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Res 74-83 RESOLUTION NO. 74-83 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF DELRAY BEACH, FLORIDA, AUTHORIZING AND DIRECTING THE MAYOR TO EXECUTE AN AGREEMENT WITH THE STATE OF FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS UNDER THE FLORIDA FINANCIAL ASSIST- ANCE FOR COMMUNITY SERVICES ACT; PROVIDING THAT THE CITY OF DELRAY BEACH WILL BE RESPONSIBLE FOR THE LOCAL MATCH REQUIRED UNDER PROVISIONS OF SAID ACT. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF DELRAY BEACH, FLORIDA, AS FOLLOWS: Section 2. That the City hereby authorizes, confirms and ap- proves the filing of the application of Planned Parenthood of South Palm Beach and Broward Counties, Inc., for grant funds under the Florida Fi- nancial Assistance and Community Services Act. The application being for the fiscal year October 1, 1983 through September 30, 1984 requesting state grant funds in the amount of $36,000. Section 2. That the Mayor is hereby authorized and directed to sign in the name and on behalf of the City an Agreement between the Flor- ida Department of Community Affairs and the City of Delray Beach, Florida, under the Florida Financial Assistance for Community Services Act, en- dorsing the program of Planned Parenthood of South Palm Beach and Broward Counties, Inc. A copy of the Agreement is attached hereto and made a part hereof. Section 3. That Planned Parenthood of South Palm Beach and Broward Counties, Inc., will be the delegate agency and subcontractor of the City of Delray Beach in connection with this grant. Section 4. That the City will be financially responsible for the local share of the grant as required pursuant to the provisions of Florida Statute Chapter 409, notwithstanding the fact that all or part of the local share is to be met or contributed by other source, i.e., contribu- tions, other agencies or organization funds. PASSED AND ADOPTED in regular session on this the 9th day of August , 1983. ATTEST: De:~ar~_menC of CcmmuniC~ Affairs ~i~;ision of Local Resource Management ' $~bm~~- Cwo copies ~T~ ~xacu:ive Can~= :~ircl~ ~aa~ One mus~ be orig.inal ~,~':; CST~ Application ~EI:i~Ni .~Iai,,e.: ' r~ of D~ B~ch~ F!o~ .T,le~hcne: (305) 278-2841 ' ~~S: [0~ N. W., 1st ~y~, Delray B~ Flo~ z!=: 33444 :=u=~Z: ¢.~' ~ rn~ ....... " ~ie%a~&'_e Ac. en~z ( s ):" P1anned Parenthood of South Palm Beach and Broward Counties Name: ~-,4,~y Mi*'~,, , ~e!m--hcne: (305) 368-1023 ;~d~---~ss: ~Planned Parenthood - 160 N. W, 4th Street, Boca Raton, FTorida 33432 -'... ::~e ~-.~ a~dress of Fer~cn au~ri:ed t:o receive f,~-.ds, if ~is ap.- .. ~-___ ~e made pay~l~ Co ~he. !~cal ~ove~enc. "Xd~ress: ' F~n~Ce ~a~t~ '~i~ 6f Delray B~, 100 N. W. 'lst Argue Delrgy B~ Zi:: 3344~ This application must be postmarked not later than Auqust 1, 1983 'to be considered~ GRA~T APPLICATION Page 2 of 7 Complete a separate page 2 for each' individual programl Use an attachment page(s) if necessary. :;ame of Program !. Give a brief overview of the proposed program. 2. Identify the.%~unet human service need that this program will address. :: 3. What hmpact will this program have on the unmet 'need? 4. Is this program currently operating? YES NO If yes, what changes, if any, will the-~e funds provide for? 5. Identify the s?.~ecific target population tha~ this program will serve (elderly, low-income, handicapped, etc.) . 62 How large is the program target population? Provide numbers. 7'. How many of'the target .popula=ion will be served by the program? Provide numbers. Will this program be coordinated with any other program or serv. ices?. Identify them and explain the coordination of services. Will these grant funds be used to match a federal or other gran~? If yes, identify the type and amount. What funds Will sustain this program after the expiration of this grant? ~L. Who will do the audit of the program? Must be a CPA firm, municipal auditor, county auditor or Clerk of Court. G.~a~~. _ 18.000 Ii_-es 5 ~=cugh 9 ) Tr_ave'. <It_~.~r (s.uecif.v on a=ta=hment) ~n-.al SFacs .' _ 9.000. T.'r ave I ....... --qu£.zmen ~_ . 4on .... ~- (Lines 24 ~cuqh 2g) 2~000 ... 9~000 . 2 9 ) .... 27.000 ), 000 ., z E~iTU~S (!;~- ~7 and 30) %~ca% Gove--r~en'- Un!'- .%.:.o%yi.-.g: D_elr&v .Beach, F1prida_ . _ · :. ,,, .mmations from tna~ivia.,ua~? ~, I. 4,500. 