Indian River County Hospital District

Regular Monthly Meeting: May 21, 2014

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



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