Indian River County Hospital District

Special Meeting- Budget Discussion: August 17, 2022

SUMMARY MINUTES
SPECIAL MEETING- FY 22-23 Budget Discussion
Indian River County Hospital District Conference Room/ Zoom
August 17, 2022
10:00 AM

TRUSTEES: Barbara Bodnar Kerry Bartlett
Allen Jones Ann Marie McCrystal

ABSENT: Karen Deigl

STAFF: Jennifer Frederick Kate Voss
Dawn Carboni Ann Marie Suriano
Jennifer Peshke, Esq.

ZOOM: Andrea Berry Bill Cooney
William Winns Marie Andress
Sabby Hightower Michael Kint
Marybeth Cunningham

ATTENDEES: Pat Knipper Lundy Fields
Ed Love Daniel Gatins
Mary Silva Linda Kloss
Alethia Dupont Moreen Burkard
Elizabeth Appleton Randy Riley
Elizabeth Adams Brett Hall
Jeffery Zipper Maiti Soria
Marty Mercado

Convene Meeting – Kerry Bartlett, Vice Chairman

Ms. Bartlett convened the budget discussion meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person. She also extended her thanks to all the funded agencies who were present at today’s meeting.

FY 22-23 Agency Funding Request Follow Up & Budget Discussion- Ann Marie Suriano, Executive Director

Ms. Suriano stated that the board met on July 12 for their first budget discussion meeting and, at that time, additional information was requested from the funded agencies regarding their funding requests. Therefore, Ms. Frederick submitted those questions to the funded agencies for follow up and prepared a detailed sheet with the responses as well as an outline of the requests separated into program and fee for service requests. Ms. Suriano explained that she would go through each item with the Trustees to see if there were any additional questions, and would also provide opportunity for the funded agency to respond as well. First, she began by addressing the Healthy Start request to support the Program Data & Sustainability Coordinator. She informed the Trustees that Healthy Start has obtained revenues from another funding source for this program and that they are withdrawing their request.

Next, there was discussion concerning the Hope for Families request and some Trustees asked for more clarification concerning the funding for the administrative and equipment cost. Ms. Frederick stated that Hope for Families submitted follow up data concerning the request which included a breakdown of expenses. It was also clarified that this request was not going towards any type of capital expense.

The discussion continued surrounding the new funding request from iRecovery. Many of the Trustees asked for further understanding of the referral process and wanted to see proven outcomes. Ms. Suriano stated that she and Ms. Carboni conducted a meeting with iRecovery to discuss their for-profit status and what would be required of them to disclose during the Districts’ annual audit of the funded agencies. Dr. Zipper, CEO of iRecovery was in attendance and provided an update to the Trustees concerning the status of the creation of their Foundation entity. He explained that the Foundation has been created and they are currently in the probationary period awaiting their final licensing from DCF. Therefore, if the Trustees felt more comfortable with providing funding directly to the Foundation, in lieu of the for-profit entity, they would be happy to partner under that direction. Next, there was discussion surrounding the effectiveness of detox and substance abuse treatment via telehealth and Dr. Zipper stated that there was a recent CMS study supporting this method of treatment. Additionally, many patients find this method to be more comfortable and supportive, as it takes place in their home. Lastly, Mr. Hall from the McCabe Connections Center addressed the group and stated that he has referred three patients to iRecovery for services and they had very positive things to say about their experience.

Next, there was discussion concerning Senior Collaborative and Mr. Riley was in attendance to answer any questions. It was discussed that supplemental information was provided to the Trustees yesterday, and many still needed time to review the same. There were no additional questions at this time. They also discussed the follow up information they received from Substance Awareness Center and were satisfied with their response and had no further questions.

Ms. Suriano stated that the next item up for discussion was the new funding request from Sunshine Physical Therapy. She explained that the agency provided supplemental information for the Trustees to review and consider. Additionally, Ms. Carboni prepared a report for the Trustees which outlined their responses to the Pre-Audit Questionnaire. Ms. Frederick informed the Trustees and she and Ms. Carboni conducted an on-site visit at Sunshine and were very impressed with their facilities and operations. There were no further questions at this time from the Trustees.

Next there was lengthy discussion concerning Tykes & Teens, and the interim Executive Director Linda Kloss asked to address the board. She thanked the Trustees for their support during this transition period and provided an update concerning their search for a new CEO, which should be completed by end of September. She then discussed that the organization has been able to remain stable through these uncertain times and have only lost two employees. Additionally, they are working with an attorney to address and correct the Audit findings from Ms. Carboni’s report. Dr. Dupont, Director of Outpatient Services addressed the board and provided a review of data and outcomes metrics from their Martin and St. Lucie County sites. Mr. Jones voiced his concerns regarding the fact that the two other programs Tykes & Teens operated in Indian River County were not sustainable and questions how this outpatient program they are requesting substantial funding for, will be more successful. Ms. Kloss explained that they are already operating the program successfully in Martin and St. Lucie County and would be utilizing the same method and proven outcomes. The program would treat 6–17-year old’s and is a needed service within the community to help combat the increased need for therapy services. There were no further questions at this time.

