SUMMARY MINUTES
FY 24-25 BUDGET DISCUSSION MEETING
Indian River County Hospital District Conference Room/ Zoom
July 9, 2024
1:00 PM
TRUSTEES: Barbara Bodnar William Cooney
Marybeth Cunningham (zoom) Karen Deigl (zoom) Paul Westcott Michael Kint Kerry Bartlett
STAFF: Jennifer Frederick Kate Voss
Frank Isele (zoom) Dawn Carboni
Kaytlin Dickens
ZOOM: Jennifer Peshke, Esq. Vicki Soule Pat Knipper Jeff Pickering Kim Jeansonne Dan Bach Lauretta Farrell David Vaina Triana Romero
ATTENDEES: Wayne Creelman Chris Drake
Convene Meeting
Ms. Cunningham convened the budget discussion meeting of the IRCHD Board of Trustees at 1:00 PM by welcoming those participating via Zoom and in person.
FY 24-25 Budget Discussion
Ms. Cunningham stated that the goal for today’s meeting is for the Trustees to agree to the highest possible millage rate, with the opportunity to decrease the rate over the next few months. She has met with Mr. Isele and has had multiple conversations about the budget. Mr. Kint has also met with Mr. Isele and from those discussions they are recommending a millage rate of .7650, which would accommodate all the funding requests brought forth and reduce the amount in reserves by 4 million. This would also mean that there would need to be a reduction of 2 million in additional expenses. There was discussion surrounding the appropriate amount of reserves the District should be maintaining. The Trustee also discussed what the millage rate had been set at in previous years and it was determined that just a few years ago the millage was at .9122. There was also discussion surrounding the development of a funding policy with guidelines and parameters that outline what the District should be funding. Mr. Isele stated that he has developed a draft policy and currently Ms. Frederick and Ms. Carboni are reviewing the same to add their comments and suggested changes. Once amended, it will be brought before the Trustees for their review and consideration. After further Trustee discussion Ms. Bodnar made a motion to approve the recommended millage rate of .7650, which was seconded by Mr. Westcott. The motion carried unanimously. Next Ms. Cunningham stated that she would like the Trustees to discuss the program funding requests and asked Ms. Frederick to walk the group through the scoring matrix she prepared.
Ms. Frederick discussed the report and explained the scoring system which an average rating is was developed from the scores provided from the Trustees feedback. However, two trustees did not complete the funding recommendation section of the evaluation therefore resulting in only five suggested funding columns. She also created a color-coding system which marked agencies into categories based on their average scores. Green and blue indicated agencies which had higher ratings and yellow and red had lower averaging scores. With this information in mind, Ms. Cunningham recommended that Ms. Frederick Walk the Trustees through the lower scoring agencies so they can discuss those requests. Discussion began with a review of the request from GlobeChek in the amount of $455,620. There was lengthy discussion surrounding this request. Many of the Trustees were concerned with the fact that this organization is a for profit entity and cannot produce the financial and audit reports required by all District funded agencies. Ms. Carboni stated that she just recently completed her onsite audit with GlobeChek and while they were responsive to her requests, many of the documents she requested were not available. There was Trustee discussion surrounding the idea of giving GlobeChek a deadline to produce the documentation requested but Ms. Carboni stated that it would be setting them up for failure as a true audit would take several months and the other financial policies do not exist. Many of the Trustees felt conflicted as they agree eye care is a needed service but wonder if there may be a more appropriate way to fund this through a different organization. Ms. Bartlett made a motion to not fund GlobeChek, which was seconded by Mr. Kint. There was further Trustee discussion, and it was recommended that the District only support funding for the refraction and scan reads. It was also recommended that the current fiscal year budget of $282,000 be awarded and not the current request of $455,620. Ms. Cunningham called the question on Ms. Bartletts motion which failed 6-1. Mr. Westcott then made a motion to approve $282,000 in funding with the condition that GlobeChek produced the requested documentation to Ms. Carboni by September 1st. This would include an explanation of what makes up the charges in the non-fee-for service portion of the request. The motion was seconded by Ms. Bodnar and passed unanimously.
