HomeMy WebLinkAboutTC Digest 2016-07-10TOWN COUNCIL WEEKLY DIGEST
July 6-10, 2016
TIBURON
Correspondence, Notices and other Information
1. Letter - June 16 - Grand Jury Report: The 911 First Responder Referral Program -More Than
a Band-Aid for Seniors
Agenda, Minutes
1. Agenda - July 13 - Tiburon Planning Commission regular meeting
REGIONAL, NOTICES AND AGENDA
Agenda, Minutes
1. Agenda - July 11- City of Belvedere Town Council Meeting
2. Agenda - July 13 - Tiburon Fire Protection District
2015/2016 MARI/1 COUNTY CIVIL GRAND JURY
The 911 First Responder Referral Program
-3 Than e152nd-Aid° ror enior.
Report Date: June 9, 2016
Public Release Date: June 16, 2016
Marin County Civil Grand Jury
The 911 First Responder Referral Program
More Than a Band-AidR For Seniors
SUMMARY
9-1-1: ... Okay, tell me exactly what's happened. [actual call]
Caller: My mother, who's 81, has fallen and kind of collapsed.
9-1-1: Are you with her now?
Caller: She's laying on the floor now and I'm walking towards her now.
9-1-1: Is she awake and breathing?
Caller: Yes, she's awake and breathing.
9-1-1: And when did this happen?
Caller: Moments ago. Maybe five minutes.
9-1-1: And do you know what caused the fall?
Caller: We don't. She was leaning against the wall when my father walked in the room.
Imagine you are a frail senior citizen living alone and finding it difficult to manage your daily
chores and stay independent. Suddenly, you find yourself on the floor, a little banged up and
unable to get up. What would you do? You would likely call 9-1-1 for help.
Most Marin County citizens have probably never needed to call 9-1-1 to report a medical
emergency. But if they did, within a few minutes they would likely see a fire engine and
ambulance arriving at their location and know that they would be in good hands.
When an emergency first responder (paramedic, firefighter, or police officer) arrives on scene,
after they treat the patient, there are two alternatives: 1) transport the patient to a nearby hospital
or 2) leave the patient at the scene. With an aging senior population, responders frequently find
themselves returning to the same patients. While they are eager to address the immediate problem,
they are unable to address the underlying issue: poor balance, poor diet, dementia, Alzheimer's or
other memory -related disease, etc.
The 911 First Responder Referral Program was launched by the San Rafael Fire Department in
2014 to empower emergency first responders to provide a referral, with the patient's consent, to
Aging and Adult Services Information and Assistance Program (part of Marin County's Health &
Human Services). If the patient doesn't want the referral at that time, the responder leaves
information behind so the patient and caregivers can learn more about available programs and
contact Information and Assistance when he or she is ready.
This report describes how the 911 First Responder Referral Program can be a win -win-win for
Marin County:
• Senior citizens' quality of life may improve by obtaining assistance in helping to manage
their long-term issues.
• Marin County's Health & Human Services has an opportunity to intervene earlier to
improve the client's health and wellness.
is Emergency first responders receive fewer 9-1-1 calls.
BACKGROUND
The percentage of Marin County residents who are at least 65 years old (senior citizens) has been
growing steadily for decades and is estimated to continue to grow for at least another decade:
30.00%
22 5090
N
a,
• 15.00%
7.50%
0.00%
Percentage of Population 65 Years and Older
1970 1920 1990 2000 2010 2020 2030 2040
Year
Many chronic health issues afflict senior citizens': heart disease, hypertension, stroke,
emphysema, asthma, chronic bronchitis, cancer, diabetes and arthritis. Having one or more of
these health problems increases the chances of falling3. According to the U.S. Centers for Disease
Control and Prevention:
■ One-third of Americans aged 65+ fall each year.
■ Every 13 seconds, an older adult is treated in the emergency room for a fall; every 20
minutes an older adult dies from a fall.
• Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-
related hospital admissions among older adults.
• Falls result in more than 2.5 million injuries treated in emergency departments annually,
including over 734,000 hospitalizations and more than 21,700 deaths.
• In 2013, the total cost of fall injuries was $34 billion.
• The financial toll for older adult falls is expected to increase as the population ages and
may reach $67.7 billion by 2020.
1
http:!!www.hayareacensus.ca.<_ov./counties/MarinCountv.htm and California Department of Finance: Report P-1
(Age): State and County Population Projections by Major Age Groups, 2010-2060 (by decade)
(http:/!www.do£ca.ltovJresearch!demographic!reportsiprojections/P-1 /)
2 Federal Interagency Forum on Aging -Related Statistics, Older Americans 2012: Key Indicators of Well -Being
http:!!azin_stats.eov'a2inestatsdotnet`Main Site/Data/2012 Documents!Docs/EntireChartbook.pdf
3 http://www.healthinaeing.oreaging- and-health-a-to-thopic:fallsfinfo:causes-and-symptoms%
4 http:,'l.vow.cdc.aov'homeandrecreationalsafetv/falls.ladultfalls.html and https://www.ncoa.oralresourceslfalls-
nrevention-fact-sheeti
June 9, 2016
Marin County Civil Grand Jury Page 2 of 15
Besides the previously mentioned chronic health issues, senior citizens are increasingly affected
by Alzheimer's disease':
• One in nine people age 65 and older has Alzheimer's disease.