Ms. Suriano stated that the Trustees had follow up questions concerning the VNA’s new request for funding the community health worker and music therapy programs. She explained that VNA has reframed the community health worker program to a social worker and Ms. Knipper provided a very detailed PowerPoint presentation which was given to the Trustees prior to todays meeting for review and asked if there were any further questions. There were discussions surrounding the VNA’s request to support the social worker and some Trustees felt this was a duplicative request for service, which is already being provided by other District funded agencies and within the current funding for the home health program. Mr. Lowe ,COO at the VNA, addressed the board and stated that the VNA is asking for support of this position so they are better able to assist their home health and hospice patients. This navigator would help provide a better continuum of care for the patients and be a liaison between the patient and their families. They currently have a limited capacity with their staff, and this person would provide much needed support to those vulnerable patients. They would also be able to identify and address any additional social issues the patient may be experiencing such as food insecurity or mental health. Ms. Suriano asked for clarification on how this service would be billed to the District, and whether it would be on a fee for services basis or as a program expense. Mr. Lowe explained that it would be billed as a program expense but they would provide back up data showing the number of patients that were served and the cost per service. Next there was discussion surrounding the request for music therapy and Mr. Jones asked for data which showed outcomes measures. Ms. Burkhart provided some examples of the benefits of music therapy which help support mental and physical health. With the District support, it will help them expand their reach within the community and provide more therapy services. Additionally, the VNA is the only agency within Indian River County who provides music therapy. They also work with the Mental Health Association and work with their at-risk youth population.

Mr. Jones asked if the group could have a discussion concerning GlobeChek which was not formally included within the budget discussion materials. Ms. Suriano stated that the original request to support eyecare services was included within Whole Family’s request however through recent discussions there has been alternative funding and GlobeChek operating structures proposed and the Trustees should be updated on the same. Mr. Jones explained that as the Trustees know the pilot program with GlobeChek and Whole Family Health Center has been successful and they are looking to expand the program to provide this service to more people in the community, in the most effective and fiscally responsible way. Since March the Globe has screened 893 patients at Whole Family Health Center and 40% of those patients needed some form of follow up care. It is also worth noting that only 12% of the patients screened were District eligible patients. Therefore, the Trustees would need to be comfortable with continuing to provide this service to not just District qualified patients. He asked Dr. Mallon to provide a brief update to the Trustees on their progress so far. Dr. Mallon stated that they weren’t able to see as many patients as they had hoped which caused them a financial loss for their staff time. However, they are pleased with the results of the pilot program and have been able to assist many patients with corrective action for their eye issues. Dr. Mallon further discussed how he believes the program can move forward and right now, there are discussions surrounding how best they can work collaboratively to expand this program to reach more individuals. There were discussions surrounding the Globe being mobile and being located throughout the county at different agencies. Currently, Whole Family Health Center has amended their funding request to include additional funding to support eyecare and GlobeChek. Ms. Suriano explained that this should be a collaborative effort and there have been discussions with the partners on the best way to do this. Therefore, there could be a placeholder of approximately $300,000 in the budget to support these efforts. Ms. Andress addressed the board and stated that Whole Family Health had originally requested $49,800 for eye care back in March, and was unsure at the time how well the pilot program was going to work. After analyzing the data, they realized they needed to request a higher amount which would include cost for the GlobeChek equipment, a 5-year lease, 2.5 staff, and the ophthalmologist reading the results from the scan. Ms. Andress further stated that she believes having the GlobeChek machine at their facility and not mobile, would be more beneficial and comfortable for their patients. Mr. Jones stated that in the next few days, he Ms. Suriano, Ms. Soule, Ms. Andress, and Dr. Mallon will meet to have further discussions on how best to move forward with this program. Mr. Jones will then provide an update to the Trustees for their consideration.

Lastly, Ms. Suriano stated that the Trustees have been provided with a breakdown of the requests separated into fee-for-service and program expenses. She also provided them with a proposed FY 22-23 budget with the current projected year end for program expenses. She will make further updates from todays discussion and circulate that document to the Trustees. It was further decided that the funding matrix would be circulated again to the Trustees for their input on the few outstanding budget line items that have not been agreed upon unanimously by the Trustees. There may also be a need for the Trustees to have an additional meeting to discuss the budget prior to the September 7th First Public Budget Hearing.

