Regular Monthly Meeting: November

Regular Monthly Meeting: November




Regular Monthly Meeting

IRCHD Conference Room/ Zoom

November 19, 2020



TRUSTEES:                             Marybeth Cunningham           Allen Jones

Barbara Bodnar                         Ann Marie McCrystal

Karen Deigl                                 Tracey Zudans


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. and welcome those participating via Zoom. Mrs. Zudans provided the invocation.


Consent Agenda-

Mrs. Cunningham asked for a motion to approve the Chairman’s Meeting Minutes dated October14, Regular Monthly Meeting Minutes dated October 15, and a November disbursement of $1,179,530.36. Mrs. McCrystal made a motion which was seconded by Mrs. Zudans. The motion carried unanimously.


District Chairwoman – Marybeth Cunningham, Chairwoman

 Mrs. Cunningham stated that the Intensive Outpatient RFP review committee will meet tomorrow to discuss the two proposals they received. The proposals received were from Tykes & Teens, along with Cleveland Clinic Indian River Hospital. Mrs. Suriano stated that she has copies of the proposals if any Trustees would like to review them.


District Counsel Report – Jennifer D. Peshke, Esq.

 Mrs. Peshke stated that the right of way transaction with the County has been completed and the documents were properly recorded. She is now working with Cleveland Clinic’s counsel to amend the easement agreement.  She continues to work with the VNA on the amended lease agreement and this item is on the agenda later in the meeting for approval.


Financial Statement Review – Allen Jones, Treasurer

 Mr. Jones stated that as the District begins its new fiscal year, it remains in sound financial condition. As of October 31, there was approximately $4.5 million dollars in reserves and the District should begin to receive its tax proceeds for the new fiscal year, around the middle of November. Around $4.1 million of the reserves have been invested into the TD Wealth Management account, which is managed by Water Walker. For the month of October, the District approved expenditures for program and administrative expenses of a little less than $1.2 million. He explained that Mrs. Suriano is working with the County to obtain reimbursement for the monies the District spent on unforeseen COVID related expenses, that local health agencies incurred. She will provide further update on the same.


Executive Director Report- Ann Marie Suriano, Executive Director  

 Mrs. Suriano stated that back in March the CARES Act was passed and Special Districts were not included as entities that could request CARES Act funding. Subsequently she discussed this matter with Jason Brown and at the time he was unsure of how much funding Indian River County would receive due to it being a county with less than 500,000 residents.  He indicated that he would follow up with Mrs. Suriano once the monies were received, however this did not take place. She was also still under the impression that Special Districts were unable to request CARES Act funds. Now just recently, she received communication from FASD which stated that Special Districts could request CARES Act funding directly from their county. Therefore, she initiated discussions with the budget office at the county to begin the reimbursement process. There is also opportunity to apply for reimbursement from the United Way, but they only provide funds for telehealth and mental health related services. District staff will continue to work on this matter and she will update the Trustees accordingly. She provided an update to the Trustees concerning the old office space, which is currently being advertised for lease or sublease. Due to COVID and many businesses having employees work from home, there is a challenge with renting out commercial office space. She also informed the Trustees that the entire building has been purchased by another entity. Mrs. Suriano was hopeful that this would provide the District with an out from the lease terms, however Mrs. Peshke indicated that the terms within our lease do not support termination if there is a sale of the property. Lastly, she is working with Cleveland Clinic to finalize the Alma Lee Memorial at the hospital.


Partners Program Annual Quality Performance Metrics Review- Allen Jones, Treasurer


Mr. Jones stated that the District created the Partners Program back in 1993 to combat the high infant mortality rate in Indian River county, which was much higher than the state average at the time. Moving forward, in 2015 the District established the quality performance metrics and when Cleveland Clinic took over operations, they also took over management of the quality performance metrics. The metrics are divided into three main components which are Healthy Infants, Healthy Mothers, and Patient Satisfaction. Under the first initiative of Healthy Infants, Mr. Jones reviewed data relating to Neonatal Mortality, which are infant deaths occurring within 27 days of birth. The three-year neonatal mortality rate for the program is at a minimum expected to better the state average as reported annually by the FDOH. Mr. Jones further explained that the Hospital District has put forth the funding to conduct a FIMR study for the county, which had not been conducted in ten years. The District stepped in to fund the study due to the fact that the State denied the Health Departments request to conduct the same. The results from this study should be available within the next few months. The second item for review was the Kotelchuck Neonatal Care Index. The Kotelchuck Prenatal Care index as reported annually by the Florida Health Department is used to evaluate the quality of prenatal care. Indian River County results are 81.5%, with the State average being 70.6, which puts Indian River well above the state average. He then discussed First Trimester Prenatal Care for Medicaid Mothers. In Indian River County 79.6% of mothers received first trimester prenatal care which is above the state average from 76.5%. The fourth and fifth initiatives measured were Breastfeeding Initiated During Hospitalization and Postpartum Visits by Mothers. He then discussed the components under the Healthy Mothers category which included Maternal Mortality; Primary C-Section Rate; and Infection Rate Associated with C-Sections. For the last three years CCIRH has maintained a 0% post C-Section Infection rate, which is an outstanding achievement. Additionally, Indian River County has achieved a 0% rate in maternal mortality as well. Lastly, Mr. Jones reviewed Patient Satisfaction data. He explained that the Partners Advisory Committee oversees a process to measure patient satisfaction. A survey will be designed similar to the Consumer Assessment of Healthcare Providers (CAPHS) used by the Center for Medicare Services. Included will be an analysis of patients rating the quality of care and service on a scale of 1 being poor to 10 being exceptional. The objective is to have at least 75% of Partners mothers rate Partners’ services as a 9 or 10 on this scale. There was a total of 799 deliveries at Partners and 683 surveys received. 85% of deliveries returned a survey and out of the 85% of returned surveys, 86% rated Partners’ services a 9 or 10.


