HomeMy WebLinkAboutDocumentation_Regular_Tab 13_06/14/2018 VILLAGE OF TEQUESTA
� DEPARTMENT OF COMMUNITY DEVELOPMENT
7
Staff Report—Village Council-F1RST RfADING lune 14, 2018
I. PETITION: Village's Code Text Amendment—ORDINANCE No. 30-18
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.
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1 ( Department of Community Development—GMH Futures of Palm Beaches—Text Amendment-Ordinance No.10-18
II. LAND USE AND ZONING
EXISTING LAND USE FUTURE LAND USE ZONING
SUBJECT PROPERTY Mixed Use Mfxed 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
Village Boulevard and Old Dixie Highway.The existing building has been vacant for a number of years; it
was originaily designed to accommodate an Assisted Living Facility(ALF).
In order to utilize ihe existing building as a Rehabilitation Facility, the applicant complied with the
following approval process as indicated below. Also, throughout the years, GMH applied and received
approval for a series of modificarions 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
def(nition 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 modificaiions 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,
2 Department of Community Development—GMH Futures of Palm Beaches—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 approval 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 8,2013 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 �•A maximum of�4A 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.
LPA Hearing Two bedroom dwelling units shall have a minimum of 750 square feet.
October 20, 2016
Special Exception Use Modification
Administrative Review for 5pecial 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 Beaches—Text Amendment-Ordinance No.10-18
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 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.
The proposed text amendment was presented and discussed at a Council Workshop on January 29,2018,
see attached workshop minutes. Also, per Staff request the Applicant provided a written statement with
regard to Detoxification and the Futures facility,see attached document.
The Code text amendment process requires a public hearing at the Local Planning Agency (LPA) Board
and two readings of the Ordinance by the Village Council,see attached Ordinance No. 10-18.
May 17,2018—Local Planning Agenty Hearing(LPAJ
The Planning & Zoning Board sitting as the Local Planning Agency recommended denial of the subject
application at the May 17, 2018 meeting by S-0 vote. The applicant conducted a power point
presentafion,see attached slides.
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, men[al 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 rehabilication facility patient require emergency or
medical detoxification, this must be completed ai an off-site faciliiy prior io beginning rehabilitation
care.
2. Private means privately owned and funded with no use of sfate 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 paiients. Partial navments
from commercial or self-funded insurance vlans mav be ���p�tprl h� rhp Rahnhilitntinr� FOCIIItV f0�
Qatient care.
Q Department of Community Development—GMH Futures of Palm Beaches—Text Amendment-Ordinance No.10-18
Nilsa Zacarias
� uesday, May 22,2018 6:47 PM
To: Niisa Zacarias
Cc: Lance Lilly;Anthony Cardamone; Deja Gilbert;Andrew D'Alessandro; Michael Couzzo; Keith
Davis
Subject: RE: next step-TEXT AMENDMENT APPLICATION
Importance: High
Nilsa,
This fs fn response to your request below, please see a written statement regarding the type of detoxification that
currently takes place at the facility. Although we are happy to answer this questton for you,please note that this
request does not have any relevance to our current application and is not part of that application. Our current
application only requests a zoning text amendment with respect to the payment allowances a client can use to pay for
treatment. "
"Futures of Palm Beach(s conducting Detox services in a manner that is fully compliant with the language set forth in the
Code of Ordinances of the Village of Tequesta under Chapter 78.Zoning. Whereas section 78-4. Definitions. l.states
"Rehabilitation care does not include emergency or medical detoxificat(on,which is specifically considered a prohibited
use. Should a rehabilitation facllity patient require emergency or medical detoxification,this must be completed at an
off-site facility prior to beginning rehabilitation care."and sect(on 78-4. Definitions. 7,further states"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.", Futures
of Palm Beach does not perform detoxification for individuais who require acute care.and our Medical Director will not
oversee detoxffication for individuals who have serious health risks as a result of their substance abuse. In both such
cases the individuals are transferred to an off-site facility for acute care prior to beginning rehabilitation care at
Futures. In fact,as an operating facility licensed in the state of Florida by the Department of Children and Families
(DCF), Futures operates under various licenses,one of them titled "Detoxification",which is formally defined by DCF as
"a process invoiving sub-acute care that is provided on a residential or an outpatient basis to assist clients who meet the
placement criteria for this component to withdraw from the physiological and psychological effects of substance abuse".
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
Village 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 tonighYs Workshop.
Council Member Pater�o was opposed to having an Executive 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. Councit 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
Viilage 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 Pate�no stated that he had sent pictures to Mr. Rodriguez
and Mr. Petrick and there were still rnany 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 Davis create a written solution to present to Council at the next Workshop
Meeting.
1. Discuss Revlslona 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 concems 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 Drive 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 info�med Council that an analysis was required by law
as a first step in the p�ocess of allowing golf carts east of the bridge. Council aaked
Manager Couzzo to research the topic further.
Viilage Council Workshop Minutes
January 29, 2018
5. Discuss Department Heads/Senior Managera—Vacation Leave Adjustment
Ms. Merlene Reid, Assistant Village Manager/Human Resources Directar asked Council
to consider changing the vacation policy for Department Heads whereas an extra week
would be added between employment years two and four. CuRently the Village vacation
policy stated that personnel that have been with the Village under five years receive two
weeks of vacation tirne. Council Member Paterno pointed out that Depa�tment Heads
currently receive six personal days in addition to vacation time. It was a Consensus of
Council to bring the item forward to a Regular Council Meeting.
