Regular Monthly Meeting- December 15, 2021

Regular Monthly Meeting- December 15, 2021

County Commissioner Chambers/ Zoom
December 12, 2021 @ 4:00 PM

TRUSTEES: Kerry Bartlett Karen Deigl
Ann Marie McCrystal Marybeth Cunningham
Barb Bodnar Michael Weiss

VIA ZOOM: Allen Jones

STAFF: Dawn Carboni Jennifer Frederick
Jennifer Peshke, Esq. Ann Marie Suriano

ATTENDEES: Andrea Berry Dr. Rosencrance
Sharron Packard Marie Andress
Pat Knipper Dan Bach
Anne Posey William Winns

Convene Meeting – Marybeth Cunningham, Chair

Mrs. Cunningham convened the regular monthly meeting of the IRCHD at 4:00 PM by welcoming those in attendance and via Zoom. Pastor Joe Moore provided the invocation and Dr. Weiss led the group in the Pledge of Allegiance.

Consent Agenda- Marybeth Cunningham, Chair

Mrs. Cunningham asked for a motion to approve the Chairman’s meeting minutes dated November 17, regular monthly meeting minutes dated November 18, and a December disbursement of $814,836.69. Mrs. McCrystal made the motion which was seconded by Ms. Deigl. The motion carried unanimously.

Resolution 2021-06- Marybeth Cunningham, Chair

Mrs. Cunningham explained that after 13 years as a Hospital District Trustee, Dr. Weiss has decided to resign, due to health reasons with he and his wife. She expressed the boards gratitude for his service and is grateful for their time working together. She presented Resolution 2021-06 and read some messages submitted from a few of the District funded agencies with their thanks. Dr. Weiss addressed the board and thanked the Trustees for their kind words.

District Counsel Report – Jennifer Peshke, Esq.

Ms. Peshke stated she is still working to finalize the matter with Cleveland Clinic’s counsel and the VNA’s counsel to amend the existing Agreements the District and the hospital entered into in 2018, to reflect these changes. She is also looking into how a potential county ordinance change regarding stormwater retention may impact the IRC floodplain and stormwater code changes as it relates to the property the Hospital District, owns with regard to the hospital campus. Additionally, the board conducted its Trustee retreat on December 7th, which she was unable to attend due to illness, but has been updated by Mrs. Suriano on the same.

Financial Statement Review- Allen Jones, Treasurer

Mr. Jones provided his treasurer’s report and stated that the District is in solid financial condition. He explained that the District has received approximately half of the projected tax revenues for the current fiscal year. Currently, there is around $12.5 million in cash and liquid investments in its accounts, less the monthly disbursement of $800,000. This leaves approximately $11.4 million in funds. Over the next serval months, the District anticipates receiving around $6.3 million more in tax revenues. Currently, the District has enough funding to fulfill its obligations to the funded agencies for the remainder of the fiscal year. Additionally, Mr. Jones spoke to the progress the District has made over the last several years. In 2016, the Districts millage rate to fulfill its operating budget was .9951. This year the millage rate is .7144, which results in a decrease of 28% over time. Other items of importance were that the hospital operations were assumed by Cleveland Clinic, the number 2 health system in the US, which moved the hospital rating from a two-star hospital to a four-star hospital. Additionally, the Gifford Health Center was expanded from a limited-service pediatric clinic to a full-service healthcare clinic, with some pharmaceutical services added recently. He stated that TCCH is overseeing this expansion and has also added more behavioral and dental health services throughout the county, in order to serve more patients. The District has also supported Healthy Start and their expansion of services, which has provided a direct and measurable impact on improving infant mortality results within Indian River County. The District is also now providing support for substance abuse support through Phoenix Rising and Substance Awareness Center, with is a much-needed service. Therefore, it is evident that the residents of Indian River County are receiving more and better healthcare services while reducing the millage and the burden to the taxpayer. He explained that the District continues to explore better ways to further improve the healthcare in the community, regardless of income, in ways that are directly accountable through metrics, but also providing treatment that is effective to help patients live a better and healthier life.

Executive Director Report- Ann Marie Suriano, Executive Director

Mrs. Suriano added to her written report under Mental Health, that Jeff Pickering at the Community Foundation offered to gather data supporting the need for detox services. They are also working to put together a facilitated session to work on a flow chart of available related services within the continuum, and options toward the next steps. She also met with Denny Nystrom, who used to own Dynamic Life Treatment Center and currently supports Dynamic Life Recovery, and has an interest in being a part of this solution contributing his knowledge and experience, along with some potential financial support.

