Indian River County Hospital District

Regular Monthly Meeting: September 19, 2024

SUMMARY MINUTES
BOARD OF TRUSTEES
INDIAN RIVER COUNTY HOSPITAL DISTRICT
REGULAR MONTHLY MEETING
County Commissioner Chambers/ Zoom
September 19, 2024

TRUSTEES: Karen Deigl Michael Kint
Marybeth Cunningham Paul Westcott
Barb Bodnar Kerry Bartlett
William Cooney, M.D.

STAFF: Kate Voss Jennifer Peshke, Esq.
Frank Isele Kaytlin Dickens Dawn Carboni Jennifer Frederick

ATTENDEES: Vicki Soule Chuck Mackett Reene Bierly Wayne Creelman
Liz Bruner Chris Deigl Erene Anderson Jan Donlan John Donlan Robyn Orzel

ZOOM: Marie Andress Anne Posey Pat Knipper Megan McFall Lisa Zahner

Convene Meeting, Invocation, Pledge & Consent Agenda

Ms. Cunningham convened the regular monthly meeting of the Indian River County Hospital District at 5:15 PM. She asked for a motion to approve Chairman’s meeting minutes dated August 26 and a September disbursement of $1,471,899.66 The motion was made by Ms. Deigl and seconded by Ms. Bartlett. The motion carried unanimously.

Ms. Cunningham reflected on the District’s budget process for fiscal year 24-25 and stated that while there were some challenges adjusting to the new method of using eC Impact, she was pleased at the improvement being made to the overall efficiency of the process. She also thanked the Trustees for their efforts and input during the budget process.

District Counsel Report- Jennifer Peshke, Esq.

Ms. Peshke stated she has responded to questions from Trustees as they have arisen pertaining to various matters the District is handling and she continues to review the annual deadlines and deliverables due to the District under the lease with CCIRH. She is also working to respond to Trustee questions with regard to the District authority under the lease with CCIRH and will provide a written summary on the same. Also, she continues to work with Ms. Deigl and Mr. Isele on negotiations to purchase the CHS property to house a future women’s sober living facility. They are making progress and will have an update for the Trustee in the next few weeks. Further, the District and VCOM have entered into a lease agreement for Human Services Building and she is working on the last phase of this process which is to confirm CCIRH will grant a waiver of the Right of First Refusal they currently hold on the parcel. Next, she stated that she has been working with Ms. Frederick to finalize the agency funding agreements. Lastly, Ms. Peshke has participated and assisted with the Trustee’s Strategic Planning efforts and continues to remain available to each Trustee in this regard.

Financial Statement Review – Michael Kint, Treasurer

Mr. Kint stated after eleven months of the fiscal year, the District is in strong financial condition. He provided a review of the year-to-date budget items and investment and cash holdings. He explained that the District has received 102%, or $12,946,443 of the $13,573,305 budgeted tax revenue, which is $12,688,060 realized, after $885,245 commissions and uncollectable taxes. Next, he reviewed the Districts investments and stated that as of August 31, all investments total $13,261,146 and discussed the various figures which are allocated; which include treasury bills and money market funds, the Florida Fixed Income Trust Preferred Deposit Pool account, and Seacoast bank. Next, he reviewed the overall program and administrative expenses. He stated that most funded agencies have expensed approximately 90% of their total budget, which is on track for this point in the year. Three agencies reflect expenses which track over their budgeted amount. He explained that those agencies had requested additional funds to cover those shortfalls, but the additional funds are not reflected in the approved budget totals. Lastly, he reviewed total administrative expense, which were over budget and discussed the various reasonings for the increase. There were no further questions or comments.

