MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
Regular Monthly Meeting Minutes
August 15, 2019
5:00 PM
TRUSTEES: Ann Marie McCrystal Michael Weiss
Karen Deigl Tracey Zudans
Barb Bodnar
VIA PHONE: Marybeth Cunningham Allen Jones
STAFF: Ann Marie Suriano Jennifer Peshke, Esq.
Kate Voss Jennifer Frederick
OTHER ATTENDEES: Vicki Soule Dan Bach
Deb Hawkins Miranda Hawker
Pat Knipper Lundy Fields
Kathy Orton Andrea Berry
Elisabeth Bublitz Ralph Turner
Michelle Genz Brittany Beautty
Convene Meeting – Michael Weiss, Vice Chair
Dr. Weiss convened the regular monthly meeting of the IRCHD at 5:00 PM by welcoming those in attendance. Rabi Birnholz provided the invocation for the meeting and Dr. Weiss led the group in the Pledge of Allegiance.
Consent Agenda- Michael Weiss, Vice Chair
Dr. Weiss asked for a motion for approval of the Chairman’s Meeting Minutes July 17, Regular Monthly Meeting Minutes dated July 18, and a July disbursement of $939,686.47. Ms. McCrystal made a motion to approve which was seconded by Ms. Deigl. The motion carried unanimously.
District Counsel Report – Jennifer D. Peshke, Esq.
Ms. Peshke provided her monthly report and stated that following the Board’s selection of TCCH to operate the Gifford Health Center, she has worked with District staff on various matters related to the Gifford Health Center and the District continues to work towards finalizing matters concerning the new Lease and Funding Agreement with TCCH, as well as the subleases for any applicable subtenants. She met with Dr. Saver and Mrs. Suriano, and they hope to finalizing negotiations with We Care and its sublease with TCCH, within the next 30 days. She has reviewed information regarding the District’s upcoming budget cycle meetings and materials, as well as all monthly meeting minutes from the monthly and special meetings as the District prepare to approve a final budget for the upcoming fiscal year.
Financial Statement Review – Ann Marie Suriano, Executive Director
Mrs. Suriano provided the financial statement review on behalf of Mr. Jones and stated that the bulk of the tax revenues have been received for this fiscal year and there is approximately $6 million in the District’s bank account, after the approval of this month’s disbursements.
Executive Director Report- Ann Marie Suriano, Executive Director
Ms. Suriano stated that the Health Department has vacated the Gifford Health Center and the District is completing some repairs which needed to be done prior to the reopening of the center on August 26th, under the operation of TCCH. While the GHC is under transition, the VNA mobile unit is available to provide services to members of that community.
Gifford Health Center Advisory Committee Update- Tracey Zudans, Trustee
Ms. Zudans stated that the last meeting took place on August 8 and the advisory committee will continue to meet every two weeks through the transition of GHC. All members on the committee have involvement within the Gifford community and have been participating collaboratively. At the last meeting the committee revised the “looking out for you” flyer which helps address rumor control and provide patients with information about the center. She further explained that the advisory committee meetings are open to the public and if any community member would like to have an item on the agenda, they may contact Ann Marie Suriano ahead of time. Additionally, TCCH has prepared a menu of services that will be provided at the center and a schedule of charges is being worked on. The schedule will be added to the menu once it is complete. Further, an open house of the GHC will take place on September 13th and she will share more details when they become available. Lastly, she stated that during the interview process for a health navigator, the committee discovered that the center needed a community at large representative and they have hired Janay Brown to fulfil the position. They are still in search of a patient navigator for the center and applicants may apply directly with TCCH.
Funded Agencies Quarterly Report-
Florida Department of Health Indian River- Miranda Hawker, Health Administrator
Ms. Hawker stated that her report covers quarters 1, 2, and 3, and as of today, the health department will no longer provide primary care and dental care services. She explained that they will now focus on their primary purpose of providing public health services to the county. She reviewed data concerning patient visits and payor source mix, along with patient satisfaction scores. She explained that the health department will be expanding its public health services for the treatment of Hepatitis and HIV. Additionally, they plan to focus on needs of the community which were identified through the county needs assessment. The Trustees thanked Ms. Hawker for her efforts and work in the Gifford Community through the Health Department. They hope that the Health Department and the District will be able to work together collaboratively moving forward, for the betterment of the community.
Visiting Nurse Association- Lundy Fields, CEO
Mr. Fields thanked the District for their financial support and stated that their report covers October 2018-June 2019. He reviewed the lines of service that the District funds which include hospice, home health, and the mobile unit. He further reviewed patient volume and quality scores regarding the same. Ms. Knipper provided an update concerning the Vulnerable Village Initiative and mobile unit. She began with a review of patient volumes on the mobile unit from last year against the current fiscal year. They have seen an increase in patients since last year but are still finding it difficult to collect the finical assistance paperwork to make them District qualified. The Oslo site continues to be the most visited site, with the Gifford Health Center following closely in second. She further reviewed patient demographics with the Trustees. Lastly, she discussed the positive change program which is part of the Vulnerable Village Initiative. The program provides support to patients with healthy lifestyle changes. She provided the Trustees with a 90 days success story for two patients and currently 30 patients are enrolled in the program.
New Business- TCCH Proposed Adjusted Sliding Fee Scale- Vicki Soule, CEO
Ms. Soule stated that TCCH is looking forward to the reopening of the GHC and that their organization continues to experience growth. TCCH is now predicting an additional 5,000 patients visits this fiscal year, but there will be no additional federal funding, and insurance companies continue to ratchet down reimbursement payments. She further explained that over 10,000 of the 24,000 unduplicated individuals who are currently using TCCH services, have income of less than 100% of the Federal Poverty Level. Currently, about 2,900 medical patients qualified for District funding in 2018. TCCH continues to seek grants and additional philanthropic support, but still depends on District support in providing medical care reimbursement to the uninsured, and lower income residents. The policy currently at TCCH, is to ask for a nominal fee of $25 for medical services for those under 100% of the Federal Poverty Level and offer a sliding fee scale for those with incomes up to 200%. Additionally, in 2018, 20% of the medical patients couldn’t pay anything for their services but were seen regardless of their ability to pay. It was suggested for the upcoming fiscal year a few District Trustees that TCCH have more affordable nominal and discounted fees for those individuals. Ms. Soule discuss the same with her Board of Directors and it proposing the following collaborative approach. She recommends that the District add a portion of the patient paid fees to the District’s reimbursement fee for TCCH. Therefore, TCCH will not ask any District qualified patients for any nominal fees or charges. Further, TCCH will reduced the amount asked of non-District qualified patients with incomes below 200%. They will also drop a separate charge for labs and other ancillary services, and will absorb the balance of the fee reduction income loss. Ms. Soule is requesting this recommendation be instituted before the reopening of the GHC on August 26. There was further Trustee discussion and Ms. Zudans made motion to approve the addition to the cost per service fee and eligible sliding fee scale, as proposed by Ms. Soule. The motion was seconded by Mr. Jones. After further Trustee discussion and clarification from Ms. Soule regarding her recommendation, the motion carried unanimously.
Public Comment- There was no public comment.
Adjourn- The meeting was adjourned at 6:15 PM
