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Home My WebLink AboutDocumentation_Planning and Zoning_Tab 2_05/17/2018- LPA � {" VILLAGE OF TEQUESTA �� ' DEPARTMENT OF COMMUNITY DEVELOPMENT � _ -�; Staff Report—Local Planning Agency(LPA)—May 17,2018 ,,,: ,,,,,, I. PETITION: Village's Code Text Amendment—ORDINANCE No. 10-18 LOCATION: 701 Old Dixie Highway,Tequesta, FL 33469 OWNER/ GMH Tequesta Holdings LLC APPLICANT 10 Campus Boulevard Newtown Square, PA 19073 REQUEST: Application from GMH Tequesta Holdings LLC to amend the Village's Code of Ordinance: Sec. 78-4 amending the definition of Rehabilitation Facility. The address of the property is 701 Old Dixie Highway,Tequesta, Florida 33469. LOCATION MAP 1♦ -1. �t ��C "�j�7$�'� { �Z.'.(, 4./.7� E. '� ��f,� ` . e /yQ�,� � � � � r� �� v � . � � �'.� - } . A .��i � �. O Q'=- l r.r.0 � . �. q o�K��7t�;*as-�wnw�aaosa+�s��16 t�S� �0�}..,&��..� r ti:A.. �a.. y�. M 2�rt1�k � e � �� _ t �;' -- .. �+'a �.-,v �l`, �� :{I Ll�� r � ��Z f� �L + 1�� .. y}� � . . 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C 4n". ��{ 4 �.: � ��„ ti i "%''.� yp�4 . �- � � r �' �' � i'' �YK �4�;�� P +.1' *h as�:�...i r. � Q�� ';t�. ��'� '4�� ``��,� -.,�°�`R� � �I1��a1 t5��d., � ` 4 ��..g� ��f� �t � � �� ^ . �� +e. �\v d g- _ ` � � � �� , c K v�� a :>-�� a 'R' � �� a �,� y.e. :� �a �-z y�E�- ' ; . rNss Cir' �` � c . �� -, ��4 t� � , � +{� �� .—F E ��"'f t£' ;�� .�.�Gr � ' .(^ iV ��,� .�fi� �S{� � R' � Z �,i 1�i; '��.��i6��{23� 1�.�D��..� � � _ ,� _ � `,� ;[�.��T. �� y �e«.a'.�,,��/. � ,-� - "�_ '� �-, 4-M..mJY 1 " Department of Community Development—GMH Futures of Palm Beach—Text Amendment-Ordinance No.10-18 � ,i . II. LAND USE AND ZONING EXISTING LAND USE FUTURE LAND USE ZONING SUBJECT PROPERTY Mixed Use Mixed Use M-U Mixed Use District III. BACKGROUND In 2010, GMH Tequesta Holdings, LLC acquired an existing three-story building located on the corner of Viliage Boulevard and Old Dixie Highway.The existing building has been vacant for a number of years; it was originally designed to accommodate an Assisted Living Facility (ALF). In order to utilize the existing building as a Rehabilitation Facility, the applicant complied with the following approval process as indicated below. A/so, throughout the years, GMH applied and received approval for a series of modifications as shown on the following summary: Code Text Amendment March 10, 2011 Village Council adopted Ordinance 1-11 amending the Mixed-Use district to add "Rehabilitation Facility" as a special exception use. Ordinance 1-11 provided 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. Ordinance 1-11 also provides an amendment to the definition of residential use to include rehabilitation facilities in the Mixed-Use district. Special Exception Use May 12, 2011 Village Council approved the Special Exception Use application. The Special Exception order included waivers/conditions of approval (See attached Order). Site Plan Review July 7, 2011 Planning and Zoning Advisory Board recommended approval of the site plan application to utilize an existing 118,716 square feet three-story building and adjacent grounds as a Rehabilitation Facility.The application included a proposed landscape plan, and one (1) monument sign. August 11, 2011 Village Council approved the proposed site plan application. After its approval, the subject property had a number of modifications as indicated below: Site Plan Modification May 17, 2012 Planning and Zoning Advisory Board recommended approval of the Site Plan Modification application that included a number of changes. The modification did not increase the square footage of the building. June 14, 2012 Village Council approved the proposed Site Plan Modification. GMH Tequesta Holdings, LLC received its Certificate of Occupancy on August 24, 2012. z � Department of Community Development—GMH Futures of Palm Beach—Text Amendment-Ordinance No.10-18 , � ';� In 2013, GMH Tequesta Holdings, LLC approached the Village of Tequesta to pursue the following amendments: Code Text Amendment June 20, 2013 Local Planning Agency (LPA) recommended approva) of Ordinance 22-13 to amend the Village's zoning code text to allow rehabilitation facilities to provide limited outpatient treatment and to allow limited collection of insurance, provide monthly reports and an annual independent audit regarding funding, occupancy and treatment requirements; and, also provide additional off-street parking requirements. July 11, 2013 Village Council approved Ordinance 22-13. Special Exception Use Modification August S, 2013 Village Council approved Special Exception Use Amendment In 2016, GMH Tequesta Holdings, LLC applied for building permits to complete the third floor of the building.The Development Order issued previously included