Indian River County Hospital District

Regular Monthly Meeting- July 20, 2023

County Commissioner Chambers/ Zoom
July 20, 2023 @ 4:00 PM

TRUSTEES: Paul Westcott Michael Kint
Marybeth Cunningham Kerry Bartlett
Barb Bodnar

ABSENT: William Cooney, M.D. Karen Deigl

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

ZOOM: Ann Marie McCrystal Pat Knipper
Stanford Erickson

ATTENDEES: Vicki Soule Caryn Toole
Wes Samons Lisa Kahle
Wilford Hart

Convene Meeting, Invocation, Pledge & Consent Agenda– Marybeth Cunningham, Chair

Ms. Cunningham convened the regular monthly meeting of the IRCHD at 4:00 PM. Reverend Derrick West the Senior Pastor at 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 June meeting minutes and a July disbursement of $1,066,210.87. Ms. Bartlett made the motion to approve which was seconded by Ms. Bodnar. The motion carried unanimously.

Chairmans Report- Marybeth Cunningham, Chair

Ms. Cunningham stated that a very important piece of business this evening is to read a proclamation recognizing Ann Marie Suriano for her time at the Hospital District. She stated that this is her last official meeting as the full time Executive Director. She read the proclamation into the record and thanked her for her dedication and service to the District.

District Counsel Report- Sebastian DeMaio, Esq.

Ms. Peshke began by congratulating Ms. Suriano on her retirement. She provided her report and stated that she continues to respond to various questions that may arise from Trustees concerning current matters the District is working on and continues to participate in the District FY 23-24 budget cycle. Additionally, the matter concerning the sale of the Hospice House parcel is moving forward and the District is waiting to receive the appraisal report outlining the value of the property. Also, she is involved with matters concerning the future utilization of the Human Services building, and the District is also awaiting the appraisal report for that property as well. Lastly, she has been involved in the process of hiring a new Executive Director and has been working with the recruiter to help facilitate the process.

Financial Statement Review- Michael Kint, Treasurer

Mr. Kint provided his report and stated that after 9 months of the fiscal year, the District is in excellent financial condition. The District has received 99.4% of its budgeted tax revenue and program and administrative expenses continue to remain under budget. Total investments with DeepBlue are $7.4 million and the investment T-bills total $4.5 million. He explained that recently one of the T-bills matured and Ms. Suriano requested that DeepBlue transfer the $1.5 million in interest earned into a money market account, which is earning 4.7% interest. Ms. Suriano confirmed the interest rate amount has increased slightly to 5.1% and stated that there was further discussion concerning reinvesting the funds and she instructed DeepBlue to reinvest the funds into a new T-bill which will mature in January.

Executive Director Report- Ann Marie Suriano, Executive Director

Ms. Suriano provided her report and stated that the kickoff meeting with BJM group to discuss the process of conducting the performance review has been scheduled. She explained that this is an initial meeting of the District staff and the team from BJM to discuss the process, timeline, and provide an overview of what will be requested from District. She stated that there will be future opportunity for any Trustee who is interested, to meet with representatives from BJM to better understand the process or have any questions answered. Additionally, she provided the Trustees with an update concerning the issues surrounding the generator at the Gifford Health Center. She explained that the current generator utilizes diesel fuel to operate and that the diesel tank has rusted and is unsafe to refill. Therefore, she has been working with the TCCH maintenance supervisor to look for a suitable replacement. Through their research it was suggested that the unit be replaced and switched to propane fuel, which is safer and more efficient. Ms. Suriano has also worked with Ms. Peshke to make sure any future purchases of a new generator were in compliance with the procurement requirements outlined in the Special Act and Florida Statutes. Therefore, she informed the Trustees that the total cost to purchase is $73,000 and she is requesting approval to move forward with the purchase of a new unit, which would take approximately 8-9 months to receive. Mr. Kint made a motion to approve, which was seconded by Ms. Cunningham. The motion carried unanimously. Next, Ms. Suriano stated that it was also discovered that there are some structural issues within the building at the Gifford Health Center and she met with an engineer to assess those issues. They provided a verbal assessment of the issues but Ms. Suriano stated that she would like to move forward with obtaining a written report of their findings which would also include repair recommendations. She further stated that any repairs to the building would also need to be done in compliance with the requirements in the Special Act and Florida Statutes, and they will look to that legal process once it is discovered what repairs need to be made and the cost associated with the same.

Funded Agency Semi Annual Report
Mental Health Collaborative & McCabe Connections Center- Wes Samons, Executive Director

Mr. Samons addressed the board and thanked them for their support of the Collaborative and Connections Center. He stated that he was hired as the Executive Director in February and has been working to become more familiar with the role, and thanked Lisa Kahle for her support during the transition. He provided updates concerning the Connections Center and Mental Health Collaborative and stated that a new benefits specialist was hired at the center and he has done well in the position. Additionally, they transitioned to a new financial oversight and are using the services of Melissa Medlock, CPA. Next, he discussed new initiatives concerning the Collaborative and stated that the board recently held a retreat which was facilitated by Michael Felix. They also updated their database of available providers in the community which helps better assist connecting clients to services. Ms. Bartlett asked if there were any overarching themes that were revealed when updating the data. Mr. Samons explained that there is a capacity issue concerning licensed therapists and psychiatric services. Additionally, long wait times continue to be an issue, with clients waiting 2-3 months to receive an appointment. He stated that he has met with representatives from CCIRH and MHA, and has held discussions on how they can work collaboratively to problem solve and address the needs. Another area of need is retention and recruitment of providers. Mr. Samons further explained that he meets monthly with independent providers in the community to gather additional information and continues to expand relationships with those providers. Next, he discussed future plans for the organization which include more community outreach. Also, they have started a pilot program at the UP Cetner, that provides outreach and support services twice a week. Additionally, they are looking to expand their Mental Health First Aid training to a peer based model. The Trustees thanked Mr. Samons for his continued efforts in providing mental health support to the community and asked that he provide them with a copy of the new strategic goals and objectives when they become available.

