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Community for a Lifetime Study Commissioned by Osceola County Produced by Community Vision


Communities for a Lifetime

Community for a Lifetime (CFAL) is a statewide initiative that began in 1999 to assist Florida communities in implementing improvements that benefit elder (60 and over) and residents overall. This project helps to provide opportunities for seniors to remain independent in their communities by making plans to improve current resources. This report will highlight those existing resources and articulate needs identified in the areas of transportation, health and wellness, housing, employment, crime and safety, volunteerism, and recreation.

County Overview

TABLE OF CONTENTS County Overview .....................2 Crime & Safety............................5 Housing & Social Services.....6 Health & Wellness.....................9 Employment..............................21 Transportation........................22 Volunteerism & Activism....26

Long before the allure of Disney, Osceola County was once the center of Florida’s cattle industry in the mid 1800’s. At current, tourism still remains a financial resource for the community however; beef production is still strong within the County. Osceola County has two incorporated cities; Kissimmee and St. Cloud, which both have a plethora of preserved historic buildings. Also, the County encompasses the areas of Poinciana, Celebration, and Harmony, which are home to scenic parks, challenging golf courses, and beautiful lakes. Osceola County recreational activities include nearly 200 miles of hiking trails, airboat adventures in the Everglades, live gators at Gatorland, record-breaking bass fishing at Lake Tohopekaliga, and a plethora of thematic restaurants. Also, in the area of entertainment, Osceola Heritage Park (OHP) in Kissimmee, Florida is a 120-acre complex which includes the 10,500-seat Silver Spurs Arena, 60,000-square foot Exhibition Building, and Osceola County Stadium (home of the Houston Astros Spring Training). Moreover, ESPN’s Wide World of Sports Complex located at Disney provides a 220 acre state of the art sports complex (ESPN is 80 percent owned by ABC, Inc., which is an indirect subsidiary of The Walt Disney Company). The complex hosts nearly 200 games and professional events each year and can accommodate more than 60 sports. The facility also includes several outdoor playing fields, a baseball stadium, and tennis courts. While the Osceola School District is the largest employer in the County, Osceola is also home to several large corporations. A few include: Tupperware Brands which is currently ranked No. 2 in Fortune magazine for the “World’s Most Admired Companies” in the category of Home Equipment Brands; and McLane/Suneast, Inc. which is a $34 billion supply chain services company. These two companies, including the others listed, make up the County’s Top Corporate Employers. Sources: Kissimmee US Airways Magazine Profile; Wide World of Sports website – http://espnwwos.disney.go.com/; Tupperware Media Room website – http://tupperware.mediaroom.com; and McLane Inc website – http://www.mclaneco.com

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United States

According to the United States Administration on Aging, there are currently 56,986,401 Americans age 60 or older in the United States. This makes up about 18.4% of the current population. The percentage of Older Americans is expected to increase over the next 40 years. The Senior Resource Alliance’s (SRA) Area Plan on Aging stated that since 1996, the number of older Americans increased by 3.3 million. Over this same time period, the number of Americans aged 45-64 who will reach age 65, increased by 39 percent. This highlights that the projected number of Americans will live longer than prior generations of older Americans. Source: U.S. Administration on Aging website: http://www.aoa.gov/aoaroot/aging_statistics/future_growth/future_growth.aspx

Florida

Throughout the later half of the 20th Century, Florida became the state where a great majority of people came to retire. In Florida, nearly a quarter of the residents are age 60 and older. Florida has the highest population proportion of elders age 65 and older than any other state in the United States, but ranks 49th in the proportion of people age 18 and older. Floridians age 85+ up has increased by about 65% since 2000. This is significant due to those 85+ up being four times more likely to need long-term care services. Those elderly below the 125% of the poverty guideline may qualify for the (SNAP) Supplemental Nutrition Assistance Program, but only about 47% receive benefits. Although not noted in the chart, of all Floridians that qualify for Medicaid AND Medicare, 71% are age 60 or more. Florida Section Sources: Critical Issues for Florida’s Future: Florida’s Aging Population. 2007. 3rd Edition; County Profiles. Florida Department of Elder Affairs. 2009 &2010

Osceola County

According to the Florida Department of Elder Affairs (DOEA), the population projection for 2010 for residents age 65 and older in Osceola County is 29,924. This is equal to about 11% of the total projected population for the County. Also, about 24% of those 60 and older live in rural areas of the county. Moreover, about 32% of Osceola County residents who are age 60 and above have at least one disability. NOTE: According to TITLE 42, CHAPTER 106 § 9902 of the United States Codes, the term “poverty line” is in reference to the official poverty line defined by the Office of Management and Budget based on the most recent data available from the Bureau of the Census. For example, for a single person in 2009, the poverty guideline was set at an annual income of $10,830. For a single person to be living below 125% of this guideline, they would be making about $8,123 per year (or 25% lower than the poverty line of $10,830 per year). Sources: County Profiles. Florida Department of Elder Affairs. 2009 &2010

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Older American Act — Millions of senior citizens have benefitted from the services provided by a federal law called the Older Americans Act. The mission of the act is “to help older people maintain maximum independence in their homes and communities and promote a continuum of care for the vulnerable elderly”. The Older American Act:

• established the Administration on Aging (AoA), which serves as the federal agency to oversee issues related to older adults. The AoA also administers newly created grant programs. • established grant support to fund state agencies on aging and local area agencies on aging. • established allotments for part-time community service jobs for unemployed low-income seniors age 55 and up with poor employment prospect. • authorized the long-term care ombudsmen program and programs structured to prevent abuse, neglect, or exploitation of older adults.

Sources: National Health Policy Forum Website: http://www.nhpf.org/library/the-basics/Basics_OlderAmericansAct_10-08-09.pdf; Administration on Aging Website: http://www.aoa.gov/aoaroot/aoa_programs/oaa/index.aspx

Senior Resource Alliance

The Senior Resource Alliance is responsible for overseeing state and federal allocated resources for senior services (including their caregivers and family members) in the Florida Department of Elder Affairs Planning and Services Area 7 (PSA 7). This area includes Osceola, Orange, Seminole, and Brevard counties (demographic info provided).

