Feb 17 Regular Monthly Meeting: January 19, 2023
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
January 19, 2023 @ 4:00 PM
TRUSTEES: Barb Bodnar Karen Deigl (via Zoom)
Marybeth Cunningham Paul Westcott
Michael Kint William Cooney, M.D.
ABSENT: Kerry Bartlett
STAFF: Kate Voss Jennifer Frederick
Ann Marie Suriano Dawn Carboni
Jennifer Peshke, Esq. (via Zoom)
ZOOM: Anne Posey Marie Andress
William Wims Cecelia Stalnaker
ATTENDEES: Lundy Fields Ann Marie McCrystal
Heather Roberts Angela Guzenski
Philip Cromer Matt Reiser
Allen Jones Gerri Smith
Wilfred Hart Pat Knipper
Convene Meeting, Invocation & Pledge– Marybeth Cunningham, Chair
Ms. Cunningham convened the regular monthly meeting of the IRCHD at 4:00 PM. Reverend Graham Bingham of the Westminster Presbyterian Church provided the invocation and Ms. Cunningham led the group in the Pledge of Allegiance.
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 Chairman, Treasurer, Secretary, and Assistant Secretary. Each office will be elected by calling for a nomination, and a second. She asked that a nomination for the Chairman, begin the process.
Mr. Kint nominated Ms. Cunningham as Chairman, which was seconded by Mr. Westcott. The motion carried unanimously.
Dr. Cooney nominated Ms. Bartlett as Vice Chairman, which was seconded by Ms. Deigl. The motion carried unanimously.
Ms. Deigl nominated Ms. Bodnar as Secretary, which was seconded by Ms. Cunningham. The motion carried unanimously.
Ms. Cunningham nominated Ms. Deigl as Assistant Secretary, which was seconded by Mr. Westcott. The motion carried unanimously.
Ms. Bodnar nominated Mr. Kint as Treasurer, which was seconded by Mr. Westcott. The motion carried unanimously.
Next, she asked the Trustees to confirm their meeting schedule for the upcoming year. After discussion, they agreed 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 at 10:00 AM. All Chairman’s meetings will be held at the District offices in the conference room.
Next Ms. Cunningham asked for a motion to approve the consent agenda and a January disbursement of $1,074,720.63. Ms. Bodnar made the motion which was seconded by Dr. Cooney. The motion carried unanimously.
Chairmans Report- Marybeth Cunningham, Chair
Ms. Cunningham began by officially welcoming the three new Trustees to the board. She stated that yesterday’s Chairman’s meeting was very productive and feels that this will be a successful group of Trustees.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshke stated that she has responded to questions from Trustees as they have arisen pertaining to various matters the District is handling. She continues to review the annual deadlines and deliverables due to the District under the Lease with Cleveland Clinic Indian River Hospital (“CCIRH”) and has responded with questions as they arise. She is also actively following the current legislative session for bills related to Hospital Districts, specifically to the sunshine law and public records act and will bring forth information when necessary. Further, the District is still on hold but continues to monitor how a potential county ordinance change regarding stormwater retention may impact the IRC floodplain and stormwater code changes as it relates to the hospital campus property. She has been actively working this past month on new Trustee orientation. She has also been working to cancel the bonds for the outgoing Trustees no longer on the board, bonding Trustees that are new to the board, and ensuring that Trustees continuing on with new terms have continued bonds. Lastly, the District received the VNA’s notice to vacate the Human Services Building (“HSB”) which they currently lease and she has met with their counsel to discuss next steps. She has also sent correspondence to Cleveland Clinic’s counsel and received a response that they are interested in entering into discussions regarding the future use of the HSB.
