SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
June 20, 2024 @ 4:00 PM
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
ZOOM: Megan McFall Kim Jeansonne Lisa Zahner Chris Baker
ATTENDEES: Tracy Griffins Shannon Bowman Mike Cianci George Pellington Michael Davis Jay King
Vicki Soule Ceclia Stalnaker
Convene Meeting, Invocation, Pledge & Consent Agenda
Ms. Cunningham convened the regular monthly meeting of the Indian River County Hospital District at 4:00 PM. Dr. Rabbi Michael Birnholz, Temple Beth Shalom provided the invocation and Ms. Cunnigham led the group in the Pledge of Allegiance.
Ms. Cunningham asked for a motion to approve the FY 24-25 funding request presentation meeting minutes dated May 2; chairman’s meeting minutes dated May 22, regular monthly meeting minutes dated May 23 and a June disbursement of $1,301,759.05. Ms. Bodnar made the motion which was seconded by Ms. Deigl. The motion carried unanimously. Additionally, Ms. Cunningham thanked Rabbi Birnholz for his positive message and wished him well on his next endeavor as he is leaving his position as Rabbi at Temple Beth Shalom, after 22 years.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshke stated that she continues to review the annual deadlines and deliverables due to the District under the Lease with CCIRH and has responded to Trustees with questions as they arise. She, Mr. Isele and Ms. Deigl continue their efforts to find a suitable property for the potential women’s sober living facility. She further explained that unfortunately they withdrew their offer on the CHS property due to the seller’s lack of response and non-traditional negotiations tactics. Next, discussed House Bill 7013, which will go into effect July 1 and the areas of the bill which will affect the District. Lastly, she stated that later in tonight’s meeting, there will be discussion surrounding the consideration of an agreement with VCOM, to lease the HSB. She has prepared resolution 2024-02 which outlines the same.
Financial Statement Review- Michael Kint, Treasurer
Mr. Kint stated after eight months of the fiscal year, the District is in sound financial condition and has received 99.6%, or $12,633,783 of the $13,573,305 budgeted tax revenue. He reviewed the year-to-date expenses versus budget report. He stated that a corrected report was submitted to update a program expense line item. There was further review and discussion surrounding this report. Lastly, he reviewed the Districts investment statement, with all investments totaling approximately $15 million.
Executive Director Report- Frank Isele, Executive Director
Mr. Isele reviewed a few items for follow-up and stated that he and Ms. Frederick looked at two additional properties for consideration regarding the women’s sober living facility. They will continue to vet these properties and provide updates when appropriate. Next, he discussed the Beyond SNAP 6-month pilot program and asked Ms. Dickens to provide an for the Trustees. Ms. Dickens stated that utilization of the program continues to increase and reviewed data relative to the same. She further indicated that Ms. McDaniel from United Against Poverty is working to prepare a request for the continuation of the program and will bring forth the same to the Trustee for consideration in the next few months. There was Trustee discussion surrounding how the data is being tracked and what the unduplicated data is showing, with regard to utilization. Next, Mr. Isele stated that Ms. Dickens is working to finalize the last few elements of the District’s performance dashboard. This will be posted to the District website with the hope that it will provide additional information and insight into the needs of the county concerning healthcare needs and gaps. Lastly, he stated that he continues to meet with Dr. Rothman monthly, following the transition of him serving in the Vice President role at CCIRH after Dr. Peter’s departure.
Funded Agency Semi Annual Reports- Childcare Resources- Tracey Griffis, Director of Wellness & Early Intervention
Ms. Griffs addressed the Trustees and provided them with a new organizational pamphlet which outlined the services available at Childcare Resources. She discussed the positive impact the District supported wellness program has had on their organization, as well as the case manager which helps provide additional support the families. She further discussed the program and gave examples of the services being provided to the families and discussed their collaborative efforts with Mental Health Association who provides counseling services for the parents. Ms. Beard addressed the board and further discussed the challenges these families are facing and the increased severity of need, along with increased cases with DCF. There was Trustee discussion and it was agreed that the need for early intervention is key and there needs to be continued and additional support for services such as these. Lastly, Ms. Bowman addressed the board and stated that the organization has purchased a new site for their school which will be located in the old fish and wildlife building on route 60. The space is approximately 30,000 square feet and will allow them to expand services and increase the number of children served to 200.