• It is the fifth leading cause of death for those age 65 and older.
• In 2015, approximately 473,000 people age 65 or older will develop Alzheimer's disease
in the United States.
• Between 2000 and 2013, deaths attributed to Alzheimer's disease increased 71 percent.
With the growth of the elderly population emergency medical providers throughout the United
States have developed a number of programs that address their common health challenges:
• Its 2002, the City of Berkeley (California) launched The Senior Injury Prevention
Prograrn6, a collaboration between Berkeley's Fire Department, Health & Human
Services, and the Division of Aging. While Alameda County's Senior Injury Prevention
Project7 actively educates people in senior centers, the City of Berkeley wanted to support
their fire departments, who could do more with frequent "elderly lift assist" calls. With
over 13,000 senior citizens, emergency first responders currently refer 4-5 seniors/month
to the Aging Services Division for follow-up case management services.
• In 2003, Hawaii's State Department of Health, Injury Prevention and Control Section
started working with community partners to prevent falls among senior citizens8 and
developed a Hawaii Falls Prevention State Plan9. Concerned that the increasing volume of
fall -related injuries being treated by emergency healthcare providers will threaten Hawaii's
healthcare system, they have convened a number of Hawaii Fall Prevention Conferences.
• In 2007, Satellite Beacht0 (Florida) started offering fall -prevention fairs and providing 90 -
minute free in-home risk assessments. After conducting approximately 100 home
inspections, emergency first responders have seen a 7% drop in falls with injuries and hip
fracture -related incidents were reduced by 37%11.
• In 2010, San Diego12 (California) implemented an electronic system for paramedics to
provide medical case manager referrals for "vulnerable patients". Using a combination of
9-1-1 and 2-1-1, these patients are able to access (free or low cost) community services to
obtain help for finding food, housing and other senior services. As a result, connecting
seniors to services within the community reduced the 9-1-1 system call volume. 2-1-1 San
$ https:iiwww.alz.or,%facts!downloads/facts figures 2015.pdf
6 http:/'www.ci.herkelev.ca.us/I-Iealth_Human ServicesfDivision on Aping/
Senior Companion_Careeiver and Injury Prevention Progranls.aspx
http:'/stopfalIs.ori'advocacvr snccess-storiesralalneda-county-senior-Injury-prevention-project/
8 http://health.ha wai i.gov/inj urvpre vention/fi les /2013: 09/HIPP-2012-2017-Fal Is -Prevention -671 KB.odf
9 https:!/www.hawaiiadre.ore/Portals/ AgencvSite/201 3Falls.pdf
10 hup:hwww.satel I itebeaclifire.com/Pdfall-preventionlci 1 n16
11 Statistics provided by Satellite Beach Fire Rescue (Florida)
12 littp:/!w vw jerns.coin!articles/print'volurne-41/issue-2 features/
how-san-diego-ems-i nteerated-system-wide-conditional-social-referrals-in-epers.html
June 9, 2016 Marin County Civil Grand Jury Page 3 of 15
Diego13 also offers a free Are You OK? automated daily phone call as a senior safety
check.
• In 2013, Delaware County (Ohio) launched the First in Response To Seniors" (FIRST)
program. Their initial challenge was establishing clear internal communication among the
various team members: first responders, service coordinators, directors and legal
representatives. A grant from local Area Agency on Aging15 covers 85% of the cost of the
program. Of the 477 referrals in 2015, eight individuals were enrolled in a Community
Support Program, and 26 individuals had new services added to their established care
plans. Thus, the FIRST program accelerated the establishment and/or addition of much
needed services.
• In 2014, Central Mason Fire & EMS16'17 (Washington State) joined with the Mason
County EMS Council to create a Falls Prevention Program, which has since expanded to
five surrounding Washington counties. Their baseline data showed that senior citizens
comprised 2/3 of hospital admissions for falls, and their initial EMS referral program
reduced falls by about 10%. They are hoping to reduce falls to a total of 30% using the
Otago Exercise Prod •amrne' 8.
• In 2015, police, fire and EMS agencies in Hamburg (New York)19 began offering free fall
prevention safety checks.
