Jul 22 BOT Regular Monthly Meeting: June 14, 2022
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
June 14, 2022 @ 4:00 PM
TRUSTEES: Allen Jones Barb Bodnar
Marybeth Cunningham Ann Marie McCrystal
ABSENT: Kerry Bartlett
STAFF: Kate Voss Jennifer Frederick
Ann Marie Suriano Dawn Carboni
ZOOM: Samantha Messina Jennifer Peshke, Esq
ATTENDEES: Tracey Griffis Tara Beard
Liz Bruner Pat Knipper
Ed Love Lundy Fields
Convene Meeting & Approval of Consent Agenda– Marybeth Cunningham, Chair
Ms. Cunningham convened the regular monthly meeting of the IRCHD at 4:00 PM by welcoming those in attendance and via Zoom. She asked for approval of the Chairman’s Meeting Minutes dated May 18; Regular Monthly Meeting Minutes dated May 19; and a June disbursement of $1,711,758.28. Ms. Deigl made the motion which was seconded by Ms. Bodnar. The motion carried unanimously.
Mrs. Cunningham stated there was a change to this evening’s agenda. Ms. Cunningham stated that Employee COLA approval was moved to tomorrow’s Chairman’s meeting and will be discussed at that time. Additionally, the approval of SRA ARP funding match, will be addressed under the Executive Directors’ report.
District Counsel Report – Jennifer Peshke, Esq.
Ms. Peshke provided an update on the matters she has been working on over the last month which have been the same ongoing issues including the amended lease with CCIRH and the VNA, Stormwater Code change with the county and the District budget cycle. Mrs. McCrystal asked if there have been any updates concerning the proposed cell tower on the land which the VNA currently utilizes for the Hospice House. Ms. Suriano stated that this matter has been placed on hold due to the pending amendments of the current lease agreement regarding the property. Therefore, the District felt it was best to wait until the amended lease agreement is complete and all parties are in agreement about the future ownership of the property.
Financial Statement Review- Allen Jones, Treasurer
Mr. Jones provided the financial report and stated the District is in sound financial condition. At the end of May the District, net of this month’s disbursements, has approximately $12.4 million in cash and cash equivalent investments. This includes a $979,000 one-year U.S. Treasury Bill, which will mature in May 2023 at $1 million, providing interest of about $21,000 or 2.5%. This compares with most of the District’s cash currently yielding about .8%. He further explained that between now and fiscal year end, the District is budgeted to spend about $5.1 million for supported programs and believes the District could be begin the next fiscal year with about $7.3 million in cash carried forward. He explained that this should mitigate against a millage increase in the next fiscal year, and with estimated property value increases would make for a further reduction in the millage rate likely. Since 2016, the millage rate to support the District’s activities has declined about 28%.
Executive Director Report- Ann Marie Suriano, Executive Director
Mrs. Suriano stated that a final budget discussion meeting has been scheduled for July 12th, which provides the Trustees with an opportunity to collectively discuss the proposed FY 22-23 budget, and she has begun to put together a proposed draft budget for their consideration. Additionally, there will be a strategic plan discussion meeting on June 28th and she asked the Trustees to provide her with their input concerning definitions and next action steps in the next week, prior to the meeting on the 28th. Lastly, she stated that last month she brought before the Trustees a request from the Senior Resource Association to provide local match funding to support their grant from the American Rescue Plan Funding. These funds would help support their Meals on Wheels program, which is a vital service to many in the community. The total amount of the request is $54,000 and she asked if the Trustees would make a motion to support the same. Mrs. McCrystal made a motion to support the request, which was seconded by Ms. Bondar. The motion carried, but Ms. Deigl recused herself from the vote, as she is directly involved with SRA as their CEO. Ms. Suriano stated that District staff will work with SRA to finalize details of how payments will be processed moving forward. Mrs. McCrystal asked if the SRA has a demand for people requesting in home respite services. Ms. Bruner indicated that she does not have the exact figure but there is a waitlist with the Area Agency on Aging and that the state recently reconfigured their database and the reports have changed, which has affected the number of individuals eligible to be placed on the waitlist. Ms. Deigl stated that because SRA is publicly funded and the in-home services they provide are provided to individuals who rely on public funded services, anyone who is in need would be placed on the waitlist. She further explained that historically they have relied on the VNA to provide these services, but as they see the need growing, they are looking at expanding their services and other avenues on how to fund this much needed service.
