SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
November 17, 2022 @ 4:00 PM
TRUSTEES: Allen Jones Barb Bodnar
Ann Marie McCrystal Marybeth Cunningham
Karen Deigl Kerry Bartlett
STAFF: Kate Voss Jennifer Frederick
Ann Marie Suriano Dawn Carboni
Jennifer Peshke, Esq
ZOOM: Pat Knipper Anne Posey
ATTENDEES: Tracey Griffis Andrea Berry
Genevieve Mallen Bridgett Jerger
Tara Beard Matt Reiser
Michael Kint William Cooney
Phil Cromer Cheryl Martinez
Michael Davis Mike Cianci
Convene Meeting & Approval of Consent Agenda– Marybeth Cunningham, Chair
Ms. Cunningham convened the regular monthly meeting of the IRCHD at 4:00 PM. Pastor Derrick West, Genesis Church provided the invocation and Ms. Bartlett led the group in the Pledge of Allegiance. Ms. Cunningham asked for a motion to approve the consent agenda which was made by Mrs. McCrystal and seconded by Ms. Deigl. The motion carried unanimously.
Chairmans Report- Marybeth Cunningham, Chair
Ms. Cunningham announced that Dr. Greg Rosencrance has submitted his resignation effective December 31, 2022. He has accepted a position as President and CEO at Thomas Health, in Charleston, West Virginia, to be closer to his children, grandchildren, and immediate family. Since 2019, Dr. Rosencrance has provided outstanding leadership throughout this transition and he will be missed.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshke provided her report and stated that she spent the past month preparing for the District annual compensation committee meeting review of the District staff. Additionally, the District received the VNA’s Notice to Vacate the Human Services Building which they currently lease from the District and she has met with their counsel to discuss next steps. This matter will be discussed further at the December monthly chairman’s meeting. Lastly, the county has requested a temporary construction easement for the 11th Drive project and this matter will be discussed later this evening under new business.
Financial Statement Review- Allen Jones, Treasurer
Mr. Jones provided his Treasurer’s report and stated that the District remains in strong financial condition. As of the 31st of October, the District has $7,337,102 in its bank accounts and another $2,430,233 in Treasury Direct bills scheduled to mature in May and August, 2023. In addition, tax revenues will begin being deposited in the accounts imminently. In 2023, the District budgeted $13.3 million in total operating expenses and since then, Trustees approved an additional $800,000 for GlobeChek. Therefore, spending is projected and budgeted to be approximately $14.1 million and tax revenues are projected to be $11.2 million. This means the District is estimating to reduce reserves in 2023 somewhat further in the next fiscal year. The District began this fiscal year with about $10.2 million in cash and investments, and Mr. Jones projects that the District will complete the fiscal year with about $7.3 million in cash and investments. Overall, the District will begin the new fiscal year in solid financial shape and with the lowest tax millage rate ever of .5115, down 48% since 2016 while, continuing to support more healthcare services for the community.
Mr. Jones further stated that someone recently told him that the Hospital District allows Indian River County the ability to solve local healthcare problems locally, and he believes this is a true and accurate assessment. Therefore, he would like to correct something he said at the IRC Taxpayer’s Association meeting in October. During the candidate forum he was asked if he would support future legislature reducing the maximum millage rate for the District from the current maximum of 5 mills to 1 mill. At the time he felt the question to be irrelevant, recognizing the millage rate has never exceeded 1 mill over many decades and is currently about 1/2 that rate. He answered that he probably wouldn’t object, but since then he has given the question more thought and would like to correct his response. He explained that while 5 mills is highly unlikely to ever be necessary to fund the District, there are potential disasters where having that flexibility might allow the District to solve a local healthcare crisis locally. For example, if the District had not brought in Cleveland Clinic in 2019, and still had Indian River Medical Center (“IRMC”) when the Covid pandemic hit in 2020, there would have most certainly been a financial crisis at IRMC, with the need for the District to financially support the hospital. Having the extra millage flexibility would have been a life saver – literally. In addition, there may come a need to issue municipal bonds to solve a healthcare need in the county. Therefore, he believes having more taxing authority would result in superior financing options, to help assist the continuum of care throughout Indian River County.
Mrs. Cunningham thanked Mr. Jones and stated that this his last in-person meeting with the District. She recognized all the work he has done as Treasurer on the District Board and stated that without his leadership, the District would not be in the strong financial position that it is in.
Executive Director Report- Ann Marie Suriano, Executive Director
Ms. Suriano stated that while it is not reflected on the current financial statement for October, the District has received almost 2 million in tax revenues in November. Additionally, she has been asked to participate on behalf of the District on the Children Services Advisory Council. Their first organizational meeting with take place this evening at 5:30 and she will be providing updates to the Trustees as appropriate. Next, she stated that she has chosen and extended an offer for the District Financial Assistance Specialist position, which was accepted. The new employee has valuable experience in this area and will begin work on December 12.
