MINUTES OF THE MEETING OF THE BOARD OF COUNTY COMMISSIONERS

BREVARD COUNTY, FLORIDA

 

 

October 9, 2008

 

 

The Board of County Commissioners of Brevard County, Florida met in special session on October 9, 2008, at 1:09 p.m. in the Government Center Florida Room, 2725 Judge Fran Jamieson Way, Viera, Florida.  Present were:  Chairman Truman Scarborough, Commissioner Chuck Nelson, Helen Voltz, and Mary Bolin, County Manager Peggy Busacca, Deputy County Attorney Shannon Wilson.  Absent was:  Commissioner Jackie Colon.

 

 

 

Commissioner Voltz welcomed everybody to the Seniors workshop today; there will be good information put out there for everybody; Commissioner Scarborough has tasked her to do this workshop on Elderly Issues; today the Board will be looking at what is available and what the needs are in the community for the seniors; and those watching will be presented with information that will be very useful, and to everybody in the audience as well.  She asked Carl Green from Prime Timers in Titusville to say a prayer. 

 

The invocation was given by Carl Green, Prime Timers, Titusville.

 

 

 

Commissioner Voltz welcomed and recognized Dr. Richard Tucker, Director Initiative on Aging and Longevity at University of Central Florida (UCF) for his accomplishments; stated Dr. Tucker joined UCF in 1972 from Emory University were he completed his PhD; his general interests are in developmental psychology, particularly as it relates to aging issues; he serves as Director of the UCF Initiative on Aging & Longevity; and current specific interests include characteristics of older Canadians in Florida with focus on health care needs, utilization of the affects of respite care on care givers for those with Alzheimer’s disease, and general issues in clinical psychology.   

 

Dr. Richard Tucker stated the introduction indicated he has been at UCF since 1972, and two days ago UCF celebrated the 40^th Anniversary of the doors opening to students; by the time he got there, there were already up to 5,000 students; and there are now over 50,000.  He advised he was the founding Director of the Initiative on Aging & Longevity but his title now is Professor.  He stated he is pleased to be here and just share some broad picture issues with the Board as it talks about aging issues in Brevard County.  He noted he is sure the Board is aware of the demographics of the population is changing dramatically, that is the proportion of people of different ages; Brevard County currently has a concentration of older adults aged 65 and over; that is 20 percent of the population; that is about 50 percent higher than the national average; and higher even than the Florida average, which is about 17½ percent. He stated Brevard County has  a significant  concentration of  older adults in comparison to Europe; the Europeans

 

in many ways are ahead in planning for aging service because the population has been older for longer than the United States; the concentration of older adults exceeds 20 percent and has for awhile; they have developed a number of services that serve as potential models for the U.S; and Secretary E. Douglas Beach is probably stealing some of their ideas when he can.  Dr. Tucker stated older adults in Brevard County do not fully represent older adults even in the State of Florida and certainly in the Country; and there is a population here that is somewhat more affluent, better educated, and hopefully, in better health.  He stated while serving on the Board of The Senior Resource Alliance, the area agency on aging of Central Florida, which covered a four-county area including Brevard, he was amazed to find out that although there were many people in that four-county area who were served through services that were channeled through the Senior Service Alliance and monitored by them in terms of Federal and State funding, that the percentage of older adults in those communities was relatively small; about 10 percent of the senior population was served through the Senior Service Network; there are many older adults out there who either do not need it or are not eligible because of income who do not use those services.  He noted it is important to realize the County is developing aging services; it is delivering aging services within the context of a society that is consumed with ageism; in his Older Hostile Workshops there were older adults who were well educated and very involved; and often, very few people raised their hands when asked if they knew what ageism meant.  He stated ageism shares some of those same characteristics where a person is sad and has attitudes and assumptions that gets them institutionalized; it begins to systematically discriminate against this group of people because of a characteristic; in this case it is age; and unlike racism, some people say that is too bad, but fortunately, that does not affect he or she.  He stated men can say sexism is terrible but that does not really affect them, of course it does; everyone, if lucky enough, will be affected by ageism and will have to realize that they live in a society that has not yet realized that ageism is under a politically correct cover; and people continue to tell age.  He advised it is interesting because people’s view of ageing tends to be relatively negative; it needs to be realized that the majority of older adults, even the oldest old, are community-based, active, and able to do most of things they want to do; and there is a big difference between decline, which is a normal process of aging, and dysfunction.  Dr. Tucker stated that type of decline begins at about age 20; he is talking about declines in maximal function; then that gradually declines in life’s course; and the biological aspects of ageing are a reality.  He advised the elderly are not only living longer, which is something that everyone knows is happening, but they are living longer better; and stated Rick Moody was the first one who brought this to his attention of distinguishing between the wellderly and elderly.  He advised  most older adults are wellderly, which needs to be kept in mind, plus making sure things are being done that will allow them to remain as healthy as possible by putting the focus on prevention and not just coming in with services once there is a problem.  He explained in terms of some of the big issues that any community faces and certainly Brevard County faces, many of the Country’s older adults do not have their support group here as they migrated to Brevard County, whether it is was because of Patrick AFB or just because it is Florida, yet their family or adult children are living elsewhere;  when needs arise for them, it is not as easy for them to give assistance to their loved ones; and that is a wonderful market for Brevard County as it is not just the services that are here but providing care management services with information for adult children in terms to helping them to help their parents that are far away.  He stated Secretary Beach would tell everyone they are living in an age of declining of Federal and State resources; and  it  is  needed  to  come  up  with  other  ways  of  finding  support to do the

things needed to do.  Dr. Tucker stated a taxing structure within Brevard County is needed; and money is generated within the County that goes towards ageing services; all counties do not have that.  He stated Brevard County has a number of community partnerships and the importance of those is providing an outreach for the older adults; and another really big issue that is true in most communities is transportation for older adults.  Mr. Tucker stated the University of Central Florida does a lot of research through its Psychology Department on Transportation, and trying to look at factors that particularly begin affecting older adults relative to driving.  He advised some students have all of their favorite stories about older drivers, but many older drivers may get to a point where they should not be on the road; the reason they are on the road is they do not have an alternative; and they do not have other kinds of transportation.  He noted fortunately in Brevard County there is Volunteers in Motion; in Orlando there is the ITM Program, which started as a pilot program several years ago; one of the most successful programs allows seniors to donate their vehicles after they have had some counseling as to why they should not be driving and that it could be a lot cheaper for them to donate their vehicle to pay for transportation services not provided by commercial taxes but by older drivers who are able to drive and may be driving the vehicles that have been donated; and this is a fee for service program, but there are a number of seniors in Brevard County who can pay for such services.  He stated another thing is meaningful activities, if they are looked at providing opportunities for seniors to be meaningfully involved in the community not just given a job but to be meaningfully involved; and the data is very clear that volunteerism benefits physical and mental help. 

 

*Commissioner Colon’s presence was noted at this time.

 

Dr. Tucker stated a great deal of information about Dementia is misunderstood; all Alzheimer’s disease is Dementia but not all Dementia is Alzheimer’s disease; a lot of people think they are the same thing but it is not; in fact, while the leading cause of Dementia is Alzheimer’s disease, it is not the only cause; five to ten percent of the Dementias are treatable and reversible; and those are the ones that he has particular interests in.  He explained he is particularly interested in that one that pursues an accurate, differential diagnosis; if going in to see a doctor with heart symptoms it would be expected that the doctor would do some tests and then the person be referred to a cardiologist; Dr. Tucker inquired if going in with cognitive symptoms and then testing what would a person expect, and stated he or she would be expected to be referred to a specialist in memory disorders who is typically a neurologist a behavioral neurologist or a physiatrist.  He advised Brevard County is very fortunate to be one of the 16 states now with memory disorder folks at Holmes Regional or in conjunction with Florida Technology.  Dr. Tucker stated the concerns about the five to ten percent say that is a relatively small percentage; When talking take five to ten percent of 5,000,000 which is estimated to be the number of cases of Alzheimer’s disease currently in the United States, or taking 400,000 to 450,000, which is the estimated number of cases in Florida, that is a very large number; even if that number was one and a particular person is that one, it is important that he or she not simply expect memory disorder to be a normal part of ageing; but it is not a normal part of ageing.  He explained there are other things that are normal about ageing; it can be embarrassing when a person forgets the name of someone who is walking right at them and he or she knows they are supposed to know their name; what people are learning about Dementia is that many of the risk factors are  things   that  increase  the  probability that he or she is going to have Dementia; and

things are related to lifestyle and not just a genetic disease.  He noted there are some elements of genetics with it but people are finding more and more that cardiovascular facts, the same facts that a person would be concerned about for good physical health, affect the health of the brain; and those are the things in which a person does have some control.  He stated the strengths about Brevard County is the fact that it is having this meeting; it is great that it already has a Commission on Ageing, which predates the Commission on Ageing in Orange County; Brevard County has a very active and innovative Alzheimer’s Center and a Community Services Council; he mentioned Volunteers in Motion; but this willingness to come together with the theme of the Florida Council on Ageing was better together; and the County will find with communication together it will find together is better.

Commissioner Bolin inquired if there is anything that the Board should be looking at regarding any ageing initiatives that it should be involved with or to look at that could be pursued.  Dr. Tucker responded there is a lot that is particular in the area of memory disorders; stated there has been more and more proactive activity, such as a program that is being kicked off in Lee County; at Lee Memorial Hospital they are doing screenings for Dementia and there is a short test; and if a person scores at a certain level he or she have red flags that maybe there is a problem.  He advised it needs to get beyond that screening; people know that those are lifestyle factors; and people know there are some things particularly engaging in mental activities, good diet, exercise, and stress management, all of which can help anyone.  He suggested having those programs; to make sure that the County has those programs; and to not wait until somebody show the signs of Dementia.

 

Commissioner Voltz thanked Dr. Tucker for being present; and stated the next issue on the Agenda is Financial and Legal Issues for seniors needing good, sound legal advice.

 

 

William A. Johnson, P.A. Elder Law Attorney stated locally he is the Vice Chairman of the Brevard Alzheimer’s Foundation, on the Board of The Space Coast Guardianship Association, and Statewide he is on the Board of The Academy of Florida Elder Law Attorney’s.  He stated he would like to comment on the legal and international things and that there is somewhat of a perfect storm brewing; there are two very powerful social economic forces brewing; the first one is the demographic wave coming of the longevity that was discussed earlier; and the second is the financial turmoil that has been going on for the past few weeks.  He advised regarding longevity, obviously people are living longer; they are living longer with chronic illnesses; and one of the concerns, at least from the legal field, is that this is going to bring up a whole range of incapacities issues from preplanning to prices planning in the fields of guardianship and long- term care plans, including medicaid.  Mr. Johnson stated it will have some challenges for the healthcare field with keeping the wellderly from the illderly.  He stated regarding financial turmoil, over $2 trillion in retirement funds have been lost in the past month and a half; many seniors can not make that up as they are not employed and have no ability to buy low and sell high or get a decent interest rate; the safest place right now is in CD’s or in the bank getting one percent as the cost of living has increased; this is coupled with the inability to sell assets and has been heard from assisted living facilities; since this data is down people can not sell their home to move into the assisted living facility or they cannot tap into their home to pay off debts;

and that itself presents another problem.  He stated a third aspect of the financial turmoil is increased prices of food and gas; his office is in Suntree and he has clients living in Cocoa Beach that can not afford to drive to his office; and the office location is not that far from Cocoa Beach. He stated couple that with the fourth prong, the healthcare costs nationally is a 9.6 percent increase; next year will be a 9.4 percent increase; and coupling those four things together on the financial side a person can see that people are living longer, needing more dollars to live longer, and are being squeezed by a lot of different financial pressures all at once.  Mr. Johnson stated his practice is predominately in crisis planning; the practice is seeing a lot of death spiral financing; in order to make ends meet seniors are putting their bills on credit cards; and then they are taking out another credit card to pay that balance.  He stated he is seeing seniors coming in with $30,000 to $50,000 worth of credit card debt with no hope of getting out of debt; of course they are going to be late on the payments so they are going to be paying 29 percent interest plus all the fees; and it is just a downward spinning cycle.  He pointed out that with the changes of the bankruptcy code they can not discharge this debt anymore; a person cannot file bankruptcy and get a clean slate; the best a bankruptcy judge can do is change 20 percent of a person’s debt; this was changed about two years ago; these people are going to be in debt until they die basically; and most of these people who have all this credit card debt are on fixed incomes.  He advised the second thing is, and this has been pointed out by Dr. Tucker, is that there are a lot of working retirees; if a person goes into Publix in Suntree or Wal-Mart in Viera, he or she will find 70 and 80 year olds working the doors; a lot of them are continuing to work; and the reason why is usually related to healthcare cost.  He noted third, there are a lot of seniors he sees that are doing without; pill splitting where he or she cannot afford their medicine so the daily dose is broken in two or they do not go to the dentist because they simply cannot afford the visit or the gas; and they are going without, which of course is just a ticking time bomb for a health care crisis.  He stated the last one is with the financial pressures on families with the elderly or their kids people are seeing kind of a rejoining of the family unit; sometimes that is for better, but a lot of times that is for the worst; people are seeing the kids sometimes move in with mom and dad and all of the sudden mom and dad’s money becomes the kids’ money; and they are able to make it as one big unit, but there is a lot of co-mingling of assets and spending down.  Mr. Johnson stated the results he has seen is there is going to be a bigger wave of elderly poor in the year 2012; these are people with $100,000 of assets or less and fixed incomes, it usually takes one good healthcare event to tip the card over; at a nursing home it is $6,000 a month; and that is usually the one good healthcare event.  Mr. Johnson advised in 2005 the Federal Government changed the Medicaid laws to make it much harder for people to get Medicaid benefits; it actually works against a person in the Medicaid world to co-join a person’s family and pool assets because there are now much more stringent rules in gifting; if he was trying to get Medicaid for himself and wanted to lend his son $5,000 to pay off a credit card he would loose a month of eligibility when applying for Medicaid and would have to somehow find that money; but it is usually not one month but six or seven months because he helped his son, sold his car for less than fare market value; and all these things are considered gifting.  He stated that charities are going to be asked to do more; and there will be seen a very big rise in older abuse exploitation.  He explained the number one perpetrator of crimes against the elderly is typically another family member who is the person that has the confidential relationship, the secret to go in and raid the bank accounts, to funnel off the jewelry, or whatever is needed.  He stated bankruptcy filings amongst the elderly people are aged 55 and up are up 151 percent.  Mr. Johnson stated that he does not want to end with the glass half empty; he will try to say the glass is half full; as Dr. Tucker said, he has found Brevard County to be one of the most forward thinking communities in the State when it comes to elder services; the County has some very dynamic thinkers who think outside the box; and there are some very caring and giving people.  He noted that a good example would be the Meals on Wheels Program; they were having  trouble raising  money  for  the  people driving the cars because of gas prices; they

sent out a call for help and the community came in and bought gas cards for them; and the community can rally.  Dr. Tucker stated the financial turmoil will end but it is not known when; and this community has the strength of the people providing those services.

 

Mr. Chris Stagman, Executive Director, Brevard Alzheimer’s Foundation, stated he would like to talk about a couple items that Dr. Tucker mentioned in his opening comments because he thinks they are relative.  He stated Dr. Tucker mentioned putting a premium on care management; that is the number one thing the Alzheimer’s Foundation is putting a premium on today; there are so many elders on waiting lists for services in the State of Florida right now because of budget cuts; there are about 40,000 Statewide alone for the Medicaid Waiver Programs because the Legislature does not have the dollars; because these folks are at home waiting for services they need care management; what has also been found is because of the name Brevard Alzheimer’s Foundation, everybody associates it with Alzheimer or Dementia; and a lot of these folks do not have that.  He noted the Alzheimer’s Foundation is starting a new non-profit called We Help Brevard to put a premium on care management for seniors; the Alzheimers stigma scares people who do not have Alzheimers; the care management component is something people are seeing where the rubber meets the road; and a premium is put on that.  He stated the second item Dr. Tucker mentioned is a taxing district; there is not a taxing district in Brevard County for elders; there is Books for Children with the Children Services Council, which United Way has kept afloat for the last five or six years; and it does have the ability as an independent special taxing district.  He explained Brevard County may want to look at that in the future; obviously that is a political hot button for the Board as elected officials when talking about taxes, in these times the County could begin to look at putting that infrastructure together; potentially using the existing Children Services Council and morphing it to some sort intergenerational approach; and that could help with funding in the future for seniors and children.

 

Dr. E. Douglas Beach, Secretary of the Florida Department of Elder Affairs, stated the administration Governor Crist put in would attain looking at that as it is a State issue; they do not have the authority to do that so the legislature has to pass something that would create senior services in taxing districts; and right now that authority is not in place in State law.   

 

Mr. Stagman stated Senator Campbell did sponsor some legislation a few years ago that died in the House needs to be looked at.  He stated he really wanted to thank the Board for its leadership; and also Dr. Beach for the revenue maximization legislature.  He stated he works with Representative Poppell, Senator Haridopolos, Dr. Beach and his staff, and Leigh Holt, Brevard County’s Delegation Coordinator; he put some legislation in Tallahassee to look at the existing Statute for revenue maximization; the United Way not only championed for this in Florida in 2002-2003 in accordance with the Healthy Kids Kid Care Program; the Federal chip dollars and the State was not accessing enough money to cover the kids because of a local match requirement; the Bill passed in 2003 unanimously and it really has not been used that much except in small areas; a couple United Ways use it for the chip money and the Healthy Kids Program; and what he looked at is how could the existing Statue open up for elder services to potentially use it to provide local dollars to get these folks off of a waiting list. He stated while they did not pass, Dr. Beach was able to pull some of the language that was useable into a conforming Bill that was passed the last day of session; since then he met with Commissioner Bolin and representative Poppell to put this work group together; and  the County is running with

it.  He noted staff has done a great job; there is a consulting group coming in to look at it from all angles, not just elder services; the concept is simple, local dollars can be used to provide a Federal match; the State budget is a mess, which we all know; and it is not going anywhere anytime soon.  Mr. Stagman stated the revenue is down and there is a gap again; he is hearing $1.8 billion cut next year; and Dr. Beach can talk about that more again later.  He stated the reality is there are some challenges.  He advised the Rev Max Bill will allow the use of local money; they do a lot of fund raisers at the local Alzheimer’s Foundation; and potentially they could put some money on the table, use this mechanism to draw down Federal dollars to help cover this.  He stated the County could put some money in with other private businesses; he feels this is a real winner for everyone if it is done right; and also to the hospitals and what services the hospitals provide the community; there are Baker Act Bed issues at Wuestoff and children issues and mental health disabilities across-the-board are being looked at as to what is already being provided that would be eligible for Federal matching dollars.  Mr. Stagman stated he is excited about it and thanks all for allowing the Alzheimer’s Foundation to do it; he came before the Board a couple months ago and asked for a little bit of money that it did not have; but they took chicken scratch and made chicken salad out of it.  He advised it is going to be a challenging year for them, with those folks on the waiting list; Dr. Tucker said earlier with the demographic ship, they are already seeing it.  in all reality, this community has a lot of thanks for all the facilities that are there and the staff to do what is being done; and the Board has supported it from day one. 