Executive Director Report- Frank Isele, Executive Director

Mr. Isele provided information on several follow up items and began by discussing the Southeast Florida Behavioral Health Network/DCF abrupt cut in funding for prevention programs, which effected several District funded agencies. He explained that he was able to speak with Representative Brackett and Senator Grall’s office and both were supportive of the Districts efforts to better understand why these cuts happened and also stated that they would look into the matter as well. He also received a call from Jessica Durant, Human Services Program Director at DCF who provided a response to the Districts request for further information regarding the funding cuts. Unfortunately, the response she provided was very vague and did not formally identity the reasoning behind the funding cuts. Next, he discussed the Sebastain River Medical Center (“SRMC”) sale to Orlando Health, which has not been finalized. However, the bankruptcy court did approve the purchase of SRMC and two other Steward Florida facilities for $439.42 million. Further, Mr. Isele provided an update on CCIRH efforts to begin providing inpatient detox services at the BHC. He stated that they are in the process of finalizing the license application and business plan for the project. They also have purchased evidence-based curriculums and started specialized clinician training, while coordinating nursing and behavioral health technician education. Lastly, they are working with local psychiatric service providers to secure a psychiatrist specializing in addiction medicine. Next, he asked Ms. Dickens to provide an update on the performance measure and health outcomes dashboard. Ms. Dickens provided the update and showed the Trustees the new updates to the dashboard, which has now been imbedded into the District’s website. He further stated that in an effort to have more accurate data to review and process, he would like the District to annually conduct a survey to obtain local data on healthcare outcomes. Therefore Mr. Isele recommended engaging the services of Clearview Research to conduct the survey. Ms. Dickens stated that representatives from the organization would be present at the October Chairman’s meeting to answer Trustees questions and concerns. Further, he stated that the District convened all parties involved in the continuum of care for the Mental Health Court, to discuss the mechanics of client flow and the distribution of funding. There will be a follow up meeting scheduled at the end of October to take a further deep dive into the program to ensure that it is operating as efficiently as possible. Lastly, Mr. Isele discussed the potential efforts to contract a grant writer to assist the District in accessing available grant funding, specifically allocated for special districts. There was Trustee discussion about the various types of grants available and how the District could best access these grants. Most Trustee felt that the District should focus solely on federal funds, and not private entities who utilize philanthropic dollars.

Funded Agency Semi Annual Reports- Senior Resource Association

Ms. Robyn Orzel, the newly hired Chief Development Officer at SRA addressed the board and stated that Ms. Bruner would be providing tonight’s update for the Trustees but that she looks forward to working with the board in the future. Ms. Bruner provided the semi-annual written report which discussed the four programs the District supports. She then spoke to the additional questions provided to the funded agencies with regard to the organization and future operations. Ms. Bruner discussed the two learnings the organization had over the last six months which included new developments within the Public Guardian Program and Meals on Wheels. She also discussed their continuous effects to recruit volunteers for the Meals on Wheels, which has expanded significantly. Next, she discussed an emerging issue they are seeing locally effecting their organization, which included the ongoing need and shortage of primary care physicians. She explained they are hopeful that the new partnership with VCOM will create additional opportunities for physicians to stay within the local area to support the community. Lastly, she stated that SRA leadership anticipates continued organizational and philanthropic growth to address existing wait lists and will respond to increasing demands for senior services. In addition to meeting increasing needs driven by population growth, projected expansion will include absorption of select services and activities previously provided by Senior Collaborative of IRC. She explained that as of Oct 1st, this absorption will be finalized with Senior Collaborative being dissolved as an organization. There was Trustee discussion, and many were unaware that Senior Collaborative was dissolving and were disappointed that they had not been notified sooner. Ms. Soule, board chair for Senior Collaborative, addressed the Trustee and stated that they are working to finalize those notification letters and communication would be sent to funded partners and the community soon. Additionally, there was discussion that the board just approved funding in the 24-25 fiscal year budget to support Senior Collaborative and that those funds should be allocated to SRA. The board requested that representatives from SRA come back before the Trustees next month with a formal request for those funds to be redistributed. Ms. Bruner confirmed that they would be prepared in October to come back before the board with their request.

Other Business

Mr. Isele stated that VCOM representatives had contacted the District informing them of an error within the lease agreement relative to the date listed for the deadline to have an fully accredited medical school developed. The current agreement does not reflect the proper amount of time and will need to be amended to 2030, in order to maintain accreditation standards. Mr. Isele stated that he has individual conversation with each Trustees discussing the same and asked that a formal vote take place this evening approved the date change to the agreement. There was Trustees discussion, and all were understanding and in favor of the amendment. Mr. Kint made the motion to approve the change which was seconded by Ms. Deigl. The motion carried unanimously.

Public Comment/Adjourn

There was no further discussion or public comment, and the meeting was adjourned at 6:10 PM.

Respectfully Submitted,

Barb Bodnar, Secretary

WILLIAM COONEY, M.D.

