HomeMy WebLinkAboutHandouts_Regular_Tab 06 _05/09/2013 `�FPAkJ
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°�� � o State of Florida Govemor
T Department of Children and Famities
"� David E. WeIlcFns
y � !° �� �t _ �� ���� Sec�etary
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MYFLFAMI LI ES. COM
Dennis Miles
Region8l Managing
Direcbr
To Whom It May Concem:
On May 8, 2093, the Department of Children and Families, Substance Abuse and Mentai Heaffih Program
Office reviewed the proposed amendment to the Vii{age of Tequesta's Oi�dinance Nc. 1-11.
The new language is as follows:
RPhabilita#i�n fa_r.ilitv means a nrivat� State of Florida licensed acil'ttv that nrovid
rehabiii care for natients who are eiahteen ve�rs�f aae or old The nrimarv
-.
oirno�s of a rehabilitation facilitv is to flrovid�, treatment for dr�� and � alc�hol addction
and eatina disorders: how�r. the rehabilit ian fac�litv m�st t� a dt!al diaanectic facilitv
staffed and ea�inoed to orovide treatment for co-occurrina di orders. Rehabiiitation
faalities mav also nrovide oroarams that oromote health. wellness and averal! lifestvle
enhanc for their residerits Rehabilitation facilities must �rovide a stn,du
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rpcirlon4i�1 livinn eanvi�nnmonf whirh inrJiir�� the fQllowina feat�res: 24ho�r an-site
secu 24-hour natierrt suc�ervision bv lic�nspd nursina staffi: ans !_a u a li tv of life services
�e��r.h as auuimmi�a pppls. harcien arPac Annrt-rnurtc r�xferiOr pa ios O� S►ttlha 9feaS_
ca mmunibr livina areas. m�ditation areas, fitn�ss r�ms. libraries. recreation ronms.
televisions. on-site food o naration_ and telenhane and intemet�cice_ Rehabilitation
facititi�� m�st urovide short-term c-�r� tr�atmertt and e�ctended care treatment. and mav
also nrovide Outnatlent Servlces and follow-uQ treatm Rehabilitation fa cilities s hall
not offer anv services for individuals_►erith a historv of viol behavior or threats to the
�ublic health safetv and welfare or the health. safetv and wetfare of �ther o�tients. The
followina definiti�ns aonl�c� ths �efir►ition of�eh�ilitatian fac' "��
OuEnadertt servicas mean�, s level of�rvlce. includina outnatlent in�enaive
R�.+�+s+�o.±� �.±.� dav/nieh+ �i+_as_�tmnn+ �rvic� or dav/niaht with cemmunitv
houslna treatrnent services. nrovided to the �a6abllitatio_n_facllltv's uatients.
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O�u natient services orovided t� oatlents residie� �ut�side the rehabilltation
facilifir shail be limited to oatlents �erho have comnl�ted the short-tenn nroara�l
-- - - ___
at the rehabilitatlon facilitv and�ltsll not account for m ve oe nt
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1�i61 of �e rahabilltiNon facilitv's oatient clienteie.
If the V'illage of Tequesta approves Or�dinance No. 1-11 as stated abvve, the Departrner�t of Children and
Families wiU be able to issue Futures of the Patm Beaches licenses to provide Outpatient, Intensive
Outpatient and Day or Night with Community Housing licenses.
