SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
May 21, 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: Marie Andress Vicki Soule Chuck Bradley Jeremy Gable Gregoy Jackson Dr. Acosta-Leon
Wayne Creelman Lauretta Farrell Kelly Williams Cecila 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. Joe LaGuardia, First Baptist Church of Vero Beach 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 April 17, regular monthly meeting minutes dated April 18 and a May disbursement of $1,841,287.53. Ms. Bodnar made the motion which was seconded by Ms. Deigl. The motion carried unanimously.
District Chairwoman- Marybeth Cunningham, Chairwoman
Ms. Cunningham stated that yesterday she attended the CCIRH Board of Directors meeting. As reported, Dr. Peter has resigned from his position as Vice President and Dr. Richard Rothman as been appointed as interim in the role. During the meeting the board also reviewed the organization’s challenges locally and statewide. They further identified that the hospital’s safety error reporting has increased 50%, which is a positive step in creating a safer hospital environment. There was also a detailed discussion on quality and safety data. Additionally, they have introduced a HUSH campaign in an effort to provide patients with a more quite environment to promote healing and increased rest. There was also discussion surrounding the hospital’s patient feedback scores and she explained that 90% of that data is from emergency department encounters.
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 continues to work with Ms. Deigl and Mr. Isele on potential properties which could be used as a detox and sober living facility for the community. They ruled out one property over zoning restrictions and have now continued to focus their efforts on the Children’s Home Society property located in the County. An offer was made to purchase, and they are waiting to hear back from the seller with a counteroffer. Next she discussed House Bill 7013 which will go into effect July 1, 2024. She explained the ways in which this new legislation will affect the District which included term limits for elected officials and the implementation that special districts must establish goals and objectives for each of its programs and activities supported by the District. Lastly, she stated that the District is still reviewing options for future use of the HSB and is also working with Cleveland Clinic on the potential uses of the 82nd Street parcel.
Financial Statement Review- Michael Kint, Treasurer
Mr. Kint stated after seven months of the fiscal year, the District is in sound financial condition and has received 92%, or $12,423,808 of our $13,573,305 budgeted tax revenue, which is $12,688,060 realized, after $885,245 commissions and uncollectable taxes. The District has continues to invest through the Florida FIT Preferred Deposit Pool and there is $9,350,263 in laddered investments. There is also $5,080,850 in the Preferred Deposit Pool account which earns 5.27% interest. Next, he reviewed the year-to-date verses budget report, and most expenses are tracking around 53%. He discussed the variance surrounding those items which were either over budget or under budget. Additionally, he informed the board that the payments for the LIP funds to AHCA, on behalf of TCCH and WFHC, were processed this month and will be reflected on next month’s financial statement.
Executive Director Report- Frank Isele, Executive Director
Mr. Isele provided an update on various items he has been working on over the last several months and stated that he will also lead a detailed discussion on the future use of the HSB and 82nd Ave parcel at tomorrow’s Chairman’s meeting. He then discussed that Districts required Performance Review is complete and he will ask the Trustees later in tonight’s meeting to approve the same. Once approved, the document will be sent up to Tallahassee to fill the requirement. Next, he asked Ms. Dickens to provide an update regarding the District impact campaign and the Beyond SNAP program. Ms. Dickens stated that the District new website is live and she has already received positive feedback on the updates made. Additionally, the District impact report for 2023 has also been posted to the website as well and she informed many of the Districts community partners that the report is available for review. There was Trustee discussion and they asked Ms. Dickens to create a community contact list for the District records. Ms. Dickens then spoke to the Beyond SNAP pilot program and stated that utilization continues to improve and United Against Poverty has increased marketing the program to its clients. Lastly, Mr. Isele stated that he will hold a monthly call with CCIRH leadership and recently met with Dr. Rothman and had a productive conversation. Additionally, he stated that CCIRH is keeping a close eye on the Steward Health Care bankruptcy and the impact it will have on the community with the sale of Sebastian River Medical Center, and the two other Stewart owned hospitals in Brevard County.
