Indian River County Hospital District

Regular Monthly Meeting: January 19, 2023

County Commissioner Chambers/ Zoom
January 19, 2023 @ 4:00 PM

TRUSTEES: Barb Bodnar Karen Deigl (via Zoom)
Marybeth Cunningham Paul Westcott
Michael Kint William Cooney, M.D.

ABSENT: Kerry Bartlett

STAFF: Kate Voss Jennifer Frederick
Ann Marie Suriano Dawn Carboni
Jennifer Peshke, Esq. (via Zoom)

ZOOM: Anne Posey Marie Andress
William Wims Cecelia Stalnaker

ATTENDEES: Lundy Fields Ann Marie McCrystal
Heather Roberts Angela Guzenski
Philip Cromer Matt Reiser
Allen Jones Gerri Smith
Wilfred Hart Pat Knipper
Elizabeth Adams

Convene Meeting, Invocation & Pledge– Marybeth Cunningham, Chair

Ms. Cunningham convened the regular monthly meeting of the IRCHD at 4:00 PM. Reverend Graham Bingham of the Westminster Presbyterian Church provided the invocation and Ms. Cunningham led the group in the Pledge of Allegiance.

Organizational Matters – Jennifer Peshke, Esq.

Ms. Peshke stated that at the beginning of each year, the Bylaws of the District require the District to reorganize and elect five officers. Any board member may make a nomination for the five offices, which include Chairman, Vice Chairman, Treasurer, Secretary, and Assistant Secretary. Each office will be elected by calling for a nomination, and a second. She asked that a nomination for the Chairman, begin the process.

Mr. Kint nominated Ms. Cunningham as Chairman, which was seconded by Mr. Westcott. The motion carried unanimously.

Dr. Cooney nominated Ms. Bartlett as Vice Chairman, which was seconded by Ms. Deigl. The motion carried unanimously.

Ms. Deigl nominated Ms. Bodnar as Secretary, which was seconded by Ms. Cunningham. The motion carried unanimously.

Ms. Cunningham nominated Ms. Deigl as Assistant Secretary, which was seconded by Mr. Westcott. The motion carried unanimously.

Ms. Bodnar nominated Mr. Kint as Treasurer, which was seconded by Mr. Westcott. The motion carried unanimously.

Next, she asked the Trustees to confirm their meeting schedule for the upcoming year. After discussion, they agreed to hold their regular monthly meeting the third Thursday of each month at 4:00 PM, at the County Commissioners Chambers, and a Chairman’s meeting on Wednesday the day before at 10:00 AM. All Chairman’s meetings will be held at the District offices in the conference room.

Next Ms. Cunningham asked for a motion to approve the consent agenda and a January disbursement of $1,074,720.63. Ms. Bodnar made the motion which was seconded by Dr. Cooney. The motion carried unanimously.

Chairmans Report- Marybeth Cunningham, Chair

Ms. Cunningham began by officially welcoming the three new Trustees to the board. She stated that yesterday’s Chairman’s meeting was very productive and feels that this will be a successful group of Trustees.

District Counsel Report- Jennifer Peshke, Esq.

Ms. Peshke stated that she has responded to questions from Trustees as they have arisen pertaining to various matters the District is handling. She continues to review the annual deadlines and deliverables due to the District under the Lease with Cleveland Clinic Indian River Hospital (“CCIRH”) and has responded with questions as they arise. She is also actively following the current legislative session for bills related to Hospital Districts, specifically to the sunshine law and public records act and will bring forth information when necessary. Further, the District is still on hold but continues to monitor how a potential county ordinance change regarding stormwater retention may impact the IRC floodplain and stormwater code changes as it relates to the hospital campus property. She has been actively working this past month on new Trustee orientation. She has also been working to cancel the bonds for the outgoing Trustees no longer on the board, bonding Trustees that are new to the board, and ensuring that Trustees continuing on with new terms have continued bonds. Lastly, the District received the VNA’s notice to vacate the Human Services Building (“HSB”) which they currently lease and she has met with their counsel to discuss next steps. She has also sent correspondence to Cleveland Clinic’s counsel and received a response that they are interested in entering into discussions regarding the future use of the HSB.

Financial Statement Review- Ann Marie Suriano, Executive Director

Ms. Suriano provided the financial statement review and stated that the District has received almost all of its tax revenue for the fiscal year. Additionally, the District began its ladder investment portfolio with DeepBlue investments, and they purchased, on behalf of the District, $8.75 million in T bills and notes that will mature on a monthly basis prior to the District disbursements. Those funds will be utilized to support District monthly operations. Prior to the ladder investment, the District also purchased bills in the amount of $5.75 million and all will provide positive interest returns of over $425,000 in 2023. Dr. Cooney asked for clarification on the Districts relationship with DeepBlue investments. Ms. Suriano explained that DeepBlue, formally known as WaterWalker, was recommended by the Florida Association of Special District as a preferred investment firm. The District began investing its surplus funds with the firm a few years ago and have had a successful relationship with them. Mr. Kint asked for clarification on the funding structure with GlobeChek as he does not see a specific budget line item for them in the District approved FY 22-23 budget. Ms. Suriano explained that initially the District funded a pilot program with GlobeChek last fiscal year. Since the pilot program was successful, they are now working collaboratively with WHFC and TCCH to continue to provide services through the Globe, however, the funding request was still in negotiations prior to the approval of the Districts FY 22-23 and unable to be included within the final budget. Therefore, the program is being supported with reserve funds but is still allocated each month on the financial statement under community support.