the completion of the third floor. On March 10,2016, building permits for the interior third floor build-out were issued. Code Text Amendment First Reading Sec. 78-180. MU mixed use district. October 3, 2016 �16) Rehabilitation facilities, subject to the following conditions: Second Reading c.A maximum of 45 49 percent of the dwelling units shall be permitted to have October 13, 2016 two bedrooms. In no case shall a dwelling unit have more than two bedrooms. Two bedroom dwelling units shall have a minimum of 750 square feet. LPA Hearing October 20, 2016 Special Exception Use Modification Administrative Review for Special Exception Use Amendment to modify the number of one bedroom and two bedroom units on the third floor. In terms of total number of units, the following changes are proposed: • Total number of units: Decrease from 75 to 73 • One bedroom units: Decrease from 38 to 34 • Two bedroom units: Increase from 30 to 32 (43.8%) The total number of beds(105 beds)will not be modified,it is in compliance with the Development Order SPR 2-11. Site Plan Modification Planning and Zoning Board Hearing October 20, 2016 Subject Application: Per code section 78-331. Division 2. Site Plan Review. Special Exception Uses are required to be processed as Site Plan Reviews. This application did not include any modifications to the building exterior and footprint of the building. The subject application included the following interior modifications in the third floor: • One bedroom units: Decrease from 15 to 11 units • Two bedroom units: Increase from 7 to 9 units 3 Department of Community Development—GMH Futures of Palm Beach—Text Amendment-Ordinance No.10-18 , , Y Special Exception Use Modification Administrative review for Special Exception Use Amendment to install a permanent 480 sq.ft.freestanding awning on east side of property over existing pavers. Site Plan Modification Planning and Zoning Board Hearing August 17, 2017 Application from GMH Tequesta Holdings LLC for a site plan modification to install a permanent 480 sq.ft.freestanding awning on east side of property over existing pavers. IV. SUBJECT APPLICATION The proposed text amendment was discussed at a Council Workshop on January 29, 2018, see attached workshop minutes notes. The Code text amendment process will require two readings of the Ordinance by the Village Council, see attached Ordinance No. 10-18.The notice of hearing for the subject hearing was advertised on May 7, 2018. The subject application is to amend the Village's Code of Ordinance, Definitions Sec. 78-4 by amending the definition of Rehabilitation Facility to provide for the limited provision of insurance payments for patient care,including partial payments from commercial or self-funded insurance plans for patient care. Please see below the existing definition of Rehabilitation Facility as stated on Sec. 78-4; the proposed text amendment is indicated on strikethrough (deleted text)and underline (new text): The following definitions apply to the definition of rehabilitation facility: 1. Rehabilitation care means diagnosis and treatment for drug and alcohol addiction disorders, eating disorders and physical, behavioral, mental or emotional issues that are directly attributed to those disorders. Rehabilitation care does not include emergency or medical detoxification, which is specifically considered a prohibited use.Should a rehabilitation facility patient require emergency or medical detoxification, this must be completed at an off-site facility prior to beginning rehabilitation care. 2. 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. Partial navments from commercial or self-funded insurance nlans mav be accented bv the Rehabilitation Facilitv for patient care. n �rl.. .�..�1.�. .,t.�,., .,++ f'+ +.,L,.11,,, +F D L. L,'1'+ +' crco�i�ucoe� � � i � 4 Department of Community Development—GMH Futures of Palm Beach—Text Amendment-Ordinance No.10-18 MINUTES VILLAGE OF TEQUESTA WORKSHOP January 29, 2018 CALL TO ORDER AND ROLL CALL The meeting was called to order at 6:00 p.m. A roll call was taken by Assistant to the Viilage Clerk, Mary Ann Grieser. Present were: Mayor Abby Brennan, Vice-Mayor Frank D'Ambra, Council Member Vince Arena, Council Member Steve Okun, and Council Member Tom Paterno. 