Funded Agency Semi Annual Reports
Sunshine Physical Therapy- Ginny Blossom, Executive Director
Ms. Blossom addressed the Trustees and provided an update regarding their clinic and District supported services. She discussed some challenges they have experienced providing therapy services but explained that with the District support they have been able to serve additional patients in their adult and pediatric therapy programs. She further stated that the clinic continues to expand, and they have increased patient volumes by 15% from last year. She then reviewed data and outcomes for the last 6 months and discussed various services lines and their outcomes. Ms. Bodnar had questions regarding their staff size and the overhead costs associated with having a staff that large. There was group discussion surrounding this and the justification for the number of staff, and what is considered industry standard. Next Ms. Blossom reviewed the additional funding request she has brought forth before the board for the current fiscal year. She stated that the request of $125,000 would be used to supplement the already approved funds $225,000 to support additional uninsured and underinsured clients, specifically those with Medicaid only. She reviewed data and figures surrounding the request and there was Trustee discussion regarding the same. There was no further discussion and Dr. Cooney made a motion to approve the additional funding request, which was seconded by Mr. Westcott. The motion carried 6-1, with Ms. Bodnar in opposition.
We Care Foundation- Jennifer Jones, Executive Director
Ms. Jones addressed the board and thanked them for their continued support, specifically through these last few years of transition. She stated that she believes the organization is finally on a path to sustainability and she provided some updates relative to the organization and its operations. She stated that they had just secured a new administrative office location and also were gifted access to an electronic health records system. She then reviewed data and outcomes for their ophthalmology clinic and stated that due to high turnover in the billing departments of their physician partners, they have had delays in submitting invoices for reimbursement. However, they have seen a volume increase of 10% in referrals from last fiscal year. There was Trustee discussion, and it was requested that data showing how many patients were successfully connected to specialty services and received those services, be provided. The Trustees recognized Ms. Jones for her work in transforming We Care over the last several years, and they were pleased with the progress they have made.
Unfinished Business- Approval of Performance Review & Approval of Accounting and Financial Practices Procedure Manual
Ms. Cunningham asked for a motion to approve the District’s Performance Review so that I may be sent up to state to fulfill the District obligations in filing the report. Mr. Isele stated that right before the meeting, Mr. Westcott noted an error on page 24 of the report. Ms. Carboni stated that she asked that this error be corrected in her initial review of the draft report last month. She believes it has been corrected on the final version of the report but will circle back to BJM to confirm the same, before the report is sent to Tallahassee. With the understanding that the error on page 24 will be corrected Ms. Deigl made a motion to approve the Performance Review which was seconded by Mr. Westcott. The motion carried unanimously.
Next, Ms. Cunningham asked for a motion to approve the Accounting and Financial Practices Procedure Manual, which was prepared and vetted by the Finance and Audit Committee. Ms. Bartlett made a motion to approve which was seconded by Ms. Bodnar. The motion carried unanimously.
Other Business- Review/discuss findings in Leapfrog Hospital Rating Report- Paul Westcott, Trustee
Mr. Westcott asked if the Trustees had reviewed the entire report on the Leapfrog website which included a dashboard with more detailed information. He also recognized Lisa Zahner who first reported on this matter in 32963. He then expressed his concerns regarding the report specifically with the fact the CCIRH has decreased their score from an A to a B, and the scoring for handwashing and MRSA. Mr. Westcott expressed additional personal points of view with regard to the oversight he believes the District is required to uphold with CCIRH. He further stated that they would like board to become more engaged where Cleveland Clinic is concerned and he made a motion to request from CCIRH their data as it relates to MRSA infections, bacterial pneumonia and identify what polices and procedures are in place, along with their strategies for dealing with those areas of concern. Dr. Cooney stated that much of the information presented in this report was from 2021 and 2022. He believes that those issues should have already been addressed and updated protocols are in place. Ms. Peshke reminded the Trustees that the proper operating procedure for a motion would be for the motion to have a second, in order for there to be Trustee discussion. Therefore, she asked if there was a second to Mr. Westcott’s motion. No Trustee seconded the motion and it failed. Ms. Cunningham stated that a yesterdays CCIRH Board of Directors meeting she was introduced to Dr. Sonja Peace, who serves as the quality supervisor CCIRH. She would like to have Dr. Peace speak to the Trustees at an upcoming Chairman’s meeting to discuss the data and protocols in place to improve quality and safety. The Trustees were in agreement to this recommendation.
Public Comment/Adjourn
Mr. Blossom introduced Katrena McMahan, who serves as the business manager at Sunshine PT. Ms. McMahan discussed her struggles with obtaining medical treatment and support for her special needs son. She stated that many health care workers she encounters, specifically at the hospital, are unfamiliar in dealing with a special needs child. Additionally, there are few resources and medical providers who treat children and adults with special needs in Indian River County, forcing families to drive hours out of country to seek healthcare. The purpose of her addressing the Trustees today was to bring awareness to this issue, with the hopes the Trustees could look at addressing the issue.
There was no further discussion or public comment, and the meeting was adjourned at 5:35 PM.
Respectfully Submitted,
Barb Bodnar, Secretary
