Mar 14 Chairman’s Meeting: March 14, 2018
Indian River County Hospital District
Hospital District Conference Room
March 14, 2018
TRUSTEES: Marybeth Cunningham; Allen Jones; Ann Marie McCrystal; Tracey Zudans; Barbara Bodnar; Dr. Michael Weiss
EXCUSED: Karen Deigl
STAFF : Ann Marie Suriano; Jennifer Frederick; Kate Voss; Jennifer Peshke, Esq.
OTHER ATTENDEES: Wayne Creelman, M.D;. Gina Palladino; Brett Hall; Myra Weiss; Vicki Soule; Miranda Hawker; Kathy Orton
Convene Meeting – Marybeth Cunningham, Chairwoman
Mrs. Cunningham convened the monthly chairman’s meeting of the IRCHD at 10:00 AM by welcoming those in attendance.
UF Clinic Update & Additional Funding Request- Wayne Creelman, M.D.
Dr. Creelman provided a historical review of the University of Florida Department of Psychiatry clinic in Vero Beach. He explained that the center just celebrated their 10th year in operation and it has successfully trained residents, fellows, postdocs and medical students. The center also offers care to approximately 7,500 people in need of mental health services and has provided over 88,000 visits. Dr. Creelman explained that through financial management at UF, administrators were able to stretch the original philanthropic investments to cover operations over the last nine years. In doing this, it allowed the center to continue operating despite the unrealized matching gift, declining reimbursements and increasing psychiatrist shortages. Recently, the Dean of College of Medicine has reviewed the clinic operations and determined that the ongoing deficit does not represent any inefficiencies of the center, but rather the manner that mental health care services are currently reimbursed. Dr. Creelman stated that the Center is one of the top performers in the UF psychiatry department however, there is now an ongoing need for operational support to the UF Center so that it may continue its work in the community. Should they not be able to raise the funding, UF has indicated that it would close the clinic. Dr. Creelman explained that the UF Department moving forward will need to obtain $300,000 in bridge funding for the academic year July, 2018- June, 2019. They have targeted further operational support from other agencies in the county to reach their goal, but are requesting $125,000 in funding from the District. There was further Trustee discussion concerning the request. Many of the Trustees voiced their concerns surrounding the clinic being unable to obtain the funding, which would result in the closed business. They felt closing the UF clinic would impact the community negatively. Others had concerns with providing the funding and the further sustainability of the program. There was subsequent discussion concerning funding the clinic at only $100,000 and providing the additional $25,000, should they not obtain that funding from other sources. Mrs. Bodnar made a motion to approve the request of $125,000, as a one-time payment and the motion was seconded by Dr. Weiss. The motion carried.
Discussion of increase in District income guidelines- Ann Marie Suriano & Jennifer Frederick
Mrs. Frederick discussed matters concerning the District’s use of the Federal Poverty Guidelines in determining if a patient is eligible for indigent care. Currently, the District approves individuals who are 150% or below the Federal Poverty level. There has been discussion among the Trustees and with funded organization about raising the level to 200%, which could potentially cause a 50% increase in volumes of qualified indigents. Mrs. Zudans requested data which would show what the financial impact of raising the rate may have on the District. It was discussed by Mrs. Suriano and Mrs. Frederick that it would be difficult to project the impact due to many unknown factors concerning what the patient is being seen for and the cost associated with that visit. There was discussion among the Trustees that the funded agencies should include the data and total projected cost for patients at 150% and 200% of the Federal Poverty level, within their 2018 funding applications which are due in April. Once the District receives these applications, Mrs. Frederick will review the same and prepare a summary of her findings. The Trustees also suggested that Mrs. Frederick look to other Florida District’s to see what percentage they use for qualifying indigent residents. The Trustees agreed that they needed more information on this matter before making a definitive decision to be considered for a vote.
Open Trustee Discussion-
Mrs. Cunningham stated that the Letter of Intent between IRMC, the District and Cleveland Clinic has been signed. Currently all agencies are conducting due diligence and it will be three weeks or more before any discussion will take place concerning the definitive agreement. She explained that the Cleveland Clinic will take the first attempt at preparing a lease agreement for review and consideration. She encouraged the Trustees to direct any questions to Mr. Boyles or Mrs. Peshke.
Review of District Board Self Evaluations- Ann Marie Suriano, Executive Director
Mrs. Suriano stated that through the strategic plan there was an effort to conduct board self-evaluations. She stated that she has reviewed the responses and six trustees completed the document. Some of the feedback addressed was the desire to have more opportunities in the community for better recognition of the District and its impact on the community. Additionally, Jarrard prepared a PowerPoint presentation that could be distributed and presented by the Trustees. Additionally, she explained that she has received feedback from the Trustees concerning the PowerPoint and will work with Jarrad to incorporate those edits. She also stated that the Trustees indicated they would like more continuing education opportunities, along with health related periodicals or magazines. She encouraged the Trustees to subscribe to Becker’s Review and the South Florida Healthcare Report. Additionally, the Trustees currently receive the publication Trustee Magazine. She encouraged the Trustees to notify her of any other continuing education opportunities they would like to engage in, so that she may bring them before the board.
Mrs. Cunningham stated that she attended the Indian River Board of County Commissioner’s meeting yesterday. She explained that many of the local government agencies in the community start their meetings with an invocation and the Pledge of Allegiance. She asked the Trustees if they would like to do the same at the District’s regular monthly meeting. The Board agreed and Dr. Weiss volunteered to lead the group in the Pledge.
Public Comment- There was no public comment.
Adjourn- The meeting was adjourned at 11:30 AM