The public might not be aware, but most fire departments and fire protection districts in Marin
County offer free home safety inspections upon request. In addition to offering inspections to look
at all home hazards (structure, vegetation, fall -prevention, etc.), the Novato Fire Protection District
offers a Fall Prevention Program that addresses several concerns that contribute to elderly falls'°.
Their first responders will soon be distributing a Tips to Prevent Falls handout.
Less well known than the emergency 9-1-1 service, the 2-1-1 service offered throughout the
United States "connects callers with hundreds of programs to help people find food, housing,
health care, senior services, child care, legal aid, volunteer opportunities and much more."2'
Accredited by the Alliance of Information and Referral Systems (AIRS)', the United Way of the
Bay Area operates the Bay Area 211 free helpline for five counties23. The 2-1-1 service provides
resource information from local agencies and it is up to the caller to make contact with any service
or agency.
13
littp://www.211sandiel..Y.,o.ora/
to http::'firehouse-servcoord.or_l/pages/16
15 httpaYwww.n4a.org/
16 Emergency Medical Services (EMS)
17 Iutp:/www_kitsapsun.cominews/local/mason/
first -responders -rake -new -approach -w ith-senio rs-pron e-to-fal is-ep-69352_4697-355196461.html
18 http://www.acc.co.nz:PRD EXT CSMP!aroups/externalproviders/
documents/publications promotion/prd ctrb118334.pdf
19
http://www.twencws.cominvs/bliffaloinewsi2015/12/15/
fire--pol ice-and-ems-personnel-volunteer-to-offer-fal l-prevention-services-to-the-elderly.html
20 Developed in partnership with Dominican University of California's Department of Occupational Therapy
21 httos:/'uwba.or,/211
�2 http://www.airs.or&'i4a/pages/index.cfin?pagelD=3376
33 Service also available at http://2 I 1 bavarea.ore./
June 9, 2016
Marin County Civil Grand Jury Page 4 of 15
METHODOLOGY
In researching this topic, the Grand Jury:
• Investigated similar programs in other states.
• Interviewed Marin fire chiefs to learn how emergency medical services and the 911 First
Responder Referral Program are deployed in their service area.
• Interviewed staff in Marin County Health & Human Services to understand how the
County handles these referrals.
• Interviewed United Way of the Bay Area staff who oversee 2-1-1 implementation.
DISCUSSION
In June 2014, the San Rafael Fire Department launched the 911 First Responder Referral
Program. Although emergency first responders observed recurring senior -related issues, they were
limited to treating the immediate problem, but could do nothing to prevent its recurrence. The 911
First Responder Referral Program developed a simple form that is sent to a referral team. The
form is provided to the referral team only if the senior citizen or adult agrees that such additional
aid or assistance is necessary and desired. However, in the early months they were challenged by
the limited capacity of the referral team.
In January 2015, Marin County's Aging and Adult Services24 established the Information and
Assistance Program (I&A), to provide customized client -centered referral support. Before 1&A
was launched, people wanting information on County programs would have to navigate a
complicated automated phone system. The new program was to provide a higher level of service, a
single contact point, and a system for follow through.
Early in 2015, San Rafael Fire Department started working with the Information and Assistance
Program to streamline the referral process and ensure referral tracking. The resulting collaboration
allows first responders to initiate a referral and know that help would be available much sooner.
The 911 First Responder Referral Program does not change what responders do or how they do
it—they simply are given "another tool for their toolbox" to help their patients. The program
simplifies the responder's job by using a standardized form and relying on Aging and Adult
Services Information and Assistance Program's expertise to find the best solutions for the patient.
Since Marin County Aging and Adult Services helps both seniors and adults, the 911 First
Responder Referral Program can also refer adults for help, although the majority of medical 9-1-1
callers are senior citizens.
To date, the Fire Department has trained 60 San Rafael Fire Department first responders and 40
San Rafael Police Department patrol officers to recognize elderly patients with age-related
problems and connect them with community resources these patients might not be aware of.
24 http:i aeine.livelonglivewellmarin.ors/
June 9, 2016 Marin County Civil Grand Jury Page 5 of 15
The Process
When someone in San Rafael calls 9-1-1 with a medical emergency:
1. 9-1-1 dispatches appropriate emergency medical services.
2. Emergency first responders (usually a fire engine and ambulance) arrive and begin
appropriate treatment.
3. The 911 First Responder Referral Program can begin after the patient is stable. While
treating the patient, first responders are also trained to be aware of their surroundings,
looking for obvious indications25 that the patient has some underlying problems, such as:
their home in disarray; they are heating their home with an oven; they are at risk for
medication interaction complications; they do not have a local support network; they have
insufficient or inedible food; their memory is impaired. While a person may appear fine in
public, in private it may be clear to the responder that they are at risk.
4. If the responder determines that their patient already has a social worker assigned to them
(in conversation, looking at their Vial of L.1.F.E.26, or from a relative), which is the case
for approximately 10% of the 9-1-1 medical callers, the responder contacts the patient's
social worker and shares their observations.
