Chairman’s Meeting: February 19, 2020

Chairman’s Meeting: February 19, 2020

Indian River County Hospital District
February 19, 2020
10:00 AM

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

ABSENT: Tracey Zudans Michael Weiss

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

OTHER ATTENDEES: Elisabeth Bublitz Andrea Berry
Bill Stengel Janet Begley
Dan Bach Marie Andress
Pat Knipper Vicki Soule
Kristen Crocker Michelle Genz
Ford Fergert Sue Tompkins

Convene Meeting – Marybeth Cunningham, Chairwoman

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

Healthy Start Doula Program Request – Andrea Berry, CEO- Healthy Start

Ms. Berry provided a brief history of the relationship between the District and Healthy Start and the funding that the District provides to Healthy Start. Additionally, Ms. Bubzlitz provided an update to the Trustees concerning the FIMR study which the District supported with additional funding. Mrs. Berry explained that she is here to request immediate funding for the community doula pilot program. This program was created to assist the approximate 100 women per year who labor alone at CCIRH. Since the creation of the program, it has exceeded the outcomes, reach and impact that they had initially expected. The volume of clients served in 2019-2020 has grown by 150% and they expect to serve 200 mothers in 2020-2021. Currently, Healthy Start is preparing to sustain the current growth for the upcoming year but have exceeded their budget for the program. They are requesting immediate funding of $18,600 that will allow Healthy Start to serve the mothers they have committed to providing this doula care to, in the current fiscal year. Mrs. McCrystal made a motion to approve the request which was seconded by Mr. Jones. There was further discussion concerning the program and the growth of the program. The motion carried unanimously. It was suggested that there be a strategic plan created for this program to support its growth. Mrs. Berry agreed and stated that she will update the board with more data when it becomes available.

Review and Discussion of Revisions to District Bylaws- Ann Marie Suriano

Mrs. Suriano stated that she circulated the amended changes to the District Bylaws, after Trustee review and input. There were minor revisions which addressed some outdated information regarding the District’s relationship with IRMC, now Cleveland Clinic. A vote on the final document will take place at next month’s regular meeting.

Mental Health Community Meeting Discussion Review- Marybeth Cunningham

Mrs. Cunningham stated that she and Mrs. Suriano met with 15 local mental health providers this month to discuss the services provided and gaps in services in the county. One issue that faces the county is there are currently no detox services. Another is the issue of recruiting, supporting and retaining mental health providers. The question being considered for solution is “What should Mental Health and Substance Use Care look like in IRC?”. The group decided to submit ideas and come back together with a facilitator to prioritize and work together toward a community solution. An issue was raised regarding transport of Baker Act patients and whether or not the new free-standing ER was an approved Baker Act receiving facility. She then reported that on January 23rd, she and Mrs. Suriano were invited to meet with representatives from the Indian River County School District and CCIRH to discuss a proposed Pilot, changing the Baker Act process for students being Baker Acted from school. This transport issue was raised again in more detail as CCIRH has had confirmation from DCF that the free-standing ER is not a dedicated receiving facility to appropriately manage Baker Acts. There have been instances where Baker Act patients have been taken to the free-standing ER and then transferred out of county to Lawnwood, to receive additional medical care and then admitted to New Horizons. It was suggested that Anne Posey, the director of the CCIR Behavioral Health center, address the Trustees and provide an overview of the Baker Act process. Lastly, Mrs. Cunningham stated that she and Mrs. Suriano then requested to meet with Sheriff Loar and Major Flowers to discuss the issue of safe transport of Indian River County residents/patients to the free-standing ER located in south county, which is owned and operated by Lawnwood Regional Medical Center from the next County. This is problematic, particularly for those low income residents that qualify for financial assistance at CCIRH, due to the fact that the free-standing ER is not a certified Baker Act clinic, and family members of the patients being Baker Acted were unaware that the patient was transferred out of county to a private hospital/facility and later billed for services they could not afford. Post these discussions and the District receiving and providing the IRC Sheriff’s office with DCF notification that CCIRH is the only approved Baker Act receiving facility in IRC, they removed the directive for residents automatically being transported to the free-standing ER for this purpose.

