MEETING: BOARD OF COUNTY COMMISSIONERS AND PALM BEACH COUNTY HEALTH CARE DISTRICT BOARD

1. CALL TO ORDER: August 31, 1999, at 3:45 p.m., in the Thomas C. McEaddy, Jr., Conference Room, Governmental Center, West Palm Beach, Florida.

(CLERK'S NOTE: No roll call was taken.)

1.A. MEMBERS AND OFFICERS PRESENT:

Chair Maude Ford Lee

Vice-Chair Warren T. Newell

Commissioner Burt Aaronson

Commissioner Mary McCarty

Commissioner Karen T. Marcus

Commissioner Tony Masilotti

Commissioner Carol A. Roberts

County Administrator Robert Weisman

Assistant County Attorney Tammy K. Fields

Deputy Clerk Deborah Dieter

HEALTH CARE DISTRICT BOARD MEMBERS PRESENT:

Chair Harold Ostrow

Vice-Chair Scott L. Porter

Arthur Anderson - Absent

Representative Ed Healey

Health Department Director Jean Marie Malecki - Absent

I. Jeffrey Pheterson

Kenneth Schenck, Jr.

(CLERK'S NOTE: The following item is numbered as it appeared on the Agenda for the Workshop Meeting of this date. A separate agenda was not provided for this meeting.)

7.A. HEALTH CARE DISTRICT

TIME CERTAIN - 3:00 P.M.

7.A.1.

FUNDING ISSUES RELATED TO THE COUNTY'S HEAD START AND SUBSTANCE ABUSE PROGRAMS. DISCUSSED WITH DIRECTION 8-31-99

Mr. Ostrow commented that, although the Health Care District was conceived of and brought to fruition by the County Commission in 1988, it was one of the best kept secrets in the County. He suggested that residents and Board members alike were not familiar with the Health Care District's functions. He asked that both boards take time today to update each other on their expectations.

Commissioner Roberts said that generally speaking the Board was under the impression that the Health Care District Board was not fulfilling their responsibilities in certain areas. She suggested that the purpose of today's meeting should be to reach an understanding as to the specific duties and funding responsibilities of each board.

Commissioner Masilotti expressed concern that the County was covering medical costs for persons enrolled in Head Start and substance-abuse treatment programs that were eligible under district funding. He suggested that deferring these costs to the district would allow the County to expand the enrollment in these programs. Commissioner Newell proposed that the district assume the management of various health services for which the County is now responsible, such as immunizations and physical examinations for Head Start children, substance abuse treatments, and prescriptions for jail inmates. He also suggested collaborating on funding for these services.

Commissioner Aaronson applauded the district for their success in operating the County Home and General Care Facility and recommended appointing a member from each board to meet and find areas for collaboration. Commissioner McCarty called attention to the excellent job the district did with the School Nursing Program, but she noted that duplicate services were being offered in other areas and should be eliminated. Commissioner Lee suggested foster care as an area for collaboration, and Commissioner Roberts stressed the importance of finding ways to prioritize the Glades area, as it has the highest population of indigent persons in the state.

Commissioner Marcus requested moving forward with the idea of appointing liaisons from each board to work together on finding solutions.

In response to the Board's comments, Mr. Ostrow agreed that these were important issues, but he explained that district taxing dollars only went so far. He referred to the County's agreement not to transfer any more health services to the district after 1995 when the district assumed responsibility for the County Home. Commissioner Aaronson interjected that regardless of the agreement, he saw no valid reason why the two groups could not work together to save money and expand services.

Chief Executive Officer W. Cecil Bennett explained that under the 40-year contract the County pays the district a fixed rate of $15 million annually toward the operation of the nursing home, but the County's payments do not account for inflation. He added that the district was willing to work with the Board but could not assume responsibility for any new programs without sufficient funding. He noted that County and district staffs have been communicating and that an understanding was reached that the district would provide health care services to County-qualified Head Start children.

Glades Representative Kenneth Schenck, Jr. confirmed that the Glades area was in need of more services, especially since the closing of the hospital. He indicated that the district needed to focus on solutions for this area and would welcome and collaborative efforts.

Vice-Chair Scott L. Porter said that the need to eliminate the duplication of services throughout the County should be a top priority, as thousands if not millions of dollars could be saved and recycled back into needed services. As an example, he noted that every major government not-for-profit agency operated its own independent eligibility determination function. Creation of a common computer database of applicants would relieve staffs from reviewing the same applicant twice. Mr. Porter emphasized the importance of the County and the Health Care District working together to squeeze out inefficiencies in the system, but he contended that the number one area of waste was probably at the state level. He suggested working together to overcome institutional roadblocks at the legislative level. Commissioner Roberts, in total agreement, recommended coordinating the legislative goals of all the major area agencies in order to develop one unified support system.

In an effort to start the process, Commissioner Newell asked how and when a committee could be set up to discuss these matters. Commissioner Marcus suggested selecting one liaison from each board. Prompted by Commissioner McCarty, Commissioner Masilotti said he would be glad to represent the County and Health Care District Board Member I. Jeffrey Pheterson said he would volunteer as the district's liaison.

After further discussion it was informally agreed that Commissioner Masilotti and Mr. Pheterson from the District would meet with respective staffs and find areas for collaboration, after which a joint meeting would be scheduled to discuss the options.

2. ADJOURNMENT

The Chair declared the meeting adjourned at 4:50 p.m.

ATTESTED: APPROVED:

Clerk Chair