Indian River County Hospital District

Chairman’s & Budget Request Presentation Meeting: June 15, 2022

Indian River County Hospital District Conference Room/ Zoom
June 15, 2022
10:00 AM

TRUSTEES: Marybeth Cunningham Karen Deigl
Ann Marie McCrystal Barb Bodnar

ZOOM: Samantha Mesena Marie Andress
Allen Jones

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

ATTENDEES: Vicki Soule Robin Curby
William Winns Andrea Fedock
Pedro Bernabe

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.

Audit Findings- Marybeth Cunningham, Chairwoman

Ms. Cunningham stated that this matter has to do with Phoenix Rising and a copy of the audit report Ms. Carboni prepared was provided to the Trustees for their review prior to todays discussion. She explained that District staff and Ms. Peshke also met with Pedro from Phoenix Rising to discuss the audit finding, and asked that the staff prepare a recommendation for the Trustees to consider relative to future funding. She then asked that Ms. Suriano provide some background information on this and discuss next steps. Ms. Suriano addressed the board and stated that a few months ago the District was served a subpoena duces tecum from the Florida Department of Law Enforcement (“FLDLE”) which requested records relative to the payments the District made to Phoenix Rising, for substance abuse treatment. The District complied with the request and were asked not to disclose the existence of the investigation with anyone other than District staff and legal counsel. Subsequently Ms. Carboni conducted her own internal audit of Phoenix Rising, as she has been doing with all the funded organizations, and created a report of those findings. In follow up discussions with the investigator from FLDLE ,who disclosed some of their findings from the investigation, many of those same items of concern were discovered within Ms. Carboni’s audit report. She further explained that the FLDLE has decided to not pursue any criminal charges due to the large number of resources it would take to bring the case to trial. Therefore, the investigation has been closed and the District is free to disclose the existence of the same to the Trustees. She then explained that based off the Audit findings it was decided that Phoenix Rising was in breach of their current funding agreement and Ms. Peshke prepared written notice of the same, which was delivered to Mr. Bernabe for his immediate attention. There has been a subsequent meeting with District staff, Ms. Peshke, and Mr. Bernabe and he was provided a detailed list of items that would need to be provided in order to cure the breach of the funding agreement. This is to provide assurance that the funds the District has provided them, are going to direct patient care. Therefore, Ms. Carboni and Ms. Frederick will be conducting a second review visit in the next week, to review documentation requested which include a full financial disclosure, access to their bank and payroll records, and access to IRCHD patient treatment records to verify that patients billed to the District were actually provided services. Lastly, Ms. Suriano stated that District staff is recommending that funding to Phoenix Rising be suspended beginning July 1, until they are able to cure the breach of the funding agreement. There was Trustee discussion and many were displeased with the fact that they were not aware there had been an investigation pending with Phoenix Rising. Ms. Peshke explained that this matter was discussed at great length due to the District’s staff concern of the Trustees not being aware. However, she spoke to the prosecutor overseeing the investigation and he firmly stated that this matter was not to be discussed with the board or in a pubic setting until the investigation was complete. There was further Trustee discussion and they were in agreement that funding should be suspended immediately, not July 1, pending the additional revie to cure the defult. Ms. Bodnar made the motion to suspend funding immediately pending the audit findings, which was seconded by Ms. Deigl. The motion carried unanimously. Additionally, Ms. Deigl made a motion to amend the May disbursement amount, less the Phoenix Rising reimbursement check. The motion was seconded by Mrs. McCrystal and carried unanimously.