2. 'Patient Fees Z. 4,500. ~ , TOTAL CA~ E M-A-~C~ .... 9,000. · ;i. :=-K£.'.~.. Sa!a=ies !nc. :!cu.=~-7 Eou.:s ., T='- $ X $ X $ X - --~' C~ker In-Kind " '- Uni.; N'umbe: Descri=~ion i Source C~:~"- ' '"'"' Units ~C___~v~letP~y ~,dDpmd reed%cal.-clinic. __$ 5.00 per sq. f~... X 1,800 sq. ft.. 9,000. $ X - $ X - 9,000 -- I%i. TCT~ OTHZR Total Mm~ 18,000~_ ~ 160~. W. 4~ StrUt.. ~ca ~to~ Florida 33432 ~ 305 )'..368-1023 ... C s~ci~y ~n Y. Sa_t a_-ie~ _. 20.6,00., ..... 8:. .Ken~a! ~.~ace . , 9,000. ._ = ~ _ ~ 400. ~- ~men= .... . , ~'~. O~%e_ (s:ecify on attacl~en~) 6,000 9~000. ~.. ~OT~ (~!nes 7 ~krouqh ~) 27.000 9._,000. ~. TOT~ EX?~SES (lAne 6 and lane !2) 27~0~ TOT.kL BUDGET 36,000. ~'~-'~ DZL~GATE AGENCY .K~.%EBY A~PROV~.S THIS A?~LICATiON ~TH ~L RULZS, ~GU~TiONS A~ CCNT~.~CTS RE~TiNG T~~: Typed N~e Typed Name ( ~ - F~-u~ive Director Title %mcal Gcv_=_-T.._-.en:ai ~ni~. A.=plyl.-.?: .__Ci.t~Lqf De!ray Beach,_F~orida ~ "'-ZJ. 5ECCM--= -=ART CF "-".__ C~T..=~CT ~Z.~i.~ -'..._- ~==.~.'---.~='~--~ ~'~-"' .~= '.." ALSO...-------~==~" '---~..-- "'= =~'..-.. T?.i. Ci.--.' OR ~.,'"~--'.. WiLl, -=.=.CVi=E T.=.EJ' -' -'-=--~-- · lard Younz ........ (305) 278-2841 .... A.--T.E~T---~ =,y: Elizabeth Arnau City Clerk · . City of Delray Beac~h ..... Planned Parenthood of South 'ATrACHME~ Palm Beach & Broward Counties Delegate Program Expenses: Salaries: . 1 full-time nurse practitioner working ~ time on this project 5,000. 2 part-time RNs working ¼ time on this proj edt 6,000. 1 ~ounselor working ¼ time on this project 3,000. 1 office manager ~rking ~ time on this project 2,600. ... 1 clinic manager working ~ time , on this project 4,000... 20,600. 20 mi. x 2 days x 50 weeks · x . 20 per mi. 400. Onher; - Laboratory Tests 2,000. Contraceptive Supplies 2,000. Medical Supplies 2,000. 6,000. 1. Give a brief overview of the proposed program: The proposed program will provide for the expansion of the phySical facilities, possibly into a larger single new building, the further develo~ant and im- plementation of Infertility Services and the continued increase in family planning~ medical, counseling and educational services. a) Expansion of physical facilities: Currently t_he South County Center is housed in 2 buildings: An affiliate- ~ned 1800 sq. ft. m~dical clinic building located at 160 N.W. 4th Street and a rented duplex apa~H,~nt used for administration and education located iamediately behind the clinic at 159 N.W. 3rd Street. The clinic building w~s purchased and occupied in 1978 when the Sunday School rooms at the Unitarian Church in Boca Raton could no longer acc~,L~date the growing clinic numbers. In 1980, the administration and education functions were moved into the_. rented duplex, again, to provide space for an ever-expanding clinic. It is now necessary, because of continued growth, to explore every avenue to provide space for increased client numbers and expansion of the education and training programs. b) Further develo~T~_nt and implementation of Infertility Services: Planned Parenthood has always offered a one session counseling for couples .... seeking a p~egnancy. This counseling explored general health, sexual history and preliminary instruction in fertility awareness with 2 addi- tional appointments for the wcr~mn to improve and check on her progress with fertility awareness. Following this counseling, a referral v~uld be made to local OB-GYNS with a specialty in Infertility for further treatment. In recent years, many marginal inccme couples seeking a pr .egnancy have turned back to Planned Parenthood because they-cannot afford the fees, often in excess of $5,000 for Infertility treatment by a private physician. The Public Health Depa~-H~nts do not offer Infertility Services and are extremely supportive of Planned ParentbLxxi's efforts. They would w~lccme · this resource for their clients seekin? a pregnancy. The affiliate Medical C~,~,~ttee (18 members) together with .the staff nurse practitioners would oversee this expansion of Infertility medical services. c) Continued increase in family planninq medical, counseling and educational services: The Planned Parenthood South County Center will continue to increase its provision-of contraceptive services, counseling and education to all persons without regard to age, Sex, or background. Low inccme residents of South County will receive medical services on a sliding fee scale based on inccme and family size. All counseling, education and referral is at no charge to clients. (60% of South County clients have no inccme or incomes less than $6,000 per year.) Contraceptive services are provided at the South County Planned Parenthood clinic: A free-standing, 1800 square feet modern building located in the ' civic center area of Boca Raton. The clinic is in a "downtown" location readily accessible by car and. public transportation. Clinic sessions are staffed by local OB-GYN's,nurse practitioners, R.N. 