FY 23-24 Budget Request Presentation/Chairman’s Meeting: May 17, 2023

FY 23-24 Budget Request Presentation/Chairman’s Meeting: May 17, 2023

Indian River County Hospital District Conference Room/ Zoom
May 17, 2023

TRUSTEES: Marybeth Cunningham Barb Bodnar
Michael Kint Paul Westcott
Kerry Bartlett
William Cooney, M.D. (zoom)

ABSENT: Karen Deigl

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

ATTENDEES: Ann Marie McCrystal Pat Knipper
Bill Stengel William Stewart, Esq.
Jennifer Jones Chuck Mackett, M.D.
Dawn Redstone Vicki Soule
Carol Kanerak

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.

VNA’s Notice of Exercise of Option to Purchase- Jennifer Peshke, Esq.

Ms. Peshke addressed the board and stated that on May 9, 2023, the Visiting Nurse Association & Hospice Foundation, Inc. (“VNA”) provided the District with formal notice of its election to exercise the option to purchase the hospice house parcel, that was granted to the VNA in the Amended and Restated Lease Agreement dated April 14th, 2021. The purpose of todays discussion is to review the options the District has with regard to the notice and that no formal decisions will be made at today’s meeting. She also informed the Trustees that the VNA will be providing a presentation to the board concerning their intentions for the parcel, next month at the Chairman’s meeting. She then discussed the options moving forward and stated that in accordance with the terms of the Special Act, and in order for the District to possess the authority necessary to sell the leased premises to the VNA, the District must first determine, by board resolution, that the leased premises is no longer useful to the District and is surplus property. It was further discussed that the District is in a long term lease with the VNA concerning the parcel, which essentially ties up any future use the District may have for the property. The parcel also has many deed restrictions which also may potentially limit its future utilization for the District. It was also discussed how CCIRH also has right of first refusal for the parcel but that it is secondary to the VNA. Ms. Cunningham encouraged the Trustees to consider this matter and follow up with Ms. Peshke should they have any questions, so they are prepared for the presentation from the VNA next month, and subsequent vote.

Discussion on Updated Executive Director Job Description & Process- Marybeth Cunningham, Chair

Ms. Cunningham stated that based on the discussions at the last board meeting, the updated Executive Director job description has been circulated to the Trustees for their review. Due to the fact that this process will take time, she would like the Trustees to vote on approval of the job description at today’s meeting, so that Ms. Huebner can move forward with posting the same. There was Trustee discussion and it was discovered that there was a typo on the last page. Additionally, it was suggested that an additional bullet be added under the qualification section which addressed the need for experience in leadership through organizational change. There was Trustee discussion and they were pleased with the updates to the document and felt it captured all of the required qualifications. Therefore, Ms. Cunningham asked for a motion to approve the job description with the additional changes. The motion was made by Mr. Westcott and seconded by Ms. Bodnar, which carried unanimously. Next there was discussion about the interview process and the manner in which each candidate will be considered. There was also discussion surrounding the idea of implementing a deadline to receive the applications. Some Trustees felt that some of these unanswered questions would be resolved as they work through the process. Additionally. Ms. Cunningham stated that Ms. Huebner spoke at length with representatives from the county about their process of hiring the new County Administrator and believes that she was provided with useful and helpful information relevant to this process.

FY 23-24 Budget Request for Funding Presentation
We Care- Jennifer Jones, Executive Director

Ms. Jones address the board and stated that she joined We Care in September 2022, and discussed the changes that have taken place within the organization since Dr. Saver’s passing. She explained that they have ended their partnership with the Health Department and are now working with TCCH, which has been a very positive experience. They are currently utilizing space at the TCCH location within the 787 building, and also have been able to utilize some of their staff for further support. They also have been working collaboratively with CCIRH and WFHC. Currently We Care has 45 volunteer physicians, and offers referrals to 25 different specialty service areas. Currently their biggest area of need is for ophthalmology services and have provided 150 ophthalmological procedures since July 2022. Therefore, the funding request before the District is to offset the cost of their ophthalmology services, as well as a part time staff person to help assist with clinics, referral follow ups, qualifying patients and internal record keeping. She also discussed their transition of keeping and tracking patient records and data and stated that the process had to be created from scratch due to the Health Department being uncooperative in providing patient records and data. Their long-term goal is to have their own electronic health records system and have been working with TCCH to track patients’ data and health records. There was Trustee discussion and many felt that a key factor in funding We Care would be for them to have stronger key performance indicators and data supporting the measured progress towards their intended outcomes. Ms. Jones mentioned that she continues to work with Ms. Frederick on developing strong KPI’s and outcome measurers and believes she will be able to provide the Trustees with the data. The total request for funding is $47,800 and Ms. Jones reviewed the breakdown of costs associated with the request which includes supplies, administrative and operating expenses.

