Special Meeting: Strategic Planning- April 6, 2023

Special Meeting: Strategic Planning- April 6, 2023

Indian River County Hospital District Conference Room/ Zoom
April 6, 2023

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

ZOOM: William Wims Jad Shalhoub
Jeff Pickering

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

ATTENDEES: Pat Knipper Ann Marie McCrystal

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the special meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person. She stated that the purpose of today’s meeting is to provide a review of the strategic plan and framework and answer any questions the new Trustees may have concerned the document. She introduced Jim Starr from Carter, who helped facilitate the Districts Strategic Planning process back in 2022. Mr. Starr began by discussing the purpose of strategic planning which provides an outline for a clean path and direction for an organization. It also helps to create alignment between activities, funding and outcomes, which are matters relative to the District operations. It also demonstrates impact and accountability which is also important when dealing with taxpayer dollars. He outlined the basis of the strategic plan which is made up of an action plan, strategic priorities, and the mission and vision of the District. Next, he provided a brief historical review of the process which began in October 2021 and was completed in April 2022. He then reviewed the strategic properties and their corresponding key performance indicators, along with the strategic action plan including a timeframe that outlined completion goals for each activity. Lastly, he reviewed the next steps concerning the strategic planning efforts which included sharing the initiative with the community and its stakeholders. He further stated that this plan is meant to be reviewed annually and the key performance indicators and action plan should be updated accordingly. Ms. Cunningham opened up the meeting for Trustee discussion and Mr. Kint addressed some questions concerning the plan, along with some areas of wording on which he would like further clarification. He first discussed the fact that many of the key performance indicators utilized Florida Charts data and he questions whether this was the best data source to be used. It was discussed that Florida Charts publishes its data on a 3-year rolling average and is data collected by the Florida Department of Health (“DOH”). DOH utilizes data from the census to populate their database in Florida Charts. Ms. Carboni and Ms. Frederick indicated the Florida Charts data has historically been used and stated that 2022 data should be available and the outcome measures will be updated accordingly. Next there was discussion about who are the key stakeholders within the community to communicate this plan and its objectives. The Trustees agreed that the stakeholders would be considered government leaders or public officers, along with persons who are responsible for community health and wellness activity. Next Mr. Westcott addressed matters concerning the CCIRH financial assistance policy for indigent care. He was recently provided with information concerning some potential barriers to care within the application process for financial assistance at CCIRH. He believes that the Districts Special Act provides the District with authority to oversee matters at CCIRH, specifically matters concerning indigent care. He would like to have more information regarding the hospitals financial assistance process and policy, to make sure the same is being administered appropriately and there are no glitches within the process that would result in barriers to care. Ms. Cunningham indicated that Dr. Peter from CCIRH has been invited to address the Trustees at the May regular monthly meeting and Ms. Suriano sent communication to the Trustees informing them of the same. She also requested that any Trustees who have concerns or questions about matters at CCIRH, should submit those to Ms. Suriano beforehand, so they can be provided to Dr. Peter and addressed in May. Ms. Suriano stated that to date she has received no responses from the Trustees and Dr. Peter is questioning whether he should attend in May, given that no questions have been provided to him. There was further discussion concerning CCIRH and their public perception within the community concerning various issues that the hospital has been facing. Ms. Suriano reiterated that she would like the Trustees to submit their concerns to her, so that she may pass along the same to Dr. Peter for his appropriate response.

Next Ms. Bartlett reviewed the responses from the provider survey that was sent out to the community stakeholders. The survey provided questions which provided the opportunity for feedback concerning healthcare improvements they would like to see within the community. She explained that they received a 20% response rate, which is relatively good for this type of survey. Ms. Bartlett reviewed areas of concern which included the need to recruit and maintain providers in the community. Additionally, there is a desire for a centralized behavioral health center that would house multiple areas of behavioral health services, including the need for detox services trended high in the responses. Ms. Bartlett feels these responses validate the discussion that the Trustees have been conducting about future needs for the community. It was further discussed that they should utilized and look to the Palm Beach County Health Care District for further guidance and support. There was no further discussion concerning the strategic plan and Ms. Voss indicated that Mr. Jeff Pickering left a public comment in the zoom meeting chat box. He stated that last year during the strategic planning process there were discussion surrounding the legislation passed that required a review of all Special Districts and he recalled there being some fear that some Special Districts may be dissolved. He asked if this was still a threat for the Hospital District. There was Trustee discussion and none of the Trustees felt that the District was under the threat of dissolution. Additionally, Ms. Voss indicated that through her discussion with several firms during the due diligence process to find a firm to conduct the District Performance Audit, some firms disclosed that the reports are being sent up to the state, but no further action has been taken. It was further discussed that the District will continue to take the matter of the Performance Audit seriously and will begin the process in January 2024. Ms. Cunningham stated that her main concern is that local representatives are not supportive of the District and its efforts, and feels that there may be a challenge having their full support. Additionally, Ms. Deigl stated that she will be meeting with a lobbyist in Tallahassee next week regarding another issue and would like to bring this matter froward to them if the board approves. The board was supportive of her offer.