's and trained counselors, many of them volunteers. Medical services include social and medical history, weight, height, blood pressure, hemoglobin, VDRL, urine, alh~umin and sugar, pregnancy testing, info~mation (written and group instruction) on birth control method, s (pill, IUD, diaphragm, foam, condom, natural family planning), breast check, heart, lung, and thyroid check, and pelvic examinations in- cluding pap sraear and GC culture. Birth control methods are prescribed and .supplied by the clinic. Clieht~ are followed for contraceptive and medical problems and notified of annual examination. The clinic also treats cca~n disorders such as vaginitis, urinary tract infections (UTI), he _rpes and pelvic inflammatory disease (PID). Counseling services include birth control, VD, sterilization, problem pregnancy and counseling. The agency has a wide variety of referral resourses in both Palm Beach and Browa~d Counties. Birth control counseling and ster- ilization counseling involve education about methods, risk-benefits, cost, resources, etc. Problem pregnancy counseling involves examination of all options open to a w~man with an unplanned pregnancy: Resources for assistance if the pregD~cy is to be full-term, adoption, foster care, abortion. Plan- ned Parenthood is the ONLY AGENCY providing pregnancy testing and problem pregrklncy counseling in Palm.. Beach County where all options are given, where birth control methods are explained, contraceptive problems are dealt with and follow-up appointments for contraceptive services are made as a part of the counseling service. The Palm Beach County Health Dept. and the -2- Palm Beach County school system utilize Planned Parenthood's .counseling services. Plarm. ed Parenthood is the ONLY SOUTH COUA~Y CLINIC offering morning evening and Saturday clinics. The Health Department in Delray Beach offers Tuesday and Thursday afternoon family planning clinics and has a 4 week wait for an initial appointment. Educational services are provided both on and off site. Education and decision making about se~3_a!ity, health care, family life and responsibility are an integral part of on site clinic and ~ounseling services. A board- certified sex educato~ (AASECT) supervises the sex education programs. Schools, youth, churchgroups and local agencies also use the educational services of Planned Parenthood. Nursing and counseling students fr~n local colleges and universities are trained in family pl=,n~ng at Planned Parenthood. -Workshops for professionals, such as public healtL school counselors, HRS employees and ministers are offered at Planned Parenthood. The proposed program' would continue medical services with the addition of trained medical and counseling staff, as needed. 2. Identify the unmet human service need that this program will address: The rapid population growth in Palm Beach County - the "bocm area" of 1/ Southeast Florida - is expected to reach 32% or 205,260 additional people- by 1990. While many of the new residents are financially secure retirees ° ~' ~ignificant 6umber are young margiD~l inccme singles and couples and Cuban and Haitian Entrants. In Delray Beach 25?5% of households have less than 10,000 per year incite, in Boynton 32.9% ,~--' This new marginal income population plus the original poverty groups are in desperate need of family planning medical services and counseling. One of the absolute proofs for this need is reflected in the high perinatal d~ath rates among non-whites in Palm Beach County. Palm Beach County leads the state and has the highest infant mortaility rate for minorities in 1981, the latest year for which figures are available - reaching 26.4 deaths for · every 1000 live births.3_/ High perinatal death rates reflect the general health and living conditions and are related to availability of prenatal care and family planning services. Low birth weight babies born to teenagers frequently beccme death rate statistics. The unmet need to be addressed by this program also relates to the problems of the unacceptably high rate of teenage pregnancy and illegitimacy in South Palm Beach County. Unplanned teenage pregnancy, resulting in an unplanned birth or an abortion, contributes to the emotional, financial'medical and social prob!