Indian River County Hospital District

Budget Discussion Meeting- July 12, 2022

SPECIAL MEETING- FY 22-23 Budget Discussion
Indian River County Hospital District Conference Room/ Zoom
July 12 2022
1:00 PM

TRUSTEES: Marybeth Cunningham Barbara Bodnar
Karen Deigl Allen Jones
Ann Marie McCrystal Kerry Bartlett

STAFF: Jennifer Frederick Kate Voss
Dawn Carboni Ann Marie Suriano

ZOOM: Jennifer Peshke, Esq. Elizabeth Appleton
Samantha Messina Dan Bach
Sabby Hightower

ATTENDEES: Pat Knipper Lundy Fields
Ed Love Paul Westcott

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the budget presentation meeting of the IRCHD Board of Trustees at 1:00 PM by welcoming those participating via Zoom and in person. She stated that she is disappointed that only two Trustees completed the Agency Funding Request Summary worksheet that was prepared by Ms. Frederick and sent out to the Trustees. She explained that staff works diligently to provide the Trustees with comprehensive summaries and documents relative to the budget, which is the most important work of the Trustees each year, and that the Trustees should review and complete the items sent to them before they are discussed at upcoming meetings.

Funded Agency Review Correspondence – Jennifer Peshke, Esq.

Mrs. Peshke indicated that the District received a response from Phoenix Rising on July 11th, in response to her correspondence dated July 5th, which notified them of their continued breach of their current funding agreement, subsequent to the District’s staff visit on June 21st to cure the breach. In the response letter from Phoenix Rising, they requested that the District provide reimbursement for the patients that they have already served in May and June, and give them until August 19th to cure any remaining breach. Currently, the District board voted in June to immediately suspend funding, pending the outcome of the third visit to Phoenix Rising and their efforts to cure the breach. Ms. Carboni addressed the board and stated that her biggest concern with the organization is lack of a financial accounting staff. She explained that there is not a CFO, controller, or staff accountant who oversees their financial matters. Additionally, they were provided the pre audit questionnaire in February, which outlined what would be required to be produced in the Audit process. They were also given two months to prepare for their Audit which was conduced in April, and were not prepared during that initial visit. Ms. Carboni explained that she provided an additional list with the requested documents and conducted a second site visit and was still not given copies or access to the requested documentation. At both visits a CCO or CFO was not present. At their third and final visit they were given access to more financial and patient records but were still not comfortable with how their operations were conducted. Ms. Deigl reminded the board that there was another issue concerning a pending criminal investigation against Phoenix Rising and asked for clarification on that matter. Ms. Cunningham stated that an investigation was conducted but they decline to prosecute due to the large number of resources it would take to bring the case to trial, however many of the discrepancies found in the Florida Department of Law Enforcements investigation were also discovered in the audit conducted by Ms. Carboni. Therefore, given this information the board must now decide how they would like to proceed with future funding reimbursement to Phoenix Rising. Ms. Cunningham asked if any Trustees were in favor of lifting the current suspension of funding and providing reimbursement for services completed in May and June. The board voted unanimously to not lift the funding suspension or process payment for services rendered in May and June. Next there was the matter of providing Phoenix Rising additional time up to August 19th, to cure the breach. There was Trustee discussion and they felt that the District provided them ample opportunity to provide the requested documents and the amount of time staff and Ms. Peshke have spent is more than that has been dedicated to any other organization who was required to provide the same within the Audit process. Additionally, Mr. Jones referenced correspondence from a CPA firm on behalf of Phoenix Rising, which stated that management had elected to omit the statement of retained earnings and sustainably all the disclosures ordinarily included in financial statements. The Trustees felt that Phoenix Rising is not accountable or transparent in their accounting practices and that the District has a fiduciary responsibility to fund agencies who are fully transparent with how District funds are utilized. Therefore, the Trustees voted unanimously to not to provide additional time to cure the breach and to terminate the current funding agreement. The Trustees agreed that this was an unfortunate situation, and that substance abuse treatment is a needed service within the community, however they have to be certain that the agencies are utilizing tax payer dollars for their intended purpose. Ms. Peshke indicated that she would send written correspondence to Phoenix Rising outlining the outcome of todays meeting.