Financial Statement Review- Ann Marie Suriano, Executive Director
Ms. Suriano provided the financial statement review and stated that the District has received almost all of its tax revenue for the fiscal year. Additionally, the District began its ladder investment portfolio with DeepBlue investments, and they purchased, on behalf of the District, $8.75 million in T bills and notes that will mature on a monthly basis prior to the District disbursements. Those funds will be utilized to support District monthly operations. Prior to the ladder investment, the District also purchased bills in the amount of $5.75 million and all will provide positive interest returns of over $425,000 in 2023. Dr. Cooney asked for clarification on the Districts relationship with DeepBlue investments. Ms. Suriano explained that DeepBlue, formally known as WaterWalker, was recommended by the Florida Association of Special District as a preferred investment firm. The District began investing its surplus funds with the firm a few years ago and have had a successful relationship with them. Mr. Kint asked for clarification on the funding structure with GlobeChek as he does not see a specific budget line item for them in the District approved FY 22-23 budget. Ms. Suriano explained that initially the District funded a pilot program with GlobeChek last fiscal year. Since the pilot program was successful, they are now working collaboratively with WHFC and TCCH to continue to provide services through the Globe, however, the funding request was still in negotiations prior to the approval of the Districts FY 22-23 and unable to be included within the final budget. Therefore, the program is being supported with reserve funds but is still allocated each month on the financial statement under community support.
Executive Director Report- Ann Marie Suriano, Executive Director
Ms. Suriano stated that her full written report was included with the meeting packet and will touch on a few highlights. First, she convened a meeting with representatives from Whole Family Health Center (“WFHC”), Treasure Coast Community Health (“TCCH”) and GlobeChek to discuss some challenges that each organization is facing with the new GlobeChek program. All parties are working to move forward and she will provide an update to the Trustee when more information is available. Additionally, the Indian River County Chamber of Commerce is holding a business after hours event at the Gifford Health Center on January 25th. She encouraged all the Trustees to attend, to see all the positive changes and updates that TCCH has done to the center.
Funded Agency Semi Annual Report
Senior Collaborative- Randy Riley, Executive Director
Mr. Riley provided an update to the Trustees and announced that he will officially retire on May 1. He Stated that the executive committee of the Senior Collaborative has hired Dawn Redstone as his replacement, and she has been working with him through this transition. He then provided a review of the financials and stated that they are in a good position with cash reserves starting the calendar year equaling six months of current operations. One challenge financially was to raise $21,000 in 2023 to meet budget. This will be done through additional grants, fundraising campaigns or events. Next, he discussed a new initiative they are working on to combat isolation for seniors, which has been identified as item through their action plan. The program, originally founded by the Tallahassee Senior Center Foundation, is called UpSlide and has won several awards since its inception. This program will be offered as a collaborative effort with TCCH, The Mental Health Collaborative, and St. Mark’s Anglican Church. There was further discussion surrounding this issue and the elements of the program and how they combat the isolation. Mr. Riley further stated that they are also working collaboratively with Senior Resource Association to provide transportation to the seniors for this program.
Mental Health Association- Philip Cromer, CEO. & Angela Guzenski, COO
Dr. Cromer addressed the board and offered to meet with any of the new Trustees should they wish to tour the MHA facility or have questions about the organization. Ms. Guzenski provided a review of their written report and began by discussing data concerning the Walk in Center. She explained that volumes had decreased due to varying factors such as closures from the two hurricanes and the holiday season. However, they are beginning to see a slight increase at the start of the year. She then discussed overall billings to the Hospital District, which have decreased over 22% over the last two years. This is also due to varying factors such as patient opting to enroll in Marketplace Insurance plans, or obtaining additional employment to meet the demands of inflation, which puts them over the District income guidelines. She has been discussing these varying issues with Ms. Frederick and would like to work with the District to be able to access more of the District funding, to support those patient services. Ms. Cunningham expressed her concern with the decreased utilization in funding and asked that Ms. Guzenski work with District staff to bring forth a proposal so that MHA is able to support those patients and utilize the budgeted funding. Next there was a review of the Drop-in Center outcomes and High School Violence Prevention Program. Dr. Cromer addressed the board and spoke of the challenges that have arisen since the implementation of the Parents Rights Bill. He explained that they are finding it more difficult to provide services to students, due to the new requirement for parental consent. There was Trustee discussion and some felt that this was an unintended consequence of Representative Grall’s goal in developing the bill. Dr. Cromer stated that they are meeting with the school district next week to formulate an action plan and better understand the requirements of the bill, in order to effectively meet the requirements but also make sure students are being provided the mental health services that are needed. Additionally, Dr. Cromer notified the board that starting in July, the funding from Southeast Florida Behavioral Health Network for the mental health court will cease. Currently Dr. Cromer is the psychologist for the mental health court and with the reduction in funding, he will no longer be able to provide his services, along with the services of two peer support staff. The total cost of their services is around $100,000. There was Trustee discussion and many were concerned with the news and asked that District staff follow up with Judge Menz, who is overseeing this program, to request additional information and how the District could help support the continuation of this much needed service.
