-profit agency; 60% of the funds come from State funding and 40% comes from federal funding; 14% funding goes to Osceola County at $2.8 million, 13% goes to Seminole County at $2.6 million, 39% goes to Orange County at $7.9 million, and 30% goes to Brevard County at $5.7 million; and most of those dollars flow through the Brevard Community Services Council. He stated there are primarily three funding sources for aging services nationwide--federal and state governments, local government, and private sector; the reason that home community-based services are so important is that it is a way to defray the costs of Medicaid at the County, State, and local levels; the State of Florida is in the bottom four nationally in home community-based services; and there is a budget crunch in Tallahassee, so it does not look like the County is going to get any real increases in funds from Tallahassee in the foreseeable future. Dr. Beach stated in Ohio there are 88 counties; over one half of them have some kind of senior citizens levy; such levy can be anything from funding a senior center to funding home and community-based services; and he does not know if Florida is ready for anything like that, but it is happening nationwide. He noted when there was the economic boom the last five or six years, contributions by individuals were at record highs; but the percentage of profits going to philanthropic activities have decreased; and the business community also needs to be brought into the picture to help them understand that if individuals are kept in their homes for a longer period of time, they can find ways to defray some of the costs at the County level. He stated there are other funding options that counties may want to do, but cannot because they are spending too much money on Medicaid; and perhaps they can figure out a way to better coordinate activities, not only locally, but Statewide.

Chairman Scarborough stated Brevard County contributes $2.5 million to Medicaid; the State sends the County the bill and it has to pay it; and it is a real factor in how it impacts everything, from the number of Sheriff's deputies to how many library books there are in the libraries.

Ms. Preston stated there has been a lot of discussion about what needs to be done in the County; the task force group and Commission on Aging members worked hard to review the County service systems and develop specific recommendations to address areas that they felt needed improvement; and Melissa Otto will discuss the Board's options.

Public Comments

Floyd Bloom stated the critical issues the Board has heard this morning are health care, housing, transportation, recreation, safety, and job opportunities; health care, transportation, recreation, and safety are all part of his main concern for seniors in the future; sidewalks provide individuals with an aerobic exercise which is healthy and also get people from here to there, which is part of the transportation problem; and if sidewalks are located properly, they provide safety for senior citizens. He noted sidewalks are a very important part of the senior life; he lives in a high-rise condominium in the Cocoa/Rockledge area; ladies have fallen and bruised themselves; and the City's Public Works Department told him that the sidewalks belong to the property owners. He stated the property owners told him that the survey shows the sidewalks are on the public right-of-way; there is a controversy and hopefully it can be resolved; and requested the Board provide a staff person to head up a committee on sidewalks and find out who is responsible for sidewalks in the area.

Commissioner Carlson stated Barbara Meyer handles pedestrian and sidewalk issues; she has coordinated many community issues in regard to sidewalks; and Ms. Meyer can talk to Mr. Bloom on his ideas.

Chairman Scarborough stated the Board may be discussing funding methodologies; there are two things that are discussed periodically--the gas tax and sales tax; either of those would be directed to some extent to the roadways; and it would be negligent on the Board's part not to see that sidewalks are fully analyzed and Mr. Bloom's concerns are answered as a part of the funding methodology.

Lou Rossi, representing Brevard Veterans Council, stated the Council has a problem getting money in Brevard County for the veterans of the United States; there are approximately 65,000 in the County; about 12,000 veterans are retired; and their retirement income is approximately $18 million a month. He advised Florida is number two with the veterans population and number 43 with funds coming from the United States for the veterans; most of the money goes to the northeast; and a hospital was needed desperately in the County, but it received a clinic. He stated it is the largest clinic in the United States, but it is still a clinic and inadequate for the veterans' needs; it takes seven months to see a doctor after a veteran has been enrolled with the clinic; and the northeastern states are getting the money that is being used for public health hospitals. Mr. Rossi expressed appreciation to the Board for its support of the veterans the Veterans Center on Merritt Island, the homeless veterans, and the Standdown once a year; stated the Board has given the veterans funds every year; it has done a lot of good for the homeless veterans in Brevard County; and there are a lot of women coming out of the service now who need extra special service. He thanked Attorney Leonard Spielvogel for free legal services to all the veterans; stated he is going to try to get on the O'Reilly show concerning funding for the veterans in Florida and Brevard County; it is a disgrace to the veterans of the United States; and the money should not stay in New York. Mr. Rossi stated it is going to be hard to get this done, but he is starting today on this project.

