SUMMARY MINUTES
CHAIRMAN’S MEETING
Indian River County Hospital District Conference Room/ Zoom
July 17, 2024
10:00 AM
TRUSTEES: Marybeth Cunningham Barb Bodnar Michael Kint Paul Westcott
William Cooney (zoom) Karen Deigl
Kerry Bartlett
STAFF: Dawn Carboni Jennifer Frederick
Kate Voss Frank Isele
Jennifer Peshke, Esq. Kaytlin Dickens
ZOOM: Lauretta Farrell Anne Posey Jeff Pickering Kim Jeansonne
Chriss Papayannis
ATTENDEES: Ann Marie McCrystal Ceclia Stalnaker
Richard Rothman, M.D. Sonya Pease, M.D.
Vicki Soule Marie Andress Theresa Malone
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.
Presentation from Sonya Pease, M.D., Chief of Quality, Safety and Patient Experience Cleveland Clinic Florida
Dr. Pease addressed the board and was also accompanied by Dr. Rothman, who is serving as the Interim Vice President at CCIRH. Dr. Pease had been asked by Ms. Cunningham to provide some information to the District regarding safety, quality and patient experience at CCIRH, which was recently also presented to the CCIRH Board of Directors. Dr. Pease explained that she is presenting the first quarter results, however some of the measures only have validated data through the end of February. She reported that they have maintained strong performance on the previous year OKR’s and have already achieved some of the 2024 targets for the year. Additionally, the new strategy of using a Vizient composite score allows them to target specific metrics by hospital versus as a region. Dr. Pease reviewed their performance metrics and that Indian River is in the top 5 performers in all of enterprise for the SQPE Composite Score which is above the 80th percentile. Their 2024 goal is set at 90% which is the highest target in the Florida Market. Next, she discussed maternal and neonatal services and reviewed data surrounding those outcomes. She also reviewed quality composite percentile data and Leapfrog safety grade projections. There was also lengthy discussion surrounding data regarding the readmission rate by area deprivation index, which Dr. Rothman spoke to. Dr. Rothman explained that the index is a measure of disadvantaged members of the community. Their goal is to find better ways to improve engagement with this patient population, with the hopes of improving outcomes for this vulnerable population. There was also lengthy discussion on access to care and what CCIRH is doing to address this issue. Dr. Rothman also discussed areas of technology they are utilizing to better patient experience. Mr. Westcott stated that a few months ago, he brought up a few areas of concern regarding infection rates and would like to know how CCIRH is planning to improve those areas. Dr. Pease spoke on these areas and how they are executing changes to provide better quality of care. There was also discussion surrounding physician recruitment and retention, which Dr. Rothman explained can be a 12-to-24-month lead time to onboard a new physician. Mr. Westcott then discussed his desire to obtain data relative to indigent care and Dr. Rothman indicated that they are working to gather this information, with the intention of reporting on the same in the next couple of months. After further Trustee discussion, Ms. Cunningham thanked Dr. Pease and Dr. Rothman for their transparency and taking the time to address the Trustees at today’s meeting.
FY 24-25 Budget Discussion- Frank Isele, Executive Director
The discussion began by reviewing the funding request from Dynamic Life. Ms. Frederick reviewed the Trustee comments submitted through the funding matrix report which included the need for a stronger board of directors and to define better outcomes. Additionally, Ms. Frederick indicated that they are still waiting to receive the organizations 990 and audit information. She did clarify that she received a letter from the CPA firm conducting the audit which stated they are in the process of preparing and it should be completed by the end of summer. There was Trustee discussion and they agreed that an audit report should be received before any FY 24-25 funding can be distributed. After further discussion Ms. Bodnar made a motion to approve the funding request, contingent upon the District receiving the organization audit report prior to the beginning of the fiscal year. The motion was seconded by Ms. Bartlett and carried unanimously.
Next there was discussion surrounding the funding request from Hope for Families. The Trustees discussed their concerns with areas of the request which included funding for supplies and transportation. Mr. Isele stated that he and District staff are working on a policy to outline specific areas of funding that the District will support moving forward and clarify specific criteria which has not been funded consistently over the years. There was additional discussion surrounding the transportation request and how best it could be tracked and managed. The Trustees agreed that they would like additional information on what is included in the transportation and medical supplies request. Mr. Westcott made a motion to fully fund the Hope for Families request contingent upon the Trustees understanding that the supplies are medical only and the transportation is truly for medical appointments. Ms. Deigl seconded the motion and it carried with Ms. Bartlett and Mr. Kint in opposition; and Ms. Cunningham recusing herself from the vote.
