A SPECIAL MEETING OF THE BOARD OF COUNTY COMMISSIONERS

NOVEMBER 25, 1980

The Lake County Board of County Commissioners met in Special Session on Tuesday, November 25, 1980, at 5:05 P.M., in the Commissioners' Meeting Room, Courthouse, Tavares, Florida. Commissioners present were: C. A. "Lex" Deems, Chairman; James R. Carson, Jr.; Glenn C. Burhans; Claude Smoak; and Thomas J. Windram. Others present were: James C. Watkins, Clerk; Sandy Minkoff, County Attorney's Office; and Pat Willman, Deputy Clerk.

BUDGETS

At 5:05 P.M. the Chairman announced the time had arrived for the advertised Public Hearing regarding budgets. Mr. Watkins, Clerk, stated the proper proof of publication was on hand and had appeared in the November 20, 1980, edition of the Sentinel Star.

Mr. Koppel, Finance Director, stated the County Commission Budget was advertised at the proposed millage of 3.139 which is 17.3% over last year's roll back. The total operating dollar figure is $5,952,865.00. The total budget is $23,843,125 which is approximately 3 million dollars less than last year.

Chairman Deems asked if anyone from the audience would like to comment.

Ms. Delores Andrejek, Yalaha, addressed the Board expressing her objections to the proposed $lO,OOO.OO funding allocated for the sterilization program of the Lake County Family Health Council and Planned Parenthood Facility.

Ms. Andrejek read a letter from Dr. Andrews, President of the Lake County Family Health Council, in which the funds were requested. Ms. Andrejek asked for the qualifications of the staff members involved in this program and the statistics regarding the number of sterilizations performed on a black and white ratio.

Ms. Andrejek indicated the staff members conducted door to door visits to recruit individuals who feels a need for the program.

She also questioned how the funding was originally brought about.

Ms. Andrejek stated she had talked with Ms. Patrowicz, who does counseling for this particular service, and Ms. Patrowicz advised her no monies come directly from Lake County to her, the money is distributed from the central office in Gainesville.

Dr. Frederick C. Andrews, President, Lake County Family Health Council, addressed the Board and stated he had been involved with this program from the concept to the present time. Dr. Andrews stated the program was originally started by the citizens of Lake County who felt a need for the service.

Dr. Andrews stated there were grant monies available for the program at that time. Dr. Andrews assured the Board and the Audience the Lake County Family Health Council was not a part of the National Planned Parenthood Council. He indicated the program does participate in Federal Grant through HRS and the monies come from the regional office and are disbursed through there.

Dr. Andrews stated this particular service is not available to all medicare recipients due to the requirements of that benefit.

Dr. Andrews stated the council does not go out and cohort people to come in. Each individual is given educational information concerning the surgery. Most of the contacts are through people who have been to the Council, they tell others and they come in voluntarily. If they request the sterilization procedure, there is a thirty (30) day waiting period under federal regulations, however; most wait longer due to the funding.

The surgery is performed through private contracting with physicians who carry their own malpractice insurance and are reponsible for what takes place in the institutions.

The County could not be liable because of funding.

Dr. Andrews informed the Board that other physicians as well as Dr. Atkinson, Lake County Health Department, were present to answer any questions.

Ms. Patrowicz informed the Board that the Council follows a text book. The material is given to the person explaining the procedure, what is going to be done, how it will be don, what the complications may be and what the individual may expect.

Ms. Patrocwicz stated this is done in simple layman terms so the individual may understand what is being done. Mrs. Patrowicz informed the Board he had been instructed, educated and is capable of doing this job and that it is not a highly technical program of instruction. Ms. Patrowicz stated that all the care after the surgery was done by the physician.

Commr. Smoak asked if tubal ligation qualifies under medicaid or possibly medicare when recommended by a physician. Commr. Smoak also asked if the County was creating another duplication of federal, state and county tax sources to the exclusion of the general public having control over the dollars.

Dr. Andrews stated these people are the ones who are either not covered under those programs. If they are covered under any programs we utilize that program, and that gives extra funding to us. If we are entitled to use the programs we do so.

Commr. Smoak asked if the Council could give a number of how many permanent sterilizations take place in Lake County through this program, not the twenty (20) that is funded by the County but the total number of sterilizations that are recommended.

Mr. Patrowicz stated she did not bring the exact figures but that off the top of her head they probably do about forty to forty-five (40-45) a year, with twenty (20) being funded by the County, and the remainder from federal or medicaid sources.

Commr. Smoak requested a copy of the booklet and also any statistical data offered by the Council.

Commr. Smoak asked what the total amount of tax dollars were used for the operation of the Council.

Ms. Patrowicz stated the budget was around $115,000.00. Commr. Smoak asked if there was any duplication between the

Council and the Lake County Health Department regarding sterilizations.

Dr. Atkinson stated the County Health Department has an extensive Family Health Planning Program, and they do serve the medically indigent. Dr. Atkinson stated if they have no source of funding for sterilization when they come to the Health Department, they are then referred to the Council for help.