~s seen in the unprotected sexually active teenager. Teenage birth rates continue at epidemic4P, roportions with 18% of all births in Palm Beach County to teenage mothers._47 Illegitimacy among non-whites in Palm Beach County has remained at a high level over the past four years; illegitimacy among whites has increased during the same period. Additionally, this program will aid in the detection of venereal disease and ca.n. cer. Venereal disease is a significant health problem in the State of Florida, since Florida ranks 4th in ss~hilis rate and only eleven states have higher gonorrhea rates. Cancer detection--breast and cervical--remain of primary importance in female health care. Breast cancer remains at a high rate, affecting one in thirteen American wcmen. The incidence of cervical cancer is increasing due to the increase of the Herpe. s II virus, increased sexual activity at an early age an~ng adolescen~ and the effect of DES in millions of American wcmen and their daughters.-~' Both VD and cancer cures depend on early detection and treatment. While these problems are present i~ ~11 segments of society, low-inccme persons are more often the victims of lack of medical care.. Planned Parenthood is also concerned for the young marginal inccme couple may wish to have children but who are having difficulty conceiving. Infertility is experienced by approximately 10% of American couples and is increasing as a problem because of increased ~exually Transmitted Diseases and the later age of childbearing among scme wc~en. Infertility medical services and treatments 1/ The Delray News, June 19, 1983 . 2/ The Sun Sentinel Nov. 21, 1982 3/ The Miami Herald, March 6, 1983 4/ Bureau of Vital Statistics, Tallahassee, Florida 5/ American Cancer Society Publications -3- are extr~nely costly ranging frc~ $3,000 to $5,000 depending on the services provided by a private OBGYN physician specializing in infertility. Planned Parenthood wishes to utilize the m~mbers of the medical c~,~ittee and the nurse practitioner to augment a comprehensive Infertility Service including couples counseling, male physical exam and semen analysis, female physical exam, fertility awareness counseling, hormone studies, Huhner testing, Endcmetrial biopsy, hysterosalpingogram, laparoscopy and hysteros- copy. The nurse practitioner would act as the primary care person handling as many aspects of the Program as possible within the clinic and referring to local participating doctors for individual testing and treatments at a reduced rate for Planned Parenthood clients. While teenage childbearing, child spacing, unacceptably high abortion rates and perinatal death rates are problems to be addressed at the Planned Parent- hood clinic through family planning medical services, the marginal income couple faced with Infertility also needs a c~,~unity resource to p£ovide counseling and medical care. 3. What impact will this program have on unmet need? The State of Florida HRS in its ARDC Dr. ogrqm currently spends $51,000 + medicaid to raise a dependent child to age 18.5--/ The total cost to the State in AFDC payments, hospital costs, intensive care nurseries and rehabilitation programs ° is ~5~zmous. By ~m~xting the South County Clinic expanded family planning medical, counseling and educational services will be available to the increasing margir~! income and entrant population of South Palm Beach County. Sufficient provision of Planned Parenthood services would significantly improve cu~,~unity health and family s~mbility, while reducing pressures on existing agencies so that citizen needs could be better served. Every week that passes without these family planning services represents tragedy to teens, entrants and marginal inccme women and their families as unwanted (and unprovided for) pregnancies and illnesses enter their lives. Depression is al- ' ~eady a significant ~raotional problem among Cuban and Haitian Entrants, exacer- bated by poverty and an atmosphere of rejection. Through a vigorous oUtreach program the "hard to reach" entrant, teenager or marginal income women will be .specifically targeted. An attempt will be made to locate these persons through institutions (agencies, schools, churches) al- l ready in contact with them. Planned Parenthood is C~L,L.