The mission of the Senior Resource Alliance is to enable elders to age with independence and dignity in the setting of their choice. They do this by: • providing information and leadership in the community • ensuring quality of services delivered to elders • advocating for elders’ issues • developing resources to increase services to elders Source: Senior Resource Alliance Website: http://www.seniorresourcealliance.org; Florida Department of Elder Affairs 2009 County Profile

Osceola Council on Aging (COA)

The Osceola Council on Aging, Inc. is a 501 (c) 3, non-profit, private charitable organization dedicated to providing services to enable independence and self-sufficiency for seniors, disabled adults and disadvantaged families. The Osceola Council on Aging delivers many elder services from funds allocated by the Older American Act, which are disseminated by the Senior Resource Alliance for Osceola County. Created in 1971, the Osceola Council on Aging, Inc. is the largest social services organization in Osceola County, providing a wide array of services and programs to meet the needs of our community. Though the name implies services for just the elderly, their scope of services extend to families as well, helping during crisis to enable generations of residents to cope with challenges. A few of these services include emergency utility and rental assistance, a family self-sufficiency program, and financial management. Source: Osceola Council on Aging

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CRIME AND SAFETY

Improved Family Safety — Elder Abuse

To be considered an elder a person must be 60 years old. (Florida Law 825.102) states, abuse as aggravated abuse, and neglect of an elderly person or disabled adult. Intentional infliction of physical or psychological injury upon an elderly person or disabled adult, active encouragement of any person to commit such an act. Great bodily harm or permanent disability or disfigurement need not be a result to be considered a violation of this definition. Abuse can be physical or psychological. (Florida Law 741) states, domestic violence, means domestic means any assault, aggravated assault, battery, aggravated battery, sexual assault, sexual battery, stalking, aggravated stalking, kidnapping, false imprisonment, or any criminal offense resulting in physical injury or death of one family or household member by another family or household member. As you can see the crimes can be associated depending on the individuals involved. Also the term aggravated being used means an outside (influence) such as a weapon, tortures, maliciously punishes or willfully and unlawfully cages an elderly person or disabled adult causing great bodily harm, permanent disability or permanent disfigurement to the person. (Florida law 825.103) states, exploitation of an elderly person or disabled adult, knowingly or by deception or intimidation, obtaining or using or endeavoring to obtain or use, an elderly persons or disabled adult’s funds, assets or property with an intent to temporarily or permanently deprive the elderly person or disabled adult of the its use, benefit or possession or to benefit someone other than the elderly person or disabled adult. It can also be a person who stands in a position of trust or has a business relationship with the elder person or disabled adult. Also the accused does not have a defense to prosecution simply because they did not know the age of the victim or is disabled. In addition, there are Older Persons Referral Cards filled out by an investigating deputy which may not warrant a criminal or civil investigation by that deputy, however, would still justify an inquiry thus the need for the elder card. These cards describe needs that the elder person may require such as food, clothing, utilities, caretaking and other types of assistance which often can be offered by various agencies in Osceola County. On average there are five to ten cards received by the Senior Services representative each week, estimating an amount of 350 per year or a total of 700 for the years 2008 and 2009 which needs to be followed up by the Senior Services representative in order to remedy the situation. Elder abuse occurs when a person uses power and control to inflict physical, sexual, emotional or financial injury or harm upon an older adult. The problem occurs in all communities and affects people of all ethnic, cultural, racial, economic and religious backgrounds. Generally, abusers use a pattern of coercive tactics, such as isolation, threats, intimidation, manipulation and violence to gain power over their victims. According to the National Center for Elder Abuse, estimates of the frequency of elder abuse range from 2% to 10% based on various sampling, survey methods, and case definitions. It is difficult to say how many older Americans are abused, neglected or exploited, in large part because surveillance is limited and the problem remains greatly hidden. Official state statistics that are available vary widely. Currently, there is no uniform reporting system. No specific statistics for Florida or Florida counties could be obtained. Sources: National Center for Elder Abuse, Florida Department of Elder Affairs and the Osceola County Sheriff’s Office Osceola County Sheriff’s Office statistics.

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HOUSING & SOCIAL SERVICES

Aging in Place

The Elder Economic Security Initiative seeks to enable policy makers, aging advocates and others in developing policies and programs to help seniors age with dignity while promoting their economic security. A key component of the initiative is the Elder Economic Security Standard (EESS) which measures well-being to determine the income and supports needed for older adults to live modestly depending on their health and life circumstances. Developed by Wider Opportunities for Women in conjunction with the Gerontology Institute at the University of Massachusetts Boston, the EESS index is a more precise and up-todate measure of seniors’ income adequacy and economic well-being, since Federal poverty thresholds do not account for the rising costs of living that seniors experience as they age. Osceola County is facing a local economy negatively affected by escalating costs of living. The Florida Department of Elder Affairs 2009 County Profile reports that 23.7% of all elder households in Osceola County carry a cost burden above 30%, and incomes below 60% of the area median income. This indicates a growing number of low-income senior households are unable to maintain financial stability. Elderly Americans challenged by rising costs for medical care and basic necessities have been seeking bankruptcy-court protection at sharply faster rates than other adults. This suggests that financial security is progressively eroding for many older Americans. From 1991 to 2007, the rate of personal bankruptcy filing among those ages 65 or older jumped by 150%, according to the AARP 2007 Consumer Bankruptcy Project. The most startling rise occurred among those ages 75 to 84, whose rate soared 433%. In previous decades, Social Security helped seniors to meet basic needs for daily living, but with a declining economy, increasing costs for food, fuel, housing and healthcare, and a general lack of retirement preparedness, elderly persons are now at greater risk for bankruptcy and financial stress. Source: Wider Opportunities for Women; Florida Department of Elder Affairs; AARP Policy & Research

The Neighborhood Stabilization Program (NSP) of Kissimmee will purchase 10 foreclosed properties through the NSP fund. The houses will be donated to the Osceola Council on Aging and will be available for rental for seniors, families with special needs, and veterans who meet eligibility guidelines. 6


HOUSING & SOCIAL SERVICES

Affordable Housing

Affordable and subsidized housing for low-income seniors and disabled adults provides safe and secure residential environments with supportive social services to enable residents to live as independently as possible. Notably, there is a demand in Osceola County for “first floor” affordable senior housing. Oftentimes, seniors who currently live on the second-floor of two story complexes need to move into a downstairs apartment and are given priority over seniors who are still on waiting lists. Several affordable housing apartment complexes may have waiting lists that range anywhere between a few months to a few years. Also, several of the 55+ apartment complexes available have closed waiting lists, meaning that they are no longer taking names to include on their current waiting list. The Osceola Council on Aging provides a list of available housing with contact information. The list provided for this report is not all inclusive.