Approval of District Employee COLA- Allen Jones, Treasure

Mr. Jones stated that he prepared a recommendation for the Trustees to review and consider prior to todays discussion. Therefore, he made a motion that District staff be given a one-time cost of living adjustment increase of 5.9% effective July 1, which was seconded by Ms. Deigl for discussion. Ms. Bodnar questioned how Mr. Jones arrived at the 5.9% figure. Mr. Jones stated he based his recommendation off of the Social Security cost of living increase which was 5.9%. Ms. Bodnar stated that based on her research of other county organizations she feels 5.9% is too high and would be more comfortable at 3% or 3.5%. Ms. Deigl also felt that the number was a bit high and would be more comfortable around 4%. Ms. Bodnar made an amended motion to approve a COLA of 3.5%. There was no second to the motion and it died. Mr. Jones and Mrs. McCrystal felt that, given the current financial climate, 5.9% was a fair number and approving a lower number would be insignificant in any savings to the tax payer. They also felt this was a good way to show appreciation to staff. After further Trustee discussion Ms. Deigl made an an amended motion to approve a COLA of 4% which was seconded by Ms. Cunningham. The motion carried 3-2 with Mr. Jones and Mrs. McCrystal in opposition.

FY 22-23 Funding Request Presentations

New Horizons- William Wims, CEO

Mr. Wims addressed the board and stated that their funding request has increased by 5% which is to help cover the cost of some of their services and the improvements they have made to the programs. One major improvement is that they have hired additional case managers which has helped provide additional support to their clients. He then explained that the funds requested will be used to provide psychiatric medical services, case management and outpatient therapy services, and injection clinic visits. There was further discussion surrounding the new request for funding concerning the injection clinic and the cost per service for the injections. He explained that the injection clinic provides a slow-release form of medication allowing a client, having problems, to avoid missing dosages or forgetting to take their medication daily. He also discussed their issues with recruiting therapists and that they rely heavily on their psychiatric nurse practitioner who is qualified to treat clients with mental health issues. There was Trustee discussion and it was agreed that New Horizons increased funding was fairly small and a reasonable request, to support the much-needed services they are providing to the community.

TCCH- Vicki Soule, CEO

Ms. Soule began by introducing Heather Miranda as the new Executive Vice President at TCCH, who is in charge of operations. Also present for todays discussion was Andrea Fedock who is the CFO. Ms. Soule stated that she would begin their presentation by reviewing their semi-annual report. She explained that volumes have increased in all service areas from last year, and the demand for services is almost overwhelming. Therefore, they are looking to expand their Oslo Road location but have encountered some obstacles along the way with zoning and county issues. Next, she discussed their expansion with pediatrics services and have hired two new pediatricians. They have also been able to hire additional nurse practitioners, but the physicians who oversee them have become overwhelmed by the work and she is trying to find a happy medium for all the practitioners. She further stated that their patient population has become more stressed and negative due to the current social factors affecting them which include homelessness, inflation and chronic illness. She maintains that TCCH is committed to providing the care and filling the gaps for this population, regardless of the many challenges they continue to face. She then addressed where she sees their organization heading in the next five years. She explained that technology will play a huge roll in their growth and how they deliver care. They would also like to focus their efforts on training opportunities for students which could help with recruitment of healthcare workers. Lastly, she discussed that TCCH may come before the Trustees before fiscal year end to request additional funding to support a shortfall they are experiencing in providing healthcare services. One of the main issues they are facing is the push back on the 340B pharmacy program and lack of affordable prescriptions.

Next, she provided the Trustee with a review of the FY 22-23 funding request. The total increase to the funding request from last year was $307,480, which is due partly to increased cost per service, and the addition of the new optometry program. Ms. Soule explained the details of the optometry program and what services would be offered to patients, which include a comprehensive exam for adults and children, and with discounted eye glasses. There was further discussion surrounding the increased cost per service for a primary care visit. Ms. Soule then discussed the request for funding concerning behavioral health services which had decreased. She explained that many of the patients who visit TCCH for behavioral health services have insurance but have high deductibles or co-pays. This leads to the patient having a large outstanding balance owed for services which they are unable to pay. Ms. Soule stated that she would like to discuss in the future how the District may be able to help assist in paying off some of that debt owed to TCCH. There was further Trustee discussion surrounding how they could help support the population who has insurance but are faced with high deductibles or co-pays, and unable to afford their visits.

Public Comment & Adjourn

Mrs. Cunningham asked for public comment and there was none. The meeting was adjourned at 11:30 AM



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