 

Commissioner Colon inquired how one of things Mr. Stagman mentioned was generational; stated more than ever the Board will be looking at those kinds of partnerships because the dollars are not there; and further inquired what some of the different kinds of partnerships they have are successful thus far.

 

Mr. Stagman explained what they have had is some good traction; when he was at United Way prior to being at the Alzheimer’s Foundation, they did a good job with the faith-based initiative there working with the Workforce Development Board, and putting the many job links in 25 churches; and there was a lot of traction from that.  Mr. Stagman stated he can tell that most of the care management happens at churches because that is where they get phone calls from, the pastor or the youth pastor that calls and says they have somebody there, and something is not quite right, and could a social worker be sent there; they need to forge those relationships, where he sees the most value is in the intergenerational box; many of the issues that affect the elderly also affects the children; but it is just funded differently.  He stated they talked about nutritional meals, school lunch, and nutritional meal programs for seniors, safety from abuse and neglect, and emotional and physical stimulation; all of those programs they fund for the little ones they also fund for the elderly; and this would not be a broad brush, but how could a person begin to align these things up to streamline services to serve both at one time to save some dollars.  He advised there are some things that can be done as a State; he knows the Governor is looking at intergenerational stuff; it is a winner and they have had intergenerational talks in the community; when Sheriff Williams was here, he put the teams for kids and seniors together; there have been some things that have had a little bit of movement; but they need to look at them a little closer to sort of reinvent some things to get it launched.

 

Commissioner Colon stated she  believes that on October 14, 2008 Joe Steckler will be honored by the Board; the Board cannot thank  him  enough for all he has done and will continue to do in

the community; and she wanted to share that the Board will be honoring him on the 14^th for everything he has done for the community.

 

Commissioner Votlz introduced Dr. John Potomski, President, Florida Medical Directors Association, Cheryl Hoffman, Senior TransServe Program, Community Services Council, and Jim Lisenfelt, Director, Brevard County Transit Services Department.

 

Dr. Potomski stated he would like to thank the Commission and also Secretary Beach for allowing him to come before this group today; the speaker before him did an elegant job of laying out the situation that everyone is in, and in general, the rest of the speakers are going to get into some more specific issues.  He stated two weeks ago today he met with Congressmen Weldon in Washington, D.C., and some of the issues they discussed was the effective economy on the senior citizens and people who have their money invested in 401K’s, IRA’s, etc., and how this is gong to affect them; what Mr. Johnson stated earlier went into those facts; and it is certainly a serious matter.  He advised that many people, when talking about nursing home costs, is an average of $6,000 a month; many folks that end up in a nursing home and have their own private assets, they are spending it down; once they run out of assets, they become a patient that is on Medicaid; he or she may have Medicare for their health and Medicaid for the cost of a stay at the nursing home for room, board, and transportation; and this brings him to the Medicaid nonemergency transportation issue.  He noted that currently the Medicaid beneficiaries are not receiving transportation services in a timely nor compassionate manner for the local provider; Medicaid Non-Emergency Transportation (MNET) is actually a misnomer in a sense because when it is said that it is non-emergency some people think it is not necessary; it should be called Medically Necessary Transportation because all medical non-emergency means is a person does not dial 9-1-1; anything other than a 9-1-1 call the folks who are on Medicaid that need medical transportation is considered MNET again; people make these trips for various reasons as they may need to be admitted to the hospital, to go to doctors visits, need chemotherapy, radiation therapy, or dialysis; and there are truly life sustaining reasons for these trips. He stated he would like to reiterate the point that it is important, and because it is not an emergency does not mean it is not important and does not mean it is something that is required to sustain life or to improve the quality of life for these folks; and it is not only the elderly.  He stated even though he is Chairman of the Commission on Ageing and President of the Florida Medical Directors Association, when involved with nursing homes these issues transcends age, but it also is the disabled adults and children that rely on the Medicaid Non-Emergency Transportation.  He stated the history behind the current issue is that several years ago the State of Florida, due to budget cuts, reduced funding for MNET across the State; Brevard County is one affected by the reduction as well; at that time, they spoke with the County and mentioned that if the County put in maybe $300,000 it might be able to keep that previous provider, but unfortunately things are tight for the County as well.  He noted things are tight for all branches of Government and they were unable to do that, so what the State did is it took a contractor, TMS, out of Tampa, which began to provide the services in Brevard County.  He stated that the only problem with that is that it is an out-of-town provider and that they have no staff or vehicles in Brevard County; so what they basically were was a middle man; they took the calls if someone needed transportation; they may have called a taxi to take someone from a nursing home to a doctors office to drop them off; and it has probably been heard before, drop off an Alzheimer’s patient at McDonalds and on the way back to forget to bring them back to the

nursing home.  He explained there have been drivers that are inebriated bringing patients to the

emergency room and if asked for credentials, he or she may have a Michigan drivers license; and there have been all kinds of problems that have come up with the transportation since it was out of the hands of a local provider.  Dr. Potomski stated what has been seen is the middle man basically taking the money and making a profit and that money, if it was given to a local provider, it could provide better transportation to the residents in Brevard County if they did not have to go through a middle man; that would take their commission as part of outsourcing the trips to other providers; there are several local providers now that are willing to bid on the Medicaid contract; and what they have asked the Commission for is Transportation Disadvantaged  (CTD) to allow local bidders when this contract expires at the end of October, as it has been asked of them to allow local bidders on this; Dr. Potomski stated if they can have local people again they will take out the middle man funds that are allotted for transportation; and that is one of the things they ask the Board for support.  He stated he will read a recent letter because they have not heard as much about transportation lately; this comes from a nurse at a hematologists office writing in as a follow up; due to HIPA; the nurse is referring to the patient as Mrs. H; hopefully this can be avoided before her next visit; and they see her today for a follow up visit.  “Mrs. H was seen today at 10:30 a.m. and was ready to be picked up today at 11:00 a.m., the patient and her aide were sitting up front by our main doors all the time making sure they were not missed. Mrs. H and her aide were not picked up until 2:05 p.m..  Mrs. H had an early breakfast and had not had lunch.  The aide did offer her some bagels that were able to be gathered together for the patient.  Multiple calls were made to the transportation company that brought Mrs. H to her appointment.  One of the comments made was that they did not remember where they had dropped Mrs. H off.  They also said she was not in the building when they came and all the while Mrs. H was sitting right by the front door while the aide the whole time would take Mrs. H outside to make sure they were not missed by transportation”.  He stated the nurse stated in the letter that she could say that because she watched her and the rest of her morning patients, also saw her as she left for lunch, and when she returned from lunch; and this is not good patient care and the aide that was with Mrs. H did all she could short of finding a way to drive Mrs. H back to the facility herself.  He stated that the letter was dated in September; and some recent examples and issues have certainly not been solved.  He stated what is being asked for is for the State to impose a $1.50 surcharge on vehicle registration throughout the State of Florida, which will help enable them to get a greater pool of dollars to fund MNET throughout the State and Brevard County. 

 

Commissioner Voltz inquired how a non-emergency does not mean not necessary; and  how does the Board get that message across to the State Legislature assuming they are the ones setting the dollars for this unnecessary problem.  Dr. Potomski responded some additional lobbying would get the message across about poor quality of transportation they are getting for medically necessary treatment.  Commissioner Voltz inquired with the contract being up at the end of the month, who bids that contract out; with Dr. Potomski responding it is the State; stated in the past several years they had Coastal Transportation; and the State allowed them to contract with Coastal Transportation.  He advised after the budget was reduced, Coastal was not able to provide the same service for a reduced rate; they had asked the County if there was any additional funding for it; the State said they had to bid it out to anybody who is willing to take the contract for Brevard County; and that is when the group out of Tampa, which is TMS, took over the contract.

 

Commissioner Voltz stated that TMS is the one that decides the transportation needs for the MNET needs in Brevard County.

 

Dr. Potomski stated the Commission for the Transportation Disadvantaged would put out the bid and then monitor the awarded contract.

 

Commissioner Voltz inquired if it is the State who awards; with Dr. Potomski responding yes it is an agency that awards the contract and monitors the contract.  Commissioner Voltz inquired will the Board have absolutely no say in that.  Dr. Potomski responded just on a staff level, but it is a Statewide standard, standard Statewide contract, standard statewide bid, so the bid that goes for Brevard County would have to meet the same performance standards.  Commissioner Voltz inquired if the County has complaints like that in regards to transportation over the past several years, does it take those to the State agency.  Dr. Potomski replied it has been done, and that is where some of the issues were; asked if there is a local provider because at one time there was no other local provider that was willing to bid on the contract; TMS was one; now but there are some local providers and he thinks that they are planning to bid on the contract.  He noted the County will probably be contacted by the Commission for the Transportation Disadvantaged; there will be a whole gamut from A through Z of people wanting to bid; and it just depends what they can do to fit in.  He stated the nonlocal guys will have to come in and work out some agreement with local providers that help to work out the trips and stuff; and it is a bit easier for the local ones to bid.

 

Commissioner Voltz inquired would the Board have any influence at all over the State agency to say the Board would like it to consider a local agency.

 

Dr. Potomski stated technically no; it cannot be done under Federal rules; and the CTD would have to meet that as well.  He stated the Board can not award any points, bonuses or preferences to logo; it will not be allowed; and pressure could be put on staff.  He stated when the bid goes out the question would be to the CTD if it will take this transportation from Brevard County for this year for “X” amount of dollars, and people say yes, or is there competitive bidding.  Dr. Potomski stated that what has improved over this whole situation is that several things, some local nursing facilities and all, have to try and get their own transportation or arrange contracts when it is feasible; and the other is at least they are going to allow other bidders to take the contract because last time there were no other bidders that were interested in it, so there was the one bidder; now at least public awareness has been raised regarding this issue and there are other people who are interested in bidding on the contract, which there is more competition out there; it would be more favorable in providing a more compassionate, professional, humane, and timely service to the elderly; and not only to the elderly but anyone that would require Medicaid necessary transportation.

 

Commissioner Voltz inquired is that a one, two, or three-year contract; Dr. Potomski responded probably a five-year contract with the proper extensions; stated it is hard to do the contract for one year because of the capital liability for what the company would have to do; and if they truly do it right the first year or two, they will make their money on the back end of the contract.

 

Cheryl Hoffman stated she is here to give some good news; she is with the Community Services Council and the Board has a blue folder; she tried to provide the Board all of the brochures for it to take back and maybe put it in a file for its assistants to have references; there is a handout that has the Council’s name on the front.  Ms. Hoffman stated she wants to tell the Board about Senior TranServe; it is a fairly new program that has been in existence for a couple of years; volunteer drivers take seniors to those medically necessary appointments; they  do doctor visits,

chemo treatments, dialysis, and also provide some trips to take a spouse to a nursing home to see their loved one because they have no way to get there; but it is so important to maintain that relationship.  She noted that she has given the Board a little bit of information about it; in the last six months Senior TranServe served 110 seniors who needed a trip; it might be a one-way or a two-way trip; usually they are round trips because they have to be brought back home.  She advised the volunteers averaged about 211 trips a month; right now there are 45 drivers who use their own cars and pay for their own gas; two drivers were lost in the last six months; one was due to death; another developed Macular Degeneration and it is not safe for her to drive anymore; so she is going to become a client now. She stated all of the volunteers are trained; they receive a little book with such information as entering and exiting the car, confidentiality, and all of those things are covered.  She explained that seniors who get trips must be able to get in and out of the car, because most of the drivers are seniors themselves; it does serve a specific group of people; the Council works hand in hand with Volunteers in Motion; and Jim Lisenfelt and she are buddies so this is a supplemental program to the County Program.  She stated volunteers are retained in an amazing way; they get a volunteer luncheon once a year; and it is hard to believe that with the price of gas that this many people drive for one lunch a year.  She stated of the trips that were requested in the last six months, 25 percent were not able to be met for a variety of reasons; and it breaks down to about one-third, one-third, and one-third; and of the trips the clients cancel before they even get scheduled because their doctor appointment changes, they are ill, or they found somebody else to take them.  She advised ten percent could not be met because the drivers were not available; drivers are always being recruited; about another ten percent cancelled after the trip had been scheduled and the volunteer driver was committed; but it was because the doctors appointment changed, the client was ill, or for some reason they did not need to make that trip.  She stated satisfaction survey’s are done on a regular basis; clients are so thankful for this service; the drivers say that they are so excited to be apart of the program because they are needed; they are desperately needed by these other seniors; and it is a win-win situation for everyone.  She stated they are excited to report that this program can be funded for the first time with County money; they are thrilled because it does take a little bit of money to put it all together; they do have one part-time paid staff person; and some marvelous volunteer schedulers work with all of the volunteers.  She stated they are really excited about where this is going; they are hoping it will continue to grow and prosper and serve the needs that otherwise would not be met; the clients make donations; there is no set fee because many folks are really living out there on the edge; but they do donate whatever he or she can. 

 

Commissioner Voltz inquired how can someone volunteer to help; Mrs. Hoffman responded on the back of the page she put the telephone numbers for the Program; the Senior TranServe Office at Community Services Council can be contacted at (321)639-8770, and a person can ask for Senior TranServe; or the could also dial 2-1-1.

 

Commissioner Voltz stated that is great and someone mentioned earlier that there is a program for people to give up their cars; and inquired who they would give their cars to; with Dr. Tucker responding that Program is in Orange County, but it is not in place in Brevard County.

 

Mrs. Hoffman stated that there is no program at this time; and she would be happy to look into it.  Commissioner Voltz stated it cannot be that tough; and surely there are many seniors who can no longer drive, have nice cars just sitting in the driveway or garages, and somebody could drive if they do not have a card the County could hook those people up.  Mrs. Hoffman stated it would be exciting to do that.

 

Mr. Lisenfelt stated he wants to cover briefly the County’s services tied in a little bit with the seniors; at Space Coast Area Transit (SCAT) they operate four different services; and he is going to give the technical terms for each, Fixed-Route Service, Paratransit Service, Agency Van Pools, and Volunteers in Motion.  Mr. Lisenfelt advised the Fixed-Route Service is the typical Fixed-Route Service that would be found pretty much anywhere else in the Country, a fixed-route is a bus that operates on a scheduled route on a scheduled time; there are 19 buses serving our 14 fixed-routes; the Board funded two additional buses for Route 1; and those are coming soon.  He advised what needs to be done is hire a couple of bus drivers and buy a couple of buses and they will be set to go; in the recent Riders Survey in May, 19 percent of the riders on the fixed-route service are age 60 plus; that leads to about 232,000 trips in FY2008; and roughly about 6,000 trips a week are senior citizens boarding and disembarking the buses.  He noted they did not drill down as to what the trip purpose was, but that is one they will be looking at to get a better idea as to why seniors are riding the buses; inquired if it is mostly medical; stated he imagines a good portion is for work; and some would be for visitation.  He stated he does want to put a couple issues that they have and seniors may have with fixed-route service in accessibility from bus stop to destination; accessibility is actually getting on and off the bus; the newer buses are now low floor; there are ramps if a person wants to stay in the front part of the bus; but other than that, a person has to come up steps; and the other part is the accessibility of getting to and from the bus stops.  He stated as they get busier, they are pulling out of the malls and some of the shopping centers that they are stopping along the street of Wal-mart on Merritt Island; traffic is too busy; they cannot keep the bus on schedule; if a person wants to get to the front door of Wal-mart, he or she rides the bus to Cocoa Beach the extra seven or eight minutes, or they cross the street; so there is some accessibility there.  He advised the other thing to think about is accessibility is just accessibility; and that really does not even have anything to do with transit.  He stated today he went to Chili’s for lunch; he drove around the back side of The Avenue; if a person was a senior and wanted to go to The Avenue, the green apartments have a wrought iron gate all the way around it; he found a secured gate that has a combination code so there is a little walkway; and it takes a person to the backside of The Avenue.  He stated it is not that appealing as he walked from there to The Avenue; there were two, big potted plants and he had to turn sideways; somebody with a vision or mobility problem does not make that very easily; so there are issues getting back and forth.  He noted there are also the same issues at bus stops and shelters; Transit is doing a survey on all its bus stops and shelters because just sticking a pole in the ground does not cut it; there are some places they cannot do much more than stick the pole in the ground; but they are trying to figure it out.  He stated they are working with cities for shelters and that sort of thing; somewhere down the long-range, Transit will get tied into intelligent transportation work, and it will signal a person’s cell phone when the bus is ten minutes out; or a person can look online to see where his or her bus is; and a sign that tells a person the bus is going to be there in ten minutes and that is coming down the line.  He advised Paratransit service is something that is door-to-door; one that staff has been doing since 1974 is Seniors at Lunch; it is funded by Community Services Council; some of the old folks still call it SNAP; but it is Seniors at Lunch and they serve about 12 locations with bus stops; and it is Meals on Wheels in reverse as the drivers take them to the congregate meal site and then take them back home a couple hours later.  He stated it is the best route to ride; it is the most fun if someone gets on the bus and if somebody is not there that is the topic of conversation; and unfortunately if a person is the new person on the bus, he or she are the topic of the conversation.  Mr. Lisenfelt stated that it is a service provided for 34 years; Paratransit is what a person thinks of as the small bus that operates; his staff corrects him because he calls it door-to-door; it is actually called curb-to-curb where a person  makes  the  reservation;  they  come  to  the  front  of  a  persons  house,  apartment, or

wherever they live; and then the person is dropped off closest to the door of the location.  He stated medical trips are the most trips made; there are about 26 buses floating around on a daily basis taking care of those needs; a couple issues they have with Paratransit is a much lower productivity; the fixed-routes average about 19 boarding an hour last month; door-to-door takes a lot of time because it has a lot of constraints; the time constraints on seat availability are if a person has somebody in a wheelchair and wants to load on a Paratransit bus, it takes five to ten minutes, to take them off it takes five to ten minutes, and the driver has lost almost 20 minutes of the hour of service without moving the bus at all so productivity has been knocked down by two thirds.  He noted the other thing is it is a little bit tougher to group trips up and get share-a-ride so it makes some difficulty; the most interesting thing is everybody in the world wants to go at 9:00 a.m.; it does not matter what the trip purpose is if its dialysis, doctors appointments, visiting, shopping, or personal reasons the demand is between 8:00 a.m. and 10:00 a.m.  Mr. Lisenfelt added a little bit of limited trip destination is done across the County; the thing is when a person calls, he or she calls for one trip at a time; if a person is on a Fixed-Route or is driving their own automobile, he or she knows they can go shopping for a prescription; but on Paratransit a person has to think ahead so each trip is its own segment so it does limit destination choices. 

