Chairman’s Meeting: April 19, 2023

Chairman’s Meeting: April 19, 2023

Indian River County Hospital District Conference Room/ Zoom
April 19, 2023

TRUSTEES: Marybeth Cunningham Barb Bodnar
Michael Kint Paul Westcott
William Cooney, M.D. Karen Deigl
Kerry Bartlett

ZOOM: Allen Jones Ann Marie McCrystal
Chriss Papyannis Robin Curby
Lundy Fields Marie Andress
Anne Posey Elizabeth Adams
Vicki Soule

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

ATTENDEES: Jad Shalhoub Cecelia Stalnaker

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person.

Presentation on CareFlo- Jad Shalhoub, President Careflo

Mr. Shalhoub addressed the board and discussed his proposal for CareFlo, which he designed to assist the District in accomplishing its 2022 strategic plan by using data analytics, empirical methods, and general healthcare management strategies. He referenced the Districts vision statement which states that the District’s vision is an innovative and integrated healthcare network that improves the health of Indian River County residents. He discussed that current modern data-analytics and initiatives help support an innovative approach to reaching goals and objectives, which the District should be utilizing to assist in . Next, he discussed a continuous improvement model which he created and was made up of five areas that include define, measure, analyze, improve and control, or (“DMAIC”). He reviewed each step to the process of this model which began with defining the challenge. He believes the biggest challenge the District is facing is an increase in population which is creating a demand for additional primary care physicians (“PCP”). This is also a national trend and he reviewed data concerning the same. The next step would be measure and analyze how many PCPs are available in Indian River County, and forecast what the increased need would be. This analysis would better support the Districts understanding of the need and the potential to purse recruitment efforts to obtain additional physicians into the community. This also helps support the Districts action steps of identifying the gaps and convening the community. He stated that this effort would be supported with the creation of an interactive map available on the District website and available to the public. He then discussed the benefits of using simulation and it could be used to project primary care outcomes, and he provided examples of how simulation has worked for other governmental agencies. The next deliverable of the project would be the creation of an indigent care dashboard which would connect all partner agencies and monitor key performance indicators. He compared this dashboard to the Districts current financial assistance database and the process of reviewing invoices for the fee-for-service billed funded agencies, and showed how the indigent care dashboard would improve the overall process. He then discussed the benefits of using data analytics and provided examples of other health care entities using this method, which included the Health Care District of Palm Beach. Lastly, he reviewed the deliverables, cost and terms for the project. There was Trustee discussion and they thanked Mr. Shalhoub for his time and efforts. The Trustees agreed this was a great deal of information provided and some what difficult to fully comprehend in this time frame, to make any decision about moving forward with engaging in his services. The Trustees felt that there was value to what he was proposing but agreed that due to staffing transition and budget process currently underway, that it was not the appropriate time to move forward with this process. Dr. Cooney volunteered to have continued discussions with Mr. Shalhoub about this matter, which could be brought back before the Trustees later in the year.

Update on CCIRH Future Use of Parcel C- Jennifer Peshke, Esq.

