HISTORY
On February 8, 2017, at the request of Commissioner John Elizabeth Aleman, the City Commission referred the item to the Land Use and Development Committee (Item C4K). On February 15, 2017, the Land Use and Development Committee discussed the item and continued it to March 8, 2017. On March 8, 2017, the Land Use and Development Committee discussed the item and continued it to the April 19, 2017 meeting.

On April 26, 2017, the City Commission referred the item to the Health Advisory Committee for discussion and recommendation (Item C4E). On May 15, 2017, the Health Advisory Committee discussed the item and recommended that it have a workshop to review the proposal in further detail prior to making a recommendation.

On June 14, 2017, the Land Use and Development Committee discussed the item and took no action. On June 19, 2017, the Health Advisory Committee held a workshop and recommended that the ordinance incorporate the modifications provided in an attached handout.

On June 28, 2017, the City Commission referred the proposed ordinance to the Planning Board for review and recommendation (Item C4A).

BACKGROUND
The City Commission has approved a temporary moratorium on the issuance of any land development permits, business tax receipts or any other license or permit for the establishment or operation of adult congregate living facilities (ACLF). In addition to ACLF’s, the moratorium applies to assisted living facilities, crisis stabilization units, residential detoxification centers, community residential homes, and residential medical rehabilitation centers, and any similar or derivative uses associated with such uses. The moratorium is in place until December 31, 2017.

The City has identified the need to update the City Code as it pertains to definitions and regulations for crisis stabilization units, residential detoxification centers, community residential homes, and residential medical rehabilitation centers. Additionally, the term adult congregate living facility (ACLF) has become obsolete and, as currently defined in the City Code, needs to be updated to conform to state law. In addition to replacing the obsolete term ‘ACLF’ with “assisted living facility,” the City Code needs to be revised to include proper licensure requirements and to comply with state law requirements.

PLANNING ANALYSIS
Initial research on state statutes and various municipal codes related to medical uses has been done. The City of Pompano Beach has been found to have very detailed requirements for such uses in their land development regulations.

Staff has also undertaken a review of medical uses within the City, utilizing business tax receipt (BTR) information, along with information from various State agencies that are responsible for the regulation of medical uses. The City currently has 25 BTR classifications for medical uses. Some medical uses have been identified where it may be beneficial to establish new classifications in order to better account for the variety of medical uses and impacts.

It is the intent of the ordinance to utilize terms that are consistent with the licenses issued by State agencies, including the Florida Agency for Healthcare Administration (AHCA), Florida Department of Health, and the Florida Department of Children and Families (DCF). This will ensure transparency for the zoning requirements for medical uses.

A suitability analysis has also been undertaken for various medical uses. For the purposes of this analysis, medical uses have been categorized by the intensity of their impact and whether or not they allow for overnight stays or permanent residence. Classes one (1) to three (3) would not allow for overnight stays, while classes four (4) to eight (8) would allow for overnight stays or permanent residence. Generally, all of the uses within a particular class would have a similar impact on the surrounding areas. The classes are generally as follows:

• Classes one (1) to three (3) would generally not allow for overnight stays:

o Class 1 – Medical uses that have an impact similar to, and often incorporate retail uses. These may include Optician, Retail Clinic, Adult Day Care Center, Electrology Facility, and Medical Office. These uses are often seen as a small accessory use to large-scale residential and hotel uses as well. These uses could be appropriate in up to 20 of the City’s zoning districts.

o Class 2 – Medical uses that generally provide medical care throughout extended working hours, along with diagnostic and testing services. These may involve the generation of higher levels of medical waste than Class I, and generate higher levels of traffic. These uses are often located within office or retail buildings, and typically schedule appointments with patients during standard working hours. These may include Ambulatory Surgical Center (ASC), Laboratory, Comprehensive Outpatient Rehabilitation Facility, End-Stage Renal Disease Center, Health Care Clinic, Prescribed Pediatric Extended Care Center, Urgent Care Center, Women’s Health Clinic, Pathologist, and Rehabilitation Agency. These uses could be appropriate in up to ten (10) of the City’s zoning districts.

o Class 3 – Medical uses which typically dispense pharmaceuticals as part of their treatment plan. These may involve frequent visits from patients who may require services from the facility on a daily basis. These may include Detoxification Centers, Intensive Outpatient Treatment Facilities, and Pain Management Clinics. These could be appropriate in up to six (6) of the City’s zoning districts.