 

Mr. Lisenfelt stated the area that a whole lot of people do not know about is Agency Van Pools; those are the blue and white vans a person sees everywhere; the County can purchase the vans and lease them out to VPSI, Inc., which is the contractor; they turn and lease them to human service agencies providing transportation disadvantaged services, and it is long-winded but it is basically providing human service transportation.  He explained that insurance, maintenance, and the back-up of replacement vehicles are provided in the lease.  He stated the cost is up to $690 a month now; as an agency, they have to provide the driver and keep the van clean; but the rest is covered by the lease.  He stated there are about 22 of those vans on the road everyday for senior transportation; there are about 50 vans going to agencies right now; and 40 percent are out there providing service to seniors.  He stated he has been to a few agencies that supersede costs; $690 a month is a lot; a person knows you can go out and buy a Lexus and lease it for about $450 a month; and the van is a lot more, but it provides insurance and the back-up, which is the biggest.  Mr. Lisenfelt stated another thing is when the van goes down with transmission issues; there is a back-up van available so transportation is not lost for a week; and the County turns the vans over every four or five years; so the Board gets a new vehicle as part of that; lease agency vans rarely go above 100,000 miles; those are replaced more often due to age than usage so there is a preserve issue there; but if the Board looks over the lifetime of its costs and measures it out, leasing it is better.  He stated what is offered is Volunteers in Motion; and they have about 10 vans on the road and SCAT just purchased five new low floor mini vans with the wheel chair ramps to help folks with wheel chairs or some mobility issues to get down off a vehicle.  He noted there are volunteers who drive and escort the passengers; majorities of trips are food shopping, prescriptions, and medical trips; almost all of the users are seniors; once again the Feds do not allow Federal money; and it is age 60 plus who ride, but there are other folks riding it.  He explained the idea is the Community Service Council came to them in the mid 1990’s before Mr. Lisenfelt was Transportation Director; they put their money where their mouth was to help work out and help design Volunteers in Motion; to this day they still fund, and the County will match it with ten percent of its money; the County probably spends a little bit more, but they are funding $75,000 a year to help keep the service on the road.  He stated that volunteers are always needed, and the phone number is (321)635-7999.  Mr. Lisenfelt stated one interesting thing is the Paratransit demand is 9:00 a.m., and Volunteers in Motion is later in the mornings or early afternoons the clients  have different needs

with different abilities out there; there is a little bit of extra capacity in the afternoon with Paratransit; and Volunteers in Motion has a little bit of extra capacity in the morning, more volunteers mean more trips on the road.  He advised a couple things he would like to point out is to remember all the passengers are pedestrians at some point; sidewalk accessibility and anything of that nature just helps especially with seniors or anybody with mobility issues; and anything that they can do to make it easier for people to get to the bus stop, shopping location, or the doctor helps the transit make it easier on folks.  Mr. Lisenfelt noted today is like a national conference for Transit, so none of the Transit friends will hear him say this, but most seniors still drive; anything the Board can do to help seniors drive and to make it safer or better for them, that is the important thing.  He stated he just wanted to put that in there with accessibility getting to and from a parking lot; and inquired why do seniors drive.  He stated for example, they took the keys away from his grandfather when he was 83; he passed away 20 years ago and he was still mad when they took his keys away; so believe it or not, one thing he did as a teenager was take him to Illinois to buy lottery tickets because Indiana did not have a lottery.  Mr. Lisenfelt stated that his grandfather would walk to the grocery store that was about two and a half blocks away.  He advised  where Commissioner Voltz lives there is no where to walk; it is two and one-half blocks to get a gallon of milk; a person’s choices are driving themselves, to ask a neighbor, or ask a family member; and a person you could not get Transit services from where Commissioner Voltz lives as it would have to be a door to door trip.  He advised it is tough because a lot of people do not want a 7-11 at the end their street or in their neighborhood; mixing up some of the land use laws will help the seniors get around; and they do not have to drive or they do not have to ride Transit as it makes it a little easier to walk.  He stated transportation senior needs permeate everything from planning and zoning to transportation to land use to a number of different things.  He stated he wants to give a little bit of news that the Federal Government came up with this program called New Freedom; it is basically a Federal Transportation Program; the issue was developed it a couple years ago and it came with a bunch of regulations at a conference and it was trying to tell the County how to use the money; and a lady from Georgia stood up and said there is just not enough juice for all the squeeze it makes them do.  Mr. Lisenfelt stated it is a wonderful line so the Department of Transportation (FDOT) has stepped in and it is not certain of all the details yet, but the way the Program was designed is they were supposed to take the money to be a community based organization and dole the money out to different folks that need transportation; they are just Transit people, they are not regulators; not a human service agency that is beyond the expertise; and FDOT has stepped up to the plate as it is going to solicit all the invitations.  He advised staff is putting a list together and will attach an application to it.  He stated he is going to talk a little bit about the Local Coordinating Board so some of the agencies will start getting letters form FDOT; that money in the next year is $144,000; it has to be matched 50 percent; so locally $144,000 has to come up; he is not sure if that is a two year total or not; if it is a two-year total, it is $70,000 a year for as long as the Fed’s decide to fund it; and that adds up to a lot of van pools that will help some of the agencies doing transportation.  He stated it is not the County that would be doing the funding; the Fed’s have stepped up; the State is helping the County on how to put together a coordination plan like that to make everybody in the County eligible; that is going to be the next four, five or six months of focus to try to make sure the County is eligible; and staff can pull these Federal funds in and help distribute them. 

 

Commissioner Colon stated when working with the Senior Center, one of the key things that folks did not understand was that seniors love to drive; they love their independence; and one of the controversies is when the Board was trying to move the Senior Center, the greatest concern was in regards to treating the Towers, that was definitely something that was a misconception; if

a person did not know the seniors and really work closely with them, the simple fact was that 90-something percent and some of the folks that are here, like Mr. Lisenfelt, was saying they drove; so wherever the Senior Center is placed it is not going to matter because folks like to drive.  She stated in regards to treating the Towers, they had their own recreation so they did not come across the street to the Senior Center and do the recreation because they were pretty much self-sufficient; it was just surprising to all, and she has been working 13 years at this, how much the seniors drive; and do not try to take away their keys because it would get ugly; those numbers are really important to know because it is underestimated what the seniors can do.  Commissioner Colon noted one of the things talked about in regards to how well their diet or exercise is really the key; so out of today’s workshop, that really needs to be kind of the main thing; if the Board is really wanting to a whole balance when it comes to the seniors, exercise is key; that is why she is excited about what the County is doing with parks and the new Senior Center because that was a key component of making sure that it was just not a building but the whole wellness component, which will be critical for everything that is being talked about; and inquired what good is it to have all these programs if people are not healthy or able to enjoy them.

 

Dr. Potomski inquired if any of the Federal purposed funding will be for wheelchairs, stretch transport, or just basically for SCAT buses.  Mr. Lisenfelt explained it is designed for transportation beyond what is required of The American Disabilities Act, which is what is done throughout the County; staff goes beyond what the Federal mandates are; it could be for a stretcher, door-to-door, wheelchair, or a van pool for the Alzheimer’s group to help subsidize the cost of its van pool; and so it could be a number of different things.

 

Dr. Potomski advised one of the things is that with people who are confined to nursing homes or  assisted living are wheelchair-bound or even some of them are stretcher-bound; and the current provider was only allowing two stretcher transports a day where many facilities have more than two stretchers going out everyday.  When Holmes Hospital a couple of years ago was told that there were going to be two stretcher transports per day, Bonnie Rudolph said, “Well this hospital is big, we need more than two a day.”  Dr. Potomski stated his great-aunt luckily is 91, still drives her great-grandson to school, and picks him up everyday; but the poor folks that are disabled, not healthy, and not able to ambulate require wheelchairs or stretchers, and their needs should be considered as well.

 

An audience member inquired if anybody is coordinating these efforts; and stated there are so many excellent things out there to get the elders around.

 

Commissioner Voltz explained that is an issue that needs to be dealt with; there is a book in the back of the room put out by Community Services Council and it is a Brevard County services for elders and caregivers; there is a lot of good information in there; staff is going to try and get out as many as it can; and there are a bunch of them in the back of the room. 

 

Dr. Potomski stated there is a Local Coordinating Board Council (LCB); people can just call them; they may not have the answer for transportation available; but if they can at least start directing folks the right way.

 

 

Commissioner Voltz introduced Mark Brimer, Mayor, City of Satellite Beach, Ron Morgan, Brevard Commission on Aging/Senior Resource Alliance Advisory Council, Cheryl Hoffman, Program Director of Community Care Programs, Community Services Council, Paula Preston, Senior Assistance Program, Community Services Council, and Libby Donoghue, Executive Director, 2-1-1 Brevard, Inc.

 

Commissioner Voltz added when finishing with this group before the Board comes back with the second half of this, it is going to take a five minute break.

 

Dr. Mark Brimer, Mayor, City of Satellite Beach, stated thanks for the opportunity to be here; he is here on behalf of the Brevard Commission on Aging; and Dr. Potomski is the Chairperson.  He advised the initiative the City has taken under Board direction is elder fall prevention; and he wants to provide the Commission on Aging’s position. He stated each member of the Commission has a power PointPresentation; and being limited on time, he will go as quickly as he can.  He advised four areas that we want to examine is first of all, for people that do not know, elder fall prevention is important, the second is what is the Brevard Commission on Aging hoping to accomplish with this initiative, which is really the mission more than anything else; inquired what impact so far has the money had that was provided by Dr. Beach and by the County Commission; where are they going form here with the mission statement moving forward from today; and stated that is really asking for the Board’s approval more than anything else to make sure they are on the right track.  He stated first of all, fall prevention awareness is needed, and this an issue in Brevard County as Dr. Tucker explained that 20 percent of the population is 65 and above; and that kind of defines where they are at today.  He noted the basic message is they assume, as Brevard Commission on Aging, that most people want to live in their homes for as long as they possibly can; that is where they want to reside for as long as possible; and they want to do whatever they can do to do that.  He advised based on that assumption they examined two questions; inquired how is that opportunity possible and what can they do to make that opportunity available for everybody who wants to live in their home for as long as possible; and who can partner with them and who they can learn from to make this initiative go even further.  Dr. Brimer stated the Board will see the strongest point that they have on the Brevard Commission on Aging is they have partnered with a number of people.  He noted some real quick facts he will go through quickly because the time is limited; these are from the Community Development Commission (CDC) and not their facts; and age 65 is the fastest growing segment of the population in the United States.  He stated falls are the leading cause of fatal and non-fatal injuries of seniors in the United States; one-third of community elders fall annually, that is age 65 and above, and there will be a fall by one out of three people per year; 50 to 60 percent of all elder falls occur in the home; 30 percent occur in the community; that is specifically what they are trying to address is the community and the home environment; and Nationally, only about 50 percent of the people who have hip fractures will be able to return home and function independently as they are going to need some type of assistance.  He stated women are nearly three times more likely to be hospitalized as a result of a fall or an injury than men, and most often that is due to the osteoporosis factor.  He explained that the Department of Health said in January 2008 falls of people age 65 years and older, 37 percent of all injuries had hip fractures; basically four out of ten people that came in to the hospital with a fracture had a hip fracture; and it is a fairly significant event.  He advised there were 19,000 hip fracture hospitalizations in 2005; females made up Nationally 73 percent of those fractures; and males made up 27 percent.  He stated Brevard County fall projections have gone from National down to the State, and now down to the local level; and this data was pulled together by Tammy Harris.   He stated in 2013 there  will  be 138,000  people age 65 and above

in Brevard County; it is estimated that approximately 5.7 of those will fall each year; that is going to result in 6,000 emergency room visits, 41,040 physician office visits, and 34,015 will require ADL assistance, which means back to the National data they will not be able to take care of themselves and will need some help at home in order to get back to a normal lifestyle.  Mr. Brimer noted lastly, 17,006 will require long term care that is about 4.7 per day that will go in nursing homes as a result of falls; that is why he thinks the County can impact this to try to slow that number down, and keep people from going into the nursing home environment.  He stated elder injuries from the CDC are the number one elder fractures that occur on an annual basis; the American Academy of Orthopaedic Surgeons says this is what happens most often when a person falls and fractures a hip; 25 percent make a full recovery, that is one out of four; 40 percent will require a nursing home admission of some length; 50 percent will be dependent upon a walker or cane for the rest of their lives; and interestingly, 20 percent will die within one year.  Dr. Brimer inquired what does the Brevard Commission on Ageing hope to accomplish; stated they have four opportunities that they are looking at under the direction of the Brevard County Commission; and of course the Department of Elder Affairs.  He stated number one is to continue to increase community awareness; number two is to increase elected official awareness; number three is to increase medical professional awareness, in other words the physician that can partner with them on this opportunity; and the fourth is to increase business awareness because a lot of falls occur in the businesses when they are in that community segment.  He advised what they did as a basic model to show the Board how they are working on this, is what is called a needs-based community fall model; this is kind of the driving force to move beyond just the elders and to look at the baby boomers as well; and if age 65 is the watershed event of when a fall occurs, they want to look above and below that for purposes of educating people and making a difference with this initiative.  He stated obviously at age 65 and above is elder, and age 65 and under is a boomer; under the elder area they want to look at wellness and prevention aspects because that is really what they mostly need at this point and time as they begin to age; under the boomers they added the component of caregiver education because there are a lot of people that take care of elders that know they have fall issues but they do not take care of that issue; and caregiver education has become a vital point through the Brevard Commission on Ageing.  He stated even though both groups may need to hear the same message, they both may have different needs in this process; in other words, somebody who is dealing with someone who has fallen has different needs than somebody that is falling; and that is why they have continued to looked on either side of the continuum so that they can pick up people as they move forward.  Dr. Brimer stated what the Brevard Commission on Ageing has done so far on how they have spent the money and the effort is a blue print has been created for fall prevention awareness and that has been going down and around to the different communities in giving; and it is about a 25 to 30-minute presentation, which takes everybody through the essential components of fall prevention awareness; and that is where they are at with the awareness component right now.  He explained what has been put together is the F.D.R. Model, which does sound like Franklin Delano Roosevelt, but it is not; it is easy to remember; he will show the Board how it works; and they provide this at the end of the seminar so the people can really drill down on what they have talked about. He stated the first part of that is falls are preventable; they talked about the fact that 40 percent of all falls are preventable; there is a reason why that person fell; and they can prevent that if they can get that information out to them.  He noted the second is to discuss medication with a person’s doctor; before and after the fall there are lot of preventative things that they can do if a person discusses the medications with their Doctor before he or she falls; third is to remove any environmental hazards, which is an eight-step process that they use to talk about; it includes how to make a person’s home and  community  safer with just getting around the house and out

of the yard safely; and at the end of the presentation they ask everybody what does F.D.R. stand for.  Dr. Brimer advised they get a good response from the crowd as to what it stands for; and that is kind of the little drill down that they use to remind people of those three elements. He stated this is the interesting part; as mentioned at the beginning, they have participants that have really been involved in this process and not everybody is up here; he is going to let these scroll through; obviously Department of Elder Affairs, County Commissioners, Housing and Human Services, Wuesthoff Health Care Systems, Publix Corporation, Brevard Commission on Ageing, Senior Resource Alliance, Cities of Cocoa, Rockledge, Palm Bay, Satellite Beach, and Titusville, the newest member to this addition, which they are really proud to have, is brought to them by Janet Brooks, which is Parrish Medical Center; and they came on board when they had a presentation in Commissioner Scarborough’s area two weeks ago. 

 

He explained that relationships, partners, and sponsors have been very helpful to them; they found that in working with this organization that they do a lot of very good things for elders; an elderly family had difficulty getting in and out of their home; he was dependent on either a wheelchair or a scooter; they built a ramp for him to be able to get in and out so that he was not just locked in his home, because it is very difficult to get out of a manufactured home when a person cannot really walk; this is one of those things that they came across; and it is just an excellent group to be working with.  He noted at the Palm Bay event they always put on a presentation by the local EMS that shows exactly what happens to a person when he or she falls in their environment; but when all these people come rushing in a person’s house to put he or she on a back board and take them out, it really drives home the message about how a person wants to prevent the falls.  He advised each of these they have vendors; at the last event in Palm Bay they had 35 vendors show up; and if just one of those people that comes in can get accustomed to the fall prevention process, they can interact with seniors and answer all types of questions.  He explained this was one of the bigger events that they had in Palm Bay; they actually had 350 people show up and listen to the Fall Prevention Seminar; it had very good attendance; and again; it would not be possible if not for the Department of Elder Affairs and the funds that it shared with them as well as the County Commission.  Dr. Brimer inquired where do they go from here; stated they have three proposed steps that they are looking at; number one, they would like to continue to roll out the F.D.R. Model simply because it is in the infancy stages and they think they can make some more headway with that; number two, they would like to build a Train the Trainer Educational Series that they can get out to the community that goes through some of the safety steps that are available in the home environment; and number three, to continue on awareness moving towards education in these four different areas, elected officials, Community and County EMS Services, medical professionals, and of course the business organizations.  He advised that is the goal over the next short period of time; and the funding that has been provided for them and the direction has been really wonderful.

 

Commissioner Bolin advised Dr. Brimer that the Board always likes to give testimonials; she can actually say that in her household she has an elder/boomer household; her family did use the service when they had their home inspected for falls; they made a lot of changes; it was quite the education; and she got her list of homework and is checking them off all the way down the list.  She thanked Mr. Brimer for that service in Satellite Beach.

 

Commissioner Voltz inquired if there are any figures on how many people have fallen and broken their hip or who have actually had a broken hip from osteoporosis and fell; with Dr. Brimer explaining the way it initially started was they went through the hospital data that is reported  to Tallahassee;  that  is  how  the  numbers  on  the hip fractures was determined; and

Nationally it is 90 to 95 percent of fractures that are hip fractures due to falls and the other five to ten percent are due to osteoporosis.

 

Commissioner Voltz introduced Mr. Ron Morgan, Brevard Commission on Aging/Senior Resource Alliance Council.

 

Mr. Morgan stated thanks to the Commissioners for authorizing the project on Brevard Commission on Aging several years and providing them with the outstanding service on Housing and Human Services with the wonderful staff, who without the support and services, there would not be a functioning Brevard Commission on Aging.  He advised that today he will cover some highlights on Brevard Commission on Aging, Senior Resource Alliance Advisory Council, and a couple of other very interesting news notes for the Board.  He noted what they do in the Brevard Commission on Aging expands on just about every topic that a person can imagine with regards to aging services, elder population, general education, and transportation;  and he would like to highlight just a couple of them pulled off the minutes from the Brevard Commission on Aging meetings.  He thanked Secretary Beach for the first item picked out on February 14, 2008 on the Senior Grant update where they received $96,635 with the Department of Elder Affairs to the Brevard Parks and Recreation Department for the Martin Andersen Senior Center in Rockledge; and it is a combined cooperation that they have with all the Departments in Brevard County and the State.  He stated the Brevard Workforce put together a non-traditional workforce survey, which evaluated all of its services in a non- traditional population, which went out to a bunch of people who are residing with family members even visiting with family members that come for a two-week visit and stay for two- years; and they may require services.  He noted the other items which were recently started in February and finished it with the official release of the National Association of Counties (NACO) cards, which is again the first card carrying portion of Brevard County that they can be proud of as a County; it is a free card; one for the entire family can be used with any other prescription card a person has, be it Medicaid Part D, or other types of insurance cards and the pharmacist will give a person the bare minimum and it will take the most providential percentage savings based on whichever card of savings off the cost.

