Friday, December 30, 2016

Not the sexiest topic

“It’s not the sexiest topic the new Collier County Commission could start with in 2017, but it’s certainly one of the most important.”

I couldn’t agree more with that statement in a recent Naples Daily News Editorial titled “Important hand off on long-term growth plans.”

The County’s population will grow to almost half a million by 2040 from 345,000 today, according to a report by the Regional Economic Research Institute at Florida Gulf Coast University. That’s a lot of change to be planned and managed! And our five County Commissioners, including the three who were newly elected this year, will decide how that growth will happen.

The issues are many and controversial: The environment. Clean water supply. Fracking. Sea level rise. Beach replenishment. Infrastructure. Economic development. Affordable housing. Parks and recreational facilities. And with each issue, decisions must be made, not only about what to do, but how to pay for it.

What better time than the start of the New Year to resolve to become better informed about our County government?

Tuesday’s Collier County Commission (BCC) Workshop on Strategic Planning and Growth Management is a great way to start!

Here are the main items on the Agenda, along with some brief observations I made while reviewing the materials to be presented:

Strategic Planning 2017

Some interesting changes to the County’s Strategic Plan will be first up at Tuesday’s meeting. The Vision is unchanged, but the Mission will now explicitly address the future:

Vision: “To be the best community in America to live, work, and play.”

Mission: “To deliver high-quality and best-value public services, programs, and facilities to meet the needs of our residents, visitors, and businesses today and tomorrow.”

The County’s six Strategic Focus Areas are unchanged:

Collier County Strategic Areas of Focus

Each Focus Area is supported by a new Strategic Goal to provide clarity, and continues to be justified by a set of Community Expectations. Some significant changes to those Expectations are proposed, most of which I agree with, although I’m curious about how Staff came up with them.

For example, in Growth Management, three new Expectations are proposed:

  • Evaluate, monitor, and plan for the effects of sea level rise.
  • Develop integrated and sustainable plans that manage water resources and solid waste.
  • Conserve, preserve, monitor, and manage natural resources in partnership with external stakeholders.

I’m pleased and encouraged to see these, and hope they will be accepted by the Commissioners with little need for debate.

In Community Health, Wellness, and Human Services, these significant changes are proposed:

  • Improve Support access to health care and wellness services. 
  • Address the needs of the community’s senior, disabled, working poor veteran and indigent populations. 

Where did these proposals come from and what will they mean for our community? Is the County explicitly saying it will play no role in improving access to health care, or in addressing the needs of the working poor? This is an area where clarification is needed, and where we can let our opinions be heard.

In Economic Development, Staff proposes explicitly stating the County’s targeted industries, which had not been done previously:

  • Promote our community as a year-round destination of choice for leisure, business, sports, and eco-tourism

This, too, is an area where community input is especially important. It has been sought in many fora in the past, but if you haven’t weighed in yet, now could be your last chance.

Update on the Eastern Collier County Planning Area Restudies

In 2015, the BCC agreed to spend $1.3 million over the next four years to redo and update (restudy) four existing plans for areas in the eastern part of the county where the future growth will take place. These areas are referred to as:

  • The Rural Fringe Mixed Use District (green)
  • The Golden Gate Area Master Plan (orange)
  • The Rural Lands Stewardship Area (blue)
  • The Immokalee Area Master Plan (yellow)


According to Tuesday’s Agenda and the Workshop Materials, Staff will give an overview of the County’s approach to growth management. Then they will review the purpose, history and status of these four area restudies. Since the Rural Fringe restudy was the first to begin, most of the focus of the presentation and discussion will be on that effort, specifically highlighting key issues needing resolution or direction from the Board prior to the public hearing phase. Then they will report on the outreach efforts to-date on the Golden Gate restudy. And finally, they will ask for Board direction on the future timing of the other two restudies.

As a 13-year resident of Collier County who reads the local paper and tries to stay informed, I have some knowledge about what’s happening in the eastern part of the County. I’ve been to the heavily agricultural area of Immokalee on several occasions, and visited the planned community of Ave Maria two or three times. I’ve had meetings and attended events at the County Offices and Community Center in Golden Gate, and was Principal for a Day at Golden Terrace Elementary School. From reading the newspaper and speaking with friends more involved than I am, I have a high-level understanding of some of the challenges Commissioners face in trying to satisfy the various parties interested in how development happens “out there.” But I'm not as informed as I would like to be.

So I am looking forward to learning more about Collier County’s growth management history and plans at Tuesday’s Workshop. With three brand new Commissioners, hopefully the presentation will be at a level that doesn’t assume in-depth knowledge.

