SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
April 17, 2025
TRUSTEES: Karen Deigl Michael Kint
Allen Jones Chuck Mackett, M.D.
Paul Westcott
ABSENT: William Cooney, M.D. Kerry Bartlett
STAFF: Kate Voss, Jennifer Peshke, Esq.,
Kaytlin Dickens, Jennifer Frederick, Frank Isele, Shanen Fox, Dawn Carboni
ATTENDEES: Rayme Knuckles
ZOOM: Wayne Creelman Carrie Lester Kim Jeansonne Matt Reiser Lisa Zahner Megan McFall Vicki Soule Barb Bodnar Raquel Rivas Anne Posey Michael Hammes
Convene Meeting, Pledge, Consent Agenda & Attorney Overview
Mr. Kint convened the regular monthly meeting of the Indian River County Hospital District at 4:00 PM. Mr. Isele provided the invocation, and Mr. Kint led the group in the pledge of allegiance. Mrs. Peshke then provided her attorney’s overview.
Next, Mr. Kint asked for a motion to approve the chairman’s meeting minutes dated March 19, the regular monthly meeting minutes dated March 20, and an April disbursement of $1,853,330.52. A motion was made by Mr. Westcott, seconded by Ms. Deigl for discussion. Mr. Westcott stated that at the March Chairman’s meeting, Dr. Creelman made some comments regarding the Women’s Recovery Residence which weren’t captured in the minutes. He would like those comments to be added to the minutes. Ms. Voss indicated that she would make the suggested edits. Therefore, Mr. Westcott made an amended motion to approve the minutes with the suggested edits, which was seconded by Ms. Deigl. The motion carried unanimously.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshke provided her report and stated that she continues to monitor the deadlines and deliverables due to the District under the lease agreement with CCIRH. Recently CCIRH submitted its semiannual report and accompanying facilities documents which were received on March 31st. She further stated that she has been working to update the District’s current conflict of interest policy and circulated an update document at yesterday’s Chairman’s meeting which was approved after a slight edit was made at the recommendation of the board. Also, she will move forward with contacting the CCIRH legal counsel to have further discussions surrounding the creation of guidelines for the District’s board chair to follow when reporting out matters related to CCIRH board meetings. Lastly, she stated that she provided the Trustees with a memo outlining the steps to move forward in an RFP process to find an operator for the Women’s Recovery Residence.
Mr. Westcott addressed the board and questioned whether CCIRH could alter the timing of reporting their financial data to better align with the Districts fiscal year so that the Trustee are reviewing more recent information. Mr. Isele stated that he would look into the matter. Additionally, Mr. Kint stated that he noticed Indian River Memorial Hospital, Inc. was referenced on several of the documents submitted within the semiannual report and questioned the usage of this name. Dr. Mackett indicated that Indian River Memorial Hospital, Inc. is still an active corporation who is ‘doing business as’ Cleveland Clinic Indian River Hospital.
Financial Statement Review
Mr. Kint provided the financial review and stated that the financial status of the District remains very good. He provided a review of the March financials which showed the District received $19,789,156 in ad valorem taxes revenue. This is 93.6% of the total revenue budgeted to be received and ahead of last year’s tax revenue received for this point in the fiscal year. Next, he reviewed the investment and cash holdings snapshot which totaled $17,772,798 and is made up of US Treasury bills and holdings in the preferred deposit pool. Next, he reviewed the year-to-date versus budget spreadsheet. He discussed a few programs which were running over budget and explained that Ms. Frederick is working with those agencies to gain a better understanding of the increase and the appropriate next steps. It was further discussed that most of the District funded agencies have been transitioned to fee for service so these increases are solely due to an increase in patient volumes.
Executive Director Report
Mr. Isele provided his report and highlighted a few items from his written report included in the packet. He stated that in the next few weeks, he and Dr. Mackett will have a call with representatives from VCOM to discuss the status of their partnership and the last hurdle of establishing themselves in Florida with an accredited residency program. He will provide further updates to the board when appropriate. Additionally, Mr. Jones addressed the area of Mr. Isele report which highlighted CCIRH economic performance, specifically the areas of behavioral health and maternity care. He stated that the District is committed to hearing the publics comments and concerns on the importance of having these services within the community and encouraged feedback from the residents of Indian River County.
Funded Agency Semi Annual Report- TC Homeless Council
Mr. Knuckles provided the six-month update and noted that since submitting the grant application two years ago, 66 clients have been served surpassing the projected 48 clients annually. Out of these, 46 individuals were housed within 92 days, and 99% remain housed without reentering the system, with only one person currently incarcerated. Only 20% have sought emergency services post-respite and maintain contact with healthcare and mental health support. He further stated that the program aims to serve 98 clients in total, surpassing the initial goal. However, challenges include delays in Social Security Disability Income applications, which now take over 200 days to approve. The program has spent its funding on chronic homeless criteria and hopes to utilize an additional $400,000 received in August to expedite housing. The loss of seven employees due to earlier funding cuts has had impacts on client engagement, and $300,000 in state funding will be lost by July 1st.
Next Mr. Knuckles provided a review of the point-in-time count which is an annual homeless count required by the U. S. Department of Housing and Urban Development, and conducted in Indian River, St. Lucie, and Martin counties. The count measures individuals who are literally homeless, meaning they live on the streets, in shelters, or places not meant for habitation. It does not include those living with family members. The current count shows a reduction in numbers with 701 counted on the Treasure Coast in 2024, down to 569 in 2025, and from 225 to 198 in Indian River County specifically. Despite this decrease, there is still a high inflow of homeless individuals compared to the outflow to permanent housing. He further explained state funding helps provide rent assistance to some, though this support may be limited moving forward. Mr. Knuckles also reviewed his perceived discrepancies in past counts, suggesting some individuals may have been counted multiple times. He also emphasized the importance of accurate data management, highlighting challenges in tracking families who have been homeless for extended periods. He further explained that increased measures are being taken to ensure accurate counts during the process. There was Trustee discussion and further clarification on the point-in-time data as well as the issues surrounding the length of stay at the respite. He stated that their organization is committed to finding permanent housing solutions for these individuals who are placed in the respite and have developed creative methods of pairing individuals together as roommates. They also work closely with TCCH to engage their residents with primary care and behavioral health services.
Other Business
Mr. Jones addressed the board and public. He stated that The District Trustees are active each month holding special, chairman’s and regular monthly meetings, but there seems to be little interest in the televised sessions that the public watches. He inquired whether a broader agenda is needed to help the public understand the work of the various agencies who receive District funding. He further stated that at a recent meeting, the Trustees discussed about a potential threat from Florida legislature which is looking to eliminate property taxes. The elimination of property taxes would significantly impact the District and other county organizations. While paying no property tax may sound appealing, this could mean local funds are sent to Tallahassee for redistribution, affecting local problem-solving with local funds. Therefore, he believes it is important to focus on local solutions and raise public awareness, as staff and trustees are working hard to efficiently manage funds and improve health outcomes in the county.
Public Comment/Adjourn
There was no further discussion or public comment. The meeting was adjourned at 4:55 PM.
Respectfully Submitted,
Karen Deigl, Secretary
