Regular Monthly Meeting Minutes: July 16, 2020

Regular Monthly Meeting Minutes: July 16, 2020




Regular Monthly Meeting

Zoom Meeting

July 16, 2020 @ 4:00 p.m.


TRUSTEES:                           Marybeth Cunningham           Allen Jones

Barbara Bodnar                      Tracey Zudans

Karen Deigl                             Dr. Michael Weiss

Ann Marie McCrystal


STAFF:                                   Ann Marie Suriano                 Jennifer Peshke, Esq.

Kate Voss                                Jennifer Frederick


Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the regular monthly meeting of the Indian River County Hospital District (“IRCHD”) at 4:00 p.m. She reviewed the regulations for conducting a meeting remotely as outlined in Governor DeSantis’ Executive Order 20-69. Ms. Cunningham asked for those who intend to speak during the meeting, to identify themselves before speaking. Ms. Zudans provided the invocation for the meeting


Consent Agenda-

Mrs. Cunningham asked for a motion to approve the Chairman’s/Budget Discussion meeting minutes dated June 17; Regular Monthly meeting minutes dated June 18, and a July disbursement of $1,148,791.80. Dr. Weiss made the motion which was seconded by Ms. Bodnar. The motion carried unanimously.


District Counsel Report – Jennifer D. Peshke, Esq.

Mr. Peshke stated that she continues to review the annual deadlines and deliverables due to the District under the Lease with CCIRH. She also is actively following the current legislative session for bills related to Hospital Districts and will bring forth information necessary regarding the current Executive Order in place lifting the requirement to meet as a physical quorum.  Currently this order expires 8.1.20 which means unless extended the District will be required to conduct its meetings with a physical quorum of four Trustees together in person. She is also working with Ms. Suriano, County staff and legal counsel, as well as discussing with Cleveland Clinic, the District granting a right of way to the county regarding a plan to extend Aviation Blvd across US 1 to the North of the Advanced Eye Care Center property which, requires access via 11th drive.

They are in the process of working through the legalities of this matter between all parties so that a recommendation can be brought before the Board of Trustees for approval.  Lastly, she is working with Ms. Suriano to review language in the District’s current office space to ensure proper legal steps and notices are taken to vacate the District’s current office space to relocate to the new office space.  She has reviewed the new lease and made suggested revisions to the language so the lease can be in a position to be executed with a start date of 8.1.20.


Financial Statement Review – Allen Jones, Treasurer

Mr. Jones stated that the District is in sound financial shape with approximately $9 million in the bank, less the $1.5 million for this month’s distributions. He anticipates that the District will finish the fiscal year with an excess of $4.2 million in its accounts. He asked the Trustees to consider variables with the changing healthcare environment being experienced from COVID-19. One item being the possible expansion of the District’s qualification guidelines to include individuals who fall between 200%-250% of the FPL. This fiscal year the District increased its guidelines to included individuals who fell between 150%-200%, which resulted in 211 additional households covered. He has requested that the District and funded agencies begin to monitor expanding the definition to 250% and the estimated cost associated with that.


Executive Director Report- Ann Marie Suriano

Ms. Suriano stated that she provided a written report within the packet and has no additional matters to discuss, unless the Trustees had any questions. There were none.


Program Liaison Report- Jennifer Frederick

Ms. Frederick provided her report and stated that since October 1, 2019 the District received a total of 1,854 new applications for individuals or households.  Additionally, there were 1,558 renewal application received for a total of 3,412 applications processed since the beginning of the fiscal year. Currently there are only approximately 25 applications in the system that still need to be processed and no other backlog. She further stated that there are over 8,000 applications in the system, but only around half are active. After two years, those inactive applications will be archived. Ms. Frederick indicated that she is working with the funded agencies to develop a way to track patient visits of those patients who fall between 200%-250% of the FPL, to get an idea of the financial impact it may have on the District.