Funded Agencies Semi Annual Reports-
Childcare Resources -Tracey Griffis, Director of Wellness & Early Intervention
Ms. Griffis addressed the board and thanked the Trustees for their support. She stated that the wellness program is about to celebrate its six-year anniversary and their partnership with the Homeless Children’s Foundation, has been a huge success. The District supported case manager position has added additional support and has allowed for some parent programing to take place, based on conscious discipline. Tara Beard Director of the Childcare Resources School addressed the board and discussed their work at the school and stated that the teachers are now going through the process of being endorsed by the Florida Infant Mental Health Association, given the increase in mental health issues in children. Next Ms. Griffis stated that through discussions with their executive team concerning emerging issues, they have identified the need to have a child life specialist present every day in the classroom. She discussed how this specialist helps support the children in the classroom with self-regulation and behavioral issues. They also work with the parents and provide support to them as well. The current child life specialist in place has decided to take a position working at the hospital and with this transition, it was discussed that there is a need for Childcare Resources to have their own mental health therapist on staff. Therefore, Ms. Griffis requested that some of the FY 22-23 funding be relocated to support the hiring of a full-time therapist. There was Trustee discussion concerning this matter, and if the current funding would fully support the transition of these funds. The Trustees asked that Ms. Griffis address the board next month with a full outline of cost associated with this request, for their consideration.
Dynamic Life- Mike Cianci, Executive Director
Mr. Cianci thanked the Trustees for their support and stated that it has been a successful year, specifically with the purchase of Dynamic Life by the First Methodist Church in Vero Beach. He explained that while Dynamic Life Recovery remains a stand-alone operation, the resources of First Methodist Church expand their community outreach. This transition has also allowed for further professional development with their budget and board of directors. He then discussed their various partnerships throughout the community and data concerning the Pastor Roger Ball Memorial Scholarship Program. 31 men have completed the program since Oct. 2021, and many of those also completed the STEP program at UP and have found gainful employment within the county. There was further review of data concerning number of residents employment status, average length of stay, and discharge rates. There was also discussion surrounding the relapse rate which has decreased by 50% since 2021. He then discussed their hope for a detox facility for Indian River County, which would provide a much-needed service. Additionally, they are hoping to open up a Women Facility based on the same model as Dynamic.
IR Healthy Start Coalition- Andrea Berry, Executive Director
Ms. Berry addressed the board and recognized Mr. Jones and Mrs. McCrystal’s achievements and dedication to their work on the District board for the community. She stated that she will miss working with them both. She then introduced her team who included Autumn Schneider, Director of Internal Operations; Taylor Farnsworth, Director of External Engagement; Genevieve Mallon, Babies and Beyond Coordinator; Bridgett Jerger, Doula Coordinator, Cheryl Martinez, Nurse Family Partnership Coordinator; and Stacey Washburn, Program Manager. She began her report by discussing some organizational changes due to Healthy Start absorbing operations of the Healthy Families Program. Next, Ms. Washburn addressed the group and provided an update concerning the Fatherhood initiative, which was started after new state legislation was passed requiring the same. Healthy Start began their program a year prior to the legislation deadline and have seen positive results from their efforts to engage fathers in their children’s development. Next there was discussion concerning the PEPW expansion. Ms. Martinez explained that this processed has now been streamlined and is able to be offered at CCIRH. Ms. Berry then discussed the FIMR expansion which has been supported by the District over the last three years. She explained that Indian River County has been chosen by the State to be in charge of St. Lucie, Martin, and Okeechobee counties FIMR and providing them with the education and tools needed for a successful program. Next, Ms. Jerger provided an update concerning the Doula program and racial disparities. She stated that Healthy Start continues to nurture its relationship with Partners to make sure that those mothers concerns are being heard. She then discussed some data concerning higher cesarian rates, that have emerged and their efforts to combat those. She explained that even with doula support, there can be instances where mothers need to advocate for themselves and their birthing process. Mrs. Cunningham questioned how a recent award that was given to CCIRH for their reduction in cesarean rates, ties into this reported increase. Ms. Berry explained that the system has improved tremendously since the CCIRH transition, and they continue to try and move the needle. There have been some struggles with women who have had a cesarean section prior and now wanting to have a vaginal birth, but not being given that option at CCIRH. Lastly, Ms. Mallon provided a review of data concerning the out of county birth rates which have risen. This increase has resulting in an extra challenge of staying connected with the mothers and babies, because they are not delivering at CCIRH. Therefore, they are working on strengthening their support with Babies and Beyond for those mothers who are delivering out of county. Ms. Berry explained that this increase in out of county births was due to the fact that the only other county OBGYN physician delivers at Lawnwood. This creates a slight barrier as aftercare services are being set up in St. Lucie County and then being transfered to Indian River. Mr. Jones asked if this out of county birthing issues could be solved by further cooperation by CCIRH. Ms. Berry indicated that she is not fully aware of the dynamics of the situation but she is hopeful that through collaborative work, there can be some further resolution.
New Business- Drainage and Temporary Construction Easements for 11th Drive Project- Jennifer Peshke, Esq.
Ms. Peshke stated that the District has received a request to enter into a drainage and temporary construction easement for the 11th Drive project. The County needs this easement to complete the project and it is a routine matter. Mr. DeBraal Indian River County attorney addressed the board and stated that easement is for pipes that run over the road, so the water can properly drain. Included within the easement is language outlining the counties assurance to maintain the pipes in perpetuity. Mrs. McCrystal made a motion to approve the easement which was seconded by Ms. Deigl. The motion carried unanimously.
Public Comment/Adjourn
There was no public comment and the meeting was adjourned at 5:30 PM
