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HomeMy WebLinkAboutMinutes 12-09-2009 ST LUCIE COUNTY PROPERTY AND HOMEOWNERS ASSOCIATION Minutes of December 9, 2009 Meeting Convened: 10 am Adjourned: 11. 15 am The meeting of the Property & Homeowners Association was held Wednesday, December 9, 2009 in Conference Room 3 of the St. Lucie County Administration Annex, 2300 Virginia Avenue, Fort Pierce. Members Present: Craig Mundt, North Beach Association Roger Bollman, Indian River Estates Linda Bollman, Indian River Estates Rev. William Bradley, Sunland Gardens Ed Boslow, Oleander Pines Sue Boslow, Oleander Pines Walter Fauth, Fort Pierce South Beach Aris Atoa, Lake Forest Pointe Tony Roach, Lake Forest Point Bill Hammer, Reserve/PGA Andy Stark, Palm Grove Hank Schmitz, Portofino Shores Alice Schmitz, Portofino Shores Diane Andrews, Queens Cove Also Present: Commissioner Chris Dzadovsky, Chairman Terri Ann Palumbo, Executive Aide to Commissioner Dzadovsky Deputy Greg Gonsalves, St. Lucie County Sheriff’s Office Catherine Chaney, St Lucie County Fire District Tangie Jennings, Rep. Rader’s Office Chief Ron Parrish, St. Lucie County Fire District Eva O’Donnell, Executive Aide to Commissioner Chris Craft Carlos Durant, St. Lucie County Fire District Asst. Fire Chief Frannie Hutchinson Ethel Rowland Mark Robitaille, CEO, Martin Memorial Health ITEM #1 – CALL TO ORDER The meeting was called to order. Commissioner Dzadovsky led the Association in the Pledge of Allegiance. Commissioner Dzadovsky introduced himself and gave a brief presentation of his background prior to his election as District 1 Commissioner. He stated that he’d lived in St Lucie County full time since 2003 but had been coming here since 1994 when he owned a dive resort in the Keys. He said whenever he came here as a visitor, he stayed in Fort Pierce. Before that he was with US Airways for 26 years, was a volunteer firefighter, which is how he came here after being injured in 2001 on a fire call. He injured both of his legs and had 12 surgeries over 7 years and couldn’t go back to his job as a flight attendant and certainly not as a firefighter. He retired here full time in 2003 and became very active in community affairs, and his first job was as president of a neighborhood association. He met all the people who had difficulties and wanted to get things done. He was the president and the vice-president of the Mariner Bay Homeowners Association as well as the Dock Committee chair. That HOA took over from the developer there, so he knows some of what HOA members face. The Homeowner Representatives and visitors in attendance gave self-introductions ITEM #2 – APPROVAL OF MINUTES Commissioner Dzadovsky asked for a motion for approval of the October 14, 2009 minutes. Approval was moved and seconded and passed unanimously by a voice vote. Mr. Hammer mentioned that he’d raised the issues of synchronizing lights on several roads in the area and had a nice conversation with the engineering department in the city of Port St Lucie, who said they do periodically study that and re-set the lights based on the current traffic situation. Mr. Hammer stated that they were pretty frank in saying they just don’t have the road capacity to handle the traffic we have. Commissioner Dzadovsky asked if there was a change or if anything needed to be followed up Mr. Hammer said no, it’s what they have to work with and with the amount of traffic they have, the mix of traffic was a problem. Some people do 30 miles an hour and some people do 50 miles an hour and that kind of bogs things down and makes time delays for certain speeds. They are working on the Crosstown Parkway and St. Lucie West Blvd. Commissioner Dzadovsky asked if there was anything else from the minutes, then asked Deputy Gonsalves for his report. ITEM #3 – ST LUCIE COUNTY SHERIFF’S REPORT Deputy Gonsalves said he had a few things he wanted to cover. First of all, there have been some problems in some of the communities: Indian River Estates has had burglaries, as has Lakewood Park and North Hutchinson Island. Citizen involvement has been great, a lot of the arrests they’re making are because people are getting involved and are notifying the Sheriff’s office when they see something out of the ordinary. Deputies are responding and have been able to catch some of the people who are committing the burglaries. One big problem that they’ve been seeing is that because of the price of metals, people are going into vacant homes and stripping them of the pipes and wires. The area out west of town is getting hit pretty badly with people stealing copper wire and air conditioning units. Several shopping plazas at night time have been hit by burglaries of air conditioning units. He said he’s proud to report to some of our homeowners associations that they’ve actually caught some of the people doing it. It’s people coming from all different areas of the state who are opportunists and they’re looking for these shopping plazas that don’t have enough lighting at night. The ones who have been caught were because of people who have reported suspicious activity. He asked the members to please pass on that during the holiday season, we’re all distracted with family and friends coming over, running errands, etc. Criminals are aware of that. They take that opportunity to target people not only at the shopping areas while they’re shopping but at times will follow people back to their homes and get them in the driveway while they have their head in the trunk trying to get their packages out. The key is to be aware of your surroundings and use common sense. Some businesses are open 24 hours, and a lot of people take that time at 3:00 in the morning to do their shopping. The problem is that at night time, especially if you go by yourself, you’re asking