Apartments (at least) Age 55+

Mobile Home Parks — Age 55+

Thousands of older adults age 55 and older reside and/or retire in mobile home parks within the County. Mobile home parks offer a host of amenities for seniors to enjoy while residing within the parks. A few of those amenities include (but are not limited to): shuffle board, bingo, clubs, swimming pools, and walking paths. While mobile home parks have added to the variety of housing options available for seniors, however, many seniors experience issues with weatherization (or other home improvement problems) that may not be eligible for free or reduced repair services. Senior Mobile Home Parks (55 and up): • Sugar Mill Mobile Home Park, St. Cloud • Teka Village Mobile Home Park, St. Cloud • The Mark Mobile Home Park, St. Cloud • Whispering Pines Mobile Home Park, Kissimmee • Windsor Mobile Home Village, Kissimmee

The Osceola Council on Aging is applying for HUD Section 202 for supportive housing for the elderly in Buena Ventura Lakes. If approved, a total of 50 units will be developed.

Source: Florida Commission on Human Relations Website: http://fchr.state.fl.us/housing_directory/search/Osceola/County ; Osceola Council on Aging

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HOUSING & SOCIAL SERVICES

Available Housing Services

Osceola “Granny Flat” Exemption In accordance with State Statute 193.703, taxpayers who build additions onto an existing home or perform extensive renovations to provide living quarters for a parent or grandparent may be entitled to a special exemption equal to the amount of the new construction (up to 20% of the homestead value). To be eligible, the property owner must have a Homestead Exemption on the property where the parent or grandparent quarters are constructed. The construction or reconstruction must be properly permitted and comply with all local land development regulations. Copies of all permits, certificate of occupancy, and plans must be submitted to the Property Appraiser’s Office. Construction or reconstruction must be substantially complete after January 7, 2003 and before January 1st of the year in which the reduction is requested. Application must be filed with the Property Appraiser’s Office annually on or before March 1st of each year. The occupant(s) of the quarters must be a parent or grandparent. The occupant(s) must be at least 62 years of age by January 1st of the year in which the reduction is requested. The occupant(s) must permanently reside on the property on or before January 1st of the year in which application in made. The occupant(s) cannot receive any benefits requiring a declaration of permanent residency on any other property in any other County or State. Source: Osceola County Property Appraiser

The Osceola County Council on Aging provides various services for seniors living in Osceola County. This includes home repair, renovations, and maintenance to improve the quality of housing owned and occupied by elderly, disabled, or low-income families. These services include: Home Repair – simple household repairs, minor modifications or adaptive alterations to improve the accessibility and comfort of homes occupied by the elderly or disabled. Includes installation of safety devices and ramps for the disabled. Chore – seasonal cleaning, yard work, lifting and moving, pest control and household maintenance for elderly persons who are unable to do these tasks for themselves because of frailty or other disabling condition. Weatherization – enables low-income families to permanently reduce their energy bills by making their homes more energy efficient. Provides energy efficiency checks and repair or replacement including insulation, doors, windows, water heaters, heating units and air conditioning. NOTE: While many seniors in Osceola County live in houses, many seniors live in mobile home parks. There is very little assistance providing weatherization and home repair services for seniors who live in mobile homes.

In addition to the Osceola Council On Aging providing services for seniors in Osceola County, they are also a designated Community Action Agency for Osceola County, providing emergency assistance and other econimic support programs. In 2009 The Council provided a total of 305 units of services for elderly clients and their families through EHEAP. 8

*Emergency Home Energy Assistance for the Elderly Program


HEALTH AND WELLNESS

Recreation and Nutrition

The Barney E. Veal Center for All Generations

The BEV Center, located at the Osceola Council on Aging is in a centralized location for the delivery of programs and services that benefit the elderly, disabled and disadvantaged families in Osceola County, including: Assessment Center – administers client screening to determine need and/or eligibility for services and provides intake and referrals. Community Conference Center – multi-purpose room rentals open to the public. Resource Library and ACCESS Center – free library, computer access the world-wide web, and partner site for on-line application system to Department of Children and Families programs. Education/Recreational Activities – provides a variety of monthly programs including quilting, dancing, computer, yoga, Tai Kwon Do, painting, bridge, dominos, creative writing, AARP Driving training, and tax assistance.

St. Cloud Senior Centers

The St. Cloud Senior Centers (3 facilities) are located near the St. Cloud Hospital and is central to several senior housing communities. The Senior Centers are owned by the City of St. Cloud and opens its doors to the St. Cloud Senior Citizens Center, Inc. to provide multiple activities at the facility. A few of the activities include: Recreational Activities – provides ballroom and country line dancing on most Mondays and Saturdays during the course of the year, respectively. They also provide quilting, oil paint, scrapbooking, shuffle board, exercise classes (including Tai Chi), several clubs, music concerts, community orchestra, and games.

Elderly Support Groups

Support groups are provided to assist seniors with existing challenges that affect their lives. The Osceola Counil on Aging provides several support groups to assist seniors and families with adjusting to new changes and providing general education, including: The Osceola Council on Aging provides: Support Groups – Grieving, Mental Health, Alzheimer’s, Multiple Sclerosis, and Lighthouse for the Blind. Jimmy’s Place – Temporary pet housing for seniors who require short term placement in hospitals or rehab center 9

Pictures provided by the Osceola Council on Aging


HEALTH AND WELLNESS

Food Service Programs

The Osceola Council on Aging offers a host of foods services to assist families and seniors in need in the county. Between 2008 and 2009, the COA provided 12,732 units of service for food baskets to families in the county. In 2009, the Council donated 894,742 tons of food for needy residents. Congregate meals provided to elderly were redesigned to fit the preferences and tastes of baby boomers. Commodities/Emergency Food – Provides supplemental foods to economically disadvantaged families on an emergent or as needed basis, at the local level. Commodities include nonperishable, shelf staple items such as canned vegetables and fruits, pasta, beans, rice and/or grain products. Typically the foods will provide groceries for a period of 3-5 days. In 2009, the Council provided 23,220 units of service for emergency food and shelter. Congregate Meals – daily, low-cost, nutritionally sound meals for elderly and disabled adults in greatest economic and social need and those at high nutritional risk, served at a congregate meal site where they can obtain other social and rehabilitative services. Home Delivered Meals – provides homebound, functionally impaired elderly, with nutritionally balanced meals in their homes. Services include: • Meals on Wheels (MOW) – subsidized, daily (weekday) meal program providing hot and cold, nutritionally sound meals served in the home. • E-Meals – emergency cold meals to meet urgent nutritional needs. • Family Meal Program – meals provided to extended members of a homebound senior caring for a custodial child or disabled person. • Frozen Meals – cold meals provided to residents in rural or distant areas. • Pet Meal Program – dry pet food provided to clients with domestic pets. • Holiday Meals – Meals served for families during the holidays.