~tted to freedcm of choice in reproductive decisions. Decisions about life-style and reproductive rights need to be based on sound and accurate infomnation (infonned consent). Such decisions also require the explora- tion of personal values and cultural mores. 4. IS this program currently operating? Yes--Planned Parenthood of South Palm Beach and Broward Counties, Inc. began as a counseling and referral agency using volunteers only, in one rocm of the local Unitarian Universalist Church in June, 1975. By December 1976, clinic services bega~, using the Sunday School rooms of the Church. In January 1978, with ployees and 25 volunteers, a local building was selected, purchased and renovated into a family planning clinic (CBS 1800 square feet). In the five years of services in the South county center, the building has been cc~pletely paid for by private contributions and the client registration has reached over 8,000, 25% of these clients being frcm Delray Beach. The South county Center now has nine employees, including a full-time Fami.l.y Planning Nurse Practitioner, fifty volunteers, and four contracted local OB-GYN's help- ing provide clinic services. The rapid expansion of the medical and counseling services at the South County clinic .re~ulred the'addition in 1980 of an adjoin- ing rental unit to acc~,~date administration and education - "the duplex". The South County Center is open Monday through Friday 8-6, Monday and Tuesday evenings for clinic and Wednesday and Thursday evenings for Lamaze prepared childbirth education classes. Seven medical clinic sessions are offered each week: Monday and Tuesday evenings, Tuesday, Thursday, Saturday (once a month) mornings and Wednesday and Thursday afternoons. Counseling is offered during all remaining time slots. 6--/ Florida Association of Planned Parenthood Affiliates (FAPPA), fact sheet, 1981 -4- If yes,what changes if any will these funds ~..rovide. for? The funding will help provide for expansion of the provision of family plan- ruing medical, counseling and educational services through the expansion of the physical facilities. The current clinic and duplex are inadequate for the rapidly growing client numbers (a 21% increase during Jan.-June 1983 over the sam~ period last year). Several staff members share the same office, with overcrowding, noise and distraction a ccrmnon problem. Volunteers do not have a desk or place to w~rk. Student training (95 student nurses received training Jan.-June 1983) is done in a hallway area 6'x 12' equipped with a sofa and coffee table. The 3 counseling cubicles, 2 are also used as offices, are 6'x6'; 6'x7'; 6'x9' and inadequate for current couples counseling and de- finatelvinade~uatefor~ exoanded Infertility Services ~ounselir~z. '~ne emucar~onaz outreacn program nas ~naaequa~e space for ma-cerza~s storage. The affiliate educator shares a "back bedroom" in the rented duplex with the administrative assistant. Rocm for group education is shared with the af- filiate c~,nHttees and their work. The funding will aid the expansion of the physical plant and the provision of services. A new larger facility will be sought with the need set at between 3,400 and 4,500 square feet (currently 2,700 sq. feet in clinic and duplex). The services are expected to expand .at approximately 15% into 1984 based on current client registration and c~L,~nity growth rates. o The. .~unds will also help augment the Infertility Service program f~, level I o (counseling) to level II (treatment). By increasing the space and ultimately staff {as needed) at the Boca Raton Center, the ¥~iting ti~ for clinic and counseling appointmmnts can be kept to a minimum, an important factor when dealing with a younger transient popula- tion. Increasing clinics will allow for a greater n ~umber of clients to .receive family planning services. The addition of more clinics will allc~v teens and working mothers (many who work odd hours as waitresses, etc.) to be able to use the clinic facilities at a time when they are free to do so, i.e., early mornings, evenings, Saturdays. 