Unfinished Business- 11th Drive Extension/Transfer of 36th Street- Phil Matson, AICP, Director IRC Community Development & Dylan Reingold, Esq., County Counsel

Mr. Matson discussed the 11th drive extension project and provided the Trustees with details regarding the same. Additionally, there was discussion surrounding the transfer of 36th street to the county, which the District currently owns. As a caveat to the District agreeing to the extension of 11th drive, the county would take over the responsibility for maintaining 36th street. Mr. Reingold stated that he is working with District counsel, and CCIRH counsel on an agreement for this matter and it will come before the board for approval in the upcoming months. Ms. Zudans asked for clarification relative to the transfer of 36th street as it relates to District real estate. Mr. Reingold explained that they are working to find the most appropriate way to transfer the roads ownership but he believes it will either be a fee simple transfer to the county or a dedication to the County from the District. The Trustees agreed unanimously to give the county authorization to move forward with a formal agreement.


New Business

 Approval of Tentative FY 20-21 Budget- Allen Jones, Treasurer

Mr. Jones stated that the District Trustees have met several times over the last few months to discuss the proposed budget for FY 2020-2021.  At today’s meeting the Trustees must vote to approve a tentative budget with a maximum millage rate which cannot be increased, but may be decreased before the final hearing in September. Therefore, Mr. Jones made a motion to approve a millage rate of .0811 for the upcoming FY 20-21. Dr. Weiss seconded the motion for Trustee discussion. Ms. Zudans stated that she feels there are some budget line items that represent mission creep and believes those items could be supported through philanthropic dollars. Additionally, the District has additional reserves set aside, as well as a reduce amount being paid to Cleveland Clinic, which supports adopting a lower millage rate. Therefore, she is not in favor of the proposed millage rate of .0811. She made an amended motion to approve the rollback rate of .7759. This motion failed for a lack of a second to the amended motion. Mrs. Cunningham asked for public comment and then called the question for the original motion of adopting a millage of .8011. The motion carried 6-1 with Ms. Zudans in opposition.


Approval of Resolution 2020-02- Marybeth Cunningham, Chairwoman

Mrs. Cunningham addressed the group and apologized for bringing this Resolution for tonight’s meeting without prior discussion with the board. She felt that this Resolution needed to be addressed as soon as possible due to the pending crisis with COVID-19 in Indian River County. She explained that the Resolution she is presenting is asking the Indian River County Board of County Commissioners to revisit and readdress taking action to require masks to be worn by anyone visiting the interior of all public places for a minimum of a 4-6-week period. She believes this is a health issue and not a political issue, and feels that the District represents and should speak to the health of the community. She cited healthcare officials’ statements that wearing masks helps slow the spread of COVID and referenced that many retailers are now requiring masks within their stores. She does agree with the sentiment of government not dictating people’s actions but believes this is a public health issue and there is an obligation to comply. She invited Dr. Rosencrance to participate in today’s meeting and provide his position on wearing masks. Dr. Rosencrance addressed the board and stated that there is clear scientific evidence that wearing a mask will help to reduce the spread of COVID-19 significantly, specifically in enclosed spaces. He referenced data with regard to the increase of the number of cases of COVID but also hospitalizations. From his perspective and as a representative of CCIRH he believes this is not a political matter but one of public health and safety.


