SUMMARY MINUTES
CHAIRMAN’S MEETING
Indian River County Hospital District Conference Room/ Zoom
April 16, 2025
10:00 AM
TRUSTEES: Chuck Mackett William Cooney Michael Kint Paul Westcott
Allen Jones Kerry Bartlett Karen Deigl
STAFF: Dawn Carboni Jennifer Frederick
Kate Voss Frank Isele
Jennifer Peshke, Esq. Kaytlin Dickens
ZOOM: Pat Knipper Barb Bodnar Ann Marie McCrystal Jeff Pickering Lisa Zahner Kelly Williams Cecelia Stalnaker Anne Posey Carrie Lester Lauretta Farrell Rauel Rivas Kim Jeansonne
ATTENDEES: Vicki Soule Bob Atwater
Convene Meeting
Dr. Cooney convened the meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person. Dr. Cooney stated that in an effort to provide better clarity to those attending via zoom, he asked that each Trustee state their name before speaking and to avoid talking over one another during Trustee discussion.
Dr. Cooney informed the Trustees that an informal meeting was held with community stakeholders involved in recovery residence work. There was discussion surrounding the different operating model’s clarity was provided surrounding services offered at recovery residences. He further stated that District staff continue to work on this project and further updates will be provided when appropriate.
Mr. Westcott requested an amendment be made to the agenda to include item 6 ‘‘other business’’. The Trustees agreed and Mr. Westcott made the motion which was seconded by Mr. Kint. The motion carried unanimously.
Review of Updated Conflict of Interest Policy & RFP Process
Ms. Peshke provided the Trustees with the updated conflict of interest policy. There was discussion surrounding the revisions, specifically regarding participation in discussion after a Trustee has recused themselves. Mr. Jones suggested clarifying the language to ensure that individuals can participate in discussion if requested by the majority of the Trustees, which was reflected on page four of the document. With those revisions identified Mr. Jones made a motion to approve the policy which was seconded by Mr. Kint. The motion carried unanimously.
Next, Ms. Peshke reviewed the in-office memorandum she prepared outlining the steps which needed to be followed when going out for a request for proposal (RFP). There were several steps which included a formal solicitation method and entity evaluation plan. Mr. Kint raised questions about the public advertisement and media requirements and asked if that should be elaborated upon. Ms. Peshke stated that this language was from Florida Statutes and many Trustees felt that listed a preferred media outlet may limit their options for publication of the RFP. There was further Trustee discussion and Ms. Bartlett recommended that a formal RFP policy be developed. Ms. Peshke indicated that she would work with the District staff on the development of the same and bring back a draft policy for the Trustees consideration in the next coming months.
Trustee Liaison Role Updates
Mr. Isele stated that several months ago, each Trustee was assigned a specific liaison role, and he reviewed those roles again with the board. It was suggested that quarterly designated Trustees would provide an update on their assigned items to the Trustees. District staff will work with the Trustees on developing a reporting out schedule to ensure effective communication.
Items for Trustee Consideration
Mr. Westcott addressed the board and stated he had a few items he wished to discuss with the board. The first being his initial request to explore the idea of seeking an attorney general opinion on the matter of the District Chairmans role as an ex-officio member of the CCIRH Board of Directors. Specifically, their dual loyalty to each board and potential for conflicts of interests. Mr. Westcott stated that he spoke with Ms. Peshke earlier in the week and she recommended that she first work with CCIRH legal counsel to develop a formalized process regarding confidentiality and reporting guidelines for the IRCHD board chair, that were agreeable to both the District and CCIRH. Mr. Westcott agreed with this approach and would withdraw his recommendation to seek a formal attorney general opinion. There was Trustee discussion, and the Trustees agreed that it is important for the District to have representation on the CCIRH board. However, there is a need to clarify what information can be released to avoid ambiguity in communication back to the Trustees. Ms. Peshke stated that she would reach out to CCIRH legal counsel to set up a meeting to discuss the next steps.