for trouble. Using ATMs at night time is another risk. The other thing is a lot of us will be traveling during this time and there have been reports where people have been gone for a matter of a couple days and their houses have been targeted. Thieves start looking for cars that aren’t in the driveway, the mail stacked up in the mailbox or newspapers in the driveway. He advised to make your house look like somebody’s there even if you’re not and to notify the Sheriff’s Office if you’re going away. They will put your house on a close patrol while you’re gone and make sure nothing is tampered with. He gave an example of a house on South Beach where a COP volunteer noticed a window cracked open and called deputies, who arrested someone inside the house. He said those things work, they’re volunteer-based, and that homeowners should take advantage of the free service as taxpayers. Mr. Roach asked if gang-related crime is down or up. Deputy Gonsalves stated that they work very closely with the Fort Pierce Police Department and they have a street crimes unit and a narcotics unit. Gangs not only hit within the city, but in the unincorporated areas like Sheraton Plaza and some of the surrounding areas. There was a big operation a few months back with about 500 arrests. Some were gang members, and a lot of drugs and guns were taken off the street. Once a year, law enforcement combines forces, even taking some members from road patrol and putting them out there. At any given time we have about 75 to 100 people working during those operations. So, he said gang-related crime is down since that operation. Commissioner Dzadovsky said he sits on the Region 5 Gang Task Force and a lot of it is how you look at statistics. Since there was a big operation, it looks like a greater number of cases for crime activity, so it’s hard to tell in the statistics. Deputy Gonsalves stated that people leaving items in the car, obvious to people outside, causes problems. There were recently burglaries in one of the cemeteries, the SEAL Museum, and it took less than 15 minutes, so don’t leave things in the car. Mr. Boslow stated that his HOA’s citizen patrol guy comes around Tuesday, 10.30 like clockwork, and asked if the times could be varied. Deputy Gonsalves said yes, they should change up their routes, and that the Sheriff’s office will ask them to do so. He said that especially on the islands where there’s beach access, it’s important to vary the route. He said he would relay the request for varying time schedules. Commissioner Dzadovsky stated that he was recently at Wal-Mart was walking through the parking lot. He saw a woman going to her car and all of a sudden her alarm kept going off. He asked her if she was okay and she said she was putting her things in her car and just wanted to be sure that if anyone’s around, people would see her in case someone tried to attack her. Deputy Gonsalves said that kind of thing works. th Commissioner Dzadovsky stated that when I lived on 10 Street he once heard somebody outside so he hit the alarm on his truck in the driveway and the next thing you know they were scurrying off. Craig Mundt stated that he is on the board of directors at the SEAL museum and because they have a lot of artifacts on display they don’t allow handbags in the museum. A lady took her handbag back outside and put it in the car and there was a theft from the vehicle. He stated that the SEAL Museum is reevaluating that policy because there has been some theft activity in the Pepper Park area. Deputy Gonsalves said that someone probably saw her do it Bill Hammer stated there was a great success story. There was a desperado eluding police last week who crashed through a construction gate into his community. The units were fabulous and it was a cooperative effort between the Sheriff’s Department, the State Police and the city of Port St. Lucie. They had the K9s in there, the helicopters near the area, and the guy finally had to swim across the pond with alligators, hide under the palmetto palms and the heat sensor on the helicopter identified him and they sent the dogs in. Deputy Gonsalves asked if that was the one with the stolen boat, or the man was stealing a boat. Mr. Hammer said yes. He’d switched vehicles and knocked the 25 foot gates right off the posts and carried him about 100 feet down the road. Deputy Gonsalves stated that if he wasn’t mistaken, the criminal was from Miami – so once again our criminals aren’t homegrown sometimes, they come from other areas. They were stealing boats. There were two guys, one guy they got there and the other guy didn’t give up too easily. Mr. Hammer said that one was apparently a sex offender also. ITEM 4 – ST LUCIE COUNTY FIRE DISTRICT REPORT Commissioner Dzadovsky asked for the Fire District update. Catherine Chaney talked about the Citizens Fire Academy starting in January, and distributed handouts. The Academy is an opportunity to learn about fire rescue and public safety from the fire rescue side. The goal is to give citizens the opportunity to tour the administration building and see what they do, to tour the new public safety complex at IRSC, and see some of the demonstrations that they can put on and the training they provide, and to visit the new EOC. The goal is to have six classes in a three month th program that meet every other Thursday. The first class will be January 14 at 4 pm at the Milner Road administration building. She said she would email the brochure if requested. She said the application and brochure are on the website as well. Mr. Hammer stated that we’re way behind on rainfall – we could have a terrible dry season coming up. He asked if there will be any plans to designate areas that are fire hazards, or to identify any properties that are out of control and in proximity to