18 Apr Chairman’s Meeting Minutes: April 18, 2018
Indian River County Hospital District
Hospital District Conference Room
April 18, 2018
TRUSTEES: Marybeth Cunningham; Allen Jones; Ann Marie McCrystal; Tracey Zudans; Barbara Bodnar; Dr. Michael Weiss; Karen Deigl
STAFF: Jennifer Frederick; Jennifer Peshke, Esq.; Kate Voss
OTHER ATTENDEES: Miranda Hawker; Rick Van Lith; Randy Riley; Vicki Soule; Michael Kint; Myra Weiss
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.
We Care Task Force Update- Ann Marie McCrystal
Mrs. McCrystal provided an update concerning the We Care task force, which met at the end of March. The group participants are Dr. Mackett, Dr. Saver, Dr. Fountain, Miranda Hawker, and Shelly Stuven. She also invited Dr. Kathy Grichnik, who is the Chief Medical Officer at IRMC, to attend as well. The group discussed the increase in patients waiting to receive specialty services and the lack of volunteer physicians who are available and willing to provide the services. There was further discussion concerning the idea of providing a reimbursement to the physicians for their services. Mrs. Hawker explained that if the physician receives payment for their services, they would lose their sovereign immunity protection provided through the state. Currently the We Care Foundation supports the cost of supplies and the physicians volunteer their time.
The Trustees also discussed the potential impact on the specialty indigent care when Cleveland Clinic takes over operations at IRMC. Mrs. Cunningham stated that during these negotiations towards a definitive agreement, Cleveland Clinic will be building their Florida Charity Care policy, which would outline this matter. Mrs. Hawker stated that the We Care Foundation is working on a contingency plan to support the program and keep it operating at the level it is today, once Cleveland Clinic takes over operations at the hospital. Mrs. McCrystal suggested that Dr. Fountain and Ms. Hawker provide a We Care program update to the Trustees at the next Chairman’s meeting, so that the Trustees may have a better understanding of the program and its operations. There was also Trustee discussion concerning what other counties near Indian River support indigent specialty care. Mrs. Hawker stated that she could further research that matter and report back to the Trustees on the same. Some Trustees felt it would be unproductive to make any changes to the We Care program until they have a better idea of the charity policy through Cleveland Clinic.
Community Health Needs Assessment Update- Jennifer Frederick & Karen Deigl
Mrs. Frederick explained that three providers, VNA, IRMC, TCCH, along with the District, are collaborating together to conduct a community health needs assessment. The group vetted four companies and has selected Professional Research Consultants. Mr. Van Lith who is coordinating this effort, stated that through their due diligence, they are looking to work with a group that had conducted prior collaborative health needs assessment. Mrs. Frederick stated that the total cost of the assessment is $52,000 which includes 500 completed surveys. The hospital will fund $27,500, TCCH would provide $6,000 in funding and the VNA will contribute an additional $1,000. The District will fund the remaining amount of $15,750 and the process will begin in May. Mrs. Deigl made a motion to approve the expense of $15,750 which will be allocated and paid from funds in the 2018-2019 fiscal year budget. The motion was seconded by Mrs. McCrystal and passed unanimously.
Indian River County Senior Collaborative- Michael Kint, CEO United Way
Ms. Deigl informed the Trustees that per recommendation from Mrs. Peshke, she must recuse herself from this discussion and any voting concerning this matter, due to the fact that she is the Chair of the Senior Collaborative Board.
Mr. Kint explained to the Trustees that the Indian River County Senior Collaborative (“IRCSC”) is creating an alliance of senior citizens, providers, advocates, funders and individuals dedicated to supporting and advocating for senior citizens in Indian River County. The Collaborative is being modeled after the impactful Metal Health Collaborative, which the District has been involved in since its inception. To facilitate the development of the IRCSC, the United Way has stepped forward and is providing the following:
1. Hiring a half-time Administrator;
2. $10,000 to support the Administrators positons;