5. Based on the indications, the responder may offer to complete a Request to Phone Me With
Help Form for services (see Appendices A and B). The fear that many patients express is
the possibility of a loss of independence and being forced to leave their home. The
responder explains that Request to Phone Me With Help simply allows a social worker to
contact them with help and refer them to appropriate services. If the patient agrees to the
referral, the patient signs the form.
6. The responder faxes the signed form to the Information and Assistance Program and also
logs their referral into a first responder referral database. Health Insurance Portability and
Accountability Act (HIPPA) regulations27 are followed to ensure that the patient's health
information is handled in confidence. If they do not wish to fill out the form, an
information sheet (see Appendices C and D) is left behind to educate the patient and their
caregivers about County resources.
7. Marin County's Aging and Adult Services Information and Assistance Program receives
the referral. They are mandated by the Older American's Act28 to respond and follow-up
on 100% of all assistance referrals. Sharing the programs and resources that might be a
good match for the client's29 needs ("resource counseling") and contacting the client's
25 In response to a 9-1-1 call, first responders are allowed to enter a dwelling without a warrant to render emergency
aid and assistance to a person whom they reasonably believe to be in distress and in need of that assistance. Once
inside on that basis, rendering that assistance could include checking for medications, but also might include looking
for other health and welfare hazards that are in plain view.
26 A small plastic vial containing an overview of a patient's medical history stored in the refrigerator. It is available
for free from any fire station in Marin County. http:/!vialoflife.comi
http://www.cros.sov/Remulations-and-Guidance!l-II PAA -Administrative -Simplification)
111 PAAGe n I n fo/down n loadsih i pail aw•.pd f
Zg
http://www.aoa.goviAoA Pro2ramsiOAA/lndex.aspx
29 Health and Human Services staff refer to first responder patients as clients.
June 9, 2016
Marin County Civil Grand Jury Page 6 of 15
family caregiver or nearby aide, as appropriate, the social worker helps these people
become aware of the client's situation. The social worker can also facilitate program
enrollment, including "a soft handoff"— to personally introduce them to an appropriate
program representative. At any point the client has the choice to decline service help.
8. First responders follow up with the Information and Assistance Program to ensure that
patient referrals were contacted, and update the patient's status in the first responder
database.
Funding
The San Rafael Fire Department's direct cost to implement the 911 First Responder Referral
Program is under $5,000/year, which the San Rafael Fire Department considers an investment in
their strategy to slow the growth rate of their 9-1-1 call volume.
Program Results
The San Rafael Fire Department's first responders enthusiastically endorse the program30:
"It's an incredible tool to use."
"We're hungry to solve problems that have aggravated us and eager to use our skills."
"It feels good to do this."
Marin County's Aging and Adult Services Information and Assistance Program (I&A) now has
social workers answering calls, doing program intakes and personally helping callers understand
available resources to Live Long Live We1131. Compared to local 2-1-1 service, 1&A provides a
much more personalized, comprehensive and up-to-date free service, by phone, email, and
website.37 They shared a typical success story:
"A year ago, I reached out to an elderly couple referred by the 911 First Responder
Referral Program, who were confused and disoriented. After speaking to the wife for a
while, she gave me the number for her daughter in Sonoma, and I called her to find out
more about her parents' situation. The daughter stated that she visits her parents every
weekend and prepares food for then. After assessing the parents' situation, I gave the
daughter resources for home caregiver agencies, linked her to telephone equipment for the
hard of hearing, and gave her information for home -delivered meals. The daughter was
very pleased with our outreach in Aging and Adult Services."
In 2015 there were 41 Aging and Adult Services referrals from the San Rafael Fire Department.
That might not sound like many referrals for a service area with an estimated senior population33
of 10,038 and 5,936 medical 9-1-1 calls. However, in previous years, these 41 people had been
30 Interviews conducted with the San Rafael Fire Department
31 http:/!asina.liveIon=livewellmarin.orOprojects
32 https://www.rnarinhlis.orn/aging-adult-services
33 http:/.%factfinder.census.govibkmk!c£'1.0/en/place/San Rafael city, California/POPULATION/PEP EST
June 9, 2016
Marin County Civil Grand Jury Page 7 of 15
responsible for over 375 calls, 90% of which were fall -related, with some people making up to
three fall -related calls a day.34
Next Steps
The Marin County Fire Chiefs Association, inspired by the results of the San Rafael Fire
Department program, is working on identifying next steps towards a County -wide emergency first
responder program and protocol. They feel that they have "hit a homerun" for fire prevention and
response, and now want to "hit a homerun" for healthcare. Many Association members have
already been implementing components of the 911 First Responder Referral Program. The goal
now is to create a better referral tracking database, offer trainings, and to develop a consistent
community outreach for the program.