 

Commissioner Voltz stated that it is for prescriptions only so anybody out there that does not have insurance can use the prescription card and get 20 percent off at no charge; the card is available to everybody; there is a large stack available; and there will be a break in a few minutes so everybody can go over there and get one.

 

Mr. Morgan noted the card is administered by the National Association of Counties; they just received the August report in from them; the total of items purchased was 4,615 and the total number of customers served was 2,773; and Brevard customers had a total savings of $46,666 in the month of August alone on just this one card.  He stated as Commissioner Voltz mentioned, it covers all prescriptions, including any prescriptions a person might have for his or her pets; and that this is the only card in the Country that does that.  He commented on discussing the television converter box and the problems coming up as the elder community is transferred in February to the new digital system and a coupon handout; so they look at every phase that they can think of to help the elders out.  He stated they can not operate without the full coordination, cooperation and service that the Community Service Council and Commission does; there are the Caregiver Support Program, Shared Cost Program, The Sunflower House Facility which has been working wonderfully for many years now, Brevard Community Kitchen, and  the Community Service Council is providing Meals on Wheels.  He noted Meals on Wheels

provides 2,000 meals a day and 550,000 meals a year out of the Brevard Community Kitchen; the our Senior Nutrition Program with Meals on Wheels helps provides the homebound seniors 60 years of age and up with a hot meal each day, delivering to 94 routes, and utilizing 700 volunteers a month; and that is an outstanding program.  He stated the Senior Assistance Program (SAP) with a trained physician, caregivers will provide care with bathing, nursing, light house keeping, shopping, meal preparation, respite, and laundry; and there are 358 professionally trained care aides and three staff members providing these services.  He stated the Transportation Work Group in February discussed many topics, including the flow of events coming up; and while on that subject, he is expecting all of the Board tomorrow morning early at the Melbourne Auditorium for the Brevard Triad Sponsored Senior Fest.  He stated they plan to have at least 2,000 people there during the course of the day who are provided with free lunch, flu shots, and blood pressure checks; and it is everything folks need to take care of their health.  He explained they reviewed the Transportation Working Group’s priorities of the (MNET) Medicaid Non-Emergency Transportation, and the Car Fit Event, which is a new event that we have had now which is sponsored by The (AARP) American Association of Retired Persons at the Sunflower House at Merritt Island Mall; and they have had additional Car Fit events to keep the seniors safe in their own cars and even actually to adjust the seats or the cushions so they can actually see over the wheel, which is a very nice benefit when anyone is driving. 

 

Mr. Morgan stated the final page of the package is a sample of the September 11, 2008 Agenda where they had an update from Angel Food Ministries and the marvelous food program they are providing down there with wonderful food at extremely low food costs to anyone that applies and is eligible for that program.  He stated they went over the Fall Prevention Event that was endorsed at the September 11, 2008 meeting, the Elder Concept Program, which he has been working with all the colleges and universities in Brevard County and elsewhere and with the (EDC) Economic Development Commission; the Brevard Workforce Development Board is going to be conducting the business survey for the program; it is a combination package of the business and education community to provide education, training, and continued learning for all  seniors; and all the Commissioners have been previously briefed.  He stated through RSVP Volunteers Program they will be releasing the Elders Survey to get feedback from all the elders in the community; feedback through all the organizations that support the elderly; and there will be a wide base to draw from to get survey inputs.  He noted those are just some highlights of what the Brevard Commission on Ageing (BCOA) working groups there are; and it has been a privilege to serve the Board and the citizens of the community.

 

Mr. Morgan added the next item is a report from the Senior Resource Alliance Advisory Council highlights from July 2008; 4,000 new slots for the Nursing Home Diversion Program has been granted; the Department of Ageing on Long Term Care Ombudsman Program Budget was accepted; there was no reduction in the Brevard Commission on Ageing contract services; and there was some funding restored for Hospice coverage.  He stated The Burt Institute still remains independent but the funding was cut off due to budgetary problems to the Institute; the Alzheimer’s Disease Research Center (ADRC) funding operation was addressed; and there was no remodeling of the Triage Unit but that money is going to be spent to make sure 7.5 full time employees maintained to support the ADRC incoming.  He advised the Harry Holcomb Memorial News and Communication Award for the National Space Club Florida Committee will be placed in Leigh Holts’ hands on November 18, 2008 at the Double Tree at the National Space Club Luncheon; and of course, Leigh is the Government Relations Manager for Brevard County, who is well deserving of this award.  He stated the final news released late last night was  that  Governor  Crist  has formally signed Executive Order 08-211 creating and authorizing

Silver Alert throughout the State; it is already operational in several counties; but Governor Crist wants to enact it Statewide; it is in the works as how to implement this as quickly and as easy as financially possible; this is similar to an Amber Alert but it is Silver for the seniors, anyone who has wandered, has dementia or just happens to be lost; and it will go on the public sign boards as well.

 

Commissioner Voltz inquired what time does the Senior Fest begin tomorrow; with Mr. Morgan replying it starts at 8:30 a.m., free lunch at 11:00 a.m., and over at 2:00 p.m.

 

Commissioner Colon explained that Mr. Morgan will be honored by the Board in November; the Board wants to thank Ron for all of his work to the community; and it is so appropriate because everyone knows how hard he has worked; he is just an increditable human being; and the Board is much honored to honor him in November.

 

Commissioner Voltz introduced Cheryl Hoffman, Program Director of Community Care Programs and Community Services Council.

 

Cheryl Hoffman stated she will be as brief as she possibly can, but she has a whole stack of things to speak about.  She requested the Board look at its packet from Community Services Council.  She advised the Community Care for the Elderly and Disabled Adult Programs is really six programs funded by State general revenue money and Medicaid waiver money; the State general revenue money must be matched ten percent and there are United Way revenue coming in to help with that; and many of the vendors give a ten percent discount because the cash can be used; and the community is so supportive by giving them that ten percent discount.  She explained that last year they served 406 elders and disabled adults; there are 1,300 on a waiting list for all programs available; 870 are of the highest need and some folks do not get on the waiting list if they are not quite frail enough to quality; those people can be followed and tracked; some people think that it is based on the length of time a person is on the waiting list; but it is based on a person’s frailty level and the severity of need.  She advised they received great news yesterday and will be enrolling some folks into the Medicaid Waiver Program who either reside in an assisted living facility or need to be there; there are some folks that are coming out of nursing homes and going into assisted living, which is a step down in severity of placement; and that is more independence so they are very happy to hear that.  She stated that Dr. Beach did tell her that they will also be opening some of the community-based folks through the Medicaid Waiver Program in the next few weeks, so they are very happy about that because those two programs have been closed for about two years.  She explained over 60 percent of the elders and disabled adults who leave these programs leave because they pass away while still living at home; less than 30 percent of the people in these programs actually do move to a more restricted setting; if a person is in assisted living it would mean moving to a nursing home; if a person lives at home it could mean moving to assisted living or a nursing home; these programs are doing what they are intended to do; and that is to keep seniors and disabled adults at home and in their community for absolutely as long as possible.

 

She noted Community Services Council provides the case management for these programs; the purchases in-home services and community based services from the area organizations and agencies; they provide homemaking, personal care, respite, adult day care services, emergency alert buttons, and even pest control so that seniors and disabled adults can remain at home; to access any of these programs a person can call the Aging and Disability Resource Center, which  is  a fairly new entity that  works  with  2-1-1, and is a one stop way for seniors and family

members to call and get information about senior services; and their number is 1-800-963-5337.  Ms. Hoffman advised the Caregivers Support Program was mentioned by Ron Morgan; this is a program that is funded by the Older Americans Act; it requires ten percent match from the community; and for every dollar that the community puts in they get nine dollars back from the State and the Federal Older Americans Act Program.  She stated this program is specifically designed to support the caregiver who is caring for an elder loved one at home or for the grandparent 60 years-plus who is caring for a minor child; if a person is 73 years old and taking care of a ten-year old, it is not the easiest job, so they support those caregivers as well; the program provides respite, training, and education to caregivers so they can continue in their roll because if the caregiver is lost, that senior that they have been caring for is most likely to end up in a nursing home; and that is what they are trying to prevent.  She stated it is a fairly small program so many of the caregivers cycle off the program after six months of respite to make room for the next caregiver; they stay in touch with that caregiver but they may not be receiving that day to day care for a time; and then if their need comes back they cycle back on to the program; but the caregivers in Brevard County are so willing to share and everybody gets a chance.  She advised they currently maintain a waiting list for those services right now; there are about 30 folks waiting for services; and caregivers who are waiting for actual respite care or consumable medical supplies.  She stated sometimes they can help with those adult incontinent products for the elders and that financial help that can keep them in the caregiving role because it is expensive to go to Wal-mart and buy Depends or Poise pads.  She explained to make this program known in the community, they go to Health Fairs and will be at the Senior Fest tomorrow; and they speak to churches and doctors to let them know the program is out there and available to them.  She noted sometimes the caregiver just needs to know they are not alone, there is somebody else who has been there, has some good tips for them walking that path and maybe that person has already walked the path that the new person is on.  She advised to access this program a person needs to call Community Care Program at Community Services Council and the number is (321)631-2746; they will be glad to get a person set up; and of course, if you call 2-1-1 they will send a person right over to them.  She stated they have a local shared-cost program, which the Board initiated and it and came about as the result of the Brevard Commission on Aging; they started the program in 2003 with a grant of $50,000 from the County; United Way came in a few months later with another $20,000 and these are folks that are elders who have no caregiver in the home who is capable and now he or she might have a spouse who is just as old but really not capable of being a caregiver.  She stated they pay a portion of the cost of their care anywhere from 30 to 100 percent of the cost-based income and expenses; the Program does the same thing as the State-supported programs; they try to keep those folks at home as long as possible; there are a few people who started the program that are still with them; and yet they also added 15 new clients.  She noted this is a program that keeps turning over, plus they serve 25 to 30 people a year; unfortunately, several years ago the County did have to reduce the funding to $25,000; they have taken a little bit of reduction in the Program; but it is very viable and is serving needs for folks who do not qualify for Medicaid, and cannot get on the Community Care for the Elderly Care Program because of limited funding at the State level; and they are participating in the cost of their care.  She stated currently 30 elders are waiting for service in the last year; only two people moved to a more restricted setting; two moved to a nursing home; one had been on the program for three and one-half years, and the other for two and one-half years, so it is doing the job of reducing inappropriate nursing home placement and keeping those elders at home for as long as possible.  She explained sometimes elders live to the point that they just have to have that 24-hour nursing home care and they need that level of skill; and that is the time when caregivers or family has to say he or she cannot do it at home anymore.  She stated to access this program, a

person calls the Community Care Program Office at (321)631-2746; Mr. Morgan previously mentioned the Sunflower House at the Merritt Square Mall; it is located between JC Penny and Dillards; it is the most amazing place and runs almost entirely by volunteers who are elderly for the most part; the oldest volunteer is 96 years old; and comes two days a week and gives back to the community.  Ms. Hoffman advised they are a Caregiver Resource Center; most of the volunteers have been caregivers at some point; they can help those new caregivers; and they also do a lot of health, maintenance, and preventative programs at the Sunflower House for seniors.  She stated they have an exercise program two days a week, chair exercises, blood pressure checks, and work with the mall walkers to encourage them; they also have a lot of caregivers training and support groups covering Dementia; and there is one group that their sole focus is the death and dying process training.  She stated some big events in the mall’s they are getting ready to have is the Caregiver Expo, which will be November 7 & 8, 2008, where community vendors set up tables and will have some health screenings and a blood drive; it will kick off the malls food drive for the holiday season; and they are going to have a great time in that first weekend of November, so please come and join them.  She stated also today they have R. L. Lewis who is one of the original Highway Men doing a live painting demonstration; he will be auctioning off his painting to support the Sunflower House at the Caregiver Expo; there are a lot of things going on at the Sunflower House; the Freedom Seven Senior Center Knits and Crochet groups meet at the Sunflower House every Thursday morning and have a contest with each other to see who can knit the most blankets for the babies at Cape Canaveral Hospital; they do some amazing things; and they can talk and knit at the same time.  She advised they have also established a Cyber Café, and with the help of Brevard County they had some computers that got replaced; they teach seniors how to get a Yahoo account and start emailing their grandkids across-the-country; they think they are pretty special; and she thinks they are special too.  She stated the Sunflower House number is (321)452-4331.  She noted the Senior Nutrition Program has two components, one is Meals on Wheels, and the Congregate Meal Program, which has a huge number of meals go out every day; there are 14 congregate sites; there are actually 100 routes for Meals on Wheels every day; and a new program is Saturday Meals for those folks who really do not get anything to eat on the weekend.  She stated many of the local corporations like Harris or Publix have purchased meals and go out and deliver them on Saturday, so that the folks have that sixth meal a week that they normally would not have; and Meals on Wheels and Seniors at Lunch Program can be reached at (321) 639-8770.

 

Commissioner Voltz inquired is there an income limit on the Meals on Wheels Program; with Ms. Hoffman responding Meals on Wheel, Congregate Meal Program, and Seniors at Lunch Program are funded by the Older Americans Act; stated they try to target the frailest and the lowest incomes, but there is no income qualification; and everyone is asked if they can make a donation to please do so, but no one is denied a meal because they can not donate.

 

Commissioner Voltz introduced Paula Preston, Senior Assistance Program, with the Community Services Council for her presentation.

 

Paula Preston stated this is the last program for the Community Services Council; and the Seniors Assistance Program is funded through the Older Americans Act and through that program they provided primarily preventative, and supportive services to seniors that are still relatively healthy but may need some assistance to maintain their health, and to maintain and avoid injury.  She stated the program provides six basic services: Housing and Improvements, Screening  and  Assessment,  Homemaking,  Respite,  Legal  Services  and  Transportation; the

Housing Improvement Program serves about 1,200 seniors a year; and it ties in very well to Mr. Brimer’s presentation.  She noted the primary focus is on safety and security of the seniors in their home;  the main services provided through that program is installation of grab bars in the bathroom areas, hand railings throughout the home to help prevent falls, access ramps both interior and exterior to help people get in and out of their homes so they can access services that they need, and in addition to that, they do some minor repairs, such as leaky faucets, install ceiling fans, and things like that in order to make the home comfortable for the senior; a person needs to be 60 and over to qualify for that service; a person needs to own their own home, there is no charge for this service; but they do ask if the senior is able to make a donation towards the cost of the materials for whatever repairs are done.  She advised another service provided is homemaking and respite; the focus is a little bit different from the services that Cheryl Hoffman provides; many of her clients have debilitating conditions that are long-term; they are going to need those services for an extended period of time, sometimes through the end of their life; but their services are really targeted towards people who need them only for a short period of time. She stated perhaps they are recovering from an illness or a hospitalization, had heart surgery or a broken hip and the doctor says he or she cannot drive for the next six weeks; and a person cannot bend over and clean their bathtub, or lift more than ten pounds.  She stated if a person has someone who lives alone they are told how to get their groceries, their home cleaned, get some of the essential things that they need in order to recover and recuperate, and how to avoid that re-hospitalization; that is where their program steps in; and they can provide those short- term homemaking services to help them with the house, errands, prescription pick-up, grocery shopping, and meal preparation to help ease their recovery and so they can become independent again.  She stated the next service they provide is legal aide service to seniors free of charge; it is usually one hour of legal advice but it can extend beyond that; it covers bankruptcy, visitation and guardianship rights for grandparents with grandchildren, housing issues, age discrimination, and unemployment issues; the one thing that it does not cover is they will not address any criminal charges that may be brought against someone; it is a very small program; they have about 430 a year of service that they can provide to people for the legal aide service; and they have seen a large number increase in the bankruptcy filing in the last year so that is a trend that they have seen with that.  She advised the last service is transportation to the congregate meal sites; they do contract the Space Coast Area Transit to provide about 33,000 one-way rides per year to their congregate dinning sites so that those folks who do not drive or do not feel comfortable driving can go there and have a hot meal, plus some socialization; and to access any of their programs people can call (321)631-2744.

 

Chairman Scarborough added that the County has all of these wonderful groups; one of the things that Attorney General Norm Wolfinger said he had somebody on his staff to work especially on exploitation of the elderly; there is not anybody here from Mr. Wolfinger’s office; and this is sort of within this.  He advised that Mr. Wolfinger had a million dollars cut from his budget from the Elder Law section of the Florida Bar; but the gentleman is now just prosecuting regular cases because of the shrinking of funding instead of elder law issues.  He stated all of these people are giving the Board a positive twist, but the overall tenor of what is going on out there is there is an overall pecking order within the system; with all due respect Mr. Beach, there are going to be certain things that are the favorite groups and then he is going to get to the social issues; education is going to be up the pecking order above these type of issues; the problem is they are so fragmented and so difficult to put a person’s hands around; and all of these different programs are touching all of these different types of people in different places.  He noted the Board needs to be very mindful that it is becoming increasingly difficult as the users   are   increasing,   their   assets   are   decreasing;   and  they  are  getting  more  elderly.  

Commissioner Scarborough stated he recalls from1990 to 2000 the population of over 85 in Brevard County more than doubled; an enormous increase, much more than all of the adjoining counties; so all of these factors are moving, less income, more vulnerability, and less community resources; so these people are at the forefront of a new type of battle and that is to maintain some degree of quality of life and dignity for the most vulnerable, decent human beings in the community.

 

Commissioner Voltz commented that somebody earlier mentioned that they could not function without volunteers; that is the key; and it is not just going in and physically doing something it is donating those gas cards.

 

Commissioner Voltz introduced Libby Donoghue, Executive Director, 2-1-1 Brevard, Inc.

