Indian River County Hospital District

Regular Monthly Meeting: December 19, 2024

SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
December 19, 2024

TRUSTEES: Karen Deigl Michael Kint
Marybeth Cunningham Paul Westcott
William Cooney, M.D. Barb Bodnar
Kerry Bartlett

STAFF: Kate Voss Jennifer Peshke, Esq.
Frank Isele Kaytlin Dickens Dawn Carboni Jennifer Frederick

ATTENDEES: Vicki Soule Charles Mackett
Lauretta Farrell Lundy Fields Sheila Gallo Brook Chipman Chuck Brocks Michael Franchek
Bill Schroeder Val Zudans
Pat Knipper Ann Marie McCrystal

ZOOM: Anne Posey Lisa Zahner Phil Cromer Allen Jones Megan McFall Stuart Kennedy Angela Dickens Thomas Jefferson Andrew Decicco Jeffrey Susi Robert McGill Lisa Witkowski Raquel Rivas Ray Osborne Cynthia Goyes Wayne Creelman Irene Cauwels Annette Melendez Jared Nemitz Marcella McPeek

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 George Pellingon provided the invocation and Dr. Cooney led the group in the pledge of allegiance. Ms. Cunningham asked for a motion to approve of the Chairman’s meeting minutes dated November 20, regular monthly meeting minutes dated November 21, and a December disbursement of $1,325,696.87. The motion was made by Ms. Deigl and seconded by Ms. Bodnar. The motion carried unanimously.

Chairman’s Report

Ms. Cunningham addressed the board and spoke of her time over the last 10 years serving as a District Trustees. She thanked the residents of Indian River County for the opportunity and the District funded agencies for their dedication to the community. She also thanked the Trustees and District staff for their work and support. She also spoke to many of the District achievements over the last ten years including the partnership with Cleveland Clinic and the transformation of the Gifford Health Center into a fully operational health care clinic.

District Counsel Report- Jennifer Peshke, Esq.

Ms. Peshke provided her report and stated that the transaction to purchase the CHS property is complete, and the LURA was successfully transferred from the property. As always, she continues to be available for Trustees to discuss various matters the District is handling at the present time. Further, the District staff is continuing to make progress with representatives from VCOM as they work to occupy the building. Ms. Peshke asked if there were any questions and Mr. Westcott stated that he would like Ms. Peshke to prepare a legal memo outlining the roles and responsibilities of the District Chairman with regard to their ex officio seat on the Cleveland Clinic Board of Directors. There was Trustee discussion and they agreed that this would be beneficial to have for the board and record. Therefore, Mr. Westcott made a motion for Ms. Peshke to prepare a legal memo defining the understanding of the dual relationship and responsibilities as Chairman of the District and the ex-officio member of the Cleveland Clinic Indian River Board of Directors, so that the individual better understands their role, their responsibilities, their liabilities, and obligations to the taxpayers and to the District Board. Ms. Bartlett seconded the motion, and it carried unanimously.

Financial Statement Review – Michael Kint, Treasurer

Mr. Kint provided his financial statement review and stated that the District remains in
good financial condition. He stated that the District has received the majority of its tax revenue and recognized the tax payers for their prompt payments. Next, he provided a review of the District’s investments and cash holdings. He then provided a review of the year-to-date expenses versus budgeted expenses and stated that the District is on track for this time period of the fiscal year.

Executive Director Report- Frank Isele, Executive Director

Mr. Isele provided his report and discussed some key initiatives that the District is currently working on which included expanding access to primary care and mental health services, along with the commitment to support the uninsured, underinsured and the ALICE population. He further discussed the acquisition of new property located at 620 and 650 10th street which will be home to a further women’s sober living residence with the capacity to accommodate up to 30 women. Additionally, the District continues to look at strengthening preventive health initiatives and expanding funding sources for the District through grant funding. Next, he provided a success story from Treasure Coast Community Health which discussed the care a patient had received since her birth and she is now taking her children to the clinic. He stated that through the District partnerships and funding, it has enabled TCCH to expand its services, maintain accessible care for underserved populations, and sustain its mission to ensure no one in the county is left behind.

Mr. Westcott asked for historical details surrounding the purchase of the women’s sober living property and what the next steps will be for the District. Mr. Isele stated that staff is working through the details and the District will not be the operator of the property. This project was set in motion a year prior to Mr. Isele beginning his role as Executive Director and he was tasked with securing a property to house women’s sober living facility. The next steps for the District will be to develop a RFP and to work with a consultant who is an expert in these types of operations.