3. United Way will serve as the fiscal agent; and
4. Providing fully equipped office in the McCabe Nonprofit Incubation Center.
There was further discussion concerning the IRCSC Steering Committee list and who was included. Mrs. McCrystal noted that some organizations in the community, who should be included, were not listed. Mrs. Zudans stated that she has concerns with providing tax payer money to an organization that does not have a track record. She believes this is a good program but that is should be funded by through community philanthropy. Mr. Jones stated that he felt was a mission creep for the District, which he believes has the sole purpose of purchasing health services for indigent community members. He feels this program may be more of a social service issue and outside of the District purview. Mrs. Cunningham feels that supporting this program would be supporting the health needs of the elderly in the community. Ms. Bodnar stated that this program could potentially keep the senior population heathier, to reduce further medical costs down the road. Mrs. McCrystal feels that this program is necessary for the community and that their request is not a large sum of money to initiate it and move the program forward. There was further Trustee discussion and Mrs. McCrystal made a motion to provide the $10,000 in funding, which was seconded by Mrs. Cunningham. The motion carried 4 to 2, with Mrs. Bodnar and Mrs. Zudans in opposition. Ms. Deigl sustained her vote. The Trustees encouraged Mr. Kint and Mr. Riley to reach out to other funders in the community to help support this program.
Mr. Kint stated that Mrs. Peshke has just cycled off the United Way Board of Directors and he presented her with a plaque of recognition for her service.
Mrs. Cunningham provided an update concerning the partnership process with Cleveland Clinic. She stated that the parties are conducting their due diligence and reviewing documentation they have collected which is being housed in separate data rooms. Mrs. Peshke stated that it should be possible to provide the Trustees with a summary of what has been collected and she will confirm this matter with Mr. Boyles. Additionally, a facility inspection of the hospital will take place the week of May 1st. This inspection is being performed by an outside firm hired by Cleveland Clinic.
Further, the parties are still working through the terms of a definitive agreement and Cleveland Clinic is working to better understand the statutes that govern the District, which are complex. The outside legal team is researching to find the best steps for a long term lease, or short term lease, depending on what is the best deal for all parties while complying with legal requirements of the District. Mrs. Cunningham explained that since most of the focus has been on the definitive agreement, they have not yet begun discussions concerning charity care and specialty lines of service that will be offered at the hospital. She explained that until the parties have a full understanding of the structure of the deal, those matters will be determined after. Additionally, Mrs. Cunningham stated that Cleveland Clinic has reaffirmed that they are committed to this deal and have no intention of walking away. Cleveland Clinic has spent considerable time on this project and has utilized many of their resources and funds. She further stated that over the next few months, Cleveland Clinic indicated that they would like to address the Trustees at a special meeting. Mrs. Cunningham informed the Trustees that years ago Cleveland Clinic entered into a long term lease with an Ohio hospital owned by a government entity. After 25 years of Cleveland Clinic operating the facility, the government entities board changed and tried to end the agreement with Cleveland Clinic, which has left them overly cautious in this type of circumstance.
Mr. Van Lith addressed a question from the Trustees concerning a new stroke program that they heard is starting at IRMC. He explained that interventional stroke has become a viable enterprise in the IRMC region. IRMC has been working with a group on this matter well before any discussion with a Cleveland Clinic partnership. He explained that IRMC has reengaged with the group to see if they can bring interventional stroke services to IRMC. Mr. Van Lith indicated that over the next few weeks, they will have more information on this matter. Additionally, Cleveland Clinic is aware of these discussions.
Mr. Jones informed the Trustees that he has been asked by the Tax Payer Association of Indian River County to provide a discussion on Cleveland Clinic and the partnership process at their June 13th meeting. He stated that this discussion will be from his point of view and not represent the District. The Association specifically wanted Mr. Jones opinion on the research and data he compiled on Cleveland Clinic. He encouraged the Trustees to attend and District staff will post a notice in the paper to avoid any issues with the Sunshine Law.
Further, Mr. Jones stated the District budget is running high and has the potential to go over the annual amount. This is partially due to the high inpatient and outpatient indigent volumes at IRMC, along with the expenses associated with the partnership process. He explained that he will provide a more in-depth report at tomorrow’s regular monthly meeting during the financial review.
Lastly, Mrs. Cunningham informed the Trustees that at tomorrow night’s meeting, the county will present a report on a proposed Aviation Blvd extension. This extension is intended to reduce the amount of traffic on 37th Street and provide an alternative route to the hospital facilitates.
Public Comment- There was no public comment.
Adjourn- The meeting was adjourned at 11:30 am.