 

Libby Donoghue mentioned for folks out in the group who may not be familiar with 2-1-1 the Mission is to connect people with services by providing information, referral, and crisis intervention; the Commission certainly is very familiar with 2-1-1; she has badgered the Board several times about it; and it has been very supportive of 2-1-1, which is much appreciated.  She advised the Board also has a packet from 2-1-1, there is a lot of information in there; and she is going to give a couple of quick highlights.  She explained between October 1, 2007 and September 30, 2008 they logged about 48,000 phone calls; of those, a little more than ten percent were from people who reported being seniors; they only get demographic information for maybe 65 percent of their callers; people do not always give their age; they can assume the actual numbers of people; and they are using 60 and older.  She advised of those callers probably 70 percent are in the younger age range in the 60 to 69 age range; those numbers surcease as the age gets older; they only had two people who reported being over 100 years old for example, who called them last year; her assumption is that people are elderly and needing services; they try to make referrals to services as they start accessing those services and getting on waiting lists; and they hear less from them as the age increases.  She stated it is more likely to be a female caller regardless of whether they are a senior or younger; and about 70 percent of the callers are females.  She explained geographically most of the calls come from South Brevard more than Central and North Brevard, kind of going along with the population.  Ms. Donoghue explained the reasons people call 2-1-1 and kind of what 2-1-1 does to respond is the most frequently reported concerns of callers, regardless of age, for them and it is about 40 percent of the calls, is inability to meet basic needs; and people do not have the money to pay their rent, utilities, and transportation.  She noted among all groups the electric bill is the most pressing basic needs problem that 2-1-1 hears about; they make a lot of referrals and the Board knows the agencies that they refer to are out of money; also they spend a fair amount of time talking to people about how they are going to manage without their electricity until there are more funds available again; and that happens across all age groups.  She stated for seniors transportation concerns tend to be the second most common basic needs problem that they hear about; and they are informing and educating them about some of the programs heard here today.  She advised the third most common basic needs problem for seniors is food; they just do not have enough money to buy the food that they need; people have all heard stories about spending the dollars on prescriptions or other things; certainly they are advising people about the prescription assistance card; they make referrals to food pantries; and they will be working with United Way over the next year as one of their initiatives is increasing access to food through the community.  She stated as the Board knows they also service the Citizen Information Line during times of disaster; Tropical Storm Fay ended up having a real impact on seniors;  and  the  second  most  common reason across-the-board that they heard from seniors

this year just happened in the last few months and that was in dealing with issues brought by Fay.  Ms. Donoghue stated that 2-1-1 made over 6,700 referrals to 737 local organizations for seniors; one of the folks asked about how people access information and how is it coordinated; that is a piece of the roll that 2-1-1 plays; they maintain a data base of local services provided by local government, private organizations, for-profit organizations, and non-profit organizations;

when people call them they can try to help he or she find the appropriate service; certainly some of the callers have the means to pay for services; they want to be able to provide information to them as well; but the majority of people who are calling are struggling financially and with other things. 

 

The meeting recessed at 3:30 p.m. and reconvened at 3:35 p.m.

 

Commissioner Voltz asked JoAnn Fisher, Clinical Coordinator, Osler Geriatric, Nursing Home Care; Kathleen LaPorte, General Manager, VITAS Hospice Care; Jim Whitaker, President, CEO, Circles of Care; Lacie Davis, Special Needs Coordinator, Office of Emergency Management; and Charlie Antoni, Brevard Veterans Council to come to the table for a seat.

 

JoAnn Fisher thanked the Board for inviting her, and advised she has worked with Dr. Potomski for almost nine years.  She mentioned that she believes in Dr. Potomski and he has been doing this for 25 years; the Nursing Home Care in Brevard County is really excellent; they are loaded with a bunch of really caring people; and she stated she feels that is important to acknowledge that.  Ms. Fisher stated she has been asked to speak about nursing homes, which is pretty broad, so she is going to cover just one topic; but before that she would like to answer one question Commissioner Voltz asked about osteoporosis; a non-traumatic fall or fracture is anything from standing on the floor which is what most of these elderly people do, they trip, they fall and break a hip; when most people trip and fall they put their hands out to break the fall, and do not break anything; most of these people with a non-traumatic fall are elder females; if a person is over 80 he or she has an 80 percent chance of having osteoporosis; it is one of the most under diagnosed and treatable disease that there is; and if a better job was done there would not be as many fractures.  She stated transitions of care is a huge issue; she was invited to sit on the Clinical Practice Guidelines Commission in Baltimore, Maryland with American Medical Directors Association; transitional care problems is National, it is not just Brevard County; there is a problem in Brevard County; and if there is anything that the Commission can do to help is wonderful.  She noted that they are getting poor, inadequate information when people come to them from hospitals or from out-of-state; there is nothing known about this person when they get them; they cannot give good care that way; they cannot give safe care; and they may not know what some of their medicines are.  She explained coming from a hospital is part of the problem; not only may the medicine list be incomplete, but the have no idea what they did for that person when they were in the hospital; so therefore they are costing the government much more money because they are retesting with diagnostics that were already done and do not need to be repeated; and that needs to be improved.  She stated that Dr. Potomski has brought through the Brevard Commission on Aging a transitional care form, which is really a discharge physician order that they worked on; it was originally a Health First form in which they tweaked so that it fits the nursing home patient better and the long-term care patient better; it is really a briefed down form; it is pretty easy to do; case managers could do this; doctors have to sign it, and fill out the medication part; and that is very important.  She stated some of the hospitals are trying to work on a Medication Reconciliation Form which is at least a good step in the right direction; at least a person would know exactly what they are supposed  to  be  on;  but  it is not complete sometimes as far as how long it needs to be treated

with certain drugs or not.  She stated she is working on another form and would like a work force to work on this to get this used in the County; it is the long term care transfer form to the emergency room or the hospital; it is really a down and dirty form; it tells them exactly what they need to know quickly; and they do not need to know everything about but who they are, who to contact if they are incapable, and why they are there, which is prime.  She stated the problem is the nurses will copy so many forms, send it in a packet with the patient, and the hospital will say that they never received anything; sometimes EMS is keeping it so they can fill out their paperwork; so this form would be great; and they would know to look for it and that this was sent on such and such day. 

 

Kathleen LaPorte stated she has been doing Hospice Care in Brevard County since 1986; and she currently works for VITAS Hospice Care and has for the past six years so she is very well informed of the Hospice issues that affect the residents in Brevard County.  She advised in Brevard County people are very fortunate to have four good hospices that meet the needs of patients and families; two of them are hospital-based, one belongs to the Health First System, one belongs to the Wuesthoff system, and then there is St. Frances Hospice in the North end of the County, which is a free-standing Hospice that has a close affiliation with Parrish Medical Center; VITAS Hospice Care is a totally independent Hospice; it is part of a National company that has serviced Brevard County for six years; although their company has been in existence for 30 years; all Hospices are reimbursed the same way, they all get Medicare coverage, Medicaid coverage, coverage from private insurances, and they all take charity care; and they provided Nationwide $9.5 million worth of charity care for end-of-life care patients.  Ms. LaPorte stated that Hospice sometimes is the best keep secret because people do not want to talk about Hospice; they talked a lot about working with seniors and wellness but there is the reality that end-of-life issues have to be addressed; most people do not realize that under Medicare and Medicaid that they have this benefit; and it covers anything related to their terminal illness 100 percent, that is all of the nursing visits, Chaplain, social worker, physician visits, home health aide visits, volunteer services, medications, equipment, supplies, any treatment whether that it be radiation as chemo is related to the reason the person is on Hospice.  She explained all Hospices get paid on a captivated rate; it is the same for all residents of Brevard County; and each Hospice probably looks at little bit differently at what types of patients they accept and what they specialize in.  She noted there is a current move for Hospices to have inpatient Hospice Units, and there are currently two in Brevard, one in Palm Bay, and one in the Wuesthoff Health system.  She stated her company is working on opening an inpatient unit in conjunction with one of the long-term care facilities; but that being said, 90 percent of people, if they are asked where they want to be at the end of life, they want to be at home surrounded by the people that they love; and she is really proud that under the Medicare benefit that there is four levels of care that are provided, routine home care, which is intermittent type of care that is provided, respite care for when a care giver gets tired and they usually do that in a skilled nursing facility, crisis care which is when there is a medical necessity or a skilled reason or symptomatic control, they can put 24-hour one-on-one care in the home, or that general inpatient, level of care, which either can be done in a hospital or skilled nursing facility.  She stated she is proud because they specialize in keeping their patients at home, as that is where they want to be; and they do a lot of crisis care in the home setting.  She advised most people think of Hospice as only for cancer patient care, but as Hospice has began to expand to more end-of-life patients, whether that be end-of-life cardiac patients, end-stage liver, end-stage lung disease, that length of stay has changed; initially the Medicare benefit was only designed only for 210 days and if a person for some reason lived beyond that 210 days the Hospices provided that  care  without  reimbursement;  Medicare  never  wanted  to  limit access to Hospice care, it

really wanted to encourage it; and because it is the most cost-effective type of care it is provided in the home setting. She stated in the early 1990’s they changed it so Hospice care continues reimbursement on that captivated rate as long as the physician says he or she is dealing with a life threatening illness with a limited life expectancy; and inquired if the Board were to look at the patient today, would it estimate that the patient has a life expectancy of six months or less.  Ms. LaPorte stated the economy that the Hospices are facing now is because they have open access and they are getting more appropriate patients; the average length of stay for a Hospice patient is about 23 days; when a person is caring for somebody at the end-of-life for 23 days, all he or she can do is crisis care; if a person can have that patient on the program a little bit longer then a person can surely provide the true type of Hospice support that they should for patients and families; the utilization of Hospice has increased Nationwide; Medicare is looking at cutting funding for Hospice care; and any support that we can get from the County Commissioners, Senators, and all representatives would be very helpful to help restore and preserve that Medicare benefit.  She stated that most Hospices are looking at major cuts to that reimbursement; inquired do people really want at the end-of-life to limit access to care for people that truly need it; stated they are a 24-hour access care; wherever that patient may be, either in the home, or nursing home, and whether they have a caregiver or not; and many Hospices may not be able to survive those cuts as those changes happen.  She explained they all provide care beyond what the Medicare benefit does on the program, which cares for about 400 patients on a daily basis, and probably with all the Hospices together the care for more than 900 patients on a daily basis; and they all provide services beyond that for what Medicare reimburses.  She added they are seeing the same issues that everyone else is seeing for people that are faced that somebody that they love is dying and they cannot afford their electric bill; they are afraid to run their oxygen because it is going to raise their electric bill; and their electric may be shut off.  She noted people come to Vitas because they will not take their medications, because they can not afford to buy it; luckily, when they get to Hospice they do pay for those medicines; but it is those medicines related to the reason they are on Hospice.  Ms. LaPorte explained VITAS Hospice Care has a foundation at the end-of-life where they provide things that are not covered under the Medicare benefit; they provide housing for people; they have had patients referred to them that live in the woods; and Vitas helps provide housing for them.  She stated they do pay electric bills and bring family members together that cannot afford to see their loved ones before the end of life; so VITAS Hospice Care is for those things that are not covered; but they are seeing more and more people that just cannot pay their day-to-day bills; and people are looking to the Foundation to help them provide the resources to keep their electric on.  He stated they have to refer people to food shelters because they just do not have enough food; they do what they can; but she is fearful that as Hospice Medicare gets reimbursement cuts, what is going to happen to these people at the end-of-life; and inquired are they then going to have those patients die in the hospital setting as opposed to at home.  She advised a monthly Hospice benefit may be $2,000 a month; in a hospital setting, on a daily basis, a person could pay $10,000 because if those people do not get Hospice care they are going to be back and forth to the hospital on a regular basis; and they are going to cut off their nose to spite their face.  She stated Hospice utilization has increased those spending dollars but it is still the most cost effective care that is provided; so anything that the Board can do as our Legislators to help pressure Hospice for the residents of Brevard County, will be a great benefit. 

 

Commissioner Voltz stated that Jim Whitaker is not present but Dr. Barry Hansel is here in his place for Circles of Care.

 

Dr. Barry Hansel explained that Jim Whitaker is enjoying a new granddaughter today who came into the world late last night; and he is here to speak on his behalf to talk a little bit about mental health needs for the elder population.  He stated he is going to tell the Board of a sentence now which is really the conclusion and that is overlooked and underserved; if the Board looks at prevalence estimates for mental disorders like depression, anxiety, psychosomatic disorders, and adjusting to the aging process, conservative estimates put the need at 20 to 25 percent of the elderly population; but listening to these numbers about people who get service coming to community mental health centers, these are national statistics but it is the same in Brevard, eight percent get services, nine percent get private care, and seven percent gets in-patient care, so there is a big gap between the prevalence and what actually gets delivered to people who are elder.  He explained he feels that one of the alarming things is people who live longer are beginning to see an increase of suicide rates, especially in older males; and that is a problem that they never really had to face before; and all these things are going to be exacerbated by the aging of the baby boomers.  He stated he just read a term the other day other people may be familiar with it; it was entitled the Silver Tsunami; and it referred to great wave of baby boomers as they age they are going to impact the transportation, housing, medical care, mental health care; a whole range of things that we have been talking about today.  He stated there are a couple of reasons why the elder tend to be underserved and overlooked is stigma; if a person formed his or her identification about mental healthcare based on movies like Psycho or One Flew Over the Cuckoos Nest, they find that folks that were born prior to 1945 really do not tend to access mental healthcare very much as they are wary of it; where they seek healthcare is from their primary family doctor; and that is another one of the problems.  He stated there are so many complex social, personal, and economical issues, as well as their physical problems, that a general doctor does not have time to get the history and sort through all those details; while the elder person might go to a primary practice doctor, he or she really may not have the training or the time to sort out everything.  Dr. Hansel stated ageism, attitudes, and misconception about the elderly, when they have a culture that emphasizes youth and everybody wants to look younger, there is not a lot of positive spin for geriatric mental health projects; another reason is the policies and practices of agencies that were commissioned to deal with mental health problems; as the Board knows, Circles of Care was one of the Federal Community Health Centers where the strategy was to put a mental health center close to the population so people would not be 30 or 40 minutes away to access care; there is a clinic near Titusville, Rockledge, and Melbourne based on this model of creating a facility near to people; but elders do not come voluntarily for mental health care.  He stated among that group they have the eight percent that they see have come either because they are brought by a family member, not self-referred, or they come because they are in some kind of crisis or emergency state; he added the problem that they have in the community is with the access of Baker Act beds for people who are involuntarily committed; and not having enough beds because of the population growth.  He explained one factor in this is that there are no services for those elder people who have psychiatric problems, especially in terms of their long-term care; so facilities and homes may have to bring the person to a psychiatric hospital where he or she may get stabilized, over seven, ten days, or two weeks.  He advised the facility may have that person for weeks if not months trying to find an appropriate, longer term placement because when somebody has been identified as having a psychiatric problem, places do not want to care for the individual even though they might be stable; if half of the admissions to the private unit are elder folks and half of them are staying months because there is not a placement, that is really blocking access to acute-care beds; and that now is spilling back into emergency rooms where people have to be held because there are not enough beds available.  He explained there are reasons of fragmentation with elders; there is a lot needed for social services, and primary care needs, communication and mental needs to communicate with primary care doctors; there could be improvements there because things are sort of fragmented; and Brevard 2-1-1 is a great agency that really has a handle on where to get access to services that are needed in terms of these complex cases.  He stated there are some things that communities can do or communities that have been successful in mental health needs of the elderly; in State mental health agencies around the Country; but in Florida there is an emphasis on the severely and persistently mentally ill, which are the Schizophrenic and the Bipolar; that is one to two percent of the population.  Dr. Hansel stated new emphasis rolled out last fall regarding people with dual disorders of substance abuse and mental health problems; there needs to be some effort at the State level to make elder mental health needs be seen as a special population with special kinds of programs; outreach programs are not good if people will not come; people have found success by just communicating; many of the depression seen in the elderly is not a natural consequence of aging; it is treatable; there is the same 70 to 75 percent rate of improvement in depression that people would see in the middle aged adult that can been seen in the elderly; and people just do not have that expectation that it is possible.  He mentioned staying socially connected is one of the greatest factors in preventing depression; keeping people satisfied with life by being connected to their community helps; and stated that will end his presentation for the Board today.

 

Lacie Davis stated she just wanted to touch on a few items from the emergency management perspective today regarding the elders; they currently have 2,087 registered in the Special Needs Registry; of that, 1,494 actually are individuals with special medical needs; and 593 are individuals who are only requesting transportation to a Red Cross shelter as many of them are seniors and do not have any other way to get to a shelter.  She stated that 1,494 does not account for the caregivers coming with them to the shelters, which pushes the numbers over the capacity limits; and they currently have four special needs shelters, one in the north with a capacity of 350, two in the central part of the County each with the capacity of 750, and one in the south with a capacity of 750.  She advised increasing the numbers to special needs clients has prompted Emergency Management to create a fifth shelter, which is expected to be operational next hurricane season; the two central shelter locations now have generators large enough to power the entire building, which is very important because it powers the air conditioner as many seniors have respiratory issues; they are in the process of working with the State to provide an additional generator to the shelter in the south so they will have three special needs shelters with generators; the two central shelters have enhanced-care sections, which are individuals that exceed their assisted care part of the shelter; and they are generally individuals in hospice eminent death, they are staffed by local hospitals.  She explained a few statistics related to elders and special needs that she has seen is they have approximately 260 precognitive impairments such as Alzheimer and Dementia, and those numbers increase every day; right now there are Hospice patients with increasing applications coming in every day; she probably receives 50 to 75 applications daily; and the numbers are definitely increasing.  She noted in reviewing the applications an increase has been noticed in seniors who live alone and do not have caregivers, and many of them have a number of medical conditions; many of them are couples and one is a caregiver to the other; and generally, the caregiver is a special needs client as well.  She stated the County and Department of Health provide excellent care at the shelters, but with the increase of individuals coming along, the burden is definitely placed on the shelter to provide an increased level to those without caregivers. 

 

Commissioner Voltz mentioned Commissioner Bolin and Commissioner Nelson are going to have to look at all of this because this is all very important; and since Commissioner Bolin is working there she understands a whole lot better than the rest.

 

Commissioner Voltz stated she spoke with Charlie Antoni, Brevard Veterans Council, during the break and what he was going to talk about is more related to healthcare, so the Board is going to skip this presentation at this time.

 

Dr. Potomski stated he would like to make one other announcement about one of the doctors from the University of Central Florida; as mentioned in the past to him, part of the information needed is to educate healthcare providers because what is happening now is that the residency programs or fellowship programs for Geriatrics there are less people going into them; yet the baby boomers are expanding, so they do have an issue; the less people training in Geriatric Medicine the more people needing the care; so what they are trying to do in Brevard County is in reference to a meeting held last year with Commissioner Colon as the Chair came to  speak at the meeting; there is a program every year in November sponsored by the Brevard County Medical Directors Association aimed at the same issues talked about today; there are about 500 medical healthcare professionals that attend this yearly to give them some education on these areas of medicine that are important; this is the 19^th year that they did it; and they are trying to empower the other healthcare professionals who may not have come from a Geriatric background with some of the principals of Geriatrics.