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HEALTH AND WELLNESS

Risk Factors

The Behavioral Risk Factor Surveillance System (BRFSS) survey was conducted among adults in Florida in 2002 and 2007. The purpose of this survey is to obtain county-level estimates of the prevalence of personal health behaviors that contribute to morbidity and mortality.

Diabetes

All residents considered, the age-adjusted death rate per 100,000 residents for diabetes in Osceola County is below the state rate (for years 2006-2008), however the rate of hospitalizations in Osceola County is significantly higher than the state average. For those residents age 60 and up, the number of residents questioned who self- reported being diagnosed with diabetes in Osceola County increased by 61%. Source: 2002 and 2007 Behavioral Risk Factor Surveillance System; Florida CHARTS 2008

Cardiovascular Disease

Heart Disease is the number one cause death for residents in Osceola County. For residents overall, the age-adjusted death rate and the age adjusted hospitalization rate showed improvement in 2008. In 2007, residents age 60 and up reported higher percentages of those who suffered from a heart attack, angina, or heart disease than any other county in PSA 7. The percentages of those who reported they had suffered from a stroke were higher than the overall state average. Source: 2007 Behavioral Risk Factor Surveillance System

Physical Activity

The prevalence of overweight and obesity in adults is a symptom of poor nutrition and physical inactivity. In 2009, the Centers for Disease Control and Prevention (CDC) reported that the US spends about 147 billion on care directly related to obesity. The Health People 2010 goal is to reduce to 15% the proportion of adults who are obese. According to the County Health Status Summary, for all residents in Osceola County, those who participate in no leisure, moderate, or physical activity is below the state average. Also the amount of all adults in Osceola County who participate in no leisure time physical activity (sedentary) is nearly 33% per 100,000 residents – significantly higher than the Healthy People 2010 goal which is to reduce the number of adults who participate in no physical activity to 20%. For those residents age 60 and up, the percentage who reported being sedentary decreased from 2002 to 2007. Source: 2002 and 2007 Behavioral Risk Factor Surveillance System; Florida CHARTS 2008; Centers for Disease Control and Prevention, Press Release July 27, 2009

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HEALTH AND WELLNESS

Obesity & Nutrition

In Osceola County, the rate of adults (over the age of 18) who are obese or overweight is similar to the overall state rate per 100,000 residents. However, overall, adults in Osceola County (and the state), have significantly higher rates as it relates to Healthy People 2010 goals. The number of adults age 60 and over in Osceola County who reported being obese or overweight in 2002 declined by 2007. However, Osceola County had higher percentages of adults who reported being overweight or obese in 2002 and 2007, than other counties in PSA 7. Source: 2002 and 2007 Behavioral Risk Factor Surveillance System; Florida CHARTS 2008

In Osceola County, the number of residents age 60 and up who reported consuming 5 or more servings of fruits and vegetables increased by about 9 percent. Overall, for Florida, residents (age 60 and up) reported a decrease in fruit and vegetable consumption for this same time period. Source: 2002 and 2007 Behavioral Risk Factor Surveillance System

Smoking

In Florida, smoking caused 28,207 deaths in 2004. Also, smoking expenditures cost the state $6,004,000,000 in 2004. Smoking increases risk of coronary heart disease, stroke, lung cancer, and death from chronic obstructive lung diseases. Lung cancer is the leading cause of cancer deaths in Osceola County, causing 470 deaths between 2003 and 2008. This is followed by colon, rectum, and anus cancers causing 163 deaths between 2003 and 2008. In 2007, the percentage of residents age 60 and up in Osceola County who reported that they were current smokers is higher than those in PSA region 7. Moreover, the percentage who reported smoking in 2002 and 2007 is higher than the overall state average. Source: CDC – Smoking and Tobacco Use; 2002 and 2007 Behavioral Risk Factor Surveillance System

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HEALTH AND WELLNESS Cancer Cancer (unspecified type) is the second leading cause of death for all residents in the County. From 2006-2008, the age adjusted death rate per 100,000 residents for colorectal cancer (15.6) was slightly higher than the state rate (15.0) and higher than the Health People 2010 goal (13.7). Prostate Cancer is the second leading cause of cancer death for men, after lung cancer in the United States. In Osceola County, prostate cancer accounted for 98 deaths among men age 60 and up between 2003 & 2008 within the County. The CDC recommends that all men talk to their doctor to make an “informed decision” about screening benefits, early detection, and treatment options. The U.S. Preventative Services Task Force (and CDC) does not recommend prostate cancer screenings for men over the age of 75. Source: 2002 and 2007 Behavioral Risk Factor Surveillance System; Florida CHARTS 2008 – Florida Death Query; Centers for Disease Control and Prevention – Prostate Cancer; Health Council of East Central Florida County Health Profile, 2006

The only cancer that is screened with a Pap test is cervical cancer. Women age 30 and over (& those 65 and over who have had a hysterectomy) who have had normal test results for a number of years, may be told by their doctor that they do not need a screening for the next 3 years. For women age 50-74, the CDC recommends that they should have a mammogram every two years. Regular mammograms lower the risk of dying from breast cancer. The breast cancer age adjusted death for all women in Osceola County is 21.6 per 100,000. The Healthy People 2010 goal rate is 21.3 per 100,000 residents Source: 2002 and 2007 Behavioral Risk Factor Surveillance System; Florida CHARTS 2008 – Florida Death Query; Centers for Disease Control and Prevention – PAP & Mammogram

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Source: 2002 and 2007 Behavioral Risk Factor Surveillance System


HEALTH AND WELLNESS

Disabilities

In 2009, 12,515 seniors were recorded to have at least one disability. Based on population estimates, 30% of seniors are recorded to have at least one disability in Osceola County. Less than one percent of the population has 2 or more disabilities. According to the chart, 33.1% of seniors self reported that they were limited in some way due to physical, mental or emotional problems. Also, of adults age 60 and up, Osceola survey participants reported the highest percentage of seniors who used special equipment because of a health problem in PSA 7. Source: 2007 Behavioral Risk Factor Surveillance System; County Profiles. Florida Department of Elder Affairs. 2009 & 2010

Health Access

In 2007, 11.1% of BRFSS survey participants self- reported not being able to see a doctor once this year due to cost. Several barriers to care exist within the county including, the fact that 24% of adults 60 and up are located in designated “rural” areas. Noteworthy, many residents age 50-59 have health issues, but do not have health insurance and do not qualify for other assistance or services. Source: 2007 Behavioral Risk Factor Surveillance System; Osceola Council on Aging, 2010.