S-�r-i3
Southeast Region - Circuit 15 � / „
111 South Sapodilla Avenue, West Palm Beach, FL 33401 �X
Mission: Protect the Vulnerable, Promote SVong and Economically Self-Sufficient Famities, and
Advance Personal and Family Recovery and Resiliency �n,��-�- -
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c�al ���c�+ -��mE
ORDINANCE NO. 1-11
AN ORDINANCE OF THE VILLAGE COUNCIL OF THE VILLAGE OF
TEQUESTA, FLORIDA, AMENDING THE VILLAGE CODE OF
ORDINANCES AT CHAPTER 78. ZONING. AT ARTICLE I. IN
GENERAL. SEC. 78-4. DEFINITIONS. BY CREATING AN ENTIRELY
NEW DEFINITION FOR "REHABILITATION FACILITY" AND BY
AMENDING THE DEFINITION OF "RESIDENTIAL USE"; AT ARTICLE
VI. SCHEDULE OF DISTRICT REGULATIONS. SEC. 78-180 MU MIXED
USE DISTRICT. BY ADDING "REHABILITATION FACILITIES" AS A
SPECIAL EXCEPTION USE, BY CREATING CONDITIONS TO BE MET
BY ALL REHABILITATION FACILITIES AND BY LIMITING THE
DENSITY FOR SUCH SPECIAL EXCEPTION USE TO 8 UNITS PER
ACRE; AND AT ARTICLE X. OFF-STREET AND ON-STREET PARKING
AND LOADING REGULATIONS. BY ADDING "REHABILITATION
FACILITIES" AS A CATEGORY AND REQUIRING REHABILITATION
FACILITIES TO PROVIDE ONE OFF STREET PARKING SPACE PER
PATIENT BED; PROVIDING THAT EACH AND EVERY OTHER
SECTION AND SUBSECTION OF CHAPTER 78. SHALL REMAIN IN
FULL FORCE AND EFFECT AS PREVIOUSLY ADOPTED; PROVIDING
A CONFLICTS CLAUSE, A SEVERABILITY CLAUSE AND AUTHORITY
TO CODIFY; PROVIDING AN EFFECTIVE DATE; AND FOR OTHER
PURPOSES.
WHEREAS, the Village of Tequesta has received a privately initiated application
from GMH Tequesta Holdings, LLC to amend the Village's zoning code text to allow
rehabilitation facilities as a special exception use in the MU Mixed use zoning district;
and
WHEREAS, said application provides a definition for "rehabilitation facility" as
well as density restrictions, parking requirements and other conditions of approval that
all rehabilitation facilities would have to meet in order to receive approval to operate
from the Village Council; and
WHEREAS, the applicant has previously advertised and held a public "town hall"
meeting to discuss with the citizens of the Village its intentions to operate a
rehabilitation facility in the MU Mixed use zoning district; and
WHEREAS, the applicant has met with Village staff on numerous occasions in
order to prepare its application in a manner that will serve not only its own purposes, but
also those of the Village ;and
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WHEREAS, the applicant has previously met with the Village Council in a
publicly noticed workshop meeting to further discuss and refine its application; and
WHEREAS, the applicant has taken into account all the input obtained at all the
aforesaid meetings and workshops, resulting in the zoning code text amendments as
set forth herein, which the Village Council believes will be in the best interests of the
Village of Tequesta, and will promote the public health, safety and welfare.
NOW, THEREFORE, BE IT ORDAINED BY THE VILLAGE COUNCIL OF THE
VILLAGE OF TEQUESTA, PALM BEACH COUNTY, FLORIDA, AS FOLLOWS:
Section 1: Chapter 78. Zoning. of the Code of Ordinances of the Village of
Tequesta is hereby amended at Article I. In General. Sec. 78-4. Definitions. by creating
an entirely new definition for "Rehabilitation facility" to be inserted alphabetically into the
existing list of definitions, and by amending the existing definition of "Residential use";
providing that these definitions shall hereafter read as follows:
Section 78-4. Definitions
Rehabilitation facilitv means a arivate State of Florida licensed facilitv that provides
rehabilitation care for natients who are eiahteen vears of aae or older. The qrimarv
purpose of a rehabilitation facilitv is to provide treatment for drua and alcohol addiction
and eatina disorders: however. the rehabilitation facilitv must be a dual diaqnostic
facilit staffed and eauipped to provide treatment for co-occurrina disorders.
Rehabilitation facilities mav also arovide oroarams that promote health. wellness and
overall lifestvle enhancements for their residents. Rehabilitation facilities must provide a
structured residential livina environment which includes the followina features: 24-hour
on-site securitv: 24-hour patient supervision bv licensed nursina staff: and aualitv of life
services such as swimmina qools. aarden areas. sqort-courts, exterior patios or sittina
areas, communitv livina areas. meditation areas, fitness rooms. libraries, recreation
rooms televisions. on-site food nreqaration, and telephone and internet service.
Rehabilitation facilities must arovide short-term care treatment and extended care
� treatment. and may also provide Outpatient Services and follow-up treatment.
