Indian River County Hospital District

Chairman’s Meeting: February 15, 2023

Indian River County Hospital District Conference Room/ Zoom
February 15, 2023

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

ZOOM: Marie Andress Lauren Meeks
Ann Marie McCrystal William Wims
Anne Posey

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

ATTENDEES: Phil Cromer Cynthia Cox
Amanda Busbin William Roller
Lisa Kahle Patty Harris
Darcy Davis Belman Andric
Karleen Russ Jax Howard
Lee Mangiapani Eric Flowers
Chriss Papayannis Vicki Soule

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person.

Mental Health Court Program Update- Judge Nicole Menz.

Judge Nicole Menz introduced herself and introduced the team she brought with her today, who help oversee all matters concerning Mental Health Court (“MHC”). She also invited three graduates from the program to share their experience with participating in the program and what their lives were like today because of the help they received. All three shared about the positive impact Judge Menz and their team had on their lives, and how through the help of the program they are able to maintain productive and healthy lives. Judge Menz discussed how an individual may be placed into mental health court, and explained that many are brought in due to their encounters with law enforcement and the program is offered as a diversion in their sentencing. Some are also placed in the program due to being deemed mentally incompetent. Next Judge Menz discussed the funding structure of the program and explained that for the last several years they have received funding from the Department of Family and Children Services (“DCF”) reinvestment grant administered by the Southeast Florida Behavioral Health Network (“SFBHN”). However, that funding will cease beginning June 2023. Amanda Busbin from the SFBHN addressed the board and stated that the three-year grant which was awarded in early 2020 for the period of July 2020 – June 2023, will not be renewed. She explained that before this year there has been open opportunities to apply for grants, so the work could continue without any gaps in service, however due to funding constraints DCF has chosen to allow this year to be open only to planning grants. This decision effects Indian River County along with 15 other counties in the state of Florida including Brevard, Duval, and Miami. Therefore, the program will need to obtain additional funding to support the period of July 1- September 30, 2023. She further stated that DCF does plan on opening up solicitations for 3-year awards, but those will not be available until July 1, 2024. Judge Menz stated that the total amount to support the shortfall is $130,000. The Trustees then heard comments from Sherriff Flowers and Karleen Russ, who is the case worker for mental health court, about the importance of the program and the benefit it offers to those individuals who choose to participate. Judge Menz then provided the Trustees with an overview of the structure of the program, and stated that each participant that is referred to the program undergoes a needs assessment and then follows an individualized program plan, which typically includes medication management, substance abuse treatments, random drug screens, frequent court attendance, weekly contact with case manager, and self-help meetings, as well as transitional housing if needed. Since the inception of MHC 593 defendants have been referred to the program and 212 have successfully graduated. Felony defendants spent a minimum of 12 months in the program and misdemeanor defendants must spend a minimum of 6 months in the program. Currently the MHC has 110 active participants and the overall recidivism rate is at 7%. She then reviewed the breakdown of funding sources that support the program which include funding from Indian River County Drug Abuse Trustee Fund, Indian River County Sherriff Office and other local and state funded resources. There was also discussion the similarities and difference between mental health court and drug court. The main being that drug court is supported through fees paid by the participants, MHC collects no fees from its participants.

Next there was discussion about the need for additional personnel to help support MHC. Ms. Cunningham stated that there was a discussion surrounding this need a the Mental Health Collaborative meeting yesterday and it was stated that there needs to be a clear picture of each funding source and what areas of the program are funded by those sources, and where any additional gaps in funding may be. It was also discussed that a group should be formed to work through this issue. Judge Cox stated that the Mental Health Collaborative did form a committee that will help facilitate this. Therefore, between now and June, that committee will work on formulating an intensive plan to bring forth to the county, on how best to support and fund this program in future years. There was group discussion and it was suggested that a District Trustee patriciate as a member of that committee and Ms. Bartlett volunteered to fulfil the role. After further Trustee discussion Ms. Deigl made a motion to approve the request, which was seconded by Ms. Bodnar. The motion carried unanimously. Lastly, Judge Menz invited the Trustees to the next Mental Health Court graduation which will take place on April 11th, to see the benefit of this program first hand.

