Chairman’s Meeting: October 18, 2023

Chairman’s Meeting: October 18, 2023

Indian River County Hospital District Conference Room/ Zoom
October 18, 2023

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

STAFF: Jennifer Peshke, Esq. Jennifer Frederick
Kate Voss Frank Isele

ZOOM: Ann Marie Suriano Vicki Soule
Marie Andress Kim Jeansonne
Anne Posey Alex Greenwood
Chriss Papayannis Pat Knipper

ATTENDEES: Ann Marie McCrystal Greg Jackson Bill Stengel William Wims Kathryn Hensley Cecelia Stalnaker

Convene Meeting

Ms. Cunningham convened the meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person. She thanked Mr. Wims and his team for accommodating their schedules and moving their presentation to today’s meeting.

Funded Agency Semi Annual Report- New Horizons-William Wims, CEO

Mr. Wims provided an update regarding New Horizons for the last six months. He discussed some challenges and learnings that the organization has faced and explained that it has been difficult to transition staff back to working in the office. Subsequently they have ended employment for some, who were unwilling to make the transition. He then introduced to Greg Jackson, who is now serving as the chief operating officer, and comes to the organization from the managing entity Southeast Florida Behavioral Health Network. Additionally, they have hired a new medical director, Dr. Acosta, who has proven in a short time to be an invaluable asset to the organization. He explained the organization is now working on focusing their efforts to strengthen their financial position and have hired a consultant to manage those matters as well as purchasing a new accounting system. They have also corrected the issues relative to the last fiscal year audit. Their board of directors has also become more involved in the financial reporting and the New Horizons executive team meets monthly with them to provide updates.

Next, he discussed their recruitment and retention of staff, which has been a challenge for the organization over that last several years. He explained that with the onboarding of the new medical director, he has focused his effort on changing the culture within staff and he are happy to report that there is a core group of staff in place. He further stated that they are working to onboard two additional practitioners to provide services and hope to have them in place by December. Additionally, as another incentive to employees they are offering tuition reimbursement and clinical hour opportunities, which has increased employee retention and participation. Lastly, the medical director and HR director are working with the new employees and potential new hires on recruitment strategies, to keep employees engaged and motivated.

Mr. Wims then provided an update regarding the New Horizons task force, which he thanked the District for spearheading. He stated through the efforts of the task force, they are looking at ways to expand services within Indian River County and have created new relationships with local providers such as Cleveland Clinic Indian River Hospital (“CCIRH”). Through these meetings it was discovered that there was available clinical space in the 787 building, and they are touring the facility with representatives from CCIRH after today’s meeting. He explained that their current location in Indian River County is far west of town and traveling to the center has created barriers for those who rely on public transportation. Moving the center to the 787 building would increase access to care as it is a centrally located facility, in turn allowing New Horizons to see additional patients and utilize the funding provided by the District. There was further Trustee discussion regarding the utilization of funding and it was questioned whether New Horizons was actively searching for additional grants or philanthropic support. Mr. Wims explained they have hosted fundraising events in the past but are currently working on the internal issues within the organization before embarking on any additional marketing or fundraising initiatives. The District thanked Mr. Wims for the update and voiced their support for the organization and stated that they are pleased with the positive changes that are taking place.

Update regarding New Horizons Task Force- Kerry Bartlett, Vice Chair

Ms. Bartlett provided the board with an update regarding the New Horizons task force. She stated that the group met recently, and New Horizons presented a PowerPoint presentation, which she provided to the Trustees for their review and information. At the meeting, there were also discussions surrounding priorities for the organization and where the District could assist in achieving those goals. She explained that the next steps will be for a timeline and priority list to be developed. Additionally, she explained that strengthening the mobile response team is a priority, as well as finding more centrally located office space in Vero Beach. She stated that as Mr. Wims discussed, CCIRH and MHA have been working collaboratively with New Horizons and those partnerships are helping in assisting them strengthen their presence within the community. Mr. Bartlett then spoke about the relationship with Dr. Acosta, the new medical director, and stated that he has made a very positive impact on the organization and has an impressive work history. He has also been instrumental in working with New Horizons to recruit and attract new staff. Lastly, she stated that the task force plans to meet again for their final meetings where some recommendation will be made regarding future goals and funding and plans to provide an update to the Trustees at the November Chairmans meeting.

Update regarding Hospice House Parcel Sale- Jennifer Peshke, Esq.

Ms. Peshke provided the Trustees with an update regarding the sale of the Hospice House parcel. She stated that she has been working with VNA counsel regarding the matter. She informed the Trustees that both VNA boards approved the District sale offer of $3.8 million and the parties are working on a sale agreement, critical dates, time line and ordering a title search for the property. She explained the purpose of the title search was to make sure that the property has a clean title and there are no incumbrances prior to the sale. She provided a brief review of the closing process and stated that the District is in a good position regarding the closing. The current agreements in place state that the buyer is responsible for all closing cost, which typically are paid by the seller in these types of transactions. There was Trustee discussion and Mr. Stengel who was present at today’s meeting on behalf of the VNA, was asked if their building timeline was still on target, as presented earlier in the year. Mr. Stengel indicated that there are various items which are affecting this and explained that they are currently reviewing how much space will be needed to house their employees. Therefore, this target is evolving, and they may reduce the overall size of the building. Mr. Stengle also recommended that once the closing has commenced that the VNA and the District coordinate a public announcement and campaign to inform the community of this project. The Trustees agreed that this would be beneficial, and that District staff should coordinate efforts with the VNA on this project.