Conclusion
Since the publication of the 2014 Grand Jury Report Aging in Marin: What's the Plan?35, the
County of Marin's Aging and Adult Services has streamlined a senior citizen referral strategy with
emergency first responders. While the 911 First Responder Referral Program is still very much in
its infancy, the Grand Jury applauds the initiative of the San Rafael Fire Department and Marin
County's Aging and Adult Services Information and Assistance Program. Based on similar
programs in the United States, the Grand Jury expects that this program, when rolled out County-
wide, will not only make a significant difference in the lives of senior citizens, it will make better
use of existing local social services, and will likely reduce many preventable 9-1-1 medical calls.
34 Statistics provided by San Rafael Fire Department
35 http:Pwww.marincounty.or '—imediaitiles departments!gi!renorts-responses/20I 3/aging in marin.pdf
June 9, 2016
Marin County Civil Grand Jury Page 8 of 15
FINDINGS
F1. Marin County's Aging and Adult Services Information and Assistance Program is a highly
proactive team of caring professionals who have a strong desire to provide personalized
assistance for improving lives of adults in the County.
F2. The San Rafael Fire Department has done an effective job implementing the 911 First
Responder Referral Program and fostering an efficient relationship with the Aging and
Adult Services Information and Assistance Program.
F3. The Marin County Fire Chiefs Association has a strong desire to roll out a consistent 911
First Responder Referral Program, which could be successful in every fire department
throughout Marin County.
RECOMMENDATIONS
R1. Marin County fire chiefs should implement the 911 First Responder Referral Program
County -wide.
R2. Marin County fire chiefs should create a community outreach campaign for the 911 Fast
Responder Referral Program.
R3. Marin County police chiefs and Sheriff should have their patrol officers/deputies attend the
911 First Responder Referral Program training.
R4. Marin County paramedic agencies should have their emergency first responders attend the
911 First Responder Referral Program training.
R5. Private ambulance companies serving Marin County should have their emergency first
responders attend the 911 First Responder Referral Program training.
Note: At the time this report was prepared, information was available at the websites listed.
Reports issued by the Civil Grand Jury do not identify individuals interviewed. Penal Code Section 929 requires that reports of
the Grand Jury not contain the name of any person or facts leading to the identity of any person who provides information to
the Civil Grand Jury. The California State Legislature has stated that i1 intends the provisions of Penal Code Section 929
prohibiting disclosure of witness identities to encourage full candor in testimony in Grand Jury investigations by protecting the
privacy and confidentiality of those who participate in any Civil Grand Jury investigation.
June 9, 2016
Marin County Civil Grand Jury Page 9 of 15
REQUEST FOR RESPONSES
Pursuant to Penal code section 933.05, the grand jury requests responses as follows:
From the following governing bodies:
• Bolinas Fire Protection District (RI, R2)
is Central Marin Police Authority (R3)
• City of Belvedere (R3)
• City of Larkspur (R1, R2)
• City of Mill Valley (R1, R2, R3)
• City of Novato (R3)
• City of San Rafael (R1, R2, R3)
• City of Sausalito (R3)
• CSA #28 (West Marin Paramedic) (R4)
• CSA #31 (County Fire) (RI, R2)
■ Kentfield Fire Protection District (R1, R2)
• Marinwood Community Service District (R1, R2)
is Novato Fire Protection District (RI, R2)
• Ross Valley Fire Department (R1, R2)
• Southern Marin Emergency Medical -Paramedic System (R4)
• Southern Marin Fire Protection District (RI, R2)
■ Stinson Beach Fire Protection District (R1, R2)
• Tiburon Fire Protection District (R1, R2)
• Town of Corte Madera (R1, R2)
■ Town of Fairfax (R3)
• Town of Ross (R3)
• Town of Tiburon (R3)
The governing bodies indicated above should be aware that the comment or response of the
governing body must be conducted in accordance with Penal Code section 933 (c) and subject to
the notice, agenda and open meeting requirements of the Brown Act.