SEAT 7

William P Cooney M.D. 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   |   1/24-12/29

Origination: Elected (2 OC)

Occupation: Retired Surgeon

Email: w.cooney@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

KERRY BARTLETT

SEAT 6

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

Email: k.bartlett@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

KAREN DEIGL

SEAT 5

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   |   1/24-12/29

Origination: Elected 1 OC | Elected NOC

Occupation: President/CEO

Email: k.deigl@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

PAUL WESTCOTT

SEAT 4

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.


Term: 
1/23-12/26   |   1/21-12/24

Origination: Elected 1 OC 

Occupation: Attorney & Mediator

Email: p.westcott@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

CHUCK MACKETT, M.D.

SEAT 3

Charles “Chuck” Mackett MD is a practicing primary care physician who has a long and storied career in military, academic and executive medicine. Dr. Mackett recently retired from Cleveland Clinic Indian River Hospital where he served for fourteen years as Chief Medical Officer, Chief of Staff and President of Indian River Medical Associates. Dr. Mackett serves on the Board of Directors of the We Care Foundation of Indian River County and the Mental Health Collaborative of Indian River County. He currently cares for patients at Treasure Coast Community Health. These experiences give Dr. Mackett a unique perspective regarding mental health, substance abuse, maternal-child care, care for veterans, preventive medicine and access to high quality medical care.

Dr. Mackett is a graduate with honors from the University of Notre Dame and is a graduate from the SUNY Upstate Medical Center in Syracuse, NY. He is a member of the Alpha Omega Alpha National Medical Honor Society and earned his Master of Medical Management degree from Carnegie Mellon University. Dr. Mackett is trained in Aerospace Medicine and is board certified in Family Medicine and Geriatrics. He is a combat veteran, former Air Force Hospital Commander and flight surgeon who served in Germany, Haiti, Japan, Korea, Romania and Iraq. His many military decorations include two Legions of Merit, a Bronze Star Medal, a Defense Meritorious Service Medal and three Air Force Meritorious Service Medals. Dr. Mackett is an Outstanding Graduate of the Air War College.

A native of Upstate New York, Dr. Mackett and his family first moved to Florida in 1996 when he served as Fight Commander and Residency Program Director at Eglin Air Force Base before later serving as Medical Group Commander at Patrick and MacDill Air Force Bases. Dr. Mackett served as Associate Professor, Executive Vice Chairman of Family Medicine and Consultant in the International and Commercial Services Division at the University of Pittsburgh Medical Center before returning permanently to Florida and Vero Beach in 2009.

As a Hospital District Trustee, Dr. Mackett plans to advocate for improved access to mental health services and access to affordable high quality primary and specialty care for all residents of Indian River County particularly mothers, children, the elderly, the underserved and veterans.

Term: 1/24-12/29

Origination: Elected NOC

Occupation:  Primary Care Physician

Email: c.mackett@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

MICHAEL KINT

SEAT 2

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

Email: kintm.irchd@gmail.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960

ALLEN JONES

SEAT 1

In 1973, Mr. Jones began a 27 year career with Merrill Lynch, eventually becoming a senior executive of the company, Senior executive positions included Chairman and CEO of Merrill Lynch Life Insurance Company, serving on the Private Client Executive Committee and various other leadership roles including leading the effort to transition Merrill Lynch to a fee based rather than commission based business. Prior to joining Merrill Lynch, Mr. Jones’ professional career began in the United States Air Force from 1964-1968, achieving the rank of Captain. He then worked with Investment Company Dabbs, Sullivan, Trulock located in Little Rock, Arkansas rising to partner before the firm was sold and joining Merrill Lynch. Mr. Jones received his B.S.B.A in 1964 from University of Arkansas. He further completed advanced management courses at the Kellogg School of Business at Northwestern University, the Wharton School of Business at the University of Pennsylvania and Stanford University. His past community service efforts include serving on the Board of Directors for the John’s Island Club from 2008-2010; Board of Directors for the Indian River Medical Center from 2007-2010; Chairman of the Indian River Medical Center Foundation from 2006-2010; Board of Directors of the Bedens Brook Golf Club; Board of Directors of the Princeton Community Hospital from 1994-1999 and the Chairman of the American Health Association, in Houston, Texas.

Term: 1/24-12/29

Origination: Elected 2 OC

Occupation: Retired CEO

Email: a.jones@irchd.com

Address: 1705 19th Pl Suite G3, Vero Beach, FL 32960