2. Discuss the Police Department Pension Plan Mayor Brennan asked Council to move item number two, Discuss the Police Department Pension Plan, to an Executive Session, immediately following tonight's Workshop. Council Member Paterno was opposed to having an Exe�cutive Session and felt the matter should be discussed at the Workshop and not behind closed doors. Vice Mayor D'Ambra suggested the discussion take place in two parts, to satisfy all of Council. Village Attorney Keith Davis explained that State Statute indicated discussions "relative to collective bargaining" were able to be closed and exempt. It was agreed that item number two would be moved to item number one on the Workshop Meeting agenda. Vice Mayor D'Ambra felt it was time to address the issue of defined benefits for police as he felt it was an equity issue. Council Member Okun revealed that he believed that retention within the Police Department was an issue due to the lack of a pension. Council Member Arena felt that he would like to bring up the topic after the Council elections in March, in order to have a set Council in place for discussions. Council Member Paterno added that he would like to discuss the subject in an open forum and that he had never heard of a recruitment problem in the Police Department before today. He reminded Council of several budget considerations coming up and felt the facts and actuaries should be presented before going behind closed doors. Actuaries were then discussed and explained in depth. It was a Consensus of Council to continue the discussion in an Executive Session, after the meeting. 3. Update on Code Compliance Mayor Brennan asked Council if they would move item number three to the next item so that staff would be able to be present. Council agreed to discussing code compliance next. Mr. Jose Rodriguez, Building Director and Mr. Joe Petrick, Code Enforcement officer were invited to speak to Council. Mr. Rodriguez informed Council that this month there had been 17 "courtesy notices" issued and 21 new code cases, in addition to the nine cases slated for the Special Magistrate. Council Member Paterno asked what the definition of "screened" was as it applied to boat storage. Mr. Rodriguez stated that the Village Council Workshop Minutes January 29, 2018 house next door was not a viable screen, nor was a chain link fence. Mr. Petrick revealed that there were different requirements for boats, depending on how long the boat had been there. According to the latest ordinance, the entire hull of any boat must be screened. Council Member Paterno stated that he had sent pictures to Mr. Rodriguez and Mr. Petrick and there were still many boats that were in violation. Mr. Petrick explained that every time a code enforcement case was opened the property appraisers page was used as verification. Council Member Paterno felt that there were many violations within the Village that were not being addressed. Attorney Davis revealed that an order finding violation was needed in order to be considered a "repeat violator". The Village issued a courtesy notice but was not required to do so. Another issue was that if the owners resided out of state, the Village had to allow ample time for them to receive the notification. Council Member Arena explained to Council that residents needed to know how the process worked. He asked that Mr. Rodriguez, Mr. Petrick and Attorney Qavis create a written solution to present to Council at the next Workshop Meeting. 1. Discuss Revisions to Proposed Tree Removal Ordinance (Ordinance 3-18) following First Reading. Attorney Davis reminded Council of the Banyan Tree issue from last year and recalled that Council had asked for a revision of the broad language reflected in the first draft of the ordinance. He asked Council for direction and offered some suggestions after speaking with Ms. Nilsa Zacarias, Community Development Director. He suggested requiring a survey only when the property line was unclear, and asked Council for clarification on tree size. Council Member Arena had concerns regarding possible requirements on survey, historical trees, tree sales, number of trees required by code, trimming trees, etc. Manager Couzzo agreed that the ordinance could be worded less rigorously. Ms. Nilsa Zacarias, felt the Village should promote the addition of trees in certain areas to protect the character of the area. Council directed Attorney Davis to develop language that would require a permit(no charge) and would also give Community Development the option of requiring a survey, if boundary lines were unclear. 4. Discuss Extending the Allowable Area for Golf Carts to the RR Tracks on Tequesta Drive Council Member Arena asked for clarification on the reason golf carts were not allowed east of the Tequesta Driye Bridge. It was determined that many years ago golf carts were allowed due to the convenience of residents traveling to and from the Tequesta Country Club. Acting Chief McGrew advised that the current minimum age for operating a golf cart was 16 years old. Attorney Davis informed Council that an analysis was required by law as a first step in the process of allowing golf carts east of the bridge. Council asked Manager Couzzo to research the topic further. Village Council Workshop Minutes January 29, 2018 5. Discuss Department Heads/Senior Managers —Vacation Leave Adjustment Ms. Merlene Reid, Assistant Village Manager/Human Resources Direc#or asked Council to consider changing the vacation policy for Department Heads whereas an extra week would be added between employment years finro and four. Currently the Village vacation policy stated that personnel that have been with the Village under five years receive two weeks of vacation time. Council Member Paterno pointed out that Department Heads currently receive six personal days in addition to vacation time. It was a Consensus of Council to bring the item fonivard to a Regular Council Meeting. 