Jul 19 Chairman’s Meeting: June 16, 2021
Indian River County Hospital District Conference Room/ Zoom
June 16, 2021
TRUSTEES: Marybeth Cunningham Barbara Bodnar
Ann Marie McCrystal Allen Jones
Karen Deigl Michael Weiss
ABSENT: Kerry Bartlett
STAFF: Ann Marie Suriano Jennifer Frederick
Kate Voss Jennifer Peshke, Esq.
Convene Meeting – Marybeth Cunningham, Chairwoman
Mrs. Cunningham convened the Chairman’s meeting of the IRCHD Board of Trustees at 10:00 PM by welcoming those participating via Zoom and in person.
Program Liaison Report- Jennifer Frederick, Program Liaison
Mrs. Frederick provided a written report for the Trustees’review prior to today’s meeting. She explained that she has received an amended funding request for the Life Line program from the VNA. It was explained that Pat Knipper met with Ms. Deigl to discuss a collaborative approach to administering the Life Line program. Therefore, they are requesting that $20,000 be reserved, which includes VNA’s previous request of $12,525, and that VNA and SRA be allowed to come back to the District in August with a fully vetted, collaborative plan to address this needed service in the community. There was further Trustee discussion surrounding this program, who would be eligible and the need. Ms. Deigl informed the Trustees that there are approximately 210 individuals on a waitlist at SRA to receive this service, so the need is there. It was decided that the $20,000 request for funding would be allocated into the budget as a placeholder. Mrs. Suriano stated that she will add a section to the proposed budget that will show a placeholder for funding requests that are still being considered. Lastly, Mrs. Frederick discussed the other items she has been working on over the last few months which included her participation in the FIMR review, as well as the Florida Department of Health Community Health Improvement Plan workgroups.
FY 21-22 Budget Discussion- Ann Marie Suriano, Executive Director
Mrs. Suriano reviewed the FY 21-22 with the Trustees and stated that her projections for the end of year expenses are higher than what is anticipated to be spent in program and administrative expenses. Additionally, approximately $3.3 million will be carried over in reserves. She further stated she has changed the budget layout document and placed the commissions and uncollectibles line items into their own section, separate from the administrative expenses. Now the administrative expense line total will only show true administrative expense. She further explained that this upcoming fiscal year budget will not include a monthly payment to CCIRH for indigent care, as the District’s financial support has been completed per the Indigent Care Agreement terms. Therefore, in working with Mr. Jones the proposed millage rate for this preliminary budget is .6335 with an ad valorem tax amount of $12,859,322. She asked for Trustee input and discussion.
Mrs. Cunningham stated she has concerns with such a large decrease to the millage rate. She proposed budgeting the same ad valorem tax amount as last fiscal year of $15,694,778 which would result in a millage of .7759. In doing this, the District would still not increase taxes and allow for additional reserves to be secured for additional support for community health services. She believes that with the rapidly increasing healthcare needs, lowering the millage substantially could put the District at a disadvantage in future years. There was further Trustee discussion concerning her recommendation and many agreed that they did not want to reduce the millage down to .6335, however it was not unanimous on .7759. Mr. Jones addressed the board and stated that he is not in favor of .7759 millage and would be concerned that public perception may be that the District is “empire building” by maintaining such large reserves. He believes the District should budget for needs that have been presented to the board and vetted. Mr. Jones stated that the current proposed budget has appropriate reserves and adding additional would not be needed. He is in favor of further Trustee input and discussion on the millage and believes the board will be able to come to a compromise. He also believes the District should examine each funded agency individually and create more substantial metrics that show evidence that healthcare is being improved in the community. Additionally, there was Trustee discussion concerning the need for the board to make decisions on potentially supporting Medicaid patients or providing some reimbursement to funded agencies for those patients. Additionally, some Trustees would like to look at the impact of increasing the District Federal Poverty Guidelines to 250% or greater. There was also discussion surrounding providing additional support for senior services, as seniors make up a large amount of the Indian River County population.
Mrs. Suriano stated that she has begun the process to create a Strategic Direction Plan for the District and a hired consultant will work with the staff and Trustees to facilitate this process. The goal of this process is for the District to define its role in assisting healthcare as a whole within the community. During this process the board will have the opportunity to review, input, discuss, and move forward with some of the funding and policy issues that have been discussed but not acted upon over the last few years. This will also be an opportunity to implement additional reporting metrics for the funded agencies, to accurately measure and review their effectiveness and impact on the community. The Trustees also discussed future funding opportunities for unmet needs and that the funded agencies bringing those requests to the District for funding consideration.
Further, Mr. Jones explained there have been discussions surrounding We Care and its sustainability moving forward. Also, he and Mrs. Suriano have met with representatives from We Care to discuss the same. From those discussions, Mr. Jones stated that he has created a draft proposal for the operations of We Care in FY 21-222, which he sent to Dr. Saver and Mr. Robinson for consideration. He discussed his proposal and stated that the objective is that this is accomplished by We Care, TCCH and WFHC working together collegially and with mutual respect for each organization’s roles. The goal would be for the patient to begin receiving the specialty services within 30 days of the referral. It is at TCCH’s and WFHC’s discretion, based on what is best for the patient, whether they refer the patient directly to CCIRH or to We Care to assist in facilitating the referral. Dr. Saver has since spoken with Mr. Jones and has agreed to his recommendation for metrics. In operating We Care with metrics, the District will be able to track and determine the effectiveness of We Care on the community. There was Trustee discussion and Mrs. Cunningham stated that for the last serval years the District has requested these same metrics and reporting, and the data has not been provided. She believes that if the District does not receive the requested information, funding for We Care should not be allocated into the upcoming fiscal year budget. The Trustees agreed to place the We Care funding request as placeholder in the budget for consideration, with the expectation that the data will be provided no later than September. There was further Trustee discussion concerning additional line items on the budget. The Trustees agreed that the funding request from Dynamic Life for new security camera system would be removed as it is not a healthcare related expense and that the funding should be obtained from philanthropic dollars. Mrs. McCrystal indicated that she is meeting with Roger Ball, to provide him with some advice on fundraising. Additionally, Mr. Jones requested better metrics from Tykes & Teens which would show their effectiveness in the community. Mrs. Cunningham stated that the District will vote to approve its tentative budget and millage rate on July 15 at its regular monthly meeting.
Public Comment & Adjourn
Mrs. Cunningham asked for public comment and there was none. The meeting was adjourned at 11:20 AM.