 

Commissioner Voltz inquired when the meeting is being held. Dr. Potomski replied that is November 19, 2008 at the Rialto Hilton in Melbourne; if the Commissioners would like to attend, he or she may do so; and even a five-minute speech would be great.  He advised last year Commissioner Colon gave a brief speech about her passion for the elders in the County; and if the current Chair of the Commission would like to speak, please feel free to do so.  He stated he would be sure to send an invitation.  Dr. Potomski stated the Commissioners will really enjoy this event and it is something that they are trying to empower the people to do better with Geriatrics patients.

 

Commissioner Voltz thanked Dr. Potomski for such great information.

 

 

Commissioner Voltz introduced Carl Green, Prime Timers, Temple Baptist Church in Titusville.  Commissioner Voltz mentioned she and Chairman Scarborough had an opportunity to visit and spend a morning with the seniors there; they were both blown away by what Prime Timers had to offer; the Board just wants to hear from Mr. Green because it thinks it is important that the rest of the community hear what they are doing; and maybe as a County can begin to do some of the things throughout the County that he is doing there.

 

Carl Green thanked Commissioner Voltz; stated his wife would be proud of him that he has not fallen asleep today without a senior nap; and inquired what Chairman Scarborough’s first impression was of the Prime Timers; with Chairman Scarborough responding a lot of gray hair, a sea of gray hair with big smiles.

 

Mr. Green has about five pages written on behalf of Tom Porter who is an excellent reporter, speaker, and an organizer; and the Board knows success is not by accident.  He stated it is sponsored by Temple Baptist Church, but not everyone is Baptist; it happens every Tuesday at 10:30 a.m. through 12:30 p.m., September through May; it is in the church social building; and it is for seniors from various churches, visitors from up north, and other places in Brevard County.  He noted there are Methodists, Nazarenes, Baptists, and Catholics once they come, they come back; and in that mix they have a real organized group.  He advised they average over 200 every Tuesday and 55 of those out of approximately 200 are volunteers; a volunteer does not get a paycheck and wants to come back; and it is no trade secret anymore.  Mr. Green stated he would like to mention a few things, such as an approximate recipe on how they do it; they have a parking lot assistant, which requires one volunteer, and greeters require two volunteers; and lunch tickets are $5 each or if a person cannot afford, it he or she will eat for free.  He noted a newsletter put together requires two volunteers; popcorn, coffee, and iced tea are available and requires one volunteer; a video operator volunteer is needed to run the machine for singing or power point presentations; food staff is in the kitchen cooking while the program is being enjoyed, which requires five volunteers; food servers to serve food to the tables require ten volunteers; and the key point to all of this is people who volunteer think of others, that is a Christian attribute, and that is well represented.  He stated there is a Prime Time band and music director with eight to ten people; a clean-up crew of five to six volunteers; and furniture crew of four to six men only who pick up the chairs and tables and arranges them back to the way it was before; and one volunteer is the photographer.  He explained the program format is conducted by the Director; they sing with the band and sing all kinds of songs; when people sing he or she comes alive in a positive way as this helps keep the mental issues away at least for this one to two hours of time; and then after singing with the band, the Director will introduce and make a big deal out of any visitors because people like to get the attention from that.  He stated there are announcements and a newsletter each week; it is similar to what he has for the Board to review, there is a door prize drawing from a $5 ticket; they ask for volunteers to bring deserts for the next meal; then they pray for the needy; and everyone needs prayer whether people admits to it or not.  He stated people need help and cannot always do it alone; and he knows that today because of the financial situation.  He stated old people are scared; they need comfort and security; it is an opportunity to help one another out; it is part of the plan to always help others; when they help they also help themselves; and they know that by experience, if people have not done it, they should try it to see what happens.  He explained they also have other activities such as Florida tours; right now they are on a bus tour to Lancaster, Pennsylvania seeing the colored leaves; he took that trip a couple years ago and it is a wonderful time for those who can afford it; sometimes people have money but nobody to leave it to; but they need to take care of themselves first, as charity begins at home.  He advised there are special projects for people in need and they try to help them out; they are always looking for ways to help others; and they have an appreciation planning lunch for the volunteers and it does not cost them anything.  He stated it is a way the leadership is trying to express its appreciation for its contribution in helping others; and for further information call Tom Porter at (321)269-1133.  He stated he was sorry for not having a PowerPoint Presentation because he liked doing things the old fashioned way because some people do not like to change, especially when they are older; do not force them into it; let them enjoy life; if they want to change then that is fine, let them change; and they will discover the internet, email, PowerPoint, Word Perfect, more bills, and frustration.  He inquired if there are any questions about this program; stated it is not by accident now; it has to be worked at; do not forget that over one-third of them are volunteers; and they want to come back and do not need a phone call reminder, as they look forward to coming.

 

Commissioner Voltz inquired how many senior citizens are turned away in the winter months; with Mr. Green responding they have more chairs for a few more to join in; like last winter, they have so many excellent programs and Tom Porter diversifies; he keeps them constantly changing and laughing, and that is part of the key to it; there are singing groups that come down here in the winter and that is a prime time opportunity to get the prime time people from up north; and they have some of these other special groups as a program supplement as well.  Mr. Green stated if anyone would like to share services they could use them and he is certain they could coordinate with Tom Porter for a time to come and speak.  He advised they had someone from Parrish Medical Center speak last week that shared part of the program.  He stated sometimes they run over because they get carried away enjoying themselves but when a person is enjoying themselves time flies; when people go back home they are back in that same old rocking chair or that same old place and it is not good when there is no cheer in their lives; and some of them come in wheelchairs and they are helped too.  He stated one gentleman lost his legs in an accident; aluminum cans are collected and given to him so he can have some supplemental money to live on; but it is people helping people with Jesus involved; and Christ is the answer for a lot of people.

 

Chairman Scarborough mentioned he was so impressed when meeting with Tom Porter; there is an ability that there could be a program used throughout the County and he feels there may be some interest with staff looking at that and coming back with some ideas; he understands that Commissioner Colon is going to be a speaker at Prime Timers; and Tom Porter stated he liked Commissioner Colon so much that he is going to have her come up and talk: and he would welcome the other Commissioners to speak as well.  He noted they have senior centers where a person can go and play bingo, but there is something different when people go there as there is a program; it is almost like going to some type of club where there is entertainment and food; but it is a very wholesome setting so when a person gets there he or she just gets carried away with it; and different people have their own songs that they want to sing.  Chairman Scarborough mentioned that he appreciates Commissioner Colon going and it will be a good time and for any other Commissioners who may go as well because it is a program he thinks the County could use; and the Board could use Tom Porter’s help in other places within Brevard, perhaps a park environment as apposed to in a religious setting. 

 

Mr. Green mentioned they have name tags and when a person does not know somebody he or she can say, “Well how are you doing, John”, and ask where they are from; it helps for an ice breaker; but on the back is people’s medical information in case he or she passes out and needs medical attention or who to call for an emergency.

 

Commissioner Colon added the biggest component, and she is so glad it is moving that way, after doing them for such a long time if a person does not take care of the spiritual component, whatever that could be, he or she is really losing out on something; and that is why the seniors go into such deep depression because they do not have family that lives here.  She advised it is not any different than all the youth programs that she works with; when she gets the youth pastors involved it is the same exact component; the seniors deal with certain things and that loneliness of going home, which is to their maker, and she feels that is really where it is the same scenario as with the youth; they have suicide rates that people do not want to talk about; and that is where the spiritual component comes in.  Commissioner Colon stated it is real exciting to know that Brevard County, especially Parks and Recreation is a place that is a key component  with  the faith-based  community;  it  is  critical  for  every  age  group that the Board

working with, whether it is women with domestic violence issues, teenage suicide, or child abuse, whatever the case may be; by putting that faith component in it just takes it to a different level; and the statistics show very clearly of the success rate.

 

 

 

Commissioner Voltz stated with each one of these different centers they will talk about their specific needs; and so there are seniors coming up to tell the Board what they see in their individual communities.  She introduced Alida Hirschfeld, Barefoot Bay/Micco Senior Center, Dottie Marino, Palm Bay Senior Center; Phyllis Principe, South Brevard Senior Center; Eugene Snook, South Brevard Senior Center; Geri Bonavito, Martin Anderson Senior Center; and Eva

 

Brior, One Senior Place.  Commissioner Voltz mentioned it has been a long period of time since they have met with the Senior Center groups such as these.

 

Alida Hirschfeld from Barefoot Bay/Micco Senior Center stated she lives in the Snug Harbor Lakes Senior Community in Micco, Florida, about the southern most area of Brevard County; and she would like to thank Chairman Scarborough for Chairing the Senior Forum for the County; and thanked Commissioner Voltz and her staff for doing the workshops.  She stated she feels it was a fantastic idea for all seniors; and a thanked all the Commissioners, as well.  She stated their workshop, which she believes was the first one in the County, was held on April 2, 2008 at the Micco Community Center with some 15 seniors, and Commissioner Voltz, and Jan Conrad representing the County Commission; there was a wide array of subjects that were discussed; and as they went around the big square table they all had different concerns for the senior population.  She noted there were Senior Lunch Programs and Meals on Wheels at the cost of $2.70 for a hot meal; a retired nurse spoke on the need for food pantries and homeless shelters; and another senior was surprised to hear that there was a Seniors Lunch Program in the area and that is if a person dials 2-1-1 on his or her telephone in Brevard County he or she can find out all the information on senior services available in the County.  She explained another suggestion was for the County to raise the thermostat up two degrees in County buildings because everyone brings sweaters and freezes; it would save the County some money on utilities; and Fort Lauderdale Airport just implemented a policy to keep their facility at 78 degrees, which is what Florida Power and Light suggests to do with your homes.  She advised another resident gave information on the Veteran’s services in Brevard County and who to contact if a person needs help; other residents discussed the Home Alone Program; it is the COPS volunteers calling seniors alone to make sure he or she is all right and that they are taking their medications on schedule; it was suggested putting advertising in the local free paper about the COPS Program; and its available services and safety issues in the area.  She stated one big topic was taxes and insurance and on how some seniors have been forced to drop their home insurance, some combining households and living together, some living on as little as $600 per month; and with the rising cost of utilities, electric, water, sewer, etc., and the rising taxes seniors cannot live anymore.  She spoke before the Board at County Workshops when it was evaluating the fire tax proposals; it was suggested that the tax be done on square footage and the value of the properties; and she is proud of the Commission because it did hear the pleas of the people; and thanked the Board for its investment in the investigation of the fire tax.  She mentioned several of the Commissioners will be leaving at the end of their term next month, but those who are staying, she hopes will inject his or her good judgment on the fire budget issue  onto  the  new Commissioners coming in.  She stated she hopes somehow there is a way

the County can help seniors more with insurance costs or property taxes.  She explained another topic they have discussed for the area was that even though they live in Brevard County they have a 772 area code, which poses a problem when calling 9-1-1; it goes into Indian River County first and then back to Brevard County; it adds lost time for the rescue service to come; the zip code also has people listed as Indian River County or Sebastian, even though they live in Brevard County; when a person orders something from a catalog he or she pays one percent more in sales tax because it shows them as Indian River County; and the drivers licenses’ sometimes come with Sebastian on it.  She advised she herself has spoken on transportation and housing; there is no public transportation in the area; there are several communities with over 5,000 homes and no public transit; they do have a bus now from Indian River County that comes to the main clubhouse in Barefoot Bay and stops at 4:00 p.m.; but if a person lives three or four miles away from the clubhouse how does he or she get there and how do they get home with groceries.  She stated many seniors are locked in their homes and depend on neighbors because of the inability for them to get to places.  Ms. Hirshfeld stated the other subject was some sort of affordable senior housing in the area; something that would be on a monetary sliding scale for rent as a person’s income and assets allow; and they need help in the south end of the County.  She requested the Board help seniors with taxes, insurance, housing, transportation, etc.; those who have Bright House cable are unable to watch the Commission meetings on television since the change in equipment; and they can listen on the radio like the old day but they have been cut from the communication with the County.  She stated she and her husband would like to personally take this opportunity to thank the Commission for scheduling these Senior Workshops throughout the County; and she hopes that with the new Commission coming in this would become semi-annual or an annual project for many years to come, so that the senior needs and voices can be heard.

 

Commissioner Voltz thanked Ms. Hirschfeld for all of her information; and she feels that one thing the Board has realized is a lot of people did not know what 2-1-1 was; they have just never heard of it; they had to be very poor to go to the Meals on Wheels; and the Board needed to find out how does it disseminate the information to everybody.

 

Dottie Marino from Palm Bay Senior Center stated she would like to start off by thanking the Board; it is very nice of it to do these Workshops; this is the first time as a Director that she has been involved at a Workshop; the Board has a copy of the forum, so everything is listed for the Board; and she will not need to go over all of that.  She stated two things that are very close to her heart is they have a senior center that has actually three generations; they have age 55-65, age 65-75, and age 75-100; and they are pretty diversified.  She explained all of the needs are different; one of the new needs that they think they need in the center is a cyber café; most of the newer seniors coming want to have a place to use Internet; they would like to offer courses to the seniors, but they do not have computers to do that; they are offering a course now in computers without computers; it would be very helpful if they had computers.  She noted one of the things again is transportation; she has learned a lot by just listening today; and she thanked the Commission for that.  She advised one thing that is very dear and close to her heart is what do the seniors in Brevard County do when they have mentally-challenged adult children living at home; she happens to have a mentally-challenged adult child who is in a residence, is taken care of, and does quite well; but she sees in the community a need for programs for seniors with adult mentally-challenged children.  She stated she would like to know and have a list of services available to seniors in the County who have adult-challenged children living at home, because one of the concerns as parents is what happens to them when they pass; and that it is

her concern.

 

Commissioner Voltz thanked Ms. Marino for her information; and stated she feels that for about eight to ten years of working with a number of people on that same issue it is still what does the Board do.  She inquired what are the parents to do; stated nobody understands unless he or she is in a situation and has an adult child who is mentally or physically disabled; and inquired if a person is getting elderly, what happens to the child, where do they go, and who takes care of them; and maybe they do not have enough money to leave an endowment fund so the children are taken care of for the rest of their lives, which is normally not the case.

 

Ms. Marino mentioned that it is an issue Nationwide and not just at the senior center; there are people out there with adult children living at home; they are seniors; and the concern is there.

 

Commissioner Colon added there are support groups that are very key; a good place to start is 2-1-1; this Board is not going to have that answer but the group at 2-1-1 is able to refer a person; and when a lot of these groups get together they go to a task force such as the Commission on Aging and then they take it one step further from there.

 

Dr. Beach stated there are a lot of programs out there for people with disabilities and the question is getting them in the right age group at the right time; so you have programs for ages 18 and 59 and programs for ages over 60; but 2-1-1 is a good place to start; and it may very well be that a person has to start out with the Department of Children and Families or the Department of Elder Affairs; but  the point is to get in that process very quickly.

 

Phyllis Principe with South Brevard Senior Center mentioned she sits on two boards, the 55 Plus Club of Satellite Beach and the South Brevard Senior Center; the senior centers are a vital part of aging and they are the best means of communication between the agencies and the individual; however, the State, Federal, and County agency message is not getting to the seniors; and some of the items that they covered were medical insurance, scams, and transportation.  She stated they have a new Wickham Park Senior Center and do have transportation to the Center; but the transportation is on the main highway; and she inquired how the seniors get from the highway to the Center. She explained seniors need counseling for wills and other legal matters, such as credit card scams; so many people do not know about 2-1-1 or any numbers in this County; there should be some means of advertising in these senior centers either through libraries or educational programs; and maybe the County can offer something.  She stated it is understood that the budget is low, but maybe some educational programs can come into the center; if food is offered she guarantees there will be good attendance; seniors are a very vital part of the community; in order for them to live independently they need to get the messages of 2-1-1 information out to them, there is a great book with information for seniors provided by Florida Department of Elder Affairs; and to get copy call 1-800-96ELDER.

 

Eugene Snook stated little over eight years ago he came to Brevard County and the first public official he met was Jackie Colon.  He mentions he has been involved in volunteer work all of that time; he is still working with the Ombudsman Program, was in the Guardian Ad Litem Program for three years, and has served in the Senior Transerve Program from its inception; and the Board has probably seen him talking about the program a couple years back.  He stated it is surprising how many people do not know what the Ombudsman Program is all about; the definition of ombudsman is a public official appointed to investigate citizen complaints against local or National government agencies that may be infringing on the rights of individuals; that is exactly  what  they  do, they  are certified  to do  investigations; and  they  are  given  every right

allowed by Governor Christ to follow-up on whatever they need to get information on for investigations to be completed.  Mr. Snook explained there are training courses that have to be completed before becoming an Ombudsmen; for an example of how this program is growing, two months ago they had 15 facilities to take care of; and now there is 21 between two individual Ombudsmen.  He explained Ombudsmen do not just investigate, they also inspect the facilities to make sure they are working the way they are supposed to be; now they do get complaints every now and then, such as a persons clothes did not come back from the laundry, etc.; what happens when they first walk in is they start looking around to see how the residents are looking, whether they are looking dirty or looking nice, clean and happy with smiles on their faces; and if they are not there is something wrong.  He stated the Ombudsmen look and smell to make sure the hallways are not smelling of urine or anything else; they spot-check on the residents to make sure they have their water next to their bed, and their call button next their bed; they ask them questions of how things are going like how is the food, and how are they treating people; and a lot of them do not want to tell of too many bad things because they are afraid that there is going to be retaliation against them from the help and the administration.  He noted when an investigation is done, they announce themselves at the door, and they look for the Administrator or Manager, it is announced to them that they are there to do an investigation on a complaint; no names are given; and so far it has worked out good.  He stated they are happy with the program and are looking for volunteers; a person does have to do a lot of driving, but driving is returned to them in mileage reimbursement; they will pay a person for breakfast if they are out at a certain time of morning, and lunch and dinner to a limitation; it does make it a lot easier to volunteer; all that is needed is peoples time; and it is a very important program because that is the only protection that the residents actually have.

 

Commissioner Voltz inquired if these are nursing homes that Mr. Snook visits; with Mr. Snook responding yes, they visit nursing homes and assisted living facilities, which can range from six residents to 250 residents.

 

Chairman Scarborough inquired if somebody has someone they know in a nursing home in Brevard County how do they contact Mr. Snook and remain anonymous; with Mr. Snook responding they are supposed to have a poster for the Ombudsman Program posted where everyone can see it. 

 

Chairman Scarborough inquired if a person did not see it and they are watching the meeting on television right now and they need to call in because he or she was visiting their neighbor and saw something and need to contact Mr. Snook, what number can they call.

 

Dr. Beach commented that it is a federal program for the Older Americans Act and so it is coordinated by the State; the State Long-Term Care Ombudsman is a guy by the name of Brian Lee who is in Tallahassee; so a person can dial 1-800-96ELDER and they can send the information to Brian Lee; he will call them back and then report the local volunteers to where they are needed to investigate the complaint; and it is an exceptional volunteer program.