It is important that we Collier voters and taxpayers become informed about what’s happening while these plans are still in the restudy phase. I have no doubt that the decisions our County Commissioners will make will affect our future quality of life.

Let’s make sure we are pay attention and participate in the process.

When and Where

The Workshop will be Tuesday, January 3, 2017, beginning at 1 PM, in the Board of County Commissioners chambers, third floor, Collier County Government Center, 3299 Tamiami Trail E., Naples, Florida 34112 (get directions). I hope to see you there!

And if you can’t make it, email your thoughts and questions to the Commissioners (find yours here):

District 1 - Donna Fiala - DonnaFiala@colliergov.net
District 2 - Andy Solis - AndySolis@colliergov.net
District 3 - Burt Saunders - BurtSaunders@colliergov.net
District 4 - Penny Taylor - PennyTaylor@colliergov.net
District 5 - Bill McDaniel - BillMcDaniel@colliergov.net



Help me reach more Collier County voters by sharing this post with your friends. You and they can subscribe to Sparker’s Soapbox by email at www.sparkers-soapbox.blogspot.com, “like” me on Facebook at www.facebook.com/sparkers.soapbox or follow me on Twitter @SparkersSoapbox.

Sunday, December 11, 2016

The School Nurse Program at Collier County Public Schools

As promised in my last post, I am returning my focus to Collier County Public Schools and our state and local government, now that the 2016 elections are behind us. I look forward to sharing what I learn with you in the weeks and months ahead.

This first post-election piece was inspired by Ann Campbell, chairman of the League of Women Voters of Collier County’s Social Policy Committee, who was formerly a nurse.

Last season, Campbell and her Committee were concerned about the downsizing of the Collier County Public Schools (CCPS) nursing staff that accompanied the renewal of the District’s contract with Naples Community Hospital for the school nurse program. The renewal had been approved unanimously by the School Board at its March 10, 2015, meeting following public comments, a presentation by Eileen Vargo, Coordinator of Health Services for CCPS, and Board discussion.

From the Executive Summary that accompanied the Board Agenda Item:

The School Health Services Act, Florida Statute 381.0056, requires health services be provided in accordance with a local School Health Services Plan, developed jointly by the County Health Department and the District School Board. Pursuant to statute, the Plan must include, at a minimum, provisions for: health appraisals; nurse assessments; nutrition assessments; health records reviews; vision screenings, hearing screenings, scoliosis and growth and development screenings; referral and follow-up of suspected or confirmed health problems; meeting emergency health needs; referral of students to appropriate health treatment; consultations with parents or guardians regarding the need for health care; maintenance of records; health counseling; required medication administration and medical procedures; prevention of communicable diseases; preventive dental services; and health needs of students with disabilities.

The approved three-year contract with NCH began at an annual cost of $2.6 million. There are provisions for annual increases based on the Bureau of Labor Statistics Medical Consumer Price Index (MCPI) not to exceed 5% per year and any new costs to support district expansion and the addition of new schools. This state requirement is an unfunded mandate.

The CCPS Health Services web page is here.

I attended a meeting last month arranged by Campbell for her Committee with Eileen Vargo, CCPS Director of Health Services, and Christene Parker, RN, Naples Community Hospital, Director of the CCPS School Nurse Program, to find out what impact the changes had over the school year. With her permission, below is Campbell's summary of the meeting.

