Budget Workshop Meeting Minutes: May 25, 2018

Budget Workshop Meeting Minutes: May 25, 2018


Budget Workshop: UF; MHA; Health Department

Indian River County Hospital District

May 25, 2018


TRUSTEES:                          Marybeth Cunningham; Allen Jones; Ann Marie McCrystal;  Dr. Michael Weiss; Barbara Bodnar


EXCUSED:                           Karen Deigl; Tracey Zudans


STAFF :                                  Ann Marie Suriano; Jennifer Frederick; Kate Voss; Jennifer Peshke, Esq. (via phone)


OTHER ATTENDEES:     Wayne Creelman, M.D.; Gina Palladino; Robert Brugnoli, Ph.D.;  Jeanne Sheperd;  Angela Guzenski; Miranda Hawker; Herman Fountain, M.D.;

Dennis Saver, M.D.;  Mayur Rao; Shelly Stuven


Convene Meeting- Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the monthly chairman’s meeting of the IRCHD at 1:00 PM by welcoming those in attendance.


Funding Requests-

 UF Center for Psychiatry & Addiction Medicine- Wayne Creelman, M.D.

  Dr. Creelman provided a review of UF’s funding request for FY 2018-2019 which totaled $185,000. He stated that one notable change in the request from the previous year is that there is a $50,000 reduction in the community psychiatry service that was offered at the Mental Health Association. He explained that the UF physicians who provided psychiatric services at the Mental Health Association one day a week, will no longer be providing services due to lack of demand. The Mental Health Association hired its own licensed psychiatrist. Additionally, Dr. Creelman indicated that the center has seen an increase in patients seeking addiction treatment services but there has been a decrease in the suboxone medication program, which is a positive indicator. Further, Dr. Creelman indicated that the number of patient visits have decreased overall since 2015. He believes this could be due to patients seeking services elsewhere. He did indicate that UF has 94 referrals from the Connections Center. Lastly, Dr. Creelman discussed UF’s efforts to raise $320,000 in funding to support the bridge gap year for the clinic. He stated with help from local community philanthropy and support, they were able to raise the funds and continue operating the clinic.


Mental Health Association- Robert Brugnoli, Ph.D.

 Dr. Brugnoli provided a review of the Mental Health Association funding request for FY 2018-2019. The total funding request is $402,000 which included support for the Mental Health Walk-In Center and Pharmacy, along with the Mental Health Drop in Center, which helps support chronically ill mental health patients. He discussed the UF community psychiatry program in which MHA utilized the services of one UF psychiatrist once a week. He explained that MHA has now hired their own in house psychiatrist and are requesting funding to support that service. He further discussed the increase in walk in visits at the Walk-In Center and stated that 20% of their visit population is now children. Additionally, MHA is working to become a Medicaid qualified center. As a new initiative for MHA, Dr. Brugnoli stated that he met with Dr. Martinez and the Indian River County School Board. Together they have developed a plan to implement a violence prevention program. He explained that MHA would be requesting $50,000 from the District but that they are not requesting the funding at this time. He asked that the Trustees keep this request in mind to be discussed at a later time when there is more information about the program available.  Dr. Brugnoli further discussed the positive impact the District Care Card program has had on helping qualifying patients. He explained that before the care card many patients had trouble qualifying or were not compliant in returning the qualification documents. Since the implementation of the card, many patients are presenting at the Center and are already qualified through another health agency in the county.


IRC Health Department- Miranda Hawker, Health Administrator & Dennis Saver, M.D.

Dr. Saver provided the Trustees with a historical review of the We Care program. He explained the clinics mission and vision, which is to provide free quality medical care to the indigent population of Indian River through donated services from local physicians and programs. Their objectives is to provide streamlined access to specialty services and increased access to specialty care for indigent population. Ms. Hawker stated that data from 2016 shows 38,456 of  residents in Indian River County are at 150% or less of the Federal Poverty Level.  In addition, 18.8% of residents under 65 were without health insurance.

Ms. Hawker provided a review of the We Care funding request. The Health Department is requesting $319,766 in funding which includes the fee-for-service charge and the additional monthly program fee. Also included is the pharmacy request of $9,000 for a total of $328,766. They project approximately 1,620 visits to the clinic next year. In addition, they have hired a social worker to help improve patient relations.  Dr. Saver discussed his concerns with the pending partnership with IRMC and Cleveland Clinic. Currently, IRMC helps support We Care by providing supplies and operating rooms, along with the supplying the volunteer physicians. He fears that Cleveland Clinic will not help support We Care at its currently level after the partnership, and he requested that the Trustee include support for specialty services in their negotiations.  Dr. Fountain reviewed the list of medical services that patients are waiting to receive and he stated that there has been a 17% increase since the beginning of the year. There was further Trustee discussion and Mr. Jones requested a list of volunteer physicians that participate in We Care so that they may address the backlog of patients by identifying physicians in the area who work in those specialty services.

Mrs. Hawker provided a review of the Health Departments funding request for 2018-2019. The total request of $732,178 includes primary care and dental services, along with funding for the Gifford Health Center (“GHC”) which supports pediatric care. Ms. Hawker stated that there has been a 38.6% decrease in visits from last year. She believes this is primarily due to the transition in reimbursement to fee-for-service, instead of a grant sum. Additionally, they are anticipating 9,305 visits this year and an average cost of $154.38, which includes any labs and pharmacy charges. The proposed funding request for primary care is $526,861 which supports direct service personnel, maintaining patient care visits, and an administrative cost will help cover their variability in funding. Further they are requesting approximately $4,000 for the Gifford Health Center (“GHC”). Ms. Hawker stated that the Health Department will be expanding services at GHC and Healthy Start Coalition will have an office at the clinic beginning July 1 to house the Nurse Partnership program. She further reviewed the dental services and pharmacy request, which totaled $181,192. There was further Trustee discussion and Mr. Jones requested data concerning the infant mortality rate in the Gifford area.


Public Comment- There was no public comment.

 Adjourn- The meeting was adjourned at 3:00 PM