Fostering collaboration to improve healthcare in Indian River County

WHAT DOES THE DISTRICT DO?

The Indian River County Hospital District assesses a property tax to provide funding to organizations ensuring that essential health care programs and services; primary, specialty, dental, and mental/behavioral health, are available to benefit the entire community. We maintain ownership of  four properties leased to other organizations for the operation of healthcare activities. The District convenes providers and funding partners to address gaps in the healthcare continuum of care and help to find and fund solutions.

Note from the Chairwoman:

This past year was another busy year for the Hospital District.  Developing the Strategic Plan with a different, broader focus than previously was both challenging and fulfilling. The Trustees and staff are challenging ourselves to assure that funds are spent in a prudent and accountable way while also ensuring that we are addressing the gaps in both healthcare accessibility and services.

We are keeping a strong focus on the availability of primary and dental care while increasing the focus on mental and behavioral health. The importance of optical health has also become a priority through the introduction of the GlobeChek at both Whole Family and TCCH. We are also expanding our reach by supporting healthcare advocates and case workers in agencies such as Childcare Resources and Hope for Families.

Two long-term Trustees, Ann Marie McCrystal and Allen Jones, have left the Board and their experience and knowledge will be missed, however, the three new Trustees are all eager to share their time, talents, and experience to continue to support our community through accessibility to quality healthcare.

As always, I continue to be proud of our dedicated, hard-working staff. I look forward to working with the staff, Trustees and other agencies in the coming year to continue to move the needle to fulfill our mission “to improve the health of Indian River County residents”.

  – Marybeth Cunningham, Chairwoman, Indian River County Hospital District

Note from the Executive Director:

This year began by engaging Carter to lead the District Trustees and staff through a Strategic Direction process. The completed framework outlines a five-year transformational plan for the Indian River County Hospital District to create greater access to healthcare services through partnerships with our community leaders and to assist in finding solutions to community health issues.

Late in 2021, we added an Internal Audit and Data Analyst position, in the spring of 2022, I obtained the Certified District Manager designation through the Florida Association of Special Districts and Florida State University, and in December, we added a full-time Financial Assistance Specialist. These additional positions and educational growth, allows our staff to provide quality program and service audits at each of our funded agencies, even greater assurance your tax dollars are well spent, enhances leadership, and provides a higher level of quality service monitoring the qualification process and reporting of residents accessing services at our funded organizations.

The District Accountability Legislation was passed this year requiring all Special Districts to provide a Performance Review of their district every 5 years. This review for Hospital Districts will begin in the fall of 2023 and is then submitted to the House and Senate for deliberation during session. We have been preparing for this review by creating written policies and procedures, providing efficiencies in our workflow and creating sound financial stability of the organization to best serve our citizens. We are also proud of the ability to provide the lowest tax assessment in the Indian River County Hospital District’s history, while providing access to the greatest amount of healthcare services available to the county’s residents.

Finally, the election this year, brings 3 new Trustees to assist in carrying out the District’s mission to improve the health of Indian River County residents, and our vision to create an innovative and integrated healthcare network that improves the health of Indian River County residents.

We welcome you to call or visit us any time.

– Ann Marie Suriano, Executive Director, Indian River County Hospital District

Annual Report Summary- 2022

STRATEGIC FRAMEWORK

The following is the result of the Strategic Direction exercise facilitated by Carter in early 2022.  This is the Framework for the Indian River County Hospital District for the next 10 years that will be revisited, monitored for success and altered as necessary every 3-5 years.  It is designed to be a collaborative effort benefiting our entire community.

Strategic Priorities

Overall Impact Indicator:  Maintain % of adults who say their overall health is “good” or “excellent” and Adults with good mental health above the State average. (Source:  Florida CHARTS)

1. Focus efforts and investments on programs that strengthen primary care, behavioral health, and prevention.

• KPI: A minimum of 90% of District program funds are focused on primary    care, behavioral health and prevention. (Source: IRCHD) FY2022-23 Program Budget $13,003,317 – 97.85%

2. Improve access to healthcare services by reducing financial barriers.

• KPI: maintain % of adults who could not see a doctor at least once in the past year due to cost below the state average. (Source:  Florida CHARTS) Enhance the Hospital District’s Financial Assistance Database to capture other financial barriers than uninsured and Federal Poverty Level (FPL) and track new & return users in all categories. (Source: IRCHD)

3. Identify community-wide healthcare gaps through convening key stakeholders to facilitate collaboration toward potential solutions.