FY 22-23 Budget Discussion Meeting – Allen Jones, Treasurer & Ann Marie Suriano, Executive Director

Mr. Jones stated that he has prepared a recommendation for the upcoming budget, which he reviewed with the Trustees for their consideration. He is recommending approving the general outline budget as prepared by Ms. Suriano, with a proposed millage of .5774. He explained that this effectively returns excess reserves of $1.7 million to the taxpayers and will leave $4.25 million in operating and healthcare contingencies if needed. Additionally, investments of $2,550,000 could be used in the future, if appraised values drop as much as 12% back to last year’s $20.6 billion level, without requiring the District to raise the millage rate while maintaining program expenditures at $13.4 million. This is assuming Trustees applied the investment reserves to make up for the loss of ad valorem tax revenue. Alternatively, he explained that the millage could be raised and leave the investment reserves unchanged at $2.55 million, or the District could release some of the reserves to keep a millage increase lower than it would have been. He further stated that 12% is the largest one year drop in the history of appraised values as referenced in the millage rate chart prepared by Ms. Suriano. Lastly, he explained that budget outlined assumes every agency gets precisely what they have requested for funding. However, if there are items in the present proposed budget that ultimately are not approved for expenditure, he suggests returning those funds not approved to investments i.e. reserves, providing the District more flexibility in the future.

Ms. Suriano addressed the board and stated that she recently attended the State of the County luncheon which provides an update concerning things that are happening in the county. At the meeting Jason Brown provided an overview of the county’s budget and explained that there was a 13% increase in the gross taxable value and approximately $500,000 in new construction. Therefore, the county is maintaining its current millage rate into next fiscal year. There were some funding requests from local organization which had increased, but they did not choose to honor those requests fully.

Next, Ms. Suriano led group discussion regarding the FY 22-23 agency funding requests. She explained that Ms. Frederick prepared a scale to reflect each request and the board reviewed the same and had lengthy discussions surrounding each request. It was decided that they would like additional information from some of the agencies pertaining to specific items in their funding request or have the agency come back in front of the board to address further questions. It was also decided that next month instead of holding a chairman’s meeting, a special meeting would be held to specifically address the follow up questions the Trustees had concerning the funding requests. Ms. Suriano stated that she would update the budget to reflect the Trustees declining to fund Phoenix Rising and Miss B’s Learning Center and place those funds into the reserves. Lastly, it was discussed that this tentative budget will be approved at next weeks regular monthly meeting.

Public Comment & Adjourn

Mrs. Cunningham asked for public comment and there was none. The meeting was adjourned at 2:50 PM.



William P Cooney MD is an orthopedic surgeon (retired) who has been a resident of Vero Beach since 2004. He practiced orthopedic surgery at Indian River Medical Center from 2006-2015 within the orthopedic practice of Prosports. He served on the IRMC Foundation for four years. Prior to this, he was a Professor of Orthopedics at Mayo Clinic in Rochester Minnesota, Chair of the Division of Hand Surgery and Vice president of the Department of Orthopedic Surgery. He served as the Vice Chairman of the Mayo Clinic Development Department. He has been President of the American Society for Surgery of the Hand, Orthopedic Research and Education Foundation, Consultant at Shrine Hospital systems. He was editor in chief of the Journal of Orthopedic Surgery and co-editor of the Journal of Hand Surgery. He held grants in hand and wrist surgery sponsored by National Institute of Health (NIH) and Stryker Orthopedics and has over 250 publications in the field of orthopedic surgery, hand, wrist and elbow surgery and microsurgery- free tissue transfers. Within Indian River County, he has served as Chairman of the Board and President of the Hope for Families Homeless Center, Board of the Indian River Hospital Foundation, We Care and Whole Family Health Center medical practices.

Term:  1/23-12/24

Origination: Elected (2 OC)

Occupation: Retired Surgeon



Kerry Bartlett,  of Vero Beach, has more than 30 years experience in philanthropy, including as vice president of the VNA & Hospice Foundation; VNA chief advancement officer from 2001-2007; and executive director of the Indian River Community Foundation from 2008-2014. Kerry is the founder of The Bartlett Company, which focuses on nonprofit and philanthropic consulting. She also is a managing director for Carter, a Vero Beach company that specializes in advancing philanthropy worldwide. Kerry has spent more than 25 years in the nonprofit sector as a fund development professional and has particular expertise in annual funds, major gifts, endowment campaigns and legacy giving. Kerry is also known for creating and implementing effective donor-centered stewardship programs that build, maintain and strengthen nonprofits’ relationships.

Term:  3/21-12/22   |   1/23-12/26

Origination: Appointed by Governor Ron DeSantis
Elected NOC

Occupation: Philanthropic Consultant/Managing Director



Karen has been President and CEO of Senior Resource Association, where she successfully advocates for older adults and their families, since 2006. In that role, she helps provide activities, education and services benefiting older and disabled adults in Indian River County. In addition, Karen provides oversight of the community mass transit system for residents and visitors of the county. As CEO, Karen is responsible for a $7 million operational annual budget and managing more than 100 employees. She ensures that fiscally sound and responsible solutions are created to provide healthcare and a better quality of life for all Indian River County residents. Karen earned a BS in Health Administration from Florida Atlantic University and an MHA from the University of Florida. She was elected to the Indian River County Hospital District Board of Trustees in 2016, and joined the Board in January 2017.