Mrs. Cunningham made a motion to adopt Resolution 2020-02, which was seconded by Ms. Deigl for discussion. Ms. Bodnar made a motion to table the resolution citing that proper procedure to develop a resolution was not followed. She stated that at the Chairman’s meeting the day prior there was no discussion with regard to a resolution being presented. Further she believes any resolution in which a Trustee or the District would like to adopt, should be properly placed on the Chairman’s agenda for discussion and any public input. There was board discussion surrounding the proper protocol for a motion to table. The motion to table was seconded by Ms. Zudans for Trustee discussion. Mr. Jones stated that while he agreed with Ms. Bodnar’s comments concerning the lack of time to review and consider this resolution, he agrees with Ms. Cunningham’s view that this is a time sensitive matter and should be considered today for a vote. Mrs. McCrystal also agreed with Ms. Bodnar and Mr. Jones comments with regard to lack of time to review the resolution but feels this is an urgent matter which should be considered today. Dr. Weiss stated that he was in favor of a mask mandate and stated that he is not in support of tabling the motion. The motion to table failed 5-2, with Ms. Zudans and Ms. Bodnar as the only Trustees in favor. There was further discussion surrounding proper notice of resolutions and public input. Ms. Zudans commented and stated that she supports Ms. Bodnar’s motion and does not feel that the Trustees or the public were given an ample time to review or comment on the resolution. She noted that the mask mandate portion at the county commissioners meeting had over two hours of public input. Mrs. Cunningham asked for public comment and Dr. Val Zudans addressed the board. He stated he believes this motion should be tabled and addressed at a later date when more public has an opportunity to comment. Ms. Deigl stated that she is in support of this resolution and feels that if the mask mandate was reconsidered by the county commission, additional public supporting the mandate would attend and speak in support, it would be approved. Dr. James Large, who is currently running for Hospital District Trustee seat three addressed the group and stated his support for the resolution citing multiple scientific studies showing that wearing masks reduces the spread of COVID-19. Dr. Zudans provided additional public comment with further scientific data and stated that he believes that policy makers are over estimating the benefit of wearing masks. He also believes that mandating individuals to comply with a mask mandate is harmful to those with medical disabilities who cannot wear masks. Ms. Stuven provided public comment and stated that if the public has already spoken out against a mandate, she does not feel revisiting the issue will make a difference. She would rather see a public health campaign which encourages county residents to voluntarily wear masks. Mrs. Cunningham called the question on the original motion to approve Resolution 2020-02. The motion carried 5-2, with Ms. Zudans and Ms. Bodnar in opposition.


Approval of Whole Family Health Funding Request- Ann Marie Suriano, ED

Ms. Suriano apologized for not giving the Trustees more time to review this request, but was accommodating Ms. Andress request to include it with this month’s agenda items, as it was an urgent request and felt it could not wait until the next meeting in August.  Ms. Andress addressed the board and spoke to Whole Family’s special funding request. The total amount of the request is $216, 212.61. She explained that most of the items in the request are telehealth related, testing kits and supplies, PPE and home health supplies. Mrs. Cunningham made a motion to approve, which was seconded by Mr. Jones for discussion. Dr. Weiss felt that the request was high and Whole Family should have made their request prior to purchasing the equipment. He also believes that they over paid for many of the electronic equipment items. Ms. Zudans thanked Ms. Andress for preparing such a thorough request, but was not in favor of providing reimbursement for computers or phone systems. She does however support funding for direct patient services and COVID-19 supplies, along with IT assistance. She made an amended motion to provide $123,000 in funding, a number which is inclusive of the items she just mentioned.  The motion was seconded by Dr. Weiss and there was further Trustee discussion, but the amended motion failed 2-5. Mrs. Cunningham called the question on the original motion to approve a special funding request in the amount of $216,212.61. After further Trustee discussion, Mrs. Cunningham asked for public comment, which there was none. The motion carried 5-2, with Ms. Zudans and Dr. Weiss in opposition.

Ms. Peshke clarified voting procedures relative to amended motions. She stated that if a Trustee makes an amended motion and that motion receives a second, the amended motion must be voted on first, before the original motion. If the amended motion does not receive a second, it dies and the board must vote on the original motion after discussion and public comment. She further stated that she has prepared a PowerPoint on Robert’s Rules of Order which she will address at next months Chairman’s meeting, to update the Trustees on proper meeting and voting protocol.


Public Comment

There was no further public comment and the meeting was adjourned at 6:00 PM