Update on Finance & Audit Committee- Michael Kint, Treasurer

Mr. Kint informed the board that the first meeting of the District’s Finance and Audit committee took place yesterday, and all members were in attendance except Jeff Smith who had a conflict. He explained that the group covered many bases regarding the group’s purpose and oversight, as well as hearing a presentation from representatives at DeepBlue regarding the Districts investment accounts. For next steps, he explained that the group plans to take a deeper look into the District’s current financial and audit policies to see what items are lacking and could be expanded upon. He further stated that Ms. Peshke plans on attending the next meeting, which is scheduled for November 14th, to provide the group with a brief overview of the Sunshine Law. He plans to update the Trustees monthly on the progress of the committee as well.

Project Update on Women’s Sober Living & Detox Center- Ann Marie Suriano

Ms. Suriano began her update by first recognizing Mr. Isele and stated that she believes he was an excellent pick as her predecessor and has enjoyed working with him over these last several weeks. She provided the Trustees with an update regarding a few items she has been working on for the District. The first being the Detox Services committee which consists of leaders from CCIRH, Substance Awareness Center, PUR Health and Wellness, Vero Beach Recovery, TCCH, Mental Health Collaborative, Southeast Florida Behavioral Network, and local law enforcement. The group has met twice and had discussions regarding the increase growth in substance misuse in the county. It was expressed during these discussions that the current providers of recovery services are trying to find appropriate inpatient care, but the capacity and distance is impossible for most people to access. In addition to building these Detox services, it has been determined that a peer program, primarily assisting law enforcement, is crucial to assisting people to successful recovery, as a support and a part of the continuum of care. She explained that current data surrounding the support and necessity of a quality, successful program continues to be collected and shared between the group members. Additionally, the Sherrif reported that he is working to obtain some of the state Opioid dollars to add 25 beds for Detox to the existing 25 medical beds in the jail. This is in partnership with TCCH as they have the contract to provide Medical, Dental and Behavioral Health services to the inmates housed in the county jail. Further there are some protocols in place between CCIRH and TCCH for overdose response and peer connection, but they currently are underutilized. She stated that Dr. Peter and CCIRH are supportive of a partnership, as they are willing to talk about how they can be part of the solution and the importance of Hospital support in medical detox. They are open to discussing how, together, they might expand the hospital campus for this purpose. Also, PUR is doing some outpatient work in the detox arena and is open to collaborating, but designated space is also a challenge for them. The group is also hoping that New Horizons could assist in this area as well and are hopeful that they will be able to occupy space within the 787 building for further development in this area. Ms. Deigl asked that Ms. Suriano include her in future communication and discussion regarding these meetings, as she would like to assist with discussion on transportation issues. Ms. Soule addressed the group and stated that while she appreciates Sherriff Flowers’ offer to house a detox facility at the jail campus, she believes that there may be some pushback from patients not wanting to receive services at that location. There was further discussion on this, and it was agreed that this matter is ongoing with details yet to be finalized regarding location, and commitment from providers.

Next Ms. Suriano provided an update regarding Women’s Sober Living Program Committee which consists of Denny Nystrom, who was the founder of Dynamic Life and continues to be a benefactor and supporter, representatives of Dynamic Life and Fellowship Recovery. The group has met twice and had discussions surrounding the team at Fellowship Recovery and their development of a very successful Women’s program and sober living environment. The main mission for the committee is to develop a place for women in Indian River County and assisting Dynamic Life, to expand into this area as they have successfully done for men in IRC. She explained that at the last meeting, Fellowship Recovery provided an outline based upon the successful model they have in the Ft. Lauderdale area which could be considered in our area, and they offered assistance in moving forward with identifying the appropriate staff and training needed. Ms. Suriano further explained that she is in the process of working with a realtor to identify potential properties and costs weighing renovation vs. new construction. She will provide the Trustees with further updates when they become available.

Other Business

Dr. Cooney stated that he would like to clarify some comments referenced in the September 20th Chairman’s meeting minutes relative to his recommendation to house a primary care clinic within the HSB. He stated that the minutes referenced that the primary reason for this was to offset the high volume of indigent patients utilizing the emergency department. He clarified that while this is a factor there are various other elements that would support the utilization of a primary care clinic within the HSB.

Ms. Cunningham stated since GlobeChek is providing their semi-annual report at tomorrow’s meeting, she wanted to provide the newer Trustees with some historical background relative to the funding of this organization. She explained that District was initially approached to fund a pilot program which would place the Globe at Whole Family Health Center and TCCH. The Globe is a vision screening tool that provides an eye exam without dilation and their goal was to offer these services to patients who otherwise would not seek eye care services. There was Trustee discussion regarding the validity of the Globe and if it was comparable to an eye exam conducted by an optometrist or ophthalmologist. There was also discussion regarding how this service was unbillable to insurance companies. The Trustees felt that they would like to have further discussions surrounding this and more clarification surrounding the Globe and its capabilities.

Public Comment & Adjourn

There was no public comment and the meeting was adjourned at 11:45 am.