Rehabilitation facilities shall not offer anv services for individuals with a historv of violent
behavior or threats to the qublic health. safetv and welfare or the health, safetv and
welfare of other aatients. The followina definitions applv to the definition of rehabilitation
facilitv:
1. Rehabilitation care means diaanosis and treatment for drua and alcohol
addiction disorders. eatina disorders and phvsical. behavioral. mental or
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emotional issues that are directiv attributed to those disorders. Rehabilitation
care does not include emeraencv or medical detoxification. which is
s ecificallv considered a qrohibited use. Should a rehabilitation facilitv patient
re uire emeraencv or medical detoxification. this must be comoleted at an off-
site facilitv prior to beainnina rehabilitation care.
2. Private means nrivatelv owned and funded with no use of state or federal
includin Medicare or Medicaid) funds for the operation of the facilitv. the
treatment of qatients. or research work that would reauire the acceptance and
treatment of federallv or state funded aatients. Private also means that the
rehabilitation facilitv mav accept funds from third partv insurance companies
as an out-of-network provider; provided, however, the rehabilitation facility
shall not acceat health insurance funds
provided by or arranqed by a health maintenance orqanization.
3. Short-term care means a nroaram desiqned for a minimum residential stav of
30 calendar davs.
4. Extended care treatment means an additional 30 to 60 calendar dav stav in
residential treatment after comaletina the initial short-term care residential
treatment aropram.
S. Outpatient services means a level of service, includinq outpatient, intensive
outpatient and dav/niqht treatment services or day/niqht with communitv
housinq treatment services, provided to the rehabilitation facility's patients.
Outpatient services provided to patients residinq outside the rehabilitation
facility shall be limited to patients who have completed the short-term
proq at the rehabilitation facility and shall not account for more than five
percent (5%) of the rehabilitation facility's patient clientele.
�.6. Follow-up treatment means a aroaram desianed for an additional one
week stav in residential treatment. subseauent to the qrevious comqletion of
the short-term care or extended care treatment proaram. and must occur at
the same facilitv where short-term care or extended care treatment was
received. Follow-uq treatment is for those patients who need additional
structured follow-uq treatment that does not reauire the clinical intensitv of the
short term or extended care treatment proaram. Follow-up treatment shall not
account for more than ten percent (10%1 of the Rehabilitation Facilitv's aatient
clientele. Follow-un care can also be in the form of electronic
correspondence or tele-conferencina. and in such cases has no limit or
restrictions reaardina the duration of the care. the location of the treatment or
the number of qarticiaatina patients.
� ;>.7._ Emeraencv or medical detoxification means the elimination of toxins such
as alcohol or controlled substances from the bodv of individuals who reauire
acute care and/or mav have serious health risks as a result of their substance
abuse. Medical or emeraencv detoxification is performed under the direct
supervision of inedical doctors and medical suqport staff. and mav include the
administration of inedication or tranauilizers in order to ease the withdrawal
ro�
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Residential use means use of land or structures thereon, or a portion thereof, as a
dwelling place for one or more families or households, i cludina residential rehabilitation
facilities in the MU mixed-use district but not otherwise including occupancy of a
transient nature such as hotels, motels, or timesharing rentals.
Section 2: Chapter 78. Zoning. of the Code of Ordinances of the Village of
Tequesta is hereby amended at Article VI. Schedule of District Regulations. Sec. 78-
180. MU mixed use district. by adding "rehabilitation facilities" as a special exception
use, by creating conditions to be met by all rehabilitation facilities, and by limiting the
density for such special exception use to 10 units per acre; providing that Sec. 78-180
shall hereafter read as follows:
Sec. 78-180. MU mixed-use district.
(a) Purpose. [This paragraph shall remain in full force and effect as previously
enacted.]
(b) Applicability of development regulations to mixed-use developmenf. [This
paragraph shall remain in full force and effect as previously enacted.]
(c) Conflicts with other regulations. [This paragraph shall remain in full force and effect
as previously enacted.]
(d) General requirements and special regulations. The following general requirements
and special regulations shall apply to planned mixed-use development within the mixed-
use district:
(1) Location. [This paragraph shall remain in full force and effect as previously
enacted.]
(2) Configuration of site. [This paragraph shall remain in full force and effect as
previously enacted.]
(3) Unity of title. [This paragraph shall remain in full force and effect as
previously enacted.]
