Feb 24 Regular Monthly Meeting: January 20, 2022
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
January 20, 2022 @ 4:00 PM
TRUSTEES: Karen Deigl Allen Jones
Ann Marie McCrystal Marybeth Cunningham
ABSENT: Barb Bodnar Kerry Bartlett
STAFF: Kate Voss Jennifer Frederick
Jennifer Peshke, Esq. Ann Marie Suriano
ATTENDEES: Robi Robinson Angela Guzenski
Samantha Messina Eric Garza
William Cooney, M.D. Phillip Cromer, Ph.D.
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. She stated that a quorum of the Trustees is not yet present, therefore she is going to change the order of the agenda to address items that do not require board action. Mr. Jones provided the invocation. Mrs. Cunningham took a moment to reflect on the untimely passing of Dr. Nick Coppola and what a loss this is to the community. Lastly, Mrs. Cunningham led the group in the Pledge of Allegiance.
Mrs. Cunningham thanked the District staff for putting together the Annual Report, which is now ready for distribution. She stated that the report is a great representation of what the District does, and it will be available for anyone who would like a copy.
District Counsel Report – Jennifer Peshke, Esq.
Ms. Peshke stated that she continues to review the annual deadlines and deliverables due to the District under the Lease with CCIRH. She also responded to the Auditors’ letter confirming there is no pending or open litigation, which is done every January in preparation for the FY 21-22 Audit report. She stated that the Florida Legislative session has begun in Tallahassee and she will be tracking any bills that would impact Special Districts. She continues to work with counsel at CCIRH and VNA to complete the easement matter and hopes to provide an update to the Trustees next month. She is also working with the county on how a potential county ordinance change regarding stormwater retention, may impact the IRC floodplain and stormwater code as it relates to the property the Hospital District owns on the hospital campus. She and Ms. Suriano attended a meeting with County representatives as well as the IRCC representatives and their counsel to learn more about this issue and she will report more on this matter as it develops. Lastly, at the beginning of the year she confirms any new bonds that are up for renewal for the Trustees. She has also canceled the bond for Dr. Weiss and is awaiting the final paperwork of cancellation.
Organizational Matters- Jennifer Peshke, Esq.
Ms. Peshke stated that at the beginning of each year, the Bylaws of the District require the District to reorganize and elect five officers. Any board member may make a nomination for the five offices, which include Chairman, Vice Chair, Treasurer, Secretary, and Assistant Secretary. Each office will be elected by calling for a nomination, and a second. She asked that the nomination for the Chairman, begin the process.
Ms. Deigl nominated Mrs. Cunningham as Chairman, which was seconded by Mr. Jones The motion carried unanimously.
Mrs. McCrystal nominated Ms. Bartlett as Vice Chairman, which was seconded by Mrs. Cunningham. The motion carried unanimously.
Ms. Deigl nominated Mrs. McCrystal as Secretary, which was seconded by Mr. Jones. The motion carried unanimously.
Mrs. Cunningham nominated Mrs. Bodnar as Assistant Secretary, which was seconded by Mrs. McCrystal. The motion carried unanimously.
Mrs. Cunningham nominated Mr. Jones as Treasurer, which was seconded by Mrs. McCrystal. The motion carried unanimously.
Next, she asked the Trustees to confirm their meeting schedule for the year. After discussion, they agree to hold their regular monthly meeting the third Thursday of each month at 4:00 PM, at the County Commissioners Chambers, and a Chairman’s meeting on Wednesday the day before. The Chairman’s meeting will be held at 10:00 am. However, in an effort to accommodate Mr. Jones’ schedule while he is in Hawaii during the months of June through October, the meetings will be held at noon. All Chairman’s meetings will be held at the District offices in the conference room.
Consent Agenda- Marybeth Cunningham, Chair
Mrs. Cunningham asked for a motion to approve the regular monthly meeting minutes dated December 16, and a January disbursement of $829,402.96. Mrs. McCrystal made the motion which was seconded by Ms. Deigl. The motion carried unanimously.
Financial Statement Review- Allen Jones, Treasurer
Mr. Jones provided his treasurer’s report and stated that the District remains in very solid financial condition. As of December 31, the District had deposits and investments of a little over $16 million, with another $2 million in tax revenues expected to be received during the fiscal year. The budgeted operating expenses for the year are around $12.4 million, and the District is in a position to fund any additional healthcare needs of the county, should they meet the Strategic Priorities identified by the Trustees. Mr. Jones explained that specifically defining these priorities remains a work in progress by the board, but it appears there are sufficient funds to support new services for county residents if needed, without a need to raise millage rates in the near future. Per his calculation,the Trustees could support up to $3 million in additional annual commitments, while still maintaining adequate reserves for unanticipated expenses and keeping millage rates at the current level. He believes the Trustees can be confident that they can continue to support emerging healthcare needs, particularly for the uninsured and marginally insured population, while being responsible to taxpayers.
