Indian River County Hospital District

Chairman’s Meeting Minutes: April 18, 2018

Chairman’s Meeting
Indian River County Hospital District
Hospital District Conference Room
April 18, 2018
10:00 AM

TRUSTEES: Marybeth Cunningham;  Allen Jones; Ann Marie McCrystal; Tracey Zudans; Barbara Bodnar; Dr. Michael Weiss; Karen Deigl

STAFF: Jennifer Frederick; Jennifer Peshke, Esq.; Kate Voss

OTHER ATTENDEES: Miranda Hawker; Rick Van Lith; Randy Riley;  Vicki Soule;  Michael Kint; Myra Weiss

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the monthly chairman’s meeting of the IRCHD at 10:00 AM by welcoming those in attendance.

We Care Task Force Update- Ann Marie McCrystal

Mrs. McCrystal provided an update concerning the We Care task force, which met at the end of March. The group participants are Dr. Mackett, Dr. Saver, Dr. Fountain, Miranda Hawker, and Shelly Stuven. She also invited Dr. Kathy Grichnik, who is the Chief Medical Officer at IRMC, to attend as well. The group discussed the increase in patients waiting to receive specialty services and the lack of volunteer physicians who are available and willing to provide the services. There was further discussion concerning the idea of providing a reimbursement to the physicians for their services. Mrs. Hawker explained that if the physician receives payment for their services, they would lose their sovereign immunity protection provided through the state. Currently the We Care Foundation supports the cost of supplies and the physicians volunteer their time.

The Trustees also discussed the potential impact on the specialty indigent care when Cleveland Clinic takes over operations at IRMC. Mrs. Cunningham stated that during these negotiations towards a definitive agreement, Cleveland Clinic will be building their Florida Charity Care policy, which would outline this matter. Mrs. Hawker stated that the We Care Foundation is working on a contingency plan to support the program and keep it operating at the level it is today, once Cleveland Clinic takes over operations at the hospital. Mrs. McCrystal suggested that Dr. Fountain and Ms. Hawker provide a We Care program update to the Trustees at the next Chairman’s meeting, so that the Trustees may have a better understanding of the program and its operations. There was also Trustee discussion concerning what other counties near Indian River support indigent specialty care. Mrs. Hawker stated that she could further research that matter and report back to the Trustees on the same. Some Trustees felt it would be unproductive to make any changes to the We Care program until they have a better idea of the charity policy through Cleveland Clinic.

Community Health Needs Assessment Update- Jennifer Frederick & Karen Deigl

Mrs. Frederick explained that three providers, VNA, IRMC, TCCH, along with the District, are collaborating together to conduct a community health needs assessment. The group vetted four companies and has selected Professional Research Consultants. Mr. Van Lith who is coordinating this effort, stated that through their due diligence, they are looking to work with a group that had conducted prior collaborative health needs assessment. Mrs. Frederick stated that the total cost of the assessment is $52,000 which includes 500 completed surveys. The hospital will fund $27,500, TCCH would provide $6,000 in funding and the VNA will contribute an additional $1,000. The District will fund the remaining amount of $15,750 and the process will begin in May. Mrs. Deigl made a motion to approve the expense of $15,750 which will be allocated and paid from funds in the 2018-2019 fiscal year budget. The motion was seconded by Mrs. McCrystal and passed unanimously.

Indian River County Senior Collaborative- Michael Kint, CEO United Way

Ms. Deigl informed the Trustees that per recommendation from Mrs. Peshke, she must recuse herself from this discussion and any voting concerning this matter, due to the fact that she is the Chair of the Senior Collaborative Board.

Mr. Kint explained to the Trustees that the Indian River County Senior Collaborative (“IRCSC”) is creating an alliance of senior citizens, providers, advocates, funders and individuals dedicated to supporting and advocating for senior citizens in Indian River County. The Collaborative is being modeled after the impactful Metal Health Collaborative, which the District has been involved in since its inception. To facilitate the development of the IRCSC, the United Way has stepped forward and is providing the following:

1. Hiring a half-time Administrator;
2. $10,000 to support the Administrators positons;
3. United Way will serve as the fiscal agent; and
4. Providing fully equipped office in the McCabe Nonprofit Incubation Center.

