Indian River County Hospital District

Regular Monthly Meeting Minutes: May 17, 2018




Regular Monthly Meeting Minutes

May 17, 2018

5:00 PM


TRUSTEES:                           Marybeth Cunningham; Allen Jones; Ann Marie McCrystal; Tracey Zudans; Karen Deigl


EXCUSED:                            Barbara Bodnar; Dr. Michael Weiss;Jennifer Peshke, Esq.


STAFF :                                  Ann Marie Suriano; Jennifer Frederick;  Kate Voss



OTHER ATTENDEES:     Aracely Romero; Eliecer Romero; Deb Hawkins;  Lundy Fields; Val Zudans; Vicki Soule; Linda Walton; Matt Reiser;

Angela Dickens


Convene Meeting- Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the regular monthly meeting of the IRCHD at 5:00 PM by welcoming those in attendance.


Invocation-Pastor Aracely Romero provided the invocation for the meeting.


Consent Agenda- Marybeth Cunningham, Chairwoman IRCHD

Mrs. Cunningham asked for a motion to approve the Chairman Meeting minutes dated April 18; Regular Monthly Meeting minutes dated April 19, and a May disbursement of $1,067,897.50 made the motion, which was seconded by Mrs. Bodnar. The motion carried unanimously.


Chairman’s Report- Marybeth Cunningham, Chairwoman IRCHD

Mrs. Cunningham stated that at yesterday’s Chairman’s meeting the board discussed the current guidelines that the District uses to qualify indigent. Currently they accept individuals who are financially under 150% of the Federal Poverty Guideline. There was discussion on raising the level to 200% but the board decided to conduct further research on this matter before approving any changes to its current policy. Additionally, she provided an update concerning the partnership process with Cleveland Clinic. She stated that they hope to have a draft agreement for the Trustees to review and comment on in June. Received


Financial Statement Review- Allen Jones, Treasurer

Mr. Jones provided the Treasurers report and stated that the District remains in sound financial condition. However, the District’s program expenditures are running slightly over budget by approximately $200,000. As a result, this year’s operating budget will be tight and there may be a need to utilize some reserve funds. Mr. Jones explained that currently, there are sufficient reserves to manage if expenditures run over budget but as he discussed previously, Trustees should be mindful of allocating further funds that are not currently in the budget.

Mr. Jones stated that at the end of April, the District bank accounts held about $9.7 million of which approximately $2.5 million is set aside as reserves for specific purposes. This leaves $7.2 million available for operational expenses, plus another $700,000 in projected tax revenue not yet received. This brings the total to $7.9 million less than expenditures approved for payment this month.


District Counsel Report- Ann Marie Suriano

Mrs. Suriano stated that she continues her involvement with the Indian River County Leadership program and today the group toured agencies that support the economy and tourism, along with culture and heritage of Vero Beach.


IRMC, Inc. Monthly Report- Nursing Update- Linda Walton, RN, SVP/CNO

  Ms. Walton provided an update concerning IRMC nursing. She explained that the hospital has improved staffing levels on the medical surgical and intermediate level of care units. Additionally, they have doubled the number of graduate nurses entering into the IRMC Nurse Residency Program and are seeing at 93% retention rate with the graduates. Further, the hospital has started a critical care nursing internship program and have expanded the internal float pool. Ms. Walton informed the Trustees that IRMC has been able to decrease the use of agency or temporary RN staffing, which has cut cost significantly. She further reviewed the latest achievements at the hospital. Recently they received the American Heart Association “Get with the Guidelines” Gold Plus Achievement. Additionally, IRMC received the Beacon Award for critical care for the 16th consecutive year.


Funded Agency Quarterly Report-

 New Horizons- Anette Gosselin, CFO

 Ms. Gosselin provided a 6-month update concerning New Horizons financial and client data. She explained that there was a slight decline in number of patients served but that service volumes have increased, which indicates that patients are maintaining their treatment plans. She further reviewed client data concerning unduplicated visits and case management services. Ms. Gosselin stated that New Horizons receives approximately 20 to 25 referrals weekly. Out of those referrals, 10-15 of them come from local health agencies such as the McCabe Connections Center, TCCH, and the IRMC Behavioral Health Center. Additionally, Ms. Gosselin explained that a continued challenge for New Horizons is the cost of service, specifically the cost of psychiatric services where the clinic at times will pay more for an hour of service than what is reimbursed by funders. Throughout the month of April, New Horizons has billed $33,373 for services provided to indigent patients. They will most likely surpass their FY 2017-2018 budget and Ms. Gosselin indicated that they would be requesting additional funding next month.


 Treasure Coast Community Health, Inc.- Vicki Soule, CEO

Ms. Soule provided a brief historical update concerning TCCH. She stated that their goal is to delivery accessible, cost-effective, high quality primary care for all, regardless of their socioeconomic status. She gave a reviewed of District reimbursement data for services in the third quarter. TCCH has also seen an increase in volume concerning patient visits in dental, medical and behavioral health services. She further reviewed the clinic patient satisfaction scores regarding patient care and ease of appointment scheduling. The average satisfaction score was around 95% positive.  Lastly, Ms. Soule discussed TCCH quality measures which include the patient experience, care coordination and safety, along with preventative health.


Public Comment-

 Val Zudans, community member congratulated his wife Tracey Zudans on her Vero Dancing with the Stars win. Mrs. Zudans raised approximately $75,000 for Healthy Start by competing in the competition. Additionally, Dr. Zudans provided feedback concerning the IRC Health Department and its transition to fee for service. Since the transition to fee for service, they Health Department have had to cut staff and are not offering as many adult primary care appointments. He encouraged the Trustees to have a system in place where the patients who used to seek care at the Health Department, are aware of the transition and inform them of other health agencies in the county that will provide primary care services to them, such as TCCH. He believes that if these patients are not aware of other agencies, they will continue to utilize the emergency department for non-emergent issues.


Adjourn- The meeting was adjourned at 6:00 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