Executive Director Report- Ann Marie Suriano, Executive Director
Mrs. Suriano provided her report and stated that next week she will be at the Florida Association of Special Districts Legislative Forum in Tallahassee. She will also be participating in the Certified District Manager certification course. While she will be in Tallahassee she has requested meetings with our local legislators Grall and Mayfield but is unsure if those meetings will still take place due to a Covid outbreak in the Senate. She informed the Trustees that she has been contacted by Verizon wireless who is interested in installing a cell phone tower on the District property near the VNA Hospice House campus or at the CCIRH Behavioral Health Center. It was explained to her by the Verizon representative that the cell signal is very weak for Verizon users in that area and would be a benefit to the community to have the tower in place. There was Trustee discussion and they agreed that for public safety purposes, there should be stronger cell service in the area. They asked Mrs. Suriano to obtain further information about the project and how disruptive it would be to install. There was also discussion concerning any compensation the District would be owed for leasing the area of land, where the tower would sit. She indicated that she would provide those details to the Trustees after further discussion with the Verizon representative. Additionally, she has received the proposal from Carter for the next step in developing a strategic plan for the District. After discussions at the Chairman’s meeting, the Trustees agreed to move forward with Carter to facilitate this process. The process should take around three months and begin in February. Lastly, she stated that four individuals have applied to fill vacant seat 7 on the District board. Those individuals are Wayne Creelman M.D., William Cooney, M.D., Brian Gallagher, and Jad Shalhoub. The deadline for the governor to appoint a candidate is February 14th, but he also has the authority to not appoint someone until the next general election, which will be held this year in November. She will keep the Trustees informed should anyone else apply.
Funded Agencies Semi-Annual Reports-
Mental Health Association- Angela Guzenski
Dr. Cromer introduced himself and Ms. Guzenski, the chief operating officer, and Heather Roberts the chief clinical officer. Also joining via Zoom is Jeanne Shepard who is the executive clinical director. Ms. Guzenski addressed the board and began the presentation by discussing the MHA Walk-In center’s support groups and service activity data. She stated that there has been an increase in diagnostic assessment screenings at the center and the need for walk-in service counseling. She also reviewed patient satisfaction survey results which had positive outcomes. Next, there was a review of the Vero Drop-In Center data and client satisfaction survey results. She indicated that they have expanded services at the drop-in center to meet the increased demand and now two mental health court peers are working in the center. They discussed the criteria in order to become a certified peer specialist, and the positive impact those peers have at the center. Ms. Guzenski then reviewed District received revenues and financial data. Ms. Roberts provided an overview of the School Violence and Suicide Prevention program which began serving students again in November for the current school year. In February they will begin to work with local sixth graders. They have seen great success with the program and many students are seeking additional therapy support after completing the program. She did indicate that there is a gap in providing support to parents with students who are suffering with mental illness and there is currently a task force that has been created to address this, and to find meaningful solutions. Some of the Trustees expressed an interest in being more informed on this matter and would like to attend the next task force meeting. Ms. Guzenski indicated that she would provide that information to the District staff, and that the Trustees were welcome to attend.
We Care Foundation- Robi Robinson, Executive Director
Mr. Robinson addressed the board and stated that Dr. Baker is joining via zoom to participate in the presentation as well. Dr. Baker stated that they are aware that We Care is in a time of transition and it is not operating as it used to. She explained that they are having a difficult time participating with the Health Department due to COVID and the Health Department’s resources are being pulled in that direction. This is one of many challenges that they are experiencing at the moment. They still have the desire to meet the needs of Indian River County and meet those gaps that the District board has defined they would like to see met. Mr. Robinson provided a brief overview of We Care. He stated that as of December 31, Dr. Fountain has retired and both nurses at the clinic were removed from their positions by the Health Department. Therefore, they no longer have any salaried employees. He then reviewed We Care clinic visit data for the period of July through December 2021. Towards the end of the year, he stated that patients were notified by the Health Department that We Care was ceasing its operations and that they should contact their primary care physician for reevaluation, treatment, or specialty referrals. Mr. Robinson stated that because he and Ms. Stuven are not Health Department employees, they are not privy to the patient data that is collected during a We Care visit and they have been denied access to the computer systems containing this data. He reviewed expenses for the clinic and customer satisfaction data from 2020 to current. He stated that since July, there were 20 cataract procedures completed and they continue to work with New Vision on this initiative. He further explained that there were funds from last fiscal year that were earmarked for support of this cataract program and he believes that these funds will carry them through 2022. He then discussed the future plans for We Care and its operations. He stated that once the. soon-to-be-hired Physician Liaison/Eligibility Referral Specialist is on board, that will help assist in connecting patients to the specialty services. The clinic will also be housed at the Health Department and no longer at the Gifford Health Center. Mrs. Cunningham stated that up until December, the District was paying for the doctor and nurses at We Care, therefore the data associated with the time period should be available to We Care and not the Health Department. Mr. Robinson explained that the data is collected at We Care but it is housed within the Health Department’s computer system. Dr. Baker further explained that when We Care was created, it was a joint effort between the Health Department and the Indian River County Medical Society, and the original charter and grant were in tandem with the Health Department. This was to ensure sovereign immunity for the volunteer physicians, and the We Care coordinator has always been a Health Department employee. She further stated that as 2021 began to wind down, the Health Department essentially locked the doors and locked out We Care from access to the computers. Additionally, the Health Department has to hire the We Care coordinator, and it has not been a priority of the Health Department to fill that position. Further, We Care has no authority in choosing the employee, and Mr. Robinson is not allowed to participate in the interview process. She stated that they are working on alternative ways to accomplish the goals they are trying to achieve but there have been many setbacks. However, the job has now been posted through the Health Department and Dr. Baker even recommended one employee for the position, but the Health Department declined that request. Many of the Trustees were concerned with the events that have transpired and are even more concerned about the patients who are now without the support of We Care. Mr. Robinson assured the board that they are working towards a solution to get the We Care clinic back up and running as soon as possible. The Trustees offered their support to We Care in order to expedite this and hope that Mr. Robinson will return soon with a solid plan of action. Additionally, it was discussed that TCCH is able to take liability for volunteer physicians which could eliminate the need to associate with the local Health Department moving forward. Mr. Robinson stated he has been in contact and told that they are also able to work with the State of Florida Department of Health to obtain sovereign immunity as well.
There was no public comment and the meeting was adjourned at 5:40 PM