• KPI: Services/programs/solutions initiated/expanded to meet community health needs efficiently and effectively.  (Source:  Community Needs Assessments and Surveys)

4. The IRC Hospital District commits to being transparent and fiscally responsible for tax dollars spent or invested to include:

• Establishing and monitoring performance metrics consistent with the healthcare provider’s patient care objectives and
• Conducting audits as appropriate to verify the validity of reported metric and financial numbers of supported healthcare providers.

INVESTMENTS

As interest rates were on the rise with the US Treasury, and lagging in the preferred deposit pool, holding most of the District’s reserve funds, the Treasurer, Allen Jones presented a proposal to the Trustees to begin purchasing US Treasury Bills. Upon approval in May, the Treasurer, working with the Executive Director, purchased $5,750,000 worth of Treasury bills through Treasury Direct. These funds are fully insured and will mature in May, August and December 2023, gaining $218,944 in interest. Towards the end of the year, the District then chose to enter into an agreement with Deep Blue Investment Advisors to provide a laddered portfolio investment strategy with maturities in the remaining months. In December of 2022, they purchased an additional $8,750,000, which is anticipated to add a net interest of approximately $190,000. This investment strategy contributed largely to the ability of the Hospital District’ to lower the FY 2022-23 millage rate.

DISTRICT FUNDED AGENCIES

The organizations listed below have been partners of the IRCHD, providing programs and services that assist us to further our mission. The following organizations have been reimbursed a total of $9,147,188 during the fiscal year of October 1, 2021- September 30, 2022.

• CCIRH Partners in Women’s Health Program $1,682,520
• Childcare Resources $116,791
• Cleveland Clinic Indian River Hospital IOP $135,648
• GlobeCheck $71,011
• Healthy Start Coalition of Indian River County $637,988
• Hope for Families Center $42,140
• County Share of Medicaid $476,141
• Mental Health Association $502,820
• Mental Health Collaborative $200,000
• New Horizons $39,930
• Senior Resource Association $88,248
• Phoenix Rising $254,000
• Substance Awareness Center $153,483
• Treasure Coast Community Health, Inc. $3,296,124
• Tykes & Teens $147,438
• University of Florida Psychiatry and Addiction Medicine $95,072
• VNA of Treasure Coast, Inc. $760,201
• We Care $82,826
• Whole Family Health Center $291,307
• Senior Collaborative $22,500
• Dynamic Life Recovery $51,000

GLOBECHEK

The Hospital District expanded its supported services to include eye care services to the residents of Indian River County to improve the health for many who may not regularly or ever receive eye care services.

Through the collaboration between Dr. William Mallon, owner of the Center for Advanced Eye Care in Vero Beach, and Whole Family Health Center, a six (6) month pilot program was implemented to offer free eye examinations using GlobeChek, an innovative and comprehensive tele-eye care platform that detects glaucoma, diabetic retinopathy, macular degeneration, and cataracts, as well as other eye and systemic diseases.

The technology is a state of the art mobile, single kiosk that consists of the same high- quality instrumentation found in an office examination to evaluate vision and ocular health. Patients are able to complete a comprehensive eye exam in less than 10 minutes (without dilation).

A certified GlobeChek doctor reviews each patient’s test results and provides a written report of its findings to their primary care physician and after evaluation, devise a management or treatment plan, as needed.

Dr. Mallon estimates that 30% of adults are in need of corrective lenses to improve their vision.  He says many people function in their daily life with impaired vision, many not realizing their handicap. GlobeChek can identify potentially serious eye disease like glaucoma and macular degeneration without symptoms.  Identifying these afflictions early before symptoms present can possibly lead to treatment preventing or controlling the advancement of the illness and ultimately preserve patient’s eyesight.

Following a successful Pilot program, Whole Family Health Center and now Treasure Coast Community Health have the ability to offer GlobeChek services to all patients regardless of their ability to pay, with support from the Hospital District.

PILOT PROGRAM DATA RESULTS

FINANCIAL ASSISTANCE PROGRAM

Beginning October 1, 2016, the Indian River County Hospital District implemented a Healthcare Financial Assistance ID Program to the residents of Indian River County who meet eligibility requirements.  The intent of this program is to remove barriers to residents who do not have the means to pay for services provided by our funded agencies.  Pursuant to the Financial Assistance ID Program the applicant must be an uninsured resident of Indian River County with a gross annual family income of less than 200% of the Federal Poverty Income Guidelines. The approved applicants are provided healthcare financial assistance at any of our funded agencies for one year and can reapply should they continue to meet the eligibility criteria.

FY 2021/2022 FINANCIAL ASSISTANCE PROGRAM DATA

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