Chairman Scarborough requested Mr. Rossi provide the documentation that indicates Florida is number 43 in funding and number two with the veterans population; and stated it will help the County lobby on behalf of the veterans in Brevard County.

Cindy Earp, Brevard County Housing Authority Commissioner, stated she has done a lot of jobs with at-risk people; one of the issues that continue to come to the forefront is transportation; it is a priority issue; and she commends the Board for such a fine snapshot of the elder population in Brevard County and the task ahead. She noted she hopes the County will continue to think about transportation; and it came up with a public transportation system, but needs to re-evaluate the needs and what can be done, and look at community-based volunteer services that are available. Ms. Earp stated the elderly do not always run on the same time frames that public transportation does; that is where churches and community-based organizations can fill in the gap; and she hopes that transportation will be a big issue for the Board's consideration.

Tibby Parker, representing Barefoot Bay Recreation District, stated she agrees with Ms. Earp's comments, particularly, the needs for transportation; and commended County staff and the volunteers for their work with the Brevard Commission on Aging. She stated as the Board is planning for its new fiscal year, it needs to review things such as gas tax, ad valorem tax, the community-based organizations, and expanding the idea of public/private partnerships. She noted Brevard Tomorrow's strategic planning initiatives have indicated transportation is a real serious issue; and urged the Board to think about transportation as it is planning for the future.

Ed McGuire expressed appreciation to the Board for the foresight it has used in establishing the Commission on Aging; stated he appreciates the fine report, which was thoughtfully written; the issues and needs have been analyzed; and the report includes a series of creative alternatives. He requested the Board adopt the report, congratulate the Commission on Aging, and show that it really means it by providing funding to continue the kind of professional work it has seen.

Christine Schnitzer stated she served on the Brevard Commission on Aging this past year; and complimented the leadership of Paula Preston. She noted while serving on the Commission, a great deal of time was spent identifying and prioritizing issues; implored the Board to pay special attention to parks and recreation; and stated senior wellness is an area of parks and recreation and the direction the County wants to go as far as prevention. She noted wellness is more than just the physical dimension; there are other dimensions, including the intellectual and vocational aspects of wellness; there are ties into part-time jobs and volunteer work that seniors can contribute to the community; and other dimensions are spiritual and emotional, which can be addressed in many solid ways from the County to its citizens. Ms. Schnitzer stated senior fitness and wellness are quality of life issues; reiterated it falls under parks and recreation; and requested the Board consider it a number one priority.

Carol Waters, Vice Chairman of Brevard Commission on Aging, stated all of the members of the Commission on Aging are aware there needs to be a community for all ages; they have tried to keep that in the forefront of their minds; it is the holistic approach that Brevard County needs and is moving toward; and as a community, it is already looking at putting in place 2-1-1. She noted the County is supporting an integrated case management computer system; and she hopes the Board will stay in the forefront and keep paddling.