Other Business

Mr. Westcott informed the board that he met with county attorney Dylan Reingold concerning a separate matter but during their discussion Mr. Reingold informed him that on April 4th the commissioners would be discussing the opioid settlement monies allocation. Therefore, he attended the meeting on the 4th and addressed the commissioners and asked them to consider working with the District in allocating those funds throughout the county. The commissioners appointed commissioner Loar to oversee the distribution of the funds and agreed that the District would be considered a stakeholder in this initiative. Mr. Westcott also informed the commissioners that the District is in discussion to support detox and residential treatment services, but nothing has been finalized in those areas yet. There was further discussion surrounding the opioid settlement monies and the allocation of those funds, and how they would be distributed. It was discussed that District staff should follow up with Mr. Reingold to see how they can work collaboratively moving forward.

Ms. Suriano stated that provided in the packet was a budget presentation meeting schedule for the Trustees review. She asked if any Trustees had conflicts with the proposed dates and there was discussion surrounding the days and location of the meetings. There was also discussion surrounding the budget presentation process and if the Trustees would like to keep the same format as last year. Ms. Frederick addressed the board and stated that 26 agencies submitted requests for funding and 5 of those were new agencies, and there are 8 new program requests from currently funded agencies. She reminded the Trustees that typically the budget process is that the Trustees are provided summaries of each request and only new agencies or agencies requesting funding for a new program, are asked to provide a formal presentation. The Trustees agreed to keep the same presentation format and would provide any conflicts with the proposed dates to Ms. Voss.

Next Ms. Cunningham stated that the Trustees received communication concerning Ms. Carboni’s resignation and there was group discussion surrounding the future of that position and how best to move forward with replacing her. Also, there was discussion surrounding how this would affect the audit process and how the process could be continued in her absence. Ms. Suriano stated that she was reviewing the job description for Ms. Carboni’s position and making some updates to the same. She also offered to begin the process of looking to hire a replacement for the position. Next Ms. Cunningham informed the board that Ms. Suriano has announced her retirement and provided correspondence from Ms. Suriano outlining the same. She stated there have been discussions with staff and legal counsel since Ms. Suriano announcement and she would like to ask approval from the board to hire a recruiter to facilitate the process of hiring a replacement Executive Director (“ED”). She explained that Ms. Suriano has agreed to stay at the District on a part time basis and facilitate the transition as needed. She would also still participate in the committees relative to the detox and the sober home facility special project. There was group discussion concerning the transition and Ms. Suriano’s continued involvement with the District. A few Trustees expressed their concerns about hiring a new person to fulfill the role but still have Ms. Suriano presence at the District. It was clarified that Ms. Suriano would not have a presence within the office but rather continue in the same capacity continuing her involvement with the few special project previously mentioned and available to help with any transitional issues with the new ED. His position would be a part time or contacted position on a virtual basis for a period of 6-9 months. It was also recommended that Ms. Carboni’s position not be filled until the new ED is hired. Therefore, Ms. Cunningham made a motion to hire a recruiter to handle matters concerning the hiring of a new ED, which was seconded by Ms. Deigl. The motion carried unanimously. Also Ms. Cunningham stated that she is currently reviewing the ED job description and making some updates that are in line with the strategic plan initiatives. She plans to have District staff distribute the same to the Trustees for their review and feedback. Additionally, she stated that the Trustees can participate in the interview process and Ms. Peshke stated that a committee could be formed as well. There was then discussion surrounding Ms. Carboni’s audit process and how the process could move forward in her absence. It was stated that Ms. Carboni and Ms. Frederick are working together to make sure Ms. Frederick has all the pre-audit questionnaire documents in place for the new agencies that are requesting funding. However, it is yet to be determined how the audit process of reviewing each funded agency will take place moving forward. Ms. Suriano stated that Ms. Carboni created strong procedures and processes for the audit, so whoever is hired will have templates to work from in order to continue the process. Mr. Westcott stated that the Trustees could possibly assist in reviewing documents for the audit and Mr. Kint stated that there may be individuals within the community willing to donate their time to help assist as well.

Public Comment & Adjourn-

Mrs. McCrystal encouraged the Trustees to hire a replacement sooner than later to fill Ms. Carboni’s position. There was no further public comment and meeting was adjourned at 12:00 PM