SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
November 21, 2024
TRUSTEES: Karen Deigl Michael Kint
Marybeth Cunningham Paul Westcott
William Cooney, M.D. (zoom) Barb Bodnar
ABSENT: Kerry Bartlett
STAFF: Kate Voss Jennifer Peshke, Esq.
Frank Isele Kaytlin Dickens Dawn Carboni Jennifer Frederick
ATTENDEES: Vicki Soule Matt Riser
Lauretta Farrell Glenn Pavin
Ginny Blossom Mike Cianic George Pellington
ZOOM: Marie Andress Anne Posey Pat Knipper Bridgett Jerger Lisa Zahner Richard Rothman, M.D.
Sonja Pease, M.D.
Convene Meeting, Invocation, Pledge & Consent Agenda
Ms. Cunningham convened the regular monthly meeting of the Indian River County Hospital District at 4:00 PM. Reverend Derrick West provided the invocation and Dr. Cooney led the group in the pledge of allegiance. Ms Cunningham asked for a motion to approve of the Chairman’s meeting minutes dated October 16, regular monthly meeting minutes dated October 17, and a November disbursement of $1,412,306.21. The motion was made by Ms. Deigl and seconded by Ms. Bodnar. The motion carried unanimously.
Ms. Cunningham addressed the board and congratulated Ms. Deigl and Dr. Cooney on the election victories to maintain their Trustee seats. She also welcomed Dr. Chuck Mackett and Mr. Allen Jones to the board, who will take their Trustee seats in January.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshke provided her report and stated that she continues to review the annual deadlines and deliverables due to the District under the Lease with CCIRH and has responded with questions as they arise. She further stated that the District is in the due diligence period for purchasing the CHS property and targeting a December 2024 closing date. Further the lease has been signed with VCOM for the HSB and preparations for their occupancy are underway. Lastly, she continues to work with Ms. Frederick on finalizing agency funding agreements for the fiscal year 2024-2025 and that process is coming to its completion.
Financial Statement Review – Michael Kint, Treasurer
Mr. Kint provided his financial statement review and stated that the District remains in
good financial condition. After one month of the fiscal year the District has a total of $9,264,641 in cash and investments. Further, the District has begun to receive its budgeted tax revenues, with the majority of those funds being received in November and December. Mr. Kint provided a review of the investment statement and year-to-date expenses and stated that the expenses for October were reported at 7.3% of the approved budget, indicating alignment with financial expectations. Additionally, there were some discrepancies in the financial reports that were noted and discussed. Those adjustments have been made and will be reflected in next month’s statements.
Executive Director Report- Frank Isele, Executive Director
Mr. Isele stated that moving forward he will be updating the Trustee and public on the Districts strategic goals and benchmarks during his report. He explained that the District is focusing on expanding access to primary care and mental health services through partnerships with local organizations. Further, efforts are being made to address healthcare disparities, particularly for uninsured populations, following the expiration of Medicaid’s continuous coverage. Initiatives are also underway to promote preventive healthcare and substance use prevention in the community. Next, he discussed a funded agency success story and spoke to the challenges a patient of Sunshine Physical Therapy clinic has suffered due to a severe injury she experienced as a young child. He explained thanks to Sunshine Physical Therapy Clinic, the patient named Maci has shown remarkable progress and he highlighted the importance of community healthcare support. He further stated that the clinic continues to face financial challenges due to losses on Medicaid visits but remains committed to providing accessible care for all.
Funded Agency Semi Annual Reports- Dynamic Life & Sunshine Physical Therapy
Mr. Cianic provided an update on Dynamic Life and reported successful operations and shared a success story of a participant who has reintegrated into society and reunited with his children. Further, the organization remains vigilant against potential changes in marijuana legislation that could impact their operations. They have now expanded their drug testing panel to include 18 different types of substances as many narcotics are available over the counter at convenience stores. This expanded testing helps Dynamic stay committed to upholding the high standards and integrity of a drug free environment. Mr. Cianic further stated that their organization is looking to hire additional staff to focus on case management and assessment and emphasized the importance of case management for effective recovery plans. They are also expanding their focus to include the families of individuals in recovery, partnering with Breaking Chains Women’s Ministry. Programs are also being developed to ensure simultaneous healing for both residents and their families. They are also looking to increase their fundraising efforts to ensure they have the financial means to support these important programs. Lastly, Mr. Cianic announced that he would be stepping down in his role as program and grants manager, but that they are actively looking for a suitable replacement. Additionally, he has accepted a board member role on Dynamics Board of Directors and has been appointed as the liaison to work directly with the Hospital District moving forward.