She also added that as We Care carries out their new model, they will no longer need exam room clinic space at the Gifford Health Center, and will be moving their offices back to the Main Health Department. This assists them in providing benefits for their support staff who are employees of the Department of Health and provides Sovereign Immunity for their volunteer physicians.

Finally, she indicated that during the GHC meeting on Tuesday evening TCCH reported that volume has increased, and the no-show rate has gone down significantly. The community is thankful and very pleased to have a full array of services back at the GHC and happy with TCCH. The communication is better than it has ever been, and Mr. Woolfork spoke on behalf of the community that they are appreciative of the partnerships and relationships that are being built providing greater health for all citizens. He thanked all for coming together in this way and especially for the District’s attention to the building continuing to listen to their needs and ensuring the provision of growing health services in the Gifford Community. Through TCCH’s work with the Community School partnership at Dodgertown Elementary School, the children are accessing dental care, eye care, and general healthcare. Additionally, they are delivering gifts to all children at the school tomorrow morning.

CCIRH Semi-Annual Verbal Report- Greg Rosencrance, MD President CCIRH

Dr. Rosencrance addressed the Board indicating that in accordance with the terms of the lease, he is presenting the CCIRH’s semi-annual verbal report. He introduced his team along with him this evening, Dr. Turner, COO, Dr. Mackett, Chief of Staff, Dr. Peter, CMO, and Mr. Fuller, CFO. Dr. Rosencrance reviewed the Core Services, highlighting statistics, advanced services and increased admissions/cases in Oncology Bariatric Surgery, Advanced Robotics, Micro Clip heart and microvalve repair, Bronchoscopy, Women’s Health MFM, Behavioral Health and Stroke. He provided data concerning indigent visits and dollars spent on services to the community for the last year. He also discussed data increases or decreases in various departments at the hospital. He reviewed Quality Benchmarks in handwashing, CDiff, staph infections, Ulcers, readmissions, blood pressure, and glucose control. He also spoke to the telephone system challenges and improvements in transitioning of the EPIC system. Dr. Rosencrance reviewed the overall finances and capital expenditures year to date, including renovations to various areas throughout the hospital. He completed his report by highlighting the year-to-date accomplishments including Leapfrog and other ratings and awards, new services, specialties and physician group acquisitions.

Integration of Behavioral Health to Optimize Prenatal Health Outcomes- Sharron Packard, Healthy Start Program Manager

Dr. Packard provided an overview of behavioral health integration. She stated that they now have the opportunity to hire new navigators who manage their coordination and intake process. Those individuals have been an integral part of Partners to help navigate services for mothers. They have also hired a licensed marriage and family therapist to work as a maternity navigation coordinator, so the point of first contact for mothers is someone with a behavioral health background. She provided a brief overview of the programming at Healthy Start with a focus on coordinated intake and referrals. This new model will allow Healthy Start to use the maternity navigators as the point of first contact. She then provided an overview of their model which was adapted from the University of Washington. She explained that the navigator will provide basic psychoeducation and identify any needs or risk factors, as well as draft a perinatal plan. Next, they will conduct bloodwork and provide an OB intake. Lastly, she provided the Trustees with information concerning the next steps for Partners and stated that Partners will be the only OB practice in the region with integrated behavioral health supports. They also plan to conduct some pilot testing to identify potential barriers and problem solve prior to full implementation. The Trustees thanked Dr. Packard for the information and are looking forward to future updates on their progress.

Funded Agencies Semi-Annual Reports-

The Indian River Healthy Start Coalition, VNA, and Whole Family Health Center presented their semi-annual reports to the District Trustees. There was Trustee questions and discussion on the same, and copies of the presentations can be requested from the District offices.

Public Comment/Adjourn

Samantha R. Messina, the grants and contracts manager for Tykes and Teens, introduced Ms. Rachel Moshman who is the new mental health consultant, a position that the District is now supporting at Tykes and Teens. Ms. Moshman stated that she is a native of Indian River County and was the program director at Childcare Resources for many years. She has worked in early childhood education since 1996 and is excited to be working with Tykes & Teens in this position.

Mr. Jad Shalhoub, business owner of Advanced Vascular Solutions in Sebastian addressed the board. He discussed his business which he co-owns with his father who is Dr. Hadi Shalhoub, a vascular surgeon in Indian River County for 20 years. He introduced himself and his educational background to the Trustees and stated that he appreciated the reports that were presented today. He expressed his interest in participating in this board’s work and would like information on how to apply for the Seat 7vacancy. Mrs. Suriano stated she will provide him with the information and help assist with the application process. With no further public comment, the meeting was adjourned at 6:15 PM