Regular Monthly Meeting: October 18, 2018

Regular Monthly Meeting: October 18, 2018

Regular Monthly Meeting
October 18, 2018
5:01 PM

TRUSTEES: Marybeth Cunningham Karen Deigl
Ann Marie McCrystal Allen Jones
Barbara Bodnar

EXCUSED: Dr. Michael Weiss Tracey Zudans

STAFF: Ann Marie Suriano Jennifer Frederick
Kate Voss Jennifer Peshke, Esq.

OTHER ATTENDEES: George Eighmy Brett Hall
Angela Dickens Warren Fuller
Rich Van Lith Vicki Soule
Derick West John Romano

Convene Meeting – Marybeth Cunningham, Chairwoman IRCHD

Mrs. Cunningham convened the regular monthly meeting of the Indian River County Hospital District (“IRCHD”) at 5:00 p.m.

Mrs. Cunningham asked for approval of first public budget hearing meeting minutes dated September 13; budget discussion meeting minutes dated September 26; special meeting minutes dated September 27, final public budget hearing meeting minutes dated September 27; regular monthly meeting minutes dated September 27; and an October disbursement of $875,545.19. Mrs. Bodnar made the motion, which was seconded by Ms. Deigl. The motion carried.

District Chairwoman – Marybeth Cunningham

Mrs. Cunningham stated that the District Trustees and IRMC Board of Directors voted unanimously to approve the Cleveland Clinic partnership. They project the deal to close by January 1, 2019. Additionally, the Districts fiscal year began in October and the board will now focus on the other matters relative to health care in the community.

District Counsel Report – Jennifer D. Peshke, Esq.

Mrs. Peshke provided her district counsel report and stated that she continues to work on the Cleveland Clinic partnership. Additionally, now that the District’s budget has been finalized for the new fiscal year, she is working with District staff to finalize the funding agreements. Further, she is working on matters concerning the Gifford Health Center and the District’s new strategic plan.

Financial Statement Review – Allen Jones, Treasurer

Mr. Jones provided a financial statement review for the fiscal year end. He stated that there were some larger expenses that are normally not incurred which included the Cleveland Clinic partnership and renovations to the VNA Human Services building. The District ended its year with approximately $2.7 million in its bank accounts.

Executive Director Report- Ann Marie Suriano, Executive Director

Mrs. Suriano provided her report and stated that she has been working with Michael Felix on the Districts strategic plan for years 2019-2022. Additionally, the preliminary results from the Health Needs Assessment were presented last week to community leaders and the final report will be available in the coming months.

IRMC, Inc. Monthly Report – Financial Update/Request for Indigent Care Funding- George Eighmy, CFO

Mr. Eighmy provided a review of the fiscal year end for IRMC. He reviewed the variance between budget and actual volumes and stated that IRMC experienced $1.6 million increase over their budget for indigent care services. It was discussed by the Trustees that the hospital had requested approximately $7.5 million for indigent care funding, based off of volumes experienced in the current year. However, the board ultimately voted and approved a lesser amount of $6,38,449 which this hospital has surpassed by $1.3 million. As stated in the Indigent Care Agreement between IRMC and the District, the hospital may request reimbursement for the additional expense incurred before the beginning of the next fiscal year. Mr. Jones indicated that the District has already spent $1.6 million from their reserve funds and that there were enough funds to cover the request but it would be close. There was further Trustee discussion concerning the fact that the 2017-2018 indigent cases had not been audited yet and that there is potential that IRMC will be required to pay back the District for patients who either didn’t qualify or found an alternative payor source. Therefore, approving a payment for the full amount, may be premature. Mrs. McCrystal recommended that the board approve the difference between what the District approved for the 2017-2018 budget request and the amount paid to the hospital for care this year, which equaled $768,937.

Mrs. McCrystal made a motion to reimburse the hospital the amount from their original budget request for fiscal year 2017-2018, versus what has been paid. Ms. Deigl seconded the motion and it carried unanimously. Mr. Jones indicated that he will continue to work with the hospital to find the true up amount.

Funded Agencies Quarterly Report-

Treasure Coast Community Health- Vicki Soule, CEO

Mrs. Soule provided a quarterly update to the Trustees concerning TCCH and its multiple clinics in Indian River County. She stated that TCCH was placed in the top 30% of Community Health Clinics nationwide. They were further recognized as a fully accredited patient centered medical home and patient centered dental home by Accreditation Association of Ambulatory Health Care. She further reviewed data concerning patient visits and outcomes and stated that the clinic has made at least a 10% improvement in one or more clinical quality outcomes.

Mental Health Collaborative- Brett Hall, Executive Director

Mr. Hall provided an update concerning the McCabe Connections center. He discussed his involvement with initiatives to seek Medicaid reform. Additionally, the advocacy program has expanded and they currently have 11 advocates. He further discussed some of the issues many clients who visit the center are experiencing such as lack of housing and substance abuse issues. He explained that in July, the State of Florida enacted new legislation that drastically changes the way opioid based medications are prescribed. Many clients who once received that medication have been unable to do so now due to the new laws. This has caused an increase in patients seeking substance abuse treatment and counseling.

New Business- Action Required

Request for Additional Funding- John Romano, CEO New Horizons

Mr. Romano reviewed the services provided for the period October, 2017 through September, 2018. He explained that New Horizons served 142 unduplicated clients for a total cost of $65,402, which is $10,402 over their budget. Therefore, Mr. Romano is requesting $10,402 for reimbursement of services they provided. Mrs. McCrystal made a motion to approve the expense, which was seconded by Ms. Deigl. The motion carried.

Public Comment-

Mr. Fields, CEO of the VNA, thanked the Trustees for their support of the county and its most vulnerable patients. He stated that he looks forward to working collaboratively with the District and other health agencies in the community.


The meeting was adjourned at 6:00 PM.

Respectfully Submitted,

Ann Marie McCrystal