(4) Density. For the purpose of this section, if dwelling units are to be
developed as part of a proposed development within the mixed-use district, the
total number of dwelling units permitted in the mixed-use district shall be
computed on the basis of 18 dwelling units per gross acre for all residential uses,
with the followina excentions: e�se�ie+��# ACLFs�v#isk� shall be computed on
the basis of 24 dwelling units per gross acre; and rehabilitation .facilities shall be
com u ed on the basis of 8 dwellina units aer aross acre.
(5) Building height. [This paragraph shall remain in full force and effect as
previously enacted.]
(e) Site plan review. [This paragraph shall remain in full force and effect as previously
enacted.]
(f) Urban design principles. [This paragraph shall remain in full force and effect as
previously enacted.]
(g) Urban design objectives. [This paragraph shall remain in full force and effect as
previously enacted.]
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(h) Permitted uses. [This paragraph shall remain in full force and effect as previously
enacted.]
(i) Specia! exception uses. Special exception uses in the mixed-use district are as
follows:
(1) -(15) [These paragraphs shall remain in full force and effect as previously
enacted.]
16) Rehabilitation facilities. subiect to the followina conditions:
a. Rehabilitation facilities shall be prohibited from beina located within
a one half mile radius of another rehabilitation facilitv.
b. Ninetv percent of the dwellina r°°��'°^+�°' '�.,�^^ units shall have a
minimum of 575 sauare feet. The remainina ten nercent of the dwellina
�u+►�e units mav �a�44 have a minimum of 500 sauare feet.
c. A maximum of fortv percent (40%1 of the dwellina units shall be
permitted to have finro (21 bedrooms. In no case shall a dwellina unit have
mor than two (21 bedrooms. Two (21 bedroom dwellina units shall have a
minimum of 750 sauare feet.
d. Occunant load for individuals receivina treatment shall not exceed
the number of bedrooms. Bedrooms and studio dwellina units shall be for
sinale occuaancv onlv. Overall densitv fo� a rehabilitation facilitv shall not
exceed eiaht (8) dwellina units aer aross acre.
e. Dwellina units shall be confiaured as follows:
1. Studio units. if provided. shall have a one �11 combination
bedroom/livina area/ kitchen. and a orivate bathroom.
2. One-bedroom units. if provided. shall have one (11 qrivate
bedroom. one (1) orivate bathroom. nrivate livina areas and a
private kitchen.
3. Two-bedroom units. if provided, shall have two (21 orivate
bedrooms. finro (2) private bathrooms. common livina areas and a
common kitchen.
f. Dwellina units shall not have seqarate individual mailina addresses.
Rather, the rehabilitation facilitv shall maintain one master address which
all residents shall reside under durina their stav at the. rehabilitation facilitv.
Rehabilitation facilities must be eauiaaed with a controlled saace
effectivelv screened from public view. for arrivals and departures of
patients. This snace shall be larae enouah to accommodate an
ambulance for transnortina oatients in and out of the facilitv.
h. Rehabilitation facilities shall be surrounded on all sides bv a fence
or wall located as close to the nroaertv lines as is practical. The fence or
wall shall be a minimum of six (61 feet in heiaht but mav be as hiah as ten
101 feet. measured from finished arade. in order to ensure privacv for
both rehabilitation facilitv oatients and for Villaae residents. The fence or
wall shall be constructed in such a manner as to comaliment and
accentuate the princiaal structures of the rehabilitation facilitv. Both the
interior and exterior sides of the fence or wall shall be landscaped in
accordance with the nrincinles set forth at Sec. 22-84 of the Villaae Code
of Ordinances. If a fence. wall or hedae is located on a corner lot or a
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double frontaae lot. a vehicular and pedestrian visibilitv trianale of a size
and dimension which comnlies with current traffic enaineerina standards
of the American Association of State Hiahwav and Transportation Officials
AASHTO) and the countv shall be provided in both directions from the
intersection point of the nropertv lines.
i. The rehabilitation facilitv shall include a backua aenerator svstem.
The s stem shall be sized for the buildina occupancv load and have a fuel
source sufficient to ooerate the facilitv for a minimum of seven davs.
i. The rehabilitation facilitv shall bv seaarate aareement auarantee
navment to the nrimarv fire rescue arovider for patient ambulance
transnort service.
k. In coniunction with the aaplication for saecial exceation use. the
rehabilitation facilitv shall submit a securitv alan that includes aatient off-
site visits. The securitv alan shall be aaaroved bv the Villaae Council with
input from the Chief of Police.