6. Dlscuss Appointrnent of Canvassing Board Member for the March 2018
Muntcipal 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
Rehabilitation 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 industry 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 both 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.
Council Mernber 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 unde�stood the environment had changed, however the
residents were clear on what they were willing to accept.
Council Member D'Ambra explained that his concern was the possibility that patients
would be signed up as in network and as such would change the caliber of clientele. He
wondered if they would still be able to deliver better outcomes as compared to other
facilities, as previously claimed. A major concern was the likelihood of relapse and/or
behavioral issues that could follow a change from the original model.
Mr. Halloway revealed that there was no interest in selling the facility, but instead in
keeping the 120 employees 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 wo�ic on the issue.
Mr. Halloway asked for a decision sooner rather than later so that he could make some
important business decisions.
ADJOURNMENT: Council Member Okun moved to adjoum the meeting; seconded by
Vice Mayor D'Ambra. The motion to adjoum carried unanimously 5-0; therefore, the
meeting was adjoumed at 8:47 p.m.
PENDING TASKS:
Boat violation language that will assist in enforcement. Asked Jce, 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 oli chan e brou ht to Council erlene Reid
Respectfully submitted,
Village Council Workshop Minutes
January 29, 2018
�����
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.
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�'`'�- PALM BEACH —
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NTURE� �
Futures of Palm Beach �
■ Objective;
� Futures of Palm Beach ("Futures")is seeking approval for a text amendment to current zoning language to allow for the
acceptance of commercial in-network third party insurance contracts
■ Reason for the ask is to broaden the universe of potential patients eligible to seek treatment at Futures AND to lower the out of
pocket cost burden for patients eligible to seek treatment at Futures
• Futures is currently losing patients,even those with PPO policies that allow for out-of-network healthcare services,as in-
network providers are being more widely supported and promoted by major private insurers
� Current Market:
■ Since 2008,insurance has become a crucial factor for patients seeking drug and alcohol addiction treatment
■ Affordable Care Act and Mental Heath Parity Act emphasize the important role of insurance
� Major private insurers are encouraging providers to join their network to better control costs that can be charged to their
members and ultimately are covered by them after deductibles and out of pockets maximums are met
■ Major private insurers are encouraging their members(patients)to go to in-network providers for medical treatment by
bifurcating deductibles—separating in-network and out-of-network tleductible and out of pocket maximum amounts,which may
discourage the use of out-of-network providers due to significantly higher out of pocket expenses to the member
■ Major private insurers are also capping out-of-network benefits on an annual basis,forcing members to utilize in-network
providers or pay out of pocket for healthcare service for out-of-network providers
■ In many cases,as evidenced by our steadily decreasing census over the last 12 months,patients with PPO plans that allow for
the use of out-of-network healthcare services are choosing to utilize in-network provitlers to reduce their out of pocket expenses
■ PPO policies allow for members to go out-of-network OR in-network. HMO,or in-network policies,ONLY allow for the members
to go in-network for healthcare.
■ Major private insurers are showing preference to in-network providers to deploy performance based programs to help evafuate
the efficacy of quality providers,ultimately directing their member base to these providers
_ _ _ 5
Futures of Palm Beach _�
.�qe o� �eques�a
.�.,.:
• Actions needed to achieve objective: -
■ Work with the Viilage of Tequesta to amend Ordinance No. 1-11 in one area of 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. artial o vments from commercial or self-funded insurance lar� ns ma_y be acce�ted b��the
Rehabilitation Facility for�atient care.
• Areas of Discussion: The following areas of discussion are ideas Futures has to offer to the Village to help them alleviate any
potential concerns the Village Council may have with the above request:
■ Maintain accreditation by either Joint Commission or CARF,the two nationally recognized accretliting bodies recognized in
the field of addiction treatment
■ Maintain good standing with SAMHSA(Substance Abuse and Mental Health Services Administration)
• Sit Quarterly or Bi-Annually with the Village Council and Police Department to review the safety and security policies and
procedures and to review any incident reports of concern that may have taken place in the prior quarter or six month
timeframe
� Amended Statement:
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 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.
----- ---- ---- _ __.. _--- ---------- -- --- -_ -- --—------------- — — 6
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Futures of Palm Beach
Village of Tequesta
Local Planning Agency Hearing
May 17, 2018
Village of Tequesta
Justification Statement
Proposed Revision to Ordinance No. 1-11, Section 78-4(2)
In 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
disorder 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 fo(lowing 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 of Tequesta
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 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 natient care. pN�••�'� �'�� ��^^�*'�^**"�
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€9�'—�&�Bi}�6@�'���ifl�-�&�'i�38i�S-�F6i�-^vac-vrixvm,,,«vrn-i"n", � ••1,,••;r�iia�--vc
o..+0,7 1..,+L.o Dol,.,l.;l:+..+; ,,, F :l:r..F .,r; .,*,. 1„ ,.L. .,..t:.,l r
Y J " �
3. Short-term care means a program designed for a minimum residential stay of 30
calendar days.
4. Extended care treatment means an additional 30 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 of Tequesta
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 sa�e 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°/a)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.
ORDINANCE NO. 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 L 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 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 Teyuesta 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:
l
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 eyuipped 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 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 faciliry:
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
2
insurance nlans mav be accented bv the Rehabilitation Facilitv for natient care.
3. Short-term care means a program designed for a minimum residential stay of 30
calendar days.
4. Extended care treatment means an additional 30 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 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 (]0%) of the
Rehabilitation facility's patient clientele. Follow-up treatment se�e 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
3
patients equivalent to five percent (5%) 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 detoxifrcation 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 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