6. Discuss Appointment of Canvassing Board Member for the March 2018 Municipal Elections as per Resolution 53-17 Attorney Davis revealed that in the case of a run off, one of three eligible Council Members would need to be present at the Supervisor of Elections office to participate in the process. Council Member Paterno volunteered to fill the position. 7. Discuss Futures Request to Change Section 78'-4(2) — Definition of Rehabititation Facility Mayor Brennan invited Mr. Michael Halloway, President of GMH Ventures, owner of Futures of Palm Beach, to introduce his colleagues. Mr. Halloway introduced: Ms.Valerie Jackson, CEO of Futures, Mr. Drew D'Alessandro, Director of Operations, and Mr. Eloy Beck, of Infinity Billing Systems. Mr. Halloway reminded Council that Futures had opened its doors in 2012 as a cash only business and had come back to Council in 2014 for permission to accept"out of network" benefits for health insurance. He relayed to Council that the irtdustry had seen a shift towards insurance companies forcing providers to become "in network", thus causing a huge stress on his business. Currently, the language in the Village ordinance did not allow Futures to accept HMO or PPO policies that were considered in network. Council Member Paterno and Council Member D'Ambra bath acknowledged that they had spoken to Mr. Halloway earlier in the week. Council expressed their concern upon learning that "detoxification" was occurring at Futures, as the Village had been clear in prior communications, that detoxification using prescription drugs was not permissible at the facility, per the original agreement. Mayor Brennan recalled that in earlier meetings Dr. Warden had promised Council that the only form of "detox" to be used was to be cognitive and behavioral therapies. She was concerned that the original business model would no longer be accurate, because insurance would ultimately dictate the clientele, pricing, length of stay, and type of treatment. Mayor Brennan felt that the original plan would be abandoned if the Village changed the protections that residents had asked for years ago. Village Council Workshop Minutes January 29, 2018 Mr. Halloway reaffirmed that the changes Futures was asking for were based upon the facility surviving, and that he wanted to preserve the high standards that they always had maintained. Counci! Member Paterno cited his surprise at the fact that "detoxification" was occurring at the facility presently. He believed the agreement did not allow the detoxification process to occur on site, now or ever. Mayor Brennan added that DCF (Department of Children and Families) Guidelines were different from the Village agreement, which she was obligated to uphold. She understood the environment had changed, however the residents were clear on what they were willing to accept. Counci! Member D'Ambra explained that his concern was the possibility that patients would be signed up as in nefinrork and as such would change the caliber of clientele. He wondered if they wauld still be able to deliver better outcomes as compared to other facilities, as previously claimed. A major concern was the likelihood of relapse andlor behavioral issues that could follow a change from the original modef. Mr. Halloway revealed that there was no interest in selling the facility, but instead in keeping the 120 emplayees working as well as helping people recover from addiction. Attorney Davis reminded Council that there was not an agreement on the line, but rather an ordinance which changed the mixed use zoning use. Mayor Brennan asked for some time so that Council could discuss and work on the issue. Mr. Halloway asked for a decision sooner rather than later so that he could make some important business decisions. ADJOURNMENT: Council Nlember Okun moved to adjoum fhe meeting; seconded by Vice Mayar D'Ambra. The motion to adjoum carried unanimoUsly 5-0; therefore, fhe meeting was adjoumed at 8,-47 p.m. PENDING TASKS: Boat violation language that will assist in enforcement. Asked Joe, Jose, ttomey Davis Dennis and Attorne Davis to et to ether on this Less a ressive wordin , no char e ermit, etc. for tree ordinance ttorne Davis Golf Cart streets and sidewalk anal sis ana er Couzzo Vacation olic chan e brou ht to Cauncil erlene Reid Respectfully submitted, Village Council Workshop Minutes January 29, 2018 ��:�n��.