Chairman’s Meeting Minutes: February 14, 2018

Chairman’s Meeting Minutes: February 14, 2018

Chairman’s Meeting
Indian River County Hospital District
Hospital District Conference Room
February 14, 2018
10:00 AM


Marybeth Cunningham

Allen Jones
Ann Marie McCrystal

Tracey Zudans

Karen Deigl

Barbara Bodnar

Dr. Michael Weiss


Ann Marie Suriano

Jennifer Frederick

Kate Voss

Jennifer Peshke, Esq.


Matt Reiser

Michelle Genz

Gerri Smith

Vicki Soule

Kathy Orton

Kathy Hendrix

Myra Weiss

Ryan Bass

Janet Begley

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. Mrs. Cunningham stated that there is a change to the agenda and Ms. Handley and Mr. Jacoby would be presenting after Mrs. Peshke.

Recommendation of Valuation Firms- Jennifer Peshke, Esq.

Mrs. Peshke stated that she submitted a memo to the board summarizing the valuation firms that were interviewed and outlined the recommendation for the retention of a firm to move forward with the process of obtaining an independent opinion on behalf of the District which would confirm that the anticipated transaction with Cleveland Clinic is fair for the District to enter into. She explained that on January 10, Mrs. Suriano, Mrs. Cunningham and she interviewed five firms to conduct this review. The firms were recommended to them by the District’s special transactional counsel GrayRobinson and Juniper Advisory. Mrs. Peshke stated that the group is recommending the District retain the firm of Stout Risius Ross, LLC and asked for a motion to approve the recommendation. Mrs. Cunningham made the motion, which was seconded by Mrs. McCrystal. There was Trustee discussion concerning this matter and Mrs. Zudans stated that she felt this process deserved an RFP and that she wanted to be involved in this process of interviewing the firms. Mrs. McCrystal stated that she felt comfortable with the fact that the Chairman, District legal counsel, and executive director conducted these interviews and due diligence on the five firms and trusts that the group brought forth this best recommendation for the process. Ms. Deigl, Mrs. Bodnar and Mr. Jones echoed Mrs. McCrystal’s comments. There was further Trustee discussion surrounding the fact that this firm is free of conflicts and has no ties to Indian River County or Indian River Medical Center. The motion carried with Mr. Jones, Mrs. McCrystal, Mrs. Bodnar, Ms. Deigl, and Mrs. Cunningham for the motion and Mrs. Zudans against. Dr. Weiss was not present for the vote. It is noted for the minutes that Mrs. Peshke clarified to the board in response to Mrs. Zudans request for an RFP that neither the Florida Statutes, not the District Special Act require to the District to issue an RFP to retain a contractor of this nature.

Tax Law Impacts on Indian River County- Emily Handley, CPA & Kip Jacoby, CPA

Mrs. Cunningham stated that she was asked by a public member what affect the new tax law would have on the District and the County. She asked that our accountants provide a short presentation on the same. Mr. Jacoby stated that the tax rates have been adjusted and lowered and there still is the graduated rate scheme, along with the bottom tax rate schedule at 10%. Historically, there was a deduction calculated pursuant to the number of individuals in the household, referred to as the standard deduction. He discussed what a deduction would look like now for a family of four whose income is 150% below the federal poverty level. He explained that with the new tax law, there is around 115% increase in a refund. Additionally, he discussed charitable deduction which has slightly changed and now an individual who is making a substantial contribution may now claim 60% of their income. He feels that this change will not affect the charitable contribution in Indian River County. Mr. Jacoby also stated that the penalty for not having health insurance has been repealed and the Trustees discussed the possible negative effects that may have by causing an increase of uninsured individuals.

Update on Community Needs Assessment- Jennifer Frederick, Program Liaison 

Mrs. Frederick stated that the IRS requires all federal qualified health agencies and not-for-profit hospitals to perform a community health needs assessment every three years. She explained that she has contacted all the agencies that participated in the collaborative community health needs assessment back in 2015, to see if they would be interested in participating again. She has heard back from TCCH and IRMC, who have agreed to participate. Additionally, she has reached out to the Health Council of Southeast Florida, who conducted the last assessment, to see if they would be willing to facilitate this process. Ms. Deigl also provided Mrs. Frederick with the contact information of Barbara Allen at SRA and Ms. Allen will be putting together a proposal for review. The Trustees recommend that Mrs. Frederick reach out to Sebastian River Medical Center to participate as well, since they are under new leadership.

Approval of Federal Poverty Guidelines- Jennifer Frederick, Program Liaison 

Mrs. Frederick stated that she is seeking approval of the 2018 Federal Poverty Guidelines. These guidelines are issued by the Department of Health & Human Services and updated yearly. She asked for a motion to approve which was made by Mrs. Zudans and seconded by Mrs. McCrystal. Mrs. Soule addressed the group and stated that for a family size of one, the 150% threshold is equal to $8.75 an hour at a 40 hour a week job, which most individuals do not have and is not a livable wage. She encouraged the Trustees to look at extending the District guideline to 200% or higher to capture those individuals who are above the 150% level. There was further Trustee discussion and they stated that this discussion should take place during the budget funding period in April. Mrs. Frederick stated that the agencies were asked to collect the data that would capture those up to 200% and that information will be reviewed during the budget presentations. The motion carried.

Trustee Public Speaking Schedule- Ann Marie Suriano

Mrs. Suriano stated that as part of the strategic plan, there was discussion about the Trustees conducting some public speaking engagements to educate the public about the District and its importance to the community. She is working with the consultants at Jarrard to put together a PowerPoint presentation that outlines the Districts history and funding efforts in the community. The document is in draft form currently but she invited the Trustees to review the same and submit any changes or additions to the presentation.

Trustee Open Discussion-

Mrs. Cunningham stated that an opportunity to visit Cleveland Clinic Weston has been extended to the District Trustees and IRMC Board of Directors. There was discussion as to what day at the beginning of March would be best for the Trustees. They agreed on March 5 for the visit and Mrs. Cunningham stated that she would discuss the same with Juniper and District staff would follow up with the Trustees as to travel arrangements and logistics.

Public Comment-

Mr. Ryan Bass, community member, stated that he feels the if the Trustees are to conduct public speaking engagements that they should take public comment by submitted questions only and refrain from floor discussion. He further stated that there needs to be a consistent message as to who the Districts consultant is for the partnership process, since Juniper is retained by IRMC. Mrs. Bass asked if Juniper was the District’s consultant. Mrs. Peshke stated that Juniper has been retained by IRMC and is paid by IRMC, however Juniper views the community of Indian River as their client for this transaction and will work to make the best deal possible for the community.

Adjourn- The meeting was adjourned at 11:30 AM