Quality of Life & Health Status

In 2007, there was a 22% decline in the number of Osceola adults age 60 and up who reported that their health was “fair or poor” than in 2002. Also, in 2007 93.3% of adults age 60 and up reported that they were “satisfied” or “very satisfied” with their lives. Source: 2007 Behavioral Risk Factor Surveillance System

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HEALTH AND WELLNESS

Health Care Services

Osceola Council on Aging

The COA provides free, quality health care to the low-income, uninsured adults age 18 and over. Services include: Primary Care, Secondary Care, Chronic Care Self-Management, Clinical Case Management, Preventative Health Screenings, Medication Management, Women’s Breast Health, Laboratory Assistance, Prescription Medication Assistance, Surgical Care Assistance, and Imaging/Radiological Assistance. Respite provides temporary relief or rest for the caregiver from the constant/continued supervision, companionship, therapeutic and/or personal care of a functionally impaired elderly or disabled person.

SHINE

The Council also hosts the SHINE (Serving Health Insurance Needs of Elders) program. This program is a state health insurance assistance program providing education materials and free unbiased insurance counseling to Florida elders, caregivers and family members.

Osceola Council on Aging – In Home Health Care Services Companion – visiting a homebound elderly person, who is social and/or geographically isolated, for the purpose of relieving loneliness and providing continuing social contact with the community. Non-medical supervision and socialization is provided by casual conversation, emotional support, encouragement and providing assistance with reading, writing letters and entertaining games. Homemaker – performance of home management duties including housekeeping, meal planning and preparation, shopping assistance and routine household activities for functionally impaired elderly and disabled. Personal Care – prevents unnecessary institutionalization for the functionally impaired elderly and disabled adults by assisting with non-medical care including: feeding, bathing, dressing, ambulation, housekeeping, supervision, emotional security and assistance securing care from appropriate sources. 15


HEALTH AND WELLNESS

Health Care Services Adult Day Care

Osceola County has only one facility that provides adult day care services. The Harry & Jeanette Weinberg Adult Day Health Care is located in Kissimmee and serves Osceola County’s frail elderly. On any given day, the facility is full. Adult Day Care Centers provide: • social, therapeutic and nursing services for functionally impaired elderly or disabled adults in a comfortable, protective environment. • an alternative to premature or inappropriate institutionalization. • assistance to members of the family to maintain functionally impaired elderly or disabled adult relatives at home and in the community through daily and/or temporary respite care.

UCF College of Medicine/ Medical Student Adopt-A-Senior

The UCF College of Medicine was established by the Florida Legislature and the Florida Board of Governors to address the growing physician shortage nationwide and provide economic benefits to Central Florida and the state. The Osceola Council on Aging, Health Services Division serves as preceptor site for these stellar medical students to allow them to prepare for careers in every discipline of medicine, from patient care to research, and to focus on individualized areas of study. The “Adopt-A-Senior” program was developed in 2010 by the medical students as a service learning initiative which partners with the Council’s Nutrition Services Division to provide homebound and isolated senior citizens with regular wellness checks. The medical students developed a “Functional Assessment” tool adapted from the Department of Elder Affairs 701B client assessment form that is used to establish benchmarks for the seniors’ functional health. The medical students provide weekly phone calls and monthly in-home visits to assess and monitor the seniors’ wellness. The goal for the medical student is to gain an understanding of the functional needs of the elderly to age in place, while practicing community-based approaches as a diversion or alternative to institutional long-term care.

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HEALTH AND WELLNESS

Facilities

Osceola County has a host of facilities to accommodate aging and disabled residents. This section will highlight several types of available facilities available in the county along with certain regulatory information. The Agency for Health Care Administration provides information related to several types of facilities that require licensing or registration. Also, the state offers the assistance of local Ombudsman Councils to ensure safety, health, and welfare of residents located within long-term care facilities. Osceola County is included in the East Central Florida District for Ombudsman Council services (with other counties in PSA 7). Aside from providing yearly assessments for every facility within PSA 7 (a total of 327 assessments in 2008-09), the 42 local Ombudsman volunteers also completed 703 complaint investigations. During 2008-09, the East Central Florida District Ombudsman Council staffed about 10% of the total Ombudsman volunteers for the state of Florida. Source: Florida Agency for Health Care Administration, Florida Health Finder Website: http:www.floridahealthfinder.gov; Florida Long-Term Ombudsmen Program.

Assisted Living Facilities (ALF) Since 2005, the total number of assisted living facilities in Osceola has doubled, but the total amount of beds (although substantial) has only increased by 20 percent. Notably, Optional State Supplementation (OSS) beds have also increased since 2005, offering about 23% more beds. OSS beds are those allocated from a state subsidy program for low-income individuals living in ALFs that are administered by the Florida Department of Children and Families. Assisted Living Facilities provide residential care for older and disabled adults who are unable to live independently. ALFs are expected to provide safety, personal care, and support services for their residents. Traditionally, they also cost less than facilities that provide 24-hour supervised care. Source: Florida Housing Search Website: http://www.floridahousingsearch.org; Florida Department of Elder Affairs – Assisted Living Facilities; Department of Elder Affairs County Health Profile 2009 & 2005.

2007 Osceola Visioning Survey Results (Representative of Osceola County population)

About 54% of adults 60 and up questioned rated the Osceola County healthcare system as either “good” or “fair”.