�,-- Lori McWilliams, MMC Village Clerk Note: These summary minutes are prepared in compliance with 286.011 F.S. and are not verbatim transcripts of the meeting. A verbatim audio record is available from the office of the Village Clerk. All referenced attachments are on file in the Village Clerk's office. ORDINANCE N0. 10-18 AN ORDINANCE OF THE VILLAGE COUNCIL OF THE VILLAGE OF TEQUESTA, FLORIDA, AMENDING THE VILLAGE CODE OF ORDINANCES AT CHAPTER 78. ZONING. ARTICLE I. IN GENERAL. SEC. 78-4. DEFINITIONS. BY AMENDING THE DEFINITION FOR "REHABILITATION FACILITY" TO PROVIDE FOR THE LIMITED PROVISION OF INSURANCE PAYMENTS FOR PATIENT CARE, INCLUDING PARTIAL PAYMENTS FROM COMIVIERCIAL OR SELF- FUNDED INSURANCE PLANS FOR PATIENT CARE; 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 to accept in-network insurance payments from clients for payment; and WHEREAS,the applicant has previously provided informational presentations at Village Council workshops; and WHEREAS, the applicant has met with Village staff in order to prepare its application in a manner that will serve not only its own purposes, but also those of the Village; and WHEREAS, the applicant has taken into account all the input obtained at all the aforesaid 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 amending the definition for "Rehabilitation facility" to provide for the limited provision of insurance payments for patient care, including partial payments from commercial or self-funded insurance plans for patient care; providing that this definition shall hereafter read as follows: 1 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 axeas, meditation areas, fitness rooms, libraxies, recreation rooms, televisions, on-site food preparation, and telephone and internet service. Rehabilitation facilities must provide rehabilitation care by means of short-term care treatment and extended care treatment as needed, and may also provide follow-up treatment and outpatient treatment to current residential patients of the Rehabilitation facility, as well as a limited number of non-residential patients who have, at a minimum, successfully completed short-term care treatment at the Rehabilitation facility. 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: l. Rehabilitation care means diagnosis and treatment for drug and alcohol addiction disorders, eating disorders and physical, behavioral, mental or emotional issues that are directly attributed to those disorders. Rehabilitation care does not include emergency or medical detoxification, which is specifically considered a prohibited use. Should a rehabilitation facility patient require emergency or medical detoxification, this must be completed at an off-site facility prior to beginning rehabilitation care. 2. 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. Partial navments from commercial or self-funded 2 insurance blans mav be accented bv the Rehabilitation Facilitv for natient care. nc�v+cm+zc��'b�FA��E�S-�6��ciai i rrciui-I�cc'zii,�,+" f" „r .,F n�t�ie�l�`�c eee�� ,a �,� ��,o no�,.,�,;i;�„�;,, �,,,.;�;� ��y .,�;�r� �.� �; � r�� ,. i„ ,.t, .,,-�;.,i „�� „r � .,,-a no,�„*;,,,-o,� o,a„ o,a „� ,-„ „� ..�� .,.., �., .b ., .,.,.�. t,.._._.., r,„�..,,___.., ..__ --�� r-- ---a�_---_-- -------- ---------- ------ t., �+;+„�o F„11 ,. „t f..r 1?o1,�L,;l;tnt;�,+� � 3. Short-term care means a program designed for a minimum residential stay of 30 calendar days. 4. Extended care treatment means an additiona130 to 60 calendar day stay in residential treatment after completing tl�e initial short-term care residential treatment program. 5. Follow-up treatment means a program designed for an additional one week stay in residential treatment, subsequent to the previous completion of the Short-term care or Extended care treatment program, and must occur at the same facility where Short- term care or Extended care treatment was received. Follow-up treatment is for those patients who need additional structured follow-up treatment that does not require the clinical intensity of the Short term or Extended care treatment program. At any given time, Follow-up treatment shall not account for more than ten percent (10%) of the Rehabilitation facility's patient clientele. Follow-up treatment e-a�€can also be in the form of electronic correspondence or tele-conferencing, and in such cases has no limit or restrictions regarding the duration of the care, the location of the treatment or the number of participating patients. 