 

Mr. Snook advised a person can call directly to the Orlando office at 1-407-228-7752 and then they will be assigned as needed.

 

Ron Morgan inquired if Mr. Snook is involved with any of the success with the Family Counseling  Program;  with  Mr. Snook  replying  he  is  involved  with  many of those successful

things and has been involved with the Residence Council meetings; and stated it has been a successful thing.

 

Mr. Morgan mentioned he helped get the Family Counseling Program and Residence Council started several years ago with the Florida Legislature starting with Brian Lee and Ron Morgan; he has not had much of a chance to check on it since being involved in other areas; he inquired if the Board has any good family counseling in any of the homes in Northern Brevard; with Ms. Principe responding in the Family Counseling meetings, they are invited; the Residence Council meetings are open; and it is amazing how much a person will learn from a resident at a Council meeting that he or she will not learn when they are checking them room to room.

 

Geri Bonavito with Martin Anderson Senior Center, stated she served as Vice President; they have about 500 paid members at the Center, but many others use the facility and participate in daily activities; and they are open Monday through Friday, offering various classes and open on Saturday for Bridge only.  She stated the center is staffed by volunteers, except for one part-time paid employee for custodial work; it is the first senior center in Brevard to host the Seniors at Lunch Program; it began last month; so far, it has been going very well; and she feels that senior centers are a valuable resource in the community.  She explained Martin Anderson’s Senior Center was established 25 years ago; at that time seniors at 65 years of age were retired and looking for activities to keep busy; and now 25 years later, seniors at 65 may still be working or playing golf and not necessarily the people that are seen at the senior center.  She advised they do have some members in South Brevard that are 55; and some of the members are up into their 80’s; she has been involved with the Senior Center for the past five years and some area of concern is transportation; they are often asked if they provide transportation to the Center; those are calls forwarded to SCAT; but unless they live close to a bus stop it probably will not be helpful.  She advised another area noticed is adult daycare at a reasonable cost; occasionally they receive calls from family members looking for a place to drop mom off for the day while the caregiver goes to work or has other activities; people at the senior center do not have a trained staff to watch over mom throughout the day; and it is not a good environment for that.  She explained most of the participants come for a certain class and then they leave; and he or she is not there for the whole day.  She advised she also volunteers with Shine counseling seniors on Medicare and Medicaid issues; at this time of year many Medicare beneficiaries find themselves in the gap with their Part D prescription plans; the new Brevard County Drug Discount Card is a great option for savings on their prescriptions; but in this situation however, they have found that some pharmacies do not have the card on hand even though that is where they are supposed to pick them up.  She stated they heard from some of their clients that their pharmacies are unaware of the Program; and one particular pharmacy that comes to mind is one in Cocoa Beach that just was totally unaware of the Brevard County program.  She stated the last thing she wants to mention is the need for affordable accessible dental care; this is a great concern for low income seniors; if their income is such that they apply and qualify for Medicaid, they are alright; but if their income is just over that level it is difficult for them to find dental care.  She stated after listening to everyone today she wonders if they are using the seniors centers as well as they could; it seems like they might be used for educating seniors more on some of these issues for disseminating information or suggestions of the Program; and seniors helping seniors could do much more to take advantage of the situations.

 

Eva Brior stated she has been in Florida for the last 30 years and she just loves Florida; she was in AARP for years and used to go to Tallahassee once every three months for the seniors; she was on the Committee for the Elderly and was amazed  on the things that they did in Florida

for the seniors; One Senior Place is new and they have only been in existence for two years; and all members are fairly new.  Eva Brior stated some of our residents probably have lived eight to ten years in Florida; a lot of them where they came from never had senior organizations; they are very happy with the progress of the club and they already have 450 members; and they have so many members that just do not understand what goes on in Florida.  She stated they hear so many rumors like do not to move to Florida, or, the doctors are not certified; when a person gets together with people, everybody does not have the same idea on a certain subject; but she had found that she had many questions to ask; and they have been answered today by listening to that has been.  She advised the most concern now is 2-1-1; folks want to know if there is going to be a directory put out for them; and she told them she would ask this week at the meeting.

 

Commissioner Voltz stated that there is a 2-1-1 Directory out there, it is very large and quite expensive at $20 or $25.

 

Ms. Hoffman explained that in a lot of the Senior Centers the books are out there with the 2-1-1 information in them and it is known to her Community Services Council is the sponsor for the Journal that is put out and they do put it out; they do put it out every couple of years because they have to update the information; and it is available at One Senior Place in the resource library.

 

Ms. Brior stated they have a fantastic library there at One Senior Place and there is not a thing in that library that cannot be found.

 

Commissioner Voltz stated the issue with the 2-1-1 book is that when somebody needs something in there they are at home, they are not down at One Senior Place, or over at the Senior Center; they need those books at home; a lot of them are not affordable to seniors; and it is not known if there is an ability for the County to provide books in the community.

 

Commissioner Colon mentioned it has been looked into and it is extremely expensive so that is why they are $20; and a person can get the same information on the web.  Commissioner Voltz stated that a lot of people do not have a computer to access that information.  Ms. Hoffman mentioned that is the advantage of dialing that 2-1-1 number; but they do need to educate this subject with maybe an article in the paper.

 

Dr. Beach stated there was a small booklet free of charge from the Senior Resource Alliance that had senior pertinent information in it.  Commissioner Colon advised that is a different booklet from 2-1-1; and the 2-1-1 booklet has every service that the County has to offer.  Dr. Beach stated the small booklet that he is speaking of is strictly for seniors; he understands the difference, and he is just saying that there is one free of charge for senior activities, which can be found through the Brevard Community Services Council.  Ms. Hirschfeld commented they are constantly inundated with new telephone books and do not pay for them, so maybe there is a way to get some sort of advertising available in that way.

 

Commissioner Colon stated that with the cuts that the County has had, it is very clear it cut so many programs; now it is good, especially with the folks here today with their information to help keep this information available to the seniors in the community; and Parks and Recreation works very closely with the seniors.  She stated the things that the County used to do for programs  are no longer there; therefore, these kinds of Workshops are very critical so a person

is able to get that kind of information; and it really empowers seniors if there is a lot of data out there.

 

Commissioner Voltz advised something that she has found in meeting with as many of the focus groups is they did love somebody coming; they said they would love to see it once every six months; once a year to just hear them; and that is very telling in general.

 

Mr. Snook explained when he was with Senior Transerve he used to carry a bunch of business cards that said 2-1-1 on them so whenever he had a question of where he can get this type of service, he would give the card and tell them to call 2-1-1, because that is what it is there for.

 

Commissioner Voltz commented it would be cheaper that way than a book.  Ms. Principe mentioned as long as 2-1-1 does not put them on hold, which is the biggest complaint heard to her.

 

Commissioner Colon added 2-1-1 was also in danger of losing its funding; it was almost on the chopping block for cuts due to budget; so every time programs were cut the Board had to look at the magnitude and the impact that it was going to cause; and all of the not-for-profits have been cut so tremendously it is scary because the need is growing even more.  She noted as many of the cuts the Board was forced to do; the two things that it focused on were transportation and the assistant programs that the County had; it added $200,000 to that one; another couple of hundred to transportation, which were the top two as far as the needs in the community; and that was not easy to try to allocate those dollars.

 

Ms. Hirschfeld stated when they had their meeting, out of 15 seniors that were there she feels that 13 never heard of 2-1-1, which is 80 percent of the people there; they were so excited to hear about it; and where she lives the folks were never really informed that the 2-1-1 service existed.                           

 

Ms. Principe inquired if there can be a volunteer in every Senior Center that would be a person someone could go to get some answers; if they do not have the answers then they could get the answer for them; and stated it is a lot better for some of the seniors not to have to call 2-1-1.

 

Dr. Beach noted that is why there is the Aging Disability Resource Center (ADRC); it is in collaboration with 2-1-1 for seniors who cannot handle telephone services; and people can get the number through Community Services Council.  Ms. Principe stated that she is aware of that program; however, a senior does not like to be put on the line and have someone say they are going to pass he or she on to another person; and if that does not solve the problem, they go to another person.  She stated there should be some sort of quick clearing if they call Community Services Council to direct them to the basic information for the problem or area in which they need assistance.  Dr. Beach stated that is what the ADRC is all about; that is their purpose to keep folks on the line, get the information to them as quickly as possible, and council them on their options; then at the end of the day to help them get whatever program they need to have; and that is the State’s purpose of the ADRC.

 

Commissioner Scarborough stated what is disturbing to him is the Board had informed seniors that are involved that really do not understand everything now; one out of five people in Brevard County that fall in this category; the other statistic is they come from a generation that does not go out and ask for help; the bare surface has been touched with the most informed, and the

best and the brightest; and underneath it, there are 100,000 people who may have problems.  He stated if these people do not have the ability to spread the word to other people down the road, it has to be where a person spreads information to five people, those five people spread information to five people, and it has to circulate fast. 

 

Dr. Beach added if the ADRC is not functioning, it is a State program, and that is something that needs to be informed to him; all of that information will be addressed in Tallahassee; and he will try to get that cleared up as quickly as possible.  He stated one of the benefits of tough budget times that a person has to look at his or her efficiencies and often fragmentation can go away if people go ahead and try to streamline programs; that is what the Governor is endorsing, and they are trying to do it with the Department of Elder Affairs; but he feels very badly that people of Brevard County are not getting the information he or she needs.

 

Alida Hirschfeld stated that she is in the southern most part of Brevard County where they have a (777) area code; if she makes a call 21 miles to Melbourne, and if she has to call the hospital from where she lives it is considered a long distance call; and any call made that is (321) area code is considered long distance.  She noted there is a very large senior citizen population in the southern most part of the County; people do not have the money to make a long distance call; it costs her $7 to call the hospital from her home phone; it is cheaper using a cell phone; but inquired how many seniors can even afford one.

 

Commissioner Voltz advised it has always been a big issue because down there when a person calls 9-1-1 it goes to Indian River County and then back to Brevard, and that is a big issue.

 

 

 

Commissioner Voltz introduced Dr. E. Douglas Beach Secretary of the Florida Department of Elder Affairs; and she is going to tell everyone a little bit about Dr. Beach.  She explained on February 13, 2007, Governor Charlie Christ appointed Dr. Douglas Beach as Secretary of the Florida Department of Elder Affairs; Secretary Beach has worked in the Ageing Network for more than 12 years; most recently he served as the Chief Executive Officer of the Senior Resource Alliance Area Agency on Ageing of Central Florida, a planning policy and resource agency serving Florida’s seniors 60 years of age and older in Brevard, Orange, Osceola and Seminole Counties; and she thanked Dr. Beach for coming and speaking with the Board today.

 

Dr. Douglas Beach stated it is great to be in Central Florida; he thinks one of the first testimonies he gave was in front of the Brevard Commission; and that was when Commissioner Scarborough was Chairman back in the late 1990’s or early 2000 period of time when the Commission on Ageing was created.  He advised Chris Stagman talked a little bit about Sheriff Williams’ program on kids and seniors, and in that whole process one of things that came out was a pole where they asked voters would he or she support a senior initiative; the support was 54 percent for senior support and 46 percent against; it was polled as to how many people would support a kids program; 52 percent was for it and 48 percent was against it; and a joint kids/senior program was 72 percent for and 28 percent against it; and it is sort of a slam dunk trying to do some of these interactive things.  He stated when he was talking about ageism, one of the issues about ageism is that many of the issues that impact seniors impact kids at the same time, so it is not unusual to talk to a group of young people and ask them how many have asked their parents to take  them to the mall so he or she can meet friends; and that happens to

seniors every day.  Dr. Beach inquired how many will be sitting around the dinner table with their parents and friends and they are talking about something historically or politically and he or she may know more than they do, but yet they are ignored because of being a kid, and stated that happens to seniors every day.  He explained people often ask why he got involved in seniors activities; he grew up on a farm and one of the things that was interesting is knew that if he or she were going to work with grandpa that things were going to be nice because he is going to nurture he or she; if a mistake is made he was going to fix it so things would be great; if a child works with dad he was going to chew on he or she all weekend; so it is just interesting to see how older people and younger people bond and it is just a great thing.  He mentioned Larry Baxter that used to be Vice President of the Eckerd Youth Foundation and lived in Brevard for a long period of time; he was able to hire Larry and he is in Tallahassee as the head of the Lifetime for Communities Program, and with his expertise and the youth in the State for senior programming he thinks that they can bring that all together.  He advised many of the discussions today and some of the programming issues cuts, that he wants talk a little bit about where they have been over the last four years with senior programming.  He stated 40 years ago the poverty rate in the population was nearly 45 percent; there were old people’s homes with working farms where people would be institutionalized; they were warehoused or expected to work for their stay; and if they could not work they were put in these places but they were dismal, dank, awful places for seniors.  He stated over the last 40 years they have had Medicaid, Medicare, and Social Security; the poverty rate in the senior population is less than eight percent today; there are great programs, such as the Older American Act, which actually allows seniors to stay in their homes for as long as possible; from a clearly economic perspective they have gone ahead and transformed a whole generation and have made what he feels is the secret economic weapon; so looking at the State of Florida today; the retirement industry is the number two industry in the State of Florida; 50 percent of all new home construction is for people 60 plus; seniors give three billion dollars more in taxes every year than they cost in the State of Florida; and seniors give nearly one billion dollars in school taxes.  He advised they represent 4.2 million seniors in the State of Florida 60 years of age and older; the last gubernatorial election those folks were 31 percent of the registered voters; yet 43 percent of the people voted; so one in two of the last gubernatorial election were senior citizens; and this being an election year, people are paying attention to them again.  He stated over 50 percent of seniors are going to end up in a nursing home at some period in their life, but most of those stays are for acute care rehab stays.  He noted in the State of Florida less than 2.1 percent of seniors are in nursing homes at any given point in time; 1.9 percent are in assisted living facilities; so they have less than four percent of the population in facilities; and 89.1 percent of seniors are what is called well elders; and they look like everyone else and they are out in the community.  Dr. Beach stated he would first like to brag about how far Brevard County has come because it is one of the leading counties that leads senior programming and how it has connected things for seniors; but they can increase the percentage of well elders in the State of Florida by one percent by decreasing Medicaid costs somewhere between $500 to $900 million; so one percent increase in well elders would go a long way in wiping out some of the deficits.  He advised he wants the seniors to sip from the Fountain of Youth, but if they can get seniors involved socially, intellectually, and physically, they can look at increasing the percentage of well elderly.  He stated Chairman Scarborough has talked a lot about seniors who are socially isolated; it is as difficult on them as smoking; seniors who are socially isolated tend to be those frequent fliers for the emergency rooms; they are soon bouncing in and out of nursing homes; since it takes less than 100 days for the average person in the State of Florida to spend down the Medicaid, they soon become a Medicaid client; and those folks are socially active, they  can  figure  out  a way to keep them in the community.  He noted that depression is

not a normal part of ageing; by talking to many doctors he or she thinks that depression is a normal part of ageing; and it just is not so.  Dr. Beach stated if there are 80 to 85 percent of the folks with Dementia have Alzheimer’s, but that other 15 to 20 percent may have depression with Dementia, or may have Dementia that is caused by the interaction of the drugs they take; and if somebody would sit down and take the time with them they may be able to figure out how to get away from some of those Dementia type issues, so the essence is social activities.  He stated the eye is intellectual activities; there was a study by Dr. Snowden, and he was looking at a group of Nuns in Tennessee, California, and Kentucky; and what he was able to show is that for those Nuns who were intellectually active in their lifetime, even though it was proven they had Alzheimer’s when they died, they did not show the symptoms while alive; for those Nuns who were not intellectually active, they had all the symptoms of Alzheimer’s; they are starting to see a lot of it now where they have computer games; there are seniors playing Wii and these memory games with hand held computers to keep active; but they are finding that they can keep them intellectually active by anything from dominos or crossword puzzles or whatever that may be able to slow down the progression of Alzheimer’s Disease.  He inquired as to why is that so important; stated what he knows is that the fastest growing population in the Nation is the 85 plus population, somewhere between 35 and 45 percent of those folks may have Dementia; and they look into how to keep them involved in the communities and keep them well for a long period of time with intellectual activities.  He noted the last part of the SIP is physical activities and the physical activities have two components; first is to make sure that everybody has a primary care doctor; Medicare is one of the best programs of its type in the world; every senior 65 plus should have a primary care provider; if they do not, then they are bouncing in and out of the emergency room and that makes no sense; get that primary care doctor; have one, two, or three check-ups a year dependent upon a persons age; but get things through early intervention.  He stated one of the things that was talked about was when growing up, his moms car just blew up and now the second one is fixing to blow; inquired what is more important, a $35 oil change or a $3,500 engine; stated they know the same thing in healthcare; they can help through early intervention and prevention; and the statistics suggested that the medical system in the United States could save somewhere between $15 and $20 billion a year.  He stated the last thing is physical activity; the four big issues with seniors are hips, hearts, depression, and diabetes; and physical activity is a positive on each one of those, so lets get our seniors up and moving.  He stated one of the programs Larry Baxter is trying to bring back is a Movement Program between kids and seniors; there is an obesity problem in the senior population; there is a huge obesity problem with the younger population; it would be nice if the seniors did not want to go to exercise to have them linked to a younger friend; and that would be a tremendous opportunity to connect seniors with the younger population.  He stated that is not to say that the budget problems in Tallahassee are difficult right now; at best the Governor is very optimistic; for those who do not know, his PHd is in Economics; he tells everybody that he is a recovering economist; and the only people that get things more wrong than they do is Meteorologists.  He advised things are tough right now, they are going through some budget exercises that he did not anticipate 18 to 19 months ago when he went to Tallahassee; but there are some positives there.  He noted one of the things in response to everything being fragmented, this requires them to become more efficient; it requires them to work better with sister agencies; and it requires them to work better at the local agencies.  He explained one of the things that Brevard County has done better than many counties throughout the State is understanding the relationship between the programs that run through Brevard County Services Council, and the various other factors in the County; Brevard is one of the new counties where the meal provider actually contracts with SCAT to take people to congregate meals; generally there is a meal provider  that goes  ahead and  buys his  or her  own vans; one  of the counties has 50 vans, 25