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HEALTH AND WELLNESS

Skilled Nursing Facilities (SNF)/ Nursing Homes In 2009, the occupancy rate for nursing facilities in Osceola County was about 89.4 percent. This is a 4.2% increase from 2005 occupancy rate records. There are currently a total of 1080 nursing beds in the county, the same amount available in 2005. In order to qualify as a skilled nursing facility/ nursing home, Florida Administrative Code 59G-4.290 provides an established level of care that must be available at the facility under Medicaid. In order to be a skilled nursing facility, the facility must provide: • 24-hour care with professional nursing services available. • Direct supervision of procedures perfomed in the presence of direct personnel. • Nurses who are licensed by the state of Florida to practice as a registered nurse or licensed practical nurse. • All professional personnel (physicians, registered nurses, allied health therapists, etc) must be Florida Licenced or Certified. • Individualized rehabilitative services that designed to restore a patient to self-sufficiency or their highest functional ability in the shortest time possible. Source: Florida Agency for Health Care Administration, Florida Health Finder Website: http:www.floridahealthfinder.gov; Department of Elder Affairs County Health Profile 2009 & 2005.

Licensed Home Health Agencies Home Health agencies in Osceola provide a variety of services that may include (not limited to): licensed nurses, social work services, therapists, companions, home health aids, and homemaker services. There is no state-administered test for home health aides working for home health agencies in Florida; however, health care aids who work at agencies without Medicaid or Medicare certification must undergo at least 40 hours of training provided by their agency. Often times, agencies provide more than the minimum hours of training for their home health aids. Those with Medicaid or Medicare certification must undergo 70 hours of training provided by the agency. Twelve agencies in Osceola County offer licensed home health care services. There are currently 2 agencies that are Medicaid Certified and 7 that are Medicare Certified. Although not listed, there are currently 19 companies that provide Homemaker and Companion Services (18 currently registered, 1 in review) within the county. The number of Homemaker and Companion companies in Osceola County has more than doubled since 2005, when only 7 companies were registered. Source: Florida Agency for Health Care Administration, Florida Health Finder Website: http:www.floridahealthfinder.gov; Florida Agency for Health Care Administration – Home Care Unit Licenses; Department of Elder Affairs County Health Profile 2009 & 2005.

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HEALTH AND WELLNESS

Hospitals

There are noted barriers to care as it relates to transportation to hospitals for rural populations in Osceola County. About a quarter of adults over the age of 60 reside in rural areas and about 81% of senior 65 and older are living in “medically underserved areas” (MUA). Medically Underserved Areas are designated by the US Department of Health and Human Services – Health Resources and Services Administration (HRSA) as having “too few primary care providers, high infant mortality, high poverty and/or high elderly population”. The number of beds provided in local hospitals for Osceola County increased by about 8 percent since 2005. Osceola Hospitals currently provide 514 total beds. A few of the services available at the hospitals include: a smoking cessation clinic, stroke center, a cancer and diabetes institute providing treatment and education, a wound healing and hyperbaric center, orthropaedic specialist, and specialist in nuclear medicine. Source: US Department of Health and Human Services – Health Resources and Services Administration (HRSA) – Medically Underserved Areas/Populations; Department of Elder Affairs County Health Profile 2009 & 2005.

Hospice Agencies Hospice agencies provide end-of-life palliative care to reduce pain and to provide the best possible quality of life for patients. Hospice agencies attempt to provide services that people have stated that they want at the end of life. Some of these services include: emotional and/or spiritual support for families and patients, an opportunity to put their life in order, enforce patients’ wishes, pain management, and a choices about related services. There are currently four hospice agencies that provide services and support for residents in Osceola County. The two companies that are located in Osceola County are listed; the other two companies are in Orange and Seminole County. Source: Florida Hospices and Palliative Care Website: http://www.floridahospice.org

2007 Osceola Visioning Survey Results Osceola seniors age 60 and up reported that certain changes (selected from a list of possible choices) would help to improve the health care system. Here are the top 3 responses: • Shared cost of health insurance (17.6%) • Wellness Programs (15.9%) • More primary doctors (13.5%)

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HEALTH AND WELLNESS

Wellness Programs

Several Insurance companies located in Osceola County provide additional activities on a daily basis available to seniors either community wide, for patrons on their health plans, or both. These activities include exercise classes, community education, and games. A few of the Wellness Programs offer the SilverSneakers® program which is a fitness program that has a focus on providing physical activity and social events for seniors.

Family Physicians Group® BVL Senior Center

The senior center located in BVL provides exercise classes three times per week that are open to seniors or retirees within the community. The exercise classes include various cardio courses and yoga designed with seniors in mind. There are also areas within the facility that are used to allow seniors to play board games or dominos. On a monthly basis, the seniors celebrate birthdays and on every 3rd Friday of the month the facility will host a themed party. The senior center also provides community education like computer classes or health seminars for seniors within the community. Seniors enrolled in their health program also receive direct information from case managers related to health.

Humana® Guidance Center

This center provides seniors with several different types of exercise classes on a weekly basis. The classes are open to seniors who are not on a Humana health plan, as well as those who are. The classes offered may change from month to month, but the Guidance Center currently provides Zumba classes, Wii Bowling, and many others. The center also provides a Coffee Club and an activity center where seniors can play games like chess, scrabble, checkers, Yahtzee®, and others at set times. Also, for senior clients who are on a Humana health insurance plan, the center provides a SilverSneakers® Yoga Stretch Class and their Humana Active Outlook (HAO) Program. The HAO program provides preventative health education on various topics during March – September.

Well Care® Welcome Room

The Welcome Room provides services for those seniors who are currently enrolled in a WellCare health plans. They provide community education on various health related topics and full calendar of activities for every month available to seniors on their health plan. They also provide gym memberships passes for members, and the SilverSneaker® program. Source: Staff at local Wellness Facilities

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EMPLOYMENT There are currently two programs that provide workforce training for low income seniors and the places them in agencies to work. Both programs have multiple benefits in that they provide senior with on the job training and that public services agencies receive valuable volunteer services. The Bureau of Labor Statistics projects that during the periods between 2008 and 2018, the labor force of persons age 55 and older, will increase by 43 percent in the United States. By the year 2018, persons age 55 and older are projected to account for nearly a fourth of the total labor force. Source: Bureau of Labor Statistics – Employment Projections 2008-2018

Experience Works

Experience Works in Central Florida is apart of a national nonprofit organization that provides an opportunity for currently unemployed, low-income seniors to receive job training and employment assistance. The Senior Community Service Employment Program (SCSEP) if funded by a program under the Older American Act. Some of the funds are used to pay the seniors minimum age to work in local private nonprofit 501(c) (3), faith-based, or government organizations for 20 hours a week. Often times, seniors find permanent jobs through their service.