Next there was discussion surrounding the request from Helping Hands of South County. The Trustees felt that this program lacked performance outcomes and a strong board of directors. The Trustees agreed that this program was outside the scope of funding for the District and Mr. Kint made a motion to not fund the request. The motion was seconded by Ms. Bodnar and carried unanimously. Next, the Trustees discussed the request from Miss B’s Learning Bee’s. The Trustees agreed that this program was not appropriate for the District to fund. Ms. Bodnar made a motion to not fund Miss B’s Learning Bee’s which was seconded by Ms. Bodnar. The motion carried unanimously.
The Trustees then had lengthy discussion surrounding New Horizons and their funding request. They agreed that New Horizons provided much needed services to the community but questioned the request for the crisis mobile response team. It was further discussed that the organization has struggled over the years financially and with compliance issues. Ms. Carboni stated that she just recently conducted her onsite audit visit to New Horizon and was impressed with the welcome she received from Mr. Wims and his team. She explained that they were responsive and forthcoming in providing the requested documentation, which she is currently reviewing. There was additional discussion surrounding the crisis mobile response team and the true effectiveness and reliability of this service. Overall, the most Trustees felt that the District should continue to support New Horizons but would like to better understand the crisis mobile response team budget. Ms. Deigl made a motion to continue to fund New Horizons, which was seconded by Mr. Westcott. The motion carried 6-1 with Mr. Kint in opposition.
Next there was discussion surrounding the request from Rite Life Services. The majority of the Trustees felt that this program was outside the scope of funding for the District. They also had concerns over the organizations structure and board of directors’ participation. Ms. Bodnar made a motion to not fund Rite Life Services, which was seconded by Ms. Bartlett. The motion carried 6-1 with Dr. Cooney in opposition.
The Trustees then had discussions surrounding the funding request from ARC, which the Trustees agreed was a great organization providing much needed services to the developmentally disabled. However, the majority of Trustees felt that this program was outside of the scope of funding for the District. There was discussion surrounding transportation services that were available for these individuals and if there were ways ARC could collaborate with other community organizations. The Trustees also felt that this program lacked measurable outcomes. After further discussion, Ms. Bartlett made a motion to not fund the request from ARC which was seconded by Dr. Cooney. The motion carried unanimously. The Trustee would like staff to reach out to ARC to see how else the District could support the organization.
Next there was discussion surrounding the funding request from the Youth Sailing Foundation. While the Trustees felt that it was a strong organization and a worthy program, they agreed that it was outside of the scope of funding for the District and lacked measurable outcomes. Ms. Bodnar made a motion not to fund the Youth Sailing Foundation which was seconded by Mr. Westcott. The motion carried unanimously.
Next there was discussion surrounding the funding request from Camp Haven, specifically the portion relating counseling and case management. There was Trustee discussion and they questioned if this would be billed by fee-for-service. It was also discussed why they are requesting the funding to provide on-site counseling, which Camp Haven stated has reduced barriers for their clients and their ability to access the service. It was also clarified that Camp Haven provides counseling services not psychiatric services. There was also Trustee discussion surrounding how this request was to replace funding that Camp Haven has lost in philanthropic funding. They also requested that representative from Camp Haven to further explain the request and cost breakdown and confirm that this can be billed at fee-for-service. After further discussion Mr. Westcott made a motion to approve the request with the caveat that the counseling be billed at fee for service and the case management portion be removed. The motion was approved and carried unanimously.
The Trustees then discussed the funding request from Crossover Mission which had increased by $90,000 from last fiscal year. The Trustees questioned why there was such a large increase and if this was a direct healthcare service. Dr. Cooney voiced his support for the organization and made a motion to approve their request for half of the amount at $50,000. There was no second and the motion failed. There was further discussion, and the majority of the Trustees felt this request was outside of the scope of the District’s funding. Ms. Cunningham made a motion not to fund the request which was seconded by Ms. Bodnar. The motion carried 6-1 with Dr. Cooney in opposition.
Next there was discussion surrounding the request from Literacy Services of Indian River County. There was lengthy discussion surrounding the organization, the services that they provide, and if it could be considered a healthcare service due to the emphasis on health literacy. While the Trustees agreed that these are good services available to the community but felt it was outside the realm of funding for the District. Ms. Bartlett made a motion not to fund the request, which was seconded by Ms. Bodnar. The motion carried unanimously.