It also came to the attention of the District office and Mrs. Cunningham that Indian River County EMS was given directive to transport all calls south of 8th Street in IRC to the free-standing ER. The same problem presents itself. They then had further discussions regarding this with county administrator Jason Brown for clarification. Upon this discussion, they were informed that the directive was altered now providing the patient with a choice of which emergency department they would like to be treated at, if the situation permits. All level two traumas will still be diverted to Lawnwood, as that is the appropriate trauma center for treatment.

Program Liaison Update- Jennifer Frederick, Program Liaison

Mrs. Frederick provided her report and discussed the first quarter outcomes concerning the financial assistance program database. She explained that there continues to be an increase in new applications with 271 uploaded in December. The District experienced the highest volume of expired applications in November which totaled 422 and the highest volume of renewals in October which totaled 288. As of December 31, 2019, the database contained 8,040 member and 3,151 of those are active clients. Since increasing the District Federal Poverty Guideline to 200%, 10% of the new applicants meet the new threshold requirement.

She further stated that she attended session one of the Indian River County Leadership programs, where they visited county government offices. The next session will focus on children and education. Additionally, she continues to attend the Together for Health group meetings on behalf of the District. While attending one of those meetings, Freddie Woolfork mentioned that the Fellsmere Action Committee Team (“FACT”) was meeting the following day and encouraged attendance. FACT’s mission is to empower the families and individuals of Fellsmere to build and sustain a thriving community. Currently they are raising funds to build a community resource center in town. Further, she and Mrs. Suriano attended United Against Poverty’s grand opening celebration which showcased their new center. Tours were available to the public and there was a special introduction to TCCH’s same day health clinic. Lastly, Mrs. Frederick stated that the 2020 updated Federal Poverty guidelines, which went into effect on January 17, were included in the meeting packet for review. The District will use the guidelines going forward for the current year.

Other Business-

Mrs. Suriano stated that the District was awarded the community partnership award from the VNA, and she and Dr. Weiss attended their board meeting last month and accepted the award on the District’s behalf. Additionally, she and Mrs. Cunningham met with representatives from the VNA to discuss the growth of the VNA and the future leasing of the District owned Human Services building. Preliminary discussions of the VNA regarding the VNA looking to build a new structure have begun and one possibility would be the land in front of VNA Hospice House, which is also District owned. These discussions are in the early stages and representative hope to have an outline with their intentions of the space in the coming months. CCIRH will also be involved in these discussions as they have right of first refusal of the HSB building, which sits on the hospital campus.

Mr. Jones asked the board to consider District financial support to the CCIRH maternity ward improvement project. He believes this is an investment in the community and would show a collaborative effort and support of maternal services within the county. He suggested a donation of $500,000. There was further Trustee discussion and some asked for additional information regarding the renovations and what services would be offered, before approving any expense. Mr. Jones will follow up with the board in the coming months.

Public Comment-

Sue Tompkins, Chair of VNA Board, spoke to the matter of the VNA wanting to build on the Hospice House parcel. She stated that while the VNA is looking to have a bigger location for its employees, this center would be of the benefit of the community and the VNA’s core mission is to improve health outcomes in the county.

Ms. Soule stated that the TCCH same day clinic located at the UP Center is now seeing patients, with an initial flow of 4-6 patients a day. However, yesterday the clinic saw 13 patients and she believes that the volumes will continue to grow once more people are aware of the services. This may result in the District funding budgeted for this project to be inadequate, so it will need to be watched closely over the next few months.

Lastly, Mrs. Cunningham stated that Mrs. Zudans has been nominated for Woman of the Year through the Junior League of Indian River County. The luncheon where the winner is announced will take place next month on the same day as the District’s Chairman’s meeting. Therefore, she asked that the Chairman’s meeting be held at 9:00 AM so that those who would like to attend the luncheon, encouraging support for Tracey, may do so and arrive on time. The Trustees agreed to the time change.

Adjourn- The meeting was adjourned at 11:45 AM