Chairman’s Meeting: December 20, 2023

Chairman’s Meeting: December 20, 2023

Indian River County Hospital District Conference Room/ Zoom
December 20, 2023

TRUSTEES: Marybeth Cunningham Barb Bodnar Michael Kint (zoom) Paul Westcott
William Cooney Karen Deigl (zoom)

ABSENT: Kerry Bartlett

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

ZOOM: Anne Posey Nancee Long
Miche D Bill Stengel Lisa Zahner Marie Andress

ATTENDEES: Ann Marie McCrystal Ann Marie Suriano Vicki Soule Rob Siedlecki Ceclia 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.

New Horizons Task Force- Frank Isele, Executive Director

Mr. Isele provided the Trustee with an update regarding the New Horizons task force and stated that they met on site with representatives from the organization on November 29th to outline recommendations from the final task force meeting. He reviewed those recommendations which included the finalization of FY 23-24 funding request; the plan for Hospital District ED to convene local stakeholders to ensure 24/7 coverage for the mobile response team in Indian River County; Ms. Carboni to complete an audit of New Horizons after 6 months, and lastly the Hospital District ED to convene treasure coast county leaders who fund New Horizons to get a sense of scope and long-term plan for providing mental health services. He further stated that Ms. Frederick has scheduled the first critical response team discussion meeting for January 8th.

Update on UF Transition- Frank Isele, Executive Director

Mr. Isele explained that the group met 3 times over the last 3 months, and it has been a fantastic collaboration. Most UF patients have now been or will be established with a new provider before the anticipated clinic closing date of December 29th. Additionally, he is pleased to announce that CCIRH has added capacity by expanding its services with contractor Amwell for the next six months, to ensure transition for many of the Medicare Advantage patients that they were having a difficult time placing with covered providers. In addition, the UF managers and staff will be staying in the area employed in a similar capacity, as their previous jobs. Mr. Isele expressed his gratitude to all those who participated in the collaborative group which included UF, Mental Health Association, Tykes & Teens, CCIRH, TCCH, WFH, VNA, McCabe Connections Center, New Horizons, Indian River School District, Suncoast Mental Health Center, Legacy Behavioral Health Center, PUR Health & Wellness, and New Season. Also, he stated that while UF has made sufficient attempt to notify patients of their closing and direct them to another provider, there will inevitably be some patients who will say they were never told UF was closing. Throughout Mr. Isele career he has overseen several clinic closures, and this does happen in some capacity, regardless of the many efforts in communicating the closure to the patients and the community. Mr. Westcott stated that he would like to know where the community is concerning ongoing capacity for behavioral health needs and would like the District to examine this more closely to see where there may be additional gaps that aren’t being addressed. There was also discussion concerning the utilization of interns to provide behavioral health services and how it has been helpful to the funded agencies to treat additional patients. It was stated that often those interns who are in the process of finishing their degrees will accept full time positions within the organization once they have graduated. The Trustees thanked Mr. Isele for his work with the collaborative group and were pleased with the outcome, given the short amount of time before the clinic was scheduled to close.

Update on Lease Agreement with VCOM- Robert Siedlecki, Esq.

Mr. Siedlecki, who addressed the board on behalf of Ms. Peshke who was out of town, provided an update concerning the discussions with VCOM and their intent to lease the Human Services Building. He stated that the parties recently met via Zoom and are still working on the details and benchmarks that would be included in the lease. During discussions it was suggested that the initial term would be a 10-year lease with an option to purchase after the 10-year term, contingent upon VCOM meeting certain benchmarks with regard to healthcare and performance. Mr. Siedlecki further explained that before entering into any purchase agreement with VCOM, Cleveland Clinic would have the right of first refusal to purchase the property. Mr. Westcott questioned if the District Trustees would have any interest assessing the potential long-term uses for the property. Additional he recommended that due to the recently proposed legislation targeting Special Districts, the proposed lease agreement should have language which would revert control of the property back to the District, should the District be dissolved through voter referendum. The Trustees asked for further clarification concerning the proposed legislation just mentioned and Mr. Siedlecki provided a brief update on the same. He explained that bill is currently just proposed legislation and has to be heard and approved in many additional committees before would be adopted into law. He further stated that District staff and he will continue to track the bill and provide updates to the Trustees when appropriate.

Ms. Cunningham also asked if there has been any additional information provided concerning the ethics training requirement, which was adopted in 2023. Ms. Voss indicated that they have been working with representatives from FASD concerning this matter but no additional information has been published concerning available curriculum for the ethics training. Ms. Voss further stated that she would follow up with FASD on this matter at the beginning of the year and provide an update to the Trustees when more information is available.

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

Ms. Suriano provided an update to the Trustees concerning the two special projects she has been working on. She first discussed her work with the collaborative group, to bring detox services to Indian River County. She stated that she and Mr. Isele recently met with Dr. Peter and Ms. Stalnaker at CCIRH to discuss potential space within the Hospital Campus, to house a detox center. Additionally, they discussed the role CCIRH could play in this area and Dr. Peter stated that they are committed to looking further into all options and partnering with providers to assist in administering the care. Currently they are committing to holding 4-6 beds at BHC and are looking into staffing and licensing requirements to provide medical detox. Further, Ken Cooper, with PUR Health indicated that he has explored being able to provide these services and will contact CCIRH to share any information he has gathered. Mr. Cooper also expressed to the group that the community also needs continued 28+ day services for those who need additional care before moving on to sober living or back into the community. Ms. Suriano stated that she is going to continue to work with Mr. Cooper on zoning and use issues with the City and County for property they currently own.

