Chairman’s Meeting Minutes: July 14, 2021

Chairman’s Meeting Minutes: July 14, 2021

Indian River County Hospital District Conference Room/ Zoom
July 14, 2021
10:00 AM

TRUSTEES: Marybeth Cunningham Barbara Bodnar
Ann Marie McCrystal Allen Jones
Kerry Bartlett

ABSENT: Karen Deigl Michael Weiss

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

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the Chairman’s meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person.

HB 1103 Discussion- Representative Erin Grall

Mrs. Cunningham explained that the District Trustees asked Representative Grall to discuss the recently adopted HB 1103 and her interpretation of the same. She explained that the bill requires all special districts to undergo a performance review every five years. The purpose for this legislation was to develop a uniform reporting process for special districts and provide detailed data on each district’s operations and efficiency. There was discussion surrounding the different types of special districts in the state and how the Hospital District is very unique in its operations. Representative Grall ensured the Trustees that the purpose of this bill is not to dissolve special districts, but to get an accurate picture of their operations and spending relative to its purpose. Representative Grall further explained that the information they collect through the performance audits will help policy makers make more informed decisions concerning spending in the States budget. She informed the Trustees that she plans to contact the State of Affairs committee staff, to obtain additional information concerning the types of entities who are qualified to conduct the performance reviews. Additionally, the Auditor General’s office will publish additional instructions concerning the audit process and requirements. Overall, Representative Grall believes this bill will provide further transparency and understanding of these special districts throughout the state. She offered her support and guidance with this process moving forward. There was further Trustee discussion and they thanked Representative Grall for her time and efforts.

Indian River Indicators Database- Jeffery Pickering, CEO Indian River Community Foundation

Mr. Pickering stated that Indian River Indicators is a program that supports the Indian River Community Foundation’s mission of building a better community through donor-driven philanthropy. This program originated after the completion of the 2019 Community Needs Assessment. He discussed the program and stated that Indian River Indicators is a resource that provides key data and information about Indian River County that is updated annually and can be used to support and sustain proven programs. It can also be used by community leaders to develop policy, promote promising practices or inspire innovation that can lead to solutions to persistent community challenges. Mr. Pickering showed the Trustees how to use the Dashboard tool on the website and walked them through the Table of Contents. He then reviewed the Overview of Our Community section of the database This section finds population and other demographic data about Indian River County. There is also a special feature mapping tool which can show where any social or health disparities exist. He then walked through additional features of the database with the Trustees. In closing, Mr. Pickering stated that that Indian River Indicators can be used by any member of the community and hope that this tool with help support solutions and ongoing challenges within Indian River County. There was Trustee discussion and Mrs. Cunningham stated that this data collected will be beneficial to the District and would help assist in the performance audit that will be required in the coming years.

