Jan 22 Regular Monthly Meeting: December 21, 2023
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
December 21, 2023 @ 4:00 PM
TRUSTEES: Paul Westcott Michael Kint
Marybeth Cunningham Kerry Bartlett
William Cooney, M.D. Barb Bodnar
ABSENT: Karen Deigl
STAFF: Jennifer Frederick Dawn Carboni
Frank Isele Kaytlin Dickens
ZOOM: Ann Marie McCrystal Ann Marie Suriano Kim Jeansonne Lisa Zahner Pat Knipper Jad Shalhoub Marie Andress Liz Adams
ATTENDEES: Shawn Laydon Kate Stoneman Cecila Stalnaker Vicki Soule
Invocation and Pledge- Mr. Isele provided the invocation and Ms. Bartlett led the group in the Pledge of Allegiance.
Attorney Overview- Robert Siedlecki, Esq.
Mr. Siedlecki read from the prepared attorneys overview, which is intended to outline the Districts purpose, operations, as well as procedures and conduct during meetings. Mr. Kint questioned the section which states that four Trustees must be physically present to constitute a quorum, and an affirmative vote of at least three Trustees shall be necessary to approve a vote. Mr. Siedlecki stated that a quorum must be made up of at least four in person Trustees and if only four Trustees are present at a meeting, three votes are needed to approve any action. Next, Mr. Westcott addressed section nine in the overview which stated that public speakers are requested not to repeat points already made by previous speakers. He believes that the public has their right to use their five-minute public comment as they see fit, and he questioned if this language would create a chilling effect on groups who may come before the board. Mr. Siedlecki stated that this was a request not a requirement and was designed to prevent speakers from repeating the same thing. Mr. Westcott questioned whether this was taken from Roberts Rules of Order and Mr. Siedlecki indicated that he would look into the matter and follow up with Mr. Westcott.
Consent Agenda– Marybeth Cunningham, Chair
Ms. Cunningham asked for a motion to approve the consent agenda and monthly disbursement of $1,276,675.26. Mr. Cooney stated that in the Chairman’s meeting minutes, Matt Reiser’s name was misspelled and asked that it be corrected. Following a correction to the spelling of Matt Reiser’s name, a motion to approve was made by Ms. Bodnar and seconded by Ms. Bartlett. The motion carried unanimously.
Chairmans Report- Marybeth Cunningham, Chair
Ms. Cunningham informed the Board that she recently took part in the CCIRH Board of Directors meeting. During the board education portion, they were given a presentation from the Bioethicist of Cleveland Clinic Florida. This person is trained to deal with ethics issues as well as ensuring quality patient care, research, and education. Currently, CCIRH is training one of their staff members to fill this role locally and she suggested that a future presentation from this individual may be beneficial to the Trustees.
District Counsel Report- Robert Siedlecki, Esq.
Mr. Siedlecki stated that their office continues to work on the matter concerning a potential lease agreement for the HSB, with VCOM, and are waiting to hear back from them concerning potential benchmarks. Additionally, he addressed the recently proposed Florida House Bill which would impose potential term limits for public officials and implement a public voter referendum effective November 3, 2026, and every ten years after. They are continuing to track this bill and there are various committees it needs to cycle through before being sent to the governor’s office for adoption. Mr. Isele stated that he spoke with local representative Robert Brackett and met with Senator Erin Grall’s assistant to express the importance of the District for Indian River County. He stated that he will continue to work on communicating to the public the value of Districts impact and how it is measured through objective data collection. Along with the importance of the Districts fiduciary responsibility to the taxpayers.
Financial Statement Review- Michael Kint, Treasurer
Mr. Kint stated that after two months of the fiscal year, the District is in excellent financial condition. In November, the District began to receive its first installments of tax revenue totaling approximately $4.2 million, which represents around 32% total tax revenue received. Historically, the District will receives the bulk of its tax revenues by the end of January. Mr. Isele stated that this was correct and the District is actually only waiting on approximately $1.3 million in remaining tax revenues. Mr. Kint continued his report and stated that program expenses are under budget by approximately $163,954 for the month and $368,893 year-to-date. Further, regular administrative expenses were over budget by $40,336 for the month and $21,888 year-to-date, and the negative variance was largely driven by three payrolls in month of November. Additionally, legal fees have been higher than average due to the VNA transaction which is underway. Mr. Kint then reviewed the District’s investment figures and stated that as of November 30, 2023, all investments total $8,753,738.03. This figure is made up of $3,404,465 in the Preferred Deposit Pool through Florida FIT, $1,250,000 in treasury bills through Treasury Direct, and $4,099,273 in cash, money market funds, and treasury bills with Deep Blue. He further explained interest from all accounts for the month was $116,694.14 and $185,846.23 fiscal year to date. Next Mr. Kint provided an update concerning the District accounting transition and stated that they have begun working with DiSalvo accountants, and the transition is going well. He stated that the financial statement reports moving forward will look slightly different and they are working to get the formatting finalized. Lastly, he stated that the Finance and Audit committee met this week and has begun the process of reviewing the District’s accounting and financial practices manual. The final document will be brought to the Trustee for their review and approval in the next few months.
