Chairman’s Meeting: November 20, 2019

Chairman’s Meeting: November 20, 2019

Indian River County Hospital District
November 20, 2019
10:00 AM

TRUSTEES: Michael Weiss Tracey Zudans
Ann Marie McCrystal Karen Deigl
Marybeth Cunningham Allen Jones
Barbara Bodnar

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

OTHER ATTENDEES: James Large David Jang
Carrie Lester Marie Andress
Vicki Soule Michelle Genz

Convene Meeting – Marybeth Cunningham, Chairwoman

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

Ms. Cunningham stated that the Cleveland Clinic Florida board meeting was held today at the hospital. All Cleveland Clinic Florida executives were in attendance and it was a productive meeting with updates concerning the future plans of the hospital. Additionally, she and Ms. Suriano met with Dr. Moxley, Dr. Packard and Dr. Pierandozzi of the Indian River County School district this week, to have further discussions on future collaborative efforts to combat mental health and violence issues within the school system in Indian River County. Ms. Suriano shared some statistics relative to self-harm, along with the increased rate of students being Baker Acted since the beginning of the school year in August. They will continue these discussions and report back to the board with new information.

Integrity Committee Report – Karen Deigl

Ms. Deigl stated that the integrity committee has met and they are currently developing a plan and format for reporting out to the community. As a review of the committee’s purpose, Ms. Deigl stated that the Integrity committee is tasked with annually reviewing the Cleveland Clinic Indian River Hospital lease agreements with the Hospital District to make sure everything is in good standing and that the hospital is fulfilling its obligations to the community.

Investment Recommendations – Allen Jones, Treasurer

Mr. Jones reviewed the proposed recommendation concerning the District’s surplus funds. It is proposed that the District establish a policy of investing temporally, the District’s surplus funds. He reviewed the requirements in which the District must meet in order to do this. He further explained that he and Ms. Suriano met with four different financial institutions to discuss the best options for the District. Subsequent to their meetings and research, they are recommending the following:

1. The selection of Water Walker Investment Advisors, Tampa, FL; TD Bank is custodian and on the qualified depositories list;
2. Select the “Preferred Deposit Pool” option receiving diversification through FDIC insured bank deposits with up to $30 million in aggregate capacity per tax ID; District is projected to pick up about $128,000 in interest, though actual results will depend upon actual interest rates available that are subject to change daily and is dependent on Federal Funds rate changes and market demand;
3. Maintain a local relationship with Seacoast bank for bill payment, deposits and wiring funds as instructed by the District; and
4. Have daily access to District funds.

There was Trustee discussion surrounding the recommendation of Water Walker and Mr. Chang from the firm addressed the group. He provided a brief history of the firm and its accomplishments, and answered additional Trustee questions. Ms. Peshke stated that she also reviewed Mr. Jones recommendation and it is in compliance with all Florida Statutes. Ms. Zudans requested that this investment policy be reviewed annually by the board and language be added to the approval resolution, for this process. Ms. McCrystal made a motion to approve Mr. Jones recommendation, which was seconded by Ms. Deigl. The motion carried unanimously.

Adult Treatment Services Request – Carrie Maynard-Lester, Substance Awareness Center of IRC

Ms. Lester, the Executive Director of the Substance Awareness center, was at today’s meeting to discuss the center and present a funding request to the board. She explained that SAC has experienced an increase in demand for adult substance abuse treatment services. In 2018, SAC began implementing a waitlist for services and in July they expanded services to help reduce the waitlist. However, the center continues to use the waitlist but have never seemed to reach the ideal counselor to client ratio that would ensure they are meeting the needs of the community in a continuous, timely manner. Additionally, Ms. Lester explained that there has been an increase in the administrative requirements associated with each admission into their programs and those changes went into effect January, 2019. One of these requirements is the use of ASAM Continuum which is a 90-minute screening interview that justified level of care using placement criteria. As Ms. Lester examined the centers services and looked to increase efficiency, she has found the need for a part time/hourly assessor. The assessor would have the clinical training necessary to triage persons who seek services, complete the structure level of care placement interview and assist with care coordination if services were needed outside the agency. In turn, having this assessor would free up the clinicians to focus on and better service the clients on their caseload, and reduce the wait for services. Therefore, she is requesting an additional funding request of $31,875 for an estimated 250 assessments. There was Trustee discussion concerning the rise of mental health and substance abuse issues in the county, and the lack of inpatient treatment options. Additionally, it was discussed that this population is extremely vulnerable and the window of opportunity for some to seek treatment is very small. If they are placed on a waitlist, they may become discouraged and decline help in the future. There was additional Trustee discussion and Dr. Weiss made a motion to approve the request, which was seconded by Ms. McCrystal. Motion carried 6-1, with Ms. Zudans in opposition. Further, Ms. Cunningham volunteered and the Trustees agreed for her to be the lead Trustee concerning the District’s involvement and support of, mental health and substance abuse issues within the community.

Learning Agenda Topic: IRCHD Roles and Responsibilities – Ann Marie Suriano

Ms. Suriano stated that through the Strategic Plan, a goal of narrowing the District’s roles and responsibilities was agreed upon. Therefore, she prepared an outline based on the Districts Special Act regarding what the District is authorized to fund and support. She asked the Trustees to begin to consider their role in supporting emerging community partnerships for seniors accessing resources, children’s services, and special populations within Indian River. She explained that Ms. Frederick will be reviewing the community health needs assessments being conducted by multiple agencies in the county, for the data concerning the most vulnerable in the community. She will then prepare a summary for the Trustees to review and consider. Ms. Suriano stated that this matter is ongoing, and there will be additional future Trustee discussion on the same.

Gifford Health Center Advisory Committee Update- Tracey Zudans

Ms. Zudans stated that Dr. Baker attended her first meeting with the committee, as the community physician representative. The committee discussed the replacement of the patient advocate position, at TCCH. The position has recently become vacant and TCCH has posted the position and is reviewing applications to make sure candidates meet all requirements. The applicant pool will then be narrowed to the top 3 or so candidates and Ms. Soule would like to hold an open house to provide a meet and greet opportunity of the candidates, prior to hiring. This would provide an opportunity for the Gifford residents, District Trustees, or anyone interested in meeting the candidates to come to the center for that event. Ms. Zudans then reviewed patient volume data concerning the GHC. In October, TCCH providers saw 279 new patients, 129 same day patients and 25 emergency department follow ups. This is out of the 665 unduplicated patients seen. The center continues to receive positive patient satisfaction feedback, and is being utilized by not only the Gifford residents, but surrounding areas of the county as well.

Program Liaison Update- Jennifer Frederick

Ms. Frederick provided her program liaison update and stated that she attended the United Against Poverty Symposium on poverty and affordable
housing. She heard a presentation by Ms. Jane Snead on the Human Experience of Poverty and Housing in Indian River County. Ms. Frederick reviewed some statistics presented to the Trustees. Ms. Frederick also attended the Health Departments local public health system assessment meeting. At this meeting, Ms. Hawker and Ms. Price of the Health Department provided an update of the priorities identified in their last community health improvement assessment and the status of their community health improvement plan. Additionally, the District’s Federal Poverty guideline increased by 200% and the District has seen an increase in application by 20% overall. Ms. Frederick and Ms. Jacko have attended various community events on behalf of the District to bring awareness to the Districts mission and help residents apply for the District Care Card.

Public Comment

James Large encouraged the Trustees to continue their discussions, efforts and potential expansion of funding services for substance abuse and mental health issues. He stated that it is a national crisis and support starts at the community level.

The meeting was adjourned at 12:00 PM