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HomeMy WebLinkAboutHandouts_Regular_Tab 06 _05/09/2013 `�FPAkJ O �F �` �,, afck Scott °�� � o State of Florida Govemor T Department of Children and Famities "� David E. WeIlcFns y � !° �� �t _ �� ���� Sec�etary h R �R' Cl 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 -_ - - - - - - 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. --- - 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 _— ___ -- - 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,��-�- - i � W r� 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 1 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 2 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� 3 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.] 4 (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 5 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 6 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. � � ��� �l i ��\�/��\ i�� ����� `�� � /1 ! i =�� �� � �I_ _ ii , � 1 �:— ����/1 � ����� ,,� � ,,� �, _ . , . ,. - Presentation For The Village of Tequesta H EALTH I NSU RANCE �� ���� ���� �'°�"� ���� M ay 9t", 2013 ��� � �� � ����y� 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�� � �� � � � .��: 1 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 � � � � � �' ��� �'��` ���'��QSa � °�fJl� ��'1e �I � �a��' O� �e� ��'��:� �� _ 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 ���� ���� �����sa � �or trne �`i � i��e o�� .i-e�� �� �,��� - Amendment#1 & Amendment#3 (Outpatient Services) NOTE: °Short-term° is defined as a 30-day minimum stay `` in Ordinance No. 1-11 F- 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 �:`� ��� � ����.� ���-�� .��osa � �=or t�� �'i � �age of �e �- �.M�� � � �: � 4� �� �� `� s.A�' 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 ���� u����n �� � �������'� ����►�� ���� l�tilizin;� �e� l�� � ���� �� ����� 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 _ . ;� � • ��� u�i�� � � P������ � ������ ����� � � �ti� i�ir�� �-I�� Ith � � � �� �� ������ 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 �. *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 ����� t,l����i �� � �������'� �l�_�►�,�:� ����� F F ��.,I�I � IZI11� ��� I��1 � ����` ��� �� �e �� Example: � Patient Service Fee Agreement $2,150/ Day Residential Treatment (2 Bedroom) � � Patient is responsible for all costs not covered by insurance �� 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 � . �`�,.�„�� �, �„�,�,�< .�., ,r�`� � , ''� ��.� � � � � � '=:,,.,, '1�`!1�'�� • . - • 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 �'�°�� ���"�� � � � ����'� . . - . 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&#2 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 ���i�� l,l��l��l �� � ��������� :'� ��.�,�k ��.�° �, ����,� _ , _ �.I�I � IZI11� ��� �t� � ���.��f����� �a�� ����� 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 �- 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 � �� � ��� ����,� ¢ - . � . . . . . 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 � �� �� ���� r = 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 �• � O � � � �. � � --- t