5. Identify the specific target population that this program will serve: This program will benefit teenagers, entrants and marginal income w~nen and their families living in the Boynton, Delray and Boca Raton areas who find them- selves without decision making skills, accurate information to make reproductive choices and without adequate r~clical care. Both Palm Beach and Br°ward Counties both have high rates of teenage pregnancy, consistent with high rates found 'in the rest of the United States. In Palm Beach County births to non-white wcmen 'under 16 y~rs of age was considered to be one of the major health probl~ns of the county.'--' In Palm Beach County 26% of non- . white births and in Broward County 27% of non-white births were to teenagers. The Alan Guttmacaher Institute reports 1/3 of the 1.55 million abortions in 1981 were to teenagers.8/ In Palm Beach County the number of abortions increased frcm 2,903 in 1979 to 3,256 in 1980. In Broward County the increase was from -6,569 to 8,539 Ln the same period.9/ These abortion numbers are unacceptably high and could be reduced with education and family planning medical services. Illegitimate birth rates in beth Brow~rd and Palm Beach Counties r~nains high, at approximately 54% of all births for non-whites and 11% for whites. Although teen-age pregnancy is m~lically high-ri~ by definition, nearly ba]f of pregnant teenagers receive no prenatal care in 'their first trimester. The death rate frcm cc~plications of pregnancy and child birth is 13% greater for 15-19 year olds and 60% greater for teenagers 14 or younger cc~pared with w~nen in their early 20' s. Early childbearing poses serious social 'and econcmic consequences for teenage mothers and their children. Teenage mothers are often forced to leave school and to forgo job training and other opportunities for econc~ic advancement. Unmarried mothers may face social disapproval, financial hardship and difficulty in finding work and child care facilities. They my be forced to turn to wel- fare for support. A New York City survey, for example, reports 72% of mothers who first gave birth between 15 and 17 were on welfare. A life begun in poverty 7/ District 9 HRS-Health Planning Council 8--/ Teenage Pregnancy: The Problem That Hasn't Gone Away, Allen Guttmacher Institute 1981 9_/ Miami Herald, November 11, 1981 often continues in poverty and perpetuates a cruel cycle. If they marry, teenage mothers are more likely to have unstable marriages and financial problems than others of same age and socio-economic status. Wc~_n who have their first child in their teen years tend to have more children in quicker succession than their peers. The suicide rate of teen mothers is seven tim~s that of other teenage girls.10/ The health risk to babies born to teenagers is enormous. They are two to three times more likely ~o die in their first year than babies born to wc~en in their early 20 's. Babies born to teenagers are often born too small, or premature, with the associated problems of mantal retardation and congenital malformations.il/ A comparison of infant mortality rates in 4 southern states and the metropol'i'tan counties in Florida shows Broward and Palm Beach Counties to have the highest non-white infant, mo.rtality for all counties in the South- east United States.12/ According to the Fiorida Inventory of Services for Adolescents HRS, the per- centage of f~ales age 15-19 at risk of unintended pregnancy who are living in families below 200% of the federal poverty index are 45% in Palm Beach County and 37% in Brow~rd County. In Palm Beach County 55% of females at risk aged 15-19 are not served by organized family planning proqr~ ams; in Broward the number exceeds 76% (one of the highest in the .State of Florida). Only 34% of the need for family planning was met during 1982 in the State of Florida, leaving 66% of the need unmet. ° Se~lly trans~t~ diseases - syphilis, gonorrhea and herpes simplex Ii - continue to plague persons