SUMMARY MINUTES
CHAIRMAN’S MEETING
Indian River County Hospital District Conference Room/ Zoom
July 16, 2025
10:00 AM
TRUSTEES: Chuck Mackett William Cooney Michael Kint Paul Westcott (zoom)
Allen Jones (zoom) Kerry Bartlett Karen Deigl
STAFF: Dawn Carboni Jennifer Frederick
Kate Voss Frank Isele
Dana McNally Kaytlin Dickens
Shanen Cox
ZOOM: Kim Jeansonne Lauretta Farrel
Kelly Williams Raquel Rivas
Carrie Lester Anne Posey Lisa Zahner Ann Marie McCrystal Rick Rothman, M.D. Aurelius Brackins Pat Knipper Tracey Griffis
Nancee Long Karl Zimmerman
ATTENDEES: Bill Stewart Megan McFall Marie Andress Colette Heid Robyn Orzel Vicki Soule Wayne Creelman Cecelia Stalnaker Gerri Rorick Ginny Blossom Anna Flaig Roger Schlossberg Linda Walton Ban Bach
Pud Lawrence
Convene Meeting & Chairman’s Comments
Dr. Cooney convened the meeting of the IRCHD Board of Trustees at 10:00 AM by welcoming those participating via Zoom and in person. He asked Ms. McNally to provide a brief overview of the process for Trustees to disclose conflicts of interest and stated that a discussion should take place before there is immediate recusal. The Trustees may then take a vote to allow the person with the potential conflict to stay for the discussion.
Maternity Services Discussion
Mr. Isele led a discussion on the maternity services in Indian River County and the future stainability of providing those services. The discussion focused on the need for comprehensive maternity care, which includes prenatal, labor and delivery, and postpartum services. Currently the data from Cleveland Clinic Indian River Hospital (CCIRH) shows that financial losses and trends indicate that maintaining these services will become harder over time, without community engagement and support to sustain these services. He referenced the closure of maternity services at Martin North Hospital and how quickly such changes can affect nearby communities, highlighting that a similar closure in Indian River County could disrupt healthcare access and harm the local economy. As Trustees consider sustainability plans, he stated that it’s crucial to understand the short and long-term health, community, and financial impacts. Maintaining access to maternity care is essential for the healthcare infrastructure’s reputation, which influences workforce recruitment and economic development. There was further discussion surrounding the financial impacts CCIRH has experienced, and they currently project annual losses of $7.7 million for the OBGYN service line, and the funding request for the Partners in Women’s Health program affects the remaining sustainability gap. There was Trustee discussion, and many felt that additional information and community input was needed before they committed to future funding beyond the Partners program request. Mr. Isele recommended conducting a county-wide survey targeting women of childbearing age to gather input on access, preferences, and barriers related to maternity care. Additionally, he would like to host a community forum in collaboration with local prenatal and postnatal care providers, allowing for public dialogue and expert perspectives. Once those initiatives have been addressed, they will be better equipped with community feedback to incorporate into the decision-making process to ensure any District investment is aligned with resident needs. After further Trustee discussion, Ms. Deigl made a motion to approve Mr. Isele’s recommendations and the cost associated with the community survey. Ms. Bartlett seconded the motion, which was approved unanimously. Mr. Isele stated that he will follow up with CCIRH and provide a detailed outline of the Trustees next steps in this process, to ensure full transparency and the willingness to remain active partners.
FY 25-26 Budget Discussion
Mr. Isele stated that he prepared a detailed memo outlining the proposed tentative budget for FY 25-26. He explained that the proposed budget allows for some unknown variables currently affecting healthcare locally and nationally. He requested the Trustees need for flexibility, vigilance, and proactive planning, and being focused on the District’s core mission, to support health care programs and services that deliver direct, measurable impact. It was decided that there would be further discussion on the budget after the additional review of the e-C impact evaluation data.
e-C Impact Evaluation Discussion
Ms. Bartlett addressed the group reminding the Trustees of the guidelines for today’s discussion, which is to build consensus on program funding. Trustee questions about programs will be directed to Ms. Frederick for follow up, instead of asking the audience for input. Discussions should focus on aligning with the District’s strategic goals and the established conflict of interest policy must be followed. Finally, public comment will be addressed at the end of the discussion and reminders about those guidelines will be read by District legal counsel.
