Indian River County Hospital District

Special Meeting Minutes: February 22, 2019

Indian River County Hospital District
February 22, 2019
1:00 PM

ATTENDEES: Miranda Hawker Pat Knipper
Vicki Soule Rose Parker
Marie Andress Nick Coppola
Ann Marie Suriano Jennifer Frederick
Michelle Genz Marybeth Cunningham
Kate Voss

Convene Meeting – Marybeth Cunningham, Chairwoman

Mrs. Cunningham convened the special meeting at 1:00 PM by welcoming those in attendance. She explained that the purpose of this meeting is to discuss the Health Departments announcement that they will be transitioning out of providing primary care and dental health services to the county. The District invited the leaders of local health agencies to discuss and share ideas to help facilitate this transition in the most effective way, while making patient care the number one priority.

Mrs. Hawker addressed the group and stated that the Health Department will continue to provide their core public health services such as immunizations, family planning, and communicable disease control. Originally, Mrs. Hawker notified the District that they would be consolidating services to the main health department on March 1. However, at the request of the District Board, they will now be transitioning primary health care services to the Gifford Health Center. This would be a short-term resolution to cut costs as they explore options for the long-term necessity to transition out of providing Primary Care and Dental services, which have become unsustainable. She explained that primary care and dental funding to the Health Department has diminished over the past several years, from multiple funding sources. Therefore, over the past several years they have been scaling down on services due to changes in the fiscal environment, as well as a decrease in revenues. The Health Department is now looking at options in the community for providing primary care services for those Health Department patients. Mrs. Hawker prepared a report of the Health Departments current volumes for reference for the other agency leaders to review.

There was further group discussion concerning new pathways for patients who were utilizing the Health Department as a primary care provider. It was discussed that patients covered by Medicaid could easily be reassigned to other providers to receive their primary care. This would be facilitated by the Health Department notifying Medicaid of the transition. The group then discussed the capacity the other agencies have, to treat the patients being transitioned. Mrs. Soule and Mrs. Andress indicated that both of their organizations have capacity to provide primary care services to those additional patients that would be transitioned from the Health Department at their current locations throughout the county. Mrs. Hawker stated that this transition will affect self-pay patients below 100% of the Federal Poverty Level, the most as they have been on a sliding fee scale, that is a $0 pay. There was group discussion surrounding the lengthy process of credentialing Medicaid providers to provide health services at a different facility other than the one where they are currently credentialed. Mrs. Soule explained that due to HRSA regulations, two separate Federal Qualified Health Centers are not permitted to provide services out of the same location, therefore they would be unable to split up the days in which a provider would be at the Gifford Health Center, which had been suggested.

Mrs. Knipper stated that the VNA mobile unit could also be available for those self-pay patients during the transition and that they would be willing to have the mobile unit parked at the Gifford Health Center an additional day during the week. There was discussion surrounding the need for a collaborative effort from all the agencies during this process. Mrs. Cunningham stated that the District would like any feedback from the providers concerning their needs during the transition.

It was further recommended that the District hire an independent person or persons to assist with qualifying those self-pay patients who have had struggles with the District qualification process. Additionally, they could also provide assistance with qualifying individuals for Medicaid. Everyone agreed that this person should be independent from all agencies and neutral. Mrs. Cunningham requested that the Health Department provide the District with an action plan concerning the discussed transition, and that the District would ultimately consider all of the options to ensure proper access. She explained that there needs to be thoughtful, concise and informative communication to the Gifford community during this transition. Although there may be some time period when primary care services are not located at Gifford, Mrs. Cunningham stated that it is a top priority of the Board to support the Gifford community by ultimately providing access to quality and sustainable health care.

Public Comment- There was no public comment.

Adjourn- The meeting was adjourned at 2:30 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