Chairman’s Meeting: January 16, 2019

Chairman’s Meeting: January 16, 2019



Indian River County Hospital District

January 16, 2019

10:00 AM


TRUSTEES:                             Marybeth Cunningham                    Tracey Zudans

Ann Marie McCrystal                       Barbara Bodnar (via phone)

Allen Jones                                         Michael Weiss


ABSENT:                                 Karen Deigl


STAFF:                                     Ann Marie Suriano                   Jennifer Frederick

Kate Voss                                    Jennifer Peshke, Esq.


OTHER ATTENDEES:           Matt Reiser                               Andrea Berry

Michelle Genz                          Janet Begley

Tony Brown                             Miranda Hawker

Vicki Soule                              Angela Guzinski

Nicholas Coppola                     Pat Knipper


                 Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the Chairman’s meeting of the IRCHD at 10:00 AM by welcoming those in attendance.

Mrs. Cunningham stated that the Trustees have asked for additional one on one discussions with Mr. Felix over the next month to further work through the District Strategic Plan. The goal would be to hold a separate meeting in February to approve the finalized plan, however, if more time is needed, the meeting could be held in March. The board felt it was important to spend ample amount of time on this process and not rush to approve a plan that was not well thought through.


                   Review and Discussion of Draft District Strategic Plan- Michael Felix, MSHA

Mr. Felix stated that this plan is to help transition the District from their main responsibility of supporting indigent care at IRMC. He explained that the plan has two goals which are accompanied by action steps. Additionally, he reviewed in detail the education agenda and its definition. There was further Trustee discussion surrounding the Districts vision statement and whether the statement should to reflect the language of the District’s Special Act. It was decided that the Trustees would provide their recommendations to Mr. Felix concerning the same. It was also decided that a specific Trustee would work with staff on the goals and action steps within the plan. There was further discussion surrounding the structure of funding the various health agencies in the community, which the District support mostly through a fee-for-service model. Mr. Felix requested that Ms. Voss set up an individual telephone conference with each Trustee to further discuss their recommendations for the plan. The board will meet next month to review and discuss the same.


                   Gifford Health Center Update- Allen Jones, Treasurer

Mr. Jones provided an update concerning the Gifford Health Center project. He stated he would like to have discussions with the board surrounding next steps for the process and once they can agree on that, move forward with more specific items at a later date. Mr. Jones explained that It has been recommended by legal counsel that the District proceed with a formal RFP concerning the operations of the Gifford Health Center.

Mrs. Peshke explained that the District initially opted to go with an RFI (“Request for Information”) process as an initial step to seek information concerning the needs and wants of the community. The RFI process allowed for an exploratory phase before a decision is made by gathering information to determine what is needed. An RFP (“Request for Proposal”) sets forth specifically what is needed by the entity putting out the RFP for solicited responses. The District has now repeatedly heard from the community health leaders and the public to ask what services are needed in the community. Additionally, the District received two responses to the RFI including one from the DOH and one from TCCH.  Upon receipt of those informal responses to the RFI, after several public meetings and further discussion and clarification with those organizations that submitted the responses to the request for information. Mrs. Peshke recommended that the District should proceed with issuing a formal RFP.

Mr. Jones explained that he, Mrs. Peshke and Mrs. Suriano will develop the RFP as soon as practical. Once a draft is prepared, the District will look to receive comments from the Trustees and public. Mr. Jones would then like to form an evaluation committee to analyze the responses from the RFP. Prior to considering the finalist, the Trustees will receive copies of each of the responses and Trustees may submit their comments to Mrs. Suriano. Mrs. Peshke stated that this process is outlined within the Florida statutes and the District will comply with those regulations. Mr. Jones further stated that evaluation committee will review the proposals and make a recommendation to the board. The estimated timeline for completion of the RFP will be this spring, with a goal of the Gifford Health Center being operational by October 1, 2019.  Mr. Jones made a motion to approve this process, which was seconded by Mrs. McCrystal. The motion carried unanimously.


            District Qualification & Guidelines Discussion- Ann Marie Suriano, Executive Director

Mrs. Suriano stated that there have been multiple Trustee discussions surrounding increasing the District’s income qualification guidelines from 150% of the Federal Poverty Level to possibly 250%. Through extensive research using the most recent U.S. Census data, she has prepared an outline of residents in Indian River County with insurance and those without. The outline further showed which residents are estimated to be at 150% or below the poverty level, along with those up to 250%. Mr. Jones provided the Trustees with a review of the financial impact of raising the guidelines as well. Both reports have been attached to these minutes, for reference. The Trustees agreed to monitor the impact on the county from the transition to Cleveland Clinic. They also discussed the possibility of slowly increasing the level each year as a way to phase in the transition for less of a financial impact initially.


            Program Liaison – Jennifer Frederick, Program Liaison

             Mrs. Frederick provided an update concerning United Against Poverty (“UP”), and stated that the center has been working to update its new facility. The new facility will help provide primary care assistance, substance abuse treatment, family services, and food support. The VNA is also working with UP to provide health physicals. Additionally, TCCH is collecting surveys from patients concerning the primary care services they receive and would like to receive, to review that data. Lastly, she informed the Trustee that the Up Center is looking for $65,000 for start up costs and may be requesting those funds from the District during the next budget cycle.


            Other Business-

Mr. Jones stated that through his work with Partners and on infant mortality rates in the county, he discovered that a formal study on infant mortality rates in Indian River has not be conducted in over ten years. He informed the Trustees that the Health Department wrote a grant to the State of Florida to obtain the study, but the request was denied. After speaking with Ms. Hawker about the importance of the data collected from the study, he proposed that the District fund the study which would cost $60,000. He clarified that some of the information found in the study would not be available for the District to review, due to legal requirements. He informed the Trustees that Ms. Hawker would be making a formal request to fund the study, along with answering any Trustee concerns or questions, tomorrow night at the regular monthly meeting.


Mrs. Cunningham stated that she was contacted by Dr. Rosencrantz, the new CEO at Cleveland Clinic Indian River Hospital (“CCIRH”), regarding Trustees contacting him directly. She reminded the board that CCIRH is in their very early stages of transition and asked that the Trustee refrain from contacting him directly on District or county matters. All communications to CCIRH should go directly to Mrs. Suriano, who will then inform Mrs. Cunningham of the same, as Mrs. Cunningham is the representative on the CCIRH board.


            Public Comment– There was no public comment.


            Adjourn- The meeting was adjourned at 1:00 PM