• Classes four (4) to eight (8) would allow for overnight stays or permanent residence:

o Class 4 – A category in which assistance is given to permanent residents with assistance in daily personal activities including but not limited to, bathing, dressing, eating, grooming, and dispensing of medicine in a residential setting. Such a facility may have no more than six (6) residents. This includes Adult Family Care Home, Assisted Living Facilities, Community Residential Homes, Homes for Special Services, Hospice Facility, Intermediate Care Facility Developmentally Disabled, and Residential Treatment Facility (Level V). These facilities are often located in single family areas and could be appropriate in up to 26 of the City’s zoning districts.

o Class 5 – A category in which assistance is given to permanent residents with assistance in daily personal activities including but not limited to, bathing, dressing, eating, grooming, and dispensing of medicine in a residential setting. Such a facility may have no more than 14 residents. This includes Adult Family Care Home, Assisted Living Facilities, Community Residential Homes, Homes for Special Services, Hospice Facility, Intermediate Care Facility Developmentally Disabled, and Residential Treatment Facility (Level V). These could be appropriate in up to 17 of the City’s zoning districts.

o Class 6 – A category in which mmedical uses generally provide 24-hour medical supervision and may implement medication management and other medical care for its residents. However, the patients do not pose a physical danger to themselves or others. They are typically in a residential setting; however, they may have some institutional components. They may contain recreational amenities to improve the quality of life of patients. Such a facility may have no more than 80 residents or patients. Such facilities are generally intended to assist permanent residents. This includes Adult Family Care Home, Assisted Living Facility, Birth Center, Community Residential Home, Day/Night Treatment Community Housing, Homes for Special Services, Hospice Facility, Intermediate Care Facility Developmentally Disabled, Nursing Home, Residential Treatment Facility (Level IV and V), and Transitional Living Facility. These could be appropriate in up to 13 of the City’s zoning districts.

o Class 7 – A category in which medical generally provide 24-hour medical supervision and may implement medication management for its residents or patients; however, they treat residents or patients who may pose a physical danger to themselves or others and security is required. They are typically of an institutional nature, though they may take place in a more residential setting. Such a facility may contain recreational amenities to improve the quality of life of patients. This includes Adult Family Care Home, Assisted Living Facility, Birth Center, Community Residential Home, Day/Night Treatment Community Housing, Homes for Special Services, Hospice Facility, Prescribed Pediatric Extended Care, Intensive Inpatient Treatment Facility, Intermediate Care facility for the Developmentally Disabled, Nursing Home, Residential Treatment Facility (Level I, II, III, IV and V), Residential Treatment Facility for Children, Residential Treatment Center for Children and Adolescents, and Transitional Living Facility. Based on an initial suitability analysis they could be appropriate in up to six (6) zoning districts.

o Class 8 – A medical use that treats a full range of medical related issues. This is the most intense medical use. Such a facility includes a Hospital, Trauma Systems, Crisis Stabilization Unit, Addiction Receiving Facility, Medication and Methadone Maintenance Treatment Facility, Detoxification Center, Organ and Tissue Procurement Facility, Intensive Inpatient Treatment Center, Prescribed Pediatric Extended Care, and Other medical uses. These are appropriate in one (1) of the City’s zoning districts (HD Hospital District).

A review of the active and applied for medical use BTR’s indicates that the City only has Class 1, 2, 6, 7, and 8 facilities.  The following table indicates the number of facilities within each class, and the zoning districts in which they are located.  A map at the end of the report identifies the location of medical uses in the City.

Medical Use Class Location by Zoning District

The proposed ordinance also contains proposals for the following:

1. The zoning districts for which the different classes of uses should be permitted.

2. Which uses should be treated as a main permitted use or require Conditional Use approval from the Planning Board within the various zoning districts.

3. Distance separation requirements between and within certain classes of facilities so as to not create excessive impacts on any particular neighborhood.

4. Minimum standards for different classes of medical uses to ensure that their impacts on surrounding areas are minimized.

5. Establishes business tax receipt (BTR) codes and fees for all uses that are identified in the ordinances.

PLANNING BOARD REVIEW
On September 26, 2017, the Planning Board transmitted the proposed Ordinance Amendment to the City Commission with a favorable recommendation.

UPDATE
The subject ordinance came before the City Commission on October 18, 2017 and was continued to a date certain of October 31, 2017, due to the lack of a quorum. Based upon feedback from members of the City Commission on October 18, 2017, and at the request of the item sponsor the following modifications have been made to the attached ordinance for consideration at First Reading:

1. Section 142-1253: New text establishing that Variances cannot be issued for separation requirements

2. Section 142-1255: Prohibit Class III medical uses in in TC-1 districts and allow them in C-PS2 districts.

3. Section 142-1256: Require that Class III medical uses not be located within 600 feet of a school, park, or religious institution.

4. Section 142-1259: Inclusion of a reasonable accommodation standard.