I. The rehabilitation facilitv shall submit auarterlv reqorts to the
Villa e's Communitv Develonment Director that establish and document
comaliance with all rehabilitation facilitv fundina and occuaancv
reauirements and restrictions.
m. In coniunction with the aaplication for sqecial exceation use. the
Villaae mav. at its discretion. secure an imaact analvsis studv. qerFormed
bv an indenendent entitv. detailina the proaosed rehabilitation facilitv's
proiected communitv wide imqacts. This studv. if qreaared. shall
s ecificallv address the rehabilitation facilitv's potential economic imqact
to the Villaae. the creation and continuation of iobs. the potential imaact
on law enforcement and criminal activitv. and the potential imnact on the
Villaae's emeraencv medical resources. In addition. the studv should
address the aroposed rehabilitation facilitv's imaact on the aualitv of life for
nei hborina aroaerties and the Villaae as a whole.
n. In coniunction with the aaalication for a business tax receipt and the
annual renewal thereof. a rehabilitation facilitv shall submit to the Villaae.
in the form of a sworn affidavit bv the rehabilitation facilitv's leaal
representative who is authorized to do so, written documentation that the
rehabilitation facilitv is in compliance with all reauirements of this secti n
as well as the definitional reauirements of Sec. 78-4. Should the
rehabilitation facilitv's business tax receiat be issued based uaon a false
affidavit. the Villaae mav seek to imaose all qenalties allowed bv law.
pursuant to Chapter 70. Article II of the Villaqe Code of Ordinances.
o. Should the rehabilitation facilitv at anv time violate anv of the
reauirements of this section or anv of the definitional reauirements of Sec.
78-4. the Villaae mav obtain relief throuah the code enforcement special
maqistrate process nursuant to Chaater 2. Article IV of the Villaae Code of
Ordinances. For nurposes of the code enforcement snecial maaistrate
process. each dav that the rehabilitation facilitv is found to be in violation
shall be considered a se�arate offense. In addition to the code
enforcement snecial maaistrate process. the Villaae mav seek anv and all
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relief available to it bv law or in eauitv. includina. but not limited to
iniunctive relief. recoverv of monev damaaes. or both.
(j) Accessory uses. [This paragraph shall remain in full force and effect as previously
enacted.]
(k) Planned mixed-use development required. [This paragraph shall remain in full force
and effect as previously enacted.]
(I) Prohibited uses. [This paragraph shall remain in full force and effect as previously
enacted.]
(m) Property development standards. [This paragraph shall remain in full force and
effect as previously enacted.]
Section 3: Chapter 78. Zoning. of the Code of Ordinances of the Village of
Tequesta is hereby amended at Article X. Off-Street and On-Street Parking and Loading
Regulations. Sec. 78-705. Required number of parking spaces. by adding "rehabilitation
facilities" as a category and requiring rehabilitation facilities to provide one parking
space per patient bed; providing that Sec. 78-705 shall hereafter read as follows:
Sec. 78-705. Required number of parking spaces.
(1) -(32) [These paragraphs shall remain in full force and effect as previously enacted.]
33) Rehabilitation facilities: One space per patient bed.
Section 4: Each and every other section and subsection of Chapter 78.
Zoning, shall remain in full force and effect as previously enacted.
Section 5: All Ordinances or parts of Ordinances in conflict herewith be and
the same are hereby repealed.
Section 6: Should any Section or provision of this Ordinance or any portion
thereof, any paragraph, sentence or word be declared by a Court of competent
jurisdiction to be invalid, such decision shall not affect the validity of the remainder of
this Ordinance.
Section 7: Specific authority is hereby granted to codify this Ordinance.
Section 8: This Ordinance shall become effective immediately upon passage.
