Indian River County Hospital District

Regular Monthly Meeting: March 15, 2018

Regular Monthly Meeting
Indian River County Commission Chambers
March 15, 2018 @ 5:00 p.m.

TRUSTEES: Marybeth Cunningham; Allen Jones; Dr. Michael Weiss; Ann Marie McCrystal; Karen Deigl; Tracey Zudans

EXCUSED: Barbara Bodnar

STAFF: Ann Marie Suriano; Jennifer Frederick;  Kate Voss;  Jennifer Peshke, Esq.

OTHER ATTENDESS: Kip Jacoby; Emily Handley; Carole Kanerak; Shannon Bowman; Reverend Derrick West; Gerri Smith; Miranda Hawker; Kathy Orton; Angela Dicken; Deb Hawkins Michelle Genz; Tara Beard; Tracey Griffis.

Convene Meeting- Marybeth Cunningham, Vice Chairwoman IRCHD

Mrs. Cunningham convened the regular monthly meeting of the Indian River County Hospital District (“IRCHD”) at 5:00 p.m. Mrs. Cunningham indicated that there are a few changes to the agenda. At yesterday’s Chairman’s meeting the District Trustees elected to start their monthly board meetings with an invocation and the pledge of Allegiance. Additionally, Ms. Morgan Libbey, Executive Director at the Public Guardianship Program will not be presenting this evening due to a scheduling conflict.

Pastor Derrick West, of The Genesis Church of Vero Beach, provided the Invocation and Dr. Weiss led the group in the Pledge of Allegiance.

Consent Agenda- Marybeth Cunningham, Chairwoman

Mrs. Cunningham asked for a motion to approve the Chairman’s meeting minutes dated February 14, regular monthly meeting Minutes dated February 15, and a March disbursement of $942,507.28. Ms. Deigl made the motion, which was seconded by Mrs. McCrystal. The motion carried unanimously.

Mrs. Cunningham stated that the District Trustees made a visit to the Cleveland Clinic Weston campus on March 5. She explained that the visit was highly informational and gave the group a chance to see how Cleveland Clinic operates their clinics in Florida. Additionally, the letter of intent was executed between the parties and the attorneys are working through the due diligence and negotiation process. There are no further updates at this time.

District Counsel Report- Jennifer Peshke, Esq.

Mrs. Peshke provided her District counsel report and stated that she continues to work with the District’s retained special transactional counsel, Gray Robinson, concerning the collaborative process with IRMC. She stated that she is available to answer any Trustees questions as they arise through this process in working towards a definitive Agreement with Cleveland Clinic.

Financial Statement Review- Allen Jones, Treasurer

Mr. Jones provided the financial statement review and stated that the District remains in sound financial shape. The bank accounts total approximately $11.5 million and there are around $7.8 million in operating funds after accounting for this month’s cash disbursements. Further, the District expects to receive an additional $1.2 million in tax receipts during the balance of the fiscal year, therefore there should be no issues with maintaining its funding responsibilities to the agencies, as long as they stay within their budgeted amounts. This is contingent on indigent care volumes lowering, which they historically do in the fourth quarter. Mr. Jones noted that IRMC’s run rate is currently well above the budgeted amount. This is due to increased volumes on outpatient visits and inpatient stays, which are up 10%. If this trend continues, expenditures for indigent care at IRMC may exceed the budgeted amount by $700,000. Further, Mr. Jones reported that the partnership search process expenditures are currently running within budgeted amounts, but there is still much legal work to be done, and it remains to be seen if the budget amounts will remain accurate.

Executive Director Report- Ann Marie Suriano

Mrs. Suriano provided her executive director report. She notified the Trustees that all pending Senate and House bills, which would affect the District, have died in this legislative session. She further discussed that the State of Florida passed an $89 billion dollar budget, which is one of the highest budgets to date. Some areas that are to be noted are the $55 million budgeted support battling the national opioid epidemic, which has been deemed a national public health crisis. She further discussed a request she received to prepare a letter of support concerning a grant for the Indian River County School District. This grant would provide funding for vocational programs that specialize in the healthcare field. The Trustees agreed that the grant would be beneficial to the community and approved Mrs. Suriano’s request to write the letter of support on behalf of the District.

Funded Agencies Quarterly Report- Childcare Resources- Shannon Bowman, Executive Director

Ms. Bowman provided an update and testimonial to the success of the therapy program at Childcare Resources and how instrumental it has been to the children who attend the school. She explained that through the program, the overall goal is to prepare the child for kindergarten. Due to the District RFP grant, Childcare Resources was able to hire Tracey Griffis as a full time registered nurse therapist. Ms. Bowman explained that having the ability to have the therapist work with each child, has produced positive results in the children’s behavior and ability to learn. She thanked the Trustees for their support.

IRMC, Inc. Monthly Report- Emergency Department Update- Karen Davis, Interim CEO

Ms. Davis provided an update concerning the IRMC Emergency Department. She discussed in detail some of the issues the ED has been experiencing and the initiatives to correct those over the last four months. Ms. Davis explained that on average, there are 200 patients that visit the ED daily and many of these patients are a level 3 or above in acuity. She stated that a large group made up of hospital employees in each department has been formed, to identity the key issues and make corrections where needed, so that they may better support the ED. Additionally, there is now a clinician who screens each patient as soon as he or she enters the ED, to determine if the patient is emergent or non-emergent. Ms. Davis stated that she anticipates over 600 patients who once were served at the Health Department are now seeking care at the ED. Because of this increase, they are working with the low acuity patients to provide them with less costly care at another provider within the county. Ms. Davis further explained that patient volumes are up 10% at the hospital, which is partially due to the harsh flu season. The Trustees inquired if all beds were being staffed and utilized to meet the volume increase and Ms. Davis assured the group that they were. The Trustees had further discussion concerning the ED and thanked Ms. Davis for her efforts.

New Business- Audit Presentation- Kip Jacoby, CPA Morgan, Jacoby, Thurm & Boyle

Mr. Jacoby provided a review of the District’s FY 2016-2017 Audit. He explained that the District’s Audit is unmodified and clean. He discussed in detail the additional sections concerning major initiatives for 2016-2017, including the process of transitioning all agencies to fee for service funding. He further reviewed the summary of assets and liability position. He explained that the net ad valorem tax revenues dropped due to the decrease in the millage rate. He further provided an overview of budget reserves and actual expenditures. Mr. Jacoby stated that the District’s budget tracked with spending. Additionally, he addressed the foot notes which are an overview and the policy and procedures for the office.

Public Comment- There was no public comment.

Adjournment- The meeting adjourned at 6:15 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