Mary Weaver, representing Cape Canaveral Hospital, stated she worked with Ms. Preston and Ms. Otto on the Brevard Commission on Aging on two subcommittees--health care and long-term care; the County has an opportunity for long-range planning for the patterns that seem to exist in society; with an aging population, the Commission has identified the alterations that occur with aging, be it the basic function of eating and dressing, intermediate function of grocery shopping and preparing meals, or advanced function of being able to manage one's own finances; and the alterations also include the changes in sensory, cognition, psycho-social aspects of life, and biophysical. She noted also with aging is related morbidity; as patients age they have a tendency to have conditions such as heart disease, diabetes and pulmonary dysfunction; statistics show that 10% of the population greater than age 65 are considered to be frail and have a two-year life expectancy; and individuals who are age 65 or older utilize somewhere between five to eight times the consumption of health care resources compared to other counterparts who are less than 65 years of age. Ms. Weaver stated complicated with that is that there are decreased resources and a decreased workforce, especially in the area of medicine, health care and nursing; and suggested there be an opportunity to partner with the private and public sector to strategically locate senior centers. She noted such centers could provide not only social activities and recreation, but education, health promotion and screening to delay alterations of aging and improve their ability to manage the conditions that occur with the aging process, and promote the recruitment, retention, and advanced education of health care providers who are caring for the elder population.

Andi Megivern, representing Accessible Structures Easy Lifestyle Homes, stated she was employed by Brevard County for 30 years as a social worker with Family and Children Services; she saw many seniors who were in need due to limited resources, housing needs, prescription needs, etc.; she retired two years ago and is now involved with her husband's business; and the main focus is to keep seniors in their homes or in new homes so they can live comfortably.

She noted her husband originally started the business of Accessible Structures when a woman indicated her husband was leaving a nursing home and coming back home, but would have a hard time getting into the house and the bathroom; it became obvious that there was a direct need for people to be able to remain in their homes; and the wife was going to be the caregiver. Ms. Megivern stated she never thought how difficult it would be if she came home now, was confined to a wheelchair, and tried to get into the shower, but could not; she and her husband have talked to people who take showers in their garages until their bathrooms can be modified; there is a real need; and she has a neighbor who is 91 years old, and if she did not have the services of Meals on Wheels, she would be in a nursing home. She commended the Board for having the foresight of developing the Commission on Aging; stated she was part of that group; and the issues need to be addressed now.

Brian Lynch, representing Florida Health Care Association of Brevard County, stated there are new Medicaid monies of $76 million Statewide that withstood the two special Legislative sessions; it is a quality improvement Bill for skilled nursing facilities; beginning January 1, 2002, it increased staffing minimums for nurses, RN's, and LPN's by 66%, and certified nursing assistants by 33%; the challenge is to retain, recruit, and train these new employees; and hopefully it is going to result in improved quality in skilled nursing facilities. He noted there will also be increases January 1, 2003 and January 1, 2004; so there is one sector of the elder community long-term care that has recently received increased funding and support; sometimes skilled nursing facilities have a bad name; the Florida Health Care Association fully supports aging in place; and there is 98% occupancy this season in Brevard County in the 19 skilled nursing facilities. Mr. Lynch stated the Association also does rehabilitation so that individuals can return home; and Florida Health Care fully supports it, as well as increasing quality for elders in skilled nursing facilities.

Bileta Henderson stated she is the caregiver for her elderly mother and disabled daughter; her mother's care has gotten beyond her ability to care for her and she is now in a nursing home; her mother's income is a bit too high for Medicaid eligibility; however, it is only 50% of what is needed to keep her in a nursing home facility. She noted she has made approximately 250 telephone calls over the last four months trying to find resources to help her mother; her parents did everything they were supposed to do in planning for the future; and no one could expect that in the time they were making their plans that heath care and insurance costs were going to substantially increase. Ms. Henderson stated her parents had always been the ones to assist other people; when it came time for her to get help for her parents, it has been next to impossible; it has been a very frustrating experience; and she is now talking to Ms. Whitley and on the right track. She noted there are legal and financial issues involved; and she hopes the Board can address the issue for people who are in the gap between those who are low income and those who can afford to provide for their own care.

Chairman Scarborough stated there is an income gap trust; there are individuals in the audience who can assist Ms. Henderson; expressed concern about information not getting out to help individuals; and stated the information needs to be shared.

Discussion of Board Options

Ms. Preston stated Ms. Otto will present some of the options that came out of the task force groups and the prioritization by citizens in the community, as well as the Commission on Aging members.

Ms. Otto presented and explained the various options in each category for consideration by the Board.

