Indian River County Hospital District

Budget Workshop Meeting Minutes: May 25, 2018


Budget Workshop: UF; MHA; Health Department

Indian River County Hospital District

May 25, 2018


TRUSTEES:                          Marybeth Cunningham; Allen Jones; Ann Marie McCrystal;  Dr. Michael Weiss; Barbara Bodnar


EXCUSED:                           Karen Deigl; Tracey Zudans


STAFF :                                  Ann Marie Suriano; Jennifer Frederick; Kate Voss; Jennifer Peshke, Esq. (via phone)


OTHER ATTENDEES:     Wayne Creelman, M.D.; Gina Palladino; Robert Brugnoli, Ph.D.;  Jeanne Sheperd;  Angela Guzenski; Miranda Hawker; Herman Fountain, M.D.;

Dennis Saver, M.D.;  Mayur Rao; Shelly Stuven


Convene Meeting- Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the monthly chairman’s meeting of the IRCHD at 1:00 PM by welcoming those in attendance.


Funding Requests-

 UF Center for Psychiatry & Addiction Medicine- Wayne Creelman, M.D.

  Dr. Creelman provided a review of UF’s funding request for FY 2018-2019 which totaled $185,000. He stated that one notable change in the request from the previous year is that there is a $50,000 reduction in the community psychiatry service that was offered at the Mental Health Association. He explained that the UF physicians who provided psychiatric services at the Mental Health Association one day a week, will no longer be providing services due to lack of demand. The Mental Health Association hired its own licensed psychiatrist. Additionally, Dr. Creelman indicated that the center has seen an increase in patients seeking addiction treatment services but there has been a decrease in the suboxone medication program, which is a positive indicator. Further, Dr. Creelman indicated that the number of patient visits have decreased overall since 2015. He believes this could be due to patients seeking services elsewhere. He did indicate that UF has 94 referrals from the Connections Center. Lastly, Dr. Creelman discussed UF’s efforts to raise $320,000 in funding to support the bridge gap year for the clinic. He stated with help from local community philanthropy and support, they were able to raise the funds and continue operating the clinic.


Mental Health Association- Robert Brugnoli, Ph.D.

 Dr. Brugnoli provided a review of the Mental Health Association funding request for FY 2018-2019. The total funding request is $402,000 which included support for the Mental Health Walk-In Center and Pharmacy, along with the Mental Health Drop in Center, which helps support chronically ill mental health patients. He discussed the UF community psychiatry program in which MHA utilized the services of one UF psychiatrist once a week. He explained that MHA has now hired their own in house psychiatrist and are requesting funding to support that service. He further discussed the increase in walk in visits at the Walk-In Center and stated that 20% of their visit population is now children. Additionally, MHA is working to become a Medicaid qualified center. As a new initiative for MHA, Dr. Brugnoli stated that he met with Dr. Martinez and the Indian River County School Board. Together they have developed a plan to implement a violence prevention program. He explained that MHA would be requesting $50,000 from the District but that they are not requesting the funding at this time. He asked that the Trustees keep this request in mind to be discussed at a later time when there is more information about the program available.  Dr. Brugnoli further discussed the positive impact the District Care Card program has had on helping qualifying patients. He explained that before the care card many patients had trouble qualifying or were not compliant in returning the qualification documents. Since the implementation of the card, many patients are presenting at the Center and are already qualified through another health agency in the county.


IRC Health Department- Miranda Hawker, Health Administrator & Dennis Saver, M.D.

Dr. Saver provided the Trustees with a historical review of the We Care program. He explained the clinics mission and vision, which is to provide free quality medical care to the indigent population of Indian River through donated services from local physicians and programs. Their objectives is to provide streamlined access to specialty services and increased access to specialty care for indigent population. Ms. Hawker stated that data from 2016 shows 38,456 of  residents in Indian River County are at 150% or less of the Federal Poverty Level.  In addition, 18.8% of residents under 65 were without health insurance.

Ms. Hawker provided a review of the We Care funding request. The Health Department is requesting $319,766 in funding which includes the fee-for-service charge and the additional monthly program fee. Also included is the pharmacy request of $9,000 for a total of $328,766. They project approximately 1,620 visits to the clinic next year. In addition, they have hired a social worker to help improve patient relations.  Dr. Saver discussed his concerns with the pending partnership with IRMC and Cleveland Clinic. Currently, IRMC helps support We Care by providing supplies and operating rooms, along with the supplying the volunteer physicians. He fears that Cleveland Clinic will not help support We Care at its currently level after the partnership, and he requested that the Trustee include support for specialty services in their negotiations.  Dr. Fountain reviewed the list of medical services that patients are waiting to receive and he stated that there has been a 17% increase since the beginning of the year. There was further Trustee discussion and Mr. Jones requested a list of volunteer physicians that participate in We Care so that they may address the backlog of patients by identifying physicians in the area who work in those specialty services.

Mrs. Hawker provided a review of the Health Departments funding request for 2018-2019. The total request of $732,178 includes primary care and dental services, along with funding for the Gifford Health Center (“GHC”) which supports pediatric care. Ms. Hawker stated that there has been a 38.6% decrease in visits from last year. She believes this is primarily due to the transition in reimbursement to fee-for-service, instead of a grant sum. Additionally, they are anticipating 9,305 visits this year and an average cost of $154.38, which includes any labs and pharmacy charges. The proposed funding request for primary care is $526,861 which supports direct service personnel, maintaining patient care visits, and an administrative cost will help cover their variability in funding. Further they are requesting approximately $4,000 for the Gifford Health Center (“GHC”). Ms. Hawker stated that the Health Department will be expanding services at GHC and Healthy Start Coalition will have an office at the clinic beginning July 1 to house the Nurse Partnership program. She further reviewed the dental services and pharmacy request, which totaled $181,192. There was further Trustee discussion and Mr. Jones requested data concerning the infant mortality rate in the Gifford area.


Public Comment- There was no public comment.

 Adjourn- The meeting was adjourned at 3:00 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