SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
April 18, 2024 @ 4:00 PM
TRUSTEES: Karen Deigl Michael Kint
Marybeth Cunningham Paul Westcott (zoom)
William Cooney, M.D.
ABSENT: Kerry Bartlett Barb Bodnar
STAFF: Kate Voss Jennifer Peshke, Esq.
Frank Isele Kaytlin Dickens Dawn Carboni Jennifer Frederick
ZOOM: Megan McFall Kim Jeansonne Lisa Zahner Chris Baker
ATTENDEES: Marie Andress Vicki Soule Chuck Bradley Jeremy Gable Gregoy Jackson Dr. Acosta-Leon
Wayne Creelman Lauretta Farrell Kelly Williams Cecila Stalnaker
Convene Meeting, Invocation, Pledge & Consent Agenda
Ms. Cunningham convened the regular monthly meeting of the Indian River County Hospital District at 4:00 PM. Pastor Nick Carter from Calvery Chapel provided the invocation and Dr. Cooney led the group in the Pledge of Allegiance.
Ms. Cunningham asked for a motion to approve the chairman’s meeting minutes dated March 20, regular monthly meeting minutes dated March 21 and an April disbursement of $1,468,744.16 Mr. Westcott made the motion which was seconded by Ms. Deigl. The motion carried unanimously. Ms. Cunningham stated that there is a change in the agenda and item 7, new business, which is a funding request from Whole Family Health Cetner, will be conducted next, in order to accommodate Mr. Westcott who is participating via Zoom.
New Business- Whole Family Health Center Funding Request for Funding- Marie Andress, CEO
Ms. Andress stated that she has submitted to the Trustees a formal request for additional funding for the current fiscal year. She explained that while preparing budget to support their application request for the next fiscal year, it became apparent that Whole Family will utilize all their approved funding in the next couple of months for medical and behavioral health uninsured patient visits as well as the budgeted pharmacy amount. They are currently estimating their shortfall in funding to be approximately $275,350 through the balance of this fiscal year. Therefore, she is requesting those additional funds to support the anticipated continued volume of uninsured patients. There was Trustee discussion surrounding alternative funding sources that Whole Family was utilizing to support other revenue losses they are experiencing. It was also suggested that they increase their fundraising and philanthropic effort to support those shortfalls as well. However, the Trustees agreed that the request was justified, as it was to support only the uninsured District qualified patients. Therefore Dr. Cooney made a motion to approve the request for $275,350, which was seconded by Mr. Kint. The motion carried unanimously.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshke stated that that she continues to review the annual deadlines and deliverables due to the District under the lease with CCIRH she corresponded with their legal counsel confirming deliverables and due dates, under the lease. Further, she stated that on April 8th the District closed the sale of the Hospice House Parcel with the VNA. Additionally, she reported that the 4-hour ethics training course for compliance with the new state ethics training requirement for elected officials is now available, and the Trustees are able to work with Ms. Voss in order to complete the same. Next, she stated that they continue to conduct due diligence on two properties, one in the County and one in the City of Vero Beach, that could be used as a potential detox and sober living facility for the community. Ms. Deigl has held meetings with city and county officials to discuss zoning matters regarding the properties and has engaged in due diligence regarding both properties. Further, she stated that The District is still in negotiations regarding the Human Services Building and is considering other options to lease it. Lastly, the District continues to work with Cleveland Clinic on the potential uses of the 82nd Street parcel.
Financial Statement Review- Michael Kint, Treasurer
Mr. Kint stated after six months of the fiscal year, the District is in sound financial condition and has received the District has received 89%, or $12,078,563 of the $13,573,305 budgeted tax revenue. He referenced the investment and cash report which shows the laddered investment earnings and cash investments. Next, he reviewed the year-to-date expenses versus the improved budget report. As noted in the report he stated that some of the program expenses are over budget, and some are below budget. He also noted that that the Low-Income Pool funds have still not been expenses as the District has not received invoices to process the same. Lastly, he provided an explanation regarding the increased administrative expenses, which were mostly due to additional legal fees, Gifford Health Center repairs, and an increase in the District’s liability insurance premium. Ms. Cunningham asked if there were any other administrative fees that the staff anticipates continuing to increase over budget. Mr. Isele explained that he is working to implement additional educational opportunities for staff and there will be an increase in this line item for the current fiscal year.