Next, Mr. Westcott stated that recently the Cleveland Clinic made an announcement that they are opening a hospital in Palm Beach County and expanding their facilities in that area. He would like Mr. Isele to send a letter of congratulations to Dr. Delaney and Dr. Rothman on behalf of the Trustees. Mr. Westcott made a motion outlining the same which was seconded by Ms. Deigl, the motion carried unanimously.

Lastly, Mr. Westcott stated that he would like the Trustees to have an update on the Districts funding guidelines for the upcoming funding cycle and Mr. Isele stated that staff will bring forth those recommendations in the next 30 days. Additionally, Mr. Westcott further recommended that that funded agency reporting process be improved and would like to have further discussions on this with the staff and Trustees. Mr. Isele stated that this is also a process the staff has been working to be more efficient.

Funded Agency Semi Annual Reports- Visting Nurse Association

Mr. Fields thanked Ms. Cunningham for her service to the board and community. Next, he provided an update regarding the VNA and its operations over the last six months. He discussed several new learnings regarding a patient’s continuum of care, specifically in the home health setting. Additionally, he spoke to the misinformation surrounding hospice care and the VNA’s work to bridge the gaps for patients and their families. He also discussed the need for more discussions on advanced care planning for seniors. Mr. Fields then reviewed some emerging issues, one of which was division in the workplace and how the VNA is working to bring the employees together for a more cohesive working environment, regardless of their personal beliefs or political affiliations. They are also working to continue to provide the highest quality care to all their patients, so patients can be restored back to their previous quality of life. He further discussed issues surrounding Medicare Advantage plans and the lack of reimbursement payments to providers or providers accepting this type of coverage. He also discussed the issues surrounding for-profit hospice centers and their lack of patient center care with that model. There was Trustee discussion and Ms. Cunningham asked for an update regarding the hospice house parcel land they purchased from the District . Mr. Fields stated that after COVID ended the VNA’s plans for the parcel had changed due to the structure of how staff works and their operations. He stated that they are currently working through visioning plans and still would like the parcel to house a facility that would support seniors in this community. He further stated that they have had discussions with other not-for-profit entities about how best the space could be utilized.

New Business- Resolution 2024-06 & 2024-07

Ms. Bodnar addressed the board and stated that it was an honor to serve the residents of Indian River County for the last eight years. She also thanked the staff for their dedication and hard work. She stated that she will truly miss working with the Trustees and it has been an honor to serve alongside them.

Ms. Peshke read aloud resolution 2024-06 and 2024-07 honoring both Ms. Cunnigham and Ms. Bodnar for their service to the board of Trustees. Dr. Cooney made a motion to adopt both resolutions, which was seconded by Mr. Kint. The motion carried unanimously.

Public Comment/Adjourn

There was no further discussion and Ms. Cunningham asked for public comment. There was several members of the public who spoke and stated the following:

Mr. Bill Schroeder, of Vero Beach addressed the board and encouraged the Trustees to focus on the issues surrounding the shortage of healthcare providers and the increased need for the same due to the growing population in Indian River County. He believes the county is growing too quickly to support the capacity needed for healthcare services.

Mr. Michael Franchek or Indian River addressed the board and stated that there should be no rushed vote on supporting any shortfalls for Cleveland Clinic and he believes that the board should be given Cleveland Clinics financial backup documentation, due to the large amount of funds being requested, and that should not fall on the taxpayers.

Dr. Val Zudans of Vero Beach addressed the board and stated that each Trustee should have a District issued email address so that members of the public may contact them directly. He then questioned the purchase of the property for a sober living facility and the validity of the need for this type of service. He would like to see backup documentation and an analysis for this need, given the expenditure of tax dollars on the same.

Ms. Sheila Gallo of Vero Beach addressed the board and expressed her concern and the concern of residents who voted for her in the District elections for any additional financial support given to Cleveland Clinic. She also discussed her interest in the District involvement with mental health, specifically with children and stated that the board should be using better metrics to measure outcomes for children on psychiatric drugs. She also stated that Ms. Deigl should recuse herself from the board because she poses a conflict of interest.

Ray Osborne of Sebastian addressed the board via zoom and discussed the need for increased telemedicine and electronic message usage for providers as an improved method of healthcare delivery. He would also like the District to conduct a cost analysis on the same.

Thomas Jefferson of Vero Beach addressed the board via zoom and reminded the trustees that they are elected officials. He spoke of the negative public perception Cleveland Clinic has in the community and voiced his displeasure of any additional District funding to the organization.

The last public comment from Lisa Witokowski was read aloud by Ms. Voss. She stated that the District should stream all board meetings live from their YouTube channel and have videos available to the public immediately. Additionally, she stated that the District should never relinquish its position of authority, accountability and context to the contract terms with Cleveland Clinic.

