Jul 21 FY 23-24 Budget Request Presentation Meeting- June 6, 2023
FY 23-24 BUDGET REQUEST PRESENTATION MEETING
Indian River County Hospital District Conference Room/ Zoom
June 6, 2023
TRUSTEES: Marybeth Cunningham Barbara Bodnar
Karen Deigl Michael Kint
Paul Westcott Kerry Bartlett
STAFF: Jennifer Frederick Kate Voss
Ann Marie Suriano
Jennifer Peshke, Esq. (via Zoom)
ZOOM: Marie Andress Kim Jeansonne
ATTENDEES: Latoya Bullard Chuck Cunningham
Marty Mercado Stephanie Rennolds
Andrew Welter-Frost Liz Bahl
Barbra Hammond Heather Moxley
Convene Meeting – Marybeth Cunningham, Chairwoman
Mrs. Cunningham convened the budget request presentation meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person.
FY 23-24 Budget Request Presentations
Miss B’s Learning Bee’s- Latoya Bullard, Executive Director
Ms. Bullard addressed the board and thanked them for the opportunity to bring forth this funding request. She provided a brief overview of Miss B’s mission which is to assist children and families from high poverty communities in IRC by providing access to academic support and behavioral services designed to help students reach and maintain proficiency in reading and math. She began by reviewing the objectives of Project COAEP (“Community Outreach Academic Enrichment Program”) and stated that the program is designed to support access to programs and services that strengthen primary care, behavioral health and prevention. Additionally, they aim to decrease the number of students displaying behaviors that prevent learning from occurring in the classroom. Next, she reviewed some goals for the program which included educating and informing staff and parents of the impact and effects of Adverse Childhood Experiences (“ACE’s”) and increase access for families in Indian River County to Applied Behavioral Analysis. She then reviewed data concerning the percentage of students who were proficient in math and reading, and made learning gains since 2019. Next, she provided a review of the funding request and how it would be implemented at the center. The total request for funding was $50,000 and would support the following services. She explained that students are provided with a Functional Behavioral Analysis (FBA) to determine the nature of the behavior. Once the functions of the behavior have been identified, an intervention is created to increase or decrease the behavior. The intervention continues until the behavior has been generalized in all settings. In the group setting, all components are the same, but it occurs on the level of the entire group. The goal of both services is to increase behaviors that are conducive to learning and help students become proficient learners. Behaviors are encouraged or minimized using positive and negative reinforcement. The services are provided by their Behavioral Team. The Team consists of a Supervising Behavior Analyst, Behavior Analyst, Teachers, and Drivers. The Supervising Behavior Analyst oversees the Board-Certified Behavior Analyst (BCBA), the development and implementation of Functional Behavioral Analysis, and Behavioral Assessment. They ensure the BCBA and all other staff members are in compliance with the Behavior Analyst Certification Board. The Board-Certified Behavioral Analyst/ Behavior Analyst is responsible for implementing assessments, completing direct observations, interviews for indirect assessment, and staffing. Teachers are responsible for implementing interventions, collecting data, and completing indirect assessments of student behavior. She further explained that the services would be offered Monday-Friday 8am- 6 pm and Saturday, 8am-2pm, and that all employees would be full time to meet the needs of the community. There was Trustee discussion and it was pointed out that 50% of the funding request was to support administrative costs. They also questioned whether she already had staff in place to implement this program. Ms. Bullard explained that she has applied for a transportation grant which she is hopeful will offset some of the administrative costs. Additionally, they have identified a Board-Certified Behavior Analyst to provide these services, and they are willing to assume the role if funding is secured.
Hope for Families Center- Marty Mercado, Executive Director
Ms. Mercado addressed the board and stated that Hope for Families continues to expand to meet the ever increasing demand for homeless services. The total request for funding is $58,133 which is an increase of $15,993 from fiscal year 22-23. She discussed the funding request and stated that District funds will be applied to an existing program which supports the role of the he Patient Navigator, which is a part-time position whose duties includes the reviewing of health records of adults and children and refers them to community services and resources. These referrals are primarily physical, mental and behavioral health. In this role, the Patient Navigator helps clients to connect to primary care providers and helps them with their overall health awareness to support sustainability within the family unit. The request also includes funding to support a driver who is available at all times, to transport residents to and from medical appointments as needed. This is important especially for those who do not have their own means of transportation and where public transportation does not fit within their appointment schedule. Additionally, this request includes and new to the Hope for Families (“HFC”) case management team, a position of Intake Case Manager. This position conducts interviews and assessments of potential new clients on the waitlist which averages between 80 to 100 families at this time. The Intake Case Manager will interview potential residents to see what possible social services are needed. This position will assess if mental health services, medical or other resources are needed while the family is in their current homeless state. Families on the waitlist must qualify for HFC services to work with the Intake Case Manager which includes a family unit with minors, and must not have a violent felony background or have a sexual offense record. Also, a small percentage of the request covers overall supervision of the program by the Director of Case Management and the Executive Director as well as the purchasing of needed supplies and equipment specific to the administration of the program. She further explained that the Intake Case Manager is also a peer who has past experience with homelessness and provides a better understanding of the struggles their clients are facing. Ms. Mercado stated that with the addition of this case manager they have been able to reduce their waitlist of families down to 60, when it was originally over 100. Also, the role of Intake Case Manager allows them to collect additional data to track chronic homelessness and identify causes as to why some individuals are choosing to remain in this lifestyle. Next, she discussed HFC Collaborative Partnerships and stated that the Patient Navigator works closely with partners from the moment they are admitted to the program and throughout their residency and upon graduation to ensure a smooth transition as residents become sustainable. The collaborative partnerships are with United Against Poverty, Treasure Coast Community Health, New Horizons, Suncoast Mental Health, Whole Family Health, Tykes & Teens and Mental Health Collaborative. They also utilize the services of the New Horizons Crisis Mobile Unit, which can be available within the hour of their call and to deescalate a mental health situation and provide immediate support for the families at HFC. Lastly, she discussed their data collection and key performance indicators, and stated that HFC is constantly working to improve their data collection to provide better reporting of outcome measures, in order to substantiate the need for their services in the community.