Executive Director Report- Frank Isele, Executive Director- Mr. Isele stated that he is deferring his report to agenda item number 9.
CCIRH Partners in Women’s Health Update- William Cooney, Trustee
Dr. Cooney provided an update concerning Partners in Women’s Health and stated that the program continues to do well and reviewed data regarding deliveries, visits, volumes, and surgeries. He then reviewed data concerning maternal death and fetal infant mortality. Next, he stated that the Mother & Baby Unit campaign continues to move forward and they have raised $7 million towards the project, and will soon begin renovations on 2 North. Additionally, they have implemented a new tracking system for the newborns, which will help to increase security. Also, CCIRH has been recognized by the Surgeon General and the State of Florida for the primary c-section rate, which has decreased from 31% down to 15% over the last several years. They attribute this success to the increased use of the Doula program, which the District has continued to support. He further explained that they are also seeing improvements to perinatal access and continuity of care, to improve maternal health through continuum of postpartum care. Also, in 2023 Partners received the Blue Distinction in Excellence in Maternity Care award, for meeting all overall quality measures. Lastly, the overall Press Gainey patient satisfaction scores show improvements in all quality measures. He further stated that Partners continues to work collaboratively with Healthy Start and continues to improve operations with the addition of Megan McFall as CEO, back in June.
Funded Agency Semi Annual Report- Treasure Coast Community Health- Vicki Soule, CEO
Ms. Soule addressed the board and provided a semi-annual update to the Trustee concerning TCCH. She stated that medical and behavioral health patient volumes increased slightly, however there was not an increase in District qualified patients. She explained that after the Medicaid expansion ended, they anticipated many patients would be without insurance, however many of those patients ended up obtaining Marketplace or private insurance coverage. Next, she discussed the decrease in dental volumes and explained that they are still struggling with recruiting additional dentists and hygienists, and dental assistants. However, they have started a training program and have been able to train five new dental assistants. They have also hired a new dental director, to help further assist with the upcoming expansion, and overhaul the scheduling system. Next, she discussed some new learnings that have been discovered over the last six months which are still the increased need for primary care and behavioral health services. She also discussed how the increased cost of living is affecting their organization and their patients. Another issue they are seeing is lack of affordable housing, which has affected their ability to retain staff, who often live in surrounding counties, and may take another position closer to their home. Lastly, she discussed how their organization will be different in the next five years and stated that she has plans to retire within 2-3 years, but a strong succession plan will be in place. They are also looking to recruit new and more diverse members to their Board of Directors, and the Chief Development Officer will be working on strategies for that process. Ms. Soule also stated that they are continuing to work on preventive care and education, so they can help fill gaps within the community. Lastly, she introduced Shawn Layton, who was recently hired to serve as the Project Director for the Mental Health Court. Mr. Layton addressed the board and stated his goal for the program is to better streamline the process already in place and create measurable objectives so they can show the community the value of this program. So far, he has had positive experiences working with the community partners and looks forward to continuing the good work being done. There was Trustee discussion concerning the program and how valuable it is to the county and providing diversion services to residents who may not otherwise receive assistance.
New Business- Approval of IRCHD Brand Refresh- Frank Isele, Executive Director
Mr. Isele stated that as discussed, he would like to make sure that work being done by the District is recognized in the community and that the District continues to be a driving force in the effort to improve health quality for its residents. In doing this, there are a few items that should be updated including the District logo and they have worked with a local company Ironside, to create this updated logo which is representative of community collaboration. He further explained that District staff provided three different logo options to the Trustees for their consideration and are now requesting a final logo be chosen at tonight’s meeting, so that they can continue to move forward with this project. Ms. Dickens reviewed the three final images and there was Trustee discussion regarding the same. The Trustees agreed that first logo was their preferred image, but asked that it be refined a bit further, and that they would like to see the image in a greyscale as well. Ms. Bartlett stated that she would like to understand further how this impact campaign is going to be communicated to the public and what are the key messages and brand promise. The other Trustees felt that these questions will be best answered after the strategic planning meeting, which is scheduled to take place in February.
Mr. Kint asked that since the announcement of the vandalism that took place at the Gifford Health Center, he questioned what security measures are in place at the facility currently. Ms. Soule stated that there is a video surveillance system which records inside and outside of the building. After police reviewed the tapes from the incident, they were able to identify the person as a member of the Gifford Community and address the situation accordingly.
Public Comment/Adjourn- There was no further Trustee discussion, and the meeting was adjourned at 5:10 PM.
Barbara Bodnar, Secretary