Indian River County Hospital District

Regular Monthly Meeting: May 18, 2023

County Commissioner Chambers/ Zoom
May 18, 2023 @ 4:00 PM

TRUSTEES: Paul Westcott Michael Kint
Marybeth Cunningham Kerry Bartlett
Barb Bodnar

ABSENT: William Cooney, M.D. Karen Deigl

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

ZOOM: Allen Jones Vicki Soule
Anne Posey Marie Andress

ATTENDEES: Mike Cianci Michael Davis
Andrea Berry Cheryl Martinez
Taylor Farnsworth Stacey Washburn
Bridgette Jerger Maria Roman
Genevieve Mallen Heather Moxley

Convene Meeting, Invocation, Pledge & Consent Agenda– Marybeth Cunningham, Chair

Ms. Cunningham convened the regular monthly meeting of the IRCHD at 4:00 PM. Pastor Anthony Onorato, of Calvary Chapel Vero Beach provided the invocation and Ms. Bartlett led the group in the Pledge of Allegiance. Ms. Cunningham asked for a motion to approve the April meeting minutes and a May disbursement of $833,209.39. Ms. Bartlett requested that few changes to the meeting minutes be made, the first being she would like it noted that she left the April 6th meeting early. Additionally, in the April 20th minutes, Ms. Huebner’s name was spelled incorrectly. Ms. Voss indicated that she would make the recommended changes to the minutes and with those corrections noted Ms. Bodnar made the motion to approve which was seconded by Ms. Bartlett. The motion carried unanimously.

Chairmans Report- Marybeth Cunningham, Chair

Ms. Cunningham stated that the job posting for the Executive Director position has been finalized and posted on the District website, along with various other publications for review and response.

District Counsel Report- Jennifer Peshke, Esq.

Ms. Peshke stated that she continues to be available to the Trustees by responding to questions that have arisen pertaining to various matters the District is handling at the present time. She informed the board that the current legislative session has ended and House Bill 199 which related to Special Districts, has passed. This will require the board to complete four hours of ethics training and the District office will keep the Trustees updated on future requirement deadlines. Additionally, the District received the VNA’s Notice to Exercise its Option to Purchase concerning the Hospice House parcel. The Trustees had discussion concerning the same at yesterdays Chairman’s meeting and the VNA will make a formal presentation to the board next month. Additionally, the District’s budget funding cycle for FY 23-24 is underway and she has participated in the funding request presentation meetings. Lastly, she continues to assist with the process of hiring a new Executive Director and has been working with the HR recruiter Ms. Huebner over the last several weeks.

Financial Statement Review- Michael Kint, Treasurer

Mr. Kint provided his treasurer’s report and stated that District is in a strong financial position. In the last month the District received an additional $403,000 in tax revenue, which makes up 3% of the total revenue. Currently the District has received 96% of its budgeted tax revenues. Additionally, after 7 months of the fiscal year both program and administrative expenses are under budget. He stated that due to this fact, the Trustees may want to evaluate the spending of some of these agencies who are significantly under budget and see if their funding requests for this upcoming fiscal year are in line with their projections. Next, he discussed matters concerning the District Finance Committee and Investment policy. Drafts of both of the documents have been provided to the Trustees for their review and comment. He asked that any changes be submitted to Ann Marie so she could implement the same. There was Trustee discussion and it was decided that the documents would come back before the board next month for final approval.

Executive Director Report- Ann Marie Suriano, Executive Director

Ms. Suriano provided her report and stated that the District has entered into a new three year term lease agreement for their current office space, with Lambert Commercial reality. Their current lease is in effect until July 31st, and at the end of that term the new lease will take effect. She explained that there was a slight increase to the monthly rent amount and she has allotted for this in the Districts FY 23-24 preliminary budget. Next, she discussed her involvement with the Children Services Advisory Committee (“CSAC”) which she and Ms. Bartlett are members. Mr. Kint also serves as a member of the grants review subcommittee and the needs assessment subcommittee for CSAC as well. She explained that CSAC has closed the application process for the IRC Human Services Managing Director and have received 12 applications, and have chosen 4 to move forward with in person interviews planned for the following week. Additionally, the application deadline for CSAC funding was Monday and it was reported that they have received 62 requests from 38 agencies for a total of $3.9 million in requested funding. She explained that total funds awarded from the County Commission to CSAC is $2,567,776, so there will not be enough funding to cover all the requests received. She further stated that there have been discussions with members from CSAC and the county to look at ways to align some of the funding provided by the District and the county, which may be considered duplicative. Ms. Suriano stated that she is working to put together a spreadsheet that outlines the various programs that both taxing authorities support. She has preliminarily identified 12 organizations, and four of those are for funding for the same programs. She further stated that with the reorganization of CSAC, which now includes District representation, she is hopeful that they will be able to move forward working with the county to review the funding structure.