The Learning Alliance- Liz Bahl, COO
Ms. Bahl discussed the mission and vision of the Learning Alliance and stated that they are dedicated to uniting the community and building support for children age birth through 3rd grade. As an alliance, they are a collective group of community members, educators, families and investors working towards their goal of having 90% of the county’s children reading on grade level by the end of third grade. She stated that their organization is continuing to focus their efforts on supporting the behavioral and mental health of the children they work with, so that they are able to reach milestones in academics. Next, she reviewed the organizations funding landscape and stated that their current budget is approximately $4.5 million of which 90% is supported by philanthropy which through COVID, they realize is unsustainable. Also, through COVID their budget increased by 33% and the organization is now looking to have more diverse and sustainable funding resources in place. It was further discussed that the organization also receive funding from CSAC. She then provided a review of the funding request which is to support the Prevention Intervention Coach who provides direct support to school leaders, teachers, staff, and parents with essential programming, including coaching, professional development, and best-practice strategies to support their students’ developmental growth. The total request for the program is $125,000 and they believe aligns with the District strategic priority of focusing efforts and investments on programs that strengthen primary care, behavioral/mental health and prevention. She then reviewed some statistics showing the need for these services, specifically within Indian River County. She then introduced Randee Bok, who currently serves in the role of Prevention Intervention Coach. Ms. Bok provided the Trustees with her education credentials and discussed her teaching practices. She also provided educational handouts to the Trustees to gain better understanding of how her teachings are implemented. There was Trustee discussion surrounding the request and the breakdown of expenses provided. Some Trustees questioned whether the District has previously supported funding for travel expenses, which is included in this request relative to the cost of Ms. Bok’s travel from one school to another.
Sunshine Physical Therapy Center- Ginny Blossom, Interim Executive Director
Ms. Blossom addressed the board and stated that Sunshine Physical Therapy Center (“SPTC”) has been undergoing organization change over the last year, and has stepped in as Interim Executive Director after Mary Silva resigned in March. She indicated that there was fear that the organization would have to cease operations due to lack of revenue and virtually no fundraising efforts from the board. She thanked the Trustees for their financial support over the last 6 months and stated that due to this funding they have been able to continue to assist Medicaid and uninsured patients. Ms. Blossom then discussed future plans to secure sustainability for the organization which includes securing additional community support through fundraising and strengthening their board governance. She then discussed the funding request which totaled $300,000, which was an increase of $150,000 from the previous fiscal year. She stated that the funds will be utilized to support therapeutic services provided to adults and children who would otherwise not receive services, due to insurance or financial constraints. She explained that this support is even more critical with rising inflation, employees and prospective employees demanding higher wages and better benefits, and Medicare and Medicaid reimbursement rates not increasing but declining by 2% this year. Additionally, approximately 36% of therapy visits at their facility requires them to seek financial support due to the patient’s financial situation or insurance constraints. The District funds will also help SPTC maintain and even increase the number of patients served. Further she explained that SPTC is the only non-profit organization in the county that provides therapeutic services, and most other facilities either do not accept Medicaid or ATA plans or significantly limit the number of such patients due to the excessive paperwork and low reimbursement rate that does not cover the cost of providing the service. There was Trustee discussion and many questioned how the organization was working to strengthen their Board of Directors and become more sustainable long term. There was also discussion surrounding how their performance outcomes were measured and tracked, along with their KPI’s. Ms. Blossom stated that she has been working with Ms. Frederick to provide the District with the data they are requesting and will continue to provide updated data and outcomes, that reflect the progress and improvements of the patients they are serving. She further explained that some of the therapy provided is ongoing and measured improvements may be recorded differently than other forms of treatment.
Ms. Cunningham informed the board that she and Ms. Suriano met with Dr. Peter and Dr. Delaney from CCIRH. The purpose of this meeting was to convey the concerns of the District, the position of the Trustees and discuss the issues which they feel the hospital should be addressing, and how the District could better help support CCIRH. Through their discussion Ms. Cunningham also reiterated how it was important for CCIRH and its representatives to communicate with the public their struggles and successes, instead of remaining quiet. She further stated that until they address the Trustees directly, there will remain a sense of discomfort. Therefore, she invited both Dr. Peter and Dr. Delany to address the board which she is hopeful will take place in July. Mr. Westcott stated that he believes the Districts Special Act provides the District with the right and obligation to hold CCIRH accountable and is hopeful that they will be more transparent and collaborative moving forward, otherwise he believes there may need to be further intervention from the District. There was also Trustee discussion concerning the CCIRH commitment and integrity committee which Ms. Deigl sits as a representative. The Trustees would like further clarification on the roles and reporting requirements of that committee
Next, Ms. Cunningham stated that Ms. Bartlett submitted some recommended changes to the Finance Committee and investment policy and procedure documents. There was Trustee discussion surrounding her recommended changes, and Ms. Suriano indicated that she would update the document to reflect the agreed upon changes from today’s discussion. The updated documents and subsequent resolution approving the same would be included with the materials at the June 15th regular monthly meeting.
Public Comment & Adjourn
Mrs. Cunningham asked for public comment and there was none. The meeting was adjourned at 12:15 PM.