neighboring properties. Ms. Chaney stated that there aren’t plans to have citizens identify dry areas but that’s a good idea. Chief Parrish stated that The Citizens Fire Academy is basically to inform the community about the Fire District does and who the Fire District is. People will also get the opportunity to sort of experience what it’s like to put on bunker gear, look at the type of calls they go on. It is not about going out into the streets like the citizens patrol program. It’s just about informing the community of what the Fire District does. He said the Fire District has no authority to to tell someone to cut their grass or trim trees. They do advise people about safe spaces, drought indexes and getting their gutters cleaned and things of that nature. But the district has no enforcement authority. Ms. Chaney said that the second program she wanted to mention is home inspection. The district is going to start offering home inspections, if residents want a firefighter to come in and do a quick inspection of their house, give some safety tips, or things like that. It will be kicked off in January and she said she would keep the members posted on that. She said the district would put information on the home inspections on their website. Commissioner Dzadovsky said to Chief Parrish that he had seen an op-ed article in the paper the past weekend in which the Chief explained a lot of what happens in the fire District, some of the challenges that they face, and about the value of education that the firefighters and EMTs go through. ITEM #5 GUEST SPEAKERS – Chief Ron Parrish (St. Lucie County Fire District) and Mark Robitaille (Martin Memorial Health Systems) Chief Parrish mentioned the Capstone IRSC program. They have a new program; it’s a bachelors program for emergency services. The Capstone students had to do a project for emergency services. So they came over and asked if there was something the Fire District could have them do and the District, through its strategic planning process was able to identify things such as the Citizens’ Fire Academy. The Citizens’ Fire Academy will go over many details of intricacies of the fire district from budgeting to operations and public education and training. The St. Lucie County Fire District is the largest special taxing district in the state of Florida. They have 449 employees right now. Today the operating budget is $ 63.5 million. They are one of the ten largest fire departments in the state of Florida, and one of the 200 largest in the world. They are the only fire department in St. Lucie County. Indian River County and Martin County have multiple fire departments. Palm Beach County has 15 to 17 departments. There is a cost savings in that regard. The fire district runs about 37,000 calls per year. They operate out of 17 fire stations, and have a Medivac at the airport. They also have special operations for confined space and hazardous materials. They’re governed by the board of fire commissioners: Commissioners Eddie Becht and Rufus Alexander from Fort Pierce, Councilmen Jack Kelly and Chris Cooper from Port St. Lucie, Commissioners Doug Coward and Chris Dzadovsky from the BOCC, and Frannie Hutchinson, who is the governor’s appointee. That board sets the policy for the Fire District. About 90% of the District’s calls are for EMS. They take between 4,000 and 4,500 fire calls per year. The Chief added that they’ve recently been seeing more fire calls than they’d like to see. Commissioner Dzadovsky commented that having a nuclear facility within the St. Lucie County boundaries means they have to be prepared for that as well, which takes additional training. Chief Parrish answered that we have 2 major thoroughfares running north and south, I-95 and the turnpike, and the only place in the state of Florida where they cross over is in St. Lucie County, so if anybody wanted to stop traffic they can stop it right there. He then showed a video presentation prepared by the IRSC Capstone students. After the video, he remarked that it was part of the students’ project, and there was no cost to the Fire District for producing the video. He continued by saying that they do a lot of public education through the Fire Prevention Bureau, including inspections and plan reviews, CPR training and more – they have a diverse program. Commissioner Dzadovsky encouraged the members to take part in the Citizens’ Fire Academy experience, and said that he’s very proud of the Fire District and everything they do. Frannie Hutchinson mentioned a side of the Fire District that many people are not aware of. At Thanksgiving time, many of the men and women devoted their Thanksgiving to delivering thousands of meals to the needy, and at the beginning of the school year they collect money and give out shoes to kids who don’t have them to start the school year. Chief Parrish added that they have cooked turkeys and delivered them for the last few years. They start cooking on Tuesday or Wednesday. This year they cooked about 300 turkeys and delivered about 1,700 meals. They are very proud of this and find it very rewarding. He added that as Ms. Hutchinson mentioned, they outfitted 100 children with shoes this year, in cooperation with the Early Learning Coalition. Commissioner Dzadovsky mentioned that Frannie Hutchinson is also a former County Commissioner. Bill Hammer asked Chief Parrish if he had a hard number or ballpark number on what the savings are on this organization countywide as opposed to separate entities. Chief Parrish said he doesn’t really like to compare the district to other fire departments because they aren’t like other fire departments. For instance, Martin County doesn’t do human resources, purchasing, finance and payroll – that’s all done through the county. The fire district does that all under its