From the following individuals:
• The Marin County Sheriff (R3)
The following individuals are invited to respond:
• Police Chief, Belvedere Police Department (R3)
• Police Chief, Central Marin Police (R3)
• Fire Chief, Corte Madera Fire Department (RI, R2)
• Police Chief, Fairfax Police Department (R3)
• President, Falcon Critical Care Transport (R5)
■ President, Falck/verihealth, Inc. (R5)
June 9, 2016
Marin County Civil Grand Jury Page 10 of 15
• Fire Chief, Larkspur Fire Department (RI, R2)
• President, Marin County Fire Chiefs Association (R1, R2)
• Fire Chief, Marin County Fire Department (R1, R2)
• President, Marin County Police Chiefs Association (R3)
• Fire Chief, Mill Valley Fire Department (R1, R2)
• Police Chief, Mill Valley Police Department (R3)
■ Chief Executive Officer, NORCAL Ambulance (R5)
• Police Chief Novato Police Department (R3)
• Police Chief, Ross Police Department (R3)
• Fire Chief, San Rafael Fire Department (RI, R2)
• Police Chief, San Rafael Police Department (R3)
• Police Chief, Sausalito Police Department (R3)
■ President, St. Joseph's Ambulance Service (R5)
• Police Chief, Tiburon Police Department (R3)
June 9, 2016 Marin County Civil Grand Jury Page 11 of 15
APPENDIX A: Request to Phone Me with Help Form (English)
Request to Phone Me with Help
First Responder Referral Project
Information and Assistance to Keep You Safe and At Home
Name Phone (415)
Address
Family Caregiver? No ❑ Yes 0
Name Phone
Any other help, such as a neighbor?
Name & relationship Phone
Describe Situation
By signing below, I invite you to ask Marin County Aging and Adult Services to phone me about ml
situation, and allow them to contact other help organizations as needed.
would like help with:
_ Transportation to medical appointments. _ Taking care of my spouse or partner.
_ House cleaning and organizing. _ Food shopping and meals. _ Reducing trip hazards.
Having more social activities. Other
Signature of Patient or Caregiver
First Responder Name
Date
Station/ Shift Station Phone or Personal Cell
-If this person was transported to Emergency: KP ❑ MGH 0 NCH 0
First Responder — please fax this completed form to both:
1. Marin County Aging & Adult Services: (415) 473-7042 or (415) 473-6465
phone (415) 457-4636, M -F 8:30-5 www.mainhhs.org/aging-adult-services
2. San Rafael Fire Department, Station 51— (415) 453-1627
The 911 First Responder Referral Project is a cooperative initiative of Senior Access, the City of San Rafael Fire Department
and the Marin County Fire Chiefs Association.
June 9, 2016
Marin County Civil Grand Jury Page 12 of 15
APPENDIX B: Request to Phone Me with Help Form (Spanish)
Solicitud para Iiamarme con Ayuda
Proyecto de Referencia del Departamento de Bomberos
Informacion y Asistencia para mantenerse seguro en casa
Nombre Telefono (415)
Direccion
Ilene cuidado familiar? No 0 Si 0
Nombre Telefono
Recibe otro tipo de ayuda; como de un vecino?
Nombre y Relacion Telefono
Describa su Situacion
Al firmar a continuacian, les permito pedir a el Servicios para Adultos del Condado de Marin que me
Ilame por mi situacion, y les permito ponerse en contacto con otras organizaciones de ayuda, segOn sea
necesario.
Me gustaria ayudar con:
_ Transporte a las citas medicas. _ Cuidado de mi conyuge o pareja.
Limpieza y organizacion de la Casa. La compra de alimentos. La reduction de riesgos de tropiezos.
Tener mas actividades sociales. Otros
Firma del Paciente o Cuidador
Nombre del Respondedor
Fecha
Estacion/grupo Tel de la estacion o personal
Si Esta persona fue trasladada a Emergencies: KP 0 MGH ❑ NCH 0
Respondedor por favor envie por fax este formulario completo a ambos:
1. Marin County Aging & Adult Services : (415) 473-7042 o (415) 473-6465
Telefono (415) 457-4636, L -V 8:30-5 w>wl.mainhhs.orgraging-adult-services
2. Departmento de Bomberos de San Rafael, Estacion 51 — (415) 453-1627
El Proyecto de Acceso para Adultos es una lniciatIvo de cooperation del 911. Departamento de Bomberos de la Ciudad de Son Rafael, y la
Asociacidn de lefes de Bornberos del Condado de Marin.
June 9, 2016 Marin County Civil Grand Jury Page 13 of 15
APPENDIX C: Marin County Aging and Adult Services Info Sheet (English)
Marin County Aging and Adult Services
Information & Assistance,
(415)-457-I N Fo, (415) 457-4636
457-info@marincounty.org
Monday — Friday, 8:30am — 5pm
Community Resource Guide
MarinHHS.org/Resources
MarinHHS.org/Aging
Do you need equipment or supplies?