Funded Agencies Semi Annual Reports-
Childcare Resources- Tracey Griffis and Tara Beard
Ms. Griffis provided her report and stated that as their programs continue to grow, they have added a Case Manager which has been a much-needed missing piece of their staff. The Case Manager has allowed them to provide better support and really address the needs of the families. Over the past year a large focus of the Wellness Team has been families enrolled in their collaborative program with the Homeless Children’s Foundation, which is also helping to address the needs of children and the entire family. Currently they are seeing 25-30% in need of crisis intervention and that number continues to rise. Additionally, there are 200 plus children on the waitlist for enrollment to their school. There was further discussion about the struggles that families are facing and it was discussed that substance abuse plays a large role. She explained that one or both parents in families with crisis situations are struggling with substance abuse and/or mental health issues. Ms. Griffis further explained that one of their main goals moving forward for future programing is to provide parent programing. She stated that there are few resources available for true parenting classes, and they would like to have something monthly for the parents of the students at their schools. They believe that the key to having healthy children is through healthy families, so the more support they can provide to the parents will produce better outcomes for the children. The biggest emerging issue they are seeing is the struggle with mental health and the increased need for mental health services for children and their families. They explained they have a pilot program with Tykes & Teens who provide infant mental health services, but they are only able to see a few of their children due to the high demand for the service and a large waitlist. They also work collaboratively with the Mental Health Association who provides mental health services to the parents of their students. Another issue many families are struggling with is finding affordable housing. In closing ,she stated that the biggest asset and support has been the addition of the Case Manager, and in having that missing piece they have been able to begin to make sustainable changes with families.
VNA- Pat Knipper, Lundy Fields, and Ed Lowe
Ms. Knipper addressed the board and thanked the Trustees for their support of the VNA and the various programs the District supports. She asked if there were any questions relative to their written semi-annual report and Ms. Cunningham had one concerning their quality scores. She stated that in a report prepared by Ms. Frederick, which showed a year-to-year comparison of their home health quality metrics scores, there was a significant decrease in drug regimen and improvements in oral medication management, and she questioned what led to this. Mr. Lowe addressed the board and stated that the VNA is aware of these decreases and has already put corrective efforts in place to increase those scores. They have also hired an individual who is a star rating expert and certified in these star rating mechanisms to help the home care team to improve their outcomes. There has also been infield training for staff, to provide additional education and support. Lastly, he explained that there were changes to the star rating system and how things are graded, so with the help of the star rating expert, they believe their outcomes will start to improve and be back up to their high standard of care that they have always maintained. Ms. Knipper provided an update on home health and stated they made improvements with their screening process concerning home health patients and have increased their patient population by 70%. She then provided an update concerning the mobile unit and stated that they were able to secure a full time CDL driver and the bus is visiting many new locations throughout the county to help reach vulnerable communities. They have also seen an uptick in illness including flu, strep and COVID. The future goals with the mobile unit are to dispatch at mobile home parks to provide education and outreach services to residents in those areas. Next, Mr. Fields addressed the board and thanked the Trustees for their continued investment in the VNA and the community. In regard to the three topics, he was asked to address concerning emerging issues, reinforcing their strategy and their five-year plan, he stated that the VNA embarked on a strategic planning exercise and one of the pillars of the strategic plan was global patient care. He explained that the VNA realized that they were a good provider of episodic care and are able to meet the goals for that specific event and then discharge the patient. However, they would like to expand upon how they treat the patient and provide a better continuum of care, post discharge. He believes that with this method, they will be able to keep patients healthier and out of the hospital. He would also like the VNA to be advocates for their patients, who may not be able to manage their healthcare matters fully. This is an ongoing initiative and will be developed gradually through coordination with other healthcare providers. There was further Trustee discussion on the same, and they thanked the VNA for their continued efforts.
Whole Family Health Center- Marie Andress, CEO
Ms. Andress asked the Trustees if they had any questions concerning her written report, along with the three-month review of the Globe Chek pilot program. She explained that Dr. Pierone had planned on attending today’s meeting but was ill and unable to attend. She requested that he and Dr. Mallon address the board next month and provide an update concerning Globe Chek, which the Trustees agreed to. Then she discussed Whole Family Health Center’s (“WFHC”) outlook for the next three years which is encompassed in their current strategic plan. She stated that they will continue to focus their efforts on primary care services. She further stated that Globe Chek has been quite an undertaking for the organization and has also brought to the forefront the continued need for specialty care. 750 patients have been screened by Globe Chek and 30% of those needed follow up specialty care. Additionally, she explained that while CCIRH has assisted with providing specialty care to their patients, there are still some service lines that are not offered and they have to find alternative solutions to getting patients into those services. There have also been challenges with the CCIRH medical records system and WFHC providers being able to access medical information for their patients which has been a barrier to providing a complete continuum of care. There was Trustee discussion and Ms. Cunningham indicated that the District would be willing to convene a group together to have further discussions on this matter, to develop a plan of action. Ms. Andress further stated that she and Ms. Soule from TCCH have begun to work collaboratively on finding specialty referral services for their patients and are in talks to develop a specialty clinic at one of their locations, to offer that specialty service one day a month. Next, she discussed the emerging issues she is seeing in the community in which she reiterated there is a need for access specialty services and general care. She explained that with the population growth, she is seeing a large increase in the need for medical and behavioral health services. There is also a need for family medicine physicians and it is difficult to recruit them and that they have been relying heavily on the APRN, RN’s, and PA’s for patient visits. There was Trustee discussion and they all agreed that the need is growing and they offered their support to Ms. Andress moving forward.
There was no public comment and the meeting was adjourned at 5:30 PM