Executive Director Report- Ann Marie Suriano, Executive Director

Ms. Suriano stated that her full written report was included with the meeting packet and will touch on a few highlights. First, she convened a meeting with representatives from Whole Family Health Center (“WFHC”), Treasure Coast Community Health (“TCCH”) and GlobeChek to discuss some challenges that each organization is facing with the new GlobeChek program. All parties are working to move forward and she will provide an update to the Trustee when more information is available. Additionally, the Indian River County Chamber of Commerce is holding a business after hours event at the Gifford Health Center on January 25th. She encouraged all the Trustees to attend, to see all the positive changes and updates that TCCH has done to the center.
Funded Agency Semi Annual Report

Senior Collaborative- Randy Riley, Executive Director

Mr. Riley provided an update to the Trustees and announced that he will officially retire on May 1. He Stated that the executive committee of the Senior Collaborative has hired Dawn Redstone as his replacement, and she has been working with him through this transition. He then provided a review of the financials and stated that they are in a good position with cash reserves starting the calendar year equaling six months of current operations. One challenge financially was to raise $21,000 in 2023 to meet budget. This will be done through additional grants, fundraising campaigns or events. Next, he discussed a new initiative they are working on to combat isolation for seniors, which has been identified as item through their action plan. The program, originally founded by the Tallahassee Senior Center Foundation, is called UpSlide and has won several awards since its inception. This program will be offered as a collaborative effort with TCCH, The Mental Health Collaborative, and St. Mark’s Anglican Church. There was further discussion surrounding this issue and the elements of the program and how they combat the isolation. Mr. Riley further stated that they are also working collaboratively with Senior Resource Association to provide transportation to the seniors for this program.

Mental Health Association- Philip Cromer, CEO. & Angela Guzenski, COO

Dr. Cromer addressed the board and offered to meet with any of the new Trustees should they wish to tour the MHA facility or have questions about the organization. Ms. Guzenski provided a review of their written report and began by discussing data concerning the Walk in Center. She explained that volumes had decreased due to varying factors such as closures from the two hurricanes and the holiday season. However, they are beginning to see a slight increase at the start of the year. She then discussed overall billings to the Hospital District, which have decreased over 22% over the last two years. This is also due to varying factors such as patient opting to enroll in Marketplace Insurance plans, or obtaining additional employment to meet the demands of inflation, which puts them over the District income guidelines. She has been discussing these varying issues with Ms. Frederick and would like to work with the District to be able to access more of the District funding, to support those patient services. Ms. Cunningham expressed her concern with the decreased utilization in funding and asked that Ms. Guzenski work with District staff to bring forth a proposal so that MHA is able to support those patients and utilize the budgeted funding. Next there was a review of the Drop-in Center outcomes and High School Violence Prevention Program. Dr. Cromer addressed the board and spoke of the challenges that have arisen since the implementation of the Parents Rights Bill. He explained that they are finding it more difficult to provide services to students, due to the new requirement for parental consent. There was Trustee discussion and some felt that this was an unintended consequence of Representative Grall’s goal in developing the bill. Dr. Cromer stated that they are meeting with the school district next week to formulate an action plan and better understand the requirements of the bill, in order to effectively meet the requirements but also make sure students are being provided the mental health services that are needed. Additionally, Dr. Cromer notified the board that starting in July, the funding from Southeast Florida Behavioral Health Network for the mental health court will cease. Currently Dr. Cromer is the psychologist for the mental health court and with the reduction in funding, he will no longer be able to provide his services, along with the services of two peer support staff. The total cost of their services is around $100,000. There was Trustee discussion and many were concerned with the news and asked that District staff follow up with Judge Menz, who is overseeing this program, to request additional information and how the District could help support the continuation of this much needed service.