6. Outpatient treatment means a regimen of treatment that may include any or all of the following services: group counseling, individual counseling, relapse prevention counseling, and educational lectures. Outpatient treatment may be offered at the following levels: "Day or Night with Community Housing" which provides a minimum of 25 hours of services per patient per week; "Day or Night" which provides 12-24 hours of services per patient per week, "Intensive Outpatient" which provides 9-11 hours of services per patient per week; and "Outpatient" which provides less than 9 hours of services per patient per week. At any given time, Outpatient treatment may only be provicled to a maximum number of non-residential 3 patients equivalent to five percent (5°10) of the Rehabilitation facility's current Short term care, Extended care and residential Follow-up treatment clientele. Outpatient treatment services can also be provided to the Rehabilitation facility's patients who are currently receiving Short-term care, Extended care or residential Follow-up treatment, and in such cases the number of participating patients is only limited by the Rehabilitation facility's residential occupancy limits as set forth at Sec. 78-180(i)(16). 7. Emergency or medical detoxification means the elimination of toxins such as alcohol or controlled substances from the body of individuals who require acute care andlor may have serious health risks as a result of their substance abuse. Medical or emergency detoxification is performed under the direct supervision of inedical doctors and medical support staff, and may include the administration of inedication or tranquilizers in order to ease the withdrawal process. Emergency or medical detoxification is a prohibited use in a Rehabilitation Facility. Section 2: Each and every other Section and Subsection of Chapter 78. Zoning. shall remain in full force and effect as previously adopted. Section 3: All ordinances or parts of ordinances in conflict be and the same are hereby repealed. Section 4: 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 5: Specific authority is hereby granted to codify this Ordinance. Section 6: This Ordinance shall take effect immediately upon passage. 4 Futures of Palm Beach Village of Tequesta Local Planning Agency Hearing May 17, 2018 Viflage of Tequesta Justification Statement Proposed Revision to Ordinance No. 1-11, Section 78-4(2) 1n 2014 we worked with the Village Council to revise the Ordinance to allow Future's to accept commercial insurance as a means of payment for treatment. However, at the time of that revision we limited the revision to only accept Out-of-Network benefits, which was very beneficial to our treatment program at that time. The insurance reimbursement landscape for behavioral healthcare, particularly substance use disorc�er has continued to experience many changes. Commercial insurance payers, for the past 24 months, have consistently challenged Out-of-Network service providers, and limited their customers' access to In-Network providers. Insurance companies are using various tactics to force service providers In-Network, namely instituting unreasonable guidelines for Out-of- Network providers as well as instituting egregious Out-of-Network deductibles and capping reimbursements. Most importantly, the overall number of insurance policies allowing for Out- of-Network benefits is shrinking due to the cost burden imposed by the insurance carriers to their members. We are requesting a revision to the Ordinance to allow Futures to treat clients with In-Network benefits, so that Futures can adapt with the changing landscape and treat the larger population of people with In-Network commercial policies, ultimately helping more people recover from addiction and helping our business and our community.This does not change the demographic of our client. Most, if not all health plans have both In-Network and Out-of-Network benefits. Insurance carriers are merely doing their best to force the use of In-Network benefits.This simply allows the insurance company to better control the rates a service provider can charge for the services they provide. Futures Of Palm Beach Village of Tequesta Local Panning Agency Hearing May 17, 2018 Village of Tequesta Proposed Revision to Ordinance No. 1-11, Section 78-4(2) Sec. 78-4(2) Definition of Rehabilitation Facility- 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. Partial payments from commercial or self-funded insurance plans may be accepted by the rehabilitation facility for patient care. 