Voters in November will decide whether the county Hospital District board acts as a careful steward of taxpayer money, or serves as a rubber stamp for Indian River Medical Center management, when they chose among a crowded field of candidates vying to serve as board members.

Three incumbents and eight newbies are running for five seats on the Hospital District board in an election that attracted very few candidates and voters before 32963 began covering the District and its sometimes rocky relationship with its hospital in 2013.

Since that time, however, the Hospital District election has attracted more and more candidates and voters, making the number of people likely to be involved in the November District election unprecedented. 

The main difference of opinion between candidates for the Hospital District, which consists of seven trustees who reimburse county healthcare providers for indigent care expenses with taxpayer dollars, is whether or not Indian River Medical Center – where most of the money goes – is transparent enough and managed well enough.

In a nutshell, incumbents Michael Weiss and Val Zudans, along with new candidate Joe Saul, question whether the hospital is well run by top management and deserving of the millions it receives in tax dollars. These candidates also question whether the hospital abides by public records laws.

Candidate Tony Woodruff (who is running against Weiss) and incumbent Ann Marie McCrystal (who is running against Saul) say they believe the hospital is well run and entitled to whatever amount it says it needs from taxpayers. Woodruff also says he believes the hospital abides by public records laws, while McCrystal notes great improvement in the past year.

Karen Deigl, who is challenging Zudans, said she is inclined to support the hospital’s requests for taxpayer dollars, but will need to study the numbers more closely. She did not offer an opinion on transparency but said she is a long-time supporter of hospital leadership.

Incumbent Gene Feinour acknowledged past management problems at the hospital, but said those problems appear to be improving, along with transparency at the hospital.

Candidate Robert Savage (who is running against candidate Omar Hussamy) said he is aware of past criticism of how the hospital is run, but needs to learn more about it.

Three candidates, orthopedist Omar Hussamy and two of his employees, Barbara Bodnar and Brittany Miller, did not return calls asking for their positions and opinions.

Probably the greatest difference of opinion and choice for voters comes from incumbent District trustee Mike Weiss and his challenger Tony Woodruff, a hospital insider who will leave his position as board chairman of the hospital foundation and board member of the hospital in September.

Weiss is outspoken about his concern that the hospital is neither well run nor transparent and does not deserve the money it gets from the District.

“I think that the hospital is so poorly managed and the Emergency Room is such a disaster with the long wait-times, and hospital leadership is so bad about sharing public documents and being transparent that I have asked hospital CEO Jeff Susi, whose salary is over a million dollars, to resign,” Weiss said. 

But his challenger, Woodruff, strongly disagrees: “I think the hospital is very well managed by Jeff Susi and others and has an excellent balance between what is spent on operations and buildings.  And I see no problem with transparency at IRMC and the availability of documents. The District meetings are open when the hospital reports. The hospital is very transparent.”

At District meetings, the hospital usually reports on topics it decides upon, rather than concerns expressed by District trustees, and, repeatedly, documents that the hospital says it will produce for District trustees and staff don’t materialize. In fact, IRMC kept completely quiet about being sued in federal court by its competitor Sebastian River Medical Center – a suit which it settled a year ago for an undisclosed amount.  But District incumbents Feinour and McCrystal both say hospital transparency has improved in the past year.

“By about 75 percent,” said Feinour, who is a retired Philadelphia bank executive. “And the hospital board is more professional than before, including the chairman of the board.”

Along with Weiss and Woodruff, voters will also have a clear choice of District trustees with incumbent Ann Marie McCrystal and challenger Joseph Saul. 

For years before becoming a District trustee, McCrystal, a retired RN and founder of the Visiting Nurse Association in Indian River County, attended District meetings and hospital board meetings, as well as the meetings of other agencies the District funds. Saul has been a frequent attendee of Hospital District meetings for the past two and a half years.

“If you are out there and available as much as I am, you get a lot of information which helps you see that the hospital has tried to be a good steward of transparency and is improving in that area as well as managing operations better,” said McCrystal.

But Saul, a retired New York dentist and healthcare lawyer, disagrees: “There is almost a complete lack of transparency at the hospital even though the laws demand that they operate in the sunshine.  A recent example is how they ignore questions about the financial results of the new cancer center.”

Further, said Saul, “the hospital would be in bankruptcy if it weren’t for taxpayers, the wonderful philanthropy and not having to pay rent to the District which owns the buildings” – which, he said, raises questions about how wisely the hospital spends money and whether the money from the District should be spread out so that other healthcare agencies get more.

McCrystal says the main mission of the District is to reimburse the hospital for indigent care with taxpayer dollars and she will continue to support that mission, despite understanding the need to spread the money around to other agencies to help with preventive care and other services. 

“Our main responsibility is to fund the hospital and, as long as there is enough money, I support spreading it around. But if the money were to dry up, I’d want to support the hospital first and foremost,” she said.

Saul counters: “I believe the taxpayers should be giving the hospital less money and giving more to other agencies to improve the health of the overall county.”

Another clear choice for voters comes with the candidacy of incumbent Zudans, a Vero Beach ophthalmologist, and challenger Deigl, director of the county’s Senior Resource Association.

Zudans points to a $4 million deficit between what the hospital-employed physicians are paid and what they bring in. On average, he said, the hospital is losing $70,000 per physician.

“Why?” he asks. “Are there not enough patients for these doctors? Is it an incentive issue?”

He says if the hospital were more accountable and transparent, taxpayers and District trustees would have a much-needed picture of how the hospital spends money and how financial losses occur.

“The Hospital District has an obligation to taxpayers to make our community healthier and should not be a rubber stamp for the hospital,” he said.

Challenger Deigl said she, too, is concerned with taxpayers getting a fair deal, but as a former paid employee of the Hospital District (its director from 2002 to 2006), she believes in a positive relationship with hospital leadership.

“I have always gotten along well with hospital CEO Jeff Susi, but then I have always had a positive relationship with most people,” she said.

Deigl said she has no particular issue to set her apart as a candidate, but she does believe that the District’s “main mission” is to fund the hospital, over other agencies.

Zudans would like other agencies like Treasure Coast Community Health clinics to get more money and the hospital to get less. He points out that TCCH clinics do not require the millions given to the hospital because they receive federal funding. Furthermore, they offer preventive medicine, including dental services.

“By spreading District money from the taxpayers around, we can improve the health of the community and treat taxpayers more fairly,” he said. 

“I will be more specific about how best to use taxpayer money once I get my fingers into the issues and do more reporting,” said Deigl.

Candidate Savage, who was a hospital CEO in West Virginia for 29 years before retiring to Vero Beach and who is running against Hussamy, said he would like to see an “increased collaborative effort involving other agencies” as part of the “community mission of keeping people out of the hospital.”

His greatest interest, he said is “improving the health of the community.” He acknowledges problems with the management of the hospital but believes those problems can and will be solved.

“I look forward to learning more,” he said.

In September, Hussamy, an orthopedic surgeon, became employed full-time by Sebastian River Medical Center, a competitor of Indian River Medical Center. This new job raises questions about whether he should be able to make decisions on IRMC funding as a District trustee.

Also, it raises the question of whether two of his employees – Bodnar, a licensed registered nurse until 1998 who is running against Feinour, and Miller, a licensed certified nursing assistant until June 1, 2016, who is running against McCrystal and Saul – also will be employed by the Sebastian hospital like Hussamy.