Indian River County Hospital District

Chairman’s Meeting: December 18, 2024

SUMMARY MINUTES
CHAIRMAN’S MEETING
Indian River County Hospital District Conference Room/ Zoom
December 18, 2024
10:00 AM

TRUSTEES: Marybeth Cunningham Barb Bodnar Michael Kint Paul Westcott
William Cooney Karen Deigl
Kerry Bartlett

STAFF: Dawn Carboni Jennifer Frederick
Kate Voss Frank Isele
Jennifer Peshke, Esq. Kaytlin Dickens

ZOOM: Anne Posey Larry Reisman Marie Andress Kim Jeansome
Mike Bolack Lisa Zahner
Ivy Marchesini Judi Miller Chuck Brookes Fran Prossick Allen Jones Deborah Shellenberger Nick Slater Cecelia Stalnaker Heather O’Shea Raquel Rivas Pat Knipper Kristina Roberts Thomas Kenny Jeff Susi Jennifer Pippin Lisa Witkowski
Andrew Decicco

ATTENDEES: Vicki Soule Jan Mooney Carol Kanarek Ann Marie McCrystal Lauretta Farrell Shaun Leydon Bob Auwaerter Sandy Stepanek Kelly Corrigan Brook Chipman Lance Lunford Jennifer Holloway Richard Corrigan Stuart Kennedy Rosemaire Wilson Rod McLachlan Bonnie Sciarretto Shane Meeks Wayne Creelman

Convene Meeting

Ms. Cunningham convened the meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person. She stated that for clarification purposes the District Trustees will not take any formal action or vote today. Today will consist of discussion only. Next, she stated that during this season of thankfulness she would like to recognize the District staff for their work this year.

TCCH & Mental Health Court Semi Annual Update

Ms. Soule stated that the six-month update regarding TCCH and their clinics was submitted to the Trustees prior to today’s meeting. Additionally, Shaun Leydon Director of the Mental Health Court program was also present for today’s meeting; to answer questions the Trustees may have regarding his report. The Trustees were pleased with the outcomes for the mental health court and felt that the programs operations were moving in a positive direction. There was also discussion encouraging them to continue to look for additional funding sources for the program. Additionally, Mr. Leydon is scheduled to meet with Ms. Frederick and Ms. Carboni for discussions on how they can develop stronger data collection and metric outcomes for the program.

Next, Ms. Soule discussed accomplishments, challenges and unforeseen events TCCH has experienced over the last 6 months. She stated that they have finished their conversion to Epic, which initially had its challenge and led to a decrease in patient encounters but has shown to improve efficiency in the long run. There was also discussion surrounding the Districts financial assistance application process required for TCCH patients and the challenges their patients experience with providing the requested documentation. Ms. Dickens stated that she is working with some of the health navigators at TCCH to work through these challenges, as well as making potential updates to the District’s financial assistance database to offer a electronic option for completing the paperwork. It was assured that the District is committed to working with TCCH to solve these issues moving forward. Lastly, Ms. Soule stated that they expect to see a dramatic increase in Indian River County residents who rely on community health centers for their primary and preventative care. Due to the uncertain changes in federal and state funding for healthcare, it could potentially drive more to the emergency department, increasing the burden on CCIRH further. This is another reason why TCCH’s expansion is so critical to the residents of Indian River County to continue to address the county’s healthcare gaps.

Continuing the discussion, Ms. Farrell addressed the board and discussed the investment request which TCCH has brough before the board. She explained that they are requesting $1 million to support the expansion of primary and prevention healthcare services. She explained that TCCH has embarked on an initiative to develop a 20,000 square foot healthcare center dedicated to children from birth to 18. The total cost of the expansion plan is $21 million, which also includes a new health center in the western part of the county. Through the New Markets Tax Credit Program and a partnership with the Florida Community Loan Fund that will provide $15 million towards this project. She further explained that to qualify for the $15 million, TCCH needs to raise an additional $4 million, to bring this project to fruition. It was further clarified that the $4 million in funds would need to be pledged by February 2025. Currently, they have raised over $800,000, with an additional $100,000 commitment grant secured. There was Trustee discussion surrounding the request and it was decided that Trustees would submit their comments to Mr. Isele for follow up, with the intention of further discussion and deliberation in January.