of all ages and ecom~x~ic strata. Teenagers tend to be the most frequent victims and young persons under 25 are u~a!!y half the reported cases. The Center for Disease Control ranked Florida's gonorrhea rate llth in the nation. There were 598 cases of gonorrhea per 100,000 persons in the S~ate, compared to a national average of 437.2 cases per 100,000 while the statistics for gonorrhea in Palm Beach County remain constant, the level of penicillin resistant gonorrhea has increased 108%: ~C.D.C. ranked Florida's infections syphilis rate 4th highest in 1981. The State had 30.1 cases of syphilis per 100,000 persons. The national average was 13.7 cases per~lO0,000. Palm Beach County's syphilis rate increased 36.7% from 1981 to 1982.~-~~/ The Cuban and Haitian Entrant will also be part of the target population. With the cc~pletion of the original family planning filmstrip, "The Planned Family" with language cassettes in English, Spanish and Creole, a tool will be available to the affiliate educator in attempting to reach the Entrant population. (The filmstrip has been contracted to Perennial Films, H~ghland Park, Ill. for dis-. trJtmation nationwide to clinics, schools and agencies.) · Barriers to delivering service to Entrants are numerous. Language and literacy levels must be considered. Cultural attitudes toward the "taking of medicine", the "keeping of appointments" and "the sex roles" must be understood. Scme Entrants will need basic education in health and hygiene. Many may re~,iwe transportation to classes or clinics. 6. How large is the program target population? Provide numbers. A population explosion has occurred in both Palm Beach and Broward Counties with a mass migration of individuals and families frc~ northern cities to the "Sun Belt". Since 1970 Palm Beach County has experienced a 65% population increase compared with a 43% increase for the total State of Florida. There were 505,605 Palm Beach County residents in 1977; 10,233 were 0-14 years and 73,880 were 15-24 years old. There were 578,728 residents in 1980. It has been estimated by the United Way that the population of Wes. t .Boca Raton now numbers close to 55,000 persons, making it one of the fastest growing'a~eas in the Nation. Brow-ard County has grown frcm a population of 620,000 in 1970 to 902,543 residents in 1977: 176,551%~re 0-14 years old and 126,342 were 15-24 years old. Broward County now has a population of 1,023,892. The South County Center is concerned with the recent building boc~ in Delray Beach, the addition of thousands (15,000 to 20,100 est.) Haitian and Cuban entrants into the Delray Beach black c~'L.'~dnity and the expected growth in nearby Boynton Beach with the arrival of a large ~torola plant. It is also concerned with the population growth in nearby 10/ "Teenage Parenthood" - Florida Cooperative Extension, 1979 11__/ March of Dimes 12/ District X H~S Family Planning M~nitor June 1983 1--3/ Tom Burns, Palm Beach County Health Dept. January 1983 -6- Brc~ard c~,~nities such as Deerfield, Pc~pano and Coral springs whose popu- lation has more than doubled in the last seven years. According to the 1980 census Boca ~aton has grown 74%, Boynton Beach 97% and Delray Beach 72% since the 1970 census. Boca Raton is expected to be the County's largest city,%~th a younger than average age population for Palm i Beach County by 1990.~--%~/15/ 7. How many of the target population will be served by the program? 'The current numbers of medical and counseling clients served at the South County Center is approximately 440 per month with a client registration of al- most 8,500. (30% 'of clients are teenagers and 60% have no inccme or less than ~,000 per year.) The purpose of the grant is to help expand the physical facilities to accc~te the growth in the medical, counseling and education program and to upgrade the Infertility Service aspect of the medical program. With increased facilities and increased staff (current facilities will not allow for additional staff) the clinic could increase the number of persons receiving services by 15% to an average of 510 visits per month or 6,120 visits per year. At present, off-site encounters, which include sex education programs, TV, radio, . new.spapers number almost 100,000 per year. The South County Center provides ser- vice to