Ms. Frederick began the discussion by reviewing requests from a few agencies which Trustees had follow-up questions, from the July 10th meeting. After discussion a consensus was made to approve the requests from CCIRH for the Partners in Women’s Health program and behavioral health integration in the ED program. Next, there was a discussion surrounding the request from the We Care Foundation. Dr. Mackett announced that he is a volunteer board member for the organization and while he has no financial and personal gain from acting as a volunteer, he still would like to recuse himself from the discussion. After further discussion surrounding the conflict, the majority felt that Dr. Mackett should leave the room and recuse himself from the discussion. Ms. Frederick discussed the request and reminded the Trustees that Ms. Soule would be attending tomorrow evening’s board meeting to provide a semi-annual update on the progress of We Care, since TCCH tentatively took over operations. The Trustees agreed that they would refrain from making any decisions until after tomorrow evening’s presentation. Next there was discussion and consensus surrounding the request from Camp Haven for psychology counseling, which was approved at the full amount of funding. Lastly, there was discussion and consensus surrounding the request from Thrive for the prevention works program, which was also approved at the full amount of funding
Ms. Frederick continued the review of the scoring evaluation tool, with the next section reviewing programs which the majority of Trustees scored only to partially fund. Consensus was made regarding the request from the Learning Alliance which the Trustees agreed to partially fund at $82,500 and sunset funding at the end of fiscal year 25-26. The request from Tykes & Teens for the mental health consultation program was discussed, which the Trustees agreed to partially fund at $199,709 with funding concluding at the end of fiscal year 25-26. Next there was discussion surrounding program request from the Senior Recourse Association. Ms. Deigl announced she had a conflict and left the room prior to discussion. The Trustees discussed the request for Meals on Wheels (MOW), Public Guardian Program and Emergency Alert Response (EARS). They recognized the value of these programs but felt they were outside the strategic direction of funding for the District. A consensus was made to fund MOW $756,210 which is 75% of their total request, with funding concluding by the end of fiscal year 27-28, with subsequent reductions those following years by 50% and then 25% . It was also agreed that the Public Guardian Program would receive partial funding of $75,000 and sunset funding at the end of fiscal year 25-26. Lastly, EARS would also receive partial funding of $65,750 and funding would conclude by the end of fiscal year 26-27. Next there was discussion surrounding the music therapy program from VNA. A consensus was made to partially fund in the amount of $76,044, with funding sunsetting at the end of fiscal year 25-26. The request from Camp Haven to support drug testing was discussed and consensus was made to approve the request but shift the funding to Thrive, who administers the testing. Next, there was discussion surrounding the Mental Health Association Parents & Child Center funding request. The Trustees requested additional information, and a hold was placed for further discussion. Discussion continued with a review of the request from Sunshine Physical Therapy. It was acknowledged that volumes had increased, which accounted for the large increase in funding. A consensus was made to support the full request. The next request was from the Treasure Coast Homeless Services Council. It was discussed that the organization had rescinded its request as they are discontinuing the program effective September 30th and Mr. Isele stated that he would remove the funds from the budget. Next, there was discussion surrounding the home health services request from VNA, which had increased significantly from last fiscal year. After Trustee discussion consensus was made to partially fund at $185,530. There was then discussion surrounding requests from the Whole Family Health Center for the pharmacy program and Tykes & Teens for general mental health services, and consensus was made to fully fund both requests. Next, there was discussion surrounding the Emergency Meals on Wheels request from the Senior Resource Association. Ms. Deigl recused herself from the discussion and Trustees agreed to support the request at full funding, with the caveat that funding is limited to 90 days per client. There was also discussion surrounding the request from Hope for Families for the medicine technician, with a consensus made to fully fund. Prior to discussion Dr. Cooney recused himself and left the room. The last item discussed was the request from VNA for hospice services. There was Trustee discussion surrounding the request and its large increase from last year. Additionally, it was noted that the agencies’ general overhead expenses were extremely high at 32%. Based on those factors, a consensus was made to partially fund at $495,842.
Continued FY 25-26 Budget Discussion
Mr. Isele stated that based on today’s decisions, he has updated the budget to reflect the program amounts approved and will circulate the budget for review, prior to tomorrow’s meeting. It was discussed that the Trustees must approve a millage cap, which cannot be increased only decreased. It was recommended that a millage of .7650 be approved at tomorrow’s meeting with the intention of having further discussions and the potential to lower the millage rate. This current budget also constitutes a 10% increase in program expenditures, which is lower than the increase from last year. This budget also leaves adequate reserves which would provide the District with 3 to 4 months of operating expenses. After further Trustee discussions Ms. Deigl made a motion to approve the tentative budget with a millage rate of .7650, which was seconded by Ms. Bartlett. The motion carried unanimously. It was clarified that the formal vote on the tentative budget will take place tomorrow at the regular monthly meeting scheduled for 4:00 PM.
Other Business
Mr. Westcott stated that in the interest of time, he will defer the letters he addressed to the board for discussion at tomorrow’s meeting.
Public Comment & Adjourn
Dr. Cooney asked for public comment but prior to that Ms. McNally reviewed the guidelines for public comment. Ms. Robyn Orzel addressed the board on behalf of the Senior Resource Association. She clarified comments made about the MOW waitlist which is managed by the Area Agency on Aging and can only be satisfied by that federal agency. She noted that a 25% cut in funding for MOW would reduce meals for 70 seniors on the waitlist. She also highlighted the importance of the guardianship program, the only one in the county, which helps indigent, incapacitated individuals access essential services. The Trustees also heard public comment from Ginny Blossom and Linda Walton who spoke in support of the MOW and Guardianship program and encouraged the Trustees to not sunset funding. Ms. Rodick, of A Caring Center for Women addressed the board and thanked the Trustees for their dedicated work in this funding cycle. She also praised the District for its support of vital programs within the community. Next, Ms. Pat Knipper addressed the board on behalf of the VNA. She spoke to the growing demand for home care and to address this, VNA increased their home health and hospice requests which includes 50% funding a bilingual nurse educator focusing on North County to improve outreach to diverse communities. If the budget for home health and hospice services is reduced, she believes fewer people would be reached. Additionally, she believes comparing budgets from fiscal year 24-25 and 25-26 is misleading because some programs were previously funded on a one-twelfth payment basis. She requested additional discussions with District staff to address challenges in these programs and reconsider the funding for home health and hospice services. There was no additional public comment, and the meeting was adjourned at 1:20 P.M.
