2. Community Development Department Moratorium Update Pain Management Clinics & Internet Cafes

3. Community Development Department BACKGROUND-Pain Management Clinics Flagler County Sheriff’s Office advise and request for moratorium Ordinance No. 2010-18 (Dec. 21, 2010) Moratorium expires Dec. 31, 2011 –Included: No cash only operation Hours of operation 7 a.m. to 9 p.m.

4. Community Development Department BACKGROUND-Pain Management Clinics Staff to provide report on findings and recommendations by Aug. 31, 2011

5. Community Development Department Pain Management Clinics Options Repeal moratorium after report on pain management clinic Do nothing - Let moratorium expire December 31, 2011 Adopt regulatory ordinance before or after expiration of moratorium

6. Community Development Department Three existing Pain Management Clinics in City (in compliance) Classified as “Medical and Professional Office” Use and Permitted in all Commercial and Office Zoning Districts including MPD with Mixed-use Future Land Use Map Designation FCSO recommends continuing moratorium to Dec. 31, 2011 to monitor results of new legislation

7. Community Development Department Pain Management Clinics Florida Legislature Action – House Bill 7095 Regulates activities by: –pain management clinics, –physicians, –pharmacies, and –wholesale drug distributors Penalties and Database Enforcement Responsibilities

8. Community Development Department Pain Management Clinics Florida Legislature Action – House Bill 7095 Enforcement Responsibilities –Flagler County Sheriff’s Office –Tri-County Narcotics Enforcement Task Force –Department of Health –State Attorney’s Office

9. Community Development Department Pain Management Clinics - Database Prescription Drug Monitoring Program (E-FORCSE) (Electronic-Florida Online Reporting of Controlled Substances Evaluation) Requires dispensing practitioners and pharmacies to report dispensing of controlled drugs to the database

10. Community Development Department Pain Management Clinics Florida Legislature Action Regulation for Pain Management Clinics Definition –“Pain-management clinic” or “clinic” means any publicly or privately owned facility: (I) That advertises in any medium for any type of pain- management services; or (II) Where in any month a majority of patients are prescribed opioids, benzodiazepines, barbiturates, or carisoprodol for the treatment of chronic nonmalignant pain (pain unrelated to cancer or rheumatoid arthritis which persists beyond the usual course of disease or the injury that is the cause of the pain or more than 90 days after surgery).

11. Community Development Department Pain Management Clinics Florida Legislature Action Require Registration with certain exceptions: –The clinic is wholly owned and operated by one or more board-certified anesthesiologists, physiatrists (D.O.), neurologists, medical specialist in pain medicine, –Licensed as part of hospital, –Affiliated with accredited medical school,

12. Community Development Department Pain Management Clinics Florida Legislature Action Facility and Physical Operations Requirement of Pain Management Clinics: –Located at publicly fixed location, –Sign with name, hours of operation, and address, –Publicly listed telephone number and fax machine, –Emergency lighting and communications, –Reception, waiting area, –Restrooms, –Administrative area, storage, –Exam rooms, treatment rooms –Sign with name and contact information of physician

13. Community Development Department Pain Management Clinics Florida Legislature Action Regulations for Physicians in Pain Management Clinics –Notify applicable board of practice at pain management clinic, –Ensure compliance of facility with health and safety requirements, (location, data collection, reporting, etc.) –Standards for quality of care and appropriateness of care, –Use counterfeit proof prescription pads –Expiration January 1, 2016

14. Community Development Department Pain Management Clinics Florida Legislature Action Pain management clinics where certain violations occur (assault and battery, burglary, theft, unlawful distribution) twice within six months, may be declared a public nuisance and abated pursuant to state statutes (local law enforcement agencies and appropriate state agencies).

15. Community Development Department Pain Management Clinics Florida Legislature Action Regulations for Physicians Limited authority to dispense controlled substances

16. Community Development Department Pain Management Clinics Florida Legislature Action Regulations for Pharmacies/Pharmacists Strengthens license requirements for pharmacies Background checks, fingerprinting Create policies and procedures to minimize fraudulent acquisition of controlled substance Reporting requirements Penalties

17. Community Development Department Pain Management Clinics Florida Legislature Action Regulations for Wholesale Distributors Perform due diligence in sale of controlled substances Report sales to Drug Enforcement Agency (DEA) Report purchase of unusual quantities Penalties

18. Community Development Department Pain Management Clinics Staff and FCSO recommend continuing moratorium to Dec. 31, 2011; –to monitor effectiveness of new legislation, –to continue on-going discussions with FCSO, and identify the potential need for local regulations, (separation requirements, on- site dispensing ban, zoning restrictions, etc.)

19. Community Development Department Moratorium Update Internet Cafes

20. Community Development Department Internet Cafes Background Ordinance 2011-10, 180 day moratorium on “internet cafes” (Moratorium began May 10, 2011) Expires on November 6, 2011 Option to extend an additional 90 days (February 4, 2012)

21. Community Development Department Internet Cafes Update on Legal Status Current Legal Status –Under Florida Statutes –Recent Attorney General Opinion –Regulation from other Counties and Municipalities No criminal enforcement at this time

22. Community Development Department Internet Cafes Current Status 9 active businesses (1 pending occupancy permit) Classified as “Retail” use and allowed in all Commercial zoning districts (C-1, C-2, and C- 3), and Master Planned Development (MPD) with Mixed-use Future Land Use Map Designation 8 are in C-2, 1 in C-1

23. Community Development Department Location of Existing Internet Cafes

24. Community Development Department Internet Cafes Options Do Nothing – Let moratorium expire Moratorium Extension – Allows for monitoring of on-going litigation & potential legislation Regulatory Ordinance – Code of Ordinances and/or Land Development Code

25. Community Development Department Internet Cafes Option – Moratorium Extension Continue monitoring of on-going litigation (other Counties and Municipalities), and Allow Florida Legislature to address issue –Action from Florida Legislature and final decision on legislation may occur at a time period beyond the expiration of moratorium extension (90 day extension to February 4, 2012) –Bill filed for 2012 Legislature to prohibit use of simulated gambling devices to conduct or promote game promotions, drawings, & games of chance.

26. Community Development Department Internet Cafes Option – Regulatory Ordinance Amendment of Code of Ordinances and/or Land Development Code to regulate or ban “Internet Cafes”

27. Community Development Department Internet Cafes Option – Regulatory Ordinance Limit number in City Operation –Fingerprint, background check for owners/employees (include recovery of administrative cost) –Trust/surety bond posted covering amount of announced prices –Software certification for fairness –No alcoholic beverages

28. Community Development Department Internet Cafes Option – Regulatory Ordinance –No minors –Security system with cameras, drop safe, silent alarm, armed security guard at night, transparency of windows for law enforcement –Limitation on size of operation including number of machines –Hours of operation –Signage (no image associated with gambling)

29. Community Development Department Internet Cafes Option – Regulatory Ordinance Location (Land Development Code) –Limit to certain zoning districts –Separation requirements Between internet cafes Between internet cafes and other uses (schools, churches, bars, etc.) –Regulations need justification Data and statistics on special conditions related to “internet cafes”

30. Community Development Department Location of Existing Internet Cafes

31. Community Development Department Zoning Limits Com-2 and Com-3 Zoning Districts

32. Community Development Department Zoning Limits Com-3 Zoning District

33. Community Development Department Zoning Limits C-1, C-2, and C-3 Zoning District with 1500 foot distance radius

34. Community Development Department Internet Cafes Staff recommends extending moratorium and drafting regulations for internet cafes Discussion