New Business- Action Required
Additional Funding Request Dynamic Life- Mike Cianci, Program Grants and Certifications Manager
Mr. Cianci addressed the board and stated that as a follow-up to discussions that took place at the District meeting on May 22, regarding the need for gap funding to support the continuation of their counseling program, they have brought forth a funding request regarding the same. He explained that due to Handley restructuring their funding lines, they will no longer receive the financial support from them to support the counseling program. Currently there is $3,300 in outstanding invoices and they anticipate an additional $2,500 in charges for May. Additionally, moving forward, the projected costs for counseling services are $4,000 per month for the remainder of the fiscal year. Therefore, the total request for funding is $21,800, with the future charges being billed on a fee for service basis. Mr. King who is a resident at Dynamic, addressed the Trustees and spoke about his experience at the center and how important the counseling services have been to his recovery efforts. There was Trustee discussion and Ms. Bartlett voiced her concern regarding Hanley withdrawing funding and abandoning their once agreed upon obligation to support the counseling program. She stated that she would like correspondence drafted to Handley informing them that the District has had discussions surrounding this matter and it would now be the obligation of the tax payer to support their lack of funding. There was further discussion and clarification about the contents of the correspondence. After further discussion, Mr. Westcott made a motion to approve the request, which was seconded by Ms. Deigl. The motion carried unanimously.
Approval of Resolution 2024-02- Jennifer Peshke, Esq.
Ms. Peshke explained that Resolution 2024-02 provides authority to the District Board Chair to execute a lease for the HSB between the District and VCOM. However, the District is still in negotiations with VCOM and the terms of the lease, so this action may be premature. There was Trustee discussion and Ms. Peshke stated that she could revise the resolution language to reflect the fact that the District is open to negotiations of a lease agreement. However, there was further Trustee discussion and they felt that this matter should be tabled to see what transpires over the next month pursuant to negotiations with VCOM.
Other Business
Mr. Westcott stated that he is following up on an item which he submitted a memorandum about several months back with regard to indigent care at CCIRH. He believes the District has an obligation under the lease to audit the CCIRH indigent care program. He further believes an audit would provide the District with an opportunity to gather information useful in the Districts strategic planning and provide assurance to the tax payer that the District is upholding it authority of oversight of CCIRH. Therefore Mr. Westcott made a motion to audit the indigent care program being performed by Cleveland Clinic, pursuant to contractual duties set forth in the lease agreement examining the following: 1. Application and approval process of indigent care patients; Length of time for a decision to be made regarding approval; Number of approvals and denials; Nature and effectiveness of any appeal process. 2. Evaluation of Outcomes and Admissions for Indigent Care Patients. 3. Assessment of the current need and anticipated growth in need. 4. Collection and understanding of data relating to acute care patients verses chronic patients; ER visits compared to admissions. 5. Demographic/Composition i.e. homelessness, age, family status, incomes. Ms. Bartlett seconded the motion for discussion. She asked Ms. Peshke to clarify the oversight of CCIRH language Mr. Westcott is citing and if it is referenced in the lease. Mr. Westcott clarified that the oversight language he is referring to is in the District’s Special Act and not in the lease agreement with Cleveland Clinic. There was Trustee discussion surrounding the data CCIRH provides annually which includes information about the number of indigent care patients seen and the total cost of these services. They are also required to notify the District should their indigent care policy process change. It was also discussed that if the District is requesting this data from CCIRH, why would they exempt other District funded agencies who also provide indigent care. There was also discussion surrounding the staff time it would take to execute such a request, which would not be able to be done with current District staff. Mr. Westcott clarified the term audit and said a request for information would be more appropriate for his motion. The Trustees also questioned what Mr. Westcott objective was in his request for information. Mr. Westcott stated that he would like assurance that there are no issues in the application process and review; data collection relative to ER usage and demographic makeup; and to assess the quality of performance in this area. Ms. Bartlett reiterated that she would like to have a legal option from Ms. Peshke about the statutory regulations with regard to oversight of the hospital’s operations. She would also like to see the documentation provided to the Trustees from Cleveland annually, which includes the indigent care policy. Additionally, she would like a copy of the memo Mr. Westcott sent out in March. After further Trustee discussion Mr. Westcott felt that it was best to table the motion for further consideration. Ms. Deigl made a motion to table Mr. Westcott’s motion, which was seconded by Ms. Bartlett. The motion carried unanimously.
Public Comment/Adjourn
There was no further discussion or public comment, and the meeting was adjourned at 5:15 PM.
Respectfully Submitted,
Barb Bodnar, Secretary