any person regardless of age, sex or residence. (A small, but significant number of our clients are teens and young adults who are without a-true per- manent residence.) However, these itinerant teens plus the Palm Beach and near- by Brow-ard County preteens and teenagers are the persons most at risk of un- planned pregnancies and the high incidents of venereal disease. Teenagers in general are more fearful of and less able to pay for m~dical services within traditional settings. Cuban and Haitian entrants have spread throughout South Florida with a signi- ficant number relocated in the Black C~nities of Delray Beach, Boynton Beach ,and the agricultural areas West of the Turnpike. Entrants are probably more · fearful of gove~nt run clinics and unable to pay for medical services in a traditional setting. The Infertility services (Level II) will initially serve a small number of persons, perhaps only 5 or 10 couples a year. However, for these persons of modest or marginal income seeking a pregD~ncy, the service can be extremely meaningf ~ul aD~ certainly is not duplicated anywhere locally. The Palm Beach County and Broward County Health Departments encourage the development of these services at Planned Parenthood as they currently do not provide Infertility Ser- vices themselves and do not have an outside referral for couples ccming to them for this particular kind of medical and counseling help. 8. Will this program be linked to any other program or services? Yes, the program will provide access to the following services: 1. Contraceptive medical services. 2. Well-wcmen GYN medica~ services. 3.Treatment for vaginitis, herpes II, urinary tract infections (UTI) and pelvic inflammatory disease (PID). 4. Counseling services. 5. Referral, including medical - also referral to over 30 agencies in Palm Beach County and over 50 agencies in Broward County. 6. Educational services. 7. Student training services. 8. VD and cancer testing, education and foll~-up. 9.Broad-based health screening for diabetes, hypertension, anemia, kidney aD~ bladder disease, diseases of heart, lung and thyroid. 10. Lamaze instruction for prepared childbirth. 14/ Florida Statistical Abstracts 1977 15/ Sun Sentinel March 7, 1982 11.Sickle cell testing and counseling/referral, available at Palm Beach County Health Department - Delray. 12. Level II Infertility Services - counseling and treatment. Explain the coordination of services: Clients are recruited through word-of-mouth, media and the education - outreach component of the agency. Planned Parenthood also maintains an updated file of local referrals for persons calling for reproductive he~]th related topics, i.e., information on LaMaze, LaLeche, schedules of Health Depa~:ent V.D. clinics, costs for vasectomies at local urologists, costs of maternity care and referrals for O.B., etc. If.Plaruned Parenthood cannot provide the specific serfice requested by a client, referrals are made to known c~,L~unity resources with the request to "get back to us" if :services could not be obtained. In the area of medical referrals, documentation exists on the client's chart regarding the referral and the result. A client may initiate contact with Planned Parenthood for pregnancy testing, be- ccmea contraceptive clinic client and be referred to the County Health Unit or a private doctor for a specific health probl~n while continuing as a contraceptive client at Planned Parenthood. A client referred frcm the Health Department may wish. th~ Counseling Infertility Services or Lamaze Classes offered by Planned o PareRthood, South County Drug Abuse or HRS counselors may bring clients into Planned Parenthood for counseling or family planning medical services. 9. Will these grant funds be used to match a federal or other ~rant? No. South County Center currently receives funding frcm private foundations and contributors, United Way of Greater Boca Raton and client fees. 10. What funds will sustain this program after ~he expiration of this ~rant? ~ Individual contributions $ 110,000 Special events 5,000 United Way-Boca Raton 40,000 Medicaid 1,000 Patient Fees 85,000 Contraceptive sales 65,300 Investment incc~e 3,000 Presentations (training workshops) 1,000 $ 310,000 11. Who will do the audit of the pro~ram? Patricia Rowe, CPA West Palm Beach, Florida