Gifford Health Center Advisory Committee Update- Barb Bodnar, Trustee

Mrs. Bodnar provided her update and stated that TCCH has hired three adult medical providers and one full time pediatric provider, who will all be located at the Gifford Health Center (“GHC”), once they are credentialed. The pharmacy at the GHC has recently opened in the previous Healthy Start space. Additionally, TCCH has hired a pharmacist and a pharmacy tech but the credentialing for insurance has not yet come through for those yet either. Therefore, medication is being filled through the Oslo pharmacy and is available for pick up at the Gifford Health Center. The group discussed the matter of the patient advocate position at GHC and the search to find a replacement after the resignation of the previous employee. Ms. Bodnar explained that committee discussion took place as to how this position was initially a requirement through the RFP. As trust has now been established with the community the committee was certain that the position is as effective or serving its original purpose. It was discussed by the group that the position will be renamed, and the job description updated to make the position more effective and successful. Mrs. Bodnar stated that Healthy Start has new space within the GHC, since they gave up their space for the pharmacy. This space has been utilized for parent and health education; breast feeding/break room for new moms; and an area for hearing screening when necessary. Ms. Bodnar stated that We Care provided an update to the committee and explained that the We Care Committee meetings have resumed and the group has met in person twice. This group consists of Dr. Fountain, Dr. Reinauer from New Vision, TCCH staff, WFHC staff, and We Care Staff. Ms. Hawker from the Department of Health has attended pre-COVID, although has not been available since the meetings resumed. She indicated that these We Care committee meetings are an opportunity for the group to determine if changes in process or services are needed at the clinic and they plan to meet every other month. It was requested that a member from the District be involved with this committee and Ms. Stuven indicated that she would add Mrs. Frederick to the meeting list, so she is notified and may attend. Ms. Bodnar indicated that We Care has been short an RN Coordinator for 2 months and have hired a new employee, who began on the 24th. Additionally, We Care is currently reviewing the backlog of referrals and attempting to reach all patients to see if they are still in need of service. If they are unable to be reached after 2 attempts, they will send a notice to contact their primary care physician to restart the process. Further, there was an update from VNA concerning COVID-19 vaccines and the Together for Health collaborative group. It was explained that with the shortage of CDL licensed individuals the VNA is struggling to find drivers for the Mobile Unit since it has been back on the road after various repairs. Currently, the unit is at Wal Mart in Vero on Mondays and Tuesdays, Wal Mart in Sebastian on Wednesdays, Fellsmere on Thursdays and at the VNA parking lot on Fridays. The VNA is also hosting groups with the Positive Change Program and are welcoming other opportunities to grow this program. Also, Mr. Woolfork announced at the meeting that a Back-to-School Bash will take place at the Gifford Youth Achievement Center (“GYAC”) on August 7 and all donations are due to the GYAC by Aug. 6. They will also be collecting new and gently used uniforms, clothing and shoes for children Kindergarten to age 12. Lastly, Ms. Soule indicated that TCCH has been awarded some facility fortification funding and in turn evaluated all the HVAC systems throughout their clinic locations. TCCH has decided to use those funds to replace the aging systems. They have also given the quote to the District, for the 6 remaining units at the GHC, which are now 18 years old, and Mrs. Suriano has added that replacement cost to the 2021-2022 budget. Ms. Soule also reported that TCCH has had the door lock system changed and added cameras to the inside and outside of the GHC for both employee and building security purposes. The Trustees thanked Ms. Bodnar for her participation with the advisory committee and for her thorough report.

FY 21-22 Budget Discussion- Ann Marie Suriano, Executive Director

Mrs. Suriano stated that after last months discussions surrounding the budget, she moved the agreed upon budget items; VNA- Lifeline, We Care Program and Dynamic Life equipment, into a “placeholder” reserve. Many Trustees agreed that they would like to approve a budget amount resulting in the same Ad Valorem Tax dollar for the current fiscal year. In addition to this, Mrs. Suriano stated that she has now received the final DR-420 form from the Property Appraisers office, and incorporated those numbers into the preliminary budget being discussed today. With these adjustments, the proposed millage rate is .7612, with an ad valorem tax revenue of $15,694,778. Included in this budget is a “placeholder” reserve for $2,631,725. Mrs. Suriano also provided to the Trustees a historical review of how the increase and decrease in property values effected the Ad Valorem Tax Millage rate assessed from 2002-present. Additionally, she explained that she and Mrs. Cunningham began conversations with the County Administrator Jason Brown about appropriateness of items within each of the respective budgets and if there are any duplications in funding. These discussions were put on hold due to COVID and she has now scheduled a meeting for August 4th, to begin those discussions once again. To quantify those potential duplications in funding, she provided the Trustees with a copy of the county commissioner budget and identified the areas she would consider to be more appropriately funded through the District. It was discussed that tomorrow the Trustees must vote to approve a preliminary budget at the highest millage agreed to by the board. The Trustees will then have the opportunity for further group discussion and analysis, along with public comment, before adopting the final budget and millage rate in September. The Trustees were asked to provide their comments to Mrs. Frederick or Mrs. Suriano concerning any specific line items in the budget, to which they would like to see removed or amended. Then District staff will compile that information together and bring the same back for group discussion at next month’s Chairman’s meeting. Mr. Jones echoed Mrs. Suriano’s comments and recommended that the Board approve this proposed budget at tomorrow’s meeting and then work through those individual line items at a subsequent meeting. Mr. Jones prepared an outline for the Trustees that reviewed other budget line items to be considered and agencies who have requested additional funding over the previous year. There was further discussion surrounding the funded agencies and the percentage of funding they receive from the District, relative to their total budget. All the Trustees agreed that the District funding should be no more than 25%-50% of the total budget of an agency. Mrs. Frederick indicated that she had provided the Trustees with a worksheet showing the total amount each agency requested in funding, relative to the agency’s total budget, for their information.

Public Comment & Adjourn

Mrs. Cunningham asked for public comment and there was none. The meeting was adjourned at 12:30 PM.