running and 25 for various cases of repair; the advantages of dealing with SCAT is that people get the best type of service possible; and he or she knows that SCAT is going to keep that going.  Dr. Beach advised the Volunteers in Motion Program is unlike any program of its kind in the State; it has won its own State awards because of its innovation; and the many things that the Board is doing with respect to connectivity, such as 2-1-1 and how it works with the Aging Disability Resource Centers and Brevard Community Services Counsil is second to none.  He stated he would like to comment on some of items heard today such as Dr. Tucker talking about Brevard’s elder population; Brevard has the fifth fastest growing senior population in Florida; the tenth fastest growing senior population in the United States; and that is interesting how that comes together.  He advised they talked a little bit about ageism and how ageism not only affects seniors but kids as well; it is in the Florida Constitution that creator of Department of Elder Affairs one of the 16 requirements in the Constitution is to combat ageism; so they are trying to do the best they can as it is a very difficult issue.  He noted one of the big issues that they talk about, and was mentioned here a little bit, is the whole idea of allowing seniors to age with independence and dignity in a self-selective setting; Brevard is beyond that and understands what the new mission is, which is to create a social, economic, and intellectual environment where people of all ages, particularly seniors, can thrive and prosper; so they want to get away from allowing the folks to age independently and selective-setting because for many of them want to get people socially involved in the community and to be able to give back; and they know that they will.  Dr. Beach stated that Jim Lisenfelt is one of the best in his field in the State and he has served with Jim for a long period of time on the Disability Disadvantaged Transportation System; what Jim has done is second to none; and he knows that transportation is one of the big issues impacting seniors.  He inquired does the Board remember the movie Cocoon; stated most people that think Cocoon was about some aliens coming down and dropping some pods in a pool in Southeast Florida; and these people were found doing back flips off the diving board; the fundamental issue that was concerning those seniors is that the big guy was going blind, and he owned the car; they did not know if they could stay connected with the community without his car; and everything evolved from that.  He stated these transportation issues are tremendous; Brevard leads the State in many of the programs; many have come from Federal and State dollars; but most of it has been from the County.  He stated he appreciates everything the County has done in the aspect of transportation.  He advised he is glad he is not Bill Johnson; he reminds him of his mom, she could always make a sow’s ear out of a silk purse; and poor Bill is just hearing the worst of it.  He stated one of the things he did talk about is these working retirees; what they are seeing right now is that a 70-year old today has the same life expectancy as a 59-year old back in 1970; what they know is in the 1960’s there was a huge revolution in the workplace; when women came into the workplace and what is said is that the workplace accommodated women and productivity actually went up rather than went down; the same thing is expected to happen in the next 20 years with seniors being part of the new workforce; and the reason is that a lot of them are going to need the money, many of them are very healthy so there is no reason to think about retiring; but there is going to be so many people in this baby boomer generation leave the workforce that people are going to have to hire someone; and a lot of these seniors may end up having encore careers, doing things differently than they are doing now but how they connect and make sure they can thrive and prosper is very important.  He mentioned Libby Donahue with 2-1-1 was one of the top five in Florida to have this service first; she does a tremendous program; and when he was at the Senior Resource Alliance they private-contracted with Libby to do some stuff to help with seniors.  He stated some of those monies have dried up; the last time he tried to get Libby to help them out she told him that he would not offer her enough money; she was right; but at the end of the day, her  programs are  second to  none.  He  advised  one  of the  things that he has

done with respect to mental health is change Florida Statues; he is now a Board member of the Substance Abuse of Mental Health Board of Florida; and that all ties back into an idea that depression is not a normal part of aging.  Dr. Beach added a story about his mother-in-law; she had Depression induced Dementia and went on a hunger strike; he took her to the doctor and she was in the hospital for a week; one of the doctors that looked at her diagnosed her with Alzheimer’s; he had seen her for 15 minutes for four days so, in 45 minutes basically made this snapped diagnosis that she had Alzheimer’s, which she ended up not having Alzheimer’s she had Depression induced Dementia, which could be taken care of with Depression drugs; and so what they want to do is make sure that they are working very closely with the physician.  He explained in Brevard there are some great senior physicians to help better understand what is the best thing to do and how to get them done.  He stated there are very few Psychiatric long-term care beds in the State of Florida; if the Board wanted to get a little bit more involved with its Delegation, that may be something to talk about; but those beds are expensive, and it is pretty tough in these types of budget issues to be looking at psychiatric long-term care beds; but the bottom line is they need to do something and will probably need to do it sooner than later.  Dr. Beach stated lastly, in just bragging a little bit about the volunteers, in 2005 through 2006 they had 43,000 volunteers in the State of Florida; they gave 2.7 million hours of service with an economic value of $51.5 million; without volunteers they are 94 percent privatized; they are about a $700 to $800 million organization; and without the volunteers they could not do what needs to be done on a daily basis.  Dr. Beach thanked the Board for inviting him.

 

Commissioner Voltz inquired when they talked earlier did he mention there may be some funds available; with Dr. Beach responding yes, it is not much but, they have a thing called Communities for a Lifetime and they have some discretionary funds coming through the Alzheimer’s Initiatives, so it will probably flow through the Member Disorder Clinic. He inquired how can they do some evidence-based programming to get the seniors to slow down, whatever Dementia they may have, and get them involved in the community more than less.  He stated they are confident that to get out of some of the economic issues is going to have to be lead by the seniors of the State of Florida; and inquired how do they make sure that in doing intellectual activities they stay engaged and involved as long as possible and to the extent possible with the effects of Dementia.

 

Commissioner Voltz inquired what about the faith-based organization; with Dr. Beach responding they did a faith-based initiative similar to what they were discussing with Pensacola; the Board may remember Democracy in America written in the 1830’s; in the book it says when Government takes over the roles of philanthropy, churches, and demigods primarily that the American experience would cease to exist; and what they are finding here is that this is a way for them to reconnect.  He explained in Pensacola 300 people came to a Ecumenical dinner; and at the end of the day, one had a very good Parrish Nurses Program, another group had a very good Senior Home Repair Program, and so what they are trying to do is piece together different programs into different churches so each could take advantage of what the other church may do.

 

Commissioner Voltz inquired if he has potential funds for the faith-based initiatives; with Dr. Beach replying there are no potential funds for the faith-based initiatives; they want to see how they are doing it here and to the extent possible help anyway that they can; but the money through the Memory Disorder Clinics will flow into the Communities for a Lifetime Program; they will coordinate through the Senior Resource Alliance in Orlando, and coordinate with the County

 

Commission to every extent possible; and they will also coordinate with Brevard Community Services Council.

 

Commissioner Voltz stated she appreciated Dr. Beach sending somebody to Tuesdays Session of the Prime Timers.

 

Dr. Beach stated Carol Waters is looking forward to it; Carol went to California to live with her daughter; and he hired her about a year and one-half ago, and as many know it was for a long-time Chair of the Memory Disorder Clinic in Brevard County.

 

Chairman Scarborough mentioned the cost of the meal at Prime Timers is substantially less than the $5; there are other operating costs as Mr. Green explained; and they involve Volunteers, but the cost is extremely small in comparison to the number of people who are touched.  He advised he is requesting that it would be a shame to walk away today with all of this information and not task the Board with two things; one of them may be something it does more internally as what has been heard today that the Board can do just a bit wiser; the second thing is even more important; he has heard things that the Board should be going to its Delegation with its Legislative Package; and inquired when submit its Legislative Package.

 

Peggy Busacca replied the Workshop is at the end of the month of October.

 

Chairman Scarborough added that at that Workshop the Board definitely needs to have in its package a Legislative Agenda on this particular elderly issue to Dr. Beach so he can just tweak it so it makes sense; and inquired how it works within the bigger picture and that Dr. Beach could help would be fantastic.  Dr. Beach stated he would love to; and anything that he can do to help Brevard would be great.

 

Ms. Busacca stated that the Agenda Package should be done by the end of next week in a draft.

 

Chairman Scarborough inquired how does the County add particular items to this; stated maybe Heidi has heard some things and she could get comments from each of the Commissioners; some things could be put together as to what the Board can do now; and maybe something could be put on the Agenda for the 28^th meeting at the end of day for Board discussion because he has a lot of things that he thinks the Board can do.

 

Peggy Busacca stated that some of the information that she heard included Federal as well as State.

 

Dr. Beach mentioned one of the things that they have not tapped is how nice it would be if the Board would give a ten percent discount on its healthcare insurance because it has a senior-friendly house; and inquired why not reach out to some of these insurance companies and see if something like that can be done.

 

Commissioner Bolin stated she talked about a checklist of everything that she needed to do to get her home senior-ready; and just going down to Lowe’s and having all the commodes changed helped so much.

 

Commissioner Voltz mentioned she has two other things and that is if anybody is watching and wanted one of the Senior Prescription Discount Cards he or she can call Tammy Harris at Housing and Human Services at (321)633-2007; but before getting to the second thing, Don Lusk would like to just give the Board a brief overview from Parks and Recreation.

 

Don Lusk, Director of Parks and Recreation stated this is information that sort of compiles what is done in Parks and Recreation; but he will email it to all the Commissioners.

 

Commissioner Voltz stated there is a gentleman in the audience that has been sitting here all day who would like to speak.

 

Mike, no last name given, stated the reason he came today is they know they have the Nursing Home Diversion Act and the Communities for a Lifetime Program is supposed to help the State save money and also try to help keep the seniors at home as long as they can.  Mike stated his wife owns a senior daycare on Merritt Island; one of the members got sick and had to go to the hospital; she was put on Hospice and the family knew they were caregivers in the past; stated they asked if his wife knew anybody that would take care of their mom, as they did not want her in a nursing home or in the hospital dying around people she does not know; so they took her into their home.  He advised after a couple more months there was another member, her son-in-law, who committed suicide; now the daughter has mom and does not know what to do; so they took on her mom as well.  He stated they see what is happening; they have been in business for a year; these people are starting to need nursing homes or assisted living; and the problem is with the regulations and understanding the Florida Statues.  He explained Florida Statues say if there are more than two people or less than, it can be an Adult Family Care Home, so they applied; they came out and inspected that; they had a couple of tags, one for something on the paperwork and another they had to have a cover on the spa, so they fixed that; the inspector came back out and reinspected the house; and happened the Adult Daycare was at a year so that had to be inspected.  He stated the inspection pass were to get everything in the mail; then on the same day at 4:00 p.m., the inspector showed up saying they were in violation of the Florida Statues and the Daycare needs and to cease immediately; and she said to get rid of these people tonight or you can be fined up to $1,000 a day.  He noted one of the Florida Statues says if they do wish to provide personal care of services on a 24-hour basis to more than two elderly persons who are not related, a person must apply for an AFL License; on the next page, the same Florida Statue it says if a person is providing care or more personal services for a period exceeding 24 hours to one or more adults who are not relatives to the owner or administrator, the fines are $1,000 a day; he does not have the money to fight $1,000 a day, but he cannot tell these people they cannot take care of their mom anymore; and inquired what are they supposed to do.  He stated he is going to have to see what happens with the $1,000 a day; they need to talk with somebody in Tallahassee because it seems to be these people in these offices who are making up laws as they go along; they are saying a person cannot have a business; somebody needs to interpret the Statues; and he cannot afford this as he spoke to an attorney for just a few minutes and it cost $750.

 

Commissioner Voltz stated that Dr. Beach will help Mike; and he will give him a telephone number to call.

 

Dr. Potomski stated the Space Coast Advocates are meeting on the 15^th at 9:00 a.m. at the Agricultural Center in Cocoa; he would like to invite the elected officials to attend; it is a group that he  is sure  the  Board is familiar with; it is all different walks of life, a sort of grass roots kind

of effort in Brevard County for things that they like to present to the County officials; and the State Legislative Delegation, breakfast is at 8:30 a.m., but the meeting starts at 9:00 a.m.

 

 

 

Chairman Scarborough inquired about next Tuesday’s meeting of the 14^th; and the Board has Chuck causing trouble again and it needs to figure out how to handle it.  He has this thing called a Small Area Plan, which will probably only take 12 hours, and he also has Dr. Niazi, which will take another 12 hours; and he inquired what was wanted for breakfast.  Commissioner Scarborough stated he guesses everyone received the email from Dr. Niazi; Dr. Niazi asked that be postponed until the 28^th; he has been advised though that is not proceeding on Dr. Nazis’ request but on the Boards request; and inquired if the Board wants to continue Dr. Nazis’ item.

 

Ms. Busacca commented the Board directed staff to notify the adjoining property owners, which we has been done so they are aware that there is a meeting on the 14^th; they do have about 13

emails and feel like if the Board wants to continue it that staff can email them and the news will get out.

 

Chairman Scarborough inquired if the Board wants to continue it because it is Dr. Nazis’ request.  Commissioner Nelson stated that several of those emails say do not continue it because apparently the last time this issue came up it got pulled and there was never any discussion; and honestly he feels it needs to get over with.  He stated the Small Area Study, if there is one, that could be moved; and there is the question about the Special Magistrate, that little piece of land, and how is that going to fit. 

 

Chairman Scarborough stated he can do it either way; the Board can hear both of them Tuesday; but he wants to tell the Board what he was going to propose; and inquired if they both can be done Tuesday.  Commissioner Nelson responded yes if the Board would like.

 

Chairman Scarborough explained what he would like to do is have two Agendas, a 9:00 a.m. Agenda with all the other items, and a 1:00 p.m. Agenda with two items; the problem has always been to have an ongoing public hearing and somebody else walks up and says my public hearing is supposed to be starting now; and he inquired if it is okay to have two Agendas.

 

Ms. Busacca stated she will do her best to notify everyone about the time.

 

Commissions Colon inquired if Commission Voltz is not at this meeting will she have a problem with that item being heard; with Commissioner Voltz replying she is not going to be there.

 

Chairman Scarborough inquired would the Board prefer to have either of those heard because these things are so dynamic; and he does not want to get there and then find out that the Board has everybody there and then it does something different.

 

Commissioner Colon stated she was under the understanding that Commissioner Voltz does not have a problem with the item being heard since she is not going to be there for that particular item.  Commissioner Voltz stated that Dr. Niazi knows that she is not going to be there and thinks that is why he has made this request to be moved on; and it is up to the Board.

Chairman Scarborough stated he has indicated two separate times to Dr. Niazi that he is not supporting this; and inquired if there support to proceed forward.  Commissioner Nelson responded no.  Chairman Scarborough explained to Commissioner Voltz that there will be a two, two vote.

 

Commissioner Colon inquired if Commissioner Voltz is supporting it; with Commissioner Voltz responding yes.

 

Peggy Busacca inquired if the Board is talking about is permission to advertise; Commissioner Voltz responded yes, that after talking to Dr. Niazi and hearing some of the stuff that has been going on in the community she was concerned about whether or not the community supported it.

 

Chairman Scarborough stated the Board hears what is going to happen but it will go ahead and hear it with an understanding that probably there will not be an affirmative action with four

 

Commissioners on a split vote; and there is no reason for the Board to walk into something that is already known.  Commissioner Nelson mentioned that one of the questions that was raised was does the community support the idea; it was presented to the Board that the neighbors had no issues; but the Board is going to hear differently this time and that may impact how some of his fellow Commissioners feel about it.

 

Commissioner Colon added that she feels Commissioner Nelson is correct to say that it was a done deal or that there is no support; she thinks that is premature because the Board has not heard from the community; that is why it is so important because if Commissioner Voltz does not have a problem with it that means that if she is not here then that is it.

 

Commissioner Voltz stated she heard one thing that community supported it and heard another thing that the community did not support it; she wants to know what the community thinks; and if she is I am not here to hear what the community thinks, then it is up to the Board.  Commissioner Colon stated that is the whole point, if Commissioner Voltz really wants to here what the community has to say then she should be here to hear it and vote on it.  Commissioner Voltz stated she does want to hear it.

 

Commissioner Colon stated if that is the case, then she wants to hear it on the 28^th; that is what the Board is saying; it is not a done deal as far as for or against; and the Board wants to hear from the community.

 

Commissioner Nelson advised there are some unhappy folks associated with this who are next door neighbors and his or her fear as to what happened last time is it will get pulled and it will reappear at some point, they want their day in court and they do not want it delayed; the County sent out notices saying it was going to be on this date; and for the Board to change it suddenly he thinks the rest of the Commission may become the enemy in the process and that is his concern.

 

Chairman Scarborough stated what he is hearing is to go ahead with it and see where it goes.  Commissioner Colon states in the same token, if the Board is saying it wants the whole community to hear it, all Commissioners need to be present; and, therefore, it is talking about a

week.  She stated it is not going to go anywhere in two more weeks; and to have all five Commissioners present is going to be really important.

 

Commissioner Nelson stated to take a vote and if he loses then he loses.

 

Motion was made by Commissioner Nelson, seconded by Commissioner Scarborough, to hear the item on October 14, 2008 as advertised.  Motion died.  Commissioner Voltz and Commissioner Colon voted nay.

 

 

Commissioner Scarborough stated that is easy enough then the Board will just have a 1:00 p.m. Agenda on October 14.

 

Commissioner Voltz stated here is why because she thinks something that Commissioner Nelson mentioned is the people want their day in court and they do not want to hear it is tabled, cancelled, they are going to think about it, or do they have to worry about it six months from now or whatever; it needs to be heard and gotten over with rather than tell them the Board decided it is not going to hear it; and then a new Commission comes on and it is going to end up six months down the road to hearing it again.

 

Chairman Scarborough stated he wants to address Commissioner Nelson because this is probably better and he will tell him why; it is because he has always been told that if something is defeated then there is basically somebody that voted for the motion wants to raise the issue again; then it comes back up; but if there is a two, two vote it does not have that dynamics and it can come back up.  He stated in other words, the Board can hear it on the 14^th, and it could be back on the 28^th if a Commissioner put it on there because it actually in fact has not been denied; and it may not get to that point, but if the Board really wants to handle it this may be actually handled at a better job.

 

Commissioner Bolin stated then it is clean decision all the way around.  Chairman Scarborough added that he understands that everybody wants to get it over with but by the same token to really get it over.

 

Commissioner Voltz stated the Board is still going to have to hear the community; it has to hear both sides; and she thinks to go ahead and have the community come up and let the Board know what is going on.

 

Ms. Busacca inquired if it is going to be heard on the 28^th, would the Board like to have a time certain so when people and notify staff can tell them.  Chairman Scarborough replied he does not want to have a time certain until he knows the dynamics of the Agenda because then he gets ahead of himself with putting the wrong thing as a time certain, so he needs to know the whole Agenda first.

 

Commissioner Bolin stated that the possibility exists that a two, two vote could happen.  Chairman Scarborough commented that it was not going to pass so the Board put it that way because it needs three votes out of four; and with two voting negative, it splits the vote.

 

Commissioner Bolin stated she could have been for or against; it is just that the Board knew it was not going to go anywhere; but she feels that Chairman Scarborough mentioned a very good

 

thing that if the Board went to the 28^th and that is why she is going with that as it is clean.  Commissioner Nelson advised he understands that, but the emails are going to come rolling in, and the Board will get the next wave.

 

Upon motion and vote, the meeting adjourned at 6:03 p.m.

 

 

ATTEST:

 

                                                                                 ________________________________

                                                                              TRUMAN SCARBOROUGH, CHAIRMAN

                                                                              BOARD OF COUNTY COMMISSIONERS

                                                                              BREVARD COUNTY, FLORIDA

SCOTT ELLIS, CLERK

 

          (S E A L)