Ms. Peshke provided the Trustee with an update concerning the Districts property located at 82nd Ave and 12th, which is referred to as Parcel C in the lease agreement between the District and Cleveland Clinic (“CC”). She stated that back in January the Trustees had a discussion on how they may make meaningful use of the parcel, to better support the healthcare needs of the community. The discussion resulted in a unanimous motion by the board directing Ms. Peshke to draft correspondence to the hospital requesting that the property be voluntarily released from the existing lease, so that it may be better utilized by the District. On March 7th the hospital sent correspondence responding to the request and indicated that were not willing to release the parcel but would be open to meet with the Trustees to discuss future plans for the property. Mrs. Peshke explained that Section 22 in the lease provides the authority for the sale of the leased premises. The conditions of sale include required notice which gives CC right of first refusal and payments to CC for any capital improvements. She further explained that the right of first refusal in Section 22.2 would be triggered if during the lease term, the District as Lessor, wanted to directly or indirectly sell, transfer, or assign all or any part of its interest in all or any portion of the Premises or any Adjacent Parcel. Therefore, legally the District could not sell it or assign or transfer it to anyone else or any other entity without giving prior notice per section 22.2, which triggers the right of first refusal. There was Trustee discussion and they determined that it is important to identify what the bigger picture use of this property would be and if its location was the right place for its intended use. Ms. Cunningham stated that she spoke with Conor Delaney, who is the President of CC Florida region. He indicated that CC does wish to utilize the parcel for hospital operations in the future but due to their current financial position are unable to commit any funds into a further development project for the parcel. There was further Trustee discussion about historical perspectives of what the original intended use for the property has been and potential future use to house a new hospital or residential detox and substance abuse treatment center. Ms. Peshke offered to set a meeting with representatives from CC to discuss this matter further. Ms. Cunningham stated that she did not feel a meeting would be productive as they have provided their response concerning their use of the parcel and have no further plans to move forward with any additional capital expense or projects at this time. Therefore, it was determined that this matter would be placed on hold until the Trustees could determine how best to utilize the parcel, which may be developed through further strategic planning initiatives.

Other Business- Personnel Update & Discussion- Marybeth Cunningham, Chair

Ms. Cunningham stated that at the at the special meeting of the board of Trustees on April 6th, the board voted in approval to move forward with the process of hiring an HR recruiter to facilitate the hiring of a new Executive Director. Therefore Ms. Cunningham signed the contact to hire Laurie Huebner, and the process is moving forward. She explained that their initial discussion she reiterated to Ms. Huebner the importance of each Trustees participation in this process, which Ms. Huebner assured her would happen. It was further discussed that Ms. Bartlett has sent a memo to the Trustees included in today’s meeting materials, with her recommendations for this process and the creation of a Succession Policy relative to replacing the Executive Director (“ED”). She also would like to have further discussion surrounding the Executive Director’s job descriptions. She stated that she has concerns that the current process is being rushed and feels the Trustees should take more time to evaluate who would be conducting the search for a new ED. Ms. Cunningham stated that she agrees that there should be further discussion surrounding the job description but is not in favor of the recommendation Ms. Bartlett set forth, which would lengthen the process of hiring a new ED. There was further Trustee discussion and most agreed that they should continue with the process outlined by Ms. Huebner, as this is a time sensitive matter. However, they did agree that further discussion surrounding the job description should take place and that a succession policy should be created. Therefore, the Trustees agreed to have these discussions at the next special meeting scheduled for May 4th. In the meantime, Ms. Cunningham stated that Ms. Huebner will be reaching out to each Trustee individually to discuss the process and listen to any concerns they may have about moving forward. Ms. Cunningham also informed the board that Ms. Suriano’s last day as a full-time employee in the office would be July 31st. This will allow her to be available through the initial budget process and approval of the tentative budget at the July regular monthly meeting.

Dr. Cooney stated that he would like to make some changes to the language in the strategic plan and Mr. Kint stated he a had a few changes as well. Ms. Cunningham agreed to place this matter on the agenda at next month’s Chairman’s meeting, so there can be discussion and a vote made.

Mr. Kint stated that he, Mr. Westcott, Ms. Cunningham and Ms. Suriano all attended the Moonshot Leader Literacy Summit on April 13th. He referenced a statistic discussed concerning students’ absentee rates, which shows that over 50% of students are absent 10 or more days out of the school year. It was explained that 8% of this figure is due to health-related issues. Ms. Cunningham thanked Mr. Kint for bringing this matter to the attention of the board and suggested that the District’s strategic plan have an initiative that addresses children’s health which would also support the Moonshot Moment. Mr. Westcott stated that another item discussed at the summit was the map of zip codes which showed health mortality inadequacies and he would like to have access to data which further addresses this, and how community entities could work more collaboratively to address this issue.

Public Comment & Adjourn-

Mrs. McCrystal stated that the board should consider hiring an interim executive director, who will be able to step in, should Ms. Suriano have to leave before her anticipated departure. This could be a current board of Trustee or community member. The meeting was adjourned at 12:00 PM