Indian River County Hospital District

Budget Presentation Meeting- June 7, 2022

Indian River County Hospital District Conference Room/ Zoom
June 7, 2022
1:00 PM

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

ABSENT: Kerry Bartlett Ann Marie Suriano

STAFF: Jennifer Frederick Kate Voss
Dawn Carboni

ZOOM: Jennifer Peshke Marie Andress
Pat Knipper

ATTENDEES: Samantha Messina Eric Garza
Elizabeth Appleton Jeffery Zipper, MD
Jose Zirena Andrea Greenlee

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.

FY 22-23 Funding Requests-

iRecovery- Dr. Jeffrey Zipper, CEO

Dr. Zipper began his presentation and discussed how this concept of providing addiction treatment services through telemedicine was created. He provided the Trustees with his credentials which included board certification in physical medicine and rehabilitation, and pain management. He explained that throughout his years treating pain management, he saw the devastation that took place from the illegal “pill mill” operations throughout the state of Florida. During this time, he was serving as President of the Florida Academy of Pain Medicine, and worked with the Florida Legislature in crafting what became known as the “pill mill” bill to put an end to the unregulated “cash pay only” criminal organizations. He further stated that in response to the opioid epidemic plaguing the nation, he founded iRecovery USA in October of 2019. He provided an overview of iRecovery and stated that it is a 100% Telemedical based multi-specialty physician group practice that specializes in the treatment of substance use disorder. The physicians are board certified in addiction medicine, psychiatry and rehabilitation medicine. They work collaboratively with their treatment team colleagues including psychologists, social workers (LCSW’s) and mental health counselors (LMHC’S) to provide medication assisted treatment and counseling for patients suffering with drug or alcohol abuse and other co-occurring mental health issues. iRecovery USA’s telemedical health care platform was conceptually designed to treat the medical and psychological needs of patients suffering with alcohol and/or opioid use disorder. This treatment is provided from the comfort of one’s home, work or anywhere there is internet connectivity on thier secure videoconferencing platform. Their social mission to democratize the treatment of substance use disorder to the historically underserved populations of Medicaid and Medicare recipients. He provided a review of the funding request which totaled $132,230, including four areas of service lines. He then reviewed the intake and prescreening process which verifies that a patient would meet criteria to participate. He further discussed what types of patients they served and the success rate of treatment and relapse rate. There was lengthy Trustee discussion and many of the Trustees were supportive of substance abuse treatment services but had a hard time conceptualizing completely virtual treatment method. Dr. Zipper stated that he would be more than happy to answer any of the Trustees’ questions and stated that they were welcome to contact him for further follow up.

Tykes & Teens- Eric Garza, CEO

Mr. Garza addressed the board and introduced himself and his team which included Elizabeth Appleton, Jose Zirena, Andrea Greenlee, and Samantha Messina. Also, board members Dr. Theresa Kelso and Pat Knipper were in attendance by Zoom. He and Ms. Appleton both shared their educational background and experience with the board and Mr. Garza then provided an overview of Tykes & Teens as an organization, which began in Martin County in 1996. Their mission is to prioritize children’s mental health in families, school and communities through prevention, education and treatment. They began providing services in Indian River County in 2019, with the Infant Mental Health Program and The Alternative to Out of School Suspension Program (“ALTOSS”). They also expanded their services to provide the CLASS program which has been operating for the last two years, and lastly their newest program Mental Health Consultation, which began one year ago. They also provided oversight to an organization Healthy Families in agreement with Healthy Start, to provide infant mental health services. Over the last few years, they began to look at what their priorities were as an organization and through those discussions it was decided that outpatient services would be their main focus. In April Mr. Garza, through the direction of the Tykes & Teens board of directors, made the decision to transition the Healthy Families program away from the oversight of Tykes & Teens, and Healthy Start was willing to take back ownership of the program, so they could focus more on providing outpatient services to the community. Therefore, the FY 22-23 funding request will include funding for an outpatient services program. There goal is to transition the two therapists who are currently supporting the CLASS program, into the role of providing outpatient services, and the CLASS program would be discontinued. He then provided an overview of the structure of the outpatient therapy program. He also discussed the challenges in being able to administer the CLASS program and why Tykes & Teens is deciding to transition away from that model. The main reason being is that many of the students they were providing services to already had a mental health care provider in place, so there was no opportunity for Tykes & Teens to work with those students and their outcomes metrics were not up to their standards. He further explained that in transitioning to outpatient services they will be able to demonstrate the true outcome of the services they provide and the impact it has on the individuals being served. Mr. Garza stated that the Tykes & Teens board is invested in continuing services in Indian River County and that they will soon embark on a capital campaign to further support their outpatient program venture. Also, their organization intends to work on expanding its philanthropic support. Ms. Appleton then provided a review of the Mental Health Consultation request and provided a brief history of the program. She stated that with the increased funding they are requesting from the District they would be able to hire two additional consultants who in turn could contract with eight new early childhood care education centers. There was Trustee discussion and Mr. Jones stated that he would like to address some of his concerns around the discontinuation of overseeing the Healthy Families program. He has received information from another source that he believes is contradictory to what Mr. Garza is reporting on the matter and asked for further clarification as to the events and reasoning behind the discontinuation of overseeing the Healthy Families program and that Tykes & Teens was unable to meet certain standards required to run the program. Mr. Garza provided a review of the events that led up to the decision to not continue the program, which were not due to being unable to meet certain financial and operation requirements needed to run the program. There was further discussion concerning the fact that if the District did not support Tykes & Teens, that they would be unable to continue to provide services in Indian River County, which Mr. Garza agreed. It was suggested that Tykes & Teens immediately begin looking for philanthropic funds to be able to support the start of providing outpatient services as soon as possible. This would make some of the Trustees feel better about the financial stability of Tykes & Teens and their sustainability in providing services to Indian River County.

Whole Family Health Center- Marie Andress, CEO

Ms. Andress addressed the board and provided an overview of the Whole Family Health Center’s (“WFHC”) funding request. She explained that there are two needed service lines that they are requesting funds for which included dental and eye care services. Another change was to their fee for service charge which has increased by 40% due to inflation costs of medical supplies, equipment, and higher salary wages. She then went into great detail about their current pilot program with GlobeChek which she explained has been quite an undertaking. She discussed the challenges they have faced thus far but stated participating in the program has shown them the need in the community for eye care services. The funding requested for eye care services would go towards furthering dialogistic services and potentially help with the purchase of eye glasses for patients. Ms. Andress then explained that over the past three years their patient population has increased threefold and they see this trend continuing in 2022 and beyond, supporting the need for increased access to care for the most vulnerable in the community. With this in mind, they have also decided to expand and provide dental services, which they plan to launch in early 2023. Lastly, she thanked the Trustees for their support over the last several years, specifically with the special funding request to support their efforts to combat COVID. She stated that they still are one of the main providers to provide treatment and testing services for COVID within Indian River County and St. Lucie County.

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