Regular Monthly Meeting: January 17, 2019

Regular Monthly Meeting: January 17, 2019




Regular Monthly Meeting

Indian River County Commission Chambers

January 17, 2019 @ 5:00 p.m.



TRUSTEES:                           Marybeth Cunningham           Tracey Zudans

Ann Marie McCrystal             Barbara Bodnar (via telephone)

Allen Jones                             Dr. Michael Weiss


ABSENT:                                Karen Deigl


STAFF:                                   Ann Marie Suriano                 Jennifer Frederick

Kate Voss                                 Jennifer Peshke, Esq.


ATTENDEES:                        Lundy Fields                           Pat Knipper

Miranda Hawker                   Carole Kanarek

Deb Hawkins                          Cecilia Escobar

Matt Reiser                              Nicholas Coppola, MD

Janet Begley                            Michelle Genz



Convene Meeting – Marybeth Cunningham, Chairwoman

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


Invocation- Mrs. Zudans provided the invocation for the meeting and Dr. Weiss led the group in the Pledge of Allegiance.


Organizational Matters- Jennifer Peshke, Esq.


Mrs. Cunningham stated that the first order of business was the election of officers. Mrs. Peshke explained that the Hospital District Bylaws require that the District reorganize at the first meeting of each year and elect five officers. Any board member may make a nomination for the five offices, which include Chairman, Vice Chair, Treasurer, Secretary, and Assistant Secretary. Each office will be elected by calling for a nomination, and a second. She asked that the nomination for the Chairman, begin the process.


Mrs. McCrystal made a motion to nominate Mrs. Cunningham for Chairman of the Board of Trustees. She spoke to Mrs. Cunningham’s leadership throughout the Cleveland Clinic process and stated that she successfully led the board to a unanimous decision to partner with Cleveland Clinic Florida. The Trustees echoed Mrs. McCrystal’s comments regarding Mrs. Cunningham’s leadership on the board. Mr. Jones seconded Mrs. McCrystal’s motion, which carried unanimously.


Mrs. Zudans nominated Dr. Weiss as Vice Chairman, which was seconded by Mrs. McCrystal. The motion carried unanimously.


Mrs. Cunningham nominated Mrs. McCrystal as secretary which was seconded by Mrs. Zudans. The motion carried unanimously.


Dr. Weiss nominated Mrs. Zudans as assistant secretary, which was seconded by Mr. Jones. The motion carried unanimously.


Dr. Weiss nominated Mr. Jones as Treasurer which was seconded by Mrs. McCrystal. The motion carried unanimously.


Mrs. Cunningham asked the Trustees if they would like to continue to hold the District’s regular monthly meeting on the third Thursday of each month at 5:00 PM. The board agreed. Additionally, the board agreed to hold a monthly Chairman’s meeting on the third Wednesday of each month at 10:00 AM. All other meetings will be scheduled on an as needed basis.


Consent Agenda- Marybeth Cunningham, Chairwoman


Mrs. Cunningham asked for a motion to approve the Chairman’s meeting minutes dated December 19; regular monthly meeting minutes dated December 20; and a January disbursement of $1,206,053.66. Mrs. McCrystal made the motion to approve, which was seconded by Dr. Weiss. The motion carried unanimously.


Mrs. Cunningham provided her Chairman’s report and stated that the District continues to work on many projects including the Strategic Plan for 2019-2021, along with the task of increasing services at the Gifford Health Center.


District Counsel Report – Jennifer D. Peshke, Esq.


Mrs. Peshke provided her counsel report and stated that she continues to work with Gray Robinson, and they are in the process of finalizing closing binders and post close items relative to the Cleveland Clinic transaction. She further stated that she attended the January 8th Gifford Health Council meeting, as the District continues to work towards finalizing matters concerning the Gifford Health Center. Additionally, she has participated at the District’s special Strategic Planning meeting over the last month.


Financial Statement Review – Allen Jones, Treasurer


Mr. Jones provided his Treasure’s report and stated that the District remains in sound financial condition with approximately $12 million in the bank. The District has also received most of their tax proceeds for the year. Mr. Jones stated that total amount of indigent care visits continues to surge at IRMC and has risen 17% over the last year. However, in accordance with the agreement with Cleveland Clinic, the District will only be responsible to provide $500,000 in funding monthly moving forward, which is significantly lower than what the District provided in reimbursements in previous years. This will provide a savings to the taxpayer over time.


