Regular Monthly Meeting: September 22, 2022

Regular Monthly Meeting: September 22, 2022

County Commissioner Chambers/ Zoom
September 22, 2022 @ 5:15 PM

TRUSTEES: Allen Jones- via Zoom Barb Bodnar
Ann Marie McCrystal Kerry Bartlett
Karen Deigl- via Zoom Marybeth Cunningham

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

ZOOM: Linda Kloss Elizabeth Appleton
Anne Posey Jeff Pickering

ATTENDEES: Bill Stengel William Stewart
Carrie Lester Andrea Berry
Miki Cianci Warren Fuller
Karissa Bolden Cheryl Martinez
Bridgett Jerger Meredith Egan
Liz Bruner

Convene Meeting & Approval of Consent Agenda– Marybeth Cunningham, Chair

Ms. Cunningham convened the regular monthly meeting of the IRCHD at 5:15 PM. She asked for a motion to approve the consent agenda which was made by Mrs. McCrystal and seconded by Ms. Bartlett. The motion carried unanimously.

Chairmans Report- Marybeth Cunningham, Chair

Ms. Cunningham stated that she would like to address some rumors she has been hearing within the community concerning Cleveland Clinic and the District’s relationship. She explained that the District has a long-term lease with Cleveland Clinic to operate the hospital and that the hospital was not sold, and the District still owns the land on which the campus sits. The current lease term is 30 years, with three options to extend 15 years, for a total of 75 years. The lease requires several reporting requirements from Cleveland Clinic to the District, which include a semi-annual verbal report and a written report. She discussed the various items included within the reporting requirements and stated that CCIRH has committed to spending 250 million in capital improvements over the next 10 years. Additionally, CCIRH was just ranked the 18th best hospital in Florida which was up 13 points from the previous year. She then discussed her gratitude for having CCIRH during the pandemic and stated that she believes IRMC would not have been able to maintain operations, leaving Vero Beach without a hospital. She further discussed their various qualifying scores which have improved and their work with IRSC by providing free tuition to nursing students. Additionally, they have begun a sports medicine partnership with Sebastian High School and established a scholarship for a nursing assistant program at the TCTC school. Lastly, she stated she understands that with all the good, there still have been issues and CCIRH is the first to admit that, however it is not within the District’s purview to get involved with the day-to-day operations of the hospital. The District will continue to have its main focus of supporting healthcare within the community.

District Counsel Report- Jennifer Peshke, Esq.

Ms. Peshke provided her report and stated that she is working with District staff on completing and distributing the funded agency agreements for the upcoming fiscal year. Additionally, the District completed its work with CCIRH and the VNA concerning amendments to existing lease agreements. Later in the meeting she will bring forth a resolution for approval outlining the same.

Financial Statement Review- Allen Jones, Treasurer

Mr. Jones provided his treasurer’s report and stated that given the discussion earlier about the new budget for the upcoming fiscal year, it is clear that the District is in good financial condition. As a result, the District is reducing next year’s millage rate by 28.5% and ad valorem tax revenues are being reduced by 18.8%. Even with those reductions, District program support will increase over 13%. Mr. Jones then reviewed some of this year’s accomplishments which include a reduction in the millage rate and additional support for program expenses. Additionally, the District continues to support access to mental health treatment and substance abuse treatment. Additionally, the prenatal services at Partners in collaboration with the Healthy Start Coalition, are delivering babies with results significantly better than the state averages even though 70% of pregnancies are high risk. Finally, the Board of Trustees continues to work collaboratively with CCIRH to improve care in the community and assist in funding the Adolescent Intensive Out Patient service program. Further he is pleased to announce that CCIRH is now a 4-star hospital as rated by CMS vs 2 star for every year prior to Cleveland Clinic taking over operations. Additionally, US News rates CCIRH as the 18th best hospital, out of over 270 hospitals analyzed in Florida. Lastly, he stated that it is an honor to be on a board that is quietly and without much controversy working to make Indian River County a healthier place to live for all of its residents.

Executive Director Report- Ann Marie Suriano, Executive Director

Ms. Suriano stated that she provided a written report to the Trustee in their packet but one area she would like to highlight is that at the October Chairman’s meeting the Trustees will meet to regroup on their strategic planning efforts and focus on new tasks associated with that endeavor.

Update on Partners and Healthy Start Care- Andrea Berry, Executive Director

Ms. Berry introduced her team which included Cheryl Martinez, RN and Bridgett Jerger, the Doula Coordinator. She stated that she has prepared a short PowerPoint presentation that outlines the collaborations between Healthy Start and Partners. She reviewed the services Healthy Start provides to CCIRH for Partners which include breastfeeding support in the hospital, post-partum nurse home visit, PEPW, health education, doula support, and childbirth education classes. Ms. Martinez addressed the board on behalf of Healthy Start and the Gifford Health Council. She thanked the Trustees for addressing the comments they brought forward at the last Gifford Health Center Advisory Committee and stated that representation for their community is so very important and they appreciate the chance to provide further information to the Trustees on the maternal mortality crisis taking place, especially with women of color. They showed two short YouTube videos which discussed the maternal mortality crisis and provided data concerning the same. She further explained that while the rates in Indian River County remain low, this is a national crisis and our community should remain diligent in supporting minority communities. Next Ms. Jerger discussed the improvements that are in place to provide better support to mothers, which include improvements to the phone system at Partners and Healthy Start. Additionally, they are providing further education opportunities including the Hear Her campaign and holding a community forum at the GYAC. The Trustees thanked the group for their continued collaborative efforts and for addressing the issues immediately.