Public Comment & Adjourn

Ms. Bartlett stated that there were various public comments received by the District and she read the same aloud. The first was from Mrs. Arthur White, of the City of Vero Beach who stated she strongly encourages the board to support the GlobeChek program and any future funding requests. Eyesight is a critical part of life and these services could be lifesaving to a patient. The second comment was from Ken Daige, from the City of Vero Beach who stated that the board should support Dr. Mallon and the GlobeChek program. The third comment was from Brooke Steinkamp, from the City of Vero Beach and a County resident who stated she previously utilized IRCHD financial assistance and there were long wait times for dental care at TCCH. Additionally, she supports Dr. Mallon and the care he has provided to the underserved. Lastly, there was comment from Phyllis Frey who stated please fund and support Dr. Mallon’s program for helping the blind. There was no further public comment and the meeting was adjourned at 11:55 AM.

WILLIAM COONEY, M.D.

SEAT 7

William P Cooney M.D. 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   |   1/24-12/29

Origination: Elected (2 OC)

Occupation: Retired Surgeon

Email: w.cooney@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

KERRY BARTLETT

SEAT 6

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

Email: k.bartlett@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

KAREN DEIGL

SEAT 5

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   |   1/24-12/29

Origination: Elected 1 OC | Elected NOC

Occupation: President/CEO

Email: k.deigl@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

PAUL WESTCOTT

SEAT 4

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.


Term: 
1/23-12/26   |   1/21-12/24

Origination: Elected 1 OC 

Occupation: Attorney & Mediator

Email: p.westcott@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

CHUCK MACKETT, M.D.

SEAT 3

Charles “Chuck” Mackett MD is a practicing primary care physician who has a long and storied career in military, academic and executive medicine. Dr. Mackett recently retired from Cleveland Clinic Indian River Hospital where he served for fourteen years as Chief Medical Officer, Chief of Staff and President of Indian River Medical Associates. Dr. Mackett serves on the Board of Directors of the We Care Foundation of Indian River County and the Mental Health Collaborative of Indian River County. He currently cares for patients at Treasure Coast Community Health. These experiences give Dr. Mackett a unique perspective regarding mental health, substance abuse, maternal-child care, care for veterans, preventive medicine and access to high quality medical care.

Dr. Mackett is a graduate with honors from the University of Notre Dame and is a graduate from the SUNY Upstate Medical Center in Syracuse, NY. He is a member of the Alpha Omega Alpha National Medical Honor Society and earned his Master of Medical Management degree from Carnegie Mellon University. Dr. Mackett is trained in Aerospace Medicine and is board certified in Family Medicine and Geriatrics. He is a combat veteran, former Air Force Hospital Commander and flight surgeon who served in Germany, Haiti, Japan, Korea, Romania and Iraq. His many military decorations include two Legions of Merit, a Bronze Star Medal, a Defense Meritorious Service Medal and three Air Force Meritorious Service Medals. Dr. Mackett is an Outstanding Graduate of the Air War College.

A native of Upstate New York, Dr. Mackett and his family first moved to Florida in 1996 when he served as Fight Commander and Residency Program Director at Eglin Air Force Base before later serving as Medical Group Commander at Patrick and MacDill Air Force Bases. Dr. Mackett served as Associate Professor, Executive Vice Chairman of Family Medicine and Consultant in the International and Commercial Services Division at the University of Pittsburgh Medical Center before returning permanently to Florida and Vero Beach in 2009.

As a Hospital District Trustee, Dr. Mackett plans to advocate for improved access to mental health services and access to affordable high quality primary and specialty care for all residents of Indian River County particularly mothers, children, the elderly, the underserved and veterans.

Term: 1/24-12/29

Origination: Elected NOC

Occupation:  Primary Care Physician

Email: c.mackett@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

MICHAEL KINT

SEAT 2

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

Email: kintm.irchd@gmail.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

ALLEN JONES

SEAT 1

In 1973, Mr. Jones began a 27 year career with Merrill Lynch, eventually becoming a senior executive of the company, Senior executive positions included Chairman and CEO of Merrill Lynch Life Insurance Company, serving on the Private Client Executive Committee and various other leadership roles including leading the effort to transition Merrill Lynch to a fee based rather than commission based business. Prior to joining Merrill Lynch, Mr. Jones’ professional career began in the United States Air Force from 1964-1968, achieving the rank of Captain. He then worked with Investment Company Dabbs, Sullivan, Trulock located in Little Rock, Arkansas rising to partner before the firm was sold and joining Merrill Lynch. Mr. Jones received his B.S.B.A in 1964 from University of Arkansas. He further completed advanced management courses at the Kellogg School of Business at Northwestern University, the Wharton School of Business at the University of Pennsylvania and Stanford University. His past community service efforts include serving on the Board of Directors for the John’s Island Club from 2008-2010; Board of Directors for the Indian River Medical Center from 2007-2010; Chairman of the Indian River Medical Center Foundation from 2006-2010; Board of Directors of the Bedens Brook Golf Club; Board of Directors of the Princeton Community Hospital from 1994-1999 and the Chairman of the American Health Association, in Houston, Texas.

Term: 1/24-12/29

Origination: Elected 2 OC

Occupation: Retired CEO

Email: a.jones@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960