Motion by Commissioner O'Brien, seconded by Commissioner Carlson, to approve Option 1, to enhance The Continuum of Care Resources, including advocate for Brevard Legislative Delegation and Florida Association of Counties, to expand the Medicaid Waiver In-home and Community-Residential Programs and the SSI/OSS Assisted Living Programs; increase State funding for Community Care for the Elderly, Home Care for the Elderly, and Alzheimer's Disease Initiative Programs; and continue efforts of the State Task Force on the Availability and Affordability of Long-term Care to improve the quality of nursing homes and nursing home care. Motion carried and ordered unanimously.

Motion by Commissioner O'Brien, seconded by Commissioner Carlson, to approve advocating for the Florida Congressional Delegation to promote federal tax incentives for individuals who purchase long-term care insurance or use private savings to fund long-term costs, including a safety net for those individuals who purchase long-term care insurance, and advocate for consumer protection for the elderly. Motion carried and ordered unanimously.

Commissioner O'Brien stated Item C reads, "Provide additional local support of $100,000 beginning fiscal year 2002-2003 to address respite care, case management, adult daycare and caregiver training to support deficits in our community"; and inquired what does "to address" mean. Ms. Otto responded Mr. Hoskinson talked about the deficits in Brevard County; there are more than 400 people on a waiting list; and the $100,000 would assist in picking up the slack in those areas of respite care, case management, adult daycare, and caregiver training.

Mr. Lusk stated the reason the $100,000 figure was picked was knowing that monies are not unlimited and the County needed to start addressing the backlog and deficit of needs.

Chairman Scarborough inquired what would the $100,000 provide. Mr. Hoskinson responded it depends on what the County wants to buy; it would be up to whoever the County designates to determine what to best buy for those funds; the people who need help the most were identified before; and there is really not a problem with the people who are eligible for Medicaid, as there is money available for those people. He noted the State is trying to push more and more people into Medicaid waiver if it can because the federal government pays 55% of it and the State pays 45%; for CCE clients, the State pays 90% and the local community pays 10%; but the people who are not eligible for Medicaid, but cannot afford to pay for the services themselves are the people who need assistance. Mr. Hoskinson stated the best solution is to try to keep individuals in their own homes and provide services to help them stay there; and a fair number of people can be helped with $100,000. Chairman Scarborough inquired does the $100,000 in any way touch the waiting list of 400 people; with Mr. Hoskinson responding affirmatively. Chairman Scarborough inquired how much would it cost to handle all 400 people; with Mr. Hoskinson responding it may cost more than $2 million. Mr. Hoskinson noted if those people go into a nursing home and they cannot afford to pay for the services, it is going to cost the County a lot more money than if it is providing in-home services.

Commissioner O'Brien stated he does not have a problem looking at the issue again; before he can expend this amount of taxpayers' money, he would like to see all the sources of funding that stream into Brevard County for the aging population and where the money goes; the Board needs to set the priorities; and there is only so much money to go around. Chairman Scarborough inquired does staff see this flowing through the CBO. Mr. Lusk responded the recommendation is above and beyond what CBO already allocates to aging; the recommendation is to put $100,000 into taking care of the Continuum of Care deficit; whatever the Board decides to spend, staff will come back to it with suggestions as to how to do it; and it could be done through the CBO process or a separate process.

Motion by Commissioner Higgs, seconded by Commissioner Carlson, to direct staff to provide options to the Board concerning additional local support of $100,000 beginning Fiscal Year 2002-2003 to address respite care, case management, adult daycare, and caregiver training to support deficits in the community, with the $100,000 for the enhanced Continuum of Care, contingent upon the Board and staff identifying additional resources during the budget process. Motion carried and ordered unanimously.

Motion by Commissioner Higgs, seconded by Commissioner O'Brien, to approve Option 2, to develop a Brevard County Public Guardian Program, including advocate for Brevard Legislative Delegation and Florida Association of Counties, to provide funding for public guardians through the Office of the Statewide Public Guardian to protect the interests of indigent older adults; and authorize staff to explore alternative methods for funding a local Public Guardian Program through use of court filing fees and other innovative funding strategies. Motion carried and ordered unanimously.

