SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
March 21, 2024 @ 4:00 PM
TRUSTEES: Barb Bodnar Karen Deigl
Marybeth Cunningham Paul Westcott
Michael Kint William Cooney, M.D.
ABSENT: Kerry Bartlett
STAFF: Kate Voss Jennifer Peshke, Esq. (zoom)
Frank Isele Kaytlin Dickens Robert Siedlecki, Esq. Jennifer Frederick
ZOOM: Megan McFall Marie Andress Lisa Zahner Deborah Shellenberger
ATTENDEES: Carrie Lester Wilfred Hart Philip Cromer Angela Guzinski Marie O’Brien Anne Posey Liz Bruner Barbara Hammond Wes Samons Heather Roberts Vicki Soule Kyleigh Savoie
Deborah Engel
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 Pellington, First Methodist Church provided the invocation and Dr. Cooney led the group in the Pledge of Allegiance.
Ms. 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 $1,312,103.05. Mr. Westcott made the motion which was seconded by Ms. Deigl. The motion carried unanimously.
Chairman’s Report & Proclamations
Ms. Cunningham read allowed two proclamations which supported the Learning Alliance Moonshot Moment and Senior Resource Association Meals on Wheels programs. Representatives from both agencies were in attendance and thanked the Trustees for their support of these important initiatives.
District Counsel Report- Robert Siedlecki, Esq.
Mr. Siedlecki provided the District counsel report and stated that they continue to review the annual deadlines and deliverables due to the District under the Lease with CCIRH and have confirmed with their counsel deliverables and due dates. Further, the sale agreement regarding the Hospice House Parcel between the Visiting Nurses Association and the District was completed. Due diligence is underway for the purchaser and a closing date for early April is currently set. He further stated that at tonight’s meeting the Trustees will vote on a resolution authorizing Ms. Cunningham to execute all closing documents relating to the sale. Next, he stated that FASD (Florida Association of Special Districts) has created a 4-hour ethics training course for compliance with the new state ethics training requirement for elected officials. Such training must be completed by each Trustee by the end of the year. Additionally, they have initiated the due diligence process to explore the feasibility of putting in an offer for the purchase of two properties in Vero Beach owned by the Children’s Home Society for a future detox and sober living facility for the community. Trustee Deigl held a meeting with Mr. Isele on March 7, to discuss next steps. Lastly, he explained at yesterday’s Chairmans meeting the Trustees voted and approved the revised District By-Laws. In brief, the revisions to the document ensured consistent use of defined terms throughout, streamlined certain sections, and clarified the ability of Trustees and members of the public to comment on issues before the Trustees.
Financial Statement Review- Michael Kint, Treasurer
Mr. Kint stated after five months of the fiscal year, the District is in sound financial condition and has received 87% of its budget tax revenue. This percentage is slightly behind the amount received last year. He explained that overall program expenses were under budget by $122,368 for the month and $799,471 year-to-date. Regular administrative expenses were over budget by $97,892 for the month and over budget by $202,455 year-to-date. He further explained that the negative variance for the month of February was primary due to two main factors, with the first being that the District’s liability insurance has increased and was budgeted monthly, but when renewed was paid in a lump sum. The second being the auditing line-item expenses were distributed over 12 months but were realized in a large invoice in February. Further, the negative variance for year to date included the two items above, plus maintenance expenses related to Gifford Health Center. Next, Mr. Kint reviewed the investment statement prepared by Mr. Isele. He also reviewed a new report he prepared that outlines the District percentage of spending for program and administrative expenditures year to date, which the Trustees felt was extremely helpful in seeing how expenses are tracking for the year. This will also help to better understand variances with program spending.
Executive Director Report- Frank Isele, Executive Director
Mr. Isele provided an update on some items he has been working on and stated that as a follow-up to the financial report, the District is still collecting significant interest income on its treasury investment. He reviewed information related to the Federal governments interest rates and stated that with this information in mind, he projects the District to receive approximately $650,000 in interest income this year. Next, he stated that New Horizons has successfully expanded service hours in Indian River County for the mobile response team, from the initial 8:00am-5:00pm to 7:00am-11:00pm. It was discussed that evening-early morning are the peak hours for MRT and the team is working with Mental Health Collaborative and other local organizations to add an overnight shift. Mr. Isele then provided an update concerning the Districts performance review and stated that they received a draft report a the end of January. After a thorough internal review, staff followed up with a group call and addressed several questions with the BJM. The expectations moving forward are that the updated draft report will be received by the end of March and BJM will be available at the April Chairman’s meeting to answer any Trustee questions. He further explained that the report is not due to the state until June, so the District is on track with the June deadline for submission. Next, he asked Ms. Dickens to provide a few updates relative to the SNAP UP program and the District Impact Campaign. Ms. Dickens stated that the District received it first invoice from United Against Poverty for the Beyond Snap program and she has created a tracking system within the District Financial Assistance Portal to track the clients utilizing the services and what products are being purchased. Next, she stated that Ironside is in the final stages of completing the District’s Annual Impact Community report, which will be electronic and available on the District website. Additionally, the new website is almost completed and the final review by staff should be completed next week.