Next there was discussion surrounding the request from Senior Collaborative, which most Trustee indicated that they would fully fund. However, there was concerns over the organizations lack of measurable outcomes. After further discussion Mr. Kint made a motion to approve the request, which was seconded by Mr. Westcott. The motion carried unanimously.
The Trustees then had discussion surrounding the finding request from Sunshine Physical Therapy. It was explained that this is a fee for service request and the funds the District provides makes up the shortfall for Medicaid payments. There was discussion regarding increase in funding request which was due to an increase in patient volumes. After further discussion Mr. Westcott made a motion to approve, which was seconded by Dr. Cooney. The motion carried 5-1 with Ms. Bodnar in opposition. Also Ms. Deigl had left the meeting and did not participate in the vote.
Next the Trustees had discussion regarding the funding request from the Learning Alliance. The Trustees agreed that they would like to better understand the requests, which included the addition of a new position for behavioral health. Also, there was discussion surrounding what other funding sources were available, specifically the IRC School District’s requirement to support these children. It was requested that the agency be brought back before the Trustees next month for further discussion and consideration.
Next the Trustees has lengthy discussion surrounding the request from Treasure Coast Homeless Services Council, which had increased by approximately $75,000 over last fiscal year. There was Trustee discussion and some questioned if Federal funds were also being used to support this program. They also felt the program was lacking measurable outcomes and wanted to be given monthly updates from the organization with data on clients being served. Additionally, they want assurance that the deficiencies in the 2022 audit report have been corrected and they have not received a copy of the 2023 report. Most Trustee were not in favor of increasing the funding support and Ms. Bartlett made a motion to approve funding in the amount of $334,113, which is the same as the current fiscal year as well as increasing the priority of Ms. Carboni completing an internal audit on the organization. Mr. Kint seconded the motion and it passed unanimously.
The Trustees then had discussion surrounding the funding request from the Veterans Council, which totaled $120,000. There was Trustee discussion and there was concern that if they began to fund these types of organizations that it may increase the chance for other Verteran organization to seek funding from the District. There was also a suggestion that instead of funding case management services to individual agencies, a resource be developed that offers case management for all. After further discussion Mr. Kint made a motion not to fund the request which was seconded by Ms. Bartlett. The motion carried 5-1 with Dr. Cooney in opposition.
Next there was discussion surrounding the request from We Care Foundation. The Trustees agreed that this organization has come a long way, from several years ago where they were struggling. However, some Trustees felt that they were still lacking measurable outcomes. After further Trustee discussion, Dr. Cooney made a motion to approve the full funding request from We Care, which was seconded by Mr. Westcott. The motion carried unanimously.
Lastly, the Trustees reviewed the funding request from the Women’s Care Center. Most Trustees were in favor of fully funding however there were questions surrounding how these services would be billed. The Trustees agreed that they would like this to be billed as a fee-for-service program and have the client’s complete financial assistance applications, like the other fee-for-service agencies are required to do. There was also discussion surrounding Partners and their ability to serve these clients instead. Ms. Frederick indicated that she spoke with representative from Partners, who are very supportive of the Women’s Care Cetner and the District supporting them. It was also explained that Partners does not have the capacity to treat these additional clients, especially on the same day or walk in basis. However, many times clients are seen at Women’s Care Center initially, provided with services and then transferred to Partners from the remainder of their OB care. There was no further discussion and Mr. Westcott made a motion to support the request with the understanding that they would bill on a fee-for-service basis. The motion was seconded by Ms. Bodnar and carried unanimously.
The Trustees agreed that they will continue to discuss the remaining funding requests items at the upcoming Chairman’s meeting on July 17th. Ms. Cunningham also confirmed that the Trustee were in agreement with the .7650 millage rate proposed to be voted on at Thursday’s regular monthly meeting. Lastly, Mr. Isele stated that after today’s discussion, he has been able to reduce the budget by $1,026,725 million.
Public Comment & Adjourn
There was no other Trustee business. Ms. Cunningham asked for public comment and there was none. The meeting was adjourned at 2:30 PM.