Motion by Commissioner Carlson, seconded by Commissioner Higgs, to establish a Commission on Aging work group to review and make recommendations to the Board for the development of pre-guardianship intervention strategies for caregivers, business and other service vendors to establish a quality pool of elder service providers, with such strategies including background checks, licensing, screenings, case management, and other ideas as determined by the work group. Motion carried and ordered unanimously.

Commissioner O'Brien stated he provided questions to Mr. Lusk concerning the 2-1-1 system; he would like to know the total expenditures for the 2-1-1 system in the years 2000 and 2001; he realizes this is a startup program; and there were approximately 20,000 inquires coming in and asking questions for information. He noted that is 1,666 calls coming in per month, 55 calls per day, and five calls per hour at this time; the County needs to look for accountability as it is spending $50,000; other agencies have also contributed; and inquired what is the cost per call, the annual cost to operate the system, the cost per hour, and the cost per received call. Commissioner O'Brien inquired what is the projected number of calls per year, month, and hour for the years 2003 through 2010; what is the projected increase in costs for each year from 2003 through 2010; what is the projected cost per call for the years 2003 through 2010; and what is the cost benefit. He expressed concern about the cost benefit to the taxpayer; and stated the County needs to take a close look at what it is spending the money on, can the money be better spent, or is it well spent. Mr. Lusk stated staff can provide the information on projections to the Board.

Commissioner Carlson inquired is there any survey detail that can be collected from the 2-1-1 process concerning the outcomes of the calls. Mr. Lusk responded the nature of the process is not to track the outcome and is an inward call type of thing; staff could look into doing that; it is not contemplated now as it is measuring what is coming in and the information that is going out; but he can work with Ms. Donoghue to see if it is something she would be willing to review. Commissioner Carlson stated the number of calls that are received is the service that is being provided and is the reflection of why the system is needed. Mr. Lusk noted there are probably some survey strategies that staff can use to get the outcomes. Commissioner Carlson noted obviously there is a huge need for the 2-1-1 system, and she agrees that the County needs to expand on it.

Motion by Commissioner Higgs, seconded by Commissioner Carlson, to approve Option 3, to enhance information and referral resources, including continue direct County support of the "2-1-1" information utility service as a critical human services infrastructure service; and explore additional funding sources to include municipal contributions, other governmental agency contributions, grants, fees for services, and federal and State demonstration funding. Motion carried and ordered unanimously.

Commissioner O'Brien stated he would like some answers to the questions before the item is placed in the budget; and it is not an automatic item to be put in the budget.

Motion by Commissioner Higgs, seconded by Commissioner Carlson, to direct the Brevard Commission on Aging review utilization of the County's television system, to disseminate information, as the County has the capacity to take all the component parts to do an excellent presentation, which can keep individuals informed. Motion carried and ordered unanimously.

Motion by Commissioner Higgs, seconded by Commissioner Carlson, to advocate for the Florida Legislature through the Brevard Legislative Delegation, Florida Transit Association and Florida Association of Counties to close the license tag fee loophole (House Bill 141), which will generate an additional $150,000 to $200,000 annually for public transportation. Motion carried and ordered unanimously.

Motion by Commissioner Higgs, seconded by Commissioner Carlson, to advocate for the Congressional Delegation to support the Space Coast Area Transit $1.5 million capital earmarked for vehicle replacements. Motion carried and ordered unanimously.

Commissioner O'Brien stated Item 4.b.3. is to consider additional local option gas taxes to support needed improvements; the Board can consider it, but it needs to be a separate consideration; and he would like to see everything the Board has said in the past three or four years about how it wants to spend the money. He noted he does not believe the County can have a long shopping list of items for the citizens approval; and it needs to be very specific. Chairman Scarborough stated the County needs to make sure there are things clearly identified and what the people want; because of the monies generated between a gas tax and a sales tax, the gas tax would be adverse to the County's interest if it wants to proceed with putting a sales tax on the ballot; and he is not prepared to support it at this time.