There was further discussion concerning the IRCSC Steering Committee list and who was included. Mrs. McCrystal noted that some organizations in the community, who should be included, were not listed. Mrs. Zudans stated that she has concerns with providing tax payer money to an organization that does not have a track record. She believes this is a good program but that is should be funded by through community philanthropy. Mr. Jones stated that he felt was a mission creep for the District, which he believes has the sole purpose of purchasing health services for indigent community members. He feels this program may be more of a social service issue and outside of the District purview. Mrs. Cunningham feels that supporting this program would be supporting the health needs of the elderly in the community. Ms. Bodnar stated that this program could potentially keep the senior population heathier, to reduce further medical costs down the road. Mrs. McCrystal feels that this program is necessary for the community and that their request is not a large sum of money to initiate it and move the program forward. There was further Trustee discussion and Mrs. McCrystal made a motion to provide the $10,000 in funding, which was seconded by Mrs. Cunningham. The motion carried 4 to 2, with Mrs. Bodnar and Mrs. Zudans in opposition. Ms. Deigl sustained her vote. The Trustees encouraged Mr. Kint and Mr. Riley to reach out to other funders in the community to help support this program.

Mr. Kint stated that Mrs. Peshke has just cycled off the United Way Board of Directors and he presented her with a plaque of recognition for her service.

Other Business

Mrs. Cunningham provided an update concerning the partnership process with Cleveland Clinic. She stated that the parties are conducting their due diligence and reviewing documentation they have collected which is being housed in separate data rooms. Mrs. Peshke stated that it should be possible to provide the Trustees with a summary of what has been collected and she will confirm this matter with Mr. Boyles. Additionally, a facility inspection of the hospital will take place the week of May 1st. This inspection is being performed by an outside firm hired by Cleveland Clinic.

Further, the parties are still working through the terms of a definitive agreement and Cleveland Clinic is working to better understand the statutes that govern the District, which are complex. The outside legal team is researching to find the best steps for a long term lease, or short term lease, depending on what is the best deal for all parties while complying with legal requirements of the District. Mrs. Cunningham explained that since most of the focus has been on the definitive agreement, they have not yet begun discussions concerning charity care and specialty lines of service that will be offered at the hospital. She explained that until the parties have a full understanding of the structure of the deal, those matters will be determined after. Additionally, Mrs. Cunningham stated that Cleveland Clinic has reaffirmed that they are committed to this deal and have no intention of walking away. Cleveland Clinic has spent considerable time on this project and has utilized many of their resources and funds. She further stated that over the next few months, Cleveland Clinic indicated that they would like to address the Trustees at a special meeting. Mrs. Cunningham informed the Trustees that years ago Cleveland Clinic entered into a long term lease with an Ohio hospital owned by a government entity. After 25 years of Cleveland Clinic operating the facility, the government entities board changed and tried to end the agreement with Cleveland Clinic, which has left them overly cautious in this type of circumstance.

Mr. Van Lith addressed a question from the Trustees concerning a new stroke program that they heard is starting at IRMC. He explained that interventional stroke has become a viable enterprise in the IRMC region. IRMC has been working with a group on this matter well before any discussion with a Cleveland Clinic partnership. He explained that IRMC has reengaged with the group to see if they can bring interventional stroke services to IRMC. Mr. Van Lith indicated that over the next few weeks, they will have more information on this matter. Additionally, Cleveland Clinic is aware of these discussions.

Mr. Jones informed the Trustees that he has been asked by the Tax Payer Association of Indian River County to provide a discussion on Cleveland Clinic and the partnership process at their June 13th meeting. He stated that this discussion will be from his point of view and not represent the District. The Association specifically wanted Mr. Jones opinion on the research and data he compiled on Cleveland Clinic. He encouraged the Trustees to attend and District staff will post a notice in the paper to avoid any issues with the Sunshine Law.

Further, Mr. Jones stated the District budget is running high and has the potential to go over the annual amount. This is partially due to the high inpatient and outpatient indigent volumes at IRMC, along with the expenses associated with the partnership process. He explained that he will provide a more in-depth report at tomorrow’s regular monthly meeting during the financial review.

Lastly, Mrs. Cunningham informed the Trustees that at tomorrow night’s meeting, the county will present a report on a proposed Aviation Blvd extension. This extension is intended to reduce the amount of traffic on 37th Street and provide an alternative route to the hospital facilitates.

Public Comment- There was no public comment.

Adjourn- 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