Next, Mr. Westcott stated that due to the recent reports Governor DeSantis has threatened the potential removal or reduction of ad valorem taxes, he believes the District should stay vigilant on this topic. He asked if the Florida Association of Special Districts has reported any guidance on this matter, which Ms. Voss stated they have not. Mr. Isele stated that while the District currently is dependent on ad valorem tax revenue, it is not required to solely operate this way, and he would like to explore other methods of generating revenue for the District. Some Trustees felt that the removal or reduction of ad valorem taxes is extremely unlikely and that the District should be more focused on the proposed Medicaid cuts and Federal funding cuts that many of the funded agencies are experiencing currently. Mr. Jones recommend that the District engage with a lobbyist in Tallahassee that can advocate on behalf of Special Districts interest.
District Staff Updates
Ms. Frederick provided an update and thanked the Trustees for participating in Monday’s special meeting for the roll out of the new funding evaluation criteria. She, Mr. Isele and Ms. Carboni have been diligently working to review the requests and hope to have their evaluations completed by April 30th. The goal moving forward would be for the e-C Impact portal to go live on May 1st for the Trustees to begin their review of the evaluations. The Trustees will then meet on May 8th to have a check-in meeting to discuss how the reviews are going one week into the process.
Ms. Carboni provided her update to the Trustees and stated she is close to completing her audit reports for the 22-23 fiscal year and just recently sent two reports out for the Trustees review. She will soon start preparing her audit schedule for the next round of reports which address fiscal year 23-24. She encouraged the Trustees to reach out should they have any questions or concerns.
Other Business
Mr. Westcott stated that he recently had a conversation with Dr. Rothman and Ms. Soule about the potential to use the TCCH mobile unit near the CCIRH emergency department as an alternative medical option for non-acute care. This may also help reorient patients towards establishing relationships with primary care physicians and deter them from using the emergency department for primary care. There was Trustee discussion, and it was stated that there are some potential legal issues surrounding this concerning boundary requirements for the mobile unit being positioned far enough away from the emergency department. It was also discussed that this matter came before the board several years ago when a similar model was proposed for the VNA mobile unit, and the project was unsuccessful due to varying factors. It was also discussed that TCCH has a medical clinic very near the hospital which could also be a viable option for patients. Ms. Soule addressed the board after Ms. Bartlett asked if she was interested in moving forward with this project. Ms. Soule stated that they have had issues with finding a suitable model for their mobile unit and are open to the potential partnership, should the legal requirements be addressed. She further stated she began these conversations with Dr. Rothman approximately a year ago, but it had been tabled until recently.
Ms. Bartlett clarified that Mr. Westcott’s role was just to convene Ms. Soule and Dr. Rothman for the initial discussion but that he would not move forward in the process due to his role as a District Trustee. She expressed her concerns that a Trustee would reach out to a funded partner to initiate conversation on a matter which could be perceive as an expectation of support or funding. Mr. Westcott confirmed that his initial role was to join the parties together based on an idea that he had and would not be involved moving forward.
Mr. Westcott stated that the 10-year commitment period for the lease with CCIRH is nearing and he wondered if it would be appropriate for the Trustees to have discussions surrounding areas of the substitution agreement. Specifically, the healthcare service areas which they are required to provide up to the 10-year mark which include behavioral health and maternity care. Dr. Cooney agreed that the board should have discussion on this matter and recommended that a special meeting designated for this topic only be held sooner than later.
Lastly, there was additional Trustee discussion surrounding an individual Trustee having offline conversations with funded agencies and/or local entities and the public. It was discussed that any time a Trustees does have conversation outside of a publicly noticed board meeting, they should always discern that they are an individual Trustee acting outside of the board. Ms. Peshke reminded the Trustee to always be conscious of the Sunshine Law and to not engage in activities which would be perceived as a violation of the same.
Public Comment & Adjourn
There was no further discussion and Dr. Cooney asked for public comment. Jeff Pickering of the Indian River Community Foundation addresses the board and stated that he appreciated Ms. Bartletts comments. He believes in the past there has been a perception that if a District Trustee was involved in a conversation or convened a group of community leaders, that there may be some influence associated with their role as a District Trustee. He believes it is important for the Trustees to distinguish in those instances that they are acting as an individual and not a District Trustees. There was no further public comment, and the meeting was adjourned at 11:30 AM.
