Indian River County Hospital District

Regular Monthly Meeting: October 18, 2018

Regular Monthly Meeting
October 18, 2018
5:01 PM

TRUSTEES: Marybeth Cunningham Karen Deigl
Ann Marie McCrystal Allen Jones
Barbara Bodnar

EXCUSED: Dr. Michael Weiss Tracey Zudans

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

OTHER ATTENDEES: George Eighmy Brett Hall
Angela Dickens Warren Fuller
Rich Van Lith Vicki Soule
Derick West John Romano

Convene Meeting – Marybeth Cunningham, Chairwoman IRCHD

Mrs. Cunningham convened the regular monthly meeting of the Indian River County Hospital District (“IRCHD”) at 5:00 p.m.

Mrs. Cunningham asked for approval of first public budget hearing meeting minutes dated September 13; budget discussion meeting minutes dated September 26; special meeting minutes dated September 27, final public budget hearing meeting minutes dated September 27; regular monthly meeting minutes dated September 27; and an October disbursement of $875,545.19. Mrs. Bodnar made the motion, which was seconded by Ms. Deigl. The motion carried.

District Chairwoman – Marybeth Cunningham

Mrs. Cunningham stated that the District Trustees and IRMC Board of Directors voted unanimously to approve the Cleveland Clinic partnership. They project the deal to close by January 1, 2019. Additionally, the Districts fiscal year began in October and the board will now focus on the other matters relative to health care in the community.

District Counsel Report – Jennifer D. Peshke, Esq.

Mrs. Peshke provided her district counsel report and stated that she continues to work on the Cleveland Clinic partnership. Additionally, now that the District’s budget has been finalized for the new fiscal year, she is working with District staff to finalize the funding agreements. Further, she is working on matters concerning the Gifford Health Center and the District’s new strategic plan.

Financial Statement Review – Allen Jones, Treasurer

Mr. Jones provided a financial statement review for the fiscal year end. He stated that there were some larger expenses that are normally not incurred which included the Cleveland Clinic partnership and renovations to the VNA Human Services building. The District ended its year with approximately $2.7 million in its bank accounts.

Executive Director Report- Ann Marie Suriano, Executive Director

Mrs. Suriano provided her report and stated that she has been working with Michael Felix on the Districts strategic plan for years 2019-2022. Additionally, the preliminary results from the Health Needs Assessment were presented last week to community leaders and the final report will be available in the coming months.

IRMC, Inc. Monthly Report – Financial Update/Request for Indigent Care Funding- George Eighmy, CFO

Mr. Eighmy provided a review of the fiscal year end for IRMC. He reviewed the variance between budget and actual volumes and stated that IRMC experienced $1.6 million increase over their budget for indigent care services. It was discussed by the Trustees that the hospital had requested approximately $7.5 million for indigent care funding, based off of volumes experienced in the current year. However, the board ultimately voted and approved a lesser amount of $6,38,449 which this hospital has surpassed by $1.3 million. As stated in the Indigent Care Agreement between IRMC and the District, the hospital may request reimbursement for the additional expense incurred before the beginning of the next fiscal year. Mr. Jones indicated that the District has already spent $1.6 million from their reserve funds and that there were enough funds to cover the request but it would be close. There was further Trustee discussion concerning the fact that the 2017-2018 indigent cases had not been audited yet and that there is potential that IRMC will be required to pay back the District for patients who either didn’t qualify or found an alternative payor source. Therefore, approving a payment for the full amount, may be premature. Mrs. McCrystal recommended that the board approve the difference between what the District approved for the 2017-2018 budget request and the amount paid to the hospital for care this year, which equaled $768,937.

Mrs. McCrystal made a motion to reimburse the hospital the amount from their original budget request for fiscal year 2017-2018, versus what has been paid. Ms. Deigl seconded the motion and it carried unanimously. Mr. Jones indicated that he will continue to work with the hospital to find the true up amount.

Funded Agencies Quarterly Report-

Treasure Coast Community Health- Vicki Soule, CEO

Mrs. Soule provided a quarterly update to the Trustees concerning TCCH and its multiple clinics in Indian River County. She stated that TCCH was placed in the top 30% of Community Health Clinics nationwide. They were further recognized as a fully accredited patient centered medical home and patient centered dental home by Accreditation Association of Ambulatory Health Care. She further reviewed data concerning patient visits and outcomes and stated that the clinic has made at least a 10% improvement in one or more clinical quality outcomes.

Mental Health Collaborative- Brett Hall, Executive Director

Mr. Hall provided an update concerning the McCabe Connections center. He discussed his involvement with initiatives to seek Medicaid reform. Additionally, the advocacy program has expanded and they currently have 11 advocates. He further discussed some of the issues many clients who visit the center are experiencing such as lack of housing and substance abuse issues. He explained that in July, the State of Florida enacted new legislation that drastically changes the way opioid based medications are prescribed. Many clients who once received that medication have been unable to do so now due to the new laws. This has caused an increase in patients seeking substance abuse treatment and counseling.

New Business- Action Required

Request for Additional Funding- John Romano, CEO New Horizons

Mr. Romano reviewed the services provided for the period October, 2017 through September, 2018. He explained that New Horizons served 142 unduplicated clients for a total cost of $65,402, which is $10,402 over their budget. Therefore, Mr. Romano is requesting $10,402 for reimbursement of services they provided. Mrs. McCrystal made a motion to approve the expense, which was seconded by Ms. Deigl. The motion carried.

Public Comment-

Mr. Fields, CEO of the VNA, thanked the Trustees for their support of the county and its most vulnerable patients. He stated that he looks forward to working collaboratively with the District and other health agencies in the community.


The meeting was adjourned at 6:00 PM.

Respectfully Submitted,

Ann Marie McCrystal



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