Executive Director Report- Ann Marie Suriano, Executive Director


Mrs. Suriano stated that the staff and the board continue to research and discuss the Federal Poverty level guideline and the possibility of increasing the same above the current 150% level.  Additionally, she continues to work with Michael Felix on the District strategic plan, which he will present at next months Chairman’s meeting. Lastly, the United Way has released the new ALICE population data and the number of individuals who are considered in that population has increased in Indian River County. She indicated that if a Trustee would like a copy of the study, they may request the same from her.


Funded Agencies Quarterly Report- IRC Health Department- Miranda Hawker, Health Administrator


Mrs. Hawker provided a quarterly update concerning the Health Department. She reviewed data concerning District qualified visits vs total visits at the main health department site, dental services and the Gifford Health Center. She also reviewed financial data concerning payor sources for the center. She stated that 88% of clients served at the main health department are at an income level of 150% or less of the Federal Poverty Guidelines. Mrs. Hawker further reviewed some performance indicators for the center as well.


Mrs. Hawker stated (as Mr. Jones explained to the Trustees at yesterday’s Chairman’s meeting), she is requesting funding to conduct a study on infant mortality in the county. By definition, infant mortality is classified as the death of a baby before its first birthday. She explained that the infant mortality rate is often used as an indicator to measure the health and well being of a population. She further reviewed data concerning the infant mortality rates in Indian River County which has improved over the last several years, however, there has been a slight trend downward and a study would allow the department to review that data and collect information on the same. The last time a study like this was conducted was over ten years ago. Dr. Weiss recommend that the District sponsor the Health Department to conduct research surrounding sickle cell anemia, and that this study the Health Department is requesting would not capture the total picture. Mrs. Hawker stated that the total cost of the project would be $60,000. Mr. Jones made a motion to approve the expense, which was seconded by Mrs. McCrystal. The motion carried 6 to 1 with Dr. Weiss in opposition.


Visiting Nurse Association, Inc.- Lundy Fields, CEO


Mr. Fields provided a quarterly update concerning the VNA, which provides hospice, home health, and mobile unit access in Indian River County. He reviewed financial data concerning those lines of services along with patient satisfaction scores. He indicated that hospice services have seen a 154% increase in indigent cases this year from FY 16-17. Further home health has also seen an increase of 6% in indigent cases with 1,491 visits in 2018. Lastly, the mobile unit volumes have declined 12% overall, and 114 indigent visits were performed for the year.

Mr. Fields further provided an update concerning the Vulnerable Village Initiative which is working in the Gifford and Wabasso areas. He stated that the village advocates continue to work within the community educating the residents about health and wellness opportunities. The VNA has also created a survey which has been beneficial in collecting data from patients who come to the bus for medical care. Per those surveys, it was discovered that the mobile unit has been effective in preventing ER admission as 26% of mobile unit patients stated that they would have gone to the ER if the mobile unit was not available.


Request for Aviation Blvd. Extension- Phil Matson, MPO


Mr. Phil Matson provided a brief historical update concerning the issues surrounding increased traffic on 37th street. He explained that the street is a vital corridor in the county as it is primary point of access to the hospital and a large number of medical related facilities and businesses. According to the County concurrency management system, 37th street is currently at more than 90% capacity. The MPO and City of Vero Beach staff have proposed developing a new two-lane roadway directly from Aviation Boulevard at US1 to the west entrance of IRMC as alternative to widening 37th Street, which would be a costly and intrusive process. According to the Florida Department of Transpiration, the new road would alleviate sufficient traffic and eliminate the need to widen the road. Therefore, the County and MPO recommend that the Hospital District consider the proposed north and south roadway segments and authorize District staff to work with County staff in preparing a draft agreement. Mr. Matson asked for a motion to approve the same. Mr. Jones made the motion to approve which was seconded by Dr. Weiss. The motion carried unanimously. Mr. Matson stated that he will be in direct contact with District staff and legal counsel, and if the Trustees had further questions or concerns, they may contact him as well.



Public Comment– There was no public comment.



Adjourn- The meeting was adjourned at 6:30 PM