own roof. Palm Beach County has a per capita cost of about $ 460 per person, and they have 880,000 people that they protect. The St. Lucie County Fire district today is at $ 185 per person. He said, “We feel as though we are very efficient in our operation because we are a government unto ourselves. We don’t belong to the county. We don’t belong to the cities. It’s our own taxing district. And we do all of those things and we do it very efficiently and comparatively as well though I don’t like to compare.” Bill Hammer said he was thinking of transferability to other separate entities in the county such as the police and sheriff’s departments. Chief Parrish stated that he had not compared to them. Bill Hammer said it’s worth thinking about with the economy being what it is, and thanked the Chief. Commissioner Dzadovsky said he wanted to mention one thing about the Local 1377 Union that’s associated with the Fire District. Local 1377. A lot of people make statements about unions but the union members of the fire district participate in the turkey cooking, the big heart brigade and they do it as volunteers. This past summer they built two Habitat for Humanity houses. They did it of their own free will, day and night. He said a lot of this doesn’t get mentioned in the newspapers, and that he’s very proud of them. He then introduced Mark Robitaille, CEO of Martin Memorial, who had come to speak as requested. Mr. Robitaille apologized for being late due to US1 being closed with a major accident. He said Chief Parrish does great job and all should be proud of the fire-rescue team. They’re extremely professional th and certainly cost-effectively run. He said that Martin Memorial just finished celebrating their 70 year. It began as organization back in 1939. It is a private non-profit 501c3, not linked to any governmental entity. They have a couple of individuals on board of directors who volunteer their time to support the advancement and quality of health care throughout the service area. The County has never played a role in Martin Memorial’s strategic planning and delivery. He said over the last 15 to 20 years, their service to St Lucie County has increased, especially because of the growth in Port St. Lucie. He first came to Stuart in 1976 when there were about 8,000 people in Port St. Lucie. In 1979/1980 they purchased 35 acres of land at Lennard Road and US 1 and built a hospital and lost their one and only CON (Certificate Of Need) but they continue to serve the community. In the 1980s they built the first urgent care center out on Port St. Lucie Blvd. He left for 10 years, but returned in 1991 as the CEO. In 1993 was out looking for some property to replace the urgent care center and met Pete Hegener who had just come in to take over St. Lucie West Development, which became Core Communities. Pete encouraged the board to buy 24 acres at St. Lucie West and Cashmere, which they did back in 1993. Sooner or later the western part of St. Lucie County and certainly west of Port St. Lucie would need additional medical facilities including a hospital. In about the mid 1990s they built the current facility there, which is a 70,000 square foot facility that has physician offices, diagnostic services at urgent care, wellness rehab, and other services. They built on 8 of the other 16 acres set aside for a hospital in 1993/94. A few years later they acquired the practice of Physician Family Associates on Tiffany and US 1 and they became part of the Martin Memorial medical group. He stated Martin Memorial is more than a hospital; they’re an integrated health care system. In addition to operating two acute care hospitals they also operate about 12 sites with ambulatory care facilities throughout from Hobe Sound to Palm City to east Port St. Lucie, and St. Lucie West with diagnostics and rehab. About 15 years ago they began the Martin Memorial Medical group after the community spoke to them and expressed the need. Today they employ about 85 physicians in their medical group, covering specialties from primary care internal medicine to radiation oncologists to neurosurgeons. They are the only community hospital that has a trauma center that has 24/7 neurosurgeon medical coverage from Palm Beach to Melbourne. 6 to 7 years ago they decided to move ahead with their CON to build a hospital in West port St. Lucie. He added that he sits on the Executive Committee of the Economic Development Council and has had the opportunity to be involved in a lot of that development. As he saw that interest moving ahead, they made the decision to relocate that hospital site to a 20 acre site on the north side of the lake, where Torrey Pines currently has their building. They purchased 20 acres there because they felt it was where the county’s population growth was really moving. They also saw the opportunity to really partner with Torrey Pines, VGTI, and others. They have an influenza trial going on right now with Dr. Rafik-Sakkaly who’s the head of the VGTI. They do quite a bit of clinical research, and have probably done 50 to 60 clinical trials in the pharmacy area. They’ve done a lot of device trials; they work very closely with the H Lee Moffitt Cancer Center in Tampa, which is now the third largest cancer center in the country. Clinical trials have always been a part of what they do and so it really provided a great opportunity to work with the life science companies as they move in. The CON was mailed last week and took about a year and a half. They are now waiting for the 30 day window that the HCA has to make a decision whether to appeal it to the appellate court system. With financing and land and equipment it’s probably a $ 118 million project. It will be financed primarily with tax-exempt revenue bonds. It will employ initially about 400 people with an