New Business
Approval of Tentative FY 23-24 Budget- Michael Kint

Mr. Kint stated that presented tonight is a tentative budget for fiscal year 23-24 and is reflective of discussion that the Trustees had at the July 11th special meeting. He explained that the Trustees obligation is to approve a budget which includes a cap on the millage rate. The Trustees agreed during discussion at the July 11th meeting to hold the millage rate at the current rate of .5110, with the understanding that over the next few months there will be further discussion and possible reduction to the overall budget. He further stated that the millage rate adopted today can only be reduced and not increased. Therefore, the budget for approval at tonight’s meeting has a proposed millage rate of .5110, which will produce an anticipated tax revenue of $13,573,305. He further explained that the first public budget hearing is scheduled to take place on September 6th at 5:01 pm, at the county commission chambers, and the final budget hearing is scheduled for September 21st at 5:01 pm, also at the county commission chambers. The regular September board meeting will take place immediately following the final hearing. Mr. Kint made a motion to approve the tentative budget adopting a mileage rate of .5110 and ad valorum tax revenue of $13,573,305. The motion was seconded by Ms. Cunningham and the motion was opened for Trustee discussion. Ms. Bartlett asked for clarification concerning the total ad valorum tax revenue of $13,573,305 verses the total program expenditures of $16.2 million, which results in a $3 million deficit. Mr. Kint confirmed this and stated that the District holds substantial reserves to cover this deficit. Mr. Westcott stated that another variable which would attribute to making up the deficit is the potential sale of the Hospice House parcel. He further stated that he will vote to approve the proposed budget as presented but pointing out that on July 11th the board was limited to their discussion concerning all budget line items, he would likely raise a couple of concerns he has on some of the other funding requests. The first being the Partners program, which he would like to see additional information provided which justifies the $800,000 increase from last fiscal year. He also has concerns over the request for the CCIRH emergency department behavioral health component. Together, both requests total 24% of the District program expense requests. He feels that CCIRH, as part of their obligation to the lease agreement, should solely support these services and not be an additional burden to the tax payers. Ms. Cunningham stated that in the next few months she would like to have a Trustee meeting where there can be discussion surrounding Cleveland Clinic and its obligations to the District under the lease, and the Districts relationship with CCIRH, as it seems there is differing opinion regarding the same among the Trustees. Mr. Kint stated that he agreed with the initial process of following the scoring matrix concerning initial budget discussion but welcomes the idea of further discussion on line items that weren’t discussed previously, and those should take place at either an upcoming special meeting or the August Chairman’s meeting. There was no further Trustee discussion and the motion carried unanimously.

Other Business

Mr. Westcott stated that after yesterday’s Chairman’s meeting, he received an email from Ms. Peshke concerning some comments he made during the meeting. He read the email which stated that three Trustees had contact her about a comment Mr. Westcott made stating that the District has the duty to help assist the hospital in its day to day operations. Those Trustees who contacted her were not comfortable with the phrase of assisting in the day-to-day operations, and believe that the lease with the hospital does not include oversight of operations. Mr. Westcott stated that he does not believe that the District being involved in the day to day operations of CCIRH is warranted or necessary. He believes the Special Act gives the District oversight responsibility for the performance of the hospital, and those rights were not contracted away in the lease agreement, and still rest with the District. He was encouraged by the meeting yesterday and would like to see the District and the hospital continue to work together and move forward, but he still feels there is work to be done. He referenced section 11 and 12 of the Special Act which he believes addresses the oversight language. He further stated that if any Trustees had further concerns or questions, he would address them at this time. Ms. Bartlett asked Ms. Peshke if Mr. Westcott’s understanding of the Special Act aligned with her understanding of the Special Act. Ms. Peshke stated that the language he is referencing, is within the Special Act, but when the act was written as the enabling legislation creating the District, the Trustees did have oversight to the daily operations of the hospital. Subsequent to this, the District entered into a lease, to lease the facilities and give authority for operation of the business, as 7 elected officials may not be the best suited individuals to run the day to day operations of a hospital. Ms. Cunningham stated that she received feedback from some participants in the room yesterday that felt Mr. Westcott was grilling the representatives from CCIRH, instead of participating in the discussion and felt that all future discussions should remain respectful. Ms. Westcott responded and referenced the process of getting CCIRH to address the board, which he felt had been put off several times and stated that he felt his decorum during the meeting was professional and to the point. He questioned whether the past board members have not asked the tough questions he has or held them accountable for their shortcomings. He believes that in order to resolve conflict it needs to be addressed head on and that to ignore the negative perception that the community holds against Cleveland Clinic and pretend that there aren’t issues that need to be delt with, would be a mistake. However, just because he is asking tough questions does not mean he does not want them to succeed. Ms. Cunningham stated that she does not believe any Trustees are ignoring the fact that there are issues, and there have been conversations about the issues community members bring to their attention regarding CCIRH. Further, she stated that Dr. Delaney called her this morning and stated that he felt that their discussion with the Trustees was productive and he would like there to be more frequent discussions between the two entities.

Mrs. Cunningham stated that members of the board will be conducting one-on-one interviews with the finalists for the Executive Director positions this week. Subsequent to those discussions the board will need to meet for a special meeting to discuss the candidates and ultimately vote to approve who will be hired for the position. Ms. Voss will be coordinating the scheduling of that and asked that she start that process.

Public Comment/Adjourn

There was no public comment, and the meeting was adjourned at 5:15 PM



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