There was no further public comment, and the meeting was adjourned at 5:30 PM.

Respectfully Submitted,

Barb Bodnar, Secretary

WILLIAM COONEY, M.D.

SEAT 7

William P Cooney M.D. 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   |   1/24-12/29

Origination: Elected (2 OC)

Occupation: Retired Surgeon

Email: w.cooney@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

KERRY BARTLETT

SEAT 6

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

Email: k.bartlett@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

KAREN DEIGL

SEAT 5

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   |   1/24-12/29

Origination: Elected 1 OC | Elected NOC

Occupation: President/CEO

Email: k.deigl@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

PAUL WESTCOTT

SEAT 4

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.


Term: 
1/23-12/26   |   1/21-12/24

Origination: Elected 1 OC 

Occupation: Attorney & Mediator

Email: p.westcott@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

CHUCK MACKETT, M.D.

SEAT 3

Charles “Chuck” Mackett MD is a practicing primary care physician who has a long and storied career in military, academic and executive medicine. Dr. Mackett recently retired from Cleveland Clinic Indian River Hospital where he served for fourteen years as Chief Medical Officer, Chief of Staff and President of Indian River Medical Associates. Dr. Mackett serves on the Board of Directors of the We Care Foundation of Indian River County and the Mental Health Collaborative of Indian River County. He currently cares for patients at Treasure Coast Community Health. These experiences give Dr. Mackett a unique perspective regarding mental health, substance abuse, maternal-child care, care for veterans, preventive medicine and access to high quality medical care.

Dr. Mackett is a graduate with honors from the University of Notre Dame and is a graduate from the SUNY Upstate Medical Center in Syracuse, NY. He is a member of the Alpha Omega Alpha National Medical Honor Society and earned his Master of Medical Management degree from Carnegie Mellon University. Dr. Mackett is trained in Aerospace Medicine and is board certified in Family Medicine and Geriatrics. He is a combat veteran, former Air Force Hospital Commander and flight surgeon who served in Germany, Haiti, Japan, Korea, Romania and Iraq. His many military decorations include two Legions of Merit, a Bronze Star Medal, a Defense Meritorious Service Medal and three Air Force Meritorious Service Medals. Dr. Mackett is an Outstanding Graduate of the Air War College.

A native of Upstate New York, Dr. Mackett and his family first moved to Florida in 1996 when he served as Fight Commander and Residency Program Director at Eglin Air Force Base before later serving as Medical Group Commander at Patrick and MacDill Air Force Bases. Dr. Mackett served as Associate Professor, Executive Vice Chairman of Family Medicine and Consultant in the International and Commercial Services Division at the University of Pittsburgh Medical Center before returning permanently to Florida and Vero Beach in 2009.

As a Hospital District Trustee, Dr. Mackett plans to advocate for improved access to mental health services and access to affordable high quality primary and specialty care for all residents of Indian River County particularly mothers, children, the elderly, the underserved and veterans.

Term: 1/24-12/29

Origination: Elected NOC

Occupation:  Primary Care Physician

Email: c.mackett@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

MICHAEL KINT

SEAT 2

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

Email: kintm.irchd@gmail.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

ALLEN JONES

SEAT 1

In 1973, Mr. Jones began a 27 year career with Merrill Lynch, eventually becoming a senior executive of the company, Senior executive positions included Chairman and CEO of Merrill Lynch Life Insurance Company, serving on the Private Client Executive Committee and various other leadership roles including leading the effort to transition Merrill Lynch to a fee based rather than commission based business. Prior to joining Merrill Lynch, Mr. Jones’ professional career began in the United States Air Force from 1964-1968, achieving the rank of Captain. He then worked with Investment Company Dabbs, Sullivan, Trulock located in Little Rock, Arkansas rising to partner before the firm was sold and joining Merrill Lynch. Mr. Jones received his B.S.B.A in 1964 from University of Arkansas. He further completed advanced management courses at the Kellogg School of Business at Northwestern University, the Wharton School of Business at the University of Pennsylvania and Stanford University. His past community service efforts include serving on the Board of Directors for the John’s Island Club from 2008-2010; Board of Directors for the Indian River Medical Center from 2007-2010; Chairman of the Indian River Medical Center Foundation from 2006-2010; Board of Directors of the Bedens Brook Golf Club; Board of Directors of the Princeton Community Hospital from 1994-1999 and the Chairman of the American Health Association, in Houston, Texas.

Term: 1/24-12/29

Origination: Elected 2 OC

Occupation: Retired CEO

Email: a.jones@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960