average salary of over $ 53,000. It will be a significant economic development project as well as obviously providing needed services. Knowing that it would be 3 or 4 years for the appeal process as well as the design and construction process, they heard from the community a need for additional emergency services out in the western part of the county. The state of Florida lifted their moratorium on development of what is known as freestanding emergency centers a couple of years ago. When they did that, Martin Memorial began to investigate that program and after a lot of research determined that it would be a valuable service to offer. They converted a portion of the building on St. Lucie West Blvd. from a wellness center (relocated to a building near the Mets stadium) and transformed about 9,000 square feet into the freestanding emergency center. Mr. Robitaille said it’s truly an extension of the st hospital emergency departments. It opened on September 1. They saw about 1,600 visits in the first month. In the last two months they’ve seen over 2,000 visits per month. If patients need to be admitted, Martin Memorial provides them information. If they’d like to be transported they will transport them either through Coastal Transportation, which is Martin Memorial’s internal group, or they work with one of the other services. Mr. Robitaille stated initially that they’ve only had to call the Fire District a few times, but Chief Parrish said it had been about 30 times since they’ve opened. Mr. Robitaille went on to state that the freestanding emergency center has been extremely well received by the community. The intention is to continue to operate that as a freestanding emergency center until the new hospital opens and then the plan would be to relocate that emergency center to the new hospital and then probably convert it back into urgent care, or other clinical services based on what’s needed 3 or 4 years down the road. They recently opened a new diagnostic center at their Tiffany and US1 location with state-of-the-art MRIs and CT capabilities to serve east Port St. Lucie, west th Port St. Lucie and Martin County. They are now about the 10 largest in Florida in St. Lucie County, and they have about 3,000 associates in their system, about 375 physicians on the medical staff. They are also supported by over 850 volunteers who contribute over 85,000 hours a year of service. They have been named as one of the top 100 hospitals in the country four times in the last ten years and last year named as a national employer of choice. He stated that having great associates, physicians and volunteers is really key to the culture of Martin Memorial, and that they are truly a community hospital. He said, “We don’t have stockholders, we have stakeholders and that’s the people in the community so we’re here to serve.” Commissioner Dzadovsky said he hoped they brought more jobs, and asked if any members had any questions. Bill Hammer said he wanted to thank Mr. Robitaille because Martin Memorial saved him a lot of time and money with your facility. Moffitt is partnering with Martin Memorial on some issues, MD Anderson speaks very highly of the services that they provide, and he can get his testing and periodic services needed here. He had radiation recently at your facility with their approval and it was outstanding. Tony Roach asked Mr. Robitaille if Martin Memorial monitors the cases of cancer that the hospital services. He said as in what’s happened at The Acreage, it seems that all the information that evolved out of that came as a surprise to everybody – that no one is monitoring an increase in types of cancer in the area. He stated that we are in a county that has a nuclear power plant, and that we have to make the presumption that the Nuclear Regulatory Commission monitors the nuclear power plant as well as Florida Power and Light. He asked if there was a leak that went undetected and got into the water supply, does the hospital collect information. If it sees a rise in either leukemia or some other type of cancer, does it notify the public or does it just keep that information? How do they monitor? Mark Robitaille said they have a comprehensive cancer center on the campus in Stuart and they have radiation oncology and medical oncologists at the St. Lucie West facility. They have a cancer committee that meets on a monthly basis that goes over all of the activity regarding cancer care including the prevalence of new cases. That committee puts out an annual report in which they report on the number of new cases as well as how those cases are broken up with regard to body system, like lung cancer, throat cancer, colon cancer, etc. that come in through their system. He said they report to the state but isn’t sure how they take that information and consolidate it with information from other hospitals and other practices. He said it may be on their website, but if not he’d be happy to supply that information. Tony Roach said he’d gotten into a protracted conversation with the EPA in Atlanta Georgia where his son-in-law just bought a house and they detected a high radon rate in the house and it came from the air. They also detected it in the water there. And during the course of the conversation the EPA expert asked him where he lived and when he said “Port St. Lucie” the EPA person said he was sure they regularly test because of the nuclear power plant and that if they don’t detect the leak in their cooling towers, the first sign would be in their water supply. He said he checked with all the area utilities and service districts here, found out they don’t regularly test for radon. He said that radon can cause stomach cancer if it’s consumed, but it’s mostly detrimental if it’s breathed in and is supposed to be the second leading cause of lung cancer