CCIRH Uncompensated Care Follow Up Discussion

Ms. Cunningham addressed the board and spoke to the historical timeline of this matter. She stated that back in July, Dr. Rothman and Dr. Pease provided a presentation to the District regarding quality and patient care at CCIRH. During that time there was discussion surrounding the hospital’s indigent care volumes and outcomes. The Trustees asked for additional information and Dr. Rothman stated that he would come back before the board in the next few months to provide an update. In September, Dr. Rothman provided a presentation which discussed uncompensated care data and the reasonings behind the increase volumes and cost associated with it. The majority of the Trustees at that time asked how the District could help and approved Ms. Cunningham and Mr. Isele as the point of contact to work with CCIRH on a proposal. She clarified that CCIRH did not request funds from the District but that she and Mr. Isele created those figures based on the conversation they had with CCIRH CFO Mr. Iannucci. She further apologized to her fellow Trustees for any indication that she was trying to rush a decision on this matter, which was not her intention. It was further explained that, Mr. Isele is still working through obtaining the responses to the follow-up questions the Trustees have submitted. She further stated that this support is in no way a bailout and that these funds make up .7% of CCIRH total budget. She also reiterated that the Trustees would have additional time to consider this in the coming months and she will no longer be part of the process. Mr. Westcott referenced the correspondence written to CCIRH in July which addressed specific items with regard to indigent care and believe those questions had not been answered. It was discussed that CCIRH may not be open to sharing all information due to some items being of strategic in nature. Mr. Westcott further questioned the transparency of this matter and items not being shared publicly. There was also discussion surrounding the process of reviewing off-cycle funding requests and whether this was being circumvented for CCIRH. Mr. Isele stated that the District has an off cycle funding request policy and it is followed in this instance as with all other requests the District receives. There was also discussion surrounding how the District reviews financial and operating information for the funded agencies and Ms. Carboni spoke to the process that in in place. She confirmed that during her review she does not treat any agency differently from the other. She further stated that when she conducted the audit review of the Partners program, CCIRH was forthcoming with all the information she requested which took her several months to review. There was also discussion surrounding CCIRH responsibility to provide the District with audited financial statements and if there was language in the partnership agreements precluding them from this. Ms. Peshke stated that she believes CCIRH is in compliance with their reporting requirements, however she would review the documents to see if there was further language referencing an obligation to provide more detailed financial information. After further Trustee discussion it was confirmed that Mr. Isele would continue to work with CCIRH on obtaining responses to the Trustee questions with a goal of having those responses in 60 days.

Public Comment & Adjourn

There was no further business and Ms. Cunningham asked for public comment. Mr. Bob Auwaerter from Indian River Shores provided this public comment and encouraged the Trustees to obtain detailed financial statements for CCIRH operations, to assure the District is not supporting operational losses. He further stated his displeasure with any additional millage increase which would result in higher taxes. Mr. Stuart Kennedy of Vero Beach provided his public comment and stated that he recognizes the complexity of these issues but based on the reporting in 32963, it does not paint this situation in a good light. He encouraged the board to provide better transparency and insight to the public, to justify any additional spending. Ms. Kelly Corrigan of Vero Beach provided her public comment and stated that she appreciated the discussion today, however she believes that the public is not appropriately informed about these issues. She also questioned the terms CCIRH lease agreement and rental forgiveness clause. She further questioned areas of CCIRH operations including doctors leaving, patient satisfaction and emergency department wait times. She encouraged the board to take additional time and effort before making any decisions with regard to funding CCIRH. Next, Ms. Voss read two public comments which were submitted via the Zoom chat. The first was from Lisa Witkowski who stated that Ms. Cunningham should recuse herself from any board vote with regard to Cleveland Clinic. Second, she referenced the terms of commitment by the District to support indigent care during 2019, 2020, 2021 and if the District is still contractually obligated to provide financial support for indigent care. Lastly, Mr. Andrew Decicco recommended that the Trustee obtain a CCIRH audit report, not only the Cleveland Clinic Florida audit report. Additionally, he would like to see the CCIRH/IRCHD partnership documents posted to the Districts website. There was no further comments or discussion. The meeting was adjourned at 11:40 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