Oct 23 Regular Monthly Meeting: September 21, 2023
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
September 21, 2023
TRUSTEES: Paul Westcott (via Zoom) Michael Kint
Marybeth Cunningham Kerry Bartlett
Barb Bodnar Karen Deigl
William Cooney, M.D. (via Zoom)
STAFF: Kate Voss Jennifer Frederick
Frank Isele Jennifer Peshke, Esq.
ZOOM: Ann Marie Suriano Barbara Holbrook
ATTENDEES: Linda Kloss Rene Bireley
Elizabeth Appleton Kim Jeansonne
Bill Stengle Carol Kanarek
Kelly Williams Ceclia Stalnaker
Consent Agenda– Marybeth Cunningham, Chair
Ms. Cunningham convened the regular monthly meeting of the IRCHD at 5:15 PM. She asked for a motion to approve the budget discussion meeting minutes dated July 11; chairman’s meeting minutes dated July 19 and August 16; regular monthly meeting minutes dated July 20; special meeting minutes dated July 28; an August disbursement of $946,096.80 and a September disbursement of $1,015,640.40. The motion was made by Ms. Bartlett and seconded by Ms. Bodnar. The motion carried unanimously.
Chairmans Report- Marybeth Cunningham, Chair
Ms. Cunningham thanked the Trustees for their participation during the budget cycle this year, especially the new Trustees who had no prior experience with the process. She is excited to see what this new fiscal year brings and the work that the District will do for the benefit of the community. She also welcomed Mr. Isele and stated that she was glad to have him as a part of the District.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshek provided her report and stated that much of her work this past month has been concerning the sale of the Hospice House parcel and working with the VNA’s legal counsel to evaluate the appraisal reports. After Trustee discussion at the Chairman’s meeting yesterday, the board submitted a counter offer of $3.8 million to the VNA and will be working with their counsel on developing a sale contract. Additionally, she has been working with the board and participated in discussions concerning the future use of the HSB and the Trustees continue to evaluate their options. Ms. Cunningham added that during yesterday’s Chairman’s meeting that the District Trustees agreed to direction concerning the future use of the HSB, which includes discussions with VCOM and their offer to bring a school of medicine to Vero Beach and utilizing some of the building to house a primary care clinic. Lastly, she has met with Mr. Isele in his new role as executive director and will continue to assist when necessary, concerning his onboarding process.
Financial Statement Review- Michael Kint, Treasurer
Mr. Kint stated that after 11 months of the District’s fiscal year, the District has received 99.97% of its tax revenue, net of commissions and uncollectable taxes. He further explained that overall program and administrative expenses are both under budget. Total investments at Deep Blue are $4.6 million and $3.1 million is invested in Treasury Direct Tbills. Mr. Kint informed the board that over the last week there was a $1.25 million Tbill that matured, and he and Mr. Isele agreed to cash the bill in to cover District operating expenses. He explained $600,00 from the bill was transferred into the Seacoast operating account and the rest will remain in the US Bank custodian account. Mr. Cuningham asked for an update concerning the amount of interest the District has received from its investments. Mr. Kint stated that the preferred deposit pool has garnered $127,000 year to date. He further stated that he would like the new finance and audit committee to review the Districts financial policies and procedures, to see if there is need for additional oversight, and evaluate the investment accounts and their returns. He plans to hold the committee’s first meeting, some time in October.
Executive Director Report- Frank Isele, Executive Director
Mr. Isele provided an update concerning the Districts performance review which is now required every five years, governed by the Special District Uniform Accountability Act. He and Ms. Voss are working to finalize the items for submission, and he will keep the Trustees updated as to the progress of this matter. There was Trustee discussion concerning how engaged the Trustees should be during this process and Mr. Westcott asked Ms. Peshke to further analyze this matter. Ms. Voss stated that right now the process is in the data collection stage, and within the next few months a draft report will be developed and will be available for Trustee review and comment. Next Mr. Isele provided an update concerning the Gifford Health Center and stated that due to some structural issues with the building they hired T.E. Schlitt engineers to review the same and prepare a report with recommendations for repairs. The report has been received and he will work of securing bids to move forward with the repairs. Next, he stated that he spent time meeting with the District funded agencies and has received a very warm welcome from everyone. Additionally, he will continue to nurture the relationship with CCIRH and met with Dr. Peter recently. He also has had discussions with representatives from VCOM and understands that there are many details still to be worked out and discussion concerning future plans for a medical school. Additionally, he recognized Dr. Cooney’s proposal concerning the creation of a primary care clinic within the HSB and will continue to move forward with discussions and exploration of this proposal. Lastly, he provided an update concerning the UF addiction and psychiatry medicine clinic, which is closing at the end of the year. He stated that the District and other mental health representatives have convened to discuss ways to successfully transfer the 2,600 patients currently being served at UF, to other behavioral health providers within the community. It was discussed that the letter is being prepared by UF notifying their patients that the clinic is closing and will also be posted in the local newspaper. It was also discussed that with the closing of the clinic it will be important to support the clinical staff in finding alternative work placement within the community.