Motion by Commissioner O'Brien, seconded by Commissioner Carlson, to support SCAT's efforts to maximize utilization of existing resources by using multi-loading strategies for origin, destination, and trip purpose.

Chairman Scarborough stated the maximization could end up with some inconvenience; with Mr. Lusk responding that is correct. Commissioner Carlson inquired what would be the inconvenience. Mr. Lusk responded as SCAT is always trying to squeeze every trip out of every thing it does, it has to make a tradeoff sometimes between efficiency of the system versus customer wants and wishes. Commissioner Higgs stated the trips and use of the revenues need to be maximized. Chairman Scarborough noted he will not support the motion because he has a problem concerning the trips for dialysis.

Chairman Scarborough called for a vote on the motion. Motion carried and ordered; Commissioner Scarborough voted nay.

Motion by Commissioner O'Brien, seconded by Commissioner Higgs, to direct staff to report back to the Board concerning the financial viability of the Coastal Ambulance system, the hospitals, or whatever avenue is cheaper to take over the responsibility of taking patients to dialysis and other patient transportation the County is presently doing; and whether it is better and less expense to the taxpayer if the County continues the operation. Motion carried and ordered unanimously.

Commissioner Higgs stated she would like to see an analysis of what would be generated from either the one-cent local option gas tax or the ninth-cent, which would come to the County; and compare it to the Municipal Service Taxing Unit (MSTU).

Motion by Commissioner O'Brien, seconded by Commissioner Higgs, to approve Option 4, to expand transportation options, including roadway and pedestrian, to provide additional local support for the prioritized list of roadway and pedestrian improvements for aging drivers. Motion carried and ordered unanimously.

Motion by Commissioner Higgs, seconded by Commissioner Carlson, to consider prioritized list of roadway and pedestrian improvements for aging drivers as possible projects for infrastructure sales tax referendum. Motion carried and ordered unanimously.

Commissioner O'Brien inquired when the County resurfaces a road, is it is putting down the wider reflective lines and bigger lettering on the signage. Mr. Thompson responded the County has not had a coordinated program on it because of his budget restrictions; typically those projects that come out of John Denninghoff's office are being addressed with that; and it is taking place to some degree, but needs to be done more aggressively.

Discussion ensued concerning sidewalks, two-laning and four-laning of certain roads, and various aspects of transportation and alternatives.

Commissioner Carlson inquired how does the County's standards compare to Department of Transportation's (DOT) standards in terms of the reflective types of things on roadways and striping. Mr. Thompson responded the County has less standards; it is one of the reasons he put it together as a best practice last year to go with a more aggressive program to match what DOT has; and drivers deserve the same amenities on each road. He showed examples of various signs to the Board and audience, including the six-inch signs which will be converted to nine-inch signs for street names; and stated the preference would be to do everything in nine-inch blades. Chairman Scarborough inquired how much more would it cost to do that. Mr. Thompson responded edgelines on the roadways are estimated at $634 per mile for 1,300 miles to be restriped; it would cost approximately $800,000 annually; thermoplastic centerlines would last typically three years; 220 miles of centerlines a year would be $330,000; and lane lines would be another $100,000 a year. Chairman Scarborough inquired about the cost for the signs. Mr. Thompson responded staff estimates for street name signs approximately $100,000 annually to convert them over. Chairman Scarborough inquired what is the cost to convert all the signs; with Mr. Thompson responding about $600,000 or $700,000 for the unincorporated areas. Chairman Scarborough requested Mr. Thompson provide a breakdown on the larger and more visible signs for roads that have the right-of-way and non-stop conditions versus those signs for non-stop conditions on sub-streets and subdivisions to get some parameters.