VNA- Lundy Field, CEO & Patricia Knipper, Senior Director Special Projects
Mr. Fields addressed the board and began by discussing the untimely passing of Kathy Peirce who was the VNA Foundation Board Chair. He asked for a moment of silence to remember her. He then began the presentation by discussing some of the challenges the VNA has been experiencing over the last year, along with some upcoming changes at the organization. He explained that staffing has been an ongoing issue, specifically the staffing of nurses and they have hired a new VP of Human Resources to take a look at areas where they can improve. Additionally, they are facing challenges with home health reimbursement rates, and he discussed the inconsistencies with being the preferred method of treatment but insurance companies providing low reimbursement payments for the service. Next, he informed the board that the VNA was successful in appealing the case against another agency challenging the VNA’s Certificate of Need for hospice care. The VNA has defended their licenses and while the other agency still has a small window of time to appeal the ruling, their legal counsel does not believe this will be the case. He publicly thanked all parties who testified on the behalf of the VNA to support them through this process. Lastly, he stated that the VNA will be vacating the Human Service Building and their new move out date is May 31st. The organization will now house their operations at the Parc 24 building which will provide a more streamlined work environment for their staff. Ms. Knipper addressed the board and provided a review of the VNA’s written report. She began by discussing the challenges they are experiencing in home care delivery due to a county-wide nursing and caregiver shortage. She also discussed the decrease and subsequent increase in numbers of home health admissions patients, which was primarily due to the referral process from CCIRH. Next, she stated that the VNA’s community music therapy program launched this fall through partnership with the Mental Health Association, Alzheimer’s & Parkinson’s Association and CCIRH Cancer unit. Lastly, she provided an update concerning the VNA Mobile Health Clinic and stated that they continue to see the number of patients who are experiencing challenges with access to same day care, utilizing the clinic. She continues to provide detail reporting to Ms. Frederick concerning the mobile clinic and is available to any Trustee who have additional questions and concerns.
Mr. Westcott addressed the board and stated that as a follow up to yesterday’s discussion concerning the immediate need for detox services in the county, that he would like Ms. Peshke explore and provide direct communication to Cleveland Clinic asking if they would be willing to release the property at 82nd Ave from the current lease agreement. If their answer to that question is no, he would then like to know what would it take to get a yes so, the District could look at future use and plans, specifically to support detox and/or a residential substance abuse treatment center. He stated that with the current lease structure the asset is tied up, and unable to be of current use to the taxpayers. Also, he stated that if Cleveland Clinic wants to release the property, the District could consider selling the property to them. He stated his main objective is to free up the asset, so it may be utilized in the near future, to further the mission of the District. Therefore Mr. Westcott made a motion for Ms. Peshke to direct a letter to Cleveland Clinic leadership over Marybeth’s signature inquiring as to their willingness to release the property out west of town, and if they are unwilling to release it freely, what terms would be agreeable to allow the release. Additionally, he would like them to provide the District with an explanation of their future plans for the property if they are unwilling to release. Dr. Cooney seconded the motion and it passed unanimously.
There was no public comment and the meeting was adjourned at 6:00 PM