ReCARES, provides free gently used health care
equipment, such as walkers, wheelchairs, canes and
commodes, and unused medical supplies, such as wound
dressings and adult diapers, Wednesdays 11 am-2pm,
3100 Kerner Blvd, San Rafael, (415) 388-8198
June 9, 2016
LIVE Lo-- LIVE elb
www.Livelonglivewellmarin.org
Marin County Civil Grand Jury Page 14 of 15
APPENDIX D: Marin County Aging and Adult Services Info Sheet (Spanish)
Servicio para Adultos y Envejecimiemto del
Condado de Marin
Informacion y Asistencia
(415).457iNFO, (415) 457-4636
457-info@marincounty.org
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June 9, 2016 Marin County Civil Grand Jury Page 15 of 15
TOWN OF TIBURON
Tiburon Town Hall
1505 Tiburon Boulevard
Tiburon, CA 94920
A-�
Agenda - Regular Meeting
Tiburon Planning Commission
July 13, 2016 — 7:30 PM
AGENDA
TIBURON PLANNING COMMISSION
CALL TO ORDER AND ROLL CALL
Chair Kulik, Vice Chair Williams, Commissioners Corcoran, Weller, and Weiner
ORAL COMMUNICATIONS
Persons wishing to address the Planning Commission on any subject not on the agenda may do so
under this portion of the agenda. Please note that the Planning Commission is not able to undertake
extended discussion, or take action on, items that do not appear on this agenda. Matters requiring
action will be referred to Town Staff for consideration and/or placed on a future Planning
Commission agenda. Please limit your comments to no more than three (3) minutes. Testimony
regarding matters not on the agenda will not be considered part of the administrative record.
COMMISSION AND STAFF BRIEFING
Commission and Committee Reports/Director's Report
ELECTION OF CHAIR AND VICE CHAIR
PUBLIC IHFARINGS
1. 2304 MAR EAST STREET: Appeal of Planning Division decision to conditionally approve a
Tidelands Permit to expand an existing dock and pier; File #TIDE2015003; Mark and Racia
Blumenkranz, Owners/Appellants; Assessor's Parcel No. 059-400-10 [DW]
MINUTES
2. Planning Commission Minutes —Meeting of May 25, 2016
ADJOURNMENT
Tiburon Planning Commission Agenda
July 13, 2016 Page 1
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AGENDA - REGULAR MEETING
BELVEDERE CITY COUNCIL
JULY 11, 2016, 6:30 P.M.
City Hall Council Chambers
450 San Rafael Avenue, Belvedere, California
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COMMENTS ON AGENDA ITEMS BY MEMBERS OF THE PUBLIC
The public ti,'ill be given an opportunity speak on each agenda item when it is called. Upon being recognized by the
!flavor, please state your name and address, and limit your oral statement to no more than three minutes. The
Council welcomes comments and questions raised by interested citizens but typically does not respond during the
comment period.
6:30 PM CALL TO ORDER
6:30 PM ADJOURN TO CONDUCT AN ANNUAL MEETING OF THE BELVEDERE
PUBLIC FINANCING CORPORATION IN COUNCIL CHAMBERS
6:35 PM RECONVENE REGULAR COUNCIL MEETING IN OPEN SESSION
PLEDGE OF ALLEGIANCE
1. Interview applicants for the various positions on City committees.
OPEN FORUM
This is an opportunity for any citizen to briefly address the City Council 011 any matter that does not appear
in this agenda. Upon being recognized by the Mayor please state your name, address, and limit your oral
statement to no more than three minutes. Matters that appear to warrant a more lengthy presentation or
Council consideration will be agendized for further discussion at a later meeting.
REPORTS & PRESENTATIONS
2. City Council Reports.
3. City Manager Reports.
CONSENT CALENDAR
The Consent Calendar consists of items that the City Council considers to be non -controversial. Unless any
item is specifically removed by any member of the City Council, staff, or audience, the Consent Calendar
will be adopted by one motion. Items removed 1i'ill he considered in the sequence as they appear below. If
any member of the audience wishes to have an item removed, please step to the microphone, state your
name, and indicate the item.
4. Approve minutes of the following:
httpJtwww.cityofbelvedere.org/Archive.aspx?AM ID=44&Type=Recent&PREVIEW=YES 1/3
7/7/2016 Belvedere, CA- Official Website
A. June 6. 2016. special City Council meeting.
B. June 13. 2016. regular City Council meeting.
5. Approve warrants of June 2016.
6. Adopt resolution authorizing the examination of sales and use tax records.
7. Approve amendment to .Dint Powers Agreement for the Belvedere -Tiburon Joint Recreation
Committee.
8. Approve response to Marin County Civil Grand Jury report. "Marin's Hidden Hunian Sex Trafficking
Challenge: It's Happening in Our Backyard."
9. Adoption of an ordinance of the City of Belvedere amending Section 20.04.035. "Tine limits for
construction." of the Belvedere Municipal Code to increase the Construction Time Limit daily fine amounts
and the maximum fine amount. and other minor administrative updates (introduced June 13. 2016).
10. Adoption ofan ordinance of the Cit -y- of Belvedere amendii>_g Title 11. "Water and 'Watercraft," of the
Belvedere Municipal Code to require boat permits. establish a fee for boat permits. and provide a penalty for
any boat in Belvedere waters without a permit in excess of 10 hours: clarify the City's authority to remove
derelict boats pursuant to existing states law; remove Chapter 11.12 to prohibit houseboats and other minor
administrative updates (Introduced June 13. 2016).