Background: Twenty years ago, in 1996, The League of Women Voters of Collier County supported the establishment of the current school nurse program under the auspices of Naples Community Hospital (NCH). Prior to that time, K – 6 students received screening (vision, hearing, spine) via the Health Department. Students’ medications were retained by and administered by school secretaries. NCH administration became concerned about the number of, often preventable, visits of school children to the Emergency Room. They stepped up to introduce a pilot school nurse program in the schools. It made a difference. 
Over the years, the NCH program has expanded to include nurses in every school at least part time and athletic trainers in all high schools. The program has had a positive impact in Collier County Schools even though it didn’t meet the nationally recommended ratio of one nurse to every 750 students. 
In May 2016, the American Academy of Pediatrics announced a policy recommendation that there should be at least one full time nurse in every school to deal with the increasing complexity of health problems among the students. 
School health nurses are often the only health care professional that students meet. The nurses intervene to reduce unneeded emergency room visits; identify critical problems requiring prompt attention by medical providers; help to reduce absenteeism; and provide support to school administration, teachers and staff. They promote a safe, healthy environment and facilitate parent involvement in the health of their children. 
There are no national guidelines for school nursing. Some states have requirements such as one nurse with advanced training in each district. No mandate exists for certified school nurses (now a recognized specialty). Florida neither mandates nor funds school nurses. It is left to county school districts to provide this important service.
Today in Collier County, there are 47,000 students being served in 50 schools. Eileen Vargo reported that CCPS Health Services and the NCH-sponsored School Nurse program work together with the Florida Department of Public Health in Collier County, Florida’s Vision Quest (providing testing and eyeglasses), The University of Florida College of Dentistry, and others to deliver high quality school health services to Collier’s students. Health needs run the gamut from seizure disorders, mental health crises, infections, minor injuries, to tube feedings and respirators. There are 2,400 children with life-threatening allergies, 100 with insulin dependent diabetes. Many of the students require individual health care plans. As the medical acuity of individual students increases, leadership must continuously evaluate how to place nursing staff to meet the needs of the children in a cost-effective manner. 
The “Lead” RN, in a “truly professional nursing role,” assesses the health needs of the children and is responsible for the training of Assistants in first aid, supportive care and more. Nurses (RNs and LPNs) are paired with Assistants in the schools according to the acuity of the students’ needs. 
Thirty schools have nursing coverage five days a week, up from 21 to 23 last year. That led to an adjustment in the other schools with five schools covered four days a week, ten covered three days, two covered two days and two with coverage one day a week. A typical day for a school nurse might involve 60 student visits or more. 
We asked Eileen Vargo about the challenges she sees at this time. Among them are: 1. Staff vacancies — there is a need to recruit and retain qualified and experienced staff; 2. The growing number of students with chronic health conditions, requiring medications or procedures at school — and the impact on staffing needs; and 3. Providing nursing services to medically fragile students in our ESE (exceptional student) special classes while also providing care for all students.
Christene Parker, who came on board to head the NCH program just before school started this year, brings a wealth of experience from her work in school nursing in New Jersey. She sees the purpose of the school nurse program as focusing on the health and wellness of all the students, thereby putting into place appropriate strategies to maintain student health and support attendance. She speaks enthusiastically about encouraging professional development for her staff to enhance nursing skills and foster critical thinking and decision-making. Christene reminds us that school nursing is an area of practice that is unlike nursing in a hospital or clinic; the school nurse works independently, with a great deal of autonomy in a community setting.


We learned a great deal during our visit with Eileen and Christene and we thank them sincerely for allowing us to get a picture of the great work that they are doing. We think one of the other challenges for children in Collier County might be matching their insurance (or lack of it) with local pediatricians in a timely manner when they are referred for care by the school nurse. Of course, we would like to see more funding for the program so the increasing needs of the children can be safely met. We hope to follow this issue and support the School Nursing Program in any way that we can.
According to the Centers for Disease Control and Prevention, "Scientific reviews have documented that school health programs can have positive effects on educational outcomes, as well as health-risk behaviors and health outcomes." It's important for voters to be aware of the many challenges faced by Florida school districts that go beyond teachers, tests and textbooks. Attending to the health needs of its students is just one of them. Many thanks to Ms. Campbell for arranging this meeting and allowing me to share her summary.
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Help me reach more Collier County voters by sharing this post with your friends. You and they can subscribe to Sparker’s Soapbox by email at www.sparkers-soapbox.blogspot.com, “like” me on Facebook at www.facebook.com/sparkers.soapbox or follow me on Twitter @SparkersSoapbox.

Friday, December 2, 2016

My brief dive into how Collier County voted

Having gotten over the shock of Donald Trump’s election, I found myself wanting to better understand the results in the context of my own community. How conservative is Collier County compared to the state as a whole? Were the results pretty much the same throughout the County, or were there pockets that voted significantly differently?

While our 87 percent voter turnout was the highest in the state (see “Voter turnout in Collier was No. 1 among Florida counties, helping Trump win”), was there a similarly strong participation at all levels of government, or just in the high-stakes, highly-publicized presidential contest?

So I did some digging into the Collier County vote results and additional information I requested from the Supervisor of Elections Office. In this post, I’ll share the highlights of my review, and some thoughts about what I learned.

How conservative is Collier County compared to the state as a whole?

The county has long been so overwhelmingly Republican that in most recent elections, no Democrat could be convinced to run.

This year, admirably, there were two notable exceptions: Democrats Annisa Karim and Tamara Paquette ran for County Commission in Districts 3 and 5, respectively. But their Republican opponents Burt Saunders and Bill McDaniel won, with 66 and 56 percent of the votes, respectively.