next to smoking .He was making the presumption that our water supply was being regularly tested only to find out from St. Lucie West services district that they only test once every nine years. The EPA expert up in Atlanta was under the presumption that since we’re next to a nuclear power plant, that we were getting tested every year. It’s not mandated by the federal government. , but he says if you’re near a nuclear power plant that they would. He said the knowledge of the situation in The Acreage didn’t come from the municipality; it came from people exchanging information. No alarm bells went off on a county level or on a state level. It was an exchange of information that got to the media and then people started looking into it. Mark Robitaille said he’s not aware of any information that’s come through the cancer committee that would indicate that there’s any type of cancer that would be related to the drinking water or the power plant. Usually the health department in each county monitors things like environmental issues such as drinking water, waste management, etc. Tony Roach asked if Martin Memorial would be reporting their statistics to the health department. Mark Robitaille said they provide that information to the health department at the state. If they saw anything unusual or that had an environmental issue, they would contact the state or county health dept and let them know. Commissioner Dzadovsky said it’s difficult to track locations that could be identifying someone’s home because of HIPAA issues. Another member stated that there was a recent article in the New York Times over the last week that had to do with testing of water supplies for various dangerous things including cancer. And it was not a laudatory article. The EPA was also rated as being kind of lax for testing and doing any action. Mark Robitaille said he’d be happy to provide the annual report from the cancer committee. Craig Mundt asked about the Martin Memorial total annual budget. Mark Robitaille said this coming year it will be about 390 million. Craig Mundt asked about the source of the budget. Mark Robitaille answered that about 70% of revenues come from Medicare, about 8 or 9% from Medicaid, about 20% from commercial activity and then a scattering of others. He said they have seen their volume stay fairly stable even in this economy but they saw a significant shift from commercial to Medicare. Medicare pays hospitals, physicians and other providers significantly less than commercial so the commercial payers are really subsidizing the system. He said they don’t receive any tax dollars or any tax support directly. They do not have an HMO. They were in the insurance business back in 2000 and decided they were not very good at that. It’s hard to be a provider and an insurance company. He said they are self-insured for all of their associates but that’s a little bit different. Commissioner Dzadovsky said to Mark Robitaille that one of the debates early on when they first opened their facility was transportation from the fire district to the emergency center and how that all transpired regarding whether or not to deliver patients to your facility or another facility, and asked him to elaborate on that issue. Mark Robitaille said that patient safely is number one. He said they modeled their facility after two others, one that’s actually operated by HCA up in the panhandle, but more closely one operated for a number of years in Ocala. Health care often is very local and people deal with those situations differently in each area. He said they decided they would make sure the fire district is comfortable with the quality and level of services we provide, and so to transitioning into a process so that they would feel comfortable and their crews would be bringing patients to the centers that are appropriate. Based on what they’ve seen in the last three and a half month, there are certainly a number of patients who typically would be transported by 911 to a hospital based center who could be very easily, safely and very timely brought to their facility. He said it’s a work in progress and they continue to dialogue and work together. Chief Parrish stated that they have been working with Martin Memorial forever, and they transport to four facilities right now: Lawnwood, St. Lucie Medical, Martin Memorial, and Indian River. They also fly to St. Mary’s if they have a pediatric trauma or something of that nature, or a burn. He said that as Mark Robitaille indicated, there is a window of opportunity to open the freestanding emergency center and there were three or four previous to that, but they were in rural settings, with the closest hospital some distance away. And so for them to be transported to this freestanding emergency room and stabilize and then re-transported was an ideal situation and that’s not necessarily the situation here. He said that Mark’s team and his team are looking at this transition program and today the fire district will transport patients to the freestanding emergency room, but they’re basic life support patients that the paramedic determines won’t be admitted to the hospital, that they’re going to be able to be managed within that facility. He said they have transported about 29 patients there and have transported about the same number out to emergency. When someone calls 911, they rush them to the freestanding emergency center and then take them to Lawnwood, St. Lucie or Martin. He said he thinks they notify their physicians to see where they’d like for them to be transported. He said if they can take a patient to a facility where there records are, where they’re physicians are, they do, but if it’s an emergency situation, they are going to take the person to the closest facility. They feel as though it’s in the best interest