11. Adoption of an ordinance of the City of Belvedere amending Title 19, "Zoning." to establish a permit
process. procedures. and standards for review and approval of Junior Second Units in existing single family
dweliings (Introduced June 13. 2016).
OTHER SCHEDULED ITE?I'IS
12. Consider appointments to various positions on City committees and commissions.
Staff recommendation: Discuss applicants and make appropriate appointments.
DECLARE ELECTION RESULTS
13. A. Adopt resolution reciting the facts of the Belvedere general election held on June 7. 201
declaring the result. and such other matters as provided by law.
B. Presentation by Mayor McAuliffe to retiring Council Member Sandy Donnell.
14. Swearing in a presentation of certificates of election to Bob McCaskill, Claire McAuliffe, and Nancy
Kemnitzer.
15. City Council reorganization.
A. Election of mayor.
B. Election of vice -mayor.
C. Presentation to outgoing Mayor McAuliffe and remarks by council member.s
ADJOURN
http://www.cityofbelvedere.org/Archive.aspx?AM ID=44&Type= Recent&PR EVI EW=YES 2/3
7/7/2016 Belvedere, CA- Official Website
NOTICE: WHERE TO VIEW AGENDA MATERIALS
Staff reports and other materials distributed to the City Council are available for public inspection at
the following locations:
> Belvedere City Hall, 450 San Rafael Avenue, Belvedere.
(Materials distributed to the City Council after the agenda packet is published are available
for public inspection at this location only.)
> Belvedere -Tiburon Library, 1501 Tiburon Boulevard, Tiburon.
To request automatic mailing of agenda materials, please contact the City Clerk at 415/435-8913.
NOTICE: AMERICANS WITH DISABILITIES ACT
The following accommodations will be provided upon request to persons with a disability; agendas
and/or agenda packet materials in alternate formats and special assistance needed to attend or
participate in this meeting. Please make your request at the Office of the City Clerk or by calling
415/435-3838. Whenever possible, please make your request four working days in advance.
http:l/www.cityofbelvedere.org/Archive.aspx?AMID=44&Type=Recent&PREVIEW=YES 3/3
TIBURON FIRE PROTECTION DISTRICT
BOARD OF DIRECTORS MEETING
AGENDA
1. CALL TO ORDER
WEDNESDAY, JULY 13, 2016
6:30 P.M., HEADQUARTERS
FIRE STATION
1679 TIBURON BLVD.
2. CONSENT CALENDAR
All items under the Consent Calendar are considered to be routine and may be approved by one motion
of the Board of Directors unless a request is made by a member of the Board, public or staff to remove
an item for separate discussion and consideration. If you wish to speak on a Consent Calendar item,
please seek recognition by the Board and do so at this time.
A. Approval of Minutes, June 8, 2016 (Action)
3. COMMUNICATIONS
4. PUBLIC OPEN TIME for items not on the agenda
This portion of the meeting is reserved for persons who want to address the Agency on any matter not
listed on the agenda. The Ralph M. Brown Act prohibits discussion of items that are not duly placed on
the agenda. Speakers are limited to three minutes. Please Note: The Chair will allow time for public
comment on each agenda item.
5. CHIEF'S REPORT
A. Monthly Report (Discussion)
B. Grand Jury Report — "2015/2016 The 911 First Responder Referral
Program: More Than a Band-Aid® for Seniors" (Discussion)
C. Grand Jury Report — "2015/2016 Marin's Hidden Human Sex Trafficking
Challenge: It's Happening in Our Backyard" (Discussion)
D. Approve Step Raise — Executive Assistant Nicole Chaput, Range 315,
Step #3, $6,254/mo., effective July 16, 2016 (Action)
6. TREASURER'S REPORT
A. Finance Committee — Directors Sears and O'Neill (Discussion)
Finance Committee Meeting — Wednesday, July 13, 2016, 1530 hrs.
Headquarters Fire Station, 1679 Tiburon Blvd.
B. Approve Warrants and Payroll (Action)
7. COMMITTEE REPORTS
A. MERA — Chief Pearce (Discussion)
B. SMEMPS — Director O'Neill (Discussion)
C. PERSONNEL — President Kirchhoff and Director O'Neill (Discussion)
8. BOARD COMMENTS
9. ADJOURNMENT
NEXT REGULAR TFPD BOARD MEETING: August 10, 2016, 6:30 P.M. A complete agenda package is
available for viewing at 1679 Tiburon Blvd. Copies of past TFPD minutes are available for viewing at the same
location.
In compliance with the Americans with Disabilities Act, if you need special assistance to participate in this
meeting, please contact the District office at 435-7zoo. Notification at least 48 hours prior to the meeting
will enable the District to make reasonable arrangements.