Ms. Ginny Blossom, Executive Director at Sunshine Physical Therapy, addressed the board and provided a six-month update on the organization. First the board heard from John Luca, PT a provider at Sunshine. He thanked the Trustees for their support and stated that with the District funding they are able to treat the most vulnerable patients in the community. Ms. Blossom began her report and discussed their financial position. She stated that they have experienced a $225,000 positive financial swing year-to-date compared to last year. Additionally, an endowment gift of $500,000 was received from the late benefactor Steve Sadleck, which will contribute to Sunshine’s legacy and growth. Next, she reviewed some challenges they are experiencing and stated that there is a significant increase in children nearing school age, necessitating a focus on school readiness in occupational and speech therapy. The organization is applying for grants to support the school readiness program and is addressing behavioral issues in children, which have escalated recently. There was discussion and it was recommended that Ms. Blossom connect with Childcare Resources to potentially partner with them to provide those needed behavioral health services. Next, Ms. Blossom stated that Sunshine has partnered with Piece of the Puzzle Behavior Analysis to integrate behavioral therapy into pediatric sessions. The initiative aims to train therapists on managing extreme behaviors to improve therapy outcomes for children. The President of the organization, Ms. Christina Morales, addressed the board and provided additional information to the Trustees about the organization. Lastly, Ms. Blossom discussed new initiatives at Sunshine and stated that they are introducing pelvic floor therapy and lymphedema therapy starting in January to fill community service gaps. Ms. Blossom also requested assistance from Ms. Deigl on a transportation issue one of her clients is experiencing with her special needs son. She further stated that there is also a need for more resources to support patients with autism and special needs and she hopes the District will look further into supporting those services in the future.
New Business- Resolution 2024-05- Conveyance of the CHS property, Jennifer D. Peshke, Esq.
Ms. Peshke stated that before the Trustees is a resolution to approve the purchase of a property from Centennial Holdings Treasure Coast LLC, which is the former site of the Children’s Home Society housing facility. After a review of the document provided in the packet, Ms. Peshke realized that it contained some incorrect information and updated the document to reflect the authorization for Ms. Cunninham to execute the final closing documents. She further discussed the amended changes and Mr. Westcott made a motion to approve the resolution with the outline changes discussed. The motion was seconded by Ms. Bodnar and carried unanimously.
Other Business
Mr. Westcott addressed the board and stated that he was not seeking formal action on this matter, however he would like there to be further exploration into the Leapfrog report and its implications for other Cleveland owned hospital facilities in the area. He suggested that Mr. Isele investigate the matter and look further into reports provided by other facilities at Cleveland Clinic and their performance metrics. Dr. Sonya Pease, Safety, Quality, Patient Experience Officer, was present on Zoom and spoke in detail about the Leapfrog ratings and projection of future ratings. She stated that significant improvements have been made since the data from these reports were collected and the organization has invested in technology to achieve 100% compliance over the four facilities. There was also discussion surrounding the communication issues that were identified across the Florida facilities and a transition to a new electronic medical record system which contributed to many of communication challenges during the reporting period. Dr. Pease further stated that a new safety event reporting system has been implemented to enhance the culture of safety and reduce harm to patients, as well as increased reporting of near-miss events has led to a decrease in actual harm reaching patients. Dr. Rothman also addressed the Trustees via zoom and spoke to Cleveland’s commitment to improve quality scores and patient outcomes. He also emphasized the importance of providing the most up-to-date patient experience and outcome metrics to the community, which is not necessarily reflected in the Leapfrog scores which are outlining data from quarter 4 in 2022. He stated that CCIRH leadership is further committed to presenting quarterly updates on performance metrics to the board, with a focus on transparency and continuous improvement.
Public Comment/Adjourn
There was no further discussion and Ms. Cunningham asked for public comment. There was no public comment, and the meeting was adjourned at 5:30 PM.
Respectfully Submitted,
Barb Bodnar, Secretary
