SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
July 17, 2025
TRUSTEES: Karen Deigl Michael Kint
Allen Jones (zoom) Chuck Mackett, M.D.
William Cooney, M.D. Kerry Bartlett
Paul Westcott
STAFF: Shanen Cox Dana McNally, Esq.
Kaytlin Dickens Jennifer Frederick Frank Isele Dawn Carboni Kate Voss
ATTENDEES: Wayne Creelman Marie Andress Laretta Farrell Colette Heid
Vicki Soule Shawn Leydon Mary Linterman Amanda Rosario Brianna Webb Rashonda Williams
Bob Atwater Cecelia Stalnaker
ZOOM: Carrie Lester Lisa Zahner Kelly Williams Jeff Pickering Liz Bahl Anne Posey Meredith Egan
Convene Meeting, Pledge, Consent Agenda & Chairman’s Report
Dr. Cooney convened the regular monthly meeting of the Indian River County Hospital District at 4:00 PM. Mr. Isele provided the invocation, and Dr. Cooney led the group in the pledge of allegiance. Dr. Cooney asked for a motion to approve the consent agenda and a July disbursement of $1,612,820.08. Ms. Deigl made the motion which was seconded by Mr. Kint. The motion carried unanimously.
Dr. Cooney stated that a proclamation has been prepared recognizing Treasure Coast Community Health and National Health Center week. He read the proclamation aloud for the record and Ms. Soule addressed the board thanking the District for its support over the last 16 years.
District Counsel Report
Ms. McNally provided the District counsel report on behalf of Ms. Peshke who was absent. She stated that the District’s regular monthly meeting packet will now include Form 8B, which is a voting conflict memorandum to be completed when a Trustee has a conflict of interest. The packet will also contain an attorney’s overview summarizing meeting practices, and the public is encouraged to review this. They continue to review the annual deadlines related to the lease with Cleveland Clinic Indian River Hospital (CCIRH) and have assisted District staff with updating internal policies for legal compliance. Additionally, they are working to finalize a letter for a permit application related to retention ponds for the VNA.
Financial Statement Review
Mr. Kint provided the District’s financial statement review and stated that the District remains in a strong financial position. At the end of nine months of the fiscal year, the District received $21,307,780 in ad valorem taxes, which is 0.7% more than budgeted. This was due to unexpected tax collections from previous years. Next, he reviewed the investment statement which shows the U.S. Treasury holdings were $8,106,172 in T-bills, maturing from now through November at an average interest of 4.25%. The money market account, holding $4,893,683, earned 4.28%. The local operating account had $1,185,253, making the total cash holdings $14,185,108, with 92% invested for growth. Next, he reviewed year-to-date expenses for programs which were $13,565,203, or 71.77% of the budget. Administrative expenses totaled $960,627, at 72.01% of the budget. Combined expenses were $14,525,830, or 71.79% overall. Last year, expenses were 74.75%. He also discussed that previous discrepancies identified in the profit and loss statement were corrected, and future statements will include depreciation figures within the profit and loss statement as well.
Executive Director Report & Staff Updates
Mr. Isele provided his report and provided additional information following the important discussion about maternity sustainability at yesterday’s chairman’s meeting. After the meeting he spoke with Dr. Rothman, who provided revised data regarding the expected deliveries, which will increase from 6% to 8.4%. CCIRH is also anticipating between 840 and 900 deliveries this year, up from 740 in 2024. He also projects continued growth of 12 to 15% annually. He also spoke with Megan McFall, and they plan to form a small work group to develop questions for a community survey which will be conducted by Vancore. The District staff are also working to organize a few community forums, with plans for one in the North and South County, and options for Zoom participation. The goal is to move forward with these initiatives as soon as possible. He also has plans to meet with county administrator John Titkanich to make him aware of these efforts.
Next, Ms. Carboni provided an update on her funded agency audit process and reported that she is finalizing the audit report for TCCH for the 2022-23 fiscal year, expecting materials from their finance department tomorrow. The report should be completed and sent to the Trustees in about two weeks, and she has updated the audit letters and documentation list for 2023-24. The first group of audit notices will be sent to nine funded agencies at the end of this month, with two more groups sent out later in the fiscal year. She has also drafted a purchasing and procurement policy and a fraud policy, which has been approved by the finance and audit committee and will be presented to the Trustees next month. She is also working with the team on the budget process and will discuss performance review recommendations at the September Board of Trustees meeting. Next, Ms. Dickens provided an update regarding the District’s financial assistance portal. She explained that some of the funded agencies notified her of issues patients were experiencing with submitting required documents for financial assistance. After review and discussion, a plan was created to allow patients to upload their own documents to the portal, which help alleviate any barriers patients are facing. This feature is now live, and Ms. Dickens has met with the agencies to guide them through the process and ensure smooth transition. She also referenced the District dashboard and patient volume for this point in the year. The data showed that consistently volumes decreased around the end of May and into June, which would contribute to lower billings to the District. Lastly, Mr. Isele provided a community impact story from the Mental Health Collaborative.
