15 Mar Regular Monthly Meeting: March 15, 2018
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
Regular Monthly Meeting
Indian River County Commission Chambers
March 15, 2018 @ 5:00 p.m.
TRUSTEES: Marybeth Cunningham; Allen Jones; Dr. Michael Weiss; Ann Marie McCrystal; Karen Deigl; Tracey Zudans
EXCUSED: Barbara Bodnar
STAFF: Ann Marie Suriano; Jennifer Frederick; Kate Voss; Jennifer Peshke, Esq.
OTHER ATTENDESS: Kip Jacoby; Emily Handley; Carole Kanerak; Shannon Bowman; Reverend Derrick West; Gerri Smith; Miranda Hawker; Kathy Orton; Angela Dicken; Deb Hawkins Michelle Genz; Tara Beard; Tracey Griffis.
Convene Meeting- Marybeth Cunningham, Vice Chairwoman IRCHD
Mrs. Cunningham convened the regular monthly meeting of the Indian River County Hospital District (“IRCHD”) at 5:00 p.m. Mrs. Cunningham indicated that there are a few changes to the agenda. At yesterday’s Chairman’s meeting the District Trustees elected to start their monthly board meetings with an invocation and the pledge of Allegiance. Additionally, Ms. Morgan Libbey, Executive Director at the Public Guardianship Program will not be presenting this evening due to a scheduling conflict.
Pastor Derrick West, of The Genesis Church of Vero Beach, provided the Invocation and Dr. Weiss led the group in the Pledge of Allegiance.
Consent Agenda- Marybeth Cunningham, Chairwoman
Mrs. Cunningham asked for a motion to approve the Chairman’s meeting minutes dated February 14, regular monthly meeting Minutes dated February 15, and a March disbursement of $942,507.28. Ms. Deigl made the motion, which was seconded by Mrs. McCrystal. The motion carried unanimously.
Mrs. Cunningham stated that the District Trustees made a visit to the Cleveland Clinic Weston campus on March 5. She explained that the visit was highly informational and gave the group a chance to see how Cleveland Clinic operates their clinics in Florida. Additionally, the letter of intent was executed between the parties and the attorneys are working through the due diligence and negotiation process. There are no further updates at this time.
District Counsel Report- Jennifer Peshke, Esq.
Mrs. Peshke provided her District counsel report and stated that she continues to work with the District’s retained special transactional counsel, Gray Robinson, concerning the collaborative process with IRMC. She stated that she is available to answer any Trustees questions as they arise through this process in working towards a definitive Agreement with Cleveland Clinic.
Financial Statement Review- Allen Jones, Treasurer
Mr. Jones provided the financial statement review and stated that the District remains in sound financial shape. The bank accounts total approximately $11.5 million and there are around $7.8 million in operating funds after accounting for this month’s cash disbursements. Further, the District expects to receive an additional $1.2 million in tax receipts during the balance of the fiscal year, therefore there should be no issues with maintaining its funding responsibilities to the agencies, as long as they stay within their budgeted amounts. This is contingent on indigent care volumes lowering, which they historically do in the fourth quarter. Mr. Jones noted that IRMC’s run rate is currently well above the budgeted amount. This is due to increased volumes on outpatient visits and inpatient stays, which are up 10%. If this trend continues, expenditures for indigent care at IRMC may exceed the budgeted amount by $700,000. Further, Mr. Jones reported that the partnership search process expenditures are currently running within budgeted amounts, but there is still much legal work to be done, and it remains to be seen if the budget amounts will remain accurate.
Executive Director Report- Ann Marie Suriano
Mrs. Suriano provided her executive director report. She notified the Trustees that all pending Senate and House bills, which would affect the District, have died in this legislative session. She further discussed that the State of Florida passed an $89 billion dollar budget, which is one of the highest budgets to date. Some areas that are to be noted are the $55 million budgeted support battling the national opioid epidemic, which has been deemed a national public health crisis. She further discussed a request she received to prepare a letter of support concerning a grant for the Indian River County School District. This grant would provide funding for vocational programs that specialize in the healthcare field. The Trustees agreed that the grant would be beneficial to the community and approved Mrs. Suriano’s request to write the letter of support on behalf of the District.
Funded Agencies Quarterly Report- Childcare Resources- Shannon Bowman, Executive Director
Ms. Bowman provided an update and testimonial to the success of the therapy program at Childcare Resources and how instrumental it has been to the children who attend the school. She explained that through the program, the overall goal is to prepare the child for kindergarten. Due to the District RFP grant, Childcare Resources was able to hire Tracey Griffis as a full time registered nurse therapist. Ms. Bowman explained that having the ability to have the therapist work with each child, has produced positive results in the children’s behavior and ability to learn. She thanked the Trustees for their support.
IRMC, Inc. Monthly Report- Emergency Department Update- Karen Davis, Interim CEO
Ms. Davis provided an update concerning the IRMC Emergency Department. She discussed in detail some of the issues the ED has been experiencing and the initiatives to correct those over the last four months. Ms. Davis explained that on average, there are 200 patients that visit the ED daily and many of these patients are a level 3 or above in acuity. She stated that a large group made up of hospital employees in each department has been formed, to identity the key issues and make corrections where needed, so that they may better support the ED. Additionally, there is now a clinician who screens each patient as soon as he or she enters the ED, to determine if the patient is emergent or non-emergent. Ms. Davis stated that she anticipates over 600 patients who once were served at the Health Department are now seeking care at the ED. Because of this increase, they are working with the low acuity patients to provide them with less costly care at another provider within the county. Ms. Davis further explained that patient volumes are up 10% at the hospital, which is partially due to the harsh flu season. The Trustees inquired if all beds were being staffed and utilized to meet the volume increase and Ms. Davis assured the group that they were. The Trustees had further discussion concerning the ED and thanked Ms. Davis for her efforts.
New Business- Audit Presentation- Kip Jacoby, CPA Morgan, Jacoby, Thurm & Boyle
Mr. Jacoby provided a review of the District’s FY 2016-2017 Audit. He explained that the District’s Audit is unmodified and clean. He discussed in detail the additional sections concerning major initiatives for 2016-2017, including the process of transitioning all agencies to fee for service funding. He further reviewed the summary of assets and liability position. He explained that the net ad valorem tax revenues dropped due to the decrease in the millage rate. He further provided an overview of budget reserves and actual expenditures. Mr. Jacoby stated that the District’s budget tracked with spending. Additionally, he addressed the foot notes which are an overview and the policy and procedures for the office.
Public Comment- There was no public comment.
Adjournment- The meeting adjourned at 6:15 PM