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Presentation For The Village of Tequesta
H EALTH I NSU RANCE �� ���� ���� �'°�"� ����
M ay 9t", 2013
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Objective:
• Futures of Palm Beach ("Futures")wants to compete on an equal footing with other high-end drug and alcohol
and eating disorder programs in the United States by accepting health insurance to help patients offset a portion of
� their patient services fee while continuing to comply with all aspects of Ordinance No. 1-11 as it stands today
, Why•
• High-end rehabilitation facilities, like Futures, have adjusted their business models to accept third party insurance
funds
• Patients entering high-end rehabilitation facilities are more inclined in today's economic environment to use their
health insurance to offset a portion of the cost of treatment
• A significant number of potential patients have chosen competing rehabilitation facilities due to our inability to
accept insurance
• Futures needs to be able to accept third party health insurance in order to operate a robust business model and
to maintain a high-level program offering
Actions Needed to Achieve Obiective:
• Work with the Village of Tequesta to amend the text of Ordinance No. 1-11 in the following manner:
A) Amend language to allow Futures to accept third party billing for patient care with strict limitations
B) Add language to allow Futures to provide outpatient services on a limited and qualified basis
• Work with the Florida Department of Children and Families ("DCF") to obtain additional outpatient services � _
licenses to be used solely for billing purposes
I�� � �� � � � .��:
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Key Points:
• A significant percentage of patients have the financial ability to pay the full patient services fee, but desire to
offset a portion of this financial burden with their existing health insurance, similar to their current billing process
with regular doctor visits, hospital stays and prescription drugs
•The patient services fee will remain at a level that classifies Futures as a high-end program and facility. The
balance of the fee that is not covered by health insurance will remain the responsibility of the patient
• Cathy Claud, former Substance Abuse Service Coordinator for DCF of Southeastern Florida, has agreed to consult
for Futures to assist in obtaining the required DCF licenses. She will assure the Village of Tequesta that the G
additional Outpatient Services licenses are needed strictly for billing purposes to health insurance providers for
patients who have contracted for a minimum 30-day stay in Futures' residential treatment program
■ By continuing to require a minimum 30-day stay for all patients, Futures' proposal provides the Village of
Tequesta with protection against creating a transient environment
• Accepting third party insurance, as proposed by Futures,will not adversely affect the residents of the Village of
Tequesta
■ Utilization of health insurance does not reflect the character of a patient
■ Prohibiting Futures from accepting State or Federally funded insurance programs and Health
Maintenance Organizations (HMO) will prevent lower cost insurance programs from participating
��utur�es' �rc��osal �or �i�e �i � �a�e o� �°e� �����
Proposed Solution: Amend Ordinance No. 1-11 in three areas of Section 78-4. Definitions
Amendment#1: Add language in the Opening Paragraph of Section 78-4. Definitions to allow a rehabilitation facility to
provide Outpatient Services
Amendment#2: Amend language in Subparagraph 2 of Section 78-4. Definitions to allow a rehabilitation facility to
accept third party billing for patient care and therefore accept third party health insurance. Add language to further
qualify the types of third party health insurance that are not permitted for acceptance by a rehabilitation facility to include
HMO insurance plans
Amendment#3: Add a new Subparagraph 5 of Section 78-4. Definitions to further define Outpatient Services as added in
Amendment#1. This amendment will define the three levels of Outpatient Services (outpatient, intensive outpatient,
day/night treatment services or day/night with community housing treatment services), and significantly limit the number
of patients residing outside of the rehabilitation facility that a rehabilitation facility can treat at any given time to:
■ A) Only patients who have completed a 30-day residential treatment program at the rehabilitation facility
where Outpatient Services are rendered
■ B) Five percent (5%) of the rehabilitation facility's patient clientele for patients residing outside the
rehabilitation facility
,<
Services Provided to Patients Livina Outside Futures
Proposed Amendment Language = Three Patient Maximum
� Futures' Promise to the Village = No Patients
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Amendment#1 &Amendment#3 IOutpatient Services)
Section 78-4. Definitions
� , Rehabilitation facility means a private State of Florida licensed facility that provides rehabilitation care for patients who are
eighteen years of age or older. The primary purpose of a rehabilitation facility is to provide treatment for drug and alcohol
addiction and eating disorders; however, the rehabilitation facility must be a dual diagnostic facility staffed and equipped
' to provide treatment for co-occurring disorders. Rehabilitation facilities may also provide programs that promote health,
wellness and overall lifestyle enhancements for their residents. Rehabilitation facilities must provide a structured
residential living environment which includes the following features: 24-hour on-site security; 24-hour patient supervision
by licensed nursing staff; and quality of life services such as swimming pools, garden areas, sport-courts, exterior patios or
sitting areas, community living areas, meditation areas, fitness rooms, libraries, recreation rooms, televisions, on-site food
preparation, and telephone and internet service. Rehabilitation facilities must provide short-term care treatment and
extended care treatment, and may also provide Outpatient Services and follow-up treatment. Rehabilitation facilities shall
not offer any services for individuals with a history of violent behavior or threats to the public health, safety and welfare or
the health, safety and welfare of other patients. The following definitions apply to the definition of rehabilitation facility:
Amendment #1:
Insert language in the definition of
rehabilitation facility to allow for such
facility to provide Outpatient Services
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- Amendment#1 & Amendment#3 (Outpatient Services) NOTE: °Short-term° is defined as a 30-day minimum stay ``
in Ordinance No. 1-11
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Section 78-4. Definitions +
i,
��
i.