Mr. Westcott asked if the board had any interest in reaching out to the Governor’s office, by way of letter, to ask for a response as to why the funding for this program had not been renewed. Ms. Deigl stated that before any correspondence is sent, the District needs to have all the facts surrounding the program grant and its funding structure. Dr. Cromer indicated that he was in Tallahassee last week lobbying for a variety of mental health initiatives and met with the Vice Chair of Health Appropriations Committee and brought up this issue with Mental Health Court. He explained that Representative Salazar who is knowledgeable about the program was unaware that the funding was being discontinued and indicated that she would look into the matter. Ms. Cunningham asked that Dr. Cromer work with the District is finding the appropriate persons to contact to further discuss this issues. It was also decided that Ms. Voss would work to follow up with all parties to set a meeting to discuss how the approved funding would be distributed, and that the appropriate back up documentation was obtained in compliance with District funding requirements.

Health Care District of Palm Beach County- Darcy Davis, CEO & Dr. Belma Andric, CMO

Mrs. Cunningham explained that Ms. Suriano and Ms. Bartlett had a discussion with Ms. Davis several months ago as to how their District operates and their strategic planning processes. Therefore, they invited Ms. Davis to address the board as a whole and provide information and understanding to the Trustees regarding the Health Care District of Palm Beach. Ms. Davis addressed the board and provided an overview of the structure of their District. She explained that they are an independent special taxing district, with a governing board who is appointed, not elected. Their board does levy a property tax and since she became CEO 6 years ago, they have dropped their millage rate by 26%. Additionally, she discussed the transition of the District from being solely a payor for healthcare services, to a provider of healthcare services, and as stated in their mission, their District is to be the health care safety net for Palm Beach County. Next, she discussed the Districts responsibility to the community and reviewed their enabling legislation statute, which like IRCHD, provides broad language outlining their purpose, which allows flexibility to achieve their mission. She then discussed their funding structure which is made up of three areas which include property tax revenues, net revenue from healthcare payment sources, and grants. She then provided an in-depth review of the services their District provides and supports, along with the entities that they own. Currently they own and operate a 70-bed rural acute care hospital, a 120 bed long-term care skilled nursing facility, 10 Federally Qualified Heath Centers (“FQHC”), which include 3 mobile clinics. They also operate a ground ambulance program which has two ambulances that provide interfacility transportation and transports for specialized treatment. Additionally, the operate a school health program which provided staffing of nurses to nearly 170 public schools in Palm Beach County. The District currently has 1,300 dedicated and committed team members who help support all these services.

Dr. Belma Andric who serves as the Chief Medical Officer and Vice President and Executive Director of Clinic Services of the District addressed the board. She provided a detailed overview of the clinic structure and how receive provided care. She explained that all patients who present at their facilities are provided with care, regardless of their ability to pay. Their financial counselors will help determine the appropriate payor source and they also utilize a sliding fee scale. Additionally, they use an integrated care model and their quality outcomes are among the top 10% in the country among FQHC’s, and all of their efforts are based on data driven outcomes. Next, she reviewed data concerning service types and patient visits, along with quality measures and performance metrics. She also reviewed the integrated care model in greater detail showing the full picture of what the continuum of care for a patient and family looks like. There was Trustee discussion on the same and they also discussed the reimbursement method for their various areas of services. Another area of focus and measurement tool they are utilizing is social determinants of health. She also reviewed data concerning mental health and substance abuse treatment, which have both increased over the last several years. She presented a chart which outlined their addiction stabilization unit patient flow, which provided an overview of their approach to substance abuse management and treatment. There was also discussion concerning their Districts management of the counties FQHC’s. Lastly, Ms. Davis discussed the Districts next steps and initiatives, which included the replacement of one of their trauma helicopters, phase two of the transition to the electronic health records system EPIC, a behavioral health network expansion, and a community partnership school project.

Other Business

Ms. Cunningham stated that since there are three new Trustees, she suggested that the Trustees hold a meeting to review the strategic plan and set action steps to move forward with the process. The Trustees agreed and District staff will work on scheduling the same.

Ms. Peshke addressed the board and provided an update concerning the VNA vacating the Human Services Building (“HSB”) and the future use of the building. She explained that next week, Ms. Suriano and representatives from CCIRH will tour the HSB so they have a better understanding of what their potential future use of the space could be. Next, she explained that correspondence was also sent to representatives at the CCIRH concerning their future utilization of the parcel at 82nd Ave, which is currently incorporated into the lease agreement with the District. Their legal counsel indicated that they are working on a response and should have something to the District in the next few weeks. She will update the Trustees on both matters when more information becomes available.

Public Comment & Adjourn

The meeting was adjourned at 12:00 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