Executive Director Report- Frank Isele, Executive Director
Mr. Isele stated that he has reached out to two consultants recommended by Mr. Westcott, regarding the future use of the HSB building and property. He was able to speak with Tracy Johnson of TK Johnson Consulting who provided her insights and stated that whatever use the District moves forward with, should align with the strategic objectives of the board. Next, he asked Ms. Dickens to provide an update regarding the Beyond SNAP 7-month pilot program in partnership with United Against Poverty. Ms. Dickens stated that utilization of the program has increased over this last month, and she continues to track the utilization and items being provided. The Trustees questioned how many other community agencies could help their clients access this service and asked Ms. Dickens to inquire how they were marketing this program. Next, Mr. Isele provided an update on the District Impact Campaign which includes a new website and annual report. Also, he stated that Ms. Dickens is developing an online dashboard around several measures that directly support the current strategic initiatives, as well as data collection to track access to care in Indian River County. Next, Mr. Isele discussed his plan to hold community listening sessions. He explained that these sessions would be held in each corner of our county to hear directly from the community about how they feel their current healthcare needs are being met in terms of access, affordability, and service, and what they would like us to consider as we plan healthcare services for the future. Lasty, Mr. Isele stated that as new leaders settle in at CCIRH, he would like to continue to focus on solving the most important issues facing healthcare delivery in IRC. He plans to hold either a bi-weekly or monthly meetings with the leadership team, to continue building and maintaining that relationship.
Funded Agency Semi Annual Reports
Camp Haven- Chuck Bradley, Executive Director
Mr. Bradley provided an update regarding Camp Haven and the grant they receive from the District to support drug/alcohol testing and administration of the program for their residents. He stated that the random drug/alcohol testing is conducted at least once per month for all residents, weekly for those in recovery for the first 120 days of their residency, and twice monthly for all others in recovery. A failed drug/alcohol test will result in the resident having additional mandatory treatment at the Substance Awareness Center, weekly drug/alcohol testing, and a strict campus curfew. A second failed test may result in a discharge from the program. Next, he reviewed data from the testing and stated that there is a pass rate of 81%, which is slightly above the target of 75%. In addition, those in recovery had a failed rate of 33% as compared to “other” of 1%. He further stated that while these results are unsurprising, they highlight the struggle to maintain sobriety and the need for psychotherapy and case management. It was also important to note that 10 or 67% of those in recovery passed the testing. Next, he discussed some learning that he and his team identified over the last 6 months. Those include the need for intense psychotherapy, case management, outpatient treatment, and compulsory random drug testing for their residents, which results in a higher chance of success rate. Additionally, they continue to see the need for additional detox facilities and residential post-detox treatment accessible to the indigent and low-income population of Indian River County. Lastly, he discussed the center’s plan to add a Phase 3 component to their program, which would include the construction or purchase of small efficiency apartments/ units offered to qualifying graduating residents at a sub-market rate. This is an effort to keep the residents in Indian River County due to a lack of affordable housing here locally. There are also discussions surrounding the fact that the Treasure Coast Homeless Services Council has transitioned out their grant funding to support rapid housing and Camp Haven will no longer receive funds from them to support their organization.
New Horizons- Gregoy Jackson, COO
Mr. Jackson provided an update regarding New Horizons, on behalf of CEO William Wims who was unable to be present for today’s meeting. Also accompanying him was New Horizons Medical Director, Dr. Acosta-Leon. Mr. Jackson stated that New Horizons continues to work on improving their eligibility process for District qualified patients, in an effort to better utilize the District funding awarded to them. He discussed some challenges the organization has been facing, which included the increased cost for staffing and labor. Additionally, he discussed the significant increase in demand for mental health services in Indian River County and stated that their current team of therapists is struggling to meet this growing need, resulting in long waitlists and limited access to critical mental health services. He further discussed their focus on the IRC Mobile Response Team (“MRT”), which has specially trained mental health professionals who travel throughout the Treasure Coast to assess individuals in crisis, determine level of care needs, and implement therapeutic procedures to promote safety within community settings. They recently hired additional staff for the MRT, to provide support and extended hours of operation. Next, he discussed their expansion of detox services and stated that they have added additional beds and are recruiting more staff to better serve the clients. Lastly, he stated the New Horizons continues to analyze the clinical care needs and payor mix, in order to provide the best quality care and remain financially viable.
Ms. Cunningham stated that the other two agency reports were written only and included within the meeting packet. However, Ms. Stalnaker was present at today’s meeting and was available to answer any questions surrounding the CCIRH report. Dr. Cooney inquired whether the renovations to the BH ED integration updates were completed and asked for an update on the progress of this project. Ms. Stalnaker stated that the space is completed and open. They have hired additional staff to support the patients seen in that area, which is psychiatric safe. She also stated that CC Tradition and Martin are also interested in using this model in their emergency departments. Additionally, Mr. Isele asked that Ms. Stalnaker provide an update regarding CCIRH efforts to bring detox services to Indian River County. She stated that there have been multiple work groups with Cleveland locally and they are developing a business plan for implementation of a medical detox at the Behavioral Health Center.
Public Comment/Adjourn
There was no further discussion or public comment, and the meeting was adjourned at 5:30 PM.
Respectfully Submitted,
Karen Deigl, Assistant Secretary