Next, she provided an update concerning the women’s sober living project and stated that they have made significant progress in this area and the group met again in December. She has been working with Denny Nystrom to identify appropriate property for women’s sober living and they were notified of a potential property that may be of interest centrally located in Vero Beach. She explained that the owner has acquired an appraisal, but as this property is not yet listed for sale and the owner and current tenant are working through disclosing a few internal matters, and she is careful not to share many specific details about the property. In her conversations with Ms. Peshke and Mr. Isele, they feel this opportunity fits with the mission of the District and provides an amazing property acquisition opportunity for the District to contribute in filling a great need within the community. Therefore, she is seeking approval from the Trustees to allow Ms. Peshke to prepare a non-binding Letter of Intent to allow the District to gather the due-diligence details that would be required to determine the ability to enter into a purchase contract for this property. There was Trustee discussion concerning purchasing an additional property and the potential of liquidation the parcel off 82nd Ave. The Trustees were open to further exploration of this idea, through a non-binding letter of intent. Ms. Bodnar made a motion to approve the same, which was seconded by Ms. Cunningham. The motion carried unanimously. Mr. Westcott stated that he would also like to further explore the District options within the lease with CCIRH, to sell the parcel on 82nd Ave, and made a motion to approve the same. Ms. Cunningham seconded the motion, and it passed unanimously.

Update on IRCHD Brand Refresh- Frank Isele, Executive Director

Mr. Isele stated that as the Trustees know, the District has been working on refreshing the IRCHD brand to raise awareness of the value of the District throughout the community. He explained that this brand refresh includes an updated logo and website. He introduced Ms. Dickens who serves as the District financial assistance and marketing specialist, and has been overseeing this project. She reviewed with the Trustees three potential updated logos, for their review and consideration. There was Trustee discussion about the rebrand and how best to move forward with launch and communication to the public. The Trustees also asked that an alternative black and white mockup of the logo be provided for their review and Ms. Dickens stated that she would provide the requested logos. Mr. Isele stated that he would like the Trustee to approve a final logo at tomorrow’s regular monthly meeting, so that they can move forward with the project.

Update on GlobeChek Services- Jennifer Frederick, Program Liaison

Ms. Frederick provided an update concerning GlobeChek and stated she was notified that the organization has secured a driver for the mobile globe and provided the Trustees with a schedule which outlines where the Globe would be available throughout the community. They are also working to create additional partnerships within the community and have reached out to representatives at the IRC School District and the IG Center. There was Trustee discussion and Ms. Frederick reviewed and clarified information regarding the reimbursement rates for the services being provided. Additionally, there was discussion concerning the referral process for patients who are seen through the Globe and need follow-up specialty care. The Trustees asked Ms. Frederick to verify with GlobeChek how patients are being referred to specialty care, to confirm that the process is fair, and patients are being given a choice as to where they seek follow-up care.

Update on Performance Review- Dawn Carboni, Internal Audit/Data Specialist

Ms. Carboni stated that District staff and the performance review team from BJM met via zoom on December 7th and the process is in good standing. The District staff has provided all the requested information and the operational report is 95% complete. She explained that there may be a few additional items which will need to be provided and a progress meeting is set for January 16th. Additionally, a draft report is still projected to be ready by the end of January. There was Trustee discussion concerning the performance review and how this process differed from a formal audit. Ms. Carboni reiterated that this was a review and not an audit, therefore there was not necessary the mentality that the District would pass or fail during this process. The main objective is to take a look at the Districts operations and efficiency.

Next, she provided the Trustee with an update concerning her internal audit process and stated that the first round of audit notices have been sent to the selected funded agencies. She also has now transitioned to the utilization of a secure electronic network which will provide a streamlined process of uploading the requested audit documents. All requested audit documentation are due back to her by the end of January and she will begin to conduct onsite visits starting in February. She further explained that one of the first audits she will be conducting is on CCIRH Partners in Women’s Health. Additionally, the Trustees requested that she provide them with an Audit schedule which outlines which agencies are being audited and the deadlines and deliverables being requested.

Other Business

Dr. Cooney addressed the board and stated that as a follow-up to communication sent to the Trustees by Mr. Isele, concerning Florida Senate President Kathleen Passidomo, “Live Healthy“ initiative. He stated that many of the areas she is focused on are similar to the Districts initiatives and he requested Mr. Isele to continue to follow these efforts and provide the Trustees with updates when available. Mr. Isele agreed and stated that it is important that the Districts healthcare priorities are in line with the state of Florida and this is a great way to stay informed on the latest trends and initiatives.

Mr. Kint stated that he has heard the name PUR Health in a few of the updates from Ms. Suriano and requested some additional information about the organization, specifically what types of services they provide in the community. District staff indicated that they would schedule Ken Cooper, the CEO of the organization, to provide a presentation at an upcoming Chairman’s meeting, to address the board.

Public Comment & Adjourn

There was no further business and Ms. Cunningham asked for public comment. Ms. Soule stated that she has been to Tallahassee a few times this year to participate in the “Live Healthy” Initiative and would provide Mr. Isele with any additional updates she receives moving forward. There was no further public comment, and the meeting was adjourned at 11:30 am.