VNA- Lundy Field, CEO & Patricia Knipper, Senior Director Special Projects

Mr. Fields addressed the board and began by discussing the untimely passing of Kathy Peirce who was the VNA Foundation Board Chair. He asked for a moment of silence to remember her. He then began the presentation by discussing some of the challenges the VNA has been experiencing over the last year, along with some upcoming changes at the organization. He explained that staffing has been an ongoing issue, specifically the staffing of nurses and they have hired a new VP of Human Resources to take a look at areas where they can improve. Additionally, they are facing challenges with home health reimbursement rates, and he discussed the inconsistencies with being the preferred method of treatment but insurance companies providing low reimbursement payments for the service. Next, he informed the board that the VNA was successful in appealing the case against another agency challenging the VNA’s Certificate of Need for hospice care. The VNA has defended their licenses and while the other agency still has a small window of time to appeal the ruling, their legal counsel does not believe this will be the case. He publicly thanked all parties who testified on the behalf of the VNA to support them through this process. Lastly, he stated that the VNA will be vacating the Human Service Building and their new move out date is May 31st. The organization will now house their operations at the Parc 24 building which will provide a more streamlined work environment for their staff. Ms. Knipper addressed the board and provided a review of the VNA’s written report. She began by discussing the challenges they are experiencing in home care delivery due to a county-wide nursing and caregiver shortage. She also discussed the decrease and subsequent increase in numbers of home health admissions patients, which was primarily due to the referral process from CCIRH. Next, she stated that the VNA’s community music therapy program launched this fall through partnership with the Mental Health Association, Alzheimer’s & Parkinson’s Association and CCIRH Cancer unit. Lastly, she provided an update concerning the VNA Mobile Health Clinic and stated that they continue to see the number of patients who are experiencing challenges with access to same day care, utilizing the clinic. She continues to provide detail reporting to Ms. Frederick concerning the mobile clinic and is available to any Trustee who have additional questions and concerns.

Other Business-

Mr. Westcott addressed the board and stated that as a follow up to yesterday’s discussion concerning the immediate need for detox services in the county, that he would like Ms. Peshke explore and provide direct communication to Cleveland Clinic asking if they would be willing to release the property at 82nd Ave from the current lease agreement. If their answer to that question is no, he would then like to know what would it take to get a yes so, the District could look at future use and plans, specifically to support detox and/or a residential substance abuse treatment center. He stated that with the current lease structure the asset is tied up, and unable to be of current use to the taxpayers. Also, he stated that if Cleveland Clinic wants to release the property, the District could consider selling the property to them. He stated his main objective is to free up the asset, so it may be utilized in the near future, to further the mission of the District. Therefore Mr. Westcott made a motion for Ms. Peshke to direct a letter to Cleveland Clinic leadership over Marybeth’s signature inquiring as to their willingness to release the property out west of town, and if they are unwilling to release it freely, what terms would be agreeable to allow the release. Additionally, he would like them to provide the District with an explanation of their future plans for the property if they are unwilling to release. Dr. Cooney seconded the motion and it passed unanimously.

Public Comment/Adjourn

There was no public comment and the meeting was adjourned at 6:00 PM



William P Cooney MD 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

Origination: Elected (2 OC)

Occupation: Retired Surgeon



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



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

Origination: Elected 1 OC | Elected NOC

Occupation: President/CEO



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.

1/23-12/26   |   1/21-12/24

Origination: Elected 1 OC 

Occupation: Attorney & Mediator



Barbara has practiced physical therapy, specializing in orthopedics and sports medicine, in her hometown of Vero Beach since 1981. She was an integral part of the sports medicine team at Vero Beach High School for 35 years. Barbara completed the reserve police academy training, and served with the Vero Beach Police Department from 1982-1989. Her volunteer involvement in the community includes serving on the City of Vero Beach Recreation Committee, Arthritis Association of Indian River County, and the Senior Good Life Games. She and her husband, Michael, enjoy spending their free time traveling in their RV and training their Labradors, Gunner and Chase, in K-9 performance events, including agility and dock jumping. Barbara is a lifelong resident of Indian River County, and received her degree in physical therapy from Chattanooga State College. Barbara 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

Origination: Elected 1 OC | Elected 1 OC

Occupation: Physical Therapist



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



Marybeth’s professional career encompasses 34 years of working for GM/Delphi in a variety of positions. Starting out as a traffic claims clerk, she worked her way through the organization, with roles in Purchasing, Engineering, and Quality and Reliability. She retired in 2009 as the executive director of Global Operations for the Packard Electric Division of Delphi. In this position, she was responsible for 94 plants in 33 countries. Marybeth has served on the board of directors for numerous non-profits, including Northeast Ohio Adoption Agency; United Way of Warren Ohio, where she served as chairman of the annual campaign for two years; Up with People; Head, Heart and Hands of Indian River Club; Indian River Community Foundation, and the Indian River Mental Health Collaborative. She earned her B.A. in Political Science from Albion College. Marybeth was elected to the Indian River County Hospital District Board of Trustees in 2014, and joined the Board in January 2015. She currently serves as Chair.


Term:  1/15-12/18   |   1/19-12/22   |   1/23- 12/24

Origination: Elected 1 OC | Elected  NOC | Elected NOC

Occupation: Retired Executive GM