5. Outpatient Services means a level of service, in u patient, intensive outpatient and day/night treatment services �
or day/night with community ho ' a ment services, provided to the rehabilitation facility's patients. Outpatient
� Services provid ients residing outside the rehabilitation facility shall be limited to patients who have completed
� the short-term program at the rehabilitation facility and shall not account for more than five percent (5%) of the
rehabilitation facility's patient clientele.
Amendment #3: Insert language as new Subparagraph 5 to further define Outpatient Services as added in Amendment#1. This
amendment provides protection to the Village of Tequesta by addressing the concern of permitting a transient environment.
Amendment#3 will drastically limit the number of patients residing outside the rehabilitation facility that a rehabilitation
facility can treat at any given time by:
A) Limiting the services for patients residing outside the rehabilitation facility to those who have completed a minimum 30-day
residential treatment program at the rehabilitation facility where Outpatient Services are rendered
B) Limiting the services to 5%of the rehabilitation facility's patient clientele for patients residing outside the rehabilitation facility
(At maximum capacity,this would only be three Outpatient Service patients residing outside of the facility at any given time,and
limited only to patients who have completed the 30-day program)
Futures will not provide Outpatient Services to patients residing outside the rehabilitation facility. Futures requires the licenses for such Outpatient
Services solely to bill health insurance providers for patients residing at the rehabilitation facility who are participating in the 30-day treatment plan
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Amendment#2
Section 78-4. Definitions
Private means privately owned and funded with no use of state or federal (including Medicare or Medicaid) funds for the
operation of the facility, the treatment of patients, or research work that would require the acceptance and treatment of
federally or state funded patients. Private also means that the rehabilitation facility may accept funds from third party
insurance companies as an out-of-network provider; provided, however, the rehabilitation facility shall not accept health
insurance funds provided by or arranged by a health maintenance organization.
Amendment #2: Remove language from Subparagraph 2 to allow
third party billing for patient care. Add language to allow for the
acceptance of third party insurance and further qualify the types
of third party health insurance which are not permitted for
acceptance by a rehabilitation facility to include health
maintenance organization insurance policies
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Health insurance providers reimburse patients after taking into account their level of inedical needs based upon periodic
reviews conducted throughout their 30-day stay
There are various levels of services that can be offered within this field:
• Residential Substance Abuse Treatment Services (Levels II & IV) _ _ _ __� .
- • Residential Substance Abuse Treatment Services (Level I, III & V)
• PHP — Partial Hospitalization Program (Day/Night Treatment Services or Day/Night with Community Housing: ,
Clinical Services) �
• IOP— Intensive Outpatient I
• OP —Outpatient Services
• Intervention
• Prevention
• Aftercare Services
• Methadone Outpatient Treatment Services
NOTE: Futures is currently licensed for the services outlined in blue. Futures needs to obtain the licenses outlined in red in order to bill the patient's
_ health insurance providers. Those licenses not outlined are of no significance to the operations of Futures nor to the health insurance initiative _ .
