SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
October 23, 2025
TRUSTEES: Michael Kint William Cooney, M.D.
Chuck Macket, M.D. Paul Westcott
ABSENT: Karen Deigl Kerry Bartlett
STAFF: Kate Voss Jennifer Peshke, Esq.
Frank Isele Kaytlin Dickens Dawn Carboni Jennifer Frederick
Shanen Cox
ATTENDEES: Richard Rothman, M.D. Kelly Williams Cecelia Stalnaker Marie Andress Colette Heid Lori McCormick
ZOOM: Kim Jeansome Ivy Marchesini Tracey Griffis Robyn Orzel Raquel Rivas Dana McNally Lisa Zahner Lauretta Farrell Matt Reiser Keith Burbank Wayne Creelman
Convene Meeting, Invocation, Pledge & Consent Agenda
Dr. Cooney convened the regular monthly meeting of the Indian River County Hospital District at 4:00 PM. He asked for a motion to approve the September meeting minutes and an October disbursement of $1,468,811.52. The motion was made by Mr. Kint and seconded by Mr. Jones. The motion carried unanimously.
Chairman’s Report
Dr. Cooney recognized the District Trustees and staff for their work in completing the budgeting process for fiscal year 25-26. He also discussed the other matters the District is currently working on including the 10th Street property letter of intent process and the partnership with VCOM. He also recognized the continued efforts of the Trustees to work alongside CCIRH to find solutions for long term support of maternity services in Indian River County. Next, he introduced Dr. Rothman, who would be providing the CCIRH annual verbal report.
Annual Verbal Report- Cleveland Clinic Indian River Hospital- Richard Rothman, M.D., Vice President & Chief Medical Officer
Dr. Rothman provided the report for CCIRH which gave highlights from the 2024 calendar year. He stated that CCRH remains the largest employer in the county, with over 2,500 caregivers who served more than half a million people in 2024. The hospital maintained or expanded its clinical services and provided over $20 million in charity care to residents in need. From 2019 to 2024, nearly $300 million was invested in operations and facility improvements, with about $30 million spent in 2024 alone. In 2025, the hospital will undergo a significant $90 million renovation of its power plant to ensure it can withstand major storms. There will be enhancements in various services, including a new labor and delivery unit with six rooms and a $2.5 million cardiac catheterization lab for minimally invasive valve replacements. The facility will also add medical office buildings to increase access to care. He further stated that despite these efforts, there is still a high demand for healthcare services, and the hospital aims to collaborate with the community to address this. Additionally, CCRIH ranks in the top 10% of hospitals in Florida for the second consecutive year. He also informed the board that the hospital’s emergency department will begin a $18 million renovation in January, enhancing triage and patient care.
Next, he discussed charity care which has increased by over 20% since 2019. The hospital acknowledges the uncertainties in healthcare and seeks to stabilize care delivery. They continue to prioritize investing in their caregivers to retain and bring in new team members amid high national attrition rates. Difficult decisions were made in 2024 to ensure sustainable operations, resulting in a 50% improvement in EBITDA margins. The behavioral health center is now running at break-even, and approximately $180,000 will be returned to taxpayers to support other care teams. Lastly, he discussed CCIRH commitment to maintain maternity services, being the largest provider in the county, delivering about 75% of all babies and achieving some of the best neonatal mortality rates in Florida. He recognized the District Trustees and looks forward to continued collaboration to foster new ideas and improvements. There was Trustee discussion, and they thanked Dr. Rothman for his presentation.
District Counsel Report- Jennifer Peshke, Esq.
Ms. Peshke provided her report and stated that the monthly meeting packets now include Form 8B, which is the Statutory Memorandum of Voting Conflict and attorney’s overview. She has also been working to review the District’s bylaws and proposed amendments based on new policies adopted this year. These amendments will be brought forward for review and possible adoption in the next month. She further discussed the partnership and lease agreement with VCOM. On October 21st she and Mr. Isele had a zoom meeting with representatives from VCOM to discuss the lease default and option to cure. The following day VCOM sent correspondence to the board reassuring their commitment to the partnership. Ms. Peshke was authorized by the board to draft an amendment to the lease agreement and will bring forth that document for review in the next month. Next, she provided an update on the VNA retention pond matter and stated that she is working to set up a meeting with VNA representatives and CCIRH to discuss next steps. Lastly, she has been working with CCIRH counsel on drafting a maternity services agreement for consideration by the board in the next coming weeks.