Term:  1/17-12/20   |   1/21-12/24

Origination: Elected 1 OC | Elected NOC

Occupation: President/CEO



Paul Westcott has been a Board Certified Workers' Compensation Attorney since 1999. In addition, Paul has earned his certification from the Florida Supreme Court as a Circuit Civil and Family Law Mediator. Receiving his Bachelor of Arts degree in both Economics and Political Science at Florida Southern College, he continued his education at Stetson University College of Law. He graduated from Stetson in 1988, having been a published member of the Stetson Law Review. Paul has been a member of the Florida Bar since 1988.  He began his practice in a combined civil litigation and transactional practice before serving as an Assistant State Attorney.  He began his career in Workers' Compensation with Rissman, Weisberg, Barrett, Hurt, Donahue & McClain P.A., where he handled Workers' Compensation cases at the trial and appellate levels.  In 1997, Paul opened the Ft. Pierce office of Hurley, Rogner, Miller, Cox, Waranch & Westcott P.A. handling workers' compensation cases at all levels throughout central and south Florida, while managing the operations of that office.  During his nearly 25 year career in Workers' Compensation, he lectured on a wide range of industry topics.

1/23-12/26   |   1/21-12/24

Origination: Elected 1 OC 

Occupation: Attorney & Mediator



Barbara has practiced physical therapy, specializing in orthopedics and sports medicine, in her hometown of Vero Beach since 1981. She was an integral part of the sports medicine team at Vero Beach High School for 35 years. Barbara completed the reserve police academy training, and served with the Vero Beach Police Department from 1982-1989. Her volunteer involvement in the community includes serving on the City of Vero Beach Recreation Committee, Arthritis Association of Indian River County, and the Senior Good Life Games. She and her husband, Michael, enjoy spending their free time traveling in their RV and training their Labradors, Gunner and Chase, in K-9 performance events, including agility and dock jumping. Barbara is a lifelong resident of Indian River County, and received her degree in physical therapy from Chattanooga State College. Barbara was elected to the Indian River County Hospital District Board of Trustees in 2016, and joined the Board in January 2017.

Term:  1/17-12/20   |   1/21-12/24

Origination: Elected 1 OC | Elected 1 OC

Occupation: Physical Therapist



Born and raised in Illinois, Michael was a Theatre and Speech Instructor at Lincoln College when he moved to Indian River County in 1984. He was the Director of Education for the Riverside Theatre for a decade, helping to build the Riverside Children’s Theatre and directing many productions. Michael is well known in the community for his 25 years of service at the United Way of Indian River County, 16 of those years as the CEO. He is very proud of his work with dozens of nonprofit agencies and his commitment to creating and strengthening community collaboratives. Michael was also an Adjunct Faculty member at Barry University for 20 years. He has served on many boards and committees over the years, including: Children’s Services Advisory Committee Needs Assessment, Chair of the Emergency Food and Shelter Program for many years, and he was a founding member of the Mental Health Collaborative, the Senior Collaborative of IRC and the IRC Executive Roundtable. As a Hospital District Trustee he is committed to serving all the citizens of our county. In particular, he hopes to see enhanced availability and affordability for behavioral/mental health for all in need.


Term: 1/23- 12/26

Origination: Elected 1 OC

Occupation: Retired CEO United Way



Marybeth’s professional career encompasses 34 years of working for GM/Delphi in a variety of positions. Starting out as a traffic claims clerk, she worked her way through the organization, with roles in Purchasing, Engineering, and Quality and Reliability. She retired in 2009 as the executive director of Global Operations for the Packard Electric Division of Delphi. In this position, she was responsible for 94 plants in 33 countries. Marybeth has served on the board of directors for numerous non-profits, including Northeast Ohio Adoption Agency; United Way of Warren Ohio, where she served as chairman of the annual campaign for two years; Up with People; Head, Heart and Hands of Indian River Club; Indian River Community Foundation, and the Indian River Mental Health Collaborative. She earned her B.A. in Political Science from Albion College. Marybeth was elected to the Indian River County Hospital District Board of Trustees in 2014, and joined the Board in January 2015. She currently serves as Chair.


Term:  1/15-12/18   |   1/19-12/22   |   1/23- 12/24

Origination: Elected 1 OC | Elected  NOC | Elected NOC

Occupation: Retired Executive GM