Funded Agencies Semi Annual Reports-

CCIRH IOP- Karissa Bolden, Clinical Manager Outpatient Services

Ms. Bolden provided a review of the program’s outcome data for the last 6 months and stated that they served a total of 40 clients and the average length of treatment was approximately 10 weeks. Out of those 40 clients served, 27 completed at least 7 weeks of treatment. She further reviewed data from the MFQ, PHQ-9, and SCARED scales, which all measure symptoms of depression and anxiety. Next, she discussed the patient satisfaction survey scores which showed positive outcomes. She then informed the Trustees that CCIRH will now be offering a young adult IOP for individuals ages 18-24. The program will be offered for 6-8 weeks and is held three times a week in the morning. She stated that they look forward to serving this population who are experiencing an increase in substance misuse. She then provided the trustees with responses to the three questions each funded agency is asked to respond to. She explained that their main challenge is engaging students to remain in the IOP. Many times, there will be buy-in from the parents but the student is unwilling to commit fully to the program. Next, she discussed how they are better supporting the students after they complete the IOP, and are offering a transition phase once they have completed the program. This includes offering virtual therapy check-ins. She then discussed emerging issues they are seeing which include lack of individual therapy for adolescents, as well as substance abuse recovery support. Lastly, she discussed that they will continue to see the use of telemedicine for providing therapy services and that this method is sometimes preferred by the patient. Mr. Pickering from the Community Foundation addressed the group and asked if there was a financial report included with today’s presentation and would like a breakdown of the cost per patient and if the cost of the program is in line with the proposed budget. Ms. Bolden provided a handout and Mr. Fuller spoke to the same. Mr. Fuller explained that at their last report in June the program has a deficit of $19,000, however, through August their position had improved and they now have a surplus of $15,000. This is representative of the 15 months and they have outperformed their proposed budget. He informed the Trustees that in order to remedy this surplus, they will not be billing the District next month for the September expense.

Senior Resource Association- Liz Bruner, VP of Philanthropy

Ms. Bruner thanked the Trustees and began her presentation by discussing what leadership believes will be strikingly different in the next 5 years. She explained that the baby boomer population is growing in the community and that Indian River County is the 6th oldest county in the country. This means more seniors will be seeking services in the community and SRA will need to be prepared to support those needs with new and expanded services. She believes a community-wide collaborative response will be needed to address this continued need. Next, she discussed that in the last six months the State of Florida made a shift in their database and is utilizing a new data collection system which is showing that waiting lists for services are even larger than previously reported. However, she is hopeful that with this change, it will show that the need is greater in Indian River County and allow them to receive additional Federal funding. Lastly, she discussed the emerging issue of the need for affordable housing, as well as funding for in-home services for seniors.

Substance Awareness Center- Carrie Maynard-Lester, Executive Director

Ms. Lester addressed the board and introduced a few of her board members who joined for today’s presentation which included Judge Nicole Menz, Brenda Bradley, and Wilford Hart. She began her presentation by discussing the importance of their peer support program and the need for those peers to be out engaging the community. She explained that the SAC peers are on-site at United Against Poverty, the Behavioral Health Center, the Source, Camp Haven, and now back at the Indian River County jail which is a key piece of community outreach. That program had been placed on hold due to COVID and she is excited to announce that they are back providing services. She then discussed the importance of Narcan training and discussed some statistics on the use of Narcan within the community. Next, she discussed that the SAC has approved their strategic plan for 2022-2024 and they look forward to working on those initiatives. Additionally, their current office space has proven to be too small to house their current staff and programs, therefore they have acquired a short-term lease for some space at the courthouse building and this has proven to be very beneficial for staff morale. They are working on a more permanent solution regarding office space, but this has been helpful in the interim. Lastly, the Trustees heard from Judge Menz who provided some insight concerning the criminal justice population and how best to treat and support those individuals. She further stated that the fentanyl crisis is here and she is seeing at least one person arrested daily, with possession of the drug. Ms. Bradley addressed the board and thanked the Trustees for their support of the expanded drug testing at Camp Haven, which will be helpful for the men to remain accountable through their transition back into society.

New Business- Approval of Resolution 2022-03- Jennifer Peshke, Esq.

Ms. Peshke stated that before the board is a Resolution to approve the First Amendment to the Amended and Restated Lease, Amendment to Memorandum of Lease and the First Amendment to Declaration of Easements, Covenants, Conditions and Restrictions. She explained that she provided the Trustees a summary of this item and the same was discussed at yesterday’s Chairman’s meeting. Therefore, she asked for a motion to approve Resolution 2022-03, which was made by Mrs. Cunningham and seconded by Ms. Bodnar. The motion carried unanimously.

Public Comment/Adjourn

Dr. David Griffin addressed the board and indicated he has been a physician in Indian River County for many years, and is a board-certified orthopedic surgeon who had his own private practice and held hospital privileges at Indian River Medical Center. He has come before the board today as a messenger concerning the many complaints and concerns that have been brought to him concerning Cleveland Clinic Indian River Hospital. At this point, he does not feel comfortable recommending CCIRH to patients and would like the District to address some of these concerns that are being brought forth regarding patient care and physician turn over. Ms. Cunningham invited him to have a conversation with her and Dr. Rosecrance to address his concerns, outside of a public forum.

There was no further public comment and the meeting was adjourned at 6:30 PM