AARP Workforce Plus Program

The AARP Workforce program is under the Workforce Central Florida agency and is funded by the Department of Labor. At any given time during the year, the Osceola County AARP Workforce Plus program employs about 21-25 Osceola seniors. Seniors receive about 6 months to a year of work training before working at a job site. Seniors are then sent to work for minimum wage and paid through the funding received by the Department of Labor.

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TRANSPORTATION LYNX Transit Availability Ridership

This table details the average number of riders per month for each of the fixed LYNX bus routes within Osceola County. Ridership along all routes from 2008 to 2009 decreased for most of the Osceola County service areas. However, the total amount of riders per month at all locations has increased since 2007. In December 2008, Route 12 Buenaventura Lakes/Boggy Creek is no longer in service. During that time, Poinciana Circular Route 426 was added to the routes provided in Osceola County. In 2009, Lynx added PickUpLine services for various areas in Poinciana and Buena Ventura Lakes. The PickUpLine service allows riders to call Lynx at least 2-hours in advance to be picked up and dropped off within any service area. Source: LYNX

LYNX Transit Availability — Paratransit Trips

Per federal guidelines, it is the responsibility of the county to provide transportation for persons recognized under the Americans with Disabilities Act (ADA). Paratransit trips must be available to clients living within ¾ mile of a regularly scheduled transit route. In order to better serve the community, Osceola County has expanded this service to include Medicaid and Transportation disadvantaged trips. Offering this assistance to a greater number of clients is not without cost, most of which is absorbed by the county. Overall, there was a 15% increase in the amount of trips provided from 2005 to 2009. For Unincorporated Osceola the amount of trips provided from 2005 to 2009 increased by 30%, while Kissimmee and St. Cloud decreased by 17% and 24%, respectively. Medicaid paratransit trips are mostly funded by the state on an “at-risk” basis. The county is entitled to a flat fee to cover the costs associated with providing these trips. Once the annual allotment is exhausted, Medicaid trips are funded by local government until the following fiscal year. Overall, the amount of Medicaid paratransit trips for the county increased by 22% from 2005 to 2009. For Kissimmee and Unincorporated Osceola, the amount of trips taken from 2007 to 2009 experienced significant increases. During those years, Kissimmee Medicaid paratransit trips increased by 60%, and Unincorporated Osceola experienced a 51% increase. St. Cloud experienced a decrease in paratransit trips from 2007 to 2009. Source: LYNX

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TRANSPORTATION The Osceola Council on Aging provides critical travel to and/or from service providers and community resources for the elderly or disabled adult who cannot transport themselves or purchase transportation from various companies that service Osceola County. In 2008, the Council provided 61,550 units of service for transportation, and 63,381 in 2009 (a 3% increase in units provided). These services include: Congregate Meal Transport – provides transportation to and from the agency’s congregate meal sites. Demand Transport – provides transportation on an as needed basis, to and from area physician offices, pharmacies, grocery stores, banking, employment, etc. to maintain self-sufficiency. Fixed Transport – provides transportation on a routine basis to area merchants, agencies and government offices. Source: Osceola Council on Aging

Access to Amenities

The 2007 Osceola County Visioning Survey provided information on the opinions of respondents 60 and older as it relates to parks and green space. About 47% of respondents indicated that they would be willing to pay to support parks, green space, and nature options. When asked about the most important amenities to have in their community, respondents 60 and older indicated education, green space, and healthcare. Also, about 75% of respondents 60 and older indicated that their most frequent mode of transportation when not going to and from work was by car. Also, 33% of respondents indicated that shopping and restaurants are within walking distance from their home. The chart indicates amenities located within 5 miles of designated 55+ (age) communities. Source: 2007 Osceola County Visioning Survey; City of Kissimmee, City of St. Cloud, & Osceola County Parks and Recreation Websites.

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transporation Crosswalks and Sidewalks

On the 2007 Osceola County Visioning Survey, adults 60 and older responded that traffic and transportation were affected the most by the population growth in Osceola County. The survey also indicated that traffic and transportation was one of the two most important issues that needed to be addressed immediately (the second was education). In order to ensure a community that allows seniors to age in place, an assessment on the current living arrangements for adults 55+ was completed in order to provide information on public accommodations near senior housing developments. The assessment includes availability of grocery/convenience stores, other amenities, available recreation, timing of traffic lights/ walk signals, signal audible tones and size, and the availability of sidewalks. The length of time allowed to cross a street of intersections in Osceola County is determined by width of the intersection being crossed. The County utilizes a formula of 3.5 seconds for every 1 foot across an intersection. Currently, there is no funding available to add sidewalks or traffic signals in the County. However, request for these amenities (sidewalks and signals) can be made through the County Planning Office. It is also important to note that the City of St. Cloud does have a plan to address issues with sidewalks. None of the crosswalk signals have alerts for those with impaired sight (audible tones or Audible Pedestrian Signals). Assessment of crosswalk timing could be + or – 3 seconds. NOTE: Some apartments and mobile home parks available for seniors may offer several amenities including, but not limited to pools, shuffle board, clubs, golf, and walking trails. This assessment includes only those amenities available around surrounding communities and not those provided by the apartment complex or Mobile Home Park. Source: 2007 Osceola County Visioning Survey (responses were statistically significant); Osceola County Planning Office

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transporation

Handicapped Parking Spaces

Due to the large number of seniors utilizing grocers located in close proximity to their homes, concerns were raised regarding the amount of available parking spaces at local grocery and convenient stores. While ADA requirements have been met, many senior are highly populated in separate communities that share the same food and shopping amenities. This alone lends itself to a higher usage of available handicapped parking spaces. 25


VOLUNTEERISM AND ACTIVISM Generations Campus

Two centralized facilities developed on property owned by the Osceola Council on Aging. Phase I, the Barney E. Veal Center, was built in 2007 to serve as the Council headquarters and primary location for service delivery. The 4-story Phase II building was completed in 2009 in cooperative partnership with the Osceola Children’s Advocacy Center, a non-profit agency providing services to children and non-offending family members that are victims of child sexual and physical abuse. Community Vision, a local grassroots organization which facilitates efforts to identify and expand community-wide resources and stakeholder involvement, occupies the first floor in partnership with the Council. The collaboration between the three agencies enhances mutual missions and increases intergenerational programming to provide long-term impact on the quality of lives of seniors, disadvantaged families and highly vulnerable at-risk youth in Osceola County.