Commr. Smoak asked how physicians are selected before surgery.

Dr. Andrews informed the Board that the physicians are volunteers and that they contribute their time and their services are performed at a revised rate.

Dr. Atkinson, Lake County Health Department, stated that in the five (5) years she had been director of the Health Department there has never been funds available for sterilization for males or females.

Ms. Patrowicz stated the agency is monitered very closely and all funds must be accounted for, all bills are submitted to Gainesville for review before being paid. The professional fees shown on the budget sheet to physicians are for their visit to the climic not for sterilizations. The doctor fees and the hospital fees are at a greatly reduced rate.

Commr. Smoak asked if patients contribute to any of the cost.

Ms. Patrowicz stated the Agency is not equipped to review private funds at all however, she feels this concept will change in the future.

Dr. Bryan Lassiter, Physician, stated he performs sterilizations and does his own additional counseling before and after surgery and that no profits are made.

Mrs. Seabold stated she feels the service is being duplicated and that these sterilizations could be handled through the Health Department by federal funds.

Commr. Deems stated that approximately $262,000 of local tax monies goes into the County Health Department each year. If the Health Department undertook this procedure they would need additional funds for staff and necessary materials and at this time they are not equipped to handle this, additional responsibility.

Mr. Walter Berry appeared before the Board and requested a breakdown of the number of people receiving this service (black and white).

Dr. Lassiter stated that race makes no difference to the Council.

Ms. Ailene Parris stated she was waiting on the sterilization surgery. Ms. Parris stated she has five (5) children, cannot take the pill and is mentally and physically unable to have additional children. Ms. Parris stated that no one came to her door to recruit her, but because she could not qualify under medicaid or insurance she was accepted by the Council.

Commr. Smoak moved to make no amendments to the Lake County Budget, Commissioner Windram seconded the motion. The motion carried unanimously.

On a motion by Commr. Windram, seconded by Commr. Burhans and carried unanimously, the Board adopted the Resolution levying a millage at 3.139 for the County Wide Budget.

At this time Mr. Chris Ford, County Attorney, read Resolution 1980-64 in its entirety.

BUDGETS/HOSPITALS

Commr. Deems stated that the next budget to be considered would be the Northeast Lake County Hospital District which bring the millage from .763 roll back to 1 mil (mandated by law), which would be a 31.1% increase over last year's budget (total this year $733,682.00).

Discussion occurred regarding the Northeast Lake County Hosptial District Budget.

On a motion by Commr. Windram, seconded by Commr. Carson and carried unanimously, the Board approved the final budget for the Northeast Lake County Hospital District.

On a motion by Commr. Carson, seconded by Commr. Windram and carried unanimously, the Board adopted the Resolution for a millage of 1.000 for the Northeast Lake County Hospital District.

At this time Commr. Carson read Resolution 1980-66 in its entirety.

On a motion by Commr. Windram, seconded by Commr. Burhans and carried unanimously, the Board approved Resolution 1980-66 as read by Commr. Carson.

BUDGETS/HOSPITALS

Commr. Deems stated that the next budget to be considered would be the Northeast Lake County Ambulance District which would brimg the millage from .191 to .343 mils. Comrnr. Smoak stated the $260,000.00 (total budget amount) was an approximate 210% increase over last year's budget amount.

On a motion by Commr. Windram, seconded by Commr. Carson and carried, the Board approved no amendments be made to the Northeast Lake County Ambulance District ($260,000.00).

Commr. Smoak voted "No".

On a motion by Commr. Windram, seconded by Commr. Burhans and carried, the Board adopted Resolution 1980-65 for the Northeast Lake County Ambulance District.

Commr. Smoak voted "No".

Chris Ford, County Attorney, read Resolution 1980-65 in its entirety.

On a motion by Commr. Windram, seconded by Commr. Burhans and carried, the Board approved the final budget for the Northeast Lake County Ambulance District ($260,200.00).

Commr. Smoak voted "No".

BUDGET/HOSPITALS

Commr. Deems stated that the next budget to be considered would be the Northwest Lake County Ambulance District which would bring the millage to .473 mils an increase of 21.3% over last year's budget.

On a motion by Commr. Windram, seconded by Commr. Burhans and carried unanimously, the Board approved no amendments be made to the Northwest Lake County Ambulance District Budget.

On a motion by Commr. Burhans, seconded by Commr. Carson and carried unanimously, the Board adopted Resolution 1980-67 for a millage of .473 for the Northwest Lake County Ambulance District.

On a motion by Commr. Burhans, seconded by Commr. Carson and carried unanimously, the Board approved the final budget for the Northwest Lake County Ambulance District ($260,200.00).

There being no further business to be brought before the

Board at this time, the meeting adjourned at 6:48 P.M.

C.A. "Lex" Deems, Chairman

James C. Watkins, Clerk