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Futures Daily Rate Schedule 30-Day Rates
Residential Substance Abuse Treatment Services $2,150/day ��
30-day residential treatment program �
(Includes 30-day treatment in a 2 bedroom unit)
Outpatient Substance Abuse Treatment Services
Day/night treatment services or day/night with community housing treatment services $1,450/day
Intensive outpatient $995/day
Outpatient $350/day
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*Note: Futures requires a minimum 30-day stay for all patients.The rates are quoted as daily rates strictly for insurance reimbursement purposes �
*Note:The patient services agreement will be based on the 30-day residential treatment program rate of$2,150/day.The patient is responsible for
$64,500 for the 30-day stay.The daily rates in this schedule are the rates that will be billed to the patient's health insurance provider depending on the
utilization review of the patient by the insurance provider throughout the 30-day stay
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Example: �
Patient Service Fee Agreement $2,150/ Day Residential Treatment (2 Bedroom) �
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Patient is responsible for all costs not covered by insurance
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Scenario: A patient is admitted and through the third party insurance company's review they are approved for 7 days of
residential treatment, 10 days of PHP, 5 days of IOP and 5 days of OP. Futures can only bill the insurance company
according to those codes and must be licensed to do so
Insurance companies dictate and approve the level of treatment type a rehabilitation facility can provide to a patient for ��
reimbursement purposes. The insurance company may approve three days of residential treatment for one patient and 10
days of residential treatment for another patient. Futures can only bill for the level of treatment dictated by the insurance
� company, and Futures must be licensed to provide such levels of care. Futures is currently not licensed for lower levels of �
Outpatient Service, therefore, cannot bill for such services
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Futures mission is to provide Cost of Residential
the highest level of treatment
Treatment 30-Day $64,500 $64,500
available to the greatest
number of atients, reducin Insurance Support for Days $0 $11,092
p g 1—7 RTC
relapses and improving lives.
Conveying our mission does Insurance Support for Days
not always eliminate the 8- 17 PHP $0 $12,458
economic impact of
treatment on the patient's Insurance Support for Days $0 $4,975
decision as highlighted here 18—22 IOP
Insurance Support for Days
23—27 OP $0 $1,750
Total Support from
Insurance $0 $30,275
Balance Due from Patient $64,500 $34,225
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. . - .
Cost of Residential
Futures has identified the Treatment 30-Day $64,500 $64,500 $64,500
need to include insurance
support into our business Insurance Support for �2
model, without disrupting our Days 1—7 RTC $o $11,�O�erd,�.�ert $11,092
model for clinical treatment 2
or service standards Insurance Support for $0 $12,458 er�5#1&$12,458
Days 8— 17 PHP P�end'n`
Insurance Support for #1
Days 18—22 IOP 0 4,�erd�erts 4,
975
P �2
Insurance Support for S�1&
Days 23—27 OP $0 $1,PCOer��en� $1,750
Total Support from
Insurance $0 $30,275 $30,275
Balance Due from
Patient $64,500 $34,225 $34,225
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Important point to note: Futures will alwavs -_
------__._
'� provide the highest level of residential � ______ Residential Treatment
substance abuse treatment services to our _
patients throughout their 30-day stay. We will U �—av�Night Treatment '� �
not reduce our level of service regardless of the 0 "*Ansive Outpatient Treatment
level of insurance reimbursement. Futures — ��^-----__
� OUtpatient Treatment
wishes to obtain the outpatient licenses (PHP, >
IOP and OP) for insurance billing purposes only. J _ _
= pat e ts elsidog uts de ofthe l eha�bil tat on 1 z 3 4 5 6 � $ 9 10111z131415 - --1 �t-_.�_ .
facility. Cathy Claud, our consultant, is willing �Level ofCare Provided 16171819202122 z3 Z4 25 26 z7
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28 z9 30
to speak with a representative from the Village �e�ei ofca�e s�uea fo�m5�ran�e �
of Tequesta to explain this is a customary Length of Stay ��
practice in dealing with health insurance
providers
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- . � . . . . .
Allow Insurance Help Success of Quality of Patients • Futures Policies & Procedures
Business • Risk Management Plan
• 24 Hour Care
Common Industry • 32 facility security cameras/24 Hour Surveillance
Practice • Maintain "high-end" level pricing
• Prohibit Federal/State/HMO/In-Network
Allow Outpatient Solely to Accept Transient • MOST IMPORTANT: Futures will not market and
Services Insurance Environment will not treat patients residing outside of the
rehabilitation facility
• Maximum exposure of three patients not living at
facility; all of which must have completed a
minimum 30-day stay
• All patients continually drug-tested throughout
treatment
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= Futures will NOT market and Limiting Restrictions:
will NOT treat patients - 5% of Total Patients (Maximum
residing outside of the V���p pe of 3 Patients)
rehabilitation facility - Patients must have completed a
Limit Outpatient minimum 30-dayStay
Exposure
Insurance DCF
Requires Requires
Licensing for Outpatient for
Billing licensing
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