Based on the results of the November elections, that strong Republican bias continues. In each of the contests for federal office (Table 1), the Republican candidate won Collier County with at least 60 percent of the votes. And in each case, the win was stronger here than in the state or Congressional district as a whole. In fact, Donald Trump won Florida with less than 50 percent of the vote.

Table 1

For details of Collier’s 2016 General Election results, click here; for Florida’s results, click here.

As of today, 51 percent of Collier registered voters are Republican, 24 percent are Democrat, and the rest are No Party Affiliation or other parties. These figures are updated daily at www.colliervotes.com.

Collier County has been and continues to be solidly Republican and much more conservative than the state as a whole.

Were there pockets of the County that voted differently?

Not only did Republicans carry the County, they carried all but five of the 60 precincts (Table 2). It is not surprising that precincts located in East Naples, Golden Gate, River Park and Immokalee went for Clinton, as they are some of the lowest income areas of the county. But interestingly, Rubio carried two of the five: precincts 156 in East Naples and 324 in Golden Gate.

Table 2

I was disappointed, though not surprised, to learn that the precinct I live in went slightly more heavily for Trump and Rubio than the County as a whole. For County results by precinct, including how the precinct you live in voted, click here.

While there are a few pockets of the County in which a majority voted differently, for the most part, the County voted Republican.

Did the strong voter turnout carry to the down-ballot races?

When a voter casts a ballot but doesn’t register a vote in one of the races on it, it registers as an “under vote.” I was again disappointed, but not surprised, to learn that Collier’s record high voter turnout did not mean a similar degree of voter participation in the less-well-known and publicized races.

Table 3

Table 3 shows that, as would be expected, the smallest percent of under votes was registered in the presidential election. Just one percent of the Collier voters who cast a ballot chose not vote for any of the presidential candidates. Ninety-nine percent did.

However moving down the ballot, the number of people who left votes blank increased. Three percent didn’t vote in the U.S. Senate race. Five percent didn’t vote in the Congressional District 19 race.

The under vote was significantly higher, meaning a significantly smaller percentage of people voted, in the State House or Senate races than in the County Commission races. For example, the under vote in the County Commission races was less than 10 percent, while the under vote in the Legislative races was more than 20 percent.

I can think of at least four possible explanations for this:

  • Voters knew less about the State offices and candidates than the local ones, and didn’t want to make an uninformed vote;
  • Voters were more motivated to vote in the County races, where there were both Republicans and Democrats on the ballot, than in the State races, where there were only Republicans;
  • Voters didn't vote in the State races since, with only a Republican and a “Write In” to choose from, the outcome was virtually predetermined;
  • Voters knowingly or unknowingly cast an invalid vote, e.g. by writing in a name other than that of the “ghost” write-ins who qualified or filling in the “Write In” oval but leaving the line for the candidate’s name blank.

The last is what I did to protest the “write-in loophole” that had closed the Republican primaries for those races.

Moving further down the ballot, the percent of under votes continued to increase. Between 26 and 28 percent of voters didn’t vote in the Fire District races, a third didn’t vote in the Mosquito Control District races, and 35 percent didn’t vote in the Soil and Water Conservation Board race.

The strong voter turnout did NOT carry to the down-ballot races.

What’s next?

Maybe that’s just how it’s always been, and maybe that’s how it is everywhere. But is that acceptable? Shouldn’t some voter education group try to do something about it?

The Naples Daily News, the League of Women Voters and others hosted Candidate Forums and made them widely available, but the questions asked of the candidates assumed a certain basic level of understanding of the issues that I suspect many voters don’t have. Many of those for whom English is a second language would surely have had trouble following the debate.

Perhaps the under vote figures could be examined by precinct to learn how pervasive the problem is and try to identify the reason(s) for it. Once that is known, more and different forms of voter outreach and education can be explored and planned. I’d be interested in readers’ thoughts and suggestions.

In any case, I am closing my book on the 2016 elections for purposes of this blog. I’m looking forward to continuing to learn and write about the Collier County School District and public education in Florida, as well as other aspects of Florida government in Sparker's Soapbox going forward. I hope you’ll continue to follow me.



Help me reach more Collier County voters by sharing this post with your friends. You and they can subscribe to Sparker’s Soapbox by email at www.sparkers-soapbox.blogspot.com, “like” me on Facebook at www.facebook.com/sparkers.soapbox or follow me on Twitter @SparkersSoapbox.