Aug 19 Regular Monthly Meeting: July 18, 2019
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
Regular Monthly Meeting Minutes
July 18, 2019
TRUSTEES: Marybeth Cunningham Tracey Zudans
Michael Weiss Ann Marie McCrystal
VIA PHONE: Karen Deigl Allen Jones
ABSENT: Barbara Bodnar
STAFF: Ann Marie Suriano Jennifer Peshke, Esq.
OTHER ATTENDEES: Morgan Libbey George Eighmy
Greg Rosencrance Vicki Soule
Marie Andress Alan Guy
Val Larcombe Ralph Turner
Warren Fuller Charles Mackett
George Eighmy David Peter
Janet Bagley Michelle Genz
Convene Meeting – Marybeth Cunningham, Chairwoman
Ms. Cunningham convened the regular monthly meeting of the IRCHD at 5:00 PM by welcoming those in attendance. Ms. Zudans provided the invocation for the meeting and Dr. Weiss led the group in the Pledge of Allegiance.
Consent Agenda- Marybeth Cunningham, Chairwoman
Dr. Weiss asked for a motion for approval of the Chairman’s Meeting Minutes dated June 20; Regular Monthly Meeting Minutes dated June 20 and a July disbursement of $936,124.40. Mrs. McCrystal made a motion to approve which was seconded by Ms. Zudans. The motion carried unanimously.
Ms. Cunningham stated that tonight the Trustees are recognizing Ms. Libbey with a proclamation for her work in the community with the Public Guardianship program. Ms. Cunningham read the proclamation and Ms. Suriano presented Ms. Libbey with a commemorative plaque.
District Counsel Report – Jennifer D. Peshke, Esq.
Ms. Peshke provided her monthly counsel report and stated that she continues to work with staff and Trustees on District matters. She has been working on the drafting of the new Gifford Health Center lease, as well as the sub-leases that will be used for the other entities involved, as well as budgeting matters with the District regarding the 2019-2020 fiscal year.
Financial Statement Review – Ann Marie Suriano, Executive Director
Mrs. Suriano provided the financial statement review on behalf of Mr. Jones. Mr. Jones prepared a written report which was included in the meeting packet. Ms. Suriano stated that the District is in sound financial condition and has received most of its tax revenues for the current fiscal year. The District continues to run under budget and it is projected to carry over $3.8 million in funds, next fiscal year. Mr. Jones added that due to the changing healthcare environment, it is important for the District to maintain flexibility in its reserve accounts, to accommodate any changes.
Executive Director Report- Ann Marie Suriano, Executive Director
Ms. Suriano stated that the District continues to focus on the Gifford Health center transition. As previously discussed, the Health Department will be vacating the building and TCCH will move in and be the provider of primary care services at GHC. We Care and Healthy Start will remain at the center through the transition, to provide services as well. She further stated that TCCH will begin to provide services on August 25. Additionally, the VNA mobile unit will be available on site to provide acute care to patients during the transition.
Cleveland Clinic Indian River Semi Annual Report- Gregory Rosencrance, MD FACP President CCIR
Dr. Rosencrance stated that his presentation would cover the current scope of services at CCIR; capital spending for 2019; goals and benchmarks in quality, along with the extent and types of care that is provided to the residents of Indian River County. He explained that Cleveland Clinic Florida developed a long-range plan for all its facilities, as a whole, and the specifics of the strategic plan are still being developed.
Areas that the institution plans to strengthen and grow are as follows:
1. Cardiovascular services;
2. Oncology services;
4. Orthopedics; and
5. Primary Care.
Additionally, there will be a focus to strengthen women’s and behavioral health services. Dr. Rosencrance stated that admissions to the Behavioral Health center are up 22% from last year. In an effort to improve patient and staff safety, they have installed additional 360-degree security cameras throughout the facility and parking lot, along with panic alarms in patient rooms.
The philanthropic campaign for the stroke program has been completed and the hospital plans to start construction in the coming days. On July 9, the hospital began its telemedicine program for the radiology department. This means that all radiology reads during 9 pm-7 am are reviewed by a Cleveland Clinic tele-radiologist. This will improve wait times for results and give local radiologists some relief. Further, CCIR electronic health records have been stabilized and by 2021 it will be included in Cleveland Clinics worldwide database.
Dr. Rosencrance reviewed the capital expenditures and stated that they approved $22.3 million in capital expenditures for 2019, and he reviewed the same in detail. He further reviewed the benchmarks for quality and stated that readmission rates have been reduced by approximately 45% since 2018. They continue to focus on hand hygiene and have seen improvement through the implementation of the “SNAP” program. He further reviewed data concerning the infection rates at the hospital, which most were all at or below their target levels.
There was further discussion surrounding volumes at the hospital. He explained that emergency department visits have increased and for this quarter are up by 722 visits, over the previous year. Inpatient admissions and surgical case volumes have increased as well. Additionally, the case mix index reports indicated that the hospital is treating sicker patients, than in previous years.
Additionally, Dr. Rosencrance reviewed data concerning care at CCIR. In the first six months, CCIR has provided $4.6 million for charity care to the residents of Indian River. This represents a 18% increase in charity care from the same time period in 2018. Further, there has been a 45% increase in inpatient behavioral health charity care. CCIR has also provided $1 million in outpatient charity care. The hospital is working toward strengthening it behavioral health and women’s services and continues to work collaboratively with other health agencies in the county.
Lastly, Dr. Rosencrance provided a review of CCIR financials and stated that the institution is $1 million ahead of last year’s budget. This is driven strictly by volumes. Since beginning his position in January, Dr. Rosencrance has held two town hall meetings. At the last meeting held, he announced a 2% on average merit increase for caregivers. He was told this was the first merit increase to take place in the last 10 years. CCIR is also implementing new uniform colors. New safety measures have also been implemented at the main campus.
Unfinished Business- We Care Additional Funding Request- Dennis Saver, M.D.- President
Dr. Saver explained that at the We Care clinic is projecting a $30,317 shortfall for their fiscal year. This shortfall was related to lower than expected number of District qualified patient visits, and not the result of higher volumes. He is here today, to request those shortfall funds from the board.
Dr. Weiss made a motion to approve the request which was seconded by Mrs. McCrystal, for discussion. There was Trustee discussion and Ms. Cunningham and Ms. Zudans indicated they were not in favor of funding the shortfall due to the fact that it was not the result of high patient volumes for direct services. However, the motion was approved 4-2.
New Business- Approval of Tentative FY 19-20 Budget- Ann Marie Suriano, Executive Director
Mrs. Suriano stated that she updated tonight’s proposed tentative budget based on yesterday’s discussion at the Chairman’s meeting. The millage rate being proposed is .8041, which is a decrease from last fiscal year. She further explained that reducing the millage to this rate would result in a savings to the taxpayer. Mrs. Zudans made a motion to approve the budget and millage of .8041 which was seconded by Mr. Jones, for discussion. Mrs. McCrystal stated that she would like to keep the millage at the same level it is currently, and she feels the proposed millage of .8041 is too low to allow for any unforeseen healthcare issues. She made an amended motion to adopt a millage of .9122, which was seconded by Dr. Weiss for discussion. There was Trustee discussion and agreed that .8041 allows for the District to fulfil its obligations to the funded agencies while maintaining substantial reserves for unforeseen issues. The amended motion failed 5-1. Mrs. Peshke indicated that the board would need to vote on the original motion proposed. That motion carried 5-1, with Mrs. McCrystal in opposition.
Public Comment- There was no public comment.
Adjourn- The meeting was adjourned at 6:00 PM