Motion by Commissioner O'Brien, seconded by Commissioner Carlson, to approve Option 5, to join regional and Statewide advocacy efforts to improve funding, resources, and treatment for aging citizens; and approve Option 6, to support staff efforts to work in cooperation with community agencies to implement Recommendation 3, using the "Healthy People, Healthy Communities" planning model, develop a specific local health care plan in partnership with local community health provider agencies, including measures that explicitly target the health and well-being of older adults. Motion carried and ordered unanimously.

Motion by Commissioner Carlson, seconded by Commissioner Higgs, to approve Recommendation 4, establish policies, procedures, and plans that specifically address housing needs of older adults; the Comprehensive Plan Housing Element and Consolidated Housing Plan should include specific goals, objectives, and policies addressing the location, design, creation, and preservation of housing for older adults; review methods by which permitting and impact fees could be handled as an incentive to increase the number of affordable senior housing units produced; and the Housing and Human Services Department Community Development Program should seek funding sources and work in partnership with developers to increase the supply of housing units for the low to moderate-income elderly. Motion carried and ordered unanimously.

Motion by Commissioner O'Brien, seconded by Commissioner Carlson, to approve Recommendation 7, the Brevard Commission on Aging should join with local service providers to develop and distribute a printed directory listing the community resources available to help older adults and their families; and request printed directory listings include font size 14 and the Brevard Commission on Aging try to find advertisers to offset the cost. Motion carried and ordered unanimously.

Motion by Commissioner O'Brien, seconded by Commissioner Carlson, to approve implementing Recommendation 8, the Brevard Workforce Development Board, through the Brevard Job Links, provide training and assistance to older adults seeking employment, increase work opportunities for older adults through outreach and job development, and market older adult workers to area employers, including bringing the training programs to the community as it is difficult for some older adults to get to the training. Motion carried and ordered unanimously.

Motion by Commissioner Carlson, seconded by Commissioner Higgs, to approve Recommendation 9, support funding of a staff position in the Parks and Recreation Department to focus on the recreational needs of older adults. Motion carried and ordered unanimously.

Chairman Scarborough inquired what happens next. Mr. Lusk stated staff has some research to do on reports that the Board is looking for concerning the Continuum of Care dollars; staff will get the information and put it in the budget if it can be done; it may not be possible this year because if the County is hit hard with Medicaid, it has to take care of that; and staff will put in the budget what needs to be put in and get the reports to the Board as requested. He noted the committees and groups will continue on; there will probably be smaller items, such as the guardianship, which will come back to the Board in a separate report after recommendations are made; and it may include fees, etc.

Chairman Scarborough stated it would be advantageous to come back and revisit the issues as a whole; he does not want to see it fragmented; and he hopes the Board will hold another workshop sometime this year. He stated the statistics represent people; the County is going to have more and more people lost with Alzheimer's; and it is only going to increase.

Commissioner Higgs stated tomorrow will be the groundbreaking for the Alzheimer's Center in South Mainland; the Board has donated the property and the Alzheimer's Foundation will be building it; and it will begin construction tomorrow for a much needed service in the south end of the County.

Commissioner O'Brien stated Lou Rossi talked about the veterans; the County should ask the veterans and their representatives to appear before the Board annually, perhaps in the month of July, 2002, when the County is starting its budget process; the County could do an update from the Veterans Memorial Center and other specific veterans organizations to see what the conditions of the veterans of Brevard County are; and Mr. Rossi cited a very large number of veterans in the community. He noted it is time for the Board to say it is interested in what the veterans are doing and what their needs are; and the veterans need to come before the Board in a public forum.

Commissioner Carlson stated the veterans can work with staff to bring back an update to the Board on an annual basis; it would be excellent information; and it needs to be a planned process. Commissioner Higgs stated the staff report would be supplemented by what the different organizations are going to do.

Commissioner Carlson commended staff for the excellent job with the presentation; and stated it is obvious that staff has complete Board support.

Upon motion and vote, the meeting adjourned at 12:45 p.m.

ATTEST:
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TRUMAN SCARBOROUGH, CHAIRMAN
BOARD OF COUNTY COMMISSIONERS
BREVARD COUNTY, FLORIDA
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SCOTT ELLIS, CLERK

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