Senior Collaborative of IR- Dawn Redstone, Executive Director

Ms. Redstone addressed the board and explained that she assumed the position of Executive Director at the beginning on May. She provided a brief history of Senior Collaborative and stated that the agency has been operating for the last five years with the purpose of helping to improve the qualify of life for the aging and assisting their caregivers and families in making informed decisions about senior services available in Indian River County. Ms. Redstone stated that their funding request of $30,000 is to support the UPSLIDE program which is an acronym for Utilizing and Promotion Social Engagement for Loneliness Isolation and Depression. She explained that this is a program based out of Tallahassee and Senior Collaborative has formed a coalition to provide this program in Indian River County. The program provides an initial screening for loneliness which determines where the client falls on the loneliness scale. There is also individual counseling available to help improve relationship skills, and in person weekly group activities and social engagement support. All services are free to clients and they are working with various collaborative partners such as Senior Resource Association and TCCH to help provide these services. Next there was discussion surrounding how they track their outcome measures and it was explained that overall evaluation plan data will be collected on an ongoing basis and clients will be screened every 6 months. Counseling and friend groups data will also be collected and reviewed every six months. Additionally, they will be tracking the number and percentage of clients who report feeling less isolated, more socially active and have improved health and happiness in the isolation assessment scores. There was Trustee discussion including what their long-term financial stability goals were for the organization to continue its mission. Ms. Soule addressed the group and stated that they are working to add additional board members with strong fundraising backgrounds to the organization. Additionally, their annual Senior Expo was a success this year and they intend on increasing vendor costs to add additional revenues.

Other Business-

Ms. Bodnar stated that in many of their semi-annual reports, the funded agencies are reporting on their struggles to recruit or hire staff, and she recommended that they look into hiring students from Indian River State College. She explained that the college has many different bachelor programs with opportunities for internships which could lead to permanent placement.

Dr. Cooney asked for clarification on the process of approving the FY 23-24 funding requests. It was explained that a tentative budget will be prepared with all the requests for consideration by the Trustees. The Trustees have also been provided a binder with all the request summaries for review and a grading matrix has been created and included. There will be a subsequent meeting where the Trustees will convene to discuss the requests and have any follow up questions answered. In July, a tentative budget will be approved. Next Dr. Cooney asked for follow up concerning the questions that were submitted to Dr. Peter at CCIRH. He is disappointed to hear that Dr. Peter will not be addressing the Trustees this month at the regular meeting and questioned why he choose not to come before the board. Ms. Suriano stated that she spoke with Dr. Peter a few days ago and he explained that as interim CEO/President at CCIRH, he must first have approval from Cleveland Clinic Ohio before providing responses to questions concerning operational matters at CCIRH. Dr. Peter fully intends on working with the District moving forward but must first go through the proper channels and protocols. Additionally, Ms. Suriano and Ms. Cunningham have a meeting scheduled with Conor Delany, the head of Cleveland Clinic Florida, to address some of these concerns and will provide the Trustees with further information when it becomes available.

Mr. Westcott addressed the group and also expressed his dissatisfaction with the fact that Dr. Peter was unable to come before the board. He also stated that he had requested an individual meeting with Dr. Peter, but was told it would be a few months before they could meet. He believes CCIRH needs to have better transparency and communication with the public and is hopeful that they will work with the District more collaboratively moving forward. He further stated that he plans to speak more on this matter at tomorrow’s regular monthly meeting.

Ms. Suriano informed the group that County Attorney Dylan Reingold provided her with a draft memo regarding the opioid settlement funds agreement, which included a section which referenced input from the District. She stated that while the Trustees haven’t had any formal discussion about the disbursements of the funds, she would like them to consider the recommendation that has been brought before the Board of County Commissioners. She explained that the county is set to receive roughly $438,000 in settlement funds over the next year and Mr. Reingold is recommending that the proceeds from the opioid settlements be used to support alternative court programs, such as mental health court and drug court. Additionally, Mr. Reingold and Commissioner Daryl Loar met with Judge Cox, Judge Menz and Judge Stone, and the judges recommend using the proceeds on assessment, treatment, testing and wrap around services, such as housing and transportation. Further, The Mental Health Court has submitted a funding request for FY 2023-24 to the District, and any amount of the opioid settlement proceeds directed to the mental health court should directly offset the local tax dollars necessary to support these services. Therefore, she asked for approval from the Trustees of this recommendation and Mr. Westcott made a motion to approve the recommendation as discussed, which was seconded by Ms. Cunningham. The motion carried unanimously.

Public Comment & Adjourn-

Mrs. McCrystal addressed the board and stated that the process for interviewing the Executive Director candidates should be well planned and structured so they do not lose interest from potential candidates. She also voiced her disappointment to learn that Dr. Peter would not be addressing the Trustee this month at the regular monthly meeting. The meeting was adjourned at 12:00 PM.