Funded Agency Semi Annual Report
CCIRH IOP & ED BH program- Cecelia Stalnaker Administrator of CCIRH BHC
Ms. Stalnaker addressed the board and announced that Karrisa Bolden has transitioned out of the organization and took a director position at the PACE Center for Girls. He introduced Kelly Williams who is an IOP therapist and has now been promoted to serve as the outpatient clinical manager. Ms. Stalnaker provided an update concerning the Intensive Outpatient Program (“IOP”) and stated that they opened their adult IOP and initially planned to serve patients 18-24. However due to varying factors with that population and their scheduled, they opened up the program to adults of all ages and have seen additional success and engagement. Ms. Williams addressed the board and shared a success story of a patient who participated in the program. There was discussion surrounding follow up after discharge and how they continued to track the success of the program. Currently they are following up around 30 and 60 days and Mr. Kint requested that this be extended to provide additional support to those patients. Next there was discussion concerning the behavioral health integration in the CCIRH emergency department. She stated that they are wrapping up the finishing touches to the renovation and creation of the BH zone and they look forward to having this dedicated space to better serve the behavioral health patients that present at the ED. She further explained that in addition to the VCOM students who are interning at CCIRH, they were just approved to receive mental health counselors and social work interns. There was also discussion concerning the fact that Vero Beach will now serve as the center for BH services for Cleveland Clinic Florida.
Tykes & Teens- Anne Posey, CEO
Ms. Posey addressed the board and recognized the work that CCIRH has done to improve access and care for behavioral health patients. She introduced her team which included Kim Jeansonne, Grants Manger and Elizabeth Appleton, Director of Early Childhood Mental Health Consultation. She provided an update concerning Tykes & Teens and stated that due to the District funding they have been able to open a physical office in Indian River county and provide the much needed behavioral health services to the community. She discussed some learnings that their team discovered over the last six months as suicide rates continue to rise in the community and nationally, it reinforces their mission of early intervention for behavioral health issues. Additionally, they are working to provide additional support to parents and are discussing the development of a parent’s peer support program. Next, she discussed their new center in Vero Beach and stated that they continue to expand their offerings for services and are working to get their name more recognized within the community. They continue to work on strategies to support this growth and remain fiscally sound to provide services. She then discussed some emerging issues she is seeing within the community and believes navigating behavioral health care remains an area that needs improvement. She stated that access is limited but with the help of the McCabe connections center, there is additional support available. However, she would like to see a larger centralized referral process that could address those gaps and connect more patients to services and collaborative mental health providers more effectively. Another area that needs support is the recruitment and retention of behavioral healthcare workers, specifically in the non-profit sector where salaries are typically lower. She further stated that Tykes & Teens is a certified training facility and recruited their own infant mental health specialist for Indian River County, who was a former student and intern with Tykes & Teens. She also discussed their issues surrounding low insurance reimbursements and stated that children mental health visits are more likely to be billed out of network. Additionally, there are additional requirements implemented by insurance companies concerning data collection and tracking, which result in additional overhead costs for the agencies. Lastly, she stated that as Tykes & Teens continues to grow, they will continue to strive to be strong presence in Indian River County. The Trustees thanked Ms. Posey for her support and reorganizing Tykes & Teens over the last year.
Mr. Bill Stengle addressed the board and stated that as the Chairman of the VNA board he would like to extend his thanks to the Trustees for their continued support and cooperation concerning the sale of the Hospice House parcel. He reiterated that the VNA understands that this land is a community asset, and they are committed to remaining a community partner and utilizing the space for the betterment of the taxpayers. There was no further public comment, and the meeting was adjourned at 6:15 PM
Barbara Bodnar, Secretary