Funded Agency Semi Annual Report –
Dynamic Life Recovery- Mike Cianci, Program Grants Manager

Mr. Cianci provided a review of the semi-annual report for Dynamic Life and stated that the organization has seen growth over the last six months. He stated that the program and operations continue to run smoothly, but one challenge they are facing is limited space and they are looking to expand in the near future. This expansion would include space for classrooms that would provide areas for training and therapy. They continue to maintain their partnership with Camp Haven and often provide referrals or receive referrals. Additionally, their partnership with the UP center continues to be positive and a great resource for the clients at Dynamic. Next Mr. Cianci stated that over the last six months, five clients have completed the Step Program at UP and have been placed at high paying jobs within the community. Next, he discussed data concerning the Rodger Ball Memorial Scholarship which included information concerning relapse and discharge rates, along with employment status and incarceration. Lastly, he stated that Dynamic continues to provide an atmosphere of community accountability in a safe and structed environment for its clients. They are appreciative of the District funding and are thankful for the opportunity to provide these scholarships.

Healthy Start Coalition- Andrea Berry, CEO

Ms. Berry addressed the board and stated that Healthy Start will soon have a leadership transition and on June 1st, they will be welcoming Megan McFall as the new CEO of Healthy Start. She will stay on through the month of June to assist in the transition and thanked the Trustees for their support during her time at the organization. She introduced her team and explained that each of them would be providing an update concerning the various programs that the District supports. Taylor Farnsworth, Director of External Engagement addressed the Trustees and provided a brief overview of Healthy Start and its mission, which is to decrease infant mortality. Next, Cheryl Martinez, Nurse Program Specialist provided the Trustees with information concerning the wrap around program and services offered through Healthy Start which directly supports mothers in Indian River County. Stacey Washburn, Direct Services Manger then discussed some recent changes that have taken place in regards to the fatherhood initiatives. She is pleased to report that the participation in the fatherhood program has been successful and they are adding a second coordinator to assist with the groups and classes. Currently 16 Dad are actively participating in the groups sessions and they have provided a 1-1 home visit for 23 Dads within the community. Next, Bridgette Jerger Doula Coordinator provided an update concerning the G.R.O.W. Doula program and stated that the Indian River County model is being used statewide and they have trained over 200 doulas in the county. Currently there are 12 active doulas working with Healthy Start and they are slated to serve 130 mothers this year. Genevieve Mallen, coordinator for the Babies and Beyond program, provided an update on same and stated they continue to work collaboratively with CCIRH and offered various support groups, which are available to their patients. Additionally, the Healthy Start lactation team will be working with CCIRH nursing staff to provide a shadow shift with a lactation specialist which will be part of their rotation during their shift. This will also be offered annually to provide the nurses with enhanced breastfeeding support and education. Lastly, Maria Roman, Maternity Navigator Coordinator, gave an update on some successes and stated that Healthy Start has been able to interact with almost all the mothers at Partners and CCIRH, pre- and post-partum. They are also working on a collaboration with Physicians to Women to be able to interact with those women as well.

Sunshine Physical Therapy- Heather Moxley, Assistant Executive Director

Ms. Moxley addressed the board and stated that Sunshine Physical Therapy has been experiencing some challenges due to the sudden departure of their Executive director back in March. Therefore, through reorganization, Ginny Blossom was named Interim Executive Director and Ms. Moxley the Assistant interim Executive Director. Ms. Moxley also serves as the clinical director and records custodian for the clinic. She discussed the report and stated that the main challenge is the low reimbursement rates received from Medicaid and that the District supports Sunshine by providing funding to offset the cost of treating those patients. She reviewed the report and stated that over the last six months the clinic saw a total of 147 patients which was made up of 39 adults and 108 pediatrics, for a total of 1449 visits. Next, she reviewed some of the outcome measures and stated that she had initially prepared the report but it was edited by another colleague who does not have a clinical background. She explained that some of the wording in the report does not address objectives, which is a key component of occupational therapy, along with visual motor skills and upper extremity coordination skills. There was Trustee discussion concerning the outcomes measures and they felt that there needed to be more clarity concerning the goals and outcomes, and what those goals are measured against for comparison, that would show improvement. Mr. Westcott stated that the area of speech development in children needs be further addressed due to the negative impact masking had on children which data shows is affecting their speech and comprehension levels. He offered to provide further support to Sunshine and help them work collaboratively with some other entities he has connection with, to address this important need. There was also Trustee discussion concerning the quarterly audit check-in that Ms. Carboni conducted on Sunshine. It was stated that there were some findings in her audit report and if a corrective action plan was in place to address those issues. Ms. Frederick indicated that the corrective action plan Sunshine submitted in response to the audit was provided with the original audit report sent to the Trustees on May 8th. The Trustees also requested that Ms. Blossom attend a future board meeting to address the Trustees and further discussed and explain how they are tracking their metrics and outcome measures.

