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