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 amending the definition for "Rehabilitation facility"to provide for the limited provision of insurance payments for patient care, including partial payments from commercial or self-funded insurance plans for patient care; providing that this definition shall hereafter read as follows: 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 rehabilitation care by means of short-term care treatment and extended care treatment as needed, and may also provide follow-up treatment and outpatient treatment to current residential patients Futures Of Palm Beach Village ofTequesta Local Panning Agency Hearing May 17, 2018 of the Rehabilitation facility, as well as a limited number of non-residential patients who have, at a minimum, successfully completed short-term care treatment at the Rehabilitation facility. 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: 1. Rehabilitation care means diagnosis and treatment for drug and alcohol addiction disorders,eating disorders and physical,behavioral,mental or emotional issues that are directly attributed to those disorders. Rehabilitation care does not include emexgency or medical detoxification, which is specifically considered a prohibited use. Should a rehabilitation facility patient require emergency or medical detoxification,this must be completed at an off-site facility prior to beginning rehabilitation care. 2. 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. Partial bavments from commercial or self-funded insurance nlans mav be accented bv the Rehabilitation Facilitv for natient care. py��•�*-� ^��m��r� *��**�� h�.,i��, „-, ,,,o,,.,,,,.o „ ��;,,�� ,,,. f,,,,, .. „�;,,*o,a , o� v • i �bn V V V V 1 �Jll+ „� n.�*�F-a��3�r�s-��e�r-c�h�--e��s�e ' '�� rPritPrl h��tL,o DoL,.,L.;l;�.,�;.,,, �.,..;1;��, f.,« .,�' „�.. .,1.,,,�. ., ..1, ,..,,.�;.,7 ,. � r � J Y b Y N�,Y"`"i�`T DoL..,l.;l;t.,r;,,,-, „ 3. Short-term care means a program designed for a minimum residential stay of 30 calendar days. 4. Extended care treatment means an additiona130 to 60 calendar day stay in residential treatment after completing the initial short-term care residential treatment program. 5. Follow-up treatment means a program designed for an additional one week stay in residential treatment, subsequent to the previous completion of the Short-term care or Extended care treatment program,and must occur at the same facility where Short-term Futures Of Palm Beach Village ofTequesta Local Panning Agency Hearing May 17, 2018 care or Extended care treatment was received. Follow-up treatment is for those patients who need additional structured follow-up treatment that does not require the clinical intensity of the Short term or Extended care treatment program. At any given time, Follow-up treatment shall not account for more than ten percent (10%) of the Rehabilitation facility's patient clientele. Follow-up treatment e-a�can also be in the form of electronic correspondence or tele-conferencing, and in such cases has no limit or restrictions regarding the duration of the care, the location of the treatment or the number of participating patients. 6. Outpatient treatment means a regimen of treatment that may include any or all of the following services: group counseling, individual counseling, relapse prevention counseling, and educational lectures. Outpatient treatment may be offered �at the following levels: "Day or Night with Community Housing"which provides a minimum of 25 hours of services per patient per week; "Day or Night" which provides 12-24 hours of services per patient per week, "Intensive Outpatient" which provides 9-11 hours of services per patient per week; and "Outpatient" which provides less than 9 hours of services per patient per week. At any given time, Outpatient treatment may only be provided to a maximum number of non-residential patients equivalent to five percent(5°Io)of the Rehabilitation facility's current Short term care,Extended care and residential Follow-up treatment clientele. Outpatient treatment services can also be provided to the Rehabilitation facility's patients who are currently receiving Short-term care, Extended care or residential Follow-up treatment, and in such cases the number of participating patients is only limited by the Rehabilitation facility's residential occupancy limits as set forth at Sec. 78-180(i)(16). 7. Emergency or medical detoxification means the elimination of toxins such as alcohol or controlled substances from the body of individuals who require acute care and/or may have serious health risks as a result of their substance abuse. Medical or emergency detoxification is performed under the direct supervision of inedical doctors and medical support staff, and may include the administration of inedication or Futures Of Palm Beach � Village of Tequesta Local Panning Agency Hearing May 17, 2018 tranquilizers in order to ease the withdrawal process. Emergency or medical detoxification is a prohibited use in a Rehabilitation Facility.