New Business- Senior Resource Association Request for Funding EARS Program- Liz Bruner, VP Philanthropy

Ms. Bruner addressed the board and stated that she has brought forth a request for additional funding for the current fiscal year to assist with a shortfall for their Emergency Alert Response Services (“EARS”) program. She explained that the new SRA CFO Gabriel Pedrero began an in-depth assessment of all SRA program expenses upon joining the organization this spring. In this process, he discovered economies of scale, which enabled future cost per participant to be reduced from $526 to $405, thereby expanding the impact of the District’s funding to more seniors who live daily with great risk for falls or other health crises. Mr. Pedreos deep dive also surfaced a small group of seniors who are currently enrolled but whose continued Emergency Alert services were not factored into the renewal process for the remainder of the District’s fiscal year. In addition, another small group of seniors in need of an Emergency Alert lifeline, have been enrolled based on their personal risk factors, resulting in program oversubscription. She further explained that this gap funding will ensure lifesaving Emergency Alert services for 21 seniors currently enrolled with renewal dates March 18-September 30, 2023; 22 seniors recently enrolled due to high-risk demand; 24 at-risk seniors expecting enrollment. The total request for funding is $27,135 which will provide annual Emergency Alert Response Services for 67 participants. There was Trustee discussion and Ms. Bartlett made a motion to approve the request, which was seconded by Ms. Bodnar. The motion carried unanimously.

Other Business

Mr. Westcott addressed the board and raised some concerns he had regarding CCIRH. He shared that CCIRH had posted a sign in the lobby of the Health and Wellness Center stating that no specimens collected by Quest Diagnostics or Lab Corp would be accepted by the hospital. He also reported that a local physician was told his specimens would no longer be accepted by CCIRH and this physician had been previously allowed to collect a specimen at his office in an outpatient setting and transfer it to the hospital lab. Under the current direction of CCIRH, the doctor will now have to arrange for the patient to go to the hospital in order to have the specimen collected there. Mr. Westcott also noted that in the Semi-Annual Report from March, CCIRH reported the development of a concierge practice. He explained that according to Section 12 of the District’s Special Act, the Hospital District is not to interfere with independent medical providers. Mr. Westcott expressed that he was concerned that CCIRH is taking advantage of its position and unfairly interfering with independent providers. Mr. Westcott also read from the Informed Consent Form used by Cleveland Clinic at all of its facilities and stated that it has been reported to him by members of the community that they are being required to sign a form that states “I voluntarily consent to all medical treatment and health care-related services that the caregivers at CCIRH consider to be necessary for me”. Mr. Westcott has also been told by members of the community that they have requested the ability to receive treatment without being required to sign the form but were told treatment would not be permitted if they did not complete the form. Mr. Westcott further stated that if this is in fact true, the consent to submitting to the Patient Acknowledgement and Consent Form is not truly voluntary and for indigent patients, a decision to not sign the form could result in an inability to get treatment and seek treatment at another hospital which does not provide indigent care. Also, Mr. Westcott pointed out that he is concerned that the form may also interfere with patients’ ability to rely on powers of attorney and medical surrogate forms. Lastly, Mr. Westcott stated that Section 11 of the Special Act allows the District to develop rules for all properties owned by the District. He believes that if CCIRH is unwilling to work collaboratively with the District, they will need to explore their ability to improve Cleveland Clinic’s level of service to the community. He also feels that CCIRH should address these concerns and others sooner than their required verbal report, which is scheduled to take place in October.

Ms. Cunningham stated that she and Ms. Suriano are scheduled to meet with Dr. Conor Delany, who is the head of Cleveland Clinic Florida, and will bring forth these concerns, along with the other concerns raised by the Trustees. She will then provide an update to the Trustee when she has more information and how CCIRH plans to address these concerns.

Public Comment/Adjourn

There was no public comment, and the meeting was adjourned at 5:30 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