The Trustees then had discussions surrounding the funding request from the Mental Health Collaborative. Ms. Frederick stated that all the Trustees were supportive of the request, however the Trustees agreed that the measurable outcomes could be improved upon. There was no further discussion and Ms. Bodnar made a motion to fully fund the request, which passed unanimously.
Next the Trustees had discussion surrounding the funding request from Samaritan Center. Ms. Frederick reviewed the comments submitted by Trustees which included their desire to see better fundraising efforts and additional collaboration with other mental health agencies. There was Trustee discussion surrounding these concerns and what opportunities there are to contract out mental health services to these agencies who are requesting financial support to hire a counselor, in order to fill a gap for this service. There was no further discussion and Ms. Bartlett made a motion to approve funding at the current fiscal year level of $78,047, which was seconded by Mr. Kint. The motion carried unanimously.
The Trustees then had discussions surrounding the funding request from Senior Resource Association. The majority of the Trustees were in support of fully funding the request, however there was concern that the District was solely supporting the public guardianship program. There was also concern over the lack of measurable outcomes for the same. After further Trustee discussions Ms. Bodnar made a motion to approve the request as submitted, which was seconded by Dr. Cooney. The motion carried with Ms. Deigl recusing herself from the vote.
Next the Trustees reviewed the request from Suncoast Mental Health Center and Ms. Frederick discussed the Trustee feedback provided in the scoring matrix. Some Trustees voiced concerns over the viability of the program and that the District was the sole source of funding. Additionally, they felt there needed to be more transparency and accountability, since it was a new program. It was also discussed that the request included budget items not typically supported by the District, such as travel and supplies. Mr. Kint proposed funding the organization at a lesser amount which he calculated. The Trustees also agreed that they would like to have this restructured to be billed at fee-for-service. With those changes in mind, Mr. Westcott made a motion to approve funding at $161,900 and restructure the request to a fee for service model. Ms. Bodnar seconded the motion and it carried unanimously.
Lastly, the Trustees had discussion surrounding the request from TCCH. Specifically, there were concerns surrounding the request for the new mobile unit and mental health court. Ms. Frederick stated that she met with Ms. Soule, Ms. Knipper and Ms. Andress yesterday to walk through their funding requests for each of their mobile units, to better understand the functions and areas of service. Ms. Soule, Ms. Knipper and Ms. Andress each addressed the Trustees and provided detailed information surrounding their mobile unit program, which included areas of service, staffing, hours of operation, and cost structure. Ms. Soule further discussed the dental portion of the TCCH mobile unit request and stated that they are still working through the cost per service model. There was Trustee discussion surrounding the increased demand for services and how mobile units have become a way to reach additional areas of the community. They also help provide same day appointments to patients, who otherwise would utilize the emergency department to seek treatment. Ms. Knipper also provided data relative to the increase in patient volumes they have experienced since 2020. She also spoke about the collaborative efforts the VNA has put forth to work with TCCH and WFHC, to provide the most effective access to care for the community. There was Trustee discussion, and it was requested that the cost of services for dental and medical care on the mobile unit be split out. Additionally, due to lack of time, the Trustees decided to wait to have the discussion surrounding the mental health court until the next meeting. Therefore, Ms. Bartlett made a motion to fund the TCCH funding request pending the discussion surrounding the mental health court portion and separating the medical and dental services for the mobile unit request. The motion was seconded by Ms. Bodnar and carried unanimously.
HSB/VCOM Lease Discussion- Frank Isele, Executive Director
Mr. Isele provided an update regarding the negotiations with VCOM to secure a lease agreement for the HSB. He explained that he had discussion with John Brockovich, who is a founder of VCOM and current Chairman of the Board. Mr. Brockovich is in favor of this partnership agreement and has given his approval from the board of directors. He further explained that they are still working through the lease terms, but things continue to move forward. Additionally, representatives from VCOM are working to schedule meetings with representatives from CCIRH to discuss their relationship moving forward. He will provide further updates to the Trustees once they are available.
Public Comment & Adjourn
There was no further business and Ms. Cunningham asked for public comment. There was no further public comment, and the meeting was adjourned at 12:30 p.m.