Funded Agency Semi Annual Reports
Substance Awareness Center- Carrie Lester, Executive Director
Ms. Lester addressed the board and stated that she prepared a full written report on all the District funded programs, which was included in the meeting packet for the Trustees review and will move forward by discussing how their organization is using the data and outcomes manager position. She explained that this position has helped them to enhance the way they track, collect, review, and discuss their data, and has been extremely helpful to their organization. It also allows them to better share this information with other community entities for increased collaborative efforts. She spoke further about their collaborative efforts and referenced the presentation she provided yesterday about the communities that care program and their work with prevention support. Ms. Savoie also provides the Trustees with a tutorial on how their data management system works and can generate information to be shared with other community entities. The Trustees were impressed with the system and Mr. Isele stated that it is his goal for the District to have this same type of platform for data collection and sharing.
TC Homeless Services Council- Rayme Nuckles, Visionary Leader
Mr. Nuckels stated that the information relative to the District funded Rapid Resolution Respite was provided in his written report. He stated that like many other community organizations, data collection and management is something their organization relies on, and they are working on ways to better improve their systems. He reviewed the client information for the last 5 months of the program and stated that they have provided 176 services to 17 households. Each enrolled individual is assessed and provided supportive case management services. Additionally, he stated that they recently received the information back from their Point in Time survey, which aims to collect data on the number of homeless individuals, including children and families, residing in Indian River County. He further stated that he is pleased to report that the number of homeless has decreased from last year and he attributes this decrease in the changes to the way their organization is dealing with and managing the homeless population. He provided additional data about the individuals surveyed and stated that a high percentage of people struggle with co-occurring issues such as chronic illness, mental health, and substance abuse. Lastly, he stated that TCHSC is beginning to utilize AI to better support their organization and they are planning a rebrand next year for their 25th anniversary.
Presentation and Approval of FY 22-23 Audit & 2022 Agreed Upon Procedures
Kip Jacoby, CPA
Mr. Jacoby provided a review of the District FY 22-23 audited financial statements and stated that the report was a clean and unmodified report, and met all standards of governmental reporting. Additionally, he provided a review of the 2022 Agreed Upon procedures report which samples six District funded agencies who are funded on a fee-for-service basis. He explained that there were only 9 exceptions in this report and has been the best report out since they began reviewing these services since 2016. There was Trustee discussion, and they were pleased with Mr. Jacoby’s reporting. Mr. Westcott made a motion to approve and accept the Aduit as presented, which was seconded by Mr. Kint. The motion carried unanimously.
Mental Health Association Request for Funding- Philip Cromer, CEO
Mr. Cromer addressed the group and provided some historical insight about how their organization came to develop a plan and visioning for a Parent & Child Center (“PACC”) but was lacking the space for implementation. The MHA’s Board and Administration agreed to take the opportunity to rent the old UF space, which would also allow the expansion of services at the Walk-In & Counseling Center and house the PACC. He further explained that Tykes and Teens and Suncoast Mental Health have also been brought on board as collaborative partners to expand their services and offer additional support to these clients at the PACC. There was further discussion about what services the center would offer and how it would be the managing entity. Dr. Cromer further stated that MHA is requesting financial assistance from the District to support start-up costs associated with opening the PACC so that the communities children and their families can have the support needed to ensure a healthy and thriving future. The total amount of funding being requested is $289,075.67 and there was Trustee discussion about how the funding would be allocated and utilized. The Trustees agreed to support the request and Ms. Deigl made a motion to approve, which was seconded by Dr. Cooney. The motion carried unanimously.
Resolution 2024-01- Robert Siedlecki, Esq.
Mr. Siedlecki stated that resolution 2024-01 authorizes Ms. Cunningham, to execute a vacant land contract with VNA for the sale of the Hospice Houe Parcel at the fair market purchase price of $3.8 million and this deal should be closed by the beginning of April. He asked for a motion to approve the resolution which was made by Ms. Deigl and seconded by Mr. Westcott. The motion carried unanimously.
Items for Consideration- Paul Westcott, Trustee
Mr. Westcott addressed the board and stated that he is not requesting specific board action, however he would like to have discussions relative to the District responsibility under the lease, as to the operations of the hospital and the District oversight authority. He interprets the language of the Special Act to place the responsibility for the District’s functions on the Trustees. The District owned facilities are to be operated for the public use and for the welfare of the District and its inhabitants. These duties and responsibilities remain with the District and have not been abrogated or diminished by the lease or the Substitution Agreement with Cleveland Clinic. He believes it is imperative that the District is able to confirm to the tax payers of the community that their interests are being fully considered and enforced. He brought forth additional concerns he has with their management of indigent care and the health care surrogate forms. He further stated that these items were brought before CCIRH in July and October 2023, and no one from the organization has contacted him to have further discussions. There was Trustee discussions, and many felt that this was not the proper forum to have detailed and important discussions surrounding their oversight and authority of CCIRH, as many Trustees had differing opinions. It was decided that the board would either hold a specially called meeting to discuss this topic only or incorporate it into the next strategic planning meeting scheduled for May.
Public Comment/Adjourn
There was no further discussion or public comment, and the meeting was adjourned at 6:00 PM.
Respectfully Submitted,
Barbara Bodnar, Secretary