to continue to do that at this point in time. It would be easier for the fire district to just take them to the freestanding emergency room and get back in service, but at this point in time they’ve determined to be in the best interest of the patient to transport them, if it’s a critical call, to a facility that will be able to manage the continuity of their care. Commissioner Dzadovsky asked when one is taken to emergency, if you he or she was then to be admitted and had to be transported again, who pays that cost, and would the insurance company pay that? Mark Robitaille answered that every system’s different. In their system at St. Lucie because they have Coastal Transportation as one of their affiliate corporations and they've been around for 25 years, it’s at no cost to the patient if they need to go to Martin Memorial. In St. Lucie County there was an ordinance passed a couple years ago that basically said that only the St. Lucie County EMS could transport a patient from a nursing home, somebody in residence or any facility directly to a hospital ER. If they’re going as a direct admit, Martin Memorial provides that service to them as part of their internal costs because it’s really like an internal transport. They transport patients between our two hospitals every day depending on the condition. Tony Roach asked if their billing is outsourced, or if they handle patient billing in-house. Mark Robitaille answered that they handle everything internally although they have a couple of different internal subsidiary corporations that do billings. The medical group bills as MFMIU (Medical and Financial Management, Inc.), the hospital bills as Martin Memorial Medical Center, but it’s all done under the umbrella of Martin Memorial. Tony Roach said he realizes that over 20% of Martin Memorial’s budget is bad debt, so how are their write-offs determined? Is it done by committee or is there a formula? Mark Robitaille answered that they have internal policies and it’s really a case by case situation. If they determine that somebody is qualified for charity care because of their income or other issues then they have internal guidelines based on federal poverty levels and family size and those types of thing – they would automatically write off, 100% of that bill. If they're a Martin county resident and they have no insurance, they qualify, and Martin County does have an indigent fund that they can provide if Medicaid breaks reimbursement. Martin Memorial employs three full time bilingual people who spend their entire day driving around Martin and St. Lucie County literally following up on patients in the woods, you name it, to try and make sure if someone is eligible for Medicaid or some other program that they’ll fill out the application process. If it’s an individual who technically wouldn’t be charity but because of economic circumstances, such as they lost their job, or don’t have insurance and are paying cash, Martin Memorial will substantially discount bills based on the individual situation. There are also payment plans for individuals. They realize that health care costs are not something people typically plan on. He said they hope that through the health care reform bill that more and more people will be insured, but whatever it is they are going to work with people on an individual basis. Commissioner Dzadovsky asked Chief Parrish and Mark Robitaille if they had any final remarks. Chief Parrish stated that the fire district worked with trying to have a facility established west of town. He said that he testified on behalf of having a facility out there. He stated that he believes a hospital on the west side of town is important for the community as well as for emergency services because it gets fire district personnel back in service faster so they can provide their services more quickly. Bill Hammer asked if a patient expresses a preference to go to Martin as opposed to St. Lucie, would that be honored except in a case where it’s inappropriate. Chief Parrish said if someone’s coming from Lakewood Park, no, because it takes the unit from there out of service for hours. He said they had a problem with diversion several years ago – one evening they had about seven of their units sitting at Indian River Hospital. When they’re out of the county, they’re not doing anyone any good. He said, “If you’re on Port St. Lucie blvd, we would take you to the facility where your physician was at. It’s easier for the patient. And we can manage from there.” Mark Robitaille stated that patients on the south side of Hutchinson Island come to Martin Memorial just because of the logistics of the bridges. But if someone’s living in the southern part of the city and the county it’s a matter of talking to the EMS staff, the decision’s made in the field. He said if a patient ends up in a facility but his or her physician practices at another facility, the patient certainly has the right, assuming he or she is stabilized, to indicate that he or she would like to be transferred to another hospital. They continually move patients not only between their two facilities but to St. Lucie Medical Center and Lawnwood. Bill Hammer said that the closest facility right now in an emergency room setup is the one at Cashmere for residents of The Reserve/PGA. They are curious as to if they request it and it’s appropriate whether they can go there. Chief Parrish asked if he meant in a basic life support call whether they can go to the freestanding emergency center. Bill Hammer stated yes, that was his question. Chief Parrish said that if it’s a basic life support call, yes. If they provide any advanced life support they will not take them there. Bill Hammer thanked Chief Parrish. Commissioner Dzadovsky asked for a brief explanation of the difference between basic and