Financial Statement Review – Michael Kint, Treasurer
Mr. Kint provided his report and stated that at the end of the 24-25 fiscal year, the District’s financial situation is strong. As of September 30th, the District received $21,311,921 in ad valorem taxes, which matches the previous month’s receipt. The U.S. Treasury holdings totaled $5,353,366, with staggered maturity dates and an average interest rate of 3.86%. The preferred deposit pool held $3,032,531 and earned 4.16% and the local operating account at Seacoast had $625,255. Overall, the District’s investment cash holdings totaled $9,011,152, close to the budgeted amount of $9,100,000 for the current fiscal year, 25-26. Next he reviewed total expenses for funded programs which were expected to be around 100%, with some deviations noted. He pointed out that additional funding for certain programs was approved in recent months but is not reflected in this report, as it compares expenses against the initial budget. Also, two CCIRH programs were under budget, including the integration of mental health in the emergency department and IOP program. Additionally, a $250,000 capital contribution for TCCH was expensed but not as a budgeted line item. Therefore, total program expenses, excluding the capital contribution, were $17,844,188, representing 94.41% of the approved budget. Administrative expenses totaled $1,270,324, which is 95.23% of the approved budget. Combined, total expenses were $19,114,512, or 94.46% of the budget, slightly under last year’s 99.37%.
Executive Director Report- Frank Isele, Executive Director
Mr. Isele provided his written report to the Trustees and stated that staff would provide some additional updates. Ms. Voss addressed the board and stated that she attended a one-day legislative session by FASD in Wellington. Key presentations included updates from the House of Representatives Select Committee on Property Taxes. On October 16th, eight bills were introduced in Florida legislation, with regard to property tax reform. She informed the board that the 2026 legislative session starts on the 12th, and she will provide monthly updates on the progress of the session. Additionally, she reminded the Trustees that their ethics training must be completed by December 31st. Lastly, she informed the board that the District is transitioning to ACH bill payment for the program expenses. She and Mr. Isele are currently working with Seacoast bank on the transition which should be completed in November.
Next, Ms. Dickens provided the Trustee with a review of the updated dashboard and data for the fiscal year end. She is working to incorporate the change to fee for service for all agencies, which will allow for better data collection. There was also discussion surrounding the federal poverty level and the potential of increasing the Districts threshold in order to support more low-income individuals.
Funded Agency Semi Annual Reports- CCIRH IOP & ED- Cecelia Stalnaker-Cauwenberghs, Administrator of CCIRH Behavioral Health Center
Ms. Stalnaker provided their report covering the period from April to September 2025 regarding the ED Behavioral Health Integration Program, which aims to improve access to mental health services by placing licensed clinicians and social workers in the emergency department. CCIRH saw over 3,000 behavioral health encounters, demonstrating operational efficiency by spending only 66.6% of the budgeted funds while providing 24/7 services. Additionally, patient wait times in the emergency department for transfers dropped significantly from 284 minutes to 143 minutes, reflecting improved patient flow for behavioral health clients. Of those assessed, 57% were admitted involuntarily, and 31% voluntarily, signaling growing community trust in the services. Follow-up care was noted, with 58.3% of discharged patients completing their assessments with referred agencies. The intensive outpatient program served 165 unique residents and achieved a high success rate, with 89% of participants avoiding further hospitalization. Next, she provided an overview of the Intensive Mental Health Outpatient program and stated that they served 165 unique Indian County residents, which exceeded expectation by 18%. They facilitated 2009 encounters, and of the $186,000 that was budgeted, only expended $124,000 from the funds provided by the District. Ms. Williams, clinical manager of the program, provided the Trustees with a success story from the program. She further stated that this client was also connected to other healthcare and behavioral health services by another District funded organization, that was close to her home, which helped reduce transportation barriers that she was facing.
Other Business
Mr. Westcott stated that he would like further exploration into the Districts current residency requirements for District qualified patients. He believes that the board should have conversations around the constitutional implications and perhaps Ms. Peshke can provide an opinion on the same.
Public Comment/Adjourn
There was no further discussion or public comment. The meeting was adjourned at 5:25 PM.Respectfully Submitted,
Karen Deigl, Secretary