St. Cloud Senior Center

The St. Cloud Senior Center is located adjacent to the city’s Civic Center. The Civic center provides a variety of activities for youth and families yearly. Several youth sporting events are held at the Civic Center on 5 acres of multi-purpose field space. The Civic Center complex also encompasses two 10,000 square foot gymnasiums for public use. The Civic center includes, a solar heated swimming pool, playground equipment, a baseball field, and covered horseshoe courts.

Intergenerational Programs

The Osceola Council on Aging Volunteer Center provides several opportunities for intergenerational involvement with youth and seniors. In 2009, volunteers provided 2,548 hours of mentoring and activities for 170 at-risk youth throughout the County. Through various partnerships, including those with the local School District, the Council provides several program options to connect generations within the community. These programs include: Children’s Hope and Mentoring Program (CHAMP) – partnership with the Osceola County School District Spirit Program matches at-risk elementary and middle school youth with seniors who volunteer to serve as mentors. Buddies Program – brings disabled teens, low-income preschoolers and frail elders together for activities that promote friendship across generations and foster self-assurance. The program partners the Council’s Adult Day Care clients with three different groups of children, including 20 students aged 14-21 from a local High School exceptional student education (E.S.E.) class, 15 (general) students participating in a child care curriculum, and 20 at-risk 3-4 year old pre-school students. Students meet once a month with 40 frail and disabled seniors for activities that include sharing stories, creating crafts, and singing. Retired & Senior Volunteer Program (RSVP) – provides older Americans the opportunity to apply their life experience to meeting community needs through volunteerism.

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VOLUNTEERISM AND ACTIVISM Volunteer Center

The Osceola Council on Aging holds the largest association of volunteers in Osceola County. Yearly, over 2,000 volunteers, including those in the medical profession, provide over 136,000 hours of service. All of the senior mentors within the CHAMP, Buddies, and RSVP intergenerational programs are volunteers. Other volunteer programs include Generation Connection (which includes those under the age of 55); Seniors With Available Time and Talent or SWATT (assist with special projects on an “as needed” basis); Hurricane Recovery Osceola (provides hurricane awareness, recovery, and preparedness in low-income communities); and Americorps Community Resource Navigators (provides navigation assistance for needy families seeking social services assistance).

Registered Voters

In 2009, about 78% of adults over the age of 60 were registered to vote in Osceola County. While seniors are only 20% of the population over the age of 18, they make up 23.4% of registered voters in County. Other than Brevard County (34.5%), Osceola has the highest percentage of registered voters age 60 and up in PSA 7. Source: Florid Department of Health CHARTS 2009; and Department of Elder Affairs County Profiles 2005 and 2009.

Leadership Legends

Community Vision has been creating new leaders through its leadership programs since 1989. As we strive to create a more leaderful community, we recognize the rich experience and vast heritage that our “golden” age residents have to offer. In partnership with the Osceola Council on Aging, the Leadership Legends program focuses on capturing the strength and experience of Osceola seniors and retired to tackle community issues. Through real life experiences, the class learns of the strengths and challenges of the community in which they live. On a bi-weekly basis (mid-February to June), the program leads the participants through a series of invigorating and insightful daylong experiences. In addition, program days contain focused community leadership skills training and capacity building activities. Upon graduations, this energized group of newly trained, mature adults tackles various community issues and projects. Class projects have included the planning of a Mardi Gras fundraiser for the Osceola Council on Aging, creating and managing a library for Bishop Grady Villas, and coordinating a school supply drive for a Gift for Teaching. Additionally, many Legends continue active community participation as Meals on Wheels, Bookmark Buddies and Bishop Grady Villas mentors. 27


Honoring the Past… Shaping the Future. Osceola County Government Programs and Services Abandoned Vehicle.........................................................................407-742-0200 Agriculture/4-H/Family..................................................................321-697-3000 Animal Control...............................................................................407-343-7101 Building Department.......................................................................407-742-0200 Business Expansion/Relocation......................................................407-742-4200 Cable Television Concerns..............................................................407-742-5900 Clerk of the Court...........................................................................407-742-3500 Community Development/Growth Management............................407-742-0200 County Commissioners...................................................................407-742-2000 Contractor Licensing.......................................................................407-742-0200 County Government Information..................................................407-742-2ASK County Manager..............................................................................407-742-2385 Curb/Sidewalk Repair.....................................................................407-343-7164 Drainage – Engineering..................................................................407-742-0662 Economic Development..................................................................407-742-4200 Employment Questions . ................................................................407-742-1200 Family Court Issues........................................................................407-742-3500 Flood Plain – Engineering..............................................................407-742-0662 Flooding/Ditch Cleaning.................................................................407-742-0662 Garbage Collection/Recycling........................................................407-962-1100 Growth Management/Community Development............................407-742-0200 Health Department..........................................................................407-343-2000 Household Chemical Collection.....................................................407-962-1100 Human Services..............................................................................407-742-8400 Jail Issues........................................................................................407-742-4444 Junk & Debris.................................................................................407-742-0200

Left to Right: Commissioners Brandon Arrington, John Quiñones, Fred Hawkins, Jr., Michael Harford and Frank Attkisson

Jury Duty........................................................................407-742-2423 Library Services.............................................................407-742-8888 Lot Mowing...................................................................407-742-0200 Miscellaneous..............................................................407-742-2ASK Mosquito Control...........................................................407-742-0200 Mowing/Brush/Tree Removal........................................407-742-0200 Noise Issues...................................................................407-742-0200 Park Information............................................................407-742-7800 Permitting.......................................................................407-742-0200 Plans Review/Inspections..............................................407-742-0200 Road/Bridge Maintenance.............................................407-343-7164 Road Signs.....................................................................407-343-7164 Unsafe Buildings............................................................407-742-0200 Veteran’s Services..........................................................407-742-8400 Visitor Information.........................................................407-847-5000 Voting Information.........................................................407-742-6000 West 192/Osceola Parkway............................................407-962-1325 Zoning Map Amendments..............................................407-742-0200 If a program or service is not listed, please call 407-742-ASK

Read about Osceola County at www.osceola.org


Community for a Lifetime