advanced life support. Chief Parish said if they provide any type of invasive medical care such as oxygen, IVs, giving medications, it’s an emergent situation. Commissioner Dzadovsky thanked Chief Parrish and Mark Robitaille. Mark Robitaille indicated he would leave materials on the table regarding the services Martin Memorial offers in St. Lucie County. ITEM #6 OLD BUSINESS Commissioner asked if there was any old business to discuss. There was none. ITEM #7 NEW BUSINESS Commissioner Dzadovsky asked if they’d like to prioritize future topics of discussion. The members had no new topics and Commissioner Dzadovsky said he’d work from the immediate list. He then introduced Terri Ann Palumbo, his executive aide, and Eva O’Donnell, Commissioner Chris Craft’s executive aide. Tony Roach stated that they’d had attorneys talk about foreclosures, but he would like someone from the banking industry to come in and explain how the TARP money is being handled. His homeowners association is sitting on 30 to 30-plus foreclosures for the past three years. Commissioner Dzadovsky said that was a great idea, and he has a lot of the same questions. Walter Fauth said he’d like to see a case study, taking a property from start to finish and going over what happens so everyone could really understand. He said he’s heard that in some cases one can’t even find out who owns a specific property. Commissioner Dzadovsky explained the solar energy initiative being taken on by St. Lucie County, and distributed a handout to everyone. He explained the County is trying to encourage the state legislature to create a Renewable Portfolio Standard that would offer opportunities for companies, manufacturers and local governments to get involved with renewable energy, green technology and the like. In the St. Lucie County BOCC’s case, they are trying to put together a Community Development Financial Institution (CDFI). It creates a nonprofit bank. The grant the County is seeking is for $5 million dollars, and it would provide seed money to let anyone contact the bank and borrow money for energy-saving devices such as air conditioning solar units, hot water, photovoltaics for the roofs, etc. He gave an example that someone could buy a hot water heater that’s gas or electric for about 200 or 300 dollars. The upfront cost for a solar water heater is about $5,000 fully installed. Amortized over a few years, in the example he gave over 10 years at 4% interest, plus taking into consideration a $2,000 rebate from the state or feds, the cost is broken down to about $50 a month. If you reduce your electric rate by that th same amount, literally, you are cost-neutral. But if you get into the 10 year, you actually start creating savings and income over time and as this comes out, you could actually end up creating wealth - $7,200 in the example given. He stated that his position is if we decentralize to some extent utility costs or the production thereof, we can then foresee the utility companies to start reducing their rates. If we had 25,000 homes with solar photovoltaics on their roofs creating their own energy and also providing energy to the grid, sooner or later that will have a huge effect on the grid and power companies will have to start managing what our requests are, our demands of lower utility costs. That's a long way off but this is really just away to help us start to give people a chance to purchase solar products or energy- efficient products that will reduce electric bills. He said that for the house that he’s renovating, to put the largest residential unit on his home was going to cost $50,000. That would produce 5,000 kilowatts and ultimately he’d be putting more energy into the grid than he’d be using. After the rebates, from the state and federal, his total out of pocket cost would be only 17,000 dollars. And based on the house’s previous owner’s electric bills, they were five to six hundred dollars. Based on whatever energy saving devices he puts in, he expects his projected bill to be 100 dollars a month, for a 500 dollar a month savings. He provided a copy of an editorial from the St. Lucie Tribune as well as a sample letter addressed to Commission Chair Grande, and asked the members to tailor it however they’d like if they are in support of the initiative, and to submit the letters to Commissioner Grande by the end of the week if possible. The initial grant is 5 million dollar and over a period of 2 to 3 years we would expect to be able to accommodate in the short term 60 to 75 applicants for their solar or other energy saving products with those loans. In that period of time we would then be able to set up the community development financial institutions, the nonprofit bank, which would then be able to attract 3 to 1 match. He stated that he’d had dozens of conversations with bankers and they are all in support of this. They’re not willing to give up a million dollars apiece right this second but they’re giving letters of support saying as this develops, they would be interested in supporting at a 3 to 1 So the County is able to achieve this 5 million dollar grant and capitalize at 15 million, they expect within 5 years to be able to loan money out to manufacturing companies, green technology businesses, and the like to come into the county, so it’s also a jobs -creating opportunity. We have the green collar task force that we are now starting to begin to prepare for, and the green collar training apprentice program to get people who are in the building trades to be able to understand and know how to deal with these new technologies and be prepared on the education side when this manufacturing base comes in these new products come out. The meeting was then adjourned. Respectfully submitted by Terri Ann Palumbo, Executive Aide to Commissioner Dzadovsky