We Care Foundation Executive Team Welcome- Shelley Stuven, Executive Director  

 Mrs. Stuven addressed the Trustees and informed them that she is retiring and leaving her position as Executive Director of the We Care Foundation and the Indian River Medical Society. She is currently working as a consultant with the new administrative team and will assist with the transition until the end of the year. She introduced Robi Robinson who will take over the Executive Director roll and Christine Scott who will work as the Director of Development. The two together will run We Care Foundation and the Medical Society. Mrs. Stuven stated that for transitional purposes, to please continue to copy her on all business-related emails.


District Funded Agency Quarterly Reports- Childcare Resources- Shannon Bowman, Executive Director & Tracey Griffis, Director of Wellness & Early Intervention

Ms. Griffis stated that Childcare Resources and the contacting centers have resumed full operations beginning August 24th. They are following strict guidelines set forth by the CDC, Department of Children and Families, Office of Early Learning, and the Health Department in order to continue to mitigate the spread of COVID-19. They are currently in the process of completing hearing and vision screenings. They also continue to alter programming to meet the ever-changing needs of our families.  She further reviewed a list of how their programming has pivoted as a result of COVID-19.  She thanked the Trustees for their continued support and reiterated how important and positive it has been to have the children back in the classroom.


District Funded Agency Quarterly Reports – New Horizons- Pat Austin, Interim CEO

Ms. Austin provided an update for New Horizons and stated the report she provided to the Trustees reflects services provided to all residents of Indian River County from all funding sources for the past fiscal year, October 1, 2019 through September 30, 2020. It demonstrates services delivered to 2,263 residents of Indian River County which includes, 1,962 adults and 301 children. She explained that the contract between the District and New Horizons specifically covers the actual services rendered to individuals and provides reimbursement for Psychiatric Services, including Psych Evaluations, Treatment Plans, Bio-Psychosocial and Medication Management; Outpatient Therapy; and Case Management. She further reviewed outcome measures for Adult Psychiatric services and Case Management. Ms. Austin then discussed the Psychosocial Rehabilitation program, which is offered at New Horizons but is not a current service which the Hospital District provides reimbursement for. She indicated that this service for clients is a game- changer. New Horizons would like to start a class where clients could become “students” at our Learning Center in downtown Vero. Here they would learn the skills of daily living and could take classes in Medication Management, Anger Management, Computer Skills, Job Hunting, and Cooking. This would be an opportunity to become on their way to independent living and self-sufficiency. Currently 7% of our students that qualify for Hospital District funding are participating in our PSR classes in Fort Pierce. The cost of attending three (3) classes a week is $108 a week or $5,616 a year, per student. Ms. Austin stated that New Horizons respectfully requests the opportunity to reallocate funds within their contract to cover up to five (5) students in the PSR/Learning Center program at a cost of $28,080.00 over the course of the year. There was further Trustee discussion surrounding the request and the Trustees agreed to the reallocation of funds. Lastly, Ms. Austin stated that New Horizons has hired a new CEO, Mr. William Winns, who will begin his duties on December 14th.


Unfinished Business- VNA Amended and Restated Lease Agreement – Jennifer D. Peshke, Esq

 Mrs. Peshke stated that as discussed prior, the VNA Amended and Restated Lease Agreement is before the Trustees tonight for approval. As a brief history, the Trustees approved a letter of intent from the VNA back in September and both parties have been working on the terms of the lease since that time. This lease is an extension of the existing Hospice House Agreement. She asked for a motion to approve the Amended and Restated Lease Agreement. The motion was made by Mrs. Zudans and seconded by Mrs. Cunningham. The motion passed unanimously.


New Business-Proclamation Recognizing Shelley Stuven- Marybeth Cunningham, Chairwoman

Mrs. Cunningham read aloud the Proclamation recognizing Ms. Stuven for her roll as Executive Director of the We Care Foundation and Indian River Medical Society. Ms. Stuven thanked the Trustees for their recognition.



 Mrs. Cunningham asked for public comment and there was none. Mrs. Zudans made a motion to adjourn which was seconded by Mrs. McCrystal. Motion carried and the meeting was adjourned at 5:00 PM