Funded Agency Semi Annual Reports
Ms. Soule addressed the board and provided an update regarding Treasure Coast Community Health (TCCH) and their clinics. They now offer the services of a consulting pharmacist which allows patients to test, treat, and get prescriptions for acute issues without waiting to see a doctor. TCCH also continues to host 16 students from FSU and VCOM, helping with their training, which benefits both the students and staff. Additionally. They are set to open a new location west of town, where they will offer full medical, dental, and behavioral health services. Further, they continue to partner with Dodgertown Elementary School by providing additional health related resources for parents and students. They are also transitioning with the help of EPIC integration and AI to an electronic scribe system, which will allow for more prompt and accurate charting. Next, Mr. Laydon provided an update on the Mental Health Court program which continues to support individuals in the court system who struggle with mental health and substance abuse issues. Lastly, Ms. Soule introduced Danielle Wynn who is the newly hired We Care director, and she provided an update regarding the future of We Care and the strides they are taking to become a more effective and coordinated organization
Unfished Business
Dr. Cooney acknowledged the three letters Mr. Westcott had prepared for Trustee consideration, the first being his opinions on the Special Act with regard to constraints on funding. Dr. Cooney stated that he would like the District’s attorneys to provide their opinion on the matter and Ms. McNally confirmed that their office is working on a memo to address the same. Mr. Westcott clarified his intention in writing the letters and stated he was concerned with previous Trustee discussions surrounding the board interpretation of the Special Act. Next, he addressed the other letter which referenced the VNA retention pond matter and stated he believes there should have been more due diligence taken to protect the interest of the District. Dr. Cooney stated that the matter has already been discussed, approved by the board, and is moving forward. Ms. McNally further stated that the only issue at hand currently being reviewed is the permit application not the potential for an easement change. Further the District is not providing any prejudice to make a different decision later on about the specific easement.
Approval of Tentative Fiscal Year 2025-2026 Budget
Mr. Kint stated that the Trustees must vote to approve a tentative budget for fiscal year 25-26. This budget reflects preliminary funding decisions made at the Chairman’s meetings, with consensus reached on 43 out of 59 proposed programs. Tentative funding has been assigned to these last programs based on evaluations and recommendations. He reviewed key items within the budget including holding $4 million in reserves for operational expenses and a healthcare emergency fund of $550,000 for healthcare access and infrastructure, while also cutting $1.8 million in community partners’ requests. The proposed millage rate of .7650 is expected to generate a gross tax revenue of $24,372,463. After accounting for commissions and uncollectible taxes, the anticipated net tax revenue will be $22,868,583. The next steps in the process will be to hold the first public budget hearing, which is scheduled for September 4th, and the final public budget hearing on September 18th, both at 5:01 p.m. Dr. Cooney asked for public comment, but prior to this Ms. McNally read the guidelines for public comment for informational purposes. Mr. Bob Atwater addressed the board and stated that keeping the millage rate the same still results in a tax increase, and Trustees should consider adopting the rollback rate to avoid this. He noted that the projected increase in ad valorem tax revenues is 8.6%, following a 65% increase last fiscal year. There was no further public comment and Mr. Kint asked for a motion to approve the budget which was made by Ms. Bartlett and seconded by Dr. Mackett. The motion carried unanimously.
Additional Funding Request Sunshine Physical Therapy
Ms. Blossom recognized the Trustees’ work and their respectful communication during recent budget discussion meetings. She stated as outlined in her request, Sunshine PT has utilized 97% of their total budget, and there are still three months left to in the fiscal year. Ms. Blossom outlined the request which is for an additional $150,000 to help support the shortfall from Medicaid and uninsured patients and would support an additional 2,508 visits. There was additional discussion surrounding their other sources of funding and clinical practice. It was also noted that they bill on a fee-for-service basis. With no further discussion Mr. Kint made a motion to approve the additional funding request, which was seconded by Ms. Deigl. The motion carried unanimously.
Public Comment/